An Overview of CPAP Services in Australian Community Pharmacies

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An Overview of CPAP Services in Australian Community Pharmacies We would be grateful if you would agree to take part in our study by answering all questions and returning the questionnaire to the researchers in the reply-paid envelope. Page 1 of 15

Page 2 of 15

This questionnaire is divided into two sections. We ask that the staff member who is MOST regularly involved in CPAP services complete section one. In some pharmacies, this person may be a pharmacy assistant or technician. Section two must be completed by a pharmacist involved in CPAP services. Thank you for your participation. SECTION ONE To be completed by the staff member MOST regularly involved with CPAP. Q1. Does your pharmacy currently provide CPAP services? Yes Please proceed to Q2. No Thank you no further questions are required. If you would like to comment on the reasons for discontinuing your CPAP service please do so in the space provided at the end of the questionnaire (Q40). PHARMACY DETAILS Q2. Which of the following best describes the location of the pharmacy? Shopping Centre Strip Mall Medical Centre Residential Other: Q3. Which of the following best describes the geographical location of the pharmacy? Metropolitan Suburban Regional Semi Rural Rural Remote Q4. Which of the following best describes the brand of the pharmacy? Chain Franchise Banner/ Buying Group Independent Other: Page 3 of 15

Q5. How many staff does the pharmacy currently employ? Pharmacists Dispensary Technicians Pharmacy Assistants Other: Full time Part Time Casual Q6. Please list the pharmacy s regular hours of operation and tick which days comprehensive CPAP services are available (ie. services besides sale of machines and equipment, such as patient appointments). Monday Tuesday Wednesday Thursday Friday Saturday Sunday Opening Time Closing Time CPAP Services Q7. Is the pharmacy currently Quality Care Pharmacy Program accredited? No Yes Currently undergoing accreditation process Q8. Does the pharmacy offer any other specialised health services in addition to CPAP? (Please tick all that apply) Clinical Interventions (registered pharmacy under the 5CPA) Disease State Management Service (registered under the 5CPA) Home Medicines Review Health Checks (please specify: ) Opioid Substitution Program Weight Loss Program (formal) Page 4 of 15

CPAP Service Particulars Q9. Where are CPAP consultations/ mask fittings conducted in the pharmacy? Private (non-enclosed) area Other: Private (enclosed) area or room Non-private area No designated area Q9a. Does this area include a bed or chair that allows the patient to try the mask on in different sleep positions? No Yes Q10. Does the pharmacy keep patient records of all current CPAP users? No Yes Q10a. If Yes, how many CPAP patients does the pharmacy currently have on record? Q11. Please tick all of the following services that are offered in the pharmacy: Machine Hire Mask Hire Machine Sales Mask Sales Mask fitting Sale of consumables (filters, seals, tubing, etc.) Home diagnosis machine hire Equipment servicing/ routine device checks Equipment repair Machine pressure checks Patient education Supply of educational materials: Leaflets DVDs Other: Counselling Patient follow-up Data downloads Written correspondence with referring physician: Initial visit only Ongoing Referrals Screening Please specify: Q11a. From your responses given in question 11 above, please rank the top THREE that you feel constitute the major part of your service: 1. (Most important) 2. 3. Page 5 of 15

Q12. How is your CPAP service advertised? (Please tick all that apply) In-store Local media Manufacturer (lists of suppliers) Referrals from physicians Word-of-mouth Pharmacy initiated promotion amongst local physicians Other: Q13. How many face-to-face CPAP-related patient consults take place each week in the pharmacy (on average)? 0-1 2-3 4-5 6-10 11-15 16-20 21-30 31-40 More than 40 Q14. What is the AVERAGE length of time spent with a patient during their INITIAL consultation (ie. involving machine set-up and mask-fitting)? Less than 15 minutes Between 15 and 30 minutes Between 30 and 45 minutes Between 45 and 60 minutes More than 60 minutes Q15. How is CPAP initiated in the pharmacy? (Please tick all that apply) Doctor s prescription Pharmacist s recommendation Sleep clinic s recommendation (based on sleep study test results) Patient request Q16. Where do the MAJORITY of CPAP prescriptions presented at the pharmacy originate from? GP surgery (local) GP surgery (non-local) Specialist physician (public hospital) Specialist physician (private clinic) Various locales (not one place more than any other) Page 6 of 15

Training Q17. How many staff are trained to provide CPAP services? Pharmacists Dispensary Technicians Pharmacy Assistants Other: No. trained to provide in-depth services No. trained to provide basic services Q18. Which staff member is USUALLY involved (during a typical week) in an initial CPAP patient consultation (ie. involving machine set up and mask fitting)? Pharmacist Dispensary technician Pharmacy assistant Q19. Please tick the method that is most often used to train staff: Pharmacists Franchise or chain course CPAP Manufacturer Course External organisation course Inhouse Selfdirected No training undertaken Dispensary Technicians Pharmacy Assistants Other: Q20. Is there a system in place for training revision, review, or for maintaining currency of knowledge? No Yes Please specify: Q21. How confident are you in your knowledge of: (please tick) Obstructive Sleep Apnea Very confident Confident Somewhat confident Not very confident CPAP Page 7 of 15

Patient Follow-Up Q22. Does the pharmacy offer a formal patient follow-up service? No Please proceed to Q22a. Yes Please proceed to Q23. Q22a. What is the main reason for not providing a formal patient followup service? Lack of time Lack of resources Follow-up not viewed as part of pharmacy s role Follow-up is managed by a third party (eg. sleep clinic) Fear of interfering with other health care professionals roles Follow-up is only provided in certain circumstances Thank you please proceed to Q26. Q23. What is the main method used for follow-up services? Telephone Face-to-face E-mail SMS Social Media Other: Q24. How soon after a patient s initial visit would they be contacted for followup? Within 24 hours Within 3 days Within 7 days Within 14 days Within 28 days Greater than 28 days Q25. How many times during the first twelve months of a patient commencing on CPAP would they be contacted for follow-up? 1-3 4-6 7-9 More than 10 A minimum of times, with further follow-up provided on a case-by-case basis. Page 8 of 15

Staff Member Details- Section One Q26. Please fill in the following details for the staff member that completed section one of the questionnaire: Q26a. What is your position in the pharmacy? (more than one may apply) Pharmacist Dispensary Technician Pharmacist-In-Charge Pharmacy Assistant Sole Proprietor/ Owner operator Manager (non-pharmacist) Partner Manager (pharmacist) Q26b. How many years of experience do you have in pharmacy? 0-3yrs 16-19yrs 4-7yrs 20-25yrs 8-11yrs 26-30yrs 12-15yrs More than 30yrs Q26c. Please tick the highest level of your educational qualifications: Secondary school Graduate Diploma TAFE Master s Degree Bachelor s Degree Doctorate Degree Bachelor s Degree with Honours This concludes section one. Thank you for taking the time to complete this questionnaire. Your participation is greatly appreciated. Page 9 of 15

SECTION TWO To be completed by the pharmacist MOST regularly involved with CPAP. Attitudes Towards CPAP Services Q27. What do you see as the biggest benefit of providing CPAP services? Financial Professional satisfaction Improved inter-professional relationships Improved professional image of the pharmacy Competitive edge Meets patient and community needs There is an undersupply of pharmacists providing this service Q28. What do you see as the biggest barriers to providing CPAP services? (Please rank the top THREE, with 1 being the biggest perceived barrier) Lack of time Lack of finances Lack of staff Turnover of trained staff Pharmacy infrastructure (eg. space, shelving) Lack of adequate training Indemnity and liability issues Inter-professional relationships Nearby competitors (including CPAP manufacturers) Online competitors (including CPAP manufacturers) Supply vs. demand (obtaining sufficient referrals) Lack of community awareness of sleep disorders and sleep apnoea Lack of support from the pharmacy profession Cost of equipment to patient Patient resistance to accept CPAP treatment Staff resistance to offering service Lack of motivation Q29. What do you see as the main advantage for patients sourcing CPAP through a community pharmacy as opposed to other CPAP providers? Accessibility and convenience of location Extended trading hours and trading days Pharmacist familiar with management of chronic diseases Pharmacist experienced with providing other specialist services Reduced waiting periods compared to other providers Patients able to meet other health needs while in the pharmacy Other: Page 10 of 15

Business Aspects Q30. Is the CPAP service offered in the pharmacy financially viable? Yes, financially viable No, service is run at a loss The service was initially run at a loss but is now viable The service was initially viable but is now run at a loss Q31. Which aspect of CPAP services provides the biggest financial gain? Q32. What is the pharmacy s average prescription volume per week? Q33. Is a fee for service charged? No, patient is only charged for products and equipment Yes, a fee for service is charged Q33a. If Yes, what is the fee for service arrangement: Patient charged an initial consult fee only Amount: $ Patient charged for every consult Amount: $ Patient charged for every consult, but initial consult fee is higher Initial consult: $ Subsequent consults: $ Other arrangement (please specify): Page 11 of 15

Future Directions Q34. Do you think pharmacies supplying CPAP services should adhere to a formalised set of professional guidelines? No Please proceed to Q35. Yes Please proceed to Q34a. Q34a. Should these standards be specific for the community pharmacy setting? No Yes Q34b. Who should author these guidelines? CPAP manufacturers Government body Pharmaceutical Society of Australia Pharmacy Guild of Australia Australasian Sleep Association Q34c. How important to you is the need for professional guidelines? Very important Important Somewhat important Not very important Please feel free to comment: Q35. Do you think pharmacies supplying CPAP services should undergo a formal accreditation process? No Yes Please feel free to comment: Q36. Do you think there is a need for more pharmacies to offer CPAP services? No (current demands are met with existing pharmacies) Yes (current demands are NOT met with existing pharmacies) Please feel free to comment: Page 12 of 15

Q37. If a pharmacy specific website directory for CPAP services was developed, would you like to be listed on it? No Yes Please feel free to comment: Q38. Is there room in your current CPAP service for role expansion or future directions that your pharmacy might take? Please provide details: Q38a. What is the biggest obstacle to implementing these changes? Q39. What do you see as the greatest area for improvement in your CPAP service (what could you do better)? Q40. Please feel free to comment on any aspect of CPAP services you feel have not been addressed in this questionnaire: Page 13 of 15

Staff Member Details- Section Two Q41. Please fill in the following details for the staff member that completed section two of the questionnaire: Q41a. Did the same staff member complete section one and section two of the questionnaire? No Please proceed to Q41b. Yes (Thank you there is no need to fill in this section if it has already been completed in section one). Q41b. What is your position in the pharmacy? (more than one may apply) Pharmacist Partner Pharmacist-In-Charge Manager (pharmacist) Sole Proprietor/ Owner operator Q41c. How many years of experience do you have in pharmacy? 0-3yrs 16-19yrs 4-7yrs 20-25yrs 8-11yrs 26-30yrs 12-15yrs More than 30yrs Q41d. Please tick the highest level of your educational qualifications: Bachelor s Degree Master s Degree Bachelor s Degree with Honours Doctorate Degree Graduate Diploma This concludes section two. Thank you for taking the time to complete this questionnaire. Your participation is greatly appreciated. Page 14 of 15

Expression of Interest in Future Studies (Optional) If you are interested in being contacted for future studies involving CPAP services in community pharmacies, please provide your contact details below. We are also interested in your thoughts on further training sessions for pharmacists involved in CPAP services. What areas would you be interested in learning more about? It would also help us to cater to this potential need if you could provide information on the best format and times for possible training sessions (eg.1-2 weekend seminars, mid-week evening lectures, etc.) Please note that by providing your contact details your questionnaire results will not be anonymous. However, this page will be detached prior to data entry of the questionnaire and stored in a separate secure location to your questionnaire. Only the members of the research team will have access to your details and your confidentiality will be maintained at all times. I (print name) consent to provide the researchers my personal contact details. I understand that the questionnaire will no longer be anonymous by providing my details. I consent to the researchers contacting me in relation to future training sessions or CPAP-related studies. Signature Date. Pharmacist contact name: Phone number: E-mail address: Pharmacy name: Pharmacy address: Areas of interest for further training: Suggested format for training: Preferred times for training sessions: Page 15 of 15