Changing understanding,perceptions, pain relief of and preference for generic medicines with patient education: An experimental intervention study

BackgroundGeneric medicines have been associated with less perceived efficacy and more side effects compared to brand name drugs. Educational interventions to improve individuals’ negative perceptions of generic medicines show contradictory effects.ObjectiveThis study investigated whether an interventional video that informs about the approval process of releasing medicines has better effects on outcomes related to perceptions and effectiveness of generic medicines in participants with headaches, in comparison with another interventional video that addresses bioequivalence between brand name and generic drugs or a control video.MethodsParticipants with frequent tension headaches were randomized to one of three groups (one of two interventional videos or the control video). One of the interventional videos explained the process of approval of generic medicines (n = 34), the other one explained the bioequivalence between brand name and generic drugs (n = 35). The control video informed participants about the epidemiology and etiology of headaches (n = 34). After watching the video, participants treated their next two consecutive episodes of headache with a brand name and a generic analgesic in randomized order.Main outcome measuresSelf-report measures of understanding and perceptions of and preference for medicines, pain severity and side effects.ResultsLinear mixed models showed that both interventional videos improved participants’ understanding of generic medicines. The generic drug approval process video enhanced the perceived effectiveness, safety and quality of generic drugs. The bioequivalence video positively influenced the preference for generic drugs. The brand name and generic drug were equally effective in relieving pain in participants who watched either the generic drug approval process or the bioequivalence video.ConclusionsInformation about both, approving a switch from brand name medicines to generic counterparts and bioequivalence, can be important and should be addressed in future educational interventions.     

Communicating benefits and risks of generic drugs to consumers: Patient and caregiver opinions of two FDA-developed educational materials

BackgroundIncreasing prescribing and dispensing of generic drugs, compared to brand drugs, may increase patient access to affordable medications. However, little is known about patients' and caregivers' needs and receptiveness regarding the design of educational materials about generic drugs.MethodsThe research used focus groups of patients and caregivers who were students or employees of one university in the Southeastern U.S. to gather input on the optimal content, format and design, delivery channel, and level of satisfaction for two existing, FDA-developed educational materials about generic drugs (infographic and brochure).ResultsParticipants stated a need for the materials to modernize their graphics, emphasize generic drug cost-savings for consumers, reduce scare tactics when discussing adverse events, and be disseminated directly from physician's offices and pharmacies. Despite an overall positive impression of the materials, participants wanted more consumer-oriented materials that were tailored to fit the needs of different types of patients/caregivers, including older adults.ConclusionsThis paper discusses how these findings relate to theories of multimedia learning and guidelines for designing health educational materials, as well as implications for the development of tailored generic drug educational materials for use in public health campaigns to improve access to medication therapy.     

Trust in the approval process of medicines mediates the effect of an educational intervention on the pain relief induced by a generic analgesic

BackgroundGeneric medicines have been associated with less efficacy compared to originator products. Educational videos explaining generic medicines can have a positive effect on perceptions of generic drugs and their pain-relieving effect.The central aim of the current study was to examine whether trust in the governmental approval process of medicines mediates the effect of educational video interventions on the pain-relieving effect induced by a generic medicine and whether trust can be built by improving individuals’ understanding of generic medication.MethodsThis is a secondary analysis of a randomized controlled trial where participants with frequent tension headaches were randomly assigned to either watching a video explaining generic drugs (n = 69) or a video informing about headaches (control group: n = 34). After watching the video, participants took an originator and a generic pain analgesic in a randomized order to treat their next two consecutive headaches. Pain severity was measured before and 1 h after taking the medicine.ResultsA multiple serial mediator model showed that improving individuals' understanding of generic medicines is associated with increased trust in medicines. Both factors together, understanding and trust, significantly mediated the effect of the video education about generic drugs on the generic's pain-relieving effect (total indirect effect: coefficient: 0.20, 95% CI: 0.42, −0.0001).ConclusionResults of this study show that improving individuals’ understanding of generic medication and trust in the process of approving medicines should be considered as important mechanisms of future educational interventions about generic medicines.     

“4＋7”带量采购对内蒙古自治区人民医院口服抗肿瘤药原研药和仿制药使用情况影响

目的 分析“4＋7”带量采购政策对内蒙古自治区人民医院口服抗肿瘤药品原研药和仿制药使用的影响，为临床药学服务和医院的药事管理提供依据。方法 采用Excel软件计算口服抗肿瘤药品的使用数量、金额、价格、用药频度（DDDs）、限定日费用（DDC）、占比、增幅、降幅，及仿制药替代率、费用节省率进行分析。结果 “4＋7”带量采购实施后，原研药和仿制药价格出现了不同幅度的降价，其中中选品种来曲唑单品价格降幅最大，降幅超过60%，原研药中价格降幅最大的是阿斯利康制药有限公司生产的吉非替尼，达30%。“4＋7”带量采购实施后，甲磺酸伊马替尼、替吉奥、来曲唑、阿那曲唑、卡培他滨、替莫唑胺仿制药DDDs均增加，而销售金额均下降。吉非替尼仿制药DDDs增幅最大，达74.17%，销售金额则增加57.38%。甲磺酸伊马替尼原研药受带量采购政策影响，DDDs和销售金额均增加，而其他相应的原研药的DDDs和销售金额均减少。“4＋7”带量采购的实施进一步提高仿制药的使用率，为医保费用节省899万元，费用节省率为49.99%。结论 带量政策实施后，药品费用支出减少，切实减轻了部分患者的用药负担。     

Medication-related problems encountered in the Program of All-Inclusive Care for the Elderly: An observational study

ObjectiveTo evaluate pharmacist-encountered medication-related problems (MRPs) among the participants of the Program of All-Inclusive Care for the Elderly (PACE).DesignThis was a retrospective analysis of proprietary pharmacy records detailing pharmacist encounters with PACE clinical staff.Setting and participantsA national provider of pharmacy services to more than 75 PACE organizations. In total, 1057 PACE participants at 69 PACE sites across the United States with documented pharmacist encounters between March and May 2018.Outcome measuresMRPs were classified using the Hepler-Strand taxonomy, and pharmacists’ recommendations made to prescribers to resolve these MRPs were classified using a modified Hoth taxonomy. In addition, pharmacists’ communication methods and prescribers’ responses were analyzed.ResultsOverall, 2004 MRPs were encountered. The most frequent MRPs identified were related to medication safety concerns, including drug interactions (720, 35.9%), adverse drug reactions (ADRs, 356, 17.8%), high doses (270, 13.5%), and unindicated drugs (252, 12.6%). Drug interactions frequently involved competitive inhibition, 3 or more drugs, opioids, anticoagulants, antiplatelets, and antidepressants. Deprescribe medication (561, 24.8%), start alternative therapy (553, 24.4%), change doses (457, 20.2%), and monitor (243, 10.7%) were the top 4 types of recommendations made by pharmacists. Among 1730 responses obtained from PACE prescribers, 78.1% (n = 1351) of pharmacists’ recommendations were accepted. Compared with electronic communication, telephonic communication was associated with more acceptance and less prescriber nonresponse (χ² = 78.5, P < 0.001).ConclusionPharmacists identified a substantial number of MRPs in PACE, especially those related to medication safety such as drug interactions and ADRs. In this practice setting, significant collaboration occured between pharmacists and PACE prescribers, as evidenced by the rate of prescribers’ acceptance of pharmacists’ recommendations. Further research is needed to fully evaluate the economic, clinical, and humanistic outcomes associated with pharmacists’ encounters in PACE.     

Work readiness scale for pharmacy interns and graduates: A cross-sectional study

IntroductionAs the number of unemployment among pharmacy graduates increases, the Saudi Ministry of Labor implemented extra measures to facilitate their training and hiring by the private sectors. Nevertheless, there is a paucity of data regarding pharmacy graduates’ work readiness (WR). Hence, we aim to assess their WR and identify predicting factors associated with WR among pharmacy graduates’ in Saudi Arabia.MethodsA 46-item self-reported pre-validated anonymous work readiness scale (WRS) survey with a 5-point Likert scale was administered to pharmacy senior students and graduates using Qualtrics XM® survey tool over the month of May 2020. The main outcome was to assess WRS for pharmacy interns and graduates and identify factors associated with work readiness.ResultsA total of 617 participants have participated in this survey, out of which 46.5% were freshly graduated pharmacists and 19.6% were pharmacy interns. Most participants (82.3%) were PharmD candidates or graduates. Around two-third of participants (63%) have successfully completed all survey items. The maximum points scored was 223 out of 230, and the median overall score was found to be 175. There was no significant association with gender, age, or type of university regarding overall scores. However, a statistically significant odds ratio was observed with PharmD program type and previous pharmaceutical marketing training (OR = 1.778, 95% CI = 1.143–2.765: OR = 0.618, 95% CI = 0.432–0.884, respectively).ConclusionThe overall median score shows a good work readiness level among pharmacy students/graduates in Saudi Arabia; however, PharmD program graduates exposed to advance pharmacy training, including the pharmaceutical marketing experience, have higher work readiness odds than Bpharm graduates. Further studies involving other related perspectives, such as stakeholders, employers, and preceptors, would give a clear image of pharmacy graduates’ job readiness levels.     

Self-reported and the actual involvement of community pharmacy professionals in the management of acute childhood diarrhea in Jazan Province,Saudi Arabia: Simulated patient visits and survey study

BackgroundAcute childhood diarrhea is one of the most common causes of dehydration, and if severe, can potentially lead to death as well. The present study was aimed at evaluating the knowledge and attitudes of community pharmacy professionals towards the management of acute childhood diarrhea and comparing them with their actual practices in Jazan Province, Kingdom of Saudi Arabia (K.S.A).MethodsSimulated patient visits and a cross-sectional survey making use of a 27-item self-report questionnaire were conducted amongst a sample of 303 community pharmacy professionals (51.2 % male and 48.8 % female) with an age range of 25–56 years, between August 1 and December 1, 2021, in Jazan Province, Saudi Arabia. Convenience sampling technique was used for the recruitment of the participants.ResultsSignificant positive correlations were seen between knowledge score (self-report survey) and practice score (simulated patient visit) regarding patients’ history taking (r = 0.65; p < 0.01), drug recommendations (r = 0.71; p < 0.01) and providing information regarding food and fluid intake (r = 0.44; p < 0.01). The alpha coefficients for all the items of the survey instrument were noted to be greater than (or) equal to the 0.70 threshold for almost all sections, hence indicating good reliability and internal consistency of the developed scale.ConclusionIn the present study, even though we observed improved participants’ performance during the self report survey, their performance level greatly dropped in actual practice. This warrants for a need for educational programs to improve their actual dispensing practices. The present study has also shown simulated patient visits to be a reliable, simple and a robust method of assessing the actual dispensing practices of community pharmacy professionals.     

Perceptions of patients on Medicare Part D medication therapy management services

ObjectivesTo determine patients’ perceptions and expectations about medication therapy management (MTM) services pertaining to the core elements of an MTM service in the community pharmacy setting, and to develop educational strategies and outreach programs aimed at increasing patients’ knowledge of MTM services and the expanded role of pharmacists in the community pharmacy setting.DesignMulticenter, cross-sectional, anonymous study.SettingFour regional community chain pharmacies in Maryland and Delaware in January and February 2006.Patients81 patients who were 18 years of age or older and able to complete the survey.InterventionSurvey containing 14 questions administered within pharmacies, two of which had patient care centers that were providing clinical services.Main outcome measurePatients’ perceptions and expectations regarding MTM services.Results49 of 81 patients (60%) had never heard of MTM services. A total of 65 patients (80%) had never had or received a medication therapy review, 63 (78%) never had or received a personal medication record, and 70 (86%) never had or received a medication action plan. Some 56% of participants (n = 45) thought that pharmacist provision of medication therapy reviews, personal medication records, medication action plans, recommendations about medications, and referral to other health care providers was very important. At least 70% of participants (n = 57) thought that having one-on-one consultation sessions with pharmacists to improve communication and relationships with their pharmacists and to improve their medication use and overall health was very important. More than 50% of participants indicated that they would like to receive brochures or talk to their pharmacist to learn more about MTM services.ConclusionPatients have very limited knowledge of the core elements of an MTM service in the community pharmacy setting. Patients reported that pharmacist provision of MTM services was important, but they were concerned about privacy and pharmacists’ time. Patients are also supportive of and believe that MTM services can improve communication and relationship with their pharmacist and improve medication use. Patients appear to prefer receiving brochures and talking to pharmacists to learn more about MTM services. This survey identified a key opportunity for pharmacists to inform patients about MTM services.     

Validating a hospital medicines formulary survey in the Western Pacific Region--a global hospital pharmacy initiative based on the Basel Statements

BackgroundIn 2008, the Basel Statements were developed to reflect the future of hospital pharmacy worldwide. Included were a key set of statements regarding the expanding role of hospital pharmacists' influence on prescribing from the management of medicines formularies to being an active member of the therapeutic decision-making process.ObjectivesThis study aimed to validate a survey to measure Basel Statement 26 regarding the role of medicines formularies and the factors that affect its use in the Western Pacific Region (WPR).MethodsThe survey was developed in consultation with a WPR advisory group and current literature. The survey was translated using the forward-backward method into Chinese (simplified) and Vietnamese. The instrument was pilot tested in a stratified random sample of 260 hospital pharmacy directors in the WPR. Principal components analysis (PCA) was applied to the data to assess construct validity of the Medicines Formulary Scale that assessed responders’ perceptions of their formulary and impact on utilization.ResultsThe Medicines Formulary Survey was completed by 107 hospital pharmacy directors or equivalent. The survey contained the Medicines Formulary Scale in addition to questions regarding the content and review process of the hospital’s formulary as well as demographic questions. Application of the PCA procedures resulted in a parsimonious 2-factor solution in which 33.8% of the variance was explained. The Cronbach alpha for the 17-item scale was found to be 0.70. The Cronbach alpha values for the first and second factor/subscales were 0.76 and 0.68, respectively.ConclusionThe Medicines Formulary Survey appears reliable and valid for assessing hospital pharmacy directors’ perceptions of hospital medicine formularies in the WPR. Further development of validated instruments to assess other areas of hospital pharmacy practice will help track the progression of hospital pharmacy and aid in globalization of the profession.     

Development of clinical pharmacy services to improve drug adherence in psychiatric hospital patients

In the present study, we investigated whether the pharmacy services in our psychiatric hospital helped to improve the attitude of psychiatric patients to drugs. The subjects were 168 patients who received advice on medication at the hospital between August 2008 and December 2009. We found that anxiety about medication in 76% of these patients was relieved by the provision of clinical pharmacy services. This can be attributed to patients gaining an understanding of the importance of taking medication at a particular time, drug types, drug efficacy and drug-induced adverse events. Patient drug adherence scores using the 10-item version of the Drug Attitude Inventory (DAI-10) were significantly improved after pharmacy services were provided, indicating an improvement in drug adherence. There was a significant positive correlation between the DAI-10 score and understanding of the necessity for medication, but no correlation between the DAI-10 score and the amount of drug administered or number of doses taken per day. These results suggest that the clinical pharmacy services improve understanding of the importance of medication timing, drug type, drug efficacy and drug-induced adverse events, and also relieve medication anxiety, enhance understanding of the necessity of taking medication and improve patient attitude to a drug. We intend to further take comprehensive measures including educational, behavioral and emotional intervention.     

厄贝沙坦片的制备工艺与溶出度一致性研究

目的 制备厄贝沙坦仿制片并对其进行工艺与溶出度一致性研究。方法 以原研药（卡压舒®）为参比制剂,通过单因素实验考察黏合剂种类、黏合剂用量、片剂硬度、不同含水量和包衣增重对溶出度的影响,确定处方组成。放大制备3批厄贝沙坦仿制片,在4种不同溶出介质中考察3批样品和原研药的溶出一致性,通过相似因子（f₂）法评价自制与参比制剂溶出曲线的相似性。结果 3% HPMC-E5作为黏合剂较5% PVP K30作为黏合剂时稳定,黏合剂用量、硬度和水分在考察的范围内基本不影响,包衣增重2%~3%,3批自制片与原研片在不同溶出介质中f₂均大于50。结论 厄贝沙坦片制备工艺稳定且自制制剂与参比制剂在不同溶出介质中的体外溶出行为一致。