Open AccessArticle
Knowledge, Attitude and Advice-Giving Behaviour of Community Pharmacists Regarding Topical Corticosteroids
Pharmacy 2017, 5(3), 41; doi:10.3390/pharmacy5030041 -
Abstract
This study examines the relationship between community pharmacists’ knowledge, attitudes to information provision and self-reported counselling behaviours in relation to topical corticosteroids and adjunct therapy in atopic eczema. A mixed-methods approach was used whereby data from interviews with community pharmacists were used to
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This study examines the relationship between community pharmacists’ knowledge, attitudes to information provision and self-reported counselling behaviours in relation to topical corticosteroids and adjunct therapy in atopic eczema. A mixed-methods approach was used whereby data from interviews with community pharmacists were used to design a structured questionnaire that a larger sample of community pharmacists completed anonymously. The questionnaire was completed and returned by 105 pharmacists (36% response rate). Pharmacists showed gaps in their knowledge on the use of topical corticosteroids in atopic eczema but had good understanding on the use of emollients. There was a significant correlation between pharmacists’ attitudes to information provision and their self-reported counselling behaviour for most themes except in relation to corticosteroid safety where less advice was given. Improving attitudes to information provision should correlate with increased counselling behaviour. However, for the theme of corticosteroid safety, further studies are needed to examine why in practice pharmacists are not providing patient counselling on this topic even though most agreed this is a topic patients should know about. Full article
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Open AccessFeature PaperArticle
Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation
Pharmacy 2017, 5(3), 40; doi:10.3390/pharmacy5030040 -
Abstract
Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation.
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Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. Aim: To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Methods: Following ethical approval and piloting, an online survey to ascertain pharmacy technicians’ views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Results: Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Conclusions: Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles. Full article
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Open AccessArticle
Experiential Education Builds Student Self-Confidence in Delivering Medication Therapy Management
Pharmacy 2017, 5(3), 39; doi:10.3390/pharmacy5030039 -
Abstract
To determine the impact of advanced pharmacy practice experiences (APPE) on student self-confidence related to medication therapy management (MTM), fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence
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To determine the impact of advanced pharmacy practice experiences (APPE) on student self-confidence related to medication therapy management (MTM), fourth-year pharmacy students were surveyed pre/post APPE to: identify exposure to MTM learning opportunities, assess knowledge of the MTM core components, and assess self-confidence performing MTM services. An anonymous electronic questionnaire administered pre/post APPE captured demographics, factors predicted to impact student self-confidence (Grade point average (GPA), work experience, exposure to MTM learning opportunities), MTM knowledge and self-confidence conducting MTM using a 5-point Likert scale (1 = Not at all Confident; 5 = Extremely Confident). Sixty-two students (26% response rate) responded to the pre-APPE questionnaire and n = 44 (18%) to the post-APPE. Over 90% demonstrated MTM knowledge and 68.2% completed MTM learning activities. APPE experiences significantly improved students’ overall self-confidence (pre-APPE = 3.27 (0.85 SD), post-APPE = 4.02 (0.88), p < 0.001). Students engaging in MTM learning opportunities had higher self-confidence post-APPE (4.20 (0.71)) vs. those not reporting MTM learning opportunities (3.64 (1.08), p = 0.05). Post-APPE, fewer students reported MTM was patient-centric or anticipated engaging in MTM post-graduation. APPE learning opportunities increased student self-confidence to provide MTM services. However, the reduction in anticipated engagement in MTM post-graduation and reduction in sensing the patient-centric nature of MTM practice, may reveal a gap between practice expectations and reality. Full article
Open AccessProject Report
How Do Pharmacists Develop into Advanced Level Practitioners? Learning from the Experiences of Critical Care Pharmacists
Pharmacy 2017, 5(3), 38; doi:10.3390/pharmacy5030038 -
Abstract
The national UK standards for critical care highlight the need for clinical pharmacists to practise at an advanced level (equivalent to Royal Pharmaceutical Society, Great Britain, Faculty Advanced Stage II (MFRPSII)) and above. Currently the UK is unable to meet the workforce capacity
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The national UK standards for critical care highlight the need for clinical pharmacists to practise at an advanced level (equivalent to Royal Pharmaceutical Society, Great Britain, Faculty Advanced Stage II (MFRPSII)) and above. Currently the UK is unable to meet the workforce capacity requirements set out in the national standards in terms of numbers of pharmacist working at advanced level and above. The aim of this study was to identify the strategies, barriers and challenges to achieving Advanced Level Practice (ALP) by learning from the experiences of advanced level critical care pharmacists within the UK. Eight participants were recruited to complete semi-structured interviews on their views and experiences of ALP. The interviews were analysed thematically and three overarching themes were identified; support, work-based learning and reflective practice. The results of this study highlight that to increase the number of MFRPSII level practitioners within critical care support for their ALP development is required. This support involves developing face-to-face access to expert critical care pharmacists within a national training programme. Additionally, chief pharmacists need to implement drivers including in house mentorship and peer review programmes and the need to align job descriptions and appraisals to the Royal Pharmaceutical Society, Great Britain, Advanced Practice Framework (APF). Full article
Open AccessArticle
Assessment of Drug Information Service in Public and Private Sector Tertiary Care Hospitals in the Eastern Province of Saudi Arabia
Pharmacy 2017, 5(3), 37; doi:10.3390/pharmacy5030037 -
Abstract
Drug information service is a dedicated and specialized service provided by pharmacists to enhance knowledge of medicines use, promote rational prescribing among prescribers, and reduce medication errors. Saudi Arabia has a National Drug and Poison Information Center (NDPIC) responsible for answering drug queries.
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Drug information service is a dedicated and specialized service provided by pharmacists to enhance knowledge of medicines use, promote rational prescribing among prescribers, and reduce medication errors. Saudi Arabia has a National Drug and Poison Information Center (NDPIC) responsible for answering drug queries. There is a lack of literature that reports the current scenario of drug information services in the country, especially the Eastern Province. This study reported the current status of drug information services being provided among tertiary care hospitals of the Eastern Province of Saudi Arabia. All hospitals provided drug information services. The qualification of personnel was mostly bachelor’s level (46.2%) and without proper training (54.8%). The most common queries received in a day were related to drug alternatives, dosage, and administration, as well as the availability of drugs. Physicians were the main users of the service. The most common health resources employed for the service was Lexi-Comp (76.9%) and Micromedex (69.2%). The use of Saudi National Formulary was not reported by any hospital, which highlights a potential research gap to address i.e., to investigate the lack of use of SNF by practitioners. Full article
Open AccessArticle
Knowledge, Attitude, and Perceptions of Pharmacists and Pharmacy Students towards Pharmacogenomics in Zimbabwe
Pharmacy 2017, 5(3), 36; doi:10.3390/pharmacy5030036 -
Abstract
The potential of pharmacogenomics (PGx) to positively impact health outcomes and quality of healthcare is well-established. However, the application of available evidence into clinical practice is still limited due to limited knowledge among healthcare professionals, including pharmacists. As a start towards building capacity
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The potential of pharmacogenomics (PGx) to positively impact health outcomes and quality of healthcare is well-established. However, the application of available evidence into clinical practice is still limited due to limited knowledge among healthcare professionals, including pharmacists. As a start towards building capacity for PGx education, we assessed knowledge, attitudes, and perceptions about PGx among practising pharmacists and pharmacy students. A cross-sectional study was conducted among pharmacists and undergraduate pharmacy students selected using a convenient sampling method—a 37-question survey instrument was used to obtain information regarding PGx among the participants. Out of a total of 131 participants, 56% of respondents showed fair-to-good PGx knowledge. Respondents’ self-reported assessment indicated that 88% had average and above knowledge scores in PGx. Practising pharmacists in Zimbabwe have positive attitudes towards PGx and would support its application to improve treatments. However, there were concerns about security and discrimination when genomics data is used by those who do not understand its meaning. Participants agreed that they would play a leading role in PGx testing if provided with appropriate training. The interest in PGx is challenged by their limited knowledge and understanding of genetics, suggesting a need to update curricula for pharmacy students and for continuing health education programmes. Full article
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Open AccessArticle
Pharmacy Practice and Education in Bulgaria
Pharmacy 2017, 5(3), 35; doi:10.3390/pharmacy5030035 -
Abstract
Pharmacies in Bulgaria have a monopoly on the dispensing of medicinal products that are authorized in the Republic of Bulgaria, as well as medical devices, food additives, cosmetics, and sanitary/hygienic articles. Aptekari (pharmacists) act as responsible pharmacists, pharmacy owners, and managers. They follow
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Pharmacies in Bulgaria have a monopoly on the dispensing of medicinal products that are authorized in the Republic of Bulgaria, as well as medical devices, food additives, cosmetics, and sanitary/hygienic articles. Aptekari (pharmacists) act as responsible pharmacists, pharmacy owners, and managers. They follow a five year Masters of Science in Pharmacy (M.Sc. Pharm.) degree course with a six month traineeship. Pomoshnik-farmacevti (assistant pharmacists) follow a three year degree with a six month traineeship. They can prepare medicines and dispense OTC medicines under the supervision of a pharmacist. The first and second year of the M.Sc. Pharm. degree are devoted to chemical sciences, mathematics, botany and medical sciences. Years three and four center on pharmaceutical technology, pharmacology, pharmacognosy, pharmaco-economics, and social pharmacy, while year five focuses on pharmaceutical care, patient counselling, pharmacotherapy, and medical sciences. A six month traineeship finishes the fifth year together with redaction of a master thesis, and the four state examinations with which university studies end. Industrial pharmacy and clinical (hospital) pharmacy practice are integrated disciplines in some Bulgarian higher education institutions such as the Faculty of Pharmacy of the Medical University of Sofia. Pharmacy practice and education in Bulgaria are organized in a fashion very similar to that in most member states of the European Union. Full article
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Open AccessEditorial
The Country Profiles of the PHARMINE Survey of European Higher Educational Institutions Delivering Pharmacy Education and Training
Pharmacy 2017, 5(3), 34; doi:10.3390/pharmacy5030034 -
Abstract
The PHARMINE (Pharmacy Education in Europe) consortium surveyed pharmacy education and practice in 2012. Surveys were updated in 2017 for publication. The PHARMINE consortium was especially interested in specialization in pharmacy education and practice (for community, hospital, and industrial pharmacy), and in the
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The PHARMINE (Pharmacy Education in Europe) consortium surveyed pharmacy education and practice in 2012. Surveys were updated in 2017 for publication. The PHARMINE consortium was especially interested in specialization in pharmacy education and practice (for community, hospital, and industrial pharmacy), and in the impact of the Bologna agreement and the directive of the European Commission on education and training for the sectoral profession of pharmacy on European degree courses. The surveys underline the varying attitudes of the different European countries to these various aspects. The surveys will now be published in Pharmacy. They will be useful to researchers in education, and to staff and students interested in mobility amongst different European and/or non-European countries. In order to assure a full understanding of the country profiles to be published in the journal Pharmacy, this introductory article describes the general format of the survey questionnaire used. Full article
Open AccessArticle
Awareness and Use of mHealth Apps: A Study from England
Pharmacy 2017, 5(2), 33; doi:10.3390/pharmacy5020033 -
Abstract
Purpose: Mobile health (mHealth) solutions have become an inevitable element of the healthcare landscape. The recommendation and use of mHealth is important, but it is often underutilised. This study was conducted in England. It aimed to determine the use and recommendation of mHealth
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Purpose: Mobile health (mHealth) solutions have become an inevitable element of the healthcare landscape. The recommendation and use of mHealth is important, but it is often underutilised. This study was conducted in England. It aimed to determine the use and recommendation of mHealth apps by pharmacists, the public’s perceptions of mHealth apps in general, and the awareness and use of health apps by diabetic patients in particular. Methods: The study used a mixed research approach, utilising a sequence of survey-based questionnaires with pharmacists and the general public, followed by semi-structured interviews with diabetic patients. Results: Pharmacists’ questionnaires revealed that 56% of the respondents were aware of health apps, 60% of which recommended them to patients. Over 76% of the individuals owned a smartphone. The types of applications that saw the most use from the general public were health and lifestyle apps (24%), social apps (19%), followed by news (18%). Although eight out of nine diabetic patients owned a smartphone, only three used diabetes apps. Diabetic patients also suggested an interest in using diabetes apps to aid in optimising care via the utilisation of visual aids, reminders, recording patient data, social coaching, and remote collaboration with healthcare professionals (HCPs), but time was seen as the biggest obstacle to using a diabetes mHealth application. Conclusion: Despite the growing number of mHealth apps, the level of awareness and usability of such apps by patients and pharmacists was still relatively low. Nevertheless, the majority who used health apps found them to be beneficial, and the public agreed that it helped them to live a healthier lifestyle. Therefore, health apps have great potential in health promotion. Pharmacists are ideally placed to promote them and make patients more aware of them. To increase the use of these apps, it is necessary to first increase awareness and knowledge of these apps, both to the public and to healthcare professionals. Full article
Open AccessArticle
Teaching Prescribing: Just What the Doctor Ordered? A Thematic Analysis of the Views of Newly Qualified Doctors
Pharmacy 2017, 5(2), 32; doi:10.3390/pharmacy5020032 -
Abstract
Undergraduate medical education has been criticised for failing to adequately prepare doctors for the task of prescribing. Pharmacists have been shown to improve medication use in hospitals. This study aims to elicit the views of intern doctors on the challenges of prescribing, and
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Undergraduate medical education has been criticised for failing to adequately prepare doctors for the task of prescribing. Pharmacists have been shown to improve medication use in hospitals. This study aims to elicit the views of intern doctors on the challenges of prescribing, and to suggest changes in education to enhance prescribing practice and potential role of the pharmacist. Semi-structured, qualitative interviews were conducted with intern doctors in their first year post qualification in an Irish hospital. Data collection was conducted until no new themes emerged and thematic analysis was performed. Thirteen interviews took place. Interns described training in practical prescribing as limited and felt the curriculum failed to convey the reality of actual prescribing. Pharmacists were perceived to be a useful, but underutilised, information source in the prescribing process. They requested an earlier introduction, and repeated exposure, to prescribing, and suggested the involvement of peers and pharmacists in this teaching. Intern doctors reported difficulties in applying knowledge gained in medical school to clinical practice. New strategies are needed to enhance the clinical relevance of the medical curriculum by rethinking the learning outcomes regarding prescribing practice and the involvement of pharmacists in prescribing education. Full article
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Open AccessReview
Investigating the Relative Significance of Drug-Related Problem Categories
Pharmacy 2017, 5(2), 31; doi:10.3390/pharmacy5020031 -
Abstract
The aim of the review was to investigate whether an assessment of clinical significance can be related to specific drug-related problems (DRPs) and hence may assist in prioritizing individual categories of DRP categorization systems. The literature search using Google Scholar was performed for
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The aim of the review was to investigate whether an assessment of clinical significance can be related to specific drug-related problems (DRPs) and hence may assist in prioritizing individual categories of DRP categorization systems. The literature search using Google Scholar was performed for the period 1990 to 2013 and comprised primary research studies of clinical pharmacy interventions including DRP and clinical significance assessments. Two reviewers assessed the titles, abstracts, and full-text papers individually, and inclusion was determined by consensus. A total of 27 unique publications were included in the review. They had been conducted in 14 different countries and reported a large range of DRPs (71–5948). Five existing DRP categorisation systems were frequently used, and two methods employed to assess clinical significance were frequently reported. The present review could not establish a consistent relation between the DRP categories and the level of clinical significance. However, the categories “ADR” and possibly “Drug interaction” were often associated with an assessed high clinical significance, albeit they were infrequently identified in the studies. Hence, clinical significance assessments do not seem to be useful in prioritizing individual DRPs in the DRP categorization systems. Consequently, it may be necessary to reconsider our current approach for evaluating DRPs. Full article
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Open AccessArticle
Competence-Based Pharmacy Education in the University of Helsinki
Pharmacy 2017, 5(2), 29; doi:10.3390/pharmacy5020029 -
Abstract
In order to meet the expectations to act as an expert in the health care profession, it is of utmost importance that pharmacy education creates knowledge and skills needed in today’s working life. Thus, the planning of the curriculum should be based on
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In order to meet the expectations to act as an expert in the health care profession, it is of utmost importance that pharmacy education creates knowledge and skills needed in today’s working life. Thus, the planning of the curriculum should be based on relevant and up-to-date learning outcomes. In the University of Helsinki, a university wide curriculum reform called ‘the Big Wheel’ was launched in 2015. After the reform, the basic degrees of the university are two-cycle (Bachelor–Master) and competence-based, where the learning outcomes form a solid basis for the curriculum goals and implementation. In the Faculty of Pharmacy, this curriculum reform was conducted in two phases during 2012–2016. The construction of the curriculum was based on the most relevant learning outcomes concerning working life via high quality first (Bachelor of Science in Pharmacy) and second (Master of Science in Pharmacy) cycle degree programs. The reform was kicked off by interviewing all the relevant stakeholders: students, teachers, and pharmacists/experts in all the working life sectors of pharmacy. Based on these interviews, the intended learning outcomes of the Pharmacy degree programs were defined including both subject/contents-related and generic skills. The curriculum design was based on the principles of constructive alignment and new structures and methods were applied in order to foster the implementation of the learning outcomes. During the process, it became evident that a competence-based curriculum can be created only in close co-operation with the stakeholders, including teachers and students. Well-structured and facilitated co-operation amongst the teachers enabled the development of many new and innovative teaching practices. The European Union funded PHAR-QA project provided, at the same time, a highly relevant framework to compare the curriculum development in Helsinki against Europe-wide definitions of competences and learning outcomes in pharmacy education. Full article
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Open AccessReview
Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices
Pharmacy 2017, 5(2), 30; doi:10.3390/pharmacy5020030 -
Abstract
Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED
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Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED. Full article
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Open AccessArticle
Clinical Outcomes Used in Clinical Pharmacy Intervention Studies in Secondary Care
Pharmacy 2017, 5(2), 28; doi:10.3390/pharmacy5020028 -
Abstract
The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases:
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The objective was to investigate type, frequency and result of clinical outcomes used in studies to assess the effect of clinical pharmacy interventions in inpatient care. The literature search using Pubmed.gov was performed for the period up to 2013 using the search phrases: “Intervention(s)” and “pharmacist(s)” and “controlled” and “outcome(s)” or “effect(s)”. Primary research studies in English of controlled, clinical pharmacy intervention studies, including outcome evaluation, were selected. Titles, abstracts and full-text papers were assessed individually by two reviewers, and inclusion was determined by consensus. In total, 37 publications were included in the review. The publications presented similar intervention elements but differed in study design. A large variety of outcome measures (135) had been used to evaluate the effect of the interventions; most frequently clinical measures/assessments by physician and health care service use. No apparent pattern was established among primary outcome measures with significant effect in favour of the intervention, but positive effect was most frequently related to studies that included power calculations and sufficient inclusion of patients (73% vs. 25%). This review emphasizes the importance of considering the relevance of outcomes selected to assess clinical pharmacy interventions and the importance of conducting a proper power calculation. Full article
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Open AccessArticle
Pharmacist Intervention Program at Different Rent Levels of Geriatric Healthcare
Pharmacy 2017, 5(2), 27; doi:10.3390/pharmacy5020027 -
Abstract
As a pharmacy service giving pharmaceutical care at different levels of health care for elderly people, we needed a standardization procedure for recording and evaluating pharmacists’ interventions. Our objective was to homogenize pharmacist interventions; to know physicians’ acceptance of our recommendations, as well
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As a pharmacy service giving pharmaceutical care at different levels of health care for elderly people, we needed a standardization procedure for recording and evaluating pharmacists’ interventions. Our objective was to homogenize pharmacist interventions; to know physicians’ acceptance of our recommendations, as well as the most prevalent drug related problems (DRP); and the impact of the pharmacists’ interventions. To achieve this goal we conducted a one year prospective study at two levels of health care: 176 nursing homes (EAR) (8828 patients) and 2 long-term and subacute care hospitals (HSS) (268 beds). Pharmacists’ interventions were recorded using the American Society of Health-System Pharmacists classification as the basis. Frequency of the different DRP and the level of response and acceptance on the part of physicians was determined. The Medication Appropriateness Index (MAI) was used to evaluate the impact of the interventions on the prescription quality. Patients’ mean age was 84.2 (EAR) and 80.7 (HSS), and in both cases, polypharmacy ≥ 9 drugs was around 63–69%. There were 4073 interventions done in EAR and 2560 in HSS. Level of response: 44% (EAR), 79% (HSS); degree of acceptance of the recommendations: 84% (EAR), 72% (HSS). Most frequent DRP: inappropriate dose, length of therapy, omissions, and financial impact. Drugs for the nervous system are those with the most DRP. MAI values/medication improved from 4.4 to 2.7 (EAR) and 3.8 to 1.7 (HSS). A normalized way of managing pharmacists’ interventions for different health care levels has been established. We are on the way to increasing collaborative work with physicians and we know which DRPs are most prevalent. Full article
Open AccessArticle
A Comparison of Parametric and Non-Parametric Methods Applied to a Likert Scale
Pharmacy 2017, 5(2), 26; doi:10.3390/pharmacy5020026 -
Abstract
A trenchant and passionate dispute over the use of parametric versus non-parametric methods for the analysis of Likert scale ordinal data has raged for the past eight decades. The answer is not a simple “yes” or “no” but is related to hypotheses, objectives,
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A trenchant and passionate dispute over the use of parametric versus non-parametric methods for the analysis of Likert scale ordinal data has raged for the past eight decades. The answer is not a simple “yes” or “no” but is related to hypotheses, objectives, risks, and paradigms. In this paper, we took a pragmatic approach. We applied both types of methods to the analysis of actual Likert data on responses from different professional subgroups of European pharmacists regarding competencies for practice. Results obtained show that with “large” (>15) numbers of responses and similar (but clearly not normal) distributions from different subgroups, parametric and non-parametric analyses give in almost all cases the same significant or non-significant results for inter-subgroup comparisons. Parametric methods were more discriminant in the cases of non-similar conclusions. Considering that the largest differences in opinions occurred in the upper part of the 4-point Likert scale (ranks 3 “very important” and 4 “essential”), a “score analysis” based on this part of the data was undertaken. This transformation of the ordinal Likert data into binary scores produced a graphical representation that was visually easier to understand as differences were accentuated. In conclusion, in this case of Likert ordinal data with high response rates, restraining the analysis to non-parametric methods leads to a loss of information. The addition of parametric methods, graphical analysis, analysis of subsets, and transformation of data leads to more in-depth analyses. Full article
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Open AccessArticle
Are We Ready to Implement Competence-Based Teaching in Pharmacy Education in Poland?
Pharmacy 2017, 5(2), 25; doi:10.3390/pharmacy5020025 -
Abstract
Pharmacists in Poland are responsible for the dispensing and quality control of pharmaceuticals. The education process in pharmacy is regulated and monitored at the national level. Pharmacy education at Jagiellonian University is organized in a traditional way based on input and content teaching.
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Pharmacists in Poland are responsible for the dispensing and quality control of pharmaceuticals. The education process in pharmacy is regulated and monitored at the national level. Pharmacy education at Jagiellonian University is organized in a traditional way based on input and content teaching. The aim of the study was to determinate whether the Jagiellonian University curriculum in the Pharmacy program meets the criteria of the European Competence Framework. The mapping of the intended curriculum was done by four academic teachers. The qualitative and quantitative analysis of the distribution of the European Competence Framework among a group of courses and study years was done. We observed that most of the personal competencies are offered to students in their senior years, while the patient care competencies are distributed equally during the cycle of the study, and only some of them are overrepresented at the senior years. We need a legislation change at the national level as well as organizational and mental change at the university level to move from learning outcome-based pharmacy education to competence-based. Full article
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Open AccessArticle
Curriculum Mapping of the Master’s Program in Pharmacy in Slovenia with the PHAR-QA Competency Framework
Pharmacy 2017, 5(2), 24; doi:10.3390/pharmacy5020024 -
Abstract
This article presents the results of mapping the Slovenian pharmacy curriculum to evaluate the adequacy of the recently developed and validated European Pharmacy Competences Framework (EPCF). The mapping was carried out and evaluated progressively by seven members of the teaching staff at the
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This article presents the results of mapping the Slovenian pharmacy curriculum to evaluate the adequacy of the recently developed and validated European Pharmacy Competences Framework (EPCF). The mapping was carried out and evaluated progressively by seven members of the teaching staff at the University of Ljubljana’s Faculty of Pharmacy. Consensus was achieved by using a two-round modified Delphi technique to evaluate the coverage of competences in the current curriculum. The preliminary results of the curriculum mapping showed that all of the competences as defined by the EPCF are covered in Ljubljana’s academic program. However, because most EPCF competences cover healthcare-oriented pharmacy practice, a lack of competences was observed for the drug development and production perspectives. Both of these perspectives are important because a pharmacist is (or should be) responsible for the entire process, from the development and production of medicines to pharmaceutical care in contact with patients. Nevertheless, Ljubljana’s graduates are employed in both of these pharmaceutical professions in comparable proportions. The Delphi study revealed that the majority of differences in scoring arise from different perspectives on the pharmacy profession (e.g., community, hospital, industrial, etc.). Nevertheless, it can be concluded that curriculum mapping using the EPCF is very useful for evaluating and recognizing weak and strong points of the curriculum. However, the competences of the framework should address various fields of the pharmacist’s profession in a more balanced way. Full article
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Open AccessArticle
Introducing Pharmaceutical Care to Primary Care in Iceland—An Action Research Study
Pharmacy 2017, 5(2), 23; doi:10.3390/pharmacy5020023 -
Abstract
Even though pharmaceutical care is not a new concept in pharmacy, its introduction and development has proved to be challenging. In Iceland, general practitioners are not familiar with pharmaceutical care and additionally no such service is offered in pharmacies or primary care settings.
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Even though pharmaceutical care is not a new concept in pharmacy, its introduction and development has proved to be challenging. In Iceland, general practitioners are not familiar with pharmaceutical care and additionally no such service is offered in pharmacies or primary care settings. Introducing pharmaceutical care in primary care in Iceland is making great efforts to follow other countries, which are bringing the pharmacist more into patient care. General practitioners are key stakeholders in this endeavor. The aim of this study was to introduce pharmacist-led pharmaceutical care into primary care clinics in Iceland in collaboration with general practitioners by presenting different setting structures. Action research provided the framework for this research. Data was collected from pharmaceutical care interventions, whereby the pharmaceutical care practitioner ensures that each of a patient’s medications is assessed to determine if it is appropriate, effective, safe, and that the patient can take medicine as expected. Sources of data included pharmaceutical care notes on patients, researcher’s notes, meetings, and interviews with general practitioners over the period of the study. The study ran from September 2013 to October 2015. Three separate semi-structured in-depth interviews were conducted with five general practitioners from one primary health care clinic in Iceland at different time points throughout the study. Pharmaceutical care was provided to elderly patients (n = 125) before and between general practitioners’ interviews. The study setting was a primary care clinic in the Reykjavik area and the patients’ homes. Results showed that the GPs’ knowledge about pharmacist competencies as healthcare providers and their potential in patient care increased. GPs would now like to have access to a pharmacist on a daily basis. Direct contact between the pharmacist and GPs is better when working in the same physical space. Pharmacist’s access to medical records is necessary for optimal service. Pharmacist-led clinical service was deemed most needed in dose dispensing polypharmacy patients. This research indicated that it was essential to introduce Icelandic GPs to the potential contribution of pharmacists in patient care and that action research was a useful methodology to promote and develop a relationship between those two health care providers in primary care in Iceland. Full article
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Open AccessArticle
Comparison of Insulin Detemir and Insulin Glargine for Hospitalized Patients on a Basal-Bolus Protocol
Pharmacy 2017, 5(2), 22; doi:10.3390/pharmacy5020022 -
Abstract
BACKGROUND: The primary purpose of this study is to determine whether insulin detemir is equivalent to insulin glargine in controlling hyperglycemia for the adult hospitalized patient on a basal-bolus treatment regimen. METHODS: A retrospective study was conducted at two acute care hospitals within
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BACKGROUND: The primary purpose of this study is to determine whether insulin detemir is equivalent to insulin glargine in controlling hyperglycemia for the adult hospitalized patient on a basal-bolus treatment regimen. METHODS: A retrospective study was conducted at two acute care hospitals within the same health system. Patients from both facilities who were initiated on a basal-bolus subcutaneous insulin regimen were included in the study. The basal-bolus regimen consisted of three components: basal, bolus, and corrective insulin with only the data from the first seven days analyzed. Once the basal-bolus protocol was initiated, all previous glycemic agents were discontinued. The target glycemic goal of the study was 100–180 mg/dL. RESULTS: In both groups, 50% of the patients had achieved the target glycemic control goal (100–180 mg/dL) by day 2 (p = 0.3). However, on the seventh or last day of basal-bolus treatment, whichever came first, 36.36% of patients receiving insulin detemir (n = 88) achieved the blood glucose reading goal compared to 52.00% in patients receiving insulin glargine (n = 100) (p = 0.03). This corresponded to an adjusted odds ratio of 2.12 (1.08 to 4.15), p = 0.03. The adjusting variables were provider type, whether the patient was hospitalized within 30 days prior and diagnosis of stroke. The mean blood glucose readings for the insulin glargine and the insulin detemir groups while on basal-bolus therapy were 200 mg/dL and 215 mg/dL, respectively (p = 0.05). The total number of blood glucose readings less than 70 mg/dL and less than 45 mg/dL was very low and there were no differences in number of episodes with hypoglycemia between the two groups. CONCLUSION: There was not a statistical difference between the two groups at 2 days, however there was on the seventh day or the last day of basal-bolus treatment. There were nonsignificant hypoglycemia events between basal insulin groups and the results for the last or seventh day of treatment may not be clinically significant in practice. Full article
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