The article explores stakeholders’ engagement before the implementation of the pooled procurement program (PPP) and the challenges encountered by the National Catholic Health Service (NCHS). The article used a qualitative research approach and a multiple case study design to solicit the views of healthcare service providers and policymakers within the NCHS. The article revealed that the National Catholic Health Secretariat (the secretariat) advocated through the Ghana Catholic Bishops Conference through the bishop responsible for health. Subsequently, the Diocesan Directors, managers, accountants, suppliers and storekeepers of all health facilities were engaged to understand their respective roles before implementing the PPP. The challenges faced came from all institutions that played a crucial role in the smooth running of the PPP. These institutions were the hospitals, suppliers, Food and Drugs Authority (FDA), National Health Insurance Scheme (NHIS) and the secretariat. The findings indicated that some managers in the hospitals were not committed to the program. Whereas, some suppliers purposely weakened the position of some other suppliers after awarding tenders by carrying their commodities directly to the hospitals and reducing the price marginally. The challenge from the NHIS perspective was the payment delays. The FDA was not proactive with post-market surveillance to check substandard commodities in the hospitals. However, in the secretariat, the deficiency was the weak systems to monitor real-time activities of the PPP at the hospitals. The article suggests that to ensure the right synergies to meet organizational objectives, the NCHS is advised to increasingly focus on identifying and sustaining the PPP by communicating with other stakeholders to achieve their mutual needs. Such a process would allow the more knowledgeable design of resource needs and allocation of scarce resources to their areas of interest.
{"title":"Stakeholder engagement in the pooled procurement program in Ghana","authors":"Kofi Ameyaw Domfeh, N. N. Appiah-Agyekum","doi":"10.1093/jphsr/rmad006","DOIUrl":"https://doi.org/10.1093/jphsr/rmad006","url":null,"abstract":"\u0000 \u0000 \u0000 The article explores stakeholders’ engagement before the implementation of the pooled procurement program (PPP) and the challenges encountered by the National Catholic Health Service (NCHS).\u0000 \u0000 \u0000 \u0000 The article used a qualitative research approach and a multiple case study design to solicit the views of healthcare service providers and policymakers within the NCHS.\u0000 \u0000 \u0000 \u0000 The article revealed that the National Catholic Health Secretariat (the secretariat) advocated through the Ghana Catholic Bishops Conference through the bishop responsible for health. Subsequently, the Diocesan Directors, managers, accountants, suppliers and storekeepers of all health facilities were engaged to understand their respective roles before implementing the PPP. The challenges faced came from all institutions that played a crucial role in the smooth running of the PPP. These institutions were the hospitals, suppliers, Food and Drugs Authority (FDA), National Health Insurance Scheme (NHIS) and the secretariat. The findings indicated that some managers in the hospitals were not committed to the program. Whereas, some suppliers purposely weakened the position of some other suppliers after awarding tenders by carrying their commodities directly to the hospitals and reducing the price marginally. The challenge from the NHIS perspective was the payment delays. The FDA was not proactive with post-market surveillance to check substandard commodities in the hospitals. However, in the secretariat, the deficiency was the weak systems to monitor real-time activities of the PPP at the hospitals.\u0000 \u0000 \u0000 \u0000 The article suggests that to ensure the right synergies to meet organizational objectives, the NCHS is advised to increasingly focus on identifying and sustaining the PPP by communicating with other stakeholders to achieve their mutual needs. Such a process would allow the more knowledgeable design of resource needs and allocation of scarce resources to their areas of interest.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42433449","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}
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.
{"title":"Predicting the effect of pharmacist’s communication with patients: medical communication analysis using facial responses","authors":"Yukina Miyagi, Saori Gocho, Naoko Yamaguchi, Yuka Miyachi, Chika Nakayama, S. Okada, Taeyuki Oshima","doi":"10.1093/jphsr/rmad029","DOIUrl":"https://doi.org/10.1093/jphsr/rmad029","url":null,"abstract":"\u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45816614","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}
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.
{"title":"What constitutes evidence for over-the-counter medicines? A cross-sectional study of community pharmacists’ knowledge, attitude, and practices","authors":"Lik De Chun, M. Anwar","doi":"10.1093/jphsr/rmad017","DOIUrl":"https://doi.org/10.1093/jphsr/rmad017","url":null,"abstract":"\u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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).\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43824955","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}
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.
{"title":"Clinical impact of comprehensive medication management services offered to geriatric and hypertensive patients","authors":"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","doi":"10.1093/jphsr/rmad028","DOIUrl":"https://doi.org/10.1093/jphsr/rmad028","url":null,"abstract":"\u0000 \u0000 \u0000 To assess the clinical impact of comprehensive medication management (CMM) services offered to geriatric and hypertensive patients in primary health care in Brazil.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43244122","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}
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.
{"title":"Perspectives of pharmacists and patients on pharmacist services to improve medication adherence among patients with diabetes in Indonesia","authors":"B. Presley, W. Groot, E. Setiawan, M. Pavlova","doi":"10.1093/jphsr/rmad025","DOIUrl":"https://doi.org/10.1093/jphsr/rmad025","url":null,"abstract":"\u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42834952","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}
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":null,"pages":null},"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}
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.
{"title":"Physicians’ attitudes toward expanding the role of community pharmacists in Al Ain, United Arab Emirates","authors":"Mohammad Alahmad, Aya Sadeq, Sham ZainAlAbdin, Moatasem Abdelsabour, Attaallah Muhaisen, Albaraa Fathelrahman, Munther S. Alnajjar, S. Aburuz","doi":"10.1093/jphsr/rmad030","DOIUrl":"https://doi.org/10.1093/jphsr/rmad030","url":null,"abstract":"\u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49052183","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}
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.
{"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":null,"pages":null},"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}
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.
{"title":"Association of chronic opioid therapy with emergency department visits and hospitalizations among super-utilizers","authors":"S. Surbhi, L. J. Harris, A. Box, J. Bailey","doi":"10.1093/jphsr/rmad011","DOIUrl":"https://doi.org/10.1093/jphsr/rmad011","url":null,"abstract":"\u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48357591","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}
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.
{"title":"Association between self-medication with antibiotics and purchase of brand-name drugs: analysis of a national survey in Peru","authors":"Jerry K. Benites-Meza, P. Herrera-Añazco, Arón A Santillán-Rodríguez, Carlos J. Zumarán-Nuñez, Luz C. Barturén-Alvarado, Vicente A Benites Zapata","doi":"10.1093/jphsr/rmad015","DOIUrl":"https://doi.org/10.1093/jphsr/rmad015","url":null,"abstract":"\u0000 \u0000 \u0000 To determine the association between self-medication with antibiotics (SMA) and purchase of brand-name drugs in Peru.\u0000 \u0000 \u0000 \u0000 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.\u0000 \u0000 \u0000 \u0000 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).\u0000 \u0000 \u0000 \u0000 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.\u0000","PeriodicalId":16705,"journal":{"name":"Journal of Pharmaceutical Health Services Research","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46692217","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}
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