This was a systematic review of the literature in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Evidence mapping was used to reveal the effect of drug reminder packaging on medication adherence, to identify research gaps and to make suggestions for future research.

Purpose: Numerous studies showed the effectiveness of pharmaceutical care in improving medication adherence in primary care patients. However, in daily pharmacy practice, the provision of pharmaceutical care appears to be limited. We aimed at quantifying the content of counseling by community pharmacy staff during patient contacts, especially adherence counseling, and at investigating pharmacist views about their practice of adherence counseling. Patients and methods: A Master’s student in Pharmacy observed patient contacts at selected community pharmacies in the region of Basel, Switzerland. Content of counseling was manually ticked on a checklist with predefined themes (administration, dose, effect, and adherence). Pharmacists working in the pharmacy were interviewed on triggers, topics, and barriers in adherence counseling. Results: In 20 community pharmacies and during a total of 148.1 hours, 1,866 patient contacts were observed. During the 1,476 patient contacts including the dispensing of one or more medications, counseling was provided to 799 (54.1%) patients; with 735 (49.8%) patients counseled about administration, 362 (24.5%) about dose, 267 (18.1%) about effect, and 99 (6.7%) about adherence. Significantly more patients received counseling when they obtained prescribed versus over-the-counter medication (P=0.002), a new prescription versus a repeat prescription (P<0.001), or when they were served by a pharmacist versus by another staff member (P<0.001). Of the 33 interviewed pharmacists, all except one reported actively approaching patients for adherence counseling. Triggers included medication-related and patient-related factors. The pharmacists named predominantly product-centered topics of adherence counseling. The most cited barriers were rejection of counseling by the patient and lack of time. Conclusion: Half of the patients receiving one or more medications were counseled, and only 6.7% of all contacts included adherence counseling. Future studies should clarify how barriers to adherence counseling at the community pharmacy can be overcome.

Consumers are confident managing minor ailments through self-care, often self-medicating from a range of over-the-counter (OTC) medicines available from community pharmacies. To minimise risks, pharmacy personnel endeavour to engage in a consultation when consumers present with OTC enquiries however they find consumers resistant. The aim was to determine stakeholder perspectives regarding barriers and facilitators for information exchange during OTC consultations in community pharmacies and to understand the elicited themes in behavioural terms. Focus groups were undertaken with community pharmacist, pharmacy assistant and consumer participants. Independent duplicate analysis of transcription data was conducted using inductive and framework methods. Eight focus groups involving 60 participants were conducted. Themes that emerged indicated consumers did not understand pharmacists’ professional role, they were less likely to exchange information if asking for a specific product than if asking about symptom treatment, and they wanted privacy. Consumers were confident to self-diagnose and did not understand OTC medicine risks. Pharmacy personnel felt a duty of care to ensure consumer safety, and that with experience communication skills developed to better engage consumers in consultations. They also identified the need for privacy. Consumers need education about community pharmacists’ role and responsibilities to motivate them to engage in OTC consultations. They also require privacy when doing so.

Background: Patient counselling and addressing drug-related problems are the pharmacist’s key activities to ensure the safe and effective use of medicines. This study aimed to describe the dispensing practice of prescribed medicines in daily community pharmacy practice and to identify factors influencing counselling provision; Methods: An observational study was conducted in community pharmacies in Basel, Switzerland. One master student in pharmacy performed non-participatory observations for one day at each of the participating community pharmacies. Patient characteristics, counselling content, additional activities, and pharmaceutical interventions were documented on a structured checklist; Results: 556 prescription encounters (PE) in 18 participating community pharmacies were observed (269 first prescriptions; 287 refill prescriptions). Patients were regular customers (n = 523, 94.1%) and 53.8 ± 23.4 years old. Counselling was provided to 367 (66.0%) customers on 2.9 ± 3.1 themes per PE. Factors influencing counselling were dispensing by the pharmacist, new customer, customer who did not refuse counselling, customer with a first prescription, with a prescription resulting in a pharmaceutical intervention, and a prescription filled by carers. During 144 PEs, 203 interventions were documented. Pharmacists proposed few additional activities and performed no cognitive pharmaceutical service; Conclusions: Our study quantified counselling and additional services at the dispensing of prescribed medicines and identified influencing factors on counselling provision at the patient, prescription, and pharmacy level.

The role of pharmacists is changing; in many countries, pharmacists have acquired new competencies. A survey conducted in 2013 mapped the clinical pharmacy services in Swiss hospitals by quantifying full-time equivalents (FTE) and depicting clinical pharmacy activities. The aim of this survey was to update these results and analyze the development in Swiss hospitals. An online questionnaire was sent to chief hospital pharmacists (n = 60). The questionnaire was developed based on the previous survey and on a literature search. The survey took place from June to September 2017. In the survey, 44 hospital pharmacies participated (return rate 73%). They counted 265.8 FTE for pharmacists; 31 offered clinical pharmacy services. Hospitals participating in both surveys (n = 32) showed a significant increase in FTE for hospital (+24.5%) and clinical (+62.7%) pharmacists. The number of training positions available for the certificate of proficiency in “clinical pharmacy” has increased by 5.5. Patient-related services are less commonly implemented in comparison to treatment and process-related services. In conclusion, the increase in FTE of clinical pharmacists was more pronounced than of hospital pharmacists in general. For further development and broader implementation of clinical pharmacy services, however, hospital pharmacies should increase the number of training positions and should direct more activities towards patient-related services.

Background: Multidrug punch cards are frame cards with 28 plastic cavities filled with a patient’s oral solid medication. They are used in primary care to facilitate medication management and to enhance adherence. Main criticism concerned handling difficulties and fading knowledge about medication of patients using them. This study aimed at exploring daily use, preferences and adherence of primary care patients using multidrug punch cards. Methods: Community pharmacies in Switzerland recruited primary care patients using multidrug punch cards. A mixed methods approach was applied with quantitative interviews performed by telephone and qualitative interviews face-to-face. Results: Of 149 eligible patients from 21 community pharmacies, 22 participated 2011 in the quantitative and 11 participated 2013/14 in the qualitative interview. Patients were very satisfied with the multidrug punch cards and stated increased medication safety. All considered adherence as very important. Self-reported adherence was 10 (median) on a visual analogue scale (0 = no intake, 10 = perfect adherence). The absence of package inserts and predefined handling difficulties e.g., tablets spiking at removal were not perceived as problems. Conclusions: Patients are satisfied with the multidrug punch cards, feel safe, mostly have no handling problems and adhere to their treatment. Trust in health-care professionals and patients’ experiences emerged as key variables for initiating multidrug punch card use and for medication adherence. This mixed methods study invalidates previous concerns about disadvantages of multidrug punch cards. Health-care professionals should actively recommend them for primary care patients with polypharmacy and poor adherence.