Pharmacy Administration Research Articles

FIP Cape Town 2024: Social and Administrative Pharmacy

Accepted abstracts under the theme: Social and Administrative Pharmacy (n=86)

Validation of a Questionnaire to Assess Patient Satisfaction with an Automated Drug Dispensing System.

Automated drug dispensing systems (ADDs) have been introduced to improve the efficiency of dispensing and patient safety. The available questionnaires measure patient satisfaction with particular aspects of ADDs. Also, the level of patient satisfaction with ADDs is not widely established. This study aimed to develop and validate a novel questionnaire to assess patient satisfaction with ADDs. Content and construct validity procedures were used to validate the 20-item questionnaire with four domains, including pharmacy administration, dispensing practice, patient education, and the dispensing system. Two hundred consenting participants took part in this study, from those who visited the outpatient pharmacy in a government hospital. The internal consistency of all four scale items shows acceptable reliability (>0.7). In the exploratory factor analysis, three items were removed due to poor factor loading and cross-loading. In the confirmatory factor analysis, the model has acceptable fit indices, including the comparative fit index (0.937), Tucker-Lewis's index (0.924), standardized root mean square residual (0.051), root mean square error of approximation (0.057), and χ2/df (1.67). The convergent and discriminant validity were established, since the average variance extracted (AVE) was ≥0.5 and the squared correlation (SC) values of one construct with other constructs were less than the AVE of the specific construct. This study offered a reliable and valid 17-item questionnaire incorporating a multi-dimensional four-factor model to evaluate patient satisfaction with ADDs. The validated questionnaire can be utilized to explore patients' perspectives on ADDs.

Counting on Change: Conquering Challenges in Teaching Pharmaceutical Calculations

All pharmacists are expected to accurately perform pharmaceutical calculations to ensure patient safety. In recent years, there have been trends in declining performance on the North American Pharmacist Licensure Examination related to calculations. Understanding the cause of this decline and determining methods to correct underlying issues could benefit pharmacy administration, faculty, students, and patients. The aims of this commentary are to present the factors impacting the students’ pharmaceutical calculations abilities, discuss the consequences of declining math skills, and provide a call to action for scholarship of teaching and learning pertaining to calculations, as well as increased administrative support to rectify this challenge.

Enhancing Taiwan's healthcare sustainability: A Delphi study on national medicines policy reforms

Background/purposeThe National Medicines Policy (NMP) is crucial as it sets the framework for ensuring access to affordable, high-quality medicines and promoting their rational use, which is essential for public health and the efficiency of the healthcare system. This study aims to evaluate the current state of Taiwan's NMP, identify pressing issues for improvement, and establish actionable suggestions through expert consensus to ensure the sustainable provision and use of medications. MethodsA modified two-round Delphi technique was employed. The first-round survey identified key issues and suggestions for policy improvement, while the second-round survey evaluated the feasibility and effectiveness of these suggestions. The expert panel, consisting of 50 specialists from pharmacy, medicine, public health, and the pharmaceutical industry, evaluated key issues related to the NMP's efficacy using a 4-point Likert scale. ResultsThe first-round survey identified 13 key issues in Taiwan's NMP, primarily focusing on the rational use and accessibility of medications. The second-round survey proposed 54 policy improvement suggestions for these issues, of which 20 were considered strong suggestions and 23 were moderate suggestions. The policy recommendations cover medication reimbursement, pharmacy professional services, administration, legislation, and education. ConclusionThe study highlights the urgent need for reforms in Taiwan's NMP, providing specific policy improvement suggestions to ensure high-quality medications and pharmaceutical services while supporting the sustainable operation of Taiwan's NHI system. The study underscores the significance of proactive measures to fortify healthcare sustainability in the face of evolving healthcare landscapes.

The issue and abolition of the Interim Regulations on Chinese Medicine Shops and Western Pharmacy Registration in the period of the Republic of China

The Interim Regulations on Chinese Medicine Shops and Western Pharmacy Registration issued by the Shanghai Bureau of Illegal Drugs in 1922, required that Chinese medicine shops in Shanghai area be audited, registered and pay registration fees. This regulation was abolished along with the dissolution of the Shanghai Bureau of Illegal Drugs in 1925. The Interim Regulations on Chinese Medicine Shops and Western Pharmacy Registration drove people, to some extent, to attach the importance and awareness of Chinese medicine and its administration. While it had some problems, such as improper intention and unclear concepts in the period of the Republic of China, a sound system for traditional Chinese medicine (TCM) administration had not been established. It confirmed that Chinese materia medica has its unique knowledge system and development form, therefore, should not be uniformly administered as Western medicine. It indicated that TCM pharmacy administration should have a reasonable system and channels to promote the development of the Chinese materia medica industry.

Variation in incidence rates of outcomes relevant to vaccine safety monitoring in a US commercially insured population by case identification algorithm

BackgroundLarge health insurance claims databases can be used to estimate rates of rare safety outcomes. We measured incidence rates of rare outcomes that could be used to contextualize adverse events among people receiving pneumococcal vaccines in clinical trials or clinical practice. However, algorithms used to identify outcomes in administrative databases are subject to error. Using two algorithms for each outcome, we assessed the influence of algorithm choice on the rates of the outcomes. MethodsWe used closed administrative medical and pharmacy claims in the Healthcare Integrated Research DatabaseSM (HIRD) to construct a broad cohort of individuals less than 100 years old (i.e., the target cohort) and a trial-similar cohort of individuals resembling those potentially eligible for a vaccine clinical trial (e.g., for a pneumococcal vaccine). We stratified by age and sex and used specific and sensitive algorithms to estimate rates of 39 outcomes including cardiac/cerebrovascular, metabolic, allergic/autoimmune, neurological, and hematologic outcomes. Specific algorithms intended to reduce false positive errors, while sensitive algorithms intended to reduce false negative errors, thereby providing lower and upper bounds for the “true” rates. ResultsWe followed approximately 40 million individuals in the target cohort for an average of 3 years. Of 39 outcomes, 14 (36 %) had a rate from the specific algorithm that was less than half the rate from the sensitive algorithm. Rates of cardiac/cerebrovascular outcomes were most consistent (mean ratio of rates from specific algorithms compared to rates from sensitive algorithms = 0.76), while the rates of neurological and hematologic outcomes were the least consistent (mean ratio of rates = 0.33 and 0.36, respectively). ConclusionsFor many cardiac/cerebrovascular outcomes, rates were similar regardless of the algorithm. For other outcomes, rates varied substantially by algorithm. Using multiple algorithms to ascertain outcomes in claims data can be informative about the extent of uncertainty due to outcome misclassification.

Abstract PS14-03: Delayed and post-treatment immune toxicities in patients with breast cancer receiving immune checkpoint inhibitors

Abstract Background: Immune checkpoint inhibitors (ICI) have improved outcomes in patients (pts) with breast cancer, however identification and management of immune-related adverse events (irAE) remains challenging. Delayed irAE have been observed, occurring even after ICI cessation. Prior analyses of delayed irAE have focused on patients with melanoma, lung, and head & neck cancer but data in patients with breast cancer are lacking. Methods: We identified pts with breast cancer who received ICI at our institution between 2012 and 2022 using pharmacy administration records. Charts were reviewed for delayed and post-treatment irAE. Delayed irAE were defined as occurring >90 days after ICI start; post-treatment irAE were defined as occurring >60 days after ICI discontinuation. Events were categorized as irAE if provider notes indicated that the toxicity was related to or possibly related to ICI. Results: 320 consecutive pts with breast cancer (219 metastatic, 96 localized disease) underwent treatment with ICI, of which 79 (25%) developed delayed irAE (40 with metastatic disease, 39 with localized disease). 54 pts had triple negative breast cancer (TNBC), 22 had hormone receptor positive (HR+) disease, and 4 had HER2+ disease. 44 pts received ICI on a clinical trial. The median number of ICI doses was 8, and the median length of follow-up after the first ICI infusion with 29 months. For delayed iRAE, median time to onset was 183 days (range 91-1800 days) with a total of 103 delayed irAE events (see table). 24 pts (7.5%) developed a post-treatment irAE with a total of 27 events. For post-treatment irAE, median time to onset was 112 days after ICI cessation (range 69-1100 days) and median time on ICI was 63 days (range 22-1724 days). 11 of 24 patients who experienced a post-treatment irAE also experienced an irAE while on treatment. Hypothyroidism, colitis, adrenal insufficiency, and hepatitis were the most common irAE at all time points. Rash primarily occurred while still on ICI. All irAE at any time point either self-resolved, resolved with systemic steroids, or continued with indefinite hormone replacement. 45 irAE required systemic steroids, not including hydrocortisone replacement for adrenal insufficiency. There were no grade 4 or 5 irAEs. Conclusions: This is the first evaluation of delayed/post-treatment irAE in a large cohort of patients with breast cancer. 79 pts (25%) experienced delayed irAEs occurring ≥ 90 days after ICI start, with median time to onset of 183 days. 89% of patients with delayed irAE also experienced an irAE at an earlier time point, indicating that early irAE may be a risk for delayed irAE. 24 pts (7.5%) experienced post-treatment irAE with median onset of 121 days after ICI cessation. Diagnosis of delayed irAE requires heightened awareness and prompt treatment. Future work is needed to identify key clinical and molecular markers that predict risk for delayed irAE to better inform treatment & monitoring. Table. Parameter Number of pts (%) Total pts receiving an ICI 320 Delayed irAE 79 (25) >1 delayed irAE 21 (27% of pts with delayed irAE) Patients with delayed irAEs who also had irAE occurring < 90 days after ICI start 70 (89% of pts with delayed irAE) Post-treatment irAE 24 (7.5) Types of delayed irAE (>90 days after ICI start) Any Grade Grade 3 Hypothyroidism 24 (23) 1 (1) Colitis/Diarrhea 19 (18) 3 (3) Rash 14 (14) 0 Adrenal Insufficiency/Hypophysitis 11 (11) 4 (4) Hepatitis 10 (10) 3 (3) Pneumonitis 4 (4) 1 (1) Arthralgia 4 (4) 0 Diabetes mellitus 3 (3) 0 Mucositis 2 (2) 1 (1) Neuropathy 2 (2) 0 Neutropenia 2 (2) 1 (1) Bronchitis 1 (1) 0 Fever 1 (1) 0 Neuromuscular Weakness 1 (1) 0 Autoimmune Hemolytic Anemia 1 (1) 1 (1) Myocarditis 1 (1) 1 (1) Acid Reflux 1 (1) 0 Sarcoidosis 1 (1) 0 Vitiligo 1 (1) 0 Types of post-treatment irAE (>60 days post ICI cessation) Any Grade Grade 3 Hypothyroidism 7 (26) 2 (7) Colitis 7 (26) 3 11) Adrenal Insufficiency/Hypophysitis 6 (22) 1 (4) Hepatitis 4 (15) 3 (11) Arthralgia 1 (4) 0 Neuropathy 1 (4) 0 Neutropenia 1 (4) 1 (4) Rash 1 (4) 0 Citation Format: Saya Jacob, Samantha Fisch, Carolyn Face, Laura Huppert, Zoe Quandt, Laura Quintal, Michelle Melisko, Melanie Majure, Jo Chien, Anne Blaes, Hope Rugo. Delayed and post-treatment immune toxicities in patients with breast cancer receiving immune checkpoint inhibitors [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PS14-03.

Pharmacist, nurse, and physician perspectives on the implementation of the pharmacist discharge care (pharm-dc) intervention: A qualitative study

BackgroundThe PHARMacist Discharge Care (PHARM-DC) intervention is a pharmacist-led Transitions of Care (TOC) program intended to reduce 30-day hospital readmissions and emergency department visits which has been implemented at two hospitals in the United States. The objectives of this study were to: 1) explore perspectives surrounding the PHARM-DC program from healthcare providers, leaders, and administrators at both institutions, and 2) identify factors which may contribute to intervention success and sustainability. MethodsFocus groups and interviews were conducted with pharmacists, physicians, nurses, hospital leaders, and pharmacy administrators at two institutions in the Northeastern and Western United States. Interviews were audio recorded and transcribed, with transcriptions imported into NVivo for qualitative analysis. Thematic analysis was performed using an iterative process, with two study authors independently coding transcripts to identify themes. ResultsOverall, 37 individuals participated in ten focus groups and seven interviews. The themes identified included: 1) Organizational, Pharmacist, and Patient Factors Contributing to Transitions of Care, 2) Medication Challenges in Transitions of Care at Admission and Discharge, 3) Transitions of Care Communication and Discharge Follow-up, and 4) Opportunities for Improvement and Sustainability. The four themes were mapped to the constructs of the CFIR and RE-AIM frameworks. Some factors facilitating intervention success and sustainability were accurate medication histories collected on admission, addressing medication barriers before discharge, coordinating discharge using electronic health record discharge features, and having a structured process for intervention training and delivery. Barriers to intervention implementation and sustainability included gaps in communication with other care team members, and variable pharmacist skills for delivering the intervention. This study identified that using educational resources to standardize the TOC process addressed the issue of variations in pharmacists’ skills for delivering TOC interventions. ConclusionsNurses, physicians, pharmacists, pharmacist leaders, and hospital administrators were in agreement regarding the usefulness of the PHARM-DC intervention, while acknowledging challenges in its implementation and opportunities for improvement. Future research should focus on developing training materials to standardize and scale the intervention, eliminating barriers to medication access pre-discharge, coordinating discharge across care team members, and communicating medication changes to primary care providers post-discharge.

Assessment of coping capacity of public health facilities with health emergency situations during an event of flood in Mumbai.

Floods had been a repeated phenomenon in India, causing considerable losses to properties, life and infrastructure, and public utilities. Floods are found to be a common natural disaster occurring not only in developing countries but also in developed nations. Hospital preparedness against disaster could help in the management of the surge of patients in an effective manner. This study aims to assess the capacity of public health facilities for coping up with health emergency situations during an event of flood in Mumbai. A cross-sectional study was conducted among 38 public health facilities in Mumbai. A purposive sampling technique was used for the selection of the health facilities. Administrative staff, medical officers, and pharmacy in charges were included in the study. The study revealed that surge capacities in hospitals were adequate as they had additional beds for monsoon-related diseases for the preceding flood situation. There was a triage policy, and the staff were trained on the same. Procurement of drugs was easy because of a good networking system between hospitals. Due to this networking system, patients were also transferred to the nearest healthcare facility in a short span of time. The response during an event of a flood in the health facilities of Mumbai city was good as they have regular training sessions to be prepared for the emergency situations during monsoon as they have repeated exposure to floods.

Drivers of citations in social pharmacy and practice research articles

BackgroundResearch in Social and Administrative Pharmacy has been expanding in the last decade. The recently published Granada Statements offer key recommendations to improve the quality of research in this field. ObjectivesTo identify the factors associated with the citations of articles in the field of social, administrative, clinical pharmacy and practice research. MethodsThis study was a retrospective, observational analysis of articles published in three leading journals. Per article Google Scholar citations was the dependent variable. Predictor variables were extracted from all articles published from 2013 to 2015. The dependent variable was dichotomized using sample's median Google Scholar citations. Logistic regression analysis was performed to identify independent predictors of citations ≥ median. ResultsThe median number of citations per article was 17 (range 0–341), with a mean of 24.2 (SD 27.6). The number of references included in the articles (OR 1.03, CI 1.02–1.04), the year of publication (OR 0.31 CI 0.21–0.46 for articles published 2015), article social media mentions (OR = 1.01, CI 1.01–1.03 and OR 1.10 CI 1.04–1.18 for Facebook and X, respectively), the topic area of research namely pharmacy services (OR 1.65, CI 1.06–2.57) and medication adherence (OR 2.22 CI 1.13–4.33) were independently associated with article having citations ≥ median. ConclusionsThe number of references, the year of publication, social media mentions and the topic area of research, namely pharmacy services and medication adherence, were associated with citations above median in the leading journals of social and administrative pharmacy research. Authors may consider providing a thorough literature review in their articles, while researchers, editors, and publishers are advised to use social media to promote newly published work. This article complements the Granada Statements and may contribute to fostering wider dissemination of the discipline's outputs.

Delayed and unmet prescription drug access linked to elevated anxiety symptoms during COVID-19: Retrospective findings from the NLSY79 child and young adult cohort

BackgroundThe COVID-19 pandemic produced substantial challenges to pharmacy systems worldwide and provoked concerns about a wider influence on mental health. While various studies have investigated the relationship between disruptions in access to healthcare and mental health, the effects of delayed and unmet access to prescription drugs on anxiety-related outcomes have been underexamined. ObjectiveThis study analyzed the impact of delayed and unmet access to prescription drugs on anxiety-related outcomes, including anxiety, inability to stop or control worrying, worrying too much, trouble relaxing, trouble sitting still, being annoyed or irritable, and fear of future events, before and during the COVID-19 pandemic. MethodsA retrospective observational study was performed using the National Longitudinal Survey of Youth 79 Child and Young Adult dataset, encompassing 2193 individuals. One-way multivariate analysis of covariance (MANCOVA) analyses were conducted to examine the relationship between access to prescription drugs and anxiety-related symptoms. ResultsThe findings show that, before the pandemic, instances of delayed/unable to access prescription drugs were either not linked to anxiety symptoms or, in some cases, were linked to anxiety symptoms but no different than during the pandemic. Delayed access to prescription drugs amid the pandemic was significantly linked with increases in anxiety symptoms not found pre-pandemic, including worrying too much (F = 18.433, p < .001, η2p = 0.017), trouble relaxing (F = 11.423, p < .001, η2p = 0.010), and being easily annoyed or irritable (F = 3.881, p = .021, η2p = 0.004). Similarly, unmet access to prescription drugs amid the pandemic was significantly linked with increases in anxiety-related symptoms not found pre-pandemic, including an inability to stop or control worrying (F = 14.666, p < .001, η2p = 0.013) and worrying too much (F = 18.433, p < .001, η2p = 0.017). ConclusionsThese results have implications for pharmacy administrators and policymakers seeking to understand and limit adverse mental health outcomes within pharmacy during times of crisis.

Orrelation of Administrative Services and Pharmacy Services to BPJS Patient Satisfaction

Introduction: According to Director Decree No. 4 Year 2009 About the Hospital requires high support and commitment to achieve quality primary care for BPJS health patients. One that can assess the success of a hospital with good quality is to increase patient satisfaction. The purpose of this study was to determine the levelof satisfaction of BPJS patients with health services, especially in administration and pharmacy waiting time. Method: This study uses a quantitative approach, especially observational analytical design to investigate the hypotheses formulated and identify potential relationships between variables this study design uses sectional scoss with questionnaires of 103 respondents who are members of BPJS Health patients. Results: Based on satisfaction that the level of BPJS patient satisfaction in each dimension of reliability 70.4%, comprehension 71.6%, guarantee 73.6%, physical evidence 69.4% and empathy 73.8%. Conclusion: patient satisfaction in hospital health services in terms of administrative services 89.3%, BPJS patient services in terms of pharmacy 89.1% and those who stated relatively fast in waiting time 64.1%

An exploratory mixed-methods evaluation of continuing education opportunities related to the care of sexual and gender minority patients from ACPE-accredited providers.

The objective of this analysis was to describe trends in continuing education opportunities for pharmacy professionals across the US related to the care of sexual and gender minority (SGM) patients. Continuing education programs offered by Accreditation Council for Pharmacy Education (ACPE)-accredited providers from 2012 through 2022 were identified by searching the ACPE database for titles containing SGM terminology. Data including ACPE provider classification, activity type, format, audience, ACPE topic designator, interprofessional accreditation, contact hours, and learning objectives were collected. Content analysis was used to categorize activities. Following removal of duplicates and non-SGM-focused programming, 726 programs were identified. The most commonly observed program characteristics included a live format (67.6%, n = 491), a pharmacist audience (77.1%, n = 560), knowledge-based activities (90.8%, n = 656), a college or school of pharmacy provider (21.6%, n = 157), an ACPE topic of pharmacy administration (50.6%, n = 367), and a focus on pharmacy rather than interprofessional audiences (87.1%, n = 632). The median program length was 1 hour (interquartile range, 1-1.25 hours). The qualitative analysis identified programs focused on topics of gender-affirming care (pharmacotherapy) (32.1%, n = 233), general SGM (26.7%, n = 194), gender-affirming care (nonpharmacotherapy), sexually transmitted infections (7.2%, n = 52), and health disparities (3.9%, n = 28). Advancement has occurred in the number of available continuing pharmacy education programs focused on the care of SGM patients. Further information regarding specific content and effectiveness of continuing education is necessary to determine strategies to better prepare pharmacy professionals to care for this growing patient population.

Knowledge, attitude and practice of community pharmacists toward irritable bowel syndrome, Sudan

Irritable Bowel Syndrome (IBS) is a common disorder affecting around 20% of the populations worldwide. Treatment of IBS typically focuses on managing predominant symptoms and the pathophysiology, such as the visceral hypersensitivity. This study was conducted to assess community pharmacist knowledge, attitude and practice of Irritable Bowel Syndrome in Khartoum locality.A descriptive cross-sectional study was done. The study was performed among all community pharmacist working at the pharmacies in the study area. Ethical approval from the Ministry of health was first granted (NUSU2021/3-5), then approvals was obtained from each of pharmacy administration. Pharmacists that were registered by Sudan medical counsel, while pharmacy technician and other staff were excluded. Association among variables was assessed through chi-square test, all tests were considered significant when p <0.05.Most of the pharmacist were females (68%, n= 70). Fifty-eight percent (n=60) had good knowledge about IBS. Ninety-three percent (n=96) knew the common symptoms. Eighty-six percent (n=89) of the participants reported that the diagnosis of IBS was based on symptoms. Although the knowledge score was good, but their knowledge about medications and lifestyle modifications was poor. Good attitude was noticed in 55% (n= 57) of the pharmacists. Sixty-one percent (n=63) of pharmacists agree with that they need courses regarding IBS. Fifty-one percent (n= 53) of them agreed with IBS has become one of the most health problems they were involved. Also fifty-one percent (n=53) of them agree with that the symptoms of IBS never disappear. Regarding practice, 63% (n= 65) of pharmacists had good practice.Majority of the participants had good knowledge and attitude and practice about IBS. The need for continuous education was recommended by the participants.

Impact of the COVID-19 Pandemic on US Pharmacy Academia Per Perspectives of Faculty and Administrators

ObjectiveThe COVID-19 pandemic has markedly affected academic and administrative facets of pharmacy education. However, to date, no study has systematically summarized pandemic-related changes at pharmacy schools across the United States. This study aimed to evaluate US pharmacy school faculty and administrators’ perspectives on the pandemic’s impact on pharmacy academia. MethodsA web-based survey was sent to US pharmacy school faculty and administrators in August 2020. The survey included questions assessing the pandemic’s impact on the faculty’s teaching, the school’s financial status, administrative aspects, and mental well-being of faculty and administrators. Descriptive statistics and 1-sample Z tests were used for conducting statistical analyses. ResultsThe survey was sent to 6177 individuals, of whom 1068 participated (17.3% response rate). In total, 931 respondents (759 faculty and 172 administrators) completed the entire survey. Both faculty and administrators experienced increased workload while their mental health and job satisfaction declined. Faculty’s teaching satisfaction, research productivity, and service activity worsened. Administrators identified decreases in revenue sources and increases in expenses associated with the pandemic. Administrators also indicated the negative impact of the pandemic on an array of administrative and academic aspects within their pharmacy schools. The qualitative analysis identified several overlapping themes highlighting the negative effects of the pandemic on the faculty’s teaching. ConclusionPresent findings indicate the negative effects of the COVID-19 pandemic on a variety of academic and administrative aspects at US pharmacy schools. These findings could provide useful information to stakeholders in pharmacy academia.

CancelRx case study: implications for clinic and community pharmacy work systems

BackgroundMedication prescribing and discontinuation processes are complex and involve the patient, numerous health care professionals, organizations, health information technology (IT). CancelRx is a health IT that automatically communicates medication discontinuations from the clinic electronic health record to the community pharmacy dispensing platform, theoretically improving communication. CancelRx was implemented across a Midwest academic health system in October 2017. The health system also operates 15 outpatient community pharmacies.ObjectiveThe goal of this qualitative study was to describe how both the clinic and community pharmacy work systems change and interact over time regarding medication discontinuations, before and after CancelRx implantation.ApproachMedical Assistants (n = 9), Community Pharmacists (n = 12), and Pharmacy Administrators (n = 3), employed by the health system were interviewed across 3-time periods between 2017 and 2018— 3-months prior to CancelRx implementation, 3-months after CancelRx implementation, and 9-months after CancelRx implementation. Interviews were audio recorded, transcribed, and conducted a hybrid analysis with deductive content analysis following the Systems Engineering Initiative for Patient Safety (SEIPS) framework and inductive analysis to capture additional codes and themes.Key resultsCancelRx changed the medication discontinuation process at both clinics and community pharmacies. In the clinics, the workflows and medication discontinuation tasks changed over time while MA roles and clinic staff communication practices remained variable. In the pharmacy, CancelRx automated and streamlined how medication discontinuation messages were received and processed, but also increased workload for the pharmacists and introduced new errors.ConclusionsThis study utilizes a systems approach to assess disparate systems within a patient network. Future studies may consider health IT implications for systems that are not in the same health system as well as assessing the role of implementation decisions on health IT use and dissemination.

National Continuing Professional Development (CPD) training needs of pharmacists in Ethiopia

BackgroundContinuing Professional Development (CPD) in pharmacy is a lifelong learning approach whereby individual pharmacists are responsible for updating and broadening their knowledge, skills, and attitudes. This is vital to ensure the delivery of high-quality patient care services. However, there is a lack of available data revealing the CPD needs of Ethiopian pharmacists. Thus, the objective of this study was to identify CPD training needs of pharmacists practicing in Ethiopia.MethodsAn institution-based cross-sectional study design with a quantitative approach was employed in this study. This assessment involved 640 pharmacists representing various sectors of the profession. Data were collected through a combination of an online platform and a face-to-face questionnaire administered in person.ResultA total of 634 participants completed and returned the questionnaires, resulting in an impressive response rate of 99.1%. A significant majority (74.1%) of the participants possessed bachelor’s degree in pharmacy (B. Pharm). Pharmaceutical Logistics and Pharmacy administration was preferentially selected as a prior CPD course by 36% of participants, of them while Pharmacotherapy (17%), Leadership/Governance (13%), Community Pharmacy (12%), Research and Development (11%) were also the subsequent top choices by participants. Off-site face-to-face lectures (59.2%), Hybrid (face-to-face + e-learning) (54.8%), and on-site on-the-job training (45.5%) were the most convenient means of CPD course delivery. On the other hand, the participants least favored print-based or correspondence programs for CPD course delivery.ConclusionsCPD holds great importance in the professional lives of pharmacists. It is critical for pharmacists, CPD providers, and those responsible for accrediting CPD programs to recognize the specific CPD requirements, preferred methods of delivery, and obstacles involved. This understanding is vital for establishing priorities and effectively planning CPD activities. In light of this, our study identified the most preferred CPD training courses and convenient delivery methods for pharmacists in Ethiopia. We recommend that CPD providers and accrediting bodies in Ethiopia refer to our findings when approving CPD courses.

Understanding pathways to health-system pharmacy administration: A journey mapping study.

Pharmacy administrators play a critical role in the success of health systems, yet pathways to pharmacy administration are incompletely understood. The purpose of this study was to explore and describe pathways to becoming a health-system pharmacy administrator, including challenges experienced and resources needed. Participants (N = 21) individually completed one or more journey maps detailing the pathway(s) to pharmacy administration and then engaged in small group discussion to identify common themes. A large group debrief was used to share and identify findings across small groups. Thematic analysis was utilized to identify common ideas shared. There was variation across the maps, illustrating many steps one might follow to become a pharmacy administrator. In the 23 maps completed, pathways most frequently began with pharmacy school (n = 9, 39.1%), high school (n = 6, 26.1%), or undergraduate training (n = 4, 17.4%). Most included residency training or dual master's of science in health-system pharmacy administration/residency training (n = 16, 69.6%). Common challenges included distractions, time constraints, grades/performance, financial constraints, and stress. Common resources needed included exposure to diverse career paths, pipeline and outreach support, mentoring, and leadership. Themes included debate about the definition of a pharmacy administrator, questions regarding the core competencies of the pharmacy administrator, discussion regarding ways to enter pharmacy administration, and reflection on the role of serendipity and networking. Understanding the pathways to pharmacy administration is critical to fostering a sustainable and competent workforce. Work must be done to identify strategies and develop processes for identifying, equipping, and retaining talented health-system pharmacy administrators and leaders.

A comparative study on teaching satisfaction of smart class and traditional class in pharmacy administration

ObjectiveTo compare the difference in teaching satisfaction between traditional classes and smart classes after adopting the smart class design for “Pharmacy Administration”.Methods20 classes were selected for traditional class teaching and smart class teaching, respectively. The first 10 classes were implemented using traditional teaching methods, and the last 10 classes were implemented using smart classes. After each 10 classes, the ten-point Likert scale was used to measure teacher satisfaction and course satisfaction, and the Mann-Whitney U test was performed on the mean value of satisfaction.ResultsThe mean and standard deviation of teacher satisfaction using traditional classes (n = 193) were 9.82 ± 0.471, and the mean and standard deviation of teacher satisfaction using smart classes (n = 199) were 9.85 ± 0.566, P > 0.05; the mean and standard deviation of course satisfaction using traditional classes (n = 193) were 9.68 ± 0.636, and the mean and standard deviation of course satisfaction using smart classes (n = 199) were 9.75 ± 0.649, P > 0.05.ConclusionAfter using the smart class teaching practice, the scores of teacher satisfaction and course satisfaction improved; the mean of teacher satisfaction increased by 0.03 points and the mean of course satisfaction increased by 0.07 points. For course satisfaction and teacher satisfaction, there is no significant difference between using traditional class and smart class.

Systematic reviews and meta-analysis with sub-groups – A commentary

As the outcomes of systematic reviews and meta-analysis are used to inform clinical practice it is imperative that the review and meta-analysis conducted is accurate and rigorous. In this commentary the authors wish to review the recommended approaches to be used when conducting a meta-analysis of quantitative data in a systematic review and outline the common errors and risks. The authors of this commentary aim to highlight the consequence of potential errors when conducting a meta-analysis using sub-groups with an example from a systematic review published in Research in Social and Administrative Pharmacy in 2019.