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Predicting the effect of pharmacist’s communication with patients: medical communication analysis using facial responses 药剂师与患者沟通效果的预测:基于面部反应的医学沟通分析
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-05-10 DOI: 10.1093/jphsr/rmad029
Yukina Miyagi, Saori Gocho, Naoko Yamaguchi, Yuka Miyachi, Chika Nakayama, S. Okada, Taeyuki Oshima
To provide patient-centred care, psychological knowledge, and skills are necessary for pharmaceutical communication. Acquisition of these communication skills is closely related to patient comprehension. Therefore, to improve pharmacist’s communication skills, pharmacist need to learn the characteristics of their medication instructions, such as posture, facial expressions, eye contact, nodding, and more. For the analysis of medical communication, there is a rating scale, functional analysis, and others. However, these methods may not match the actual emotions due to their analysis skills and the psychological stress of the patients. In this study, we examined the methods to evaluate patient-pharmacist communication using emotion recognition AI software, which recognises emotions from facial expressions. With the cooperation of six simulated patients (SP) and eight pharmacists, we recorded the SP’s facial expressions during medication instruction. The facial expression video was analysed using emotion recognition AI, which can obtain emotion values (anger, contempt, disgust, fear, joy, sadness, surprise, and engagement). We compared the emotion of the extracted peaks with the feedback and calculated the emotion match rate. As a result, 33% of the emotions matched in the peak and feedback. This result indicates that emotion recognition AI cannot capture every feedback emotion. However, in joy, the result was not affected by engagement, and the match rate between peak and feedback was high. In the future, emotion recognition AI will allow us to assess the effects of communication skills of the pharmacists on the psychological state of the patients more objectively and noninvasively.
为了提供以病人为中心的护理,心理学知识和技能是药学沟通所必需的。这些沟通技巧的习得与病人的理解能力密切相关。因此,为了提高药师的沟通能力,药师需要了解其用药说明的特点,如姿势、面部表情、眼神交流、点头等。对于医疗传播的分析,有评分量表、功能分析等。然而,由于分析能力和患者的心理压力,这些方法可能与实际情绪不相符。在本研究中,我们研究了使用情绪识别AI软件评估患者与药剂师沟通的方法,该软件可以从面部表情中识别情绪。在6名模拟患者(SP)和8名药师的合作下,我们记录了SP在给药过程中的面部表情。使用情绪识别AI对面部表情视频进行分析,可以获得情绪值(愤怒,蔑视,厌恶,恐惧,喜悦,悲伤,惊讶和参与)。将提取的峰的情感与反馈进行比较,计算情感匹配率。结果,33%的情绪在峰值和反馈中是一致的。这一结果表明,情绪识别AI无法捕捉到每一个反馈情绪。然而,在快乐方面,结果不受参与度的影响,峰值和反馈之间的匹配率很高。未来,情感识别AI将使我们能够更客观、无创地评估药师沟通技巧对患者心理状态的影响。
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引用次数: 0
What constitutes evidence for over-the-counter medicines? A cross-sectional study of community pharmacists’ knowledge, attitude, and practices 什么构成非处方药的证据?社区药剂师的知识、态度和实践的横断面研究
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-05-03 DOI: 10.1093/jphsr/rmad017
Lik De Chun, M. Anwar
To assess the knowledge, attitude and practices of evidence-based medicine (EBM) with regard to over-the-counter (OTC) medicines among New Zealand community pharmacists. A pre-piloted, self-administered online questionnaire was disseminated through email to 2788 registered community pharmacists. The questionnaire covered the aspects of knowledge, attitude and barriers towards EBM, and factors influencing pharmacists’ product recommendations. Responses were collected over 4 weeks in January 2021. Data were analysed using SPSS (version 26). A total of 326 responses were collected (11.7% response rate). Participants had an average knowledge score of 15.6 (out of 33). More than 50% had a favourable attitude towards EBM. Insufficient time (20.2%) and a lack of resources (16.4%) were reported as the major barriers to practicing EBM. The majority (72.8%) of participants believed that guideline recommendations were important for OTC recommendations; however, 44.9% would always use their own judgement. Recent graduates (P = 0.048) and pharmacists with a higher level of education (P = 0.00) scored significantly higher for knowledge. A higher knowledge score predicted ‘more favourable’ attitude towards EBM. Deficiencies exist in community pharmacists’ EBM-related knowledge, attitude and practices. An educational intervention targeting older pharmacists is required since the relevant knowledge was found to be deteriorating with age.
评估新西兰社区药师对非处方(OTC)药品的循证医学(EBM)知识、态度和实践。通过电子邮件向2788名注册社区药剂师分发了一份预先试点的、自我管理的在线问卷。问卷内容包括对循证医学的知识、态度和障碍,以及影响药师产品推荐的因素。在2021年1月的4周内收集了反馈。数据分析使用SPSS (version 26)。共收集问卷326份,回复率11.7%。参与者的平均知识得分为15.6分(满分33分)。超过50%的受访者对循证医学持正面态度。时间不足(20.2%)和缺乏资源(16.4%)被认为是实施循证医学的主要障碍。大多数(72.8%)的参与者认为指南建议对OTC推荐很重要;然而,44.9%的人总是用自己的判断。应届毕业生(P = 0.048)和受教育程度较高的药师(P = 0.00)的知识得分显著高于毕业生(P = 0.048)。知识得分越高,表明对循证医学的态度“越有利”。社区药师的ebm相关知识、态度和实践存在不足。由于发现相关知识随着年龄的增长而恶化,因此需要针对老年药剂师进行教育干预。
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引用次数: 0
Perspectives of pharmacists and patients on pharmacist services to improve medication adherence among patients with diabetes in Indonesia 药师和患者对药师服务改善印尼糖尿病患者服药依从性的看法
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-28 DOI: 10.1093/jphsr/rmad025
B. Presley, W. Groot, E. Setiawan, M. Pavlova
Pharmacists’ role in diabetes care is developing in improving medication adherence. Implementation of pharmacist services needs to consider patients’ and pharmacists’ perspectives as service users and providers, respectively. Therefore, this study investigates both perspectives on suitable pharmacist services to improve medication adherence in Indonesia. This study used data collected based on open-ended survey questions, which were part of a survey among 917 patients and 99 pharmacists in community health centres (CHCs) and three hospitals in Surabaya, Indonesia. The open-ended questions aimed to elicit the perspective of patients and pharmacists on pharmacist services. The data were digitally recorded, transcribed and analysed in Atlas.ti 9th software using a pre-defined coding book. The data were then quantified. Most patients indicated they did not need services to improve medication adherence (67.25% CHCs vs. 63.06% hospitals). Those who did need services mostly preferred educational-based pharmacist services. This was also pharmacists’ most frequently mentioned service (45.45%). Consultation/counselling was the most common service to improve adherence according to pharmacists (66.67%) and patients (15.53% CHCs vs. 19.89% hospitals). Reminders about medication use and providing discussion sessions/seminars, and home care were other options mentioned. Limited human resources, time and pharmacists’ high workload were the most commonly identified barriers to implementing the desired pharmacist services. Patients and pharmacists had similar perspectives on the desired services to improve medication adherence, especially educational-based services and consultation/counselling. Barriers to implementing services should be considered when evaluating the current practice and preparing for pharmacists’ future role in patient care.
药师在糖尿病护理中的作用是提高药物依从性。实施药师服务需要分别考虑作为服务使用者和提供者的患者和药师的观点。因此,本研究从两个角度探讨合适的药剂师服务,以提高用药依从性在印度尼西亚。本研究使用了基于开放式调查问题收集的数据,这些问题是对印度尼西亚泗水市社区卫生中心(CHCs)和三家医院的917名患者和99名药剂师进行调查的一部分。开放式问题旨在引出患者和药剂师对药剂师服务的看法。数据以数字方式记录、转录并在Atlas中进行分析。第9个软件使用预先定义的编码书。然后对数据进行量化。大多数患者表示他们不需要服务来改善药物依从性(67.25%的中医院对63.06%的医院)。那些确实需要服务的人大多更喜欢以教育为基础的药剂师服务。这也是药剂师提及最多的服务(45.45%)。药师(66.67%)和患者(15.53%的中医院对19.89%的医院)认为咨询/辅导是改善依从性最常见的服务。提醒药物使用、提供讨论会议/研讨会和家庭护理是被提及的其他选择。有限的人力资源、时间和药剂师的高工作量是实施所需药剂师服务的最常见障碍。患者和药剂师对改善服药依从性所需的服务,特别是以教育为基础的服务和咨询/咨询有相似的看法。在评估当前实践和为药剂师在病人护理中的未来角色做准备时,应考虑实施服务的障碍。
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引用次数: 0
Clinical impact of comprehensive medication management services offered to geriatric and hypertensive patients 老年及高血压患者综合用药管理服务的临床效果
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-28 DOI: 10.1093/jphsr/rmad028
C. P. Rezende, M. Nascimento, Sabrina Gonçalves Ferreira, Bruna Damázio Santos, Carina de Morais Neves, Grazielli Cristina Batista de Oliveira, Y. A. Nascimento, Djenane Ramalho-de-Oliveira
To assess the clinical impact of comprehensive medication management (CMM) services offered to geriatric and hypertensive patients in primary health care in Brazil. A quasi-experimental study was carried out with patients followed up in primary care in three Brazilian cities (n = 346). McNemar’s test was used to assess the clinical impact of the service. A total of 1308 drug therapy problem (DTPs) were identified and 581 (44.4%) were resolved. Among the DTPs, the majority were related to non-adherence to therapy (23.9%; n = 313) or the need for additional medications (18.2%; n = 238). It was observed an increase in the proportion of people who had their blood pressure controlled at the last visit when compared with the first visit. This study indicates that the CMM service can contribute to achieving blood pressure control in geriatric and hypertensive patients. The frequency of DTPs was high in the studied population, but many DTPs were resolved by pharmacists.
评估巴西初级卫生保健机构向老年和高血压患者提供的综合药物管理(CMM)服务的临床影响。一项准实验研究对巴西三个城市的初级保健患者进行了随访(n = 346)。McNemar的测试被用来评估这项服务的临床影响。共发现药物治疗问题1308个,解决581个(44.4%)。在dtp中,大多数与不坚持治疗有关(23.9%;N = 313)或需要额外药物(18.2%;N = 238)。与第一次就诊相比,在最后一次就诊时血压得到控制的患者比例有所增加。本研究提示CMM服务有助于实现老年和高血压患者的血压控制。研究人群中dtp的发生率较高,但许多dtp是由药剂师解决的。
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引用次数: 0
Emergency contraception – pharmacists’ knowledge and attitude on emergency contraceptives’ dispensing practices 紧急避孕——药师对紧急避孕药具配药的知识和态度
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-28 DOI: 10.1093/jphsr/rmad026
W. Akande-Sholabi, Valerie Dehinde-Joseph, S. J. Showande
Emergency contraceptives have the potential to reduce health complications in women with unintended/unwanted pregnancies. Access to availability and use of emergency contraceptive pills (ECPs) is influenced by pharmacist knowledge and attitudes, and there are limited data in Nigeria on pharmacists’ ECPs dispensing practices. This study assessed pharmacists’ knowledge, attitude and practice towards the use of emergency contraceptives. A cross-sectional study conducted among 100 community pharmacists in Ibadan metropolis, Nigeria with the use of a self-administered structured questionnaire. The questionnaire contained Likert-type 17-item knowledge, 9-item attitude and 15-item practice scales. The scales utilised 5–7 graded responses. The scaled score was graded as good and poor knowledge, positive and negative attitude and high, moderate or low-level practice of emergency contraception. The ability to predict the level of practice of emergency contraception, based on the pharmacist’s knowledge and attitude towards the use of ECP, was determined with hierarchical multiple regression as P < 0.05. Good knowledge of emergency contraceptives was displayed by 51.5% of the pharmacists, and 51.9% had a positive attitude towards the use of ECPs. The level of ECP dispensing practices was high among 43.4% of pharmacists and low among 30.1% of pharmacists. More than 30% of the pharmacists offer a high level of educational services practice for ECPs. Pharmacists’ knowledge (β = 0.348, P = 0.002) and attitude (β = −0.302, P = 0.007) were predictive of the dispensing practice of ECPs. The community pharmacists have good knowledge of emergency contraceptive use and showed a positive attitude towards the dispensing of emergency contraceptive pills.
紧急避孕药具有可能减少意外怀孕/意外怀孕妇女的健康并发症。获得和使用紧急避孕药受药剂师的知识和态度的影响,尼日利亚关于药剂师分发紧急避孕药做法的数据有限。本研究评估药师对紧急避孕药具使用的知识、态度和做法。在尼日利亚伊巴丹市的100名社区药剂师中进行了一项横断面研究,采用自我管理的结构化问卷。问卷包含李克特式17项知识量表、9项态度量表和15项实践量表。量表采用5-7级的回答。量表得分分为了解紧急避孕知识的好与差、态度的积极与消极、做法的高、中、低。基于药师对ECP使用的知识和态度预测紧急避孕实践水平的能力,经层次多元回归检验,P < 0.05。51.5%的受访药师对紧急避孕药具有一定的了解,51.9%的受访药师对ECPs的使用持积极态度。43.4%的药师ECP调剂水平高,30.1%的药师ECP调剂水平低。超过30%的药剂师为ecp提供高水平的教育服务实践。药师知识(β = 0.348, P = 0.002)和态度(β = - 0.302, P = 0.007)对ECPs配药行为有预测作用。社区药师对紧急避孕药的使用有较好的认识,对紧急避孕药的发放持积极态度。
{"title":"Emergency contraception – pharmacists’ knowledge and attitude on emergency contraceptives’ dispensing practices","authors":"W. Akande-Sholabi, Valerie Dehinde-Joseph, S. J. Showande","doi":"10.1093/jphsr/rmad026","DOIUrl":"https://doi.org/10.1093/jphsr/rmad026","url":null,"abstract":"\u0000 \u0000 \u0000 Emergency contraceptives have the potential to reduce health complications in women with unintended/unwanted pregnancies. Access to availability and use of emergency contraceptive pills (ECPs) is influenced by pharmacist knowledge and attitudes, and there are limited data in Nigeria on pharmacists’ ECPs dispensing practices. This study assessed pharmacists’ knowledge, attitude and practice towards the use of emergency contraceptives.\u0000 \u0000 \u0000 \u0000 A cross-sectional study conducted among 100 community pharmacists in Ibadan metropolis, Nigeria with the use of a self-administered structured questionnaire. The questionnaire contained Likert-type 17-item knowledge, 9-item attitude and 15-item practice scales. The scales utilised 5–7 graded responses. The scaled score was graded as good and poor knowledge, positive and negative attitude and high, moderate or low-level practice of emergency contraception. The ability to predict the level of practice of emergency contraception, based on the pharmacist’s knowledge and attitude towards the use of ECP, was determined with hierarchical multiple regression as P < 0.05.\u0000 \u0000 \u0000 \u0000 Good knowledge of emergency contraceptives was displayed by 51.5% of the pharmacists, and 51.9% had a positive attitude towards the use of ECPs. The level of ECP dispensing practices was high among 43.4% of pharmacists and low among 30.1% of pharmacists. More than 30% of the pharmacists offer a high level of educational services practice for ECPs. Pharmacists’ knowledge (β = 0.348, P = 0.002) and attitude (β = −0.302, P = 0.007) were predictive of the dispensing practice of ECPs.\u0000 \u0000 \u0000 \u0000 The community pharmacists have good knowledge of emergency contraceptive use and showed a positive attitude towards the dispensing of emergency contraceptive pills.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47319303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Physicians’ attitudes toward expanding the role of community pharmacists in Al Ain, United Arab Emirates 阿拉伯联合酋长国艾因市医师对扩大社区药剂师作用的态度
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-27 DOI: 10.1093/jphsr/rmad030
Mohammad Alahmad, Aya Sadeq, Sham ZainAlAbdin, Moatasem Abdelsabour, Attaallah Muhaisen, Albaraa Fathelrahman, Munther S. Alnajjar, S. Aburuz
To explore physicians’ attitudes toward expanding the role of community pharmacists to include traditional and advanced pharmaceutical care activities. In addition, the study assessed factors influencing physicians’ attitudes. A cross-sectional study was conducted among physicians in Al Ain, United Arab Emirates (UAE), in 2019. Participants were randomly selected and were practicing physicians in Al Ain. A questionnaire was hand-delivered and consisted of four sections: demographic information, general attitudes, attitudes towards traditional and attitudes towards advanced pharmaceutical care activities. Two hundred twenty-nine (response rate ~92.0%) practicing physicians agreed to participate in this study. The majority (95.1%, n = 218) agreed with expanding pharmacists’ activities beyond their traditional role and facilitating pharmacists’ access to patients’ medical records (85.4%, n = 196). Physicians’ overall attitudes toward traditional pharmaceutical care were positive (~80%, n = 183), particularly regarding improving patient adherence, providing drug information, patient counselling, and identifying, monitoring, and resolving drug-related problems. On the other hand, physicians were partially accepting of pharmacists’ involvement in advanced pharmaceutical care services (~46%, n = 108). The majority of them considered pharmacists competent in generic substitution (75.6%, n = 173) and in adjusting drug therapy based on agreed protocols (56.1%, n = 128). However, they considered them less competent for therapeutic substitution (41.5%, n = 95), treating certain minor illnesses (41.5%, n = 95), and refilling repeat prescriptions independently (22%, n = 50). Overall, physicians’ attitudes were positive toward 9 out of 12 expanded activities for community pharmacists. This study has shown that UAE physicians have agreed that the pharmacist’s role should extend beyond dispensing medications. Physicians have also positive attitudes toward expanding community pharmacists’ activities to include all of the traditional pharmaceutical care activities. On the other hand, physicians had a negative attitude toward most of the advanced activities.
探讨医生对扩大社区药师的作用,使其包括传统和先进的药学服务活动的态度。此外,本研究还评估了影响医生态度的因素。2019年,在阿拉伯联合酋长国(UAE)艾因的医生中进行了一项横断面研究。参与者是随机选择的,都是艾因的执业医生。问卷由四部分组成:人口统计信息、一般态度、对传统的态度和对先进药学服务活动的态度。229名执业医师同意参与本研究,回复率为92.0%。大多数(95.1%,n = 218)同意扩大药剂师在其传统角色之外的活动,并促进药剂师获取患者医疗记录(85.4%,n = 196)。医生对传统药学服务的总体态度是积极的(约80%,n = 183),特别是在提高患者依从性、提供药物信息、患者咨询以及识别、监测和解决药物相关问题方面。另一方面,医生部分接受药师参与高级药学服务(~46%,n = 108)。他们中的大多数认为药师在仿制药替代(75.6%,n = 173)和根据商定方案调整药物治疗(56.1%,n = 128)方面有能力。然而,他们认为他们在治疗替代(41.5%,n = 95)、治疗某些小病(41.5%,n = 95)和独立配药重复处方(22%,n = 50)方面的能力较差。总体而言,医生对12个社区药剂师扩大活动中的9个持积极态度。这项研究表明,阿联酋的医生已经同意,药剂师的作用应该超出配药。医生也对扩大社区药剂师的活动,包括所有传统的药学服务活动持积极态度。另一方面,医生对大多数高级活动持否定态度。
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引用次数: 0
The link between knowledge and practices in relation to herbal supplement use: for a rapid transfer of knowledge in the field of phytovigilance and pharmacovigilance health care systems 草药补充剂使用方面的知识和实践之间的联系:植物警戒和药物警戒卫生保健系统领域的知识快速转移
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-26 DOI: 10.1093/jphsr/rmad021
Naseem Mohammed Abdulla, I. Blair, B. Ádám, A. Oulhaj, A. Jairoun
The use of health supplements (HSs) is increasing globally. It is essential to better understand health care providers’ knowledge, attitudes and practices (KAP) regarding HS use and their associated adverse events (AEs). Thus, we conducted a cross-sectional study of health care professionals in Dubai. Four hundred and twenty-seven health care professionals from hospitals, clinics (public and private) and community pharmacies completed an online questionnaire that collected demographic data and enquired about their experience with HSs. Simple descriptive statistics were used to characterise participants. Based on 10 questions, a summary score was created for the overall KAP of respondents. For each question, an affirmative response scored 1 and a negative response scored 0. A total score of 10 was therefore obtainable; logistic regression was used to identify the correlates of those scores. The results showed that 18.3% (n = 78) of respondents had good KAP concerning HS, 38.9% (n = 166) had fair KAP and 42.9% (n = 183) had poor KAP. Scores were significantly higher among non-UAE nationals compared with UAE nationals (P = 0.001), among physicians and pharmacists compared with other health care practitioners (P = 0.000), and among practitioners with more than 6 years of experience compared to those with 6 years of experience or less (0.017). No association was found between KAP scores and age, marital status, employment status or educational level. Despite the popularity and widespread use of HS among the general population in Dubai, knowledge of HSs and their possible adverse effects is limited among health professionals. This was the first study to investigate this topic in the United Arab Emirates. Further policies are needed to reduce the potential for adverse events related to HS use. Additionally, educational programs are required for health care professionals to address current low levels of knowledge.
健康补充剂(HS)的使用在全球范围内不断增加。必须更好地了解卫生保健提供者对HS使用及其相关不良事件的知识、态度和做法(KAP)。因此,我们对迪拜的医疗保健专业人员进行了一项横断面研究。来自医院、诊所(公立和私立)和社区药房的427名医疗保健专业人员完成了一份在线问卷,收集了人口统计数据,并询问了他们使用HSs的经历。使用简单的描述性统计数据来描述参与者的特征。基于10个问题,为受访者的总体KAP创建了一个总结分数。对于每个问题,肯定回答得1分,否定回答得0分。因此,总分为10分;逻辑回归用于确定这些分数的相关性。结果显示,18.3%(n=78)的受访者在HS方面有良好的KAP,38.9%(n=166)的受访者有一般的KAP和42.9%(n=183)的受访者的KAP较差。非阿联酋国民的得分明显高于阿联酋国民(P=0.001),医生和药剂师的得分显著高于其他医疗从业者(P=0.000),与6年或6年以下经验的从业者相比,6年以上经验的从业者(0.017)。KAP分数与年龄、婚姻状况、就业状况或教育水平之间没有关联。尽管HS在迪拜的普通人群中很受欢迎并广泛使用,但卫生专业人员对HS及其可能的不良影响的了解有限。这是第一项在阿拉伯联合酋长国调查这一主题的研究。需要进一步的政策来减少与HS使用相关的不良事件的可能性。此外,还需要卫生保健专业人员的教育计划来解决目前知识水平低的问题。
{"title":"The link between knowledge and practices in relation to herbal supplement use: for a rapid transfer of knowledge in the field of phytovigilance and pharmacovigilance health care systems","authors":"Naseem Mohammed Abdulla, I. Blair, B. Ádám, A. Oulhaj, A. Jairoun","doi":"10.1093/jphsr/rmad021","DOIUrl":"https://doi.org/10.1093/jphsr/rmad021","url":null,"abstract":"\u0000 \u0000 \u0000 The use of health supplements (HSs) is increasing globally. It is essential to better understand health care providers’ knowledge, attitudes and practices (KAP) regarding HS use and their associated adverse events (AEs). Thus, we conducted a cross-sectional study of health care professionals in Dubai.\u0000 \u0000 \u0000 \u0000 Four hundred and twenty-seven health care professionals from hospitals, clinics (public and private) and community pharmacies completed an online questionnaire that collected demographic data and enquired about their experience with HSs. Simple descriptive statistics were used to characterise participants. Based on 10 questions, a summary score was created for the overall KAP of respondents. For each question, an affirmative response scored 1 and a negative response scored 0. A total score of 10 was therefore obtainable; logistic regression was used to identify the correlates of those scores.\u0000 \u0000 \u0000 \u0000 The results showed that 18.3% (n = 78) of respondents had good KAP concerning HS, 38.9% (n = 166) had fair KAP and 42.9% (n = 183) had poor KAP. Scores were significantly higher among non-UAE nationals compared with UAE nationals (P = 0.001), among physicians and pharmacists compared with other health care practitioners (P = 0.000), and among practitioners with more than 6 years of experience compared to those with 6 years of experience or less (0.017). No association was found between KAP scores and age, marital status, employment status or educational level.\u0000 \u0000 \u0000 \u0000 Despite the popularity and widespread use of HS among the general population in Dubai, knowledge of HSs and their possible adverse effects is limited among health professionals. This was the first study to investigate this topic in the United Arab Emirates. Further policies are needed to reduce the potential for adverse events related to HS use. Additionally, educational programs are required for health care professionals to address current low levels of knowledge.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48565173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association of chronic opioid therapy with emergency department visits and hospitalizations among super-utilizers 慢性阿片类药物治疗与急诊科就诊和住院的关系
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-26 DOI: 10.1093/jphsr/rmad011
S. Surbhi, L. J. Harris, A. Box, J. Bailey
Patients with complex medical needs and high inpatient utilization frequently use opioids for non-malignant chronic pain. We examine the association between chronic opioid therapy and healthcare utilization among high-need, high-cost patients insured by Medicare. This study is a retrospective cohort study of Medicare beneficiaries in a medically underserved metropolitan area. Patients were included in the study if they had ≥2 hospitalizations or ≥1 hospitalization and ≥2 emergency department (ED) visits in a 6-month-period preceding an index hospitalization between July 2011 and June 2014. Exclusion criteria included substance abuse, psychosis and malignancy. Multivariable negative binomial regression models assessed associations between baseline opioid medication use and subsequent ED and hospital visits for the study population and two subgroups: (1) those with chronic pain and (2) those with both chronic pain and a primary care provider. The majority of high-need, high-cost patients filled opioid prescriptions of ≥7-day supply (51%). Yet only 2.7% of patients with chronic pain received an opioid prescription of ≥7-day supply from an ED provider in the baseline period. Overall (n = 677), receipt of a ≥7-day opioid supply was positively associated with subsequent ED utilization but not subsequent hospitalization. Among those with chronic pain and ≥1 primary care practice visit (N = 481), opioid use was associated with inpatient utilization but not ED utilization. Receipt of adjuvant pain prescriptions was not protective of hospitalizations or ED visits. Chronic pain and opioid therapy are common among high-need, high-cost patients and they are independently associated with higher ED and hospital utilization. Novel patient-centred outpatient pain management strategies have potential to reduce inpatient care in this population.
具有复杂医疗需求和高住院使用率的患者经常使用阿片类药物治疗非恶性慢性疼痛。我们研究了慢性阿片类药物治疗与医疗保健利用之间的关系,这些患者是高需求、高成本的医疗保险患者。本研究是一项对医疗服务不足的大都市地区医疗保险受益人的回顾性队列研究。如果患者在2011年7月至2014年6月指数住院前6个月内住院≥2次或住院≥1次且急诊(ED)就诊≥2次,则纳入研究。排除标准包括药物滥用、精神病和恶性肿瘤。多变量负二项回归模型评估了研究人群和两个亚组的基线阿片类药物使用与随后的ED和医院就诊之间的关系:(1)慢性疼痛患者和(2)既有慢性疼痛又有初级保健提供者的患者。大多数高需求、高成本的患者使用≥7天的阿片类药物处方(51%)。然而,在基线期,只有2.7%的慢性疼痛患者从急诊科接受了≥7天供应的阿片类药物处方。总体而言(n = 677),接受≥7天阿片类药物供应与随后的ED使用呈正相关,但与随后的住院无关。在慢性疼痛和≥1次初级保健就诊的患者(N = 481)中,阿片类药物使用与住院利用率相关,而与ED利用率无关。接受辅助止痛处方对住院或急诊科就诊没有保护作用。慢性疼痛和阿片类药物治疗在高需求、高成本的患者中很常见,它们与较高的ED和医院使用率独立相关。新的以患者为中心的门诊疼痛管理策略有可能减少这一人群的住院治疗。
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引用次数: 0
Association between self-medication with antibiotics and purchase of brand-name drugs: analysis of a national survey in Peru 使用抗生素自行用药与购买名牌药物之间的关系:秘鲁一项全国性调查的分析
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-24 DOI: 10.1093/jphsr/rmad015
Jerry K. Benites-Meza, P. Herrera-Añazco, Arón A Santillán-Rodríguez, Carlos J. Zumarán-Nuñez, Luz C. Barturén-Alvarado, Vicente A Benites Zapata
To determine the association between self-medication with antibiotics (SMA) and purchase of brand-name drugs in Peru. A secondary analysis was conducted using a nationally representative survey from 2014 to 2016. The exposure variable was self-medication (SM), which is defined as the purchase of drugs for self-administration without a medical prescription. The study outcome was the purchase of brand-name drugs (yes/no). Sociodemographic variables, such as health insurance and type of institution, were considered as confounders. To assess the association between SMA and the purchase of brand-name drugs, the crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) were calculated with their confidence intervals at 95% (95% CI) using a Poisson-type generalized linear model and considering the complex survey design. A total of 1862 participants were analysed; 54.4% of the participants were women with a mean age of 39.3 years. The prevalence rate of SMA was 54.3%, whereas that of the purchase of brand-name drugs was 55.3%. The adjusted Poisson regression analysis showed an association between SMA and the purchase of brand-name drugs (aPR = 1.28; 95% CI: 1.18–1.37; P < 0.001). It was found that 5 of 10 respondents SMA. Approximately 6 of 10 respondents that SMA used brand-name drugs. SMA is associated with a higher probability of purchasing brand-name drugs.
在秘鲁,确定抗生素自我用药(SMA)与购买名牌药物之间的关系。第二次分析是在2014年至2016年进行的一项具有全国代表性的调查。暴露变量为自我用药(SM),定义为在没有医生处方的情况下自行购买药物。研究结果是购买品牌药(是/否)。社会人口变量,如医疗保险和机构类型,被认为是混杂因素。为了评估SMA与购买名牌药之间的关系,采用poisson型广义线性模型并考虑复杂的调查设计,计算粗患病率(cPR)和调整患病率(aPR),其置信区间为95% (95% CI)。总共分析了1862名参与者;54.4%的参与者是女性,平均年龄为39.3岁。SMA的患病率为54.3%,而购买名牌药的患病率为55.3%。经校正泊松回归分析,SMA与品牌药购买存在相关性(aPR = 1.28;95% ci: 1.18-1.37;P < 0.001)。结果发现,10名受访者中有5名SMA。大约6 / 10的受访者表示SMA使用了品牌药。SMA与购买名牌药物的可能性较高有关。
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引用次数: 0
Treatment-related problems and their cost among patients hospitalised with asthma exacerbation 哮喘恶化住院患者的治疗相关问题及其费用
IF 0.7 Q4 HEALTH CARE SCIENCES & SERVICES Pub Date : 2023-04-20 DOI: 10.1093/jphsr/rmad027
Haya Tabaza, R. A. Abu Farha, A. Naser, O. Awwad
Treatment-related problems (TRPs) are events associated with patients’ managements adversely affecting the patients’ optimum outcomes. Asthma is a common chronic condition characterised by acute episodes of exacerbation. In Jordan, data regarding TRPs in asthma exacerbations are lacking. This study aimed to identify/classify TRPs among patients hospitalised with asthma exacerbation in Jordan and to estimate their costs. A retrospective observational cohort study (Jan 2017–Jul 2021) was conducted in a tertiary centre in Jordan. TRPs were identified during hospitalisation and at discharge using a standardised classification tool and assessed for their severity. Potential cost savings (the extra cost of medication/procedure associated with TRPs) and potential cost avoidance (the cost avoidable by preventing TRPs and their associated adverse drug events) were investigated. A total of 494 cases were included in the study. A total of 3933 TRPs (2931 during hospitalisation; 1002 at discharge) were identified with a mean of 4.7 ± 2.2 and 2.0 ± 1.2 TRPs during hospitalisation and at discharge, respectively. ‘Unnecessary drug therapy’ (40.8%) and ‘ineffective/incomplete drug therapy’ (44.1%) were the most common TRPs during hospitalisation and at discharge, respectively. In 82% of the cases, systemic corticosteroids were administered for a longer period than recommended. Most of the TRPs were of moderate severity. Potential cost savings and cost avoidance were estimated to be USD 30 919.3 and USD 734 179.9 respectively, with a total cost of USD 766 046.8. The prevalence and cost of TRPs among asthma exacerbations are relatively high. Interventions to reduce such problems are necessary to avoid the negative clinical outcomes of TRPs and their economic burden on patients and healthcare systems.
治疗相关问题(TRPs)是与患者管理相关的事件,对患者的最佳结果产生不利影响。哮喘是一种常见的慢性疾病,其特征是急性发作。在约旦,缺乏关于哮喘加重中trp的数据。本研究旨在识别/分类约旦哮喘加重住院患者中的trp,并估计其成本。一项回顾性观察队列研究(2017年1月至2021年7月)在约旦的一个三级中心进行。在住院期间和出院时使用标准化分类工具确定trp,并评估其严重程度。潜在的成本节约(与trp相关的额外药物/程序成本)和潜在的成本避免(通过预防trp及其相关药物不良事件可避免的成本)进行了调查。研究共纳入494例病例。总共3933例trp(住院期间2931例;1002例(出院时),住院和出院时trp平均值分别为4.7±2.2和2.0±1.2。“不必要的药物治疗”(40.8%)和“无效/不完全药物治疗”(44.1%)分别是住院和出院时最常见的trp。在82%的病例中,全身性皮质类固醇的使用时间比推荐的要长。大多数trp的严重程度为中等。潜在的成本节约和成本避免估计分别为30 919.3美元和734 179.9美元,总成本为766 046.8美元。哮喘加重患者中trp的患病率和费用相对较高。减少此类问题的干预措施是必要的,以避免trp的负面临床结果及其对患者和卫生保健系统的经济负担。
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引用次数: 1
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Journal of Pharmaceutical Health Services Research
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