Zealand Pharmacy Research Articles

Workplace bullying in pharmacy – a study on prevalence, impacts and barriers to reporting

Purpose The study aims to estimate the prevalence of workplace bullying, personal and work-related impacts, reporting practices for bullying, and the reasons for not reporting bullying incidents in the New Zealand pharmacy sector.Design/methodology/approach An online survey was conducted among registered pharmacists and pharmacist interns in New Zealand from June to August 2020. The questionnaire comprises both close-ended and semi-structured free-text questions. Goldberg’s 12-item General Health Questionnaire (GHQ-12) assessed the respondents’ general psychological health status, and a 22-item Negative Acts Questionnaire-Revised (NAQ-R) was used to estimate bullying prevalence together with the self-rated/self-labeled questions. The qualitative information obtained from the free-text responses was used to support and elaborate on the quantitative results.Findings The self-labeled prevalence of workplace bullying was 36.9%, with almost 10% reporting it occurring almost daily to several times per week. The 54.7% prevalence based on the NAQ-R assessment compares well with the prevalence of witnessing the incidents (58.5%). Psychological distress symptoms were experienced by 37.1% in pre-COVID and 45.3% during COVID-year 1. Supervisors or direct managers were the commonest perpetrators (32.7%). Only 28.8% of those who experienced bullying had reported the incidents formally.Research limitations/implicationsThis study is cross-sectional, and the relationships indicated are bi-directional. The consistency of the results is reassuring, however inferring causality of effect is challenging. Future studies and analyses should focus on this. This study suggests that in the pharmacy environment bullying from the top is reasonably prevalent, is not commonly reported and requires the design and implementation of prevention and management strategies that take into account and mitigate these bullying factors. Professional pharmacy leadership organizations, National Health Authority and Pharmacy regulators could play a significant role in awareness and training to reduce bullying with the development and promotion of strategies to curb it and improve reporting.Originality/value This is the first paper to describe the prevalence and impact of workplace bullying, and the practices of reporting bullying incidents in the New Zealand pharmacy sector. Based on empirical evidence, pharmacists represent a small share of total healthcare workforce, yet the overall prevalence of bullying is consistent with professions with much larger numbers such as medicine and nursing.

Why are we still waiting? Views of future-focused policy and the direction of the profession from dissatisfied recent pharmacy graduates

PurposeThe New Zealand Pharmacy Action Plan 2016–20 acknowledges the young, highly qualified pharmacist workforce, and seeks to address pharmacist underutilisation in the wider health setting. Anecdotal evidence suggests many recently qualified pharmacists are dissatisfied with the profession. Therefore, those completing BPharm programs after 2002, who had left or were seriously considering leaving the New Zealand pharmacy profession, were invited to comment on future-focused pharmacy documents, and the current direction of pharmacy in New Zealand.Design/methodology/approachAn online questionnaire was open December 2018 to February 2019. Recruitment occurred via e-mail lists of universities and professional organisations, print and social media, and word-of-mouth. Free-text responses were thematically analysed using a general inductive approach.FindingsFrom the 328 analysable surveys received, 172 respondents commented on the documents and/or direction of the pharmacy profession. Views were mixed. Overarching document-related themes were positive direction, but concern over achievability, the lack of funding details, lack of implementation, their benefits for pharmacists and the public, and ability to bring about change and secure a future for the profession. Overall pharmacy was considered an unattractive profession needing to change.Originality/valueThis study highlights dissatisfied recent BPharm graduates agree with the vision in the documents but do not see progress towards achieving the vision occurring, leading to frustration and exit in some cases. Policymakers should be aware of these views as considerable resource goes into their development.

Why do pharmacists leave the profession? A mixed-method exploratory study.

Background:Recent New Zealand policy documents aim for pharmacists to be retained, and promote the provision of extended clinical pharmacy services. However, younger pharmacists have expressed dissatisfaction with the profession on informal social for a.Objectives:To explore the characteristics, and perspectives of pharmacy as a career, of recent Bachelor of Pharmacy (BPharm, four-year degree) graduates who have left, or are seriously considering leaving the New Zealand pharmacy profession in the near future and where they have gone, or plan to go.Methods:We conducted a cross-sectional study with a mixed-method explanatory sequential design. An anonymous online survey among those who completed their pharmacy undergraduate degree (BPharm or equivalent) in 2003 or later and who had left or who were seriously considering leaving the New Zealand pharmacy profession in the next five years, was open from 1st December 2018 to 1st February 2019. Recruitment occurred via University alumni databases, pharmacy professional organisations, pharmaceutical print media, social media and word-of-mouth. Ten semi-structured interviews were then conducted with a purposive sample of survey respondents. Descriptive statistics were generated from the quantitative data and qualitative data were analysed using manifest content analysis.Results:We received 327 analysable surveys of which 40.4% (n=132) were from those who had already left the New Zealand pharmacy sector at the time of the data collection and the rest (59.6% n=195) were those working within the sector, but seriously considering leaving the profession. Reasons most commonly reported for studying pharmacy were having an interest in health and wanting to work with people. The most common reasons for leaving, or wanting to leave, were dissatisfaction with the professional environment, including inadequate remuneration, and a perceived lack of career pathways or promotion opportunities. A wide range of career destinations were declared, with medicine being most frequently reported.Conclusions:Most of the reasons for leaving/considering leaving the profession reported relate to the values and features of the pharmacy profession such as the professional environment, remuneration and career pathways. These findings are consistent with other studies and may represent a barrier to achieving the aims of recent health policy documents.

What do patients' want? Time to innovate medicine information leaflets

Introduction : Medicines information leaflets help equip patients to be in control of their own healthcare, and support the safe and effective use of medicines. Leaflet design and content can influence patients’ willingness to read them; poor examples can cause confusion and anxiety. A leaflet may be the only information patients receive due to consultation time constraints and patient preference. The New Zealand pharmacy council code of ethics and the HDC code of rights require patients be fully informed; ineffective leaflets may result in ethical requirements not being fulfilled. This study’s aim was to provide an up-to-date review of the literature to determine patients’ requirements for design and content of medicine information leaflets. Methods : Embase, Medline, Scopus, and Web of Science were searched from 2008-2015, followed by bibliography and citation searching. A data extraction form was used to synthesise qualitative data from the selected studies. A comprehensive list of recommendations for leaflet content was developed. Government recommendations for leaflet design from Europe, New Zealand, UK, and USA were compared with outcomes from studies in the review. Results : 19 studies from seven countries met inclusion criteria. Existing medicines information leaflets do not meet patients’ needs and appear ineffective. Current leaflets lack required information and may contain unessential material, affecting patients’ perception and willingness to read it. The acceptable length of leaflets varies; tailoring of leaflets to individuals requirements is necessary. Application of good design principles improve readability, comprehension, and ability to locate information. Variation was found in the recommendations from health regulatory bodies and the literature. Discussion : Medicine information leaflets must be well designed and meet patients’ information needs. Types and quantity of information required differs between patients. Automated information tailoring to patients’ requirements (e.g. by indication, age, sex) might generate effective leaflets. In New Zealand there is little regulatory guidance given to those creating medicine information leaflets. The design principles identified here can be used as a template. Conclusions : Many medicines information leaflets do not meet patients’ needs and will not be used. Leaflet design affects patients’ understanding and ability to find information and must be optimised according to good design principles. Leaflets should clearly explain patients’ benefits and risks and avoid the inclusion of irrelevant information for individuals. Ideally, information should be tailored to each patient. Lessons learned : Current practice of passively giving pre-printed leaflets is outdated and ineffective. The ability to use automated programs for leaflet tailoring would be a desirable innovation. New Zealand needs stronger guidance on the use of good design principles for those creating medicine information leaflets. Limitations : Authors of the original studies could not be contacted to provide more detailed information. Studies examined intended adherence, not actual adherence. The search focus was patient information leaflets, not how patients’ want information presented and design information was gathered from the studies identified. Suggestions for further research : Evaluation of medicine information leaflets available in New Zealand and investigation of patient use and opinion; differing requirements for over-the-counter and prescription-only medicines. Additionally, whether images would improve leaflet effectiveness.

Could it be done safely? Pharmacists views on safety and clinical outcomes from the introduction of an advanced role for technicians.

There is ample evidence that pharmacists' interventions in patient care improve patient outcomes; however, community pharmacists do not necessarily have the time available to undertake these roles. One way to address this problem is to enable technicians to take on a greater role in the mechanical aspects of the dispensing process. This study aimed to investigate the opinions of New Zealand pharmacists regarding the potential introduction of an advanced technician's role into the New Zealand pharmacy setting. The survey was sent to all pharmacists registered with the New Zealand Pharmacy Council who had indicated a willingness to receive research-related requests (n = 2095). The full survey consisted of yes/no questions and five-point Likert scale questions regarding opinions. A number of the questions allowed respondents to make free-text comments. One of these questions focused on the separation of the clinical and mechanical aspects of the dispensing process. The free-text responses to this question were subjected to thematic analysis. Of 2095 surveys mailed out 736 were returned, yielding a return rate of 36%. Many of the respondents took the opportunity to make comments to individual questions in the overall survey and 400 pharmacists provided additional comments to the specific question regarding the separation of the clinical from the mechanical process of dispensing. The comments received centered on three key themes: Improvements to clinical outcomes, the impact, both positive and negative, on dispensing errors, and the need for quality procedures to minimize the safety risk. The pharmacists were of the opinion that the separation of clinical from mechanical parts of the dispensing process would increase the time available to spend interacting with patients. Coupled with more time dedicated to a clinical assessment of prescriptions they could appreciate this would improve clinical outcomes for the patients. Clear and stringent guidelines and standard operating procedures were proposed to ensure that safety standards do not change.

New Zealand consumers' perceptions of private insurance for pharmaceuticals.

Private insurance plays a minor role in paying for pharmaceuticals in New Zealand, despite controversy about access through the public health system. The present study examines New Zealand consumers’ perceptions of private insurance for pharmaceuticals. A self-administered questionnaire was completed by 433 consumers at thirty pharmacies. The questionnaire included 18 questions on demographics, insurance status, perceptions of private insurance for pharmaceuticals and confidence in the public health system. Forty six percent of respondents had private health insurance. Respondents were more likely to have private health insurance as household income increased, and confidence in the public health system decreased. (Over two thirds of respondents were either confident or very confident in the public health system). Nineteen percent had private health insurance for pharmaceuticals, and the likelihood was not affected by household income or confidence in the public health system. Sixty one percent believed private insurance for pharmaceuticals would increase availability and affordability of pharmaceuticals. However, just over half were willing to pay for private insurance for pharmaceuticals. Of these, over two thirds were only willing to pay $20 per year or less. New Zealand pharmacy consumers’ willingness to pay for private insurance for pharmaceuticals is very low.

The impact of focused teaching sessions on New Zealand pharmacy students’ attitudes to people suffering from schizophrenia and other mental illnesses

The impact of focused teaching sessions on New Zealand pharmacy students’ attitudes to people suffering from schizophrenia and other mental illnesses

Pharmacy Students’ Use of and Beliefs About Traditional Healthcare

Health professional students come from many different cultural backgrounds, and may be users of traditional healthcare (also known as ethnomedicine or folk medicine). This study aimed to explore New Zealand pharmacy students' knowledge and beliefs about traditional healthcare, and to examine whether these changed during the course. A questionnaire was administered to students in 2011 and again in 2013. Students were from a wide range of ethnic groups. Their reported use of traditional healthcare increased (from 48% in 2011 to 61% in 2013) and was usually for minor illness or prevention. Non New Zealand European students were more likely to use traditional healthcare. Use of traditional healthcare was relatively common, and after exposure to a biomedical curriculum students seemed to be more, rather than less likely to report using traditional healthcare. Education about traditional healthcare should not be based on the assumption that all healthcare students are unfamiliar with, or non-users of, traditional healthcare.

EEG alpha power and methadone treatment

Event Abstract Back to Event EEG alpha power and methadone treatment Grace Y. Wang1, 2*, Trecia A. Wouldes3, Rob Kydd3 and Bruce R. Russell1, 2 1 The University of Auckland, School of Pharmacy, New Zealand 2 The University of Auckland, Centre of Brain Research, New Zealand 3 The University of Auckland, Department of Psychological Medicine, New Zealand Background: A small number of studies conducted mostly during the 70’s have examined EEG changes in patients undertaking methadone maintenance treatment (MMT) during resting states and have shown inconsistent effects of MMT on brain function. Some of the inconsistencies may have arisen because of differences in sample size and variations in the inclusion criteria of participants. Objective: The objective of this study was to address the limitations of earlier research by examining the effect of MMT on resting alpha rhythm using electroencephalography (EEG). Method: The average power of alpha (8-13 Hz) rhythm was measured in 32 MMT patients, 17 opiate users and 25 healthy volunteers. A one-way analysis of variance with group as a fixed factor with age and years of education entered as covariates tested the differences between groups. Post-hoc comparisons were Bonferroni corrected. Results: During the eyes open condition, a significantly higher alpha amplitude was found in active opiate users in contrast to healthy controls in the frontal (F=4.93, p=0.01), central (F=4.25, p=0.02), temporal (F=5.28, p=0.007) and parietal-occipital regions (F=3.85, p=0.03). There was no difference either between the MMT group and healthy controls or between the MMT and opiate groups. Furthermore, there were no group differences in alpha power during the eyes closed condition. Conclusion: The abnormal electrical neural activity presented in active opiate users may be minimised following chronic MMT. The normalising effect of MMT may be related to a low level of sustained activation of the opiate receptors with proper dosing of methadone. Acknowledgements Funding for this study was provided by New Zealand Pharmacy Education Research Funding (NZPERF) References Feinstein, B., & Hanley, J. (1975). EEG findings in heroin addicts during induction and maintenance on methadone [Research Support, U.S. Gov't, Non-P.H.S.]. Electroencephalography & Clinical Neurophysiology, 39(1), 96-99. Fingelkurts, A. A., Fingelkurts, A. A., Kivisaari, R., Autti, T., Borisov, S., Puuskari, V., Kähkönen, S. (2007). Composition of EEG Oscillations and their Temporal Characteristics International Journal of Psychophysiology. Fingelkurts, A. A., Fingelkurts, A. A., Kivisaari, R., Autti, T., Borisov, S., Puuskari, V., Kähkönen, S. (2009). Methadone restores local and remote EEG functional connectivity in opioid. International Journal of Neuroscience 119(9), 1469-1493. Lenn, N. J., Senay, E. C., Renault, P. F., & Deuel, R. K. (1976). Neurological assessment of patients on prolonged methadone maintenance [Research Support, U.S. Gov't, Non-P.H.S.]. Drug & Alcohol Dependence, 1(4), 305-311. Martin, W. R., Jasinski, D. R., Haertzen, C. A., Kay, D. C., Jones, B. E., Mansky, P. A., & Carpenter, R. W. (1973). Methadone--a reevaluation. Archives of General Psychiatry, 28(2), 286-295. Keywords: Methadone treatment, Opiates, Alpha power, resting EEG, opiate receptors Conference: ACNS-2012 Australasian Cognitive Neuroscience Conference, Brisbane, Australia, 29 Nov - 2 Dec, 2012. Presentation Type: Poster Presentation Topic: Other Citation: Wang GY, Wouldes TA, Kydd R and Russell BR (2012). EEG alpha power and methadone treatment. Conference Abstract: ACNS-2012 Australasian Cognitive Neuroscience Conference. doi: 10.3389/conf.fnhum.2012.208.00111 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 25 Oct 2012; Published Online: 07 Nov 2012. * Correspondence: Ms. Grace Y Wang, The University of Auckland, School of Pharmacy, Auckland, New Zealand, g.wang@auckland.ac.nz Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers Grace Y Wang Trecia A Wouldes Rob Kydd Bruce R Russell Google Grace Y Wang Trecia A Wouldes Rob Kydd Bruce R Russell Google Scholar Grace Y Wang Trecia A Wouldes Rob Kydd Bruce R Russell PubMed Grace Y Wang Trecia A Wouldes Rob Kydd Bruce R Russell Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.

Work patterns and uptake of continuing education in a two-year cohort of New Zealand pharmacy technicians

Abstract Objective To investigate the current practice, continuing education uptake and future work intentions of pharmacy technicians in New Zealand. Method Postal questionnaire survey of all 148 technicians certificated through the Open Polytechnic of New Zealand who started training in 1991 and 1992. Responses were obtained from 83 (56 per cent) of the target population. Key findings While most technicians regularly performed the duties for which they had been trained, some were also performing more demanding tasks, such as unit dose dispensing and deliveries for rest homes. A smaller number were engaged in more managerial tasks while fewer still were working beyond the confines of their legally defined role by undertaking extemporaneous compounding and preparing Controlled Drugs. Many felt restricted within their current role and wished to see it extended. Perhaps for that reason, most had undertaken some form of continuing education/professional development, not all of them with the support of their pharmacist employer(s). Conclusions While pharmacy technicians' aspirations and activities might be perceived by some as threatening the traditional role of pharmacists, technicians could also assist pharmacists to move further from the dispensary into the new age of counselling and other forms of patient management and care.

Preceptors, Interns, and Newly Registered Pharmacists' Perceptions of New Zealand Pharmacy Graduates' Preparedness to Practice

To determine the perceptions of pharmacy interns and newly registered pharmacists and preceptors regarding the preparedness of graduates to enter professional practice. A questionnaire was developed from the New Zealand Competence Standards for the Pharmacy Profession (pharmacist level), with additional questions on communication skills included. The instrument contained 16 items and was mailed to preceptors (n=141), interns (n=72), and newly-registered pharmacists (n=101). Microsoft Excel (pivot tables) was used to analyse the quantitative responses. The final question asked respondents to provide free-text comments about the questionnaire, graduates and the program and responses were analyzed quantitatively and thematically. The response rates were 54.6% (n = 77) for preceptors, 100% (n = 72) for interns and 45.5% (n = 46), for newly registered pharmacists. The majority of responses (87.6%; n=2,562) were in agreement that the degree had prepared graduates for practice. Overall, preceptor perceptions of graduates' preparedness for practice were less favorable than graduates' self-perceptions of their preparedness. Four themes were identified from the free-text comments: the need for improved skills, more professional attitudes, better English communication, and additional training in extemporaneous compounding. Feedback elicited from graduates and preceptors was helpful in identifying the strengths and weaknesses of a new bachelor of pharmacy (BPharm) program and proved useful in both the accreditation and curriculum revision processes.

New Zealand pharmacy students' knowledge of health, healthcare and medicines issues in developing countries

Abstract Objective This study aimed to assess students' knowledge of health, healthcare and medicines in developing countries, as a first step toward developing appropriate teaching materials on these topics. Setting School of Pharmacy, University of Otago, New Zealand. Method A questionnaire was administered to second and third year pharmacy students at the University of Otago, in class time. Key findings Two hundred and three students completed the questionnaire (83% of 245). Students showed awareness of the nature of health problems in developing countries, though they tended to significantly underestimate the extent of these problems, and the extent of differences in life expectancy between the richest and poorest nations. Their knowledge and understanding of medicines issues was variable: 87% correctly indicated that oral rehydration in childhood diarrhoea would save many lives, but nearly half the students did not know that antibiotics could be purchased without a prescription in many developing countries, or thought that they could not. Students indicated considerable interest in working as a pharmacist in a developing country in the future, and in taking courses in international healthcare. New Zealand students tended to exhibit better knowledge of the development level of selected countries, and the extent of significant health problems, but less knowledge of medicines-related issues, and some more negative views of people in developing countries than students from outside New Zealand. Conclusion Students show interest in learning and working in developing countries, but there are gaps in their knowledge about health, healthcare and pharmacy in those countries. Stimulating student's interest and awareness of developing countries may contribute towards addressing the health professional ‘brain drain’ from developing to developed countries.

Extemporaneous compounding in New Zealand hospitals

Abstract Objective The skill to compound non-sterile products is one of the seven competencies required of entry-level pharmacists for registration with the New Zealand Pharmacy Council. The need for extemporaneous compounding skills has been questioned in other countries, as it is argued that the skill is not often required in modern pharmacy settings. The aim of the current study was to determine the scope and frequency of extemporaneous compounding in New Zealand hospitals Method Retrospective data were collected from eight large hospitals where extemporaneous compounded is regularly undertaken, for the period June 1, 2004 to December 31, 2004. Data were retrieved from compounding logbooks and batch sheets in hospital dispensaries. Data were collected from the north and south islands of the country. There are 32 hospitals of various sizes in New Zealand but extemporaneous compounding is not undertaken at all of them due to staff shortages or lack of demand. Key findings There were 2015 products compounded over the seven-month period, with an average of 251.9 per month. Suspensions were the most frequently compounded oral dosage form. Omeprazole suspension was the most frequently compounded extemporaneous product. Nearly one-third of the compounded products were for beta-blockers. Creams, ointments and non-oral solutions were the most common topical compounded products. Conclusion Pharmacists perform a broad range of extemporaneous compounding, and the skill of compounding is thus an essential competency for all hospital pharmacists.

The state and the market: the impact of pharmacy licensing on the geographical distribution of pharmacies

In Norway and Finland the state controls the number and location of pharmacies through a system of pharmacy licensing. In New Zealand pharmacy numbers and location are determined by the decisions of individual pharmacists. Pharmacy licensing is designed to improve access to pharmacy services in rural areas, while leading to lower numbers of pharmacies than more market-driven systems. This paper looks at whether licensing achieves these goals. While recognizing that pharmacy numbers and location are affected by other factors, it concludes that licensing allows governments to improve access to pharmacies in rural areas without increasing the total number of pharmacies.

Gender and occupational change: women and retail pharmacy in New Zealand

Recent work on women and professions has suggested that gender is an important influence on occupations' success in establishing and maintaining professional privileges. It has been argued that women have been excluded from professionalising occupations, and that feminisation is linked with de skilling, declining rewards and the development of secondary labour markets, in which women are concentrated. However, the case study of New Zealand pharmacy suggests that this is an incomplete account of the links between gender and professionalisation. For instance, women were partially excluded from retail pharmacy in order to maintain the market structure desired by pharmacists, but their entry in large numbers in the 1960s was an unintended consequence of the success of pharmacists' professionalisation project.

New Zealand Pharmacy Act. Definition of a drug

New Zealand Pharmacy Act. Definition of a drug