title: Chronotherapy in practice: the perspective of the community pharmacist.
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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Faculty of Pharmacy, University of Sydney, Room S114, Pharmacy and Bank Building A15, Science Road, Camperdown, NSW, 2006, Australia. gaga8947@uni.sydney.edu.au.|Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia. gaga8947@uni.sydney.edu.au.
authors.forename: Gagandeep
authors.initials: G
authors.lastname: Kaur
authors.affiliation: Faculty of Pharmacy, University of Sydney, Room S114, Pharmacy and Bank Building A15, Science Road, Camperdown, NSW, 2006, Australia.
authors.forename: Yuh-Lin
authors.initials: YL
authors.lastname: Gan
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.|Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Craig L
authors.initials: CL
authors.lastname: Phillips
authors.affiliation: Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.|Department of Respiratory & Sleep Medicine, Royal North Shore Hospital, Sydney, NSW, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Wong
authors.affiliation: Faculty of Pharmacy, University of Sydney, Room S114, Pharmacy and Bank Building A15, Science Road, Camperdown, NSW, 2006, Australia.
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003157:Community Pharmacy Services; D003376:Counseling; D055870:Drug Chronotherapy; D005260:Female; D066296:Grounded Theory; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009517:New South Wales; D010465:Perception; D010595:Pharmacists / Q000523:psychology*; D011369:Professional-Patient Relations
keywords: Australia; Chronotherapy; Circadian rhythms; Community pharmacist; Timing of drug administration