Personne : Guillaumie, Laurence
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Université Laval. Faculté des sciences infirmières
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- PublicationRestreintPsychosocial factors associated with pharmacists’ antidepressant drug treatment monitoring.(American Pharmacists Association, 2020-03-12) Grégoire, Jean-Pierre; Guillaumie, Laurence; Humphries, Brittany; Lauzier, Sophie; Moisan, Jocelyne; Villeneuve, DenisObjective: Patients undergoing antidepressant drug treatment (ADT) may face challenges regarding its adverse effects, adherence, and efficacy. Community pharmacists are well positioned to manage ADT-related problems. Little is known about the factors influencing pharmacists’ ADT monitoring. This study aimed to identify the psychosocial factors associated with pharmacists’ intention to perform systematic ADT monitoring and report on this monitoring. Design: Cross-sectional study based on the Theory of Planned Behavior (TPB). Setting and participants: Community pharmacists in the province of Quebec, Canada. Outcome measures: Pharmacists completed a questionnaire on their performance of ADT monitoring, TPB constructs (intention; attitude; subjective norm; perceived behavioral control; and attitudinal, normative, and control beliefs), and professional identity. Systematic ADT monitoring was defined as pharmacists’ reporting 4 or more consultations with each patient during the first year of ADT to address adverse effects, adherence, and efficacy. Hierarchical linear regression models were used to identify the factors associated with the intention and reporting of systematic ADT monitoring and Poisson working models to identify the beliefs associated with intention. Results: A total of 1609 pharmacists completed the questionnaire (participation ¼ 29.6%). Systematic ADT monitoring was not widely reported (mean score ¼ 2.0 out of 5.0), and intention was moderate (mean ¼ 3.2). Pharmacists’ intention was the sole psychosocial factor associated with reporting systematic ADT monitoring (P < 0.0001; R2 ¼ 0.370). All TPB constructs and professional identity were associated with intention (P < 0.0001; R2 ¼ 0.611). Perceived behavioral control had the strongest association. Conclusion: Interventions to promote systematic ADT monitoring should focus on developing a strong intention among pharmacists, which could, in turn, influence their practice. To influence intention, priority should be given to ensuring that pharmacists feel capable of performing this monitoring. The main barriers to overcome were the presence of only 1 pharmacist at work and limited time. Other factors identified offer complementary intervention targets.
- PublicationAccès librePatients’ beliefs about adherence to oral antidiabetic treatment : a qualitative study(Dovepress, 2015-03-10) Grégoire, Jean-Pierre; Guillaumie, Laurence; Giguère, Gabriel; Lauzier, Sophie; Moisan, Jocelyne; Guénette, LinePurpose: The purpose of this study was to elicit patients' beliefs about taking their oral antidiabetic drugs (OADs) as prescribed to inform the development of sound adherence-enhancing interventions. Methods: A qualitative study was performed. Adults with type 2 diabetes who had been taking an OAD for >3 months were solicited to participate in one of six focus groups. Discussions were facilitated using a structured guide designed to gather beliefs related to important constructs of the theory of planned behavior. Four coders using this theory as the theoretical framework analyzed the videotaped discussions. Results: Forty-five adults participated. The most frequently mentioned advantages for OAD-taking as prescribed were to avoid long-term complications and to control glycemia. Family members were perceived as positively influential. Carrying the OAD at all times, having the OAD in sight, and having a routine were important facilitating factors. Being away from home, not accepting the disease, and not having confidence in the physician's prescription were major barriers to OAD-taking. Conclusion: This study elicited several beliefs regarding OAD-taking behavior. Awareness of these beliefs may help clinicians adjust their interventions in view of their patients' beliefs. Moreover, this knowledge is crucial to the planning, development, and evaluation of interventions that aim to improve medication adherence.
- PublicationAccès libreRevisiting the internal consistency and factorial validity of the 8-item Morisky Medication Adherence Scale(SAGE Publications, 2016-10-19) Grégoire, Jean-Pierre; Zongo, Arsène; Guillaumie, Laurence; Lauzier, Sophie; Moisan, Jocelyne; Guénette, LineObjective: To assess the internal consistency and factorial validity of the adapted French 8-item Morisky Medication Adherence Scale in assessing adherence to noninsulin antidiabetic drug treatment. Study Design and Setting: In a cross-sectional web survey of individuals with type 2 diabetes of the Canadian province of Quebec, self-reported adherence to the antidiabetes drug treatment was measured using the Morisky Medication Adherence Scale-8. We assessed the internal consistency of the Morisky Medication Adherence Scale-8 with Cronbach’s alpha, and factorial validity was assessed by identifying the underlying factors using exploratory factor analyses. Results: A total of 901 individuals completed the survey. Cronbach’s alpha was 0.60. Two factors were identified. One factor comprised five items: stopping medication when diabetes is under control, stopping when feeling worse, feeling hassled about sticking to the prescription, reasons other than forgetting and a cross-loading item (i.e. taking drugs the day before). The second factor comprised three other items that were all related to forgetfulness in addition to the cross-loading item. Conclusion: Cronbach’s alpha of the adapted French Morisky Medication Adherence Scale-8 was below the acceptable value of 0.70. This observed low internal consistency of the scale is probably related to the causal nature of the items of the scale but not necessarily a lack of reliability. The results suggest that the adapted French Morisky Medication Adherence Scale-8 is a two-factor scale assessing intentional (first factor) and unintentional (second factor) non-adherence to the noninsulin antidiabetes drug treatment. The scale could be used to separately identify these outcomes using scores obtained on each of the sub-scales.
- PublicationAccès libreThe development of a community pharmacy-based intervention to optimize patients’ use of and experience with antidepressants : a step-by-step demonstration of the intervention mapping process(M D P I AG, 2018-05-02) Grégoire, Jean-Pierre; Guillaumie, Laurence; Gagnon, Hélène; Villeneuve, Denis; Santina, Tania; Lauzier, Sophie; Moisan, JocelyneObjective: To describe the development of a community pharmacy-based intervention aimed at optimizing experience and use of antidepressants (ADs) for patients with mood and anxiety disorders. Methods: Intervention Mapping (IM) was used for conducting needs assessment, formulating intervention objectives, selecting change methods and practical applications, designing the intervention, and planning intervention implementation. IM is based on a qualitative participatory approach and each step of the intervention development process was conducted through consultations with a pharmacists’ committee. Results: A needs assessment was informed by qualitative and quantitative studies conducted with leaders, pharmacists, and patients. Intervention objectives and change methods were selected to target factors influencing patients’ experience with and use of ADs. The intervention includes four brief consultations between the pharmacist and the patient: (1) provision of information (first AD claim); (2) management of side effects (15 days after first claim); (3) monitoring treatment efficacy (30-day renewal); (4) assessment of treatment persistence (2-month renewal, repeated every 6 months). A detailed implementation plan was also developed. Conclusion: IM provided a systematic and rigorous approach to the development of an intervention directly tied to empirical data on patients’ and pharmacists’ experiences and recommendations. The thorough description of this intervention may facilitate the development of new pharmacy-based interventions or the adaptation of this intervention to other illnesses and settings.
- PublicationAccès libreWomen's beliefs on early adherence to adjuvant endocrine therapy for breast cancer : a theory-based qualitative study to guide the development of community pharmacist interventions(MDPI, 2018-06-09) Guillaumie, Laurence; Provencher, Louise; Humphries, Brittany; Lemieux, Julie.; Lauzier, Sophie; Moisan, Jocelyne; Dionne, Anne; Collins, StéphanieAdjuvant endocrine therapy (AET) taken for a minimum of five years reduces the recurrence and mortality risks among women with hormone-sensitive breast cancer. However, adherence to AET is suboptimal. To guide the development of theory-based interventions to enhance AET adherence, we conducted a study to explore beliefs regarding early adherence to AET. This qualitative study was guided by the Theory of Planned Behavior (TPB). We conducted focus groups and individual interviews among women prescribed AET in the last two years (n = 43). The topic guide explored attitudinal (perceived advantages and disadvantages), normative (perception of approval or disapproval), and control beliefs (barriers and facilitating factors) towards adhering to AET. Thematic analysis was conducted. Most women had a positive attitude towards AET regardless of their medication-taking behavior. The principal perceived advantage was protection against a recurrence while the principal inconvenience was side effects. Almost everyone approved of the woman taking her medication. The women mentioned facilitating factors to encourage medication-taking behaviors and cope with side effects. For adherent women, having trouble establishing a routine was their main barrier to taking medication. For non-adherent women, it was side effects affecting their quality of life. These findings could inform the development of community pharmacy-based adherence interventions.
- PublicationAccès libreContributions and challenges faced by primary health care nurse practionners for chronic disease management : a qualitative study among key informants(American Association of Nurse Practitioners, 2019-01-01) Vermette, Sarah; Bujold, Louise; Guillaumie, Laurence; Bujold, Mathieu; Pelletier, Jérôme; Lauzier, Sophie; Martin, ElisabethBackground and Purpose: The increasing prevalence of chronic diseases is driving health care systems to rethink their operations. Despite numerous studies supporting the advantages of primary health care nurse practitioners (PHCNPs) in chronic disease management, implementing practices that fully utilize the skills of these practitioners seems impeded in the Canadian province of Québec. This study explores the views of leaders involved in primary health care regarding the contributions PHCNPs can make in chronic disease management and the challenges they face in doing so. Methods: Through semi-structured interviews, an exploratory descriptive qualitative study was conducted with 20 key informants across Québec who hold a variety of professional positions connected to PHCNPs. Conclusions: PHCNPs were perceived to be able to improve self-management support for chronic diseases. In reality, however, PHCNPs are mainly devoting their time to clientelein acute care, and current regulations governing their practices limit their involvement in chronic disease management.Implications for Practice: Integrating PHCNPs offers a unique opportunity for health care settings to redefine the roles of family physicians and registered nurses and to restructure practices toward a chronic disease-oriented system. A clinical manager should be designated to monitor this re-structuring process and ensure its success.
- PublicationAccès librePatient perspectives on the role of community pharmacists for antidepressant treatment : a qualitative study(Canadian Pharmacists Association, 2018-02-09) Grégoire, Jean-Pierre; Guillaumie, Laurence; Ndayizigiye, Alice; Lauzier, Sophie; Beaucage, Clément; Villeneuve, Denis; Moisan, JocelyneObjectives : Patients prescribed antidepressant drug treatment (ADT) for major depression report several needs in relation to their treatment, and a large proportion of these patients will end ADT prematurely. Community pharmacists may play an important role in monitoring ADT and supporting these patients. However, little is known about patient experiences of the services provided in community pharmacies. The objectives of this study were to 1) explore patients’ experiences with the services community pharmacists provide for ADT and 2) identify potential avenues for improvement of pharmacists’ services within the context of ADT. Methods : A qualitative descriptive exploratory study was conducted among individuals diagnosed with major depression who had initiated ADT at some point in the 12 months prior to their participation in the study. A total of 14 persons recruited in a local health centre and a community-based organization participated in individual interviews. A thematic analysis of the interview transcripts was conducted. Results : Pharmacists tend to concentrate their involvement in treatment at initiation and at the first refill when questions, uncertainties and side effects are major issues. Patients felt that the pharmacists’ contributions consisted of providing information and reassurance; in these respects, their needs were met. Participants had few ideas as to what additional services pharmacists could implement to improve patients’ experience with ADT. Patients’ sole expectations were that pharmacists extend this information role to the whole length of the treatment and enhance the confidentiality of discussions in pharmacy. Conclusion : Pharmacists should provide counselling throughout the entire treatment rather than passively waiting for patients to ask their questions. However, facilitation of open discussions may not be achieved unless confidentiality at pharmacies is secured.
- PublicationAccès librePredicting noninsulin antidiabetic drug adherence using a theoretical framework based on the theory of planned behavior in adults with type 2 Diabetes a prospective study(Williams & Wilkins Co., 2016-04-01) Grégoire, Jean-Pierre; Guillaumie, Laurence; Zomahoun, Hervé Tchala Vignon; Lauzier, Sophie; Moisan, Jocelyne; Guénette, LineUnderstanding the process behind noninsulin antidiabetic drug (NIAD) nonadherence is necessary for designing effective interventions to resolve this problem. This study aimed to explore the ability of the theory of planned behavior (TPB), which is known as a good predictor of behaviors, to predict the future NIAD adherence in adults with type 2 diabetes. We conducted a prospective study of adults with type 2 diabetes. They completed a questionnaire on TPB variables and external variables. Linear regression was used to explore the TPB's ability to predict future NIAD adherence, which was prospectively measured as the proportion of days covered by at least 1 NIAD using pharmacy claims data. The interaction between past NIAD adherence and intention was tested. The sample included 340 people. There was an interaction between past NIAD adherence and intention to adhere to the NIAD (P = 0.032). Intention did not predict future NIAD adherence in the past adherers and nonadherers groups, but its association measure was high among past nonadherers (β = 5.686, 95% confidence interval [CI] -10.174, 21.546). In contrast, intention was mainly predicted by perceived behavioral control both in the past adherers (β = 0.900, 95% CI 0.796, 1.004) and nonadherers groups (β = 0.760, 95% CI 0.555, 0.966). The present study suggests that TPB is a good tool to predict intention to adhere and future NIAD adherence. However, there was a gap between intention to adhere and actual adherence to the NIAD, which is partly explained by the past adherence level in adults with type 2 diabetes.