International Journal of Pharmacy Practice最新文献

Background: Conscientious objection (CO), the refusal to participate in activities conflicting with one's ethical, religious, or moral beliefs, can present challenges in aligning personal values with professional obligations, particularly in delivering patient-centred care. There is a paucity of information on pharmacists and CO. This scoping review aimed to explore and map published current literature investigating pharmacists' views on CO, including the types of services involved, prevailing attitudes, and influencing factors towards decision-making.

Methods: A comprehensive search was conducted across five databases (MEDLINE, EMBASE, APA PsycINFO, SCOPUS, and International Pharmaceutical Abstracts) to identify primary literature from the past 20 years that reported pharmacists' views on CO.

Results: A total of 18 articles corresponding to 16 distinct studies were included. These comprised quantitative surveys and qualitative interview studies, and one modified Delphi study. Pharmacists commonly objected to the provision of hormonal contraception and supply of abortifacient medications based on several reasons, including perceived professional obligations, religious influences, work environment, and perception of autonomy. Decision-making also hinged on the type of service and the anticipated emotional distress, burden, or clinical consequences for patients. Pharmacists also expressed concerns about ensuring continuity of care.

Conclusion: Practising pharmacists navigate CO by balancing personal beliefs with professional responsibilities, which are influenced by intrapersonal and environmental factors. Referral can accommodate CO and help ensure continuity of care, but robust legal and ethical frameworks are essential. Strengthening these frameworks and conducting profession-specific research are critical to informing policy and continuity of care.

Objectives: Pharmacists play a pivotal role in safeguarding antimicrobial use and optimising antimicrobial stewardship. The aim of the study was to assess the antimicrobial stewardship knowledge of undergraduate pharmacy students and to map the student responses to the themes of the World Health Organisation antimicrobial stewardship interventions practical guide, with a view to inform recommendations of further teachings that could be incorporated in future curricula.

Methods: Following the conclusion of an infectious diseases academic unit, pharmacy students completed a post-unit reflection. The responses were analysed using summative content analysis and mapped to the World Health Organisation antimicrobial stewardship interventions practical guide, which describes 10 commonly used stewardship interventions ('themes').

Key findings: Students overall resonated with themes that are applicable prior to or at the time of prescribing more than those applicable after prescribing. Out of 610 Australian-based students and 181 Malaysian-based students, 61.6% and 33.7%, respectively, felt confident to intervene when antimicrobial prescribing is not optimal. The two themes students resonated with the most were Clinician education and Self-directed antibiotic reassessments (antibiotic timeouts). In contrast, the two least represented themes were Prior authorization of restricted antimicrobials and De-labelling of spurious antibiotic allergies.

Conclusions: Reflection responses demonstrated that pharmacy students do feel confident to intervene when antimicrobial prescribing is inappropriate, and resonate with their role being most impactful at the pre-prescribing time point, especially through clinical education. Further incorporation of content related to obtaining approval prior to prescribing restricted antimicrobials and de-labelling of allergies into the curriculum is encouraged, as these interventions were generally underrepresented by students.

Objectives: Explore gamification to support student learning of minor ailment prescribing.

Methods: Online games were designed for the three most challenging minor ailments identified by a pharmacy student needs assessment. Post-game evaluation was collected.

Key findings: Online/live- and offline/homework-mode Quizizz games were engaged by 23 and 46 students, respectively. Average knowledge scores were 52% (nausea and vomiting in pregnancy), 47% (pinworms and threadworms), and 41% (impetigo), respectively. Gamification was perceived to be effective in reinforcing knowledge, recognizing knowledge blind spots, and patient-assessment concepts.

Conclusions: Identifying knowledge gaps and familiarizing with minor ailment prescribing through interactive gamification was positively received by students.

Objectives: To explore realist evaluations, focusing on their utility in pharmacy-related practice and education research.

Methods: Realist evaluations are a theory-driven approach to research that provides a robust account of the nature of programs and how they work in answering the question, "what works (or does not work) for whom in what circumstances and why (not)?". In realist evaluations, the context in which it is implemented, the mechanisms that trigger change, and the outcomes that result are explored.

Key findings: Realist evaluations provide a more informed approach to targeting and refining programs to suit a diverse and complex healthcare system. Realist evaluations have been used by researchers from a variety of health professional disciplines to evaluate programs and interventions to improve public health, health care policy, and tertiary education institutions. Examples of the complex settings where researchers have used this method for the evaluation process include supervision training workshops, rural immersion training programs, faculty development courses, safe medication administration programs, and the ability of managers to effect change.

Conclusion: Realist evaluations are powerful methodological approaches for studying complex interventions and support managing the nuances associated with constrained resources, differing governing policies and diverse population groups.

Objectives: The objective of the study was to evaluate if using a validated psychometric test, The Big Five Personality Test, would identify an association between personality traits among hospital pharmacists and certain clinical services.

Methods: This study used a descriptive design. Pharmacists working in a hospital setting providing care to adult patients at the McGill University Health Centre in predefined clinical services (haematology-oncology/oncology clinic, intensive care unit, emergency medicine, internal medicine, geriatrics, infectious diseases) were included. Participants had 10 days to respond to the questionnaire.

Key findings: Clinical service had a large effect on 'Extraversion' (η2 = 0.336) and 'Conscientiousness' (η2 = 0.297), and there was a significant difference between the group means (P = .025 and P = .05, respectively). A Tukey's post hoc test showed that the significant difference found for 'Extraversion' was mainly due to differences in means between emergency medicine and geriatrics pharmacists (P = .040). Although there was no significant difference between the group means for 'Openness' and 'Neuroticism', clinical service had a large effect on these traits (η2 = 0.283 and η2 = 0.237, respectively).

Conclusions: These results suggest that there is an association between personality traits and clinical services when using a psychometric test, such as the BFPT, as the observed group differences in personality traits (e.g. extraversion, conscientiousness) were associated with large effect sizes. Further research is needed to better understand the practical implications of these traits in the hiring process or the selection of a clinical service.

Background: A two-week elective course on diversity competences within the pharmaceutical curriculum at the Medical Faculty of Vilnius University was designed and implemented.

Aim: This study aimed to evaluate the changes in the students' knowledge of diversity concepts, their attitudes towards ethnic minorities, and their understanding of diversity-sensitive healthcare after the course.

Methods: A pre-post longitudinal survey was conducted. Students evaluated their knowledge of diversity concepts on a scale from 1 to 10. Attitudes were measured with a validated instrument assessing physicians' opinions about healthcare for ethnic minorities, modified for the context of pharmaceutical care. Understanding of diversity-sensitive care was explored using an open-ended question.

Results: In 2023 and 2024, 40 students attended the course. Most were female, aged 22 or 23, having parents with university-level education; all were born in Lithuania. The before-after increase in knowledge scores was most pronounced and significant for those diversity concepts that initially scored the lowest, i.e. intersectionality, implicit bias, reflexivity, and diversity theory. Both before and after the course, the highest scores were for the attitude showing positive perception of minority patients, while the perception that minority patients prefer a paternalistic communication style had the lowest scores. Already before the course, the students, to some extent, were knowledgeable about the diversity-sensitive healthcare.

Conclusion: The study indicates that a two-week course on diversity competence within the university pharmacy curriculum improves student knowledge of diversity concepts. These results may encourage educational management of pharmaceutical programs in other European universities to implement diversity competence training.

Objectives: To assess training, perceptions, and behaviours of pharmacy professionals and trainees about the relationship between climate change, environmental sustainability, and pharmacy practice.

Methods: We conducted a cross-sectional survey-based study of a global sample of pharmacy professionals and trainees. Participants were recruited between June 2023 to March 2024 using professional networks and a snowball sampling approach. Descriptive statistics and content analysis were used to analyse survey results.

Key findings: Four-hundred forty participants representing 24 countries responded to the survey. Participants identified as pharmacists, pharmacy students, or postgraduate pharmacy trainees practicing in a variety of settings. A majority reported substantial worry about the health impacts of climate change and had no prior training related to climate change. One-third of respondents indicated that pharmacists should address climate change and environmental issues. Many identified some action taken in their professional role. Barriers towards further action included lack of knowledge, time, and resources.

Conclusions: Pharmacy professionals and trainees globally are concerned about the health impacts from climate change and the environment. Further resources, support, and education are needed to support pharmacists in caring for patients experiencing climate-health impacts and in connecting with other health professionals doing this critical work.

Objectives: To evaluate the impact of a pharmacist-led primary care review clinic on reducing opioid prescribing.

Methods: Retrospective analysis of routinely collected opioid prescription data for patients using strong opioids for pain at a practice with high social deprivation and staffed mainly by locum GPs.

Key findings: Forty-seven patients were reviewed. The median opioid dose before review was 80 mg oral morphine equivalent. After intervention, the median dose was 30 mg. Thirty-seven (78.7%) patients had reduced doses or discontinued opioids. No adverse events were reported.

Conclusions: A pharmacist-led clinic aimed at reducing opioid medication appears feasible and effective.

Objectives: To identify the types of non-remunerated services provided by pharmacists in (redacted country) community pharmacies and the time spent delivering these services.

Methods: A direct observational study was conducted with data collected by 74 undergraduate pharmacy students on experiential placement. Each student was randomly assigned three 2-h observation periods to document the activities performed by community pharmacists. Details on the type of non-remunerated service, involved parties, and duration were recorded in Qualtrics. Descriptive statistics were used to analyze the types of services provided, the people involved, and the time taken.

Key findings: During 444 h of observation, 903 non-remunerated interactions were recorded. The most common types of interactions included: Queries about medicine availability (23%, n = 205). provision of medicine information to patients (12%, n = 106) and changes to dose administration aids (9%, n = 85). Most interactions involved only one other person (91%, n = 819), typically the patient or carer (79%, n = 704), and occurred face-to-face (66%, n = 594). The majority of interactions (69%, n = 624) lasted 5 min or less; however, discussions involving multiple topics were generally longer.

Conclusion: Australian community pharmacists provide a substantial number and diverse range of non-remunerated services. While individual interactions are typically brief, the cumulative time commitment is significant and may have important public health implications.