Breast is best? A small-scale study exploring knowledge, attitudes, and training amongst community pharmacists about breastfeeding

IF 1.5 Q3 PHARMACOLOGY & PHARMACY International Journal of Pharmacy Practice Pub Date : 2023-11-30 DOI:10.1093/ijpp/riad074.034
D. Kamdar, Y. El Kout Oustah, M. Elbashir
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Previous research has found a lack of knowledge and training on medicines use during lactation and breastfeeding-related conditions, often leading to unnecessary cessation of breastfeeding.2 To explore breastfeeding knowledge, attitudes, and training amongst community pharmacists. Following ethical approval from Kingston University and a pilot study, a paper questionnaire comprising 24 mixed-style questions was distributed to community pharmacists in the London boroughs of Ealing and Brent. The Raosoft online calculator was used to calculate the sample size of 110 pharmacists at 95% confidence interval. Semi-structured interviews were conducted using a validated interview guide. Analyses were performed using SPSS software alongside thematic analysis for interview responses. Response rate was 75% (n=82/110) and 9 pharmacists participated in the interviews. 47.6% (n=39/82) pharmacists rated their current breastfeeding knowledge as neither poor nor good or lower. Only 11% (n=9/82) pharmacists stated the duration of breastfeeding should be greater than 2 years. 27.2% (n=12/44) pharmacists felt slightly or not confident providing over-the-counter medicines to breastfeeding patients compared to 61.4% (n=27/44) when making recommendations for breastfeeding-related conditions such as mastitis or nipple thrush. Thematic analysis highlighted the need for further research into medication use safety during lactation as pharmacists lacked confidence to make recommendations based on Summary of Product Characteristics (SPC). 50% (n=41/82) pharmacists stated their knowledge was obtained from personal experience. 100% (n=82/82) of participants agreed that more education and training must be provided, and thematic analysis showed pharmacists would prefer a spiralled approach starting at university level, through foundation year training and post-registration. The majority of pharmacists showed somewhat or high confidence advising patients about over-the-counter medication safety during lactation, but this was reversed when confronted with breastfeeding-related conditions, in contrast to findings from Byerley2 where the majority of pharmacists were not confident about medicines advice. Pharmacists have a positive attitude towards breastfeeding with all desiring further training. Changes to pharmacy education and training are needed to develop pharmacists’ understanding on breastfeeding generally and medicines safety with the need for robust evidence from clinical trials to improve pharmacist’s confidence to advise appropriately,3 or at least to educate pharmacists about specialised resources such as the Drug and Lactation Database or Breastfeeding Network. Study strengths included providing information about an area with limited literature and a reasonable response rate. Limitations included a small sample size in a small geographical area. Only community pharmacists were surveyed but with evolving roles, it would benefit surveying primary care pharmacists. 1. Unicef. Breastfeeding in the UK [Internet]. [Place unknown]: Unicef; [date unknown] [cited 2023 Mar 11]. Available from: https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/ 2. Byerley EM, Perryman DC, Dykhuizen SN, Haak JR, Grindeland CJ, Williamson JDM. Breastfeeding and the Pharmacist’s Role in Maternal Medication Management: Identifying Barriers and the Need for Continuing Education. J Pediatr Pharmacol Ther [Internet]. 2022 Feb [cited 2023 Mar 10]; 27(2):102-108. Available from: https://www.researchgate.net/publication/358489674_Breastfeeding_and_the_Pharmacist%27s_Role_in_Maternal_Medication_Management_Identifying_Barriers_and_the_Need_for_Continuing_Education 3. Hussainy SY, Dermele N. Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: A review. Int Breastfeed J [Internet]. 2011 Aug [cited 2023 May 16]; 6(1):1-16. Available from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-6-11","PeriodicalId":14284,"journal":{"name":"International Journal of Pharmacy Practice","volume":"72 2 1","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Pharmacy Practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/ijpp/riad074.034","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}
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Abstract

The United Kingdom (UK) has one of the lowest breastfeeding rates in Europe, with the last Infant Feeding Survey showing a reduction from 81% of mothers initiating breastfeeding to 0.5% still breastfeeding at 12 months.1 It provides multiple health benefits for mothers and infants, and promoting breastfeeding is an important public health strategy, impacting the future health of the population. Community pharmacists are accessible and trusted healthcare professionals, giving expert advice on medication use and public health. Previous research has found a lack of knowledge and training on medicines use during lactation and breastfeeding-related conditions, often leading to unnecessary cessation of breastfeeding.2 To explore breastfeeding knowledge, attitudes, and training amongst community pharmacists. Following ethical approval from Kingston University and a pilot study, a paper questionnaire comprising 24 mixed-style questions was distributed to community pharmacists in the London boroughs of Ealing and Brent. The Raosoft online calculator was used to calculate the sample size of 110 pharmacists at 95% confidence interval. Semi-structured interviews were conducted using a validated interview guide. Analyses were performed using SPSS software alongside thematic analysis for interview responses. Response rate was 75% (n=82/110) and 9 pharmacists participated in the interviews. 47.6% (n=39/82) pharmacists rated their current breastfeeding knowledge as neither poor nor good or lower. Only 11% (n=9/82) pharmacists stated the duration of breastfeeding should be greater than 2 years. 27.2% (n=12/44) pharmacists felt slightly or not confident providing over-the-counter medicines to breastfeeding patients compared to 61.4% (n=27/44) when making recommendations for breastfeeding-related conditions such as mastitis or nipple thrush. Thematic analysis highlighted the need for further research into medication use safety during lactation as pharmacists lacked confidence to make recommendations based on Summary of Product Characteristics (SPC). 50% (n=41/82) pharmacists stated their knowledge was obtained from personal experience. 100% (n=82/82) of participants agreed that more education and training must be provided, and thematic analysis showed pharmacists would prefer a spiralled approach starting at university level, through foundation year training and post-registration. The majority of pharmacists showed somewhat or high confidence advising patients about over-the-counter medication safety during lactation, but this was reversed when confronted with breastfeeding-related conditions, in contrast to findings from Byerley2 where the majority of pharmacists were not confident about medicines advice. Pharmacists have a positive attitude towards breastfeeding with all desiring further training. Changes to pharmacy education and training are needed to develop pharmacists’ understanding on breastfeeding generally and medicines safety with the need for robust evidence from clinical trials to improve pharmacist’s confidence to advise appropriately,3 or at least to educate pharmacists about specialised resources such as the Drug and Lactation Database or Breastfeeding Network. Study strengths included providing information about an area with limited literature and a reasonable response rate. Limitations included a small sample size in a small geographical area. Only community pharmacists were surveyed but with evolving roles, it would benefit surveying primary care pharmacists. 1. Unicef. Breastfeeding in the UK [Internet]. [Place unknown]: Unicef; [date unknown] [cited 2023 Mar 11]. Available from: https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/ 2. Byerley EM, Perryman DC, Dykhuizen SN, Haak JR, Grindeland CJ, Williamson JDM. Breastfeeding and the Pharmacist’s Role in Maternal Medication Management: Identifying Barriers and the Need for Continuing Education. J Pediatr Pharmacol Ther [Internet]. 2022 Feb [cited 2023 Mar 10]; 27(2):102-108. Available from: https://www.researchgate.net/publication/358489674_Breastfeeding_and_the_Pharmacist%27s_Role_in_Maternal_Medication_Management_Identifying_Barriers_and_the_Need_for_Continuing_Education 3. Hussainy SY, Dermele N. Knowledge, attitudes and practices of health professionals and women towards medication use in breastfeeding: A review. Int Breastfeed J [Internet]. 2011 Aug [cited 2023 May 16]; 6(1):1-16. Available from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-6-11
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母乳是最好的?探索社区药剂师对母乳喂养的认识、态度和培训的小规模研究
英国是欧洲母乳喂养率最低的国家之一,最近一次婴儿喂养调查显示,开始母乳喂养的母亲比例从 81% 降至 12 个月时仍在母乳喂养的 0.5%。1 母乳喂养对母亲和婴儿的健康有多重益处,促进母乳喂养是一项重要的公共卫生战略,影响着人口的未来健康。社区药剂师是既方便又值得信赖的医疗保健专业人员,可就药物使用和公共卫生问题提供专业建议。以往的研究发现,社区药剂师缺乏哺乳期用药及与母乳喂养相关疾病的知识和培训,这往往会导致不必要的停止母乳喂养2。 在获得金斯顿大学(Kingston University)的伦理批准并进行试点研究后,我们向伦敦伊灵区(Ealing)和布伦特区(Brent)的社区药剂师发放了由 24 个混合式问题组成的纸质问卷。我们使用 Raosoft 在线计算器计算了 110 名药剂师的样本量,置信区间为 95%。采用经过验证的访谈指南进行了半结构化访谈。在对访谈回答进行主题分析的同时,还使用 SPSS 软件进行了分析。 回复率为 75%(n=82/110),9 名药剂师参与了访谈。47.6%(n=39/82)的药剂师将其目前的母乳喂养知识评为 "既不差也不好 "或更低。只有 11% (n=9/82) 的药剂师表示母乳喂养时间应超过 2 年。27.2%(n=12/44)的藥劑師對於向哺乳期病人提供非處方藥物感到有少許信心或沒有信心,相比之下,61.4%(n=27/44)的藥劑師對於向哺乳期病人提供乳腺炎或乳頭皰疹等與母乳餵哺有關的建議則感到有信心。主题分析强调,由于药剂师对根据产品特征摘要 (SPC) 提出建议缺乏信心,因此需要进一步研究哺乳期的用药安全问题。 50%(n=41/82)的药剂师表示他们的知识来自个人经验。100%(n=82/82)的参与者同意必须提供更多的教育和培训,主题分析表明药剂师更倾向于从大学阶段开始,通过基础年培训和注册后培训的螺旋式方法。 大多数药剂师对在哺乳期向患者提供非处方药安全建议表现出了一定或高度的信心,但在面对与母乳喂养相关的情况时,这种信心却发生了逆转,这与拜尔利(Byerley)2 的研究结果形成了鲜明对比,在拜尔利的研究中,大多数药剂师对药物建议没有信心。药剂师对母乳喂养持积极态度,并希望接受进一步培训。药剂学教育和培训需要改变,以提高药剂师对母乳喂养和药物安全的总体认识,同时需要临床试验的有力证据来增强药剂师提供适当建议的信心,3 或至少让药剂师了解药物和哺乳期数据库或母乳喂养网络等专业资源。 该研究的优点包括:提供了有关文献有限的领域的信息,以及合理的回复率。局限性包括样本量小,地域范围小。只对社区药剂师进行了调查,但随着药剂师角色的不断变化,对初级保健药剂师进行调查也会有所裨益。 1.联合国儿童基金会。英国的母乳喂养[互联网]。[地点不详]:Unicef; [date unknown] [cited 2023 Mar 11].Available from: https://www.unicef.org.uk/babyfriendly/about/breastfeeding-in-the-uk/ 2.Byerley EM, Perryman DC, Dykhuizen SN, Haak JR, Grindeland CJ, Williamson JDM.母乳喂养与药剂师在产妇用药管理中的作用:识别障碍和继续教育的必要性。J Pediatr Pharmacol Ther [Internet].2022 年 2 月 [2023 年 3 月 10 日引用]; 27(2):102-108.Available from: https://www.researchgate.net/publication/358489674_Breastfeeding_and_the_Pharmacist%27s_Role_in_Maternal_Medication_Management_Identifying_Barriers_and_the_Need_for_Continuing_Education 3.Hussainy SY, Dermele N. Health professionals and women towards medication use in breastfeeding:综述。Int Breastfeed J [Internet].2011 年 8 月 [2023 年 5 月 16 日引用];6(1):1-16。Available from: https://internationalbreastfeedingjournal.biomedcentral.com/articles/10.1186/1746-4358-6-11
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来源期刊
CiteScore
2.90
自引率
5.60%
发文量
146
期刊介绍: The International Journal of Pharmacy Practice (IJPP) is a Medline-indexed, peer reviewed, international journal. It is one of the leading journals publishing health services research in the context of pharmacy, pharmaceutical care, medicines and medicines management. Regular sections in the journal include, editorials, literature reviews, original research, personal opinion and short communications. Topics covered include: medicines utilisation, medicine management, medicines distribution, supply and administration, pharmaceutical services, professional and patient/lay perspectives, public health (including, e.g. health promotion, needs assessment, health protection) evidence based practice, pharmacy education. Methods include both evaluative and exploratory work including, randomised controlled trials, surveys, epidemiological approaches, case studies, observational studies, and qualitative methods such as interviews and focus groups. Application of methods drawn from other disciplines e.g. psychology, health economics, morbidity are especially welcome as are developments of new methodologies.
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