Pharmacy Work Research Articles

Despair and hope: Is the retail community pharmacy workforce in danger of becoming a monopsony labor market?

ObjectiveMergers of big chain retail community pharmacies can affect the competitiveness of the pharmacy workforce to negotiate better wages and work conditions. However, it is unclear whether these types of mergers are generalizable to the U.S. pharmacy workforce. We should observe this effect when comparing annual wage trends between retail community pharmacy workers and nonretail community pharmacy workers. In the absence of this effect, annual wage trends would be similar. To examine this theory, annual wage trends for community pharmacy workers were compared with hospital pharmacy workers between 2012 and 2022. Design, setting and participantsA serial cross-sectional study was performed to compare the annual wages between retail community pharmacy workers and hospital pharmacy workers between 2012 and 2022 using data from the U.S. Bureau of Labor and Statistics (BLS). Pharmacy workforce was categorized as pharmacists, pharmacy technicians, and pharmacy aides (clerks) and grouped into retail or hospital pharmacy settings based on the North American Industry Classification System. Pharmacy workers’ annual wages were based on the U.S. BLS Quarterly Census of Employment and Wages data. Outcome measuresAnnual wages. ResultsBetween 2012 and 2022, statistically significant annual wage reduction was greater among pharmacists in the retail than pharmacists in the hospital setting by −$1974 (95% CI −$2921 to −$1026) per year. However, these trends were not statistically significant among pharmacy technicians and pharmacy aides. Pharmacy technicians in the retail and hospital settings had a 3.4% and 7.0% increase in average annual wages, respectively. Pharmacy aides in the retail and hospital settings had a 16.8% and 21.6% increase in average annual wages, respectively. ConclusionAlthough pharmacists’ annual wages decreased, it is unclear whether this was caused by the monopsony labor market. These findings suggest that there may be inefficiencies in the retail community pharmacy labor market, which may stimulate policies to improve pharmacy workforce conditions and patient safety.

Integrating Patient Safety Discussions with First-Year Doctor of Pharmacy Students in a Skills Lab Course.

The patient safety problem has been well established for over 20 years in the United States (U.S.), and there is a recognized focus on ensuring that health professions' trainees receive explicit education in various patient safety principles and practices. While the literature provides examples of different approaches towards patient safety education for pharmacy students, there are few that focus on first-year pharmacy students. This educational observational study describes the implementation and evaluation of two 20 min patient safety learning activities integrated into a required pharmacy skills lab course. The first learning activity utilized a mock prescription and patient safety checklist that had students identify patient safety problems on the prescription, followed by a group discussion of implications for the patient. The second learning activity used images of common safety problems with a facilitated group discussion to have students identify systems-based solutions to those problems. Our study's findings revealed that students were able to identify basic patient safety problems and safety solutions, although some additional foundational information may be needed, particularly for students who may not have pharmacy work experience. Additional research is needed to continue building a literature base on patient safety education approaches, particularly for first-year pharmacy students.

Workplace wellbeing in community pharmacy practice: A cross-sectional study in Can Tho, Vietnam.

Among pharmacy workers, low workplace wellbeing can lead to reduced effectiveness. However, to date, studies on this issue are limited within the community pharmacy setting in Vietnam. This study was conducted to identify the component aspects of workplace wellbeing and their associations with demographic characteristics. The cross-sectional descriptive study was conducted in Can Tho, Vietnam. Self-administered questionnaires were hand-delivered to all pharmacy workers working at selected community pharmacies. The workplace wellbeing scale comprised 18 items. In total, 382 pharmacy workers participated in this study. Factor analysis revealed three fundamental aspects to workplace wellbeing: Factor 1 - perceived self-worth and job satisfaction, Factor 2 - positive emotions with work, and Factor 3 - negative emotions with work. Factor 1 showed a positive correlation with Factor 2, with a correlation coefficient (ρ) of 0.509, while both Factor 1 (ρ = -0.399) and Factor 2 (ρ = -0.416) demonstrated negative correlations with Factor 3. Higher income was associated with higher positive emotions with work (P = 0.008), higher perceived self-worth and job satisfaction (P = 0.013), and lower negative emotions with work (P < 0.001). Workplace wellbeing of pharmacy workers in their professional environments was associated with financial aspects. These findings suggest that policies aimed at improving income for pharmacy workers could bring benefits to enhancing job satisfaction and workplace wellbeing.

Perceptions of the COVID-19 Vaccine and Willingness to Receive Vaccination among Health Workers in Nigeria: A Cross-sectional Study.

COVID-19 vaccine hesitancy is a major barrier to vaccine uptake, and the achievement of herd immunity is required to reduce morbidity and mortality and protect the most vulnerable populations. In Nigeria, COVID-19 vaccine hesitancy has been high, and uptake remains very low. Healthcare workers (HCWs) in Nigeria can help support public health efforts to increase vaccine uptake. This study evaluates Nigerian HCWs' acceptance and intent to recommend the COVID-19 vaccine. Cross-sectional survey among 1,852 HCWs in primary, secondary, and tertiary care settings across Nigeria. Respondents included doctors, nurses, pharmacy workers, and clinical laboratory professionals who have direct clinical contact with patients in various healthcare settings. A 33-item questionnaire was used in the study, with two of the questions focused on the COVID-19 vaccine. The responses to the two questions were analyzed using Chi-square (c2) tests and independent t-tests to determine the acceptance of the vaccine. The majority of respondents were younger than 34 years (n = 1,227; 69.2%) and primarily worked in hospitals (n = 1,278; 72.0%). Among the respondents, 79.2% (n = 1,467) endorsed the COVID-19 vaccine as a critical tool in reducing the impact of the disease, and 76.2% (n = 1,412) will accept and recommend the vaccine to their patients. The younger HCWs were more likely to endorse and recommend the vaccine to their patients. There is a moderately high COVID-19 vaccine acceptance rate among HCWs surveyed in our study. The confidence of HCWs in its use and their willingness to recommend it to their patients can provide a potentially useful element in increasing acceptance by the larger population in Nigeria.

The role of pharmacists in the detection and referral of patients with unmet psychosocial care needs: lessons from a Flemish collaboration between community pharmacy and psychosocial work

Community pharmacists are highly accessible care providers who are well-embedded in the community and usually have a close relationship with their patients. This places them in a good position to detect unmet psychosocial needs and refer patients to the psychosocial care services in their neighborhood. Therefore, a collaboration between community pharmacists and a psychosocial care organization was set up in Flanders (BE) to explore the potential role of pharmacists in the detection and referral of patients with psychosocial needs. The aim is to reach a patient population with (unmet) psychosocial needs, such as mental health problems, financial issues, family problems, substance abuse, domestic violence,... There is special attention to vulnerable groups. These needs are captured during patient visits to a community pharmacy for standard care. Pharmacists were trained by an e-learning in the topic of psychosocial wellbeing to detect unmet needs, talk about personal problems and how to help and refer these patients.&#x0D; This project is named #CAVAsa and is a collaboration between the Flemish network of pharmacists (VAN), the Flemish centers for general wellbeing (CAW) and the universities of Antwerp and Leuven. All parties worked together through all stages of the project. Sponsoring is provided by the Flemish Government. The project is currently running, and a total of 200 pharmacists are participating. Quantitative data are collected through an online registration form filled in by pharmacists. Collection started in July 2022 and is still running untill January 2023. Physical meetings were held as well to share experiences between pharmacists and the social workers and to provide extra support if needed.&#x0D; Since the start of the registration in July 2022 until today, a total of 160 patient contacts were registered in which psychosocial wellbeing was discussed. More details about the nature of these contacts will be available at the moment of the conference. During focus group discussions prior to this data collection, pharmacists indicated that they are willing to take up this role because patient wellbeing and personal assistance are key values of community pharmacy. It can be concluded that structural collaborations between community pharmacy and psychosocial care are very valuable and should be further supported. #CAVAsa is a good example of integrated care in which a whole person approach is supported, as it targets not only mental health care needs, but also broader social needs such as poverty and loneliness.&#x0D; Evaluation of the quantitative data is planned for January 2023. Results will be discussed during a multidisciplinary closing conference in which all stakeholders will be involved. After this evaluation, it is our goal to further expand this initiative to all of Flanders and make the collaboration between pharmacists and social workers more sustainable.&#x0D;

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.

Self-propelled Employees – Co-workership in Swedish Community Pharmacies

In this article, work in Swedish pharmacies is examined.With the Nordic concept of co-workership as a frame, the aim is to examine how employees in pharmacies view and handle their work situations and the reasons behind them. Data were mainly collected with 20 qualitative semi-structured interviews in five different pharmacies. The data were organized and analyzed by using the content analysis process. In the studied pharmacies, it can be summarized as work was carengried out in a self-propelled way. Employees take an overall responsibility for the workplace, have ambition to help others and to be a part of a good team, while most of the work is carried out individually and independently.

PENERAPAN APLIKASI SIPIO BERBASIS SMARTPHONE UNTUK MENINGKATKAN PELAYANAN FARMASI KLINIK APOTEKER DI RSUD SIMPANG LIMA GUMUL KEDIRI

The world increasingly familiar with the digital world encourages the government to transform, especially in public services. Digital transformation in the public service sector is principally carried out to present public services that can adapt to society's needs. This will be optimal if it is carried out collaboratively across agencies regarding data utilization and service delivery. This collaboration is not limited to between government agencies but also across BUMN/D and private parties to provide excellent service to the community. For this reason, policies have been established that encourage and direct the four targets of accelerating the transformation of public services, namely the realization of electronic-based public services for each type of service (e-service), public complaints as the basis for public service policies, strengthening innovation ecosystems and strengthening integrated services. In supporting this, ASN, especially supervisory officials, need insight into technological developments in preparing organizations to utilize technology that suits their needs in improving electronic-based public services (e-services) to the public. The SIPIO application (Consultation and Drug Information Services) was created as an innovative service that can maximize the pharmacist's clinical pharmacy work so that patients or health workers who need information about drugs can easily communicate with pharmacists.

SOCIOECONOMIC AND BEHAVIORAL FACTORS CONTRIBUTING TO ANTIBIOTICS NON-ADHERENCE

Background: Antibiotics therapy is the crucial treatment plan employed in community settings. Antibiotics effectiveness and population adherence are key causes of the efficacy of antibiotics therapy. Objectives: In this study, we pursue to explore the factors that affect patients adherence to antibiotics therapy to enhance the population adherence and to create awareness among the community related to antibiotics non-adherence. Methodology: A questionnaire survey was conducted among the university students having age range 18-40 years who had use antibiotics in the previous 6 months, data analyses were performed using SPSS version 16 by applying descriptive statistics and bivariate correlation function. Results: A total of 203 respondents participated in the survey, among them 184 participants provided complete data and were included in the study. Up to 96.7% of participants showed non-adherence to antibiotics regimen, (total adherence score &lt;8), whereas 3.3% of participants showed good adherence, (total adherence score ≥8). Discontinuation of antibiotics due to fear of adverse effects and lack of basic knowledge about antibiotics were the important factors associated with antibiotics non-adherence. Conclusion: A range of factors was linked with non-adherence to antibiotics therapy including discontinuing treatment once the symptoms improve, changing antibiotic due to ineffectiveness, difficulty in taking prescribed dose, non-availability of pharmacy and busy work schedule.

Pharmacy work: Intrinsic motivation and extrinsic rewards across role and setting

BackgroundPharmacists’ and pharmacy technicians’ stress and job turnover are at an all-time high. Both intrinsic motivations and extrinsic rewards play key roles in workplace satisfaction. Differences in workplace satisfaction have been identified when comparing chain pharmacies, independent pharmacies, and health systems work settings. ObjectivesCognitive evaluation theory was applied to explore the influence of intrinsic motivations and extrinsic rewards on both pharmacists’ and pharmacy technicians’ perceptions of motivations and rewards across various workplace settings. MethodsA 92-item questionnaire was administered to 129 pharmacists and 111 pharmacy technicians. Participants were primarily recruited at a state pharmacy association annual meeting and via online forums. The questionnaire captured participant demographics including role and work setting (i.e., chain, independent, or health systems), demographic variables, and perceptions about work including autonomy, competence, relationships, pay satisfaction, and benefit satisfaction. ResultsA 2-way multivariate analysis of covariance was conducted to test hypothesized differences by role (pharmacist or pharmacy technician) and setting (chain, independent, or health systems). Results show pharmacy personnel in independent and hospital systems settings felt more positive about relationships, competence, pay satisfaction, and benefit satisfaction than those in chain settings. There were no role differences between pharmacists and pharmacy technicians on these outcomes. DiscussionThese findings highlight challenges of working in chain pharmacy environments. Results reveal that although pay does not differ across work settings, feelings about both the work and compensation satisfaction do vary across settings. Because role did not drive these relationships, this suggests a need to attend to working conditions for pharmacy personnel. ConclusionIntrinsic motivation elements of competence and relationships are statistically different among employment settings. Relationships and feelings of competence are perceived more favorably in independent and health systems, rather than chain settings. More studies on intrinsic motivations of pharmacy employees within these settings are needed.

Patient satisfaction and associated factor at red cross pharmacies in Addis Ababa, Ethiopia

BackgroundPatient satisfaction is a crucial aspect of healthcare, reflecting the positive feelings patients experience when using a service. It serves as an indicator of the gap between expected and actual service quality from the patient's perspective. Measuring patient satisfaction is recommended for healthcare providers at all levels as it contributes to improvement efforts. In recent times, pharmacy services have evolved beyond merely supplying medications to becoming more patient-centered and caring. Given the high number of patients relying on the limited Red Cross community pharmacies in the city, this study aims to assess patient satisfaction and identify factors associated with patient satisfaction towards Red Cross Pharmacies in Addis Ababa, Ethiopia.Patients and methodsCross sectional study design was conducted from August 15 to August 30, 2022 in three Red Cross Pharmacies in Addis Ababa. Patients were selected by Convenience sampling technique. Structured questionnaire was used to assess patient satisfaction. Bivariate and Multivariate logistic regression were computed to assess statistical association between the outcome variable, and independent variables. SPSS version 21 was used for analysis.ResultsFour hundred seven participants were willing and completed the study. The overall satisfaction towards Red Cross pharmacy service was 60.4%. Inadequate counselling was main reason for dissatisfaction (45%). Regarding associated factors, unavailability of some medications (Adjusted odds ratio = 0.393, 95% CI: 0.208–0.741), unfair medication cost (Adjusted odds ratio = 0.613, 95% CI: 0.607–0.910), and lack of organized pharmacy work flow (Adjusted odds ratio = 0.105, 95% CI: 0.049–0.221) were negatively associated with clients’ satisfaction.ConclusionThis study provides significant insights into patient satisfaction with Red Cross pharmacy services in Addis Ababa, Ethiopia, revealing an overall patient satisfaction rate of 60.4%. While a substantial number of patients had positive experiences, dissatisfaction due to inadequate counseling was a notable concern. Factors negatively associated with patient satisfaction, including medication unavailability, unfair cost, and a lack of organized workflow, further highlight the need for targeted interventions to improve patient experiences. Addressing these issues will be critical to enhance pharmaceutical care services and bridge the gap between patient needs and satisfaction.

Perceptions of Community Pharmacists toward the National E-Prescribing Service (Wasfaty) and Exploring the Benefits and Challenges of the Service: A Descriptive Study from Qassim Region, Saudi Arabia.

Electronic prescribing systems (e-prescription) for medications have many benefits, including patient safety, increase in patient satisfaction, efficiency of pharmacy work, and quality of patient care. However, few studies have been conducted to evaluate the national e-prescription system "Wasfaty" service in Saudi Arabia, which was recently adopted. The aims of this study were to explore the benefits observed through the use of the system and most frequent challenges experienced by community pharmacists in the Qassim region of Saudi Arabia. This study was conducted using a descriptive survey on a web-based platform. The target population of the study included community pharmacists in the Qassim region of Saudi Arabia who worked in pharmacy chains utilizing the e-prescription service between September 2022 and November 2022. Descriptive statistics along with multiple ordinal regression were used for data analysis. The study population consisted of 124 pharmacists, of which 62.9% (78/124) were males and 37.1% (46/124) were females. Most of the participants had a positive perception of the e-prescription system with regard to medication safety, with 68.6% (85/124) indicating that e-prescriptions reduce the risk of dispensing errors. However, 81.5% (101/124) did not agree that the e-prescription system resulted in a reduction in workload, and 70.2% (87/124) disagreed that the service increased patient satisfaction. The results of this study indicated that the national e-prescription system has many benefits to healthcare employees and improves their work, particularly for patient safety, reducing medication errors, and improving the management of patient medications. The participants believe that there is a need to improve communication with prescribers, showing concern about the unavailability of some medications; thus, it is important for policymakers to encourage other pharmacy chains and suppliers to join the service to increase patient access to medications.

Preliminary Study on Knowledge, Attitudes and Practices on Selling Over-the-Counter Oral Medicines by Pharmacy Workers in Colombo District

Over-the-counter is also known as non-prescription medicine. Although, OTC can be bought without a prescription, self-medication and overusing the medications can cause many side effects. Hence, responsible selling of drugs with recommendations on proper and safe use is a key role of pharmacists and other pharmacy workers. The aim of this study was to investigate knowledge, attitudes and practices of selling orally administered OTC medicines by pharmacy workers in the Colombo district. A descriptive cross-sectional study was performed among pharmacy workers in the Colombo district, including pharmacists and non-pharmacists using a structured questionnaire. The ethical clearance was obtained from Ethics Review Committee, CINEC Campus. Out of 100 participants, 45 were males and 55 were females. As a percentage, 15% were pharmacists, 37% were assistant pharmacists and 48% were supporting workers in the pharmacy. Although Paracetamol is an OTC drug that is commonly sold in pharmacies, only 42% of the participants know the maximum adult daily dose as four g/day. The remaining 58% were not aware of the correct daily adult dose for Paracetamol and among those 13.79% were pharmacists. Further, 86% of the participants were aware that generally antacids should be taken 30 minutes before the meal to get effective action and 14% were unaware. Out of this, 14.28%, 35.71% and 50% are pharmacists, pharmacy assistants and other support staff respectively. Although antibiotics are not OTC medicine, 17% disagreed with the statement that “Antibiotics should not dispense for the common cold on patient demands”. Among the participants, 47% believe pharmacists are only responsible for dispensing and counselling patients on the drug prescribed by physicians. Although 44 % of participants never issued non-OTC medicine without a prescription, 48% have issued prescription-only drugs without a prescription occasionally, while 8% have issued non-OTC medicine without a prescription. According to the results, some workers were still unaware of the correct information regarding the OTC. It is concluded that some of the healthcare workers at pharmacies require further knowledge of OTC oral medicines.

Prevalence, drivers and surveillance of antibiotic resistance and antibiotic use in rural China: Interdisciplinary study.

This study aimed to characterise antibiotic prescribing and dispensing patterns in rural health facilities in China and determine the community prevalence of antibiotic resistance. We investigated patterns and drivers of antibiotic use for common respiratory and urinary tract infections (RTI/UTI) in community settings, examined relationships between presenting symptoms, clinical diagnosis and microbiological results in rural outpatient clinics, and assessed potential for using patient records to monitor antibiotic use. This interdisciplinary mixed methods study included: (i) Observations and exit interviews in eight village clinics and township health centres and 15 retail pharmacies; (ii) Urine, throat swab and sputum samples from patients to identify potential pathogens and test susceptibility; (iii) 103 semi-structured interviews with doctors, patients, pharmacy workers and antibiotic-purchasing customers; (iv) Assessment of completeness and accuracy of electronic patient records through comparison with observational data. 87.9% of 1123 recruited clinic patients were prescribed antibiotics (of which 35.5% contained antibiotic combinations and >40% were for intravenous administration), most of whom had RTIs. Antibiotic prescribing for RTIs was not associated with presence of bacterial pathogens but was correlated with longer duration of infection (OR = 3.33) and presence of sore throat (OR = 1.64). Fever strongly predicted prescription of intravenous antibiotics (OR = 2.87). Resistance rates in bacterial pathogens isolated were low compared with national data. 25.8% of patients reported antibiotics use prior to their clinic visit, but only 56.2% of clinic patients and 53% of pharmacy customers could confirm their prescription or purchase included antibiotics. Diagnostic uncertainty, financial incentives, understanding of antibiotics as anti-inflammatory and limited doctor-patient communication were identified as key drivers of antibiotic use. Completion and accuracy of electronic patient records were highly variable. Prevalence of antibiotic resistance in this rural population is relatively low despite high levels of antibiotic prescribing and self-medication. More systematic use of e-records and in-service training could improve antibiotic surveillance and stewardship in rural facilities. Combining qualitative and observational anthropological methods and concepts with microbiological and epidemiological investigation of antibiotic resistance at both research design and analytic synthesis stages substantially increases the validity of research findings and their utility in informing future intervention development.

An Interactive Online Interprofessional Opioid Education Training Using Standardized Patients.

Opioid pain management is complex and requires a collaborative approach. To prepare health professions students to care for patients who have chronic pain, we developed an interprofessional education (IPE) session for delivery using a virtual platform that featured a standardized patient (SP) interaction. The SP case highlighted a patient on opioids for chronic low back pain resulting from a car accident. Despite no improvement in pain or function, the patient continued taking opioids and developed behaviors that could represent opioid misuse. During the synchronous, online session, interprofessional teams of students interviewed an SP and collaborated to develop a holistic care plan to address the patient's pain and potential opioid misuse. The session evaluation included pre- and postsession surveys. Over 750 students from medicine, pharmacy, nursing, and social work programs participated in the virtual IPE sessions during a single year. Students rated the session positively. Matched survey responses suggested improved confidence in knowledge and skills, and learning through Zoom was rated favorably. We successfully implemented a synchronous online IPE session involving SP interactions that allowed students to practice team-based care of a patient with chronic pain who was taking opioids. Based on the success of this IPE session, including the success of the online delivery model, future IPE sessions will continue virtually.

Interprofessional Education to Address Substance Use among Adults with Persistent Pain: A Pre-Post Program Evaluation

BackgroundSubstance use disorders (SUDs) are highly prevalent among adults with persistent pain. Yet, standard competencies for integrating pain and SUD content are lacking across health science student curricula. Additionally, pharmacotherapies to treat SUDs are underutilized. AimTo address these gaps, a team of health science faculty created an interprofessional simulation activity using a standardized patient and evaluated learner outcomes related to assessment and treatment of comorbid persistent pain and substance use. MethodsA total of 304 health science students representing nursing, medicine, pharmacy, and social work programs attended virtual learning sessions. Interprofessional student teams developed a team-based care plan for an adult with musculoskeletal pain who takes prescribed opioids while using alcohol. Pre- and post-activity surveys assessing knowledge and confidence were matched for 198 students. Descriptive statistics summarized survey data with inferential analysis of paired data. ResultsThe largest significant improvements between pre- and post-activity knowledge were observed in items specific to pharmacotherapy options for alcohol and opioid use disorders. Similar gains were noted in students’ confidence regarding pharmacotherapies. No significant differences were noted on pre-post-activity knowledge scores between the three main profession groups (medicine, nursing, and pharmacy). ConclusionsStudents attending this interprofessional simulation demonstrated improved knowledge and confidence, particularly in pharmacotherapies for alcohol and opioid use disorders. Replication of such programs can be used to provide consistent content across health science disciplines to heighten awareness and receptivity to medications available to treat SUDs in people treated for persistent pain. The curriculum is freely available from the corresponding author.

Experience and attitudes of pharmacists towards challenges and adaptive measures to new norm in ward pharmacy practice during the COVID-19 pandemic

BackgroundCOVID-19 pandemic has created challenges to the ward pharmacy practice. Challenges arose due to new norms in the ward pharmacy practice. Adaptive measures to overcome these challenges were important to sustain the quality of pharmaceutical care. This study aimed to identify the perceived challenges and attitudes towards adaptive measures in the ward pharmacy practice during the COVID-19 pandemic and determined their association with pharmacists’ characteristics.MethodThis cross-sectional study was conducted in 14 Perak state hospitals and 12 primary health clinics through an online survey. All ward pharmacists and trainee pharmacists with at least 1 month of ward pharmacy experience and working in government-funded health facilities were included. The validated survey tool consisted of demographic characteristics, pharmacists’ experience towards challenges (22 items), and their attitude towards adaptive measures (9 items). Each item was measured based on a 5-point Likert scale. One-way ANOVA and logistic regression were employed to determine the association of pharmacists’ characteristics against their experience and attitude.ResultsOut of 175 respondents, 144 (81.8%) were female, and 84 (47.7%) were Chinese. Most pharmacists served in the medical ward (124, 70.5%). Commonly reported perceived challenges were difficulties in counselling medication devices (3.63 ± 1.06), difficulties in clerking medication history from family members (3.63 ± 0.99), contacting family members (3.46 ± 0.90), patient’s digital illiteracy in virtual counselling (3.43 ± 1.11) and completeness of the electronic records (3.36 ± 0.99). For attitude towards adaptive measures, improving internet connection (4.62 ± 0.58), ensuring availability of multilingual counselling videos (4.45 ± 0.64), and provision of internet-enabled mobile devices (4.39 ± 0.76) were the most agreeable by the pharmacists. Male (AOR: 2.63, CI 1.12–6.16, p = 0.026) and master’s degree holders (AOR: 2.79, CI 0.95–8.25, p = 0.063) had greater odds of high perceived challenging experience scores. Master’s degree holders (AOR: 8.56, CI 1.741–42.069, p = 0.008) were also more likely to have a positive attitude score towards adaptive measures.ConclusionPharmacists faced multiple challenges in the ward pharmacy practice during the COVID-19 pandemic, especially in medication history assessment and patient counselling. Pharmacists, especially those with higher levels of education and longer tenure, exhibited a higher level of agreement towards the adaptive measures. The positive attitudes of pharmacists towards various adaptive measures, such as improvement of internet infrastructure and digital health literacy among patients and family members, warrant immediate action plans from health authorities.

Applying a co‐design approach with key stakeholders to design interventions to reduce illegal wildlife consumption

Abstract Co‐design, an approach that seeks to incorporate the experiences and perspectives of different stakeholders, is increasingly being used to develop audience‐oriented behaviour change interventions. The complexity of wildlife consumption behaviour makes the co‐design approach an important potential tool for the design of conservation interventions that aim to reduce illegal wildlife trade. Yet, little is known about how to adapt and apply the co‐design approach to the wildlife trade sector. Here, we applied a co‐design approach to develop interventions aimed at reducing illegal animal‐based medicine consumption in China. We conducted three workshops with key stakeholders: consumers of animal‐based medicines, pharmacy workers who sell them and traditional Chinese medicine (TCM) doctors who prescribe them. We then developed a theory of change to ensure the relevance of the co‐designed intervention prototypes. Our co‐design process identified five main pathways of interventions, including two inclusive solutions that may have been previously overlooked in behaviour change work in this context. These were an intervention to promote the appropriate use of TCM and one to increase consumers' capacity to identify the legality of products. Our prototype interventions also enhanced existing views related to the role of medical practitioners in health‐risk communication. We used our co‐design process and reflections on its application to this specific market to provide guidelines for future conservation program planning in the broader wildlife trade context. Some intervention prototypes produced during co‐design may need wider stakeholder involvement to increase their feasibility for implementation. We show that the co‐design process can integrate multiple stakeholders' perspectives in the ideation stage, and has the potential to produce inclusive intervention designs that could drive innovation in conservation efforts to reduce illegal consumption of a range of wild species. Read the free Plain Language Summary for this article on the Journal blog.

Doctor of pharmacy as a career option: a cross-sectional study exploring PharmD students and practitioners expectations in Jordan

ObjectiveThis study aimed to (1) investigate the expectations and preferences of PharmD students and practitioners regarding their role in the health care system, and (2) to contrast those expectations and preferences of PharmD practitioners with real-life practice in Jordan.MethodsTwo cross-sectional descriptive questionnaires were used to collect data from PharmD students and PharmD practitioners in Jordan. A total number of 330 students and 280 practitioners were interviewed. The responses to all questions were encoded, entered, and summarized as frequencies and percentages or as means and standard deviations. Comparisons between groups were performed using Chi-square test. A p-value of < 0.05 was considered significant.ResultsBoth PharmD students and practitioners chose working as a clinical pharmacist in a hospital as their first-choice job. However, their second and third jobs choices were significantly different as practitioners opted for income as a main criterion for job selection. Interestingly, salary expectations by PharmD students were significantly higher than the reality as reported by PharmD practitioners. Both students and practitioners placed the work environment as the highest priority criterion for making a work choice on the work environment. In general, both students and practitioners agree on the ideal roles of PharmD graduate with the issues of prescribing and compounding responsibilities being the ones with the highest disparity between practitioners and students. Significant differences were found between the student’s and practitioner’s perceptions of the ideal role of a PharmD in and the current professional practice in Jordan.ConclusionJob preferences and salary expectations differ significantly between students and practitioners. Professional orientation of PharmD. students should be implemented to minimize misconceptions of their job nature, availability, and compensations. The fact that students do not prefer to work in a community pharmacy should be addressed by educational institutions and professional organizations. The prescribing and compounding responsibilities of pharmacists should be also emphasized in the curricula of pharmacy schools and worked in by professional organization to achieve optimal implementation in real-life practice.

Exploring stakeholders' perspectives on the quality of services provided through community pharmacies

IntroductionIt is important to understand the factors impacting the quality of services provided through community pharmacies. Exploring how key stakeholders perceive good quality in these services is a logical first step. This could also inform the development of quality measures, such as quality indicators (QIs). AimTo identify key stakeholders' perspectives on the quality of services provided through community pharmacies in Norway, specifically by exploring their experiences and perceptions about what constitutes good service quality. MethodsA convenient sampling approach was used to recruit participants for five semi-structured focus groups from Facebook, pharmacy chains, and patient organizations. The interviews with twenty-six participants were conducted via Microsoft Teams. Interviews were transcribed verbatim, and an inductive thematic analysis with a reflexive approach was used. ResultsFour main themes emerged from the analysis; 1) sufficient and substantively suitable information to cover individual needs, 2) communication skills and relationships with the pharmacy professionals, 3) customer satisfaction with knowledgeable employees and conveniently located pharmacies, and 4) factors that affect the pharmacy working environment. ConclusionThis study has identified areas that pharmacy professionals and customers regard as essential to define good quality of community pharmacy services. Effective communication skills, appropriate provision of information, customer satisfaction, and working environment are all essential factors when developing quality metrics for community pharmacies.