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International Journal of Clinical Pharmacy

, Volume 38, Issue 1, pp 171–182 | Cite as

Chronotherapy in practice: the perspective of the community pharmacist

  • Gagandeep KaurEmail author
  • Yuh-Lin Gan
  • Craig L Phillips
  • Keith Wong
  • Bandana Saini
Research Article

Abstract

Background Optimising the time of drug administration in alignment with circadian rhythms to enhance the clinical effect or minimise/avoid adverse effects is referred to as chronotherapy. Pharmacists have a key role in providing medicine related information, including counselling about the optimal time for medication administration. Where applicable, the principles of chronotherapy should underlie this aspect of medication counselling. Despite significant developments in the science of chronotherapy for specific pharmacological treatments, the perspective of pharmacists about their understanding and application of these principles in practice has not been explored. Objective To explore community pharmacist’s viewpoints about and experience with the application of chronotherapy principles in practice. Setting Community pharmacies within metropolitan Sydney in New South Wales, Australia. Methods Semi-structured, face to face interviews with a convenience sample of community pharmacists were conducted. All interviews were audio-recorded, transcribed verbatim and thematically analyzed using a ‘grounded theory’ approach, given the novelty of this area. Main outcome measure Community pharmacists’ awareness, current practice and future practice support requirements about the principles of chronotherapy. Results Twenty-five semi-structured interviews were conducted. Most participants reported encountering cases where clinical decision making about suggesting appropriate times of drug administration to patients was needed. Their approach was mainly pragmatic rather than based on theoretical principles of circadian variation in drug disposition or on current or emerging evidence; thus there was an evidence practice chasm in some cases. However, most participants believed they have an important role to play in counselling patients about optimal administration times and were willing to enact such roles or acquire skills/competence in this area. Conclusion Community pharmacists contribute to the safe and effective use of medications in providing the patients with information on optimal timing of drug administration during counselling. Further education, practical training and access to information may help pharmacists in translating principles of chronotherapy into the practice.

Keywords

Australia Chronotherapy Circadian rhythms Community pharmacist Timing of drug administration 

Notes

Acknowledgments

The authors wish to thank the community pharmacists who consented to take part in the interview. Gagandeep Kaur is the recipient of scholarships from the NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS). Yuh-Lin Gan is the recipient of Summer Scholarship by Faculty of Pharmacy at The University of Sydney.

Funding

None.

Conflicts of interest

None.

Supplementary material

11096_2015_228_MOESM1_ESM.docx (31 kb)
Supplementary material 1 (DOCX 31 kb)

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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2015

Authors and Affiliations

  • Gagandeep Kaur
    • 1
    • 2
    Email author
  • Yuh-Lin Gan
    • 1
  • Craig L Phillips
    • 2
    • 3
  • Keith Wong
    • 2
    • 3
  • Bandana Saini
    • 1
  1. 1.Faculty of PharmacyUniversity of SydneyCamperdownAustralia
  2. 2.Woolcock Institute of Medical Research, University of Sydney SydneyAustralia
  3. 3.Department of Respiratory & Sleep MedicineRoyal North Shore HospitalSydneyAustralia

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