Transcript Community Pharmacists` Role in Colorectal Cancer Screening

Community Pharmacists'
Role in Colorectal Cancer
Screening
ACCN Research Roundtable
Hershey, PA
September 28, 2007
Co-Investigators:
Cathy A. Coyne, MPH, PhD
Division of Community Health
Lehigh Valley Hospital
Allentown, Pennsylvania
Lesley-Ann Miller, PhD
Drug Use Policy and Pharmacoeconomics
MD Anderson Cancer Center
University of Texas
Linda Jacknowitz, MLS
Cristina Demian, MD, MPH
Mary Babb Randolph Cancer Center
Cancer Prevention and Control
West Virginia University
Methodology
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Mailed survey (9-pages)
Random sample of 1000 licensed
pharmacists in West Virginia
Notification letter sent, following by
survey with coverletter
Reminder postcard, replacement
survey, telephone follow-up
Results
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333 pharmacists not eligible to participate
2 deceased
15 retired
45 surveys returned, address unknown
58 not practicing in West Virginia
213 did not have direct contact with patients
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Total eligible sample: 667
Respondents: 337 (50.5% response rate)
Respondent Characteristics
Gender (% male)
55.5
Mean age (yrs)
43.9
Degree (% respondents)
BS
86.4
MS
PharmD
More than one
0.6
8.0
3.9
Pharmacy Setting
(Percentage of respondents)
Independent Pharmacy
National Chain Pharmacy
National Chain Grocery/Supermarket
National Chain Department Store
Regional Chain Pharmacy
Type of county where pharmacist
works (urban/rural)
Own pharmacy/store
32.0
27.6
8.3
7.1
4.7
70.3/36.7
14.5
Percentage reporting proactive
counseling services
Diabetes
Blood pressure screening
82.2
75.7
Smoking cessation
Hormone replacement therapy
Colorectal cancer screening
Prostate cancer screening
75.4
40.7
13.6
12.2
Percentage of Community Pharmacists reporting
potential barriers to patient counseling
Percentage of respondents
100
80
Lack of reimbursement
Lack of time
60
45.9
40
30.6
20.4
20
0
Lack of patient interest
30.3
Lack of pharmacist
knowledge
Community pharmacists’ perceived effectiveness
of colorectal cancer screening tests
for average risk patients 50+ year of age
Percentage of respondents
"very effective"
100
80.7
Colonoscopy
80
Flex Sig
60
40
20
0
51.9
FOBT
36.8
DCBE
31.2
Pharmacists don’t have role in
cancer prevention counseling
78.6% disagree
Pharmacists should only have
responsibility to counsel about
medications
77.2% disagree
Community pharmacists’ agreement to
statement indicating that they are confident in their
ability to instruct patients on proper FOBT use
50
Percentage of respondents
41.2
40
Strongly agree
Agree
30
24.9
0
Disagree
17.5
20
10
Undecided
8.3
Strongly disagree
7.7
FOBT kits for sale in pharmacy
22.7%
None sold
1-5 kits sold/month
24%
52%
Potential facilitators to pharmacists’ counseling
patients about colorectal cancer screening
95.5
100
92.6
Percentage of respondents
85.7
80
Screening is cost effective
60
40
20
0
CRC is a serious public
health problem
CRC screening is as
important as other
screenings
Pharmacist attitudes regarding counseling responsibilities Percentage that agree it is pharmacists’
responsibility to counsel patients about…
95.8
Percentage of respondents
100
FOBT
94.7
Sigmoid/colonoscopy
Smoking cessation
80
74.6
Sun screen use
PSA
60
40
20
0
37.1
40.5
Potential barriers to pharmacists’ counseling
Patients about colorectal cancer screening
Physicians are responsible
100
Percentage of respondents
Pharmacists uncomfortable
80
Too busy
57
60
44.2
40
20
0
44.2
Likelihood of participating in training
120
100
95.8
Counseling- FOBT kit use
Percentage of respondents
90.3
82.8
80
76.4
86.1
89.4
81.9
Counseling-Sigmoid/colonoscopy
82.2
76.8
Counseling -diabetes management
Counseling -Smoking cessation
60
Guidelines-CRC
Counsel-skin cancer prevention
40
Guidelines-breast cancer screening
Guidelines-prostate cancer screening
20
0
Guidelines-cervical cancer