Exploratory research in clinical and social pharmacy最新文献

Background

Agile coaching, recognized as a more advanced methodology compared to education, is hypothesized to yield superior outcomes in enhancing psychological safety perception.

Objective

Investigating the effectiveness of agile interventions versus no intervention on psychological safety perception, this randomized controlled trial aimed to clarify outcomes.

Methods

The survey sample consisted of 54 licensed pharmacists, with each group comprising 18 participants: E1 underwent Agile Coaching, E2 underwent Agile Education, and C served as the control. After six weeks, psychological safety perception was measured using a validated scale, and statistical analyses, including the Kruskal-Wallis test and Mann-Whitney U test, were conducted.

Results

The group undergoing agile coaching showed the most substantial enhancements in psychological safety perception compared to others. Mann-Whitney U test revealed no significant difference in psychological safety perception between E1 and E2 groups before (Z = −0.938, p = 0.348) and after intervention (Z = −1.269, p = 0.204). Significant differences were observed between E1 and C both before (Z = −2.693, p = 0.007) and after intervention (Z = −1.414, p = 0.157). Significant differences were found between E2 and C before (p = 0.038) but not after intervention (p = 0.962).

Conclusions

The findings suggest that agile coaching could be an effective intervention for enhancing psychological safety in organizational settings, particularly in community pharmacies. Further research is warranted to explore long-term effects and generalize findings to broader contexts.

Use of automated dispensing cabinets (ADCs) is increasing in hospital settings. ADCs bring various potential benefits, among which are improvements to patient safety and reduction of medication errors. A core function of ADCs is to prevent medication stock outs by triggering an order when stock is reaching low levels. A quantifiable patient safety measure is the occurrence of omitted or delayed doses, which can range in severity from being negligible, to potentially fatal. The purpose of this review is to identify and synthesise the existing evidence regarding the impact of ADCs situated in secondary and tertiary care inpatient settings, on the rate of omitted and delayed doses as a specific subsection of medication errors. In April 2024 searches were conducted in Embase, PubMed and CINAHL, with additional articles discovered through citation searching and from colleagues. A total of 375 articles were returned from the search. Nine articles met the inclusion criteria. The most common reason for exclusion was due to lack of relevance. The included papers were focused on centres which had implemented six or fewer ADCs. The studies mostly presented findings which suggest ADCs have a positive impact on the rate of omitted or delayed doses, although crucially only two papers correlated missed doses due to unavailability of medications The studies highlighted other factors which should be considered prior to the implementation of ADCs. Factors included staffing requirement, type of stock held in the cabinets, and interoperability with other systems. Studies only reported omitted or missed doses, none reported results on delayed doses. It is widely accepted that ADCs can prevent medication unavailability but there is a paucity of evidence linking the improved availability of medications through the utilisation of ADCs with the perceived impact on missed or delayed doses. Further multi-centre studies are needed to determine this causality.

Parkinson's disease (PD) is a progressive neurodegenerative disease which primarily presents with the core symptoms of rigidity, postural instability, tremor, and bradykinesia. Non-adherence to prescribed PD treatments can have significant ramifications, such as poor symptom control and greater disease burden. Reasons for poor adherence are multifaceted, particularly when medication regimens are complex and often based on perceptual and practical barriers. Additionally, engaging fully non-adherent patients in research is challenging since they may have dropped out of service provision, yet their contribution is vital to fully understand the rationale for non-adherence.

This paper aims to present a case study on the perspectives of one person with PD, a participant in a previously published qualitative study investigating the barriers and facilitators to medication adherence in PD. In this paper, the participant's diagnostic journey is described, and experiences of medical consultations are summarised to explain their reasons for not adhering to any of the standard UK PD treatments prescribed. The participant's preferences for using Vitamin B1 (thiamine) injections to manage the symptoms are reported and the rationale for doing so is discussed. We consider the case through the lens of a behavioural science approach, drawing on health psychology theory, the Theoretical Domains Framework (TDF), to inform the review and the practical challenges faced when analysing the data for this participant. Implications for pharmacy practice, in particular, are also put forward with view to ensuring that patients such as Mr. Wilkinson are provided with the opportunity to discuss treatment choices and self-management of long-term conditions such as PD. We also discuss the importance of reaching under-represented members of the population in medication adherence research, which embraces the principles of equality, diversity, and inclusion in research.

Interrogating the literature is among the first steps a researcher undertakes when actuating a research project or also when any scholar might seek to know what has been done in an area, best practices for conducting a certain activity, or simply to seek answers for a question ranging from one's own personal curiosity to those that might affect departmental or institutional guidance. Decisions on the type of review process to undertake is one that is not taken lightly. This methods commentary outlines the reasons for conducting a scoping review versus a systematic review for topics related to pharmacy education. Considerations for conducting the scoping review are outlined including considerations for writing a protocol prior to conducting a scoping review, to potential platforms to use for transparency of sharing data, processes related to guidelines for data extraction and types of search strategies utilized.

Background

Thai pharmacists' roles have increasingly shifted to a system-focused role in providing public health services. A competency framework in this area is essential to workforce development.

Objective

This study aimed to summarize and synthesize the literature on pharmaceutical public health competencies of Thai pharmacists.

Methods

The Scopus, MEDLINE, and Web of Science (Clarivate) databases were searched. The search criteria included “public health”, “health promotion”, “primary care”, “community pharmacy”, “pharmacy” and “pharmacist”. Documents published in English and Thai between January 2011 and December 2020 were also examined. Unpublished documents were included. A 3-step inductive coding technique was used to develop the competency framework. To validate the findings, a 2-round, modified Delphi method was employed with 20 Thai pharmaceutical specialists between August 2022 and January 2023. The Scale-level Content Validity Index (S-CVI) was used to assess validity.

Results

The database search yielded 1429 articles. Fifty-seven articles were selected. The analysis identified 5 competency domains. The domains, along with their related competency elements and behavioral statements, were provided for expert assessment. The S-CVI scores in the first and second rounds were 0.78 and 0.93, respectively. The terminology and categories of competencies have been improved. This outcome resulted in a pharmaceutical public health competency framework for Thai pharmacists. The framework consists of 5 competency domains: 1) individual and family health promotion (3 competency elements with 10 behavioral statements), 2) community empowerment for well-being communities (6 competency elements with 23 behavioral statements), 3) information management and evidence-based practice (3 competency elements with 10 behavioral statements), 4) communication for health promotion (3 competency elements with 6 behavioral statements), and 5) pharmacoepidemiology and support for public health emergencies and epidemics (2 competency elements with 5 behavioral statements).

Conclusion

Pharmaceutical public health competencies for Thai pharmacists were developed through extensive literature review and expert consultation.

Background

In many European countries, flu vaccination coverage rates are below the 75% target. During the COVID-19 pandemic, many pharmacists around Europe were involved as vaccine administrators and demonstrated positive results in improving vaccine uptake. This paper explores the challenges, accomplishments, and best practices of various European pharmacists' associations in administering vaccines and positively contributing to public health.

Methods

Eight pharmacists representing various associations from different countries across Europe (Italy, Belgium, Poland, Portugal, France, and Germany) convened to discuss their role as vaccination providers, the advantages, and strategies for improvement, and to identify barriers and gaps in the vaccination administration process, especially focusing on the administration of seasonal flu vaccines.

Results

Currently, 15 European countries allow community pharmacists to dispense and administer flu vaccines. Among the ones that attended the meeting, Portugal initiated the flu immunization program at the pharmacy earliest, before the COVID era, but in other countries, the process started only in the last couple of years. Initial hesitancy and reluctance by other HCPs or institutions were overcome as the pilot projects showed positive and cost-effective public health results. Today, pharmacists are considered crucial professional figures to provide immunization services against COVID-19, the flu, and other vaccine-preventable diseases, and pursue important public health goals.

Key takeaways to enhance the pharmacist's role in providing immunization services against vaccine-preventable diseases include improving interaction with policymakers and the public, generating real-world evidence highlighting public health benefits, and ensuring ongoing professional education and training for pharmacists.

Conclusion

Vaccinating pharmacists are gaining recognition of their role and the benefits derived from their broader involvement in the healthcare system, including immunization programs. Further efforts are needed in each country for an adequate recognition of the profession and a broader utilization of pharmacy services to exploit the benefit of immunization, especially against the flu.

Background

Antipsychotics are commonly administered to nursing home residents with dementia, despite the associated risk of severe adverse events.

Objective

This study aimed to explore healthcare professionals' experiences in caring for nursing home residents with dementia, with a focus on rationales behind the use of antipsychotics.

Method

Twelve semi-structured interviews with healthcare professionals' from Danish nursing homes were conducted and analyzed using the method Systematic Text Condensation.

Results

Nonpharmacological interventions were reported as the primary approach to care and the first-choice treatment for behavioral and psychological symptoms of dementia (BPSD). Use of antipsychotics was considered to serve as a last resort, reserved for residents with severe symptoms. However, most informants preferred a more limited use. The study identified four main barriers to reduce the use of antipsychotics: “Scarcity of resources”, “Perceiving antipsychotic use to provide relieve”, “Reluctance towards deprescribing” and “Limited access to medical counseling”, and three potential enablers: “Updating knowledge and nonpharmacological competencies”, “Management support and clear procedures” and “Regularity in interdisciplinary collaboration”.

Conclusion

The treatment and care were reported as primarily following guidelines in BPSD. Several barriers were perceived to challenge the healthcare professionals' preference of limited use of antipsychotics. To further reduce the use, this study highlights the importance of understanding the adverse effects caused by limited resources, enhancing employee knowledge and competencies and ensuring regular interprofessional collaboration for assessing and reassessing the need to use antipsychotics.

Introduction

Community pharmacists (CPs) are the most accessible healthcare professionals in primary care due to pharmacies' open-door policy and convenience, resulting in high patient and prescription volumes, and numerous free-of-charge consultations. Therefore, they are at high risk for burnout.

Objectives

The primary objective of this study was to assess the levels of burnout among community pharmacists in Greece, marking the first investigation of its kind within the country. Additionally, this study aimed to explore potential correlations between demographic variables and other health-related factors with burnout scores.

Methods

This study used a quantitative cross-sectional design involving two validated questionnaires(the Greek version of Maslach (MBI) questionnaire and the SF-36 questionnaire). Prior to data collection, all the relevant documentation was approved by the Metropolitan College Research Ethics Committee and was adopted under the auspices of the Panhellenic Pharmaceutical Association. Random sampling was used. Data collection period was July to August 2022.

Results

A total of 368 responses were included in the analysis, with the majority being pharmacy-owners (n = 292, 79.3%). Notably, a significant proportion of respondents were female practitioners working within community pharmacy settings (n = 230, 62.5%). Analysis revealed that the sample exhibited low levels of personal achievement (M = 30.99, SD = 6.41), high levels of emotional exhaustion (M = 41.73, SD = 6.94), and moderate levels of depersonalization (M = 23.38, SD = 3.78), indicative of substantial occupational burnout. Furthermore, gender had a discernible impact on depersonalization, with women scoring higher than men (t = −3.29, p < 0.01). Pharmacists who identified medicine shortages as their primary challenge in daily practice reported lower emotional burnout and depersonalization, albeit with a diminished sense of accomplishment (t = −2.62, p < 0.01).

Conclusions

This study sheds light on burnout levels and health-related quality of life among community pharmacists in Greece.

Introduction

In the dynamic landscape of healthcare, pharmacists play a critical role in ensuring the well-being of communities, and having solid professional organisations to support pharmacists is essential in crucial activities, including continuing education, advocacy and establishing service standards. Eight pharmacy organisations play vital roles in representing pharmacists in various sectors and collectively contribute to developing, regulating, and promoting the pharmacy profession in Australia. However, a notable lack of female representation in these organisations' leadership roles has led to an increased focus on gender balance and equity.

Objective

To determine if the gender distribution in pharmacy leadership aligns with the pharmacy workforce in Australia (64% women) and how it has changed in the five years since our last study on the issue.

Setting

Australia.

Method

Eight key Australian pharmacy organisations were identified. The website for each organisation was accessed, and data were recorded for their 2023 boards/committees/councils based on annual reports. Data recorded include name, number of males, number of females, and the gender of the president/chair of each board/committee/council.

Results

Data were obtained for 340 separate professional committee members from the eight organisations (including state/territory branches) in 2023. Gender balance in pharmacy organisations has increased significantly since 2018, with women's representation in leadership positions now at 58% (47% 2018).

Conclusion

Gender equity within Australian pharmacy professional organisations has significantly progressed.

Introduction: Autonomy is considered a vital principle of professionalism. In recent years, despite important advances, the Pharmacy and pharmacists' autonomy has been questioned due to conflicts that jeopardize the consolidation of this profession in the division of work in health. Objective: to understand the construct of autonomy based on perceptions of formal leaders associated with professional organizations. Methods: A qualitative study was conducted through interviews with key informants. The data obtained were submitted to content analysis. Results: Perceptions about the autonomy in pharmaceutical practice were categorized according to strengths, weaknesses, opportunities, and threats to this construct. Conclusion: The findings allowed us to understand the autonomy of pharmaceutical practice in Brazil, generate hypotheses about the future of Pharmacy, and build strategies to maintain its occupational status.