Personne :
Guillaumie, Laurence

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Université Laval. Faculté des sciences infirmières
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Women'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

2018-06-09, Guillaumie, Laurence, Provencher, Louise, Humphries, Brittany, Lemieux, Julie., Lauzier, Sophie, Moisan, Jocelyne, Dionne, Anne, Collins, Stéphanie

Adjuvant 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.

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Psychosocial factors associated with pharmacists’ antidepressant drug treatment monitoring.

2020-03-12, Grégoire, Jean-Pierre, Guillaumie, Laurence, Humphries, Brittany, Lauzier, Sophie, Moisan, Jocelyne, Villeneuve, Denis

Objective: 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.

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Patient perspectives on the role of community pharmacists for antidepressant treatment : a qualitative study

2018-02-09, Grégoire, Jean-Pierre, Guillaumie, Laurence, Ndayizigiye, Alice, Lauzier, Sophie, Beaucage, Clément, Villeneuve, Denis, Moisan, Jocelyne

Objectives : 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.