Perceptions and attitudes of Jordanian paediatricians towards off-label paediatric prescribing

Objective To assess current experiences and attitudes of hospital based paediatricians towards off-label medicine prescribing. Setting Paediatric hospital wards and out-patient clinics. Design A prospective, questionnaire based study. Results A 30 item questionnaire was sent to 300 hospital based paediatricians and 250 (83%) were returned completed. Over 69% of responders were familiar with the term off-label medicines. However, only 28% were knowingly prescribing off-label medicines to children. The majority of respondents (90%) expressed concerns about the safety and efficacy of off-label medicines. Only 15% had observed Adverse Drug Reactions, and 31% a treatment failure. The vast majority of respondents (83%) did not obtain informed consent or tell parents they were prescribing off label medicines to their children. Conclusions Off-label prescribing of medicines to children is a familiar concept to the majority of paediatricians in Jordan although only a smaller number are aware that it is common in their practice. Respondents showed concern about off label prescribing, although the majority do not consider it necessary to inform parents. More comprehensive research is needed in this area in Jordan and other Middle Eastern countries.     

Satisfaction predictors and attitudes towards electronic prescribing systems in three UK hospitals

Objective Measuring satisfaction of technology users, along with satisfaction determinants, is important to enhance system utilisation and identify potential problems. The aim of this study was to investigate pharmacists’ and doctors’ attitudes towards e-prescribing systems, and assess the predictors of their satisfaction. Method A cross-sectional survey was conducted, with 67 pharmacists and 335 doctors in three English hospitals completing a pre-piloted, postal questionnaire. Results The majority of pharmacists and doctors agreed that their e-prescribing system improved the efficiency of prescribing, and reduced dosage regimen errors. However, the majority did not believe that the system created more time for near-patient clinical activities, or sped up patient discharge. More pharmacists than doctors believed that the system improved the quality of patient care. Doctors were more likely to perceive that the e-prescribing system reduced formulation and omission errors. Doctors and pharmacists from the same hospital had similar opinions about the strengths and weaknesses of the e-prescribing system. Nine variables (out of 29 potential independent variables), seven of which were related to e-prescribing system efficiency, were significant predictors of user satisfaction. Conclusion Overall, respondents were satisfied with the systems; however, pharmacists were generally more satisfied than doctors. The number of satisfaction predictors related to the feelings about e-prescribing system efficiency was larger than those predictors related to the quality of patient care. Implications for practice These findings contribute to better understanding of how pharmacists and doctors perceive e-prescribing systems, and also have implications for system development, training, and how an e-prescribing system can be most effectively ‘marketed’ to different user groups.     

Views of pharmacist prescribers,doctors and patients on pharmacist prescribing implementation

Aim The aim of this study was to explore the perspectives of pharmacist supplementary prescribers, their linked independent prescribers and patients, across a range of settings, in Scotland, towards pharmacist prescribing. Method Telephone interviews were conducted with nine pharmacist prescribers, eight linked independent prescribers (doctors) and 18 patients. The setting was primary and secondary care settings in six NHS Health Board areas in Scotland. Key findings In general, all stakeholders were supportive of pharmacists as supplementary prescribers, identifying benefits for patients and the wider health care team. Although patients raised no concerns, they had little idea of what to expect on their first visit, leading initially to feelings of apprehension. Pharmacists and doctors voiced concerns around a potential lack of continued funding, inadequate support networks and continuing professional development. Pharmacists were keen to undertake independent prescribing, although doctors were less supportive, citing issues around inadequate clinical examination skills. Conclusions Pharmacists, doctors and patients were all supportive of developments in pharmacist supplementary prescribing, although doctors raised concerns around independent prescribing by pharmacists. The ability of pharmacists to demonstrate competence, to be aware of levels of competence and to identify learning needs requires further exploration.     

Pharmacy provision of emergency contraception to men: A survey of pharmacist attitudes in Rhode Island

ObjectiveTo describe pharmacy staff members's attitudes and practices related to male emergency contraception (EC) requests, as well as the occurrence of male purchases in Rhode Island.DesignCross-sectional study.SettingPharmacies throughout Rhode Island during April to August 2008.Participants226 pharmacists and pharmacy technicians.InterventionParticipants were mailed a 21-item closed-ended questionnaire.Main outcome measuresDemographics, EC provision practices, recall of male EC purchases, and attitudes toward male EC access.ResultsOf 151 pharmacies surveyed, 91 responded, providing 226 individual pharmacy staff member surveys. Among this population, 95.6% sold EC. Although 59.7% believed male EC purchases occurred rarely, 63.3% sold EC to a man in the previous year. Ten (4.4%) respondents refused sale of EC to a man. Respondents were less likely to agree that men should always have access if they also believed that access would decrease regular contraceptive use (P = 0.008) and if they could not verify the female recipient'ss consent (P < 0.001).ConclusionPharmacists and technicians commonly believed that male EC purchases did not occur or occurred rarely; however, more than one-half of this population sold EC to men. Although the majority expressed personal reservations against providing EC to men, they still agreed that men should have access to EC. These findings suggest that pharmacies are an acceptable setting for male EC access and that although refusal exists, it may not be a barrier to access.     

山西省泽州县农村人群癫痫流行病学抽样调查

目的 :调查了解我国农村地区癫痫的患病率以及治疗缺口 ,为开展防治工作提供依据。方法 :采用随机整群抽样的方法以村为单位确定调查人群 ,由经过统一培训的医生入户调查 ,共调查 10 2 73人。凡初筛调查时确诊或可疑为癫痫者均经神经科医师再次访查确诊。结果 :本次调查共确诊癫痫患者 60例 ,患病率为 5 .8‰ ,活动性癫痫患病率为 3 .3‰ ,年发病率为 3 8.9/10万。全部患者中有 5 3 .3 %未治疗 ,2 5 %的患者治疗不正规 ,活动性癫痫的治疗缺口高达 61.8%。结论 :我国农村地区癫痫患病率大大高于以往的报道 ,患者中约有 2 /3以上没有得到正确治疗 ,应尽快制订合理的干预对策     

上海市医疗机构药学技术人员基本状况调查

目的：调查分析上海市医疗机构药学技术人员的基本情况，为促进医院药学工作模式的改革。加强医药学工作的建设和规划提供依据。方法，函发调查表，获取各医院床位数，门诊日均工作量以及药学部门技术人员职称，学历，岗位分布等数据，检索《中国生物学献光盘数据库》，获得各药学部门负责人发表的学术论情况。数据来自416所医院（其中三级医院28所，二级医院52所，一级医院336所），涉及药学技术人员6403名（其中药师5303名）。结果：药师队伍中高级、中级、初级职称人数之比为2：9：55；博士、硕士、本科、大专、中专学历的人数比为1：8：76：118：398。但是，各类人员分布不均，平均每年三级医院拥有的高级职称，中级职称人数显高于二级医院，一级医院拥有的人类，博士、硕士学历的人员主要分布在三级医院，三级医院，二级医院中门，急诊调剂岗位上高级，中级职称的人员比例低于其他部门，三级医院平均每百张床位配备的住院药房药学技术人员仅1名。论较多的作均为高级职称，有的还是博士生导师或硕士生导师。结论：上海市医院药学技术人员职称结构，学历结构难以胜任当前药学服务模式转换的工作，发表论情况显示出学术集中趋势，学科带头人效应明显，如何提高药师队伍整体素质和学术水平是摆在全体药师面前的重要课题。     

Attitudes towards drugs — a survey in the general population

Background: Studies have shown that many drugs have a lower effectiveness in clinical practice than would be expected from results reported in randomised controlled clinical trials. Many factors influence the use of drugs. Personal factors such as knowledge, attitudes, motivation, expectations are considered to be of particular consequence. The aim of the study was to analyse attitudes towards drugs from an epidemiological perspective.Design: Cross-sectional surveySetting:The county of Uppsala, Sweden, 1995.Results: 5,404 completed the questionnaire (response rate=68%). A majority either considered drugs as something positive, a help (60%), or as something necessary but evil (38%). A small proportion — around 2% — considered drugs as a danger. There were differences in attitudes according to education and income, self-care orientation, medication knowledge, and state of health. We also found differences in attitudes between users and non-users of certain types of drugs. Users of hypertensive drugs more often considered drugs as necessary but evil than did non-users of these drugs, while users of psychotropic drugs more often viewed drugs as something positive than did patients who did not use psychotropic drugs.Conclusion: A better understanding of the general attitudes towards drugs is important when giving both written and oral information to patients and to the public at large. It is also important to be aware of differences in attitudes between various patient groups and that certain patients, e.g., patients prescribed hypertensive drugs, could require more attention from health care professionals.     

Impact of a clinical pharmacist on antibiotic prescribing. A multicenter trial.

Within the past two decades, hospital pharmacists have become increasingly involved in providing consultation to physicians for drug management. Antibiotic use has become a complex and rapidly expanding discipline, complicated by the introduction of multiple new antimicrobial agents, each with unique features, and the pressures of prospective payment schemes. This study demonstrated that a team including a pharmacist had a positive impact on medical residents' utilization of antibiotics.     

Risky drinking among community pharmacy customers in New Zealand and their attitudes towards pharmacist screening and brief interventions

Introduction and Aims. To estimate the prevalence of risky drinking among customers in community pharmacies and to explore customer attitudes towards screening and brief intervention (SBI). Design and Methods. Cross‐sectional, anonymous survey, using random selection of community pharmacies in New Zealand to collect data using self‐completion questionnaires and an opportunity to enter a prize draw. Participants were customers/patients attending the community pharmacy on a specific, randomly selected day (Monday to Friday) in one set week. Alcohol Use Disorder Identification Test (AUDIT)‐C using a cut‐off score of 5 was used to measure risky drinking. Attitudes towards pharmacists engaging in SBI for risky drinkers were measured. Results. 2384 completed customer/patient questionnaires from 43 participating pharmacies. Almost 84% ever drank alcohol and using a score of 5 or more as a cut‐off, 30% of the sample would be considered as risky drinkers. Attitudes were generally positive to pharmacists undertaking SBI. Logistic regression with AUDIT‐C positive or negative as the dependent variable found those taking medicines for mental health and liver disease being more likely to score negative on the AUDIT‐C, and smokers and those purchasing hangover cures were more likely than average to have a positive AUDIT‐C screen. Discussion and Conclusions. This study indicates there is scope for community pharmacists to undertake SBI for risky drinking, and that customers find this to be acceptable. Targeted screening may well be useful, in particular for smokers. Further research is required to explore the effectiveness of SBI for risky drinkers in this setting.[Sheridan J, Stewart J, Smart R, McCormick R. Risky drinking among community pharmacy customers in New Zealand and their attitudes towards pharmacist screening and brief interventions. Drug Alcohol Rev 2012;31:56–63]