Is present pharmacy education adapted to needs? Survey results from young practitioner views regarding pharmacy education outcome towards a national reform in Hungary

BackgroundThe pharmacist career is constantly adapting to societal and health care needs. The past decade has seen a growing demand for curricular development to align graduation outcome with workforce competencies.ObjectiveThis study aims to identify expectations for both didactic and experiential components of a new curriculum based on young pharmacist practitioner views.MethodsAn online survey questionnaire was used in 2019–2020 to evaluate the pharmacy curriculum to detect indicators or key areas which require comprehensive reform.ResultsThe predominant majority of the 205 study participants recommended reduction in credit hours for Natural Sciences (78.54%) and a similar increase in the Theoretical and Practical Expertise Module (77.9%). Pharmaceutical care, clinical therapeutics and clinical pharmacy competencies should also be more highlighted in the program. Findings indicate the current training does not prepare for problem-solving and daily workplace challenges (72.7%) or for extended pharmacist skills and competencies (71.71%). Results show inconsistency in practical training experience, as all respondents participated in practical training for drug manufacturing and analysis but 61.0% reported no hands-on skills training in a hospital-clinical simulation setting. Indications for practitioner involvement into the natural sciences and biomedical subjects (86.3%) confirm the obvious need for more practice-oriented education.ConclusionsEducational reforms seem to be inevitable to achieve measurable improvement in professional practice and skills competency. The country specific demand for a needs-based pharmacy education reflects global trends but may also provide useful insights for individual transitions to transform education through practice and improve practice through education.     

Moral reasoning perspectives of community pharmacists in situations of drug shortages

BackgroundDrug shortages affect health systems worldwide. Research in community pharmacy has focused on the nature, extent and impact of these shortages on patients and pharmacists. However, pharmacists’ moral reasoning in situations of drug shortages has not been addressed.ObjectiveTo explore the moral reasoning perspectives of Dutch community pharmacists in situations of drug shortages.MethodAn electronic survey was developed around three drug shortage scenarios with a varying impact on patient outcomes: a Contraceptive, a Parkinson's and an Osteoporosis scenario. Pharmacists rated the likelihood of nine handling options and rated and ranked 13 considerations that may have played a role therein. The considerations represented three moral reasoning perspectives (MRPs): a business orientation (BO), a rules and regulations (RR), and a professional ethics (PE) MRP. Principle component analysis (PCA) was used to investigate construct validity of the MRPs. MRP rating and MRP ranking scores measured the relative importance of the different MRPs of pharmacists in the three shortages.ResultsResults from 267 Pharmacists were obtained. They reported mostly similar handling in the three shortages, except for the likelihood to make agreements with prescribers or other pharmacists and regarding the decision to import a product. The PCA analysis confirmed the three MRPs that accounted for 29% of variance in the data. Both the MRP rating and especially the MRP ranking scores indicated that PE-MRP considerations were most influential on pharmacists' intended handling of the shortages. In the Contraceptive and the Osteoporosis scenarios, the relative importance of a BO-MRP was higher than in the Parkinson's scenario.ConclusionPharmacists predominantly reason with a PE-MRP when handling drug shortages. However, this perspective can be compromised when the drug shortage is perceived to have a lower impact on patient outcomes and when alternative drugs or therapy are expensive.     

A national study of the mental health literacy of community pharmacists

BackgroundCommunity pharmacists are in a prime position to communicate with and assist those with mental health needs. However, mental health literacy, which includes beliefs and knowledge of mental health conditions, can impact the provision of pharmacy services. The mental health literacy of community pharmacists in New Zealand is currently unknown.ObjectivesTo assess the mental health literacy of community pharmacists in New Zealand.MethodsWe employed a national cross-sectional online survey, evaluating attitudes towards mental illness, ability to recognise depression using a vignette and followed by questions related to the helpfulness of various interventions, and willingness to provide pharmacy services for people with mental illness in comparison to cardiovascular diseases. Additionally, opportunities for mental health training were explored. Participants were community pharmacists working in New Zealand contacted via mailing lists of professional bodies.ResultsWe received responses from 346 participants. The majority of participants showed positive attitudes towards mental illness and correctly identified depression in the vignette (87%). Participants rated counsellors (84%) and physical activity (92%) as the most helpful professionals and intervention respectively while only 43% considered antidepressants as helpful for depression. When compared to other people in the community, long-term functioning of the individual described in the vignette was rated poorly, especially in terms of increased likelihood to attempt suicide (85%) and reduced likelihood to be a productive worker (64%). Approximately 30% of participants reported reduced confidence/comfort while approximately half of participants reported greater interest in providing mental health-related care compared to cardiovascular disease. The participants also highlighted several areas for future mental health training they wished to undertake.ConclusionsWe have identified positive attitudes towards mental illness in our study. Participants correctly identified and supported evidence-based interventions for mild to moderate depression. However, we highlighted the need for ongoing mental health training to address knowledge gaps and enhance the confidence in providing mental health-related care.     

带教通科临床药师学习慢性肾脏病的教学实践

目的：提高通科临床药师学习慢性肾脏病的培训质量。方法：总结临床经验，优化带教模式。结果：带教药师紧扣大纲要求，了解学员基础与需求，制订个体化教学计划；组织组内学习，开展药物知识和临床指南讲课、教学查房与问诊；作业书写与临床实践并重。结论：带教老师引导学员快速有效地掌握慢性肾脏病一体化治疗和肾衰药物剂量调整的原则与操作，紧扣临床思维和实践技能的培养，为学员以后的临床工作奠定基础。     

基于“互联网+”探索针对2型糖尿病出院患者的创新型药学随访服务模式

目的 利用“互联网+”技术手段,探索针对2型糖尿病出院患者的创新型药学随访服务模式。方法 选取2019年1月至2019年5月于我院内分泌科住院治疗好转后出院2型糖尿病患者,开展“互联网+”药学随访3个月,通过比较患者随访前后用药依从性Morisky问卷评分、2型糖尿病患者自我管理能力评分以及糖尿病综合控制指标的变化情况,评估“互联网+”药学随访的干预效果。结果 药学随访3个月后,2型糖尿病出院患者用药依从性得分从1.94±1.32下降至1.09±0.95(P＜0.05),自我管理能力评分由61.91±19.36提高到79.12±13.62(P＜0.05)；糖化血红蛋白水平从(9.49±2.31)%下降至(6.69±1.49)%(P＜0.05),低密度脂蛋白胆固醇水平从(2.65±0.95)mmol/L下降至(2.22±0.71)mmol/L(P＜0.05),空腹血糖水平随访前后分别为(6.72±1.38)mmol/L、(6.79±1.07)mmol/L(P>0.05)无显著性差异,基础血糖保持良好。结论 “互联网+”药学随访模式,能显著提高2型糖尿病出院患者的用药依从性、自我管理能力以及糖尿病综合指标的控制水平,拓展了医疗机构临床药师的药学服务空间,值得在临床实践中进一步完善推广。     

Opioid use disorder and the COVID 19 pandemic: A call to sustain regulatory easements and further expand access to treatment

Abstract

We highlight the critical roles that pharmacists have related to sustaining and advancing the changes being made in the face of the current COVID-19 pandemic to ensure that patients have more seamless and less complex access to treatment. Discussed herein is how the current COVID-19 pandemic is impacting persons with substance use disorders, barriers that persist, and the opportunities that arise as regulations around treatments for this population are eased.     

以合理用药为核心的中药临床药师参与新型冠状病毒肺炎（NCP）防治的基本切入点及必要性分析＊

新型冠状病毒肺炎爆发以来，我国以最快的响应速度发布了《新型冠状病毒感染的肺炎诊疗方案》，并明确指示在新型冠状病毒肺炎防治工作中建立健全中西医协作机制，使中医药尽早、尽快参与其中，积极发挥其作用。本研究从中药临床药学的角度，以国家及各省区发布的新型冠状病毒肺炎的预防及诊疗方案为切入点，分析中药临床药师参与新型冠状病毒肺炎防治的可行性及必要性，提出中药临床药师参与新型冠状病毒肺炎的防治及公共卫生突发事件的观点，以期能为壮大中医药参与传染性疾病队伍，完善中医药多力量参与公共卫生突发事的体制提供参考。     

An assessment of the current practice of community pharmacists for the disposal of medication waste in the United Arab Emirates: A deep analysis at a glance

ObjectiveThe study aimed to identify the current practice carried out by community pharmacists to dispose of expired medications in their workplace and assess any practical steps utilized to reduce medication waste.MethodA cross-sectional study was conducted among community pharmacists in the United Arab Emirates (UAE). The participants were asked about their routine practice in disposing of different expired medications and the current actions taken to reduce the number of disposed medicines.ResultsThe study included (n = 418) community pharmacists. More than a third of expired liquid, solid, and semi-solid dosage forms were collected by licensed contractors. In addition, more than a third of the pharmacists disposed of different dosage forms via unauthorized methods (general garbage, sink and toilet). Most expired drugs were skin and hair products, antibiotics and analgesics. The majority of pharmacists (68.4 %, n = 286) agreed that expired pharmaceutical and non-pharmaceutical products, other than those disposed of via contractor, should be done through a specialized centre. This opinion was found to be strongly associated with years of practice as community pharmacists (P < 0.05).ConclusionPart of the existing disposal practices for expired pharmaceutical products in the UAE is carried out by contractors licensed by health authorities. However, concern remains regarding some pharmaceutical and non-pharmaceutical products that have not been disposed of correctly. Additionally, there is a need for a specialized center for medication disposal (p < 0.05). A stock limitation is the best practice for managing medication quantities in stock (p < 0.05).     

临床药师对乙肝后肝硬化腹水合并肌脓肿患者的药学监护

【摘要】〓临床药师参与1例乙肝后肝硬化腹水合并肌脓肿患者的药学监护,提出抗乙肝病毒采用强效和低耐药的恩替卡韦单药长期治疗;患者凝血功能不好,抗感染治疗上将利奈唑胺更换为万古霉素,并监测万古霉素的血药谷浓度,调整给药剂量和频次等用药建议,提高疗效和减少药品不良反应的发生率。