General practitioners’ management of psychostimulant drug misuse: Implications for education and training

Aims: To provide baseline data regarding GPs’ knowledge, experience, and attitudes toward the management of PsychoStimulant Drug Misuse (PSDM) patients to inform future education and training initiatives.

Methods: A structured cross-sectional postal questionnaire was developed following initial content setting interviews, piloted then sent to a sample of 250 GPs in north east Scotland.

Findings: A 52.13% response rate was achieved after two reminders. Over 42% of GPs expressed uncertainty about their knowledge regarding PSDM. The majority were aware that some patients were using psychostimulant drugs (61.5%), and 62.7% thought this was increasing. More than half the GPs did not have experience in managing PSDM. Although 57% of respondents agreed that GPs should be involved over half (54.1%) were not personally willing to do so.

Conclusion: GPs are aware of the rise in PSDM prevalence in their communities, but chose to keep their involvement minimal. The majority thought that the most suitable way to manage PSDM patients was primarily by specialist services with minimum input from them. A change in attitudes, education and guidance are necessary to encourage GPs to be more involved in the management of PSDM patients.     

Anabolic–Androgenic Steroid Use Among Brazilian Bodybuilders

This cross-sectional, quantitative, exploratory study investigated the prevalence and profile of anabolic–androgenic steroids (AAS) users amongst a convenience sample of 510 bodybuilders from 52 gyms, in João Pessoa, Brazil, with a structured questionnaire containing selected questions about socioeconomic and training variables on the use of AAS. Data were analyzed using frequency and chi-square tests. AAS prevalence use was 20.6%; mostly young men (98.1%), of a low education level (46.7%), who trained for more than 4 years (49.5%). The use of AAS was related to the use of dietary supplements. About 81% of consumed AAS consisted of Deca-Durabolin, Winstrol, and Sustanon. Study's limitations are noted.     

Can pharmacy assistants play a greater role in public health programs in community pharmacies? Lessons from a chlamydia screening study in Canberra,Australia

BackgroundLittle is known about the engagement of pharmacy assistants (PA) in public health service provision.ObjectiveTo explore the experiences of PA participating in a study to determine whether a cash reward, offered to consumers and pharmacy businesses, increased participation in community pharmacy-based chlamydia screening.MethodsPA experience of the study education and training package, participant recruitment and conducting screening (providing information about chlamydia, specimen collection and handling urine samples) were evaluated using knowledge assessment, a questionnaire and focus groups.ResultsTwenty PA participated in the study: 15 (75%) completed all education and training components, 20 (100%) completed the questionnaire and 10 (50%) attended a focus group. PA rated all education and training components as effective (mean visual analog scale scores >8.5). Most PA (13/18, 72.2%) did not support/were unsure about continuing the program, citing the 25% repeat testing rate (presumed to relate to the cash reward) and privacy/confidentiality issues as reasons. Qualitative analysis suggested that minimizing repeat testing, improved workload management and recognition of, and remuneration for, education and training would make this model more acceptable to PA.ConclusionFindings from this study support the assertion that PA can play a significant role in public health initiatives.     

中英医院药学技术人员职业发展及教育模式探讨

目的 以英国药学技术人员的职业发展和教育模式为借鉴，以期为中国医院药学事业的发展提供实践依据。方法 介绍英国国家药学教育与药学技术人员发展框架及医院药师的受教育和职业发展路径，找出两国在药师培养、工作模式的不同和差距，提出促进中国临床药学事业发展、药学教育改革和临床药师培养的建议。结果与结论 英国的药学教育以培养面向临床及患者工作的药师为目的，学制4年，药学硕士学位，教学内容偏重临床实践。中国的药学教育起步较晚，药学人才培养模式与课程设置未突出该课程"交叉、实践性强"的特点；英国的药学教育模式、药学人才培养体系及医疗体制对其医院药学服务发展具有重要的作用，对中国药学人才培养模式与课程设置改革有借鉴意义。     

马尔康市少数民族地区村医健康素养调查

目的 通过调查马尔康市少数民族村医健康素养现状，为促进少数民族地区健康教育提供科学依据。方法 采用整群抽样方法，2018年10月16日至11月1日以参加2018年四川省深度贫困县"一村一医"合格村医培训工程的村医76名作为调查对象，以《健康66条——中国公民健康素养读本》为基础，自编问卷开展调查。问卷包括健康基本知识和理念、健康生活方式和行为、健康基本技能3个维度。分析不同人口学特征村医三个评价纬度差异及各项问题知晓情况。结果 马尔康市少数民族村医达到健康素养水平基本要求的比例为0.0%；达到基本技能素养水平基本要求的比例为9.0%，达到基本知识和理念素养水平基本要求的比例为6.6%、达到健康生活方式和行为素养水平基本要求的比例为0.0%；不同年龄、不同学历的少数民族村医在健康素养总得分差异有统计学意义（P<0.05）；少数民族村医健康素养总得分与文化程度呈正相关（r=0.430，P<0.05）；不同人口学特征的少数民族村医在健康生活方式和行为得分差异无统计学意义（P>0.05）。结论 马尔康市少数民族村医健康素养水平总体较低，应加强针对少数民族村医的健康教育工作。     

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.     

Integrating simulation into advanced pharmacy practice experience curriculum: An innovative approach to training

BackgroundThe use of simulation-based education (SBE) in pharmacy education can help students acquire the essential clinical knowledge and skills for practice and can enhance patients' safety. Simulation-based training has been implemented in inter-professional education training, introductory pharmacy practice experiences, pharmacy residency training. Still, there is limited information in the literature that assesses the use of simulation in advanced pharmacy practice experience (APPE).ObjectiveTo evaluate the impact of integrating SBE into APPE on students' learning outcomes, training costs, and satisfaction.MethodThis study presents a new training model of a 5-week clerkship experience where sixth-year pharmacy students alternate between hospital wards and simulation rooms. Student assessment rubrics were used to measure students’ achievements and report faculty feedback. Students filled scenario evaluation forms to assess their simulation satisfaction rate.ResultsA total of 57 students completed a full block of simulation-based, followed by hospital-based blocks practicing in the same medical specialty in both blocks. This newly structured experience provided fourteen direct patient care training seats per rotation and saved around 25,000 Saudi Riyals per rotation. The mean grades in both simulation and hospital-based blocks were mostly above 90% in all learning outcomes. Cognitive skills and affect learning outcomes mean grades were higher in the simulation-based group—most of the students being satisfied with the simulation scenarios.ConclusionSBE integration into APPE can supplement hospital-based experiential training to achieve the best learning outcomes with improved students' satisfaction.     

A systematic review of the role of pharmacists in vaccination services in low-and middle-income countries

BackgroundPharmacists' role in vaccination has expanded in some countries with pharmacists having greater authority to perform various immunization activities, from vaccine storage, vaccine adverse event reporting, vaccination education and advocacy, to vaccine administration. However, pharmacists’ present involvement in vaccination services is poorly understood across low- and middle-income countries (LMICs).ObjectiveTo identify and synthesize evidence on pharmacists’ roles in offering vaccination services in LMICs.MethodsWe searched three databases (PubMed, Embase, Scopus) and the gray literature to identify articles which described pharmacist involvement in vaccination services in LMICs. We abstracted data on reported roles of pharmacists in vaccination, as well as relevant country, vaccines, and populations served.ResultsFrom the initial 612 records we identified, twenty-five (n = 25) studies representing 25 LMICs met our inclusion criteria. The most commonly reported role of pharmacists in vaccination across identified LMICs was vaccine advocacy and education (n = 15 countries). Pharmacist administered vaccination and storage of vaccines at pharmacies was reported in 8 countries. An additional 6 countries reported allowing vaccination at community pharmacies by other healthcare professionals. Immunization related training for pharmacists was reported or required in 8 countries. Fewer studies reported that pharmacists have access to patient immunization records in their respective LMICs (n = 6 countries) or had reported pharmacist involvement in vaccine adverse event reporting (n = 4 countries).ConclusionsPharmacists have the potential to play an important role in increasing access to vaccines and improving coverage, yet evidence of their role in vaccinations remains limited across LMICs. Greater documentation of pharmacists’ involvement in vaccination services in LMICs is needed to demonstrate the value of successful integration of pharmacists in immunization programs.     

Long‐term impact of addictions training for medical residents

The present survey was conducted to determine the long‐term impact of addictions training on the practice patterns of physicians who completed a specialized addictions residency training program. Medical residents and medical research fellows who participated in a residency training program in addictions from 1981 through 1991 at the Addiction Research Foundation in Toronto were mailed a brief questionnaire about their training experience. Of the 27 physicians who responded to the questionnaire (73% response rate), 52% were currently working in the addictions field. Of the 13 who were not working in the field, 77% reported using their addictions training in their current practice. Thus, 89% of the physicians who participated in the specialized addictions residency training program and responded to the survey reported continued utilization of their training several years after the experience.     

Alcohol in Europe – Public Health Perspective: Report summary

Background: Two previous studies have demonstrated the parlous state of undergraduate medical education. A third study was undertaken to evaluate any change.

Methodology: All deans, heads of psychiatry and addiction specialists working in 28 British medical schools were surveyed by questionnaire. Items included time allocated to formal training, clinical resources, training objectives, professional confidence and competence, postgraduate facilities, plans for change, opinion on the importance of addiction in the curriculum, and scientific credibility.

Findings: There was a 100%, 71% and 46% response rate from specialists, heads, and deans respectively. Medical students were receiving, on average, six hours of formal training in substance misuse over their entire course. Although there was disparity in responses between the three groups, there was a clear consensus that the addiction field had scientific credibility. However, this achievement has not been translated into more training, and there is pessimism about any likelihood of change.

Discussion: Barriers to training such as too few addiction specialists, stigma, and tensions in academia resulting from the Research Assessment Exercise, are identified.

Conclusion: Since the General Medical Council and the Alcohol Harm Reduction Strategy have explicitly stated the need for undergraduate training, ways in which medical students, as ‘users’ of the undergraduate training package, may be the drivers of change, are suggested.     

Knowledge and Barriers Among Physicians Toward Adverse Drug Reaction Reporting at a Tertiary Care Hospital in Saudi Arabia

Background:Spontaneous reporting systems are essential as they help detect serious unknown adverse drug reaction (ADR). However, underreporting of ADR is a commonly associated problem. This research work aims to assess knowledge, barriers, and factors that encourage the reporting of ADR among physicians.Methods:A total of 600 physicians working at a tertiary referral hospital in Riyadh, Saudi Arabia, were included in this cross-sectional study. A pretested questionnaire was used.Results:Out of the 600 physicians, 240 (40%) completed the questionnaire. Most of the participants (85.4%) could correctly define ADR; nearly 75% physicians were unaware of the spontaneous reporting of ADR in Saudi Arabia. A total of 175 (72.9%) physicians had not reported any ADR among their patients in the last year; 40% of the physicians said that they did not report ADR because they were unaware of the online reporting of ADR. Providing guidelines and regular bulletins on the reporting of ADR is a critical aspect that encourages physicians to report ADR (51%). Education and training are the most recognized measures for improving the reporting of ADR.Conclusion:Physicians were adequately aware of ADR but inadequately aware of the reporting system and reporting authorities. Continuing medical education, training, and integration of the reporting of ADR into physicians’ various clinical activities may improve ADR reporting.     

Chronic pain management -can we do better? An interview-based survey in primary care

SUMMARY

Background: Persisting pain is demoralising and debilitating for patients and their carers. Most patients with chronic pain do not need the services of a specialised pain clinic and are appropriately managed by their general practitioner (GP).

Method: Interviewers approached 569 GPs to assess their satisfaction with the management of patients with chronic non-malignant (i.e. non-cancer related) pain (CNMP). The survey was carried out from November 2001 to January 2002 in general practices in the UK. GPs were randomly selected as representative of the basic population who treat CNMP. The survey was conducted in a face-to-face interview in the GP surgery using a questionnaire consisting of 35 open questions covering practice information, treatment of CNMP, pain management and multidisciplinary support.

Results: 504 (88.6%) of GPs completed the structured questionnaire. 81% of GPs believed that a significant number of patients received suboptimal management. Optimal control of symptoms was estimated to occur in less than half of patients. The main barriers to achieving good pain control were identified as side-effects of therapies (74%) and patient compliance (58%). 60% of respondents expressed concerns regarding efficacy of available therapies. Although 91% of GPs considered specialised pain services as beneficial, only 14% of patients were referred to hospital for symptom management. 96% of GPs felt that the management of chronic pain could be improved in their locality and 81% expressed an interest in relevant training.

Conclusion: Most GPs believe that the management of chronic pain can be improved. Further education of all healthcare professionals who manage patients in pain is needed to bring about such a change.     

Brief overdose education can significantly increase accurate recognition of opioid overdose among heroin users

BackgroundIn an effort to increase effective intervention following opioid overdose, the New York State Department of Health (NYSDOH) has implemented programs where bystanders are given brief education in recognizing the signs of opioid overdose and how to provide intervention, including the use of naloxone. The current study sought to assess the ability of NYSDOH training to increase accurate identification of opioid and non-opioid overdose, and naloxone use among heroin users.MethodsEighty-four participants completed a test on overdose knowledge comprised of 16 putative overdose scenarios. Forty-four individuals completed the questionnaire immediately prior to and following standard overdose prevention training. A control group (n = 40), who opted out of training, completed the questionnaire just once.ResultsOverdose training significantly increased participants’ ability to accurately identify opioid overdose (p < 0.05), and scenarios where naloxone administration was indicated (p < 0.05). Training did not alter recognition of non-opioid overdose or non-overdose situations where naloxone should not be administered.ConclusionsThe data indicate that overdose prevention training improves participants’ knowledge of opioid overdose and naloxone use, but naloxone may be administered in some situations where it is not warranted. Training curriculum could be improved by teaching individuals to recognize symptoms of non-opioid drug over-intoxication.     

药物临床试验质量影响因素调查分析

目的：探讨药物临床试验实施过程中质量影响的关键因素。方法：以药物临床试验质量管理规范（Good Clinical Practice,GCP）培训、方案设计、知情同意书签署、受试者依从性、临床试验记录和报告、试验用药品管理、不良事件（Adverse Events,AE）/严重不良事件（Serious Adverse Events,SAE）上报、项目质控措施和比例等内容为参照制定调查问卷,对药物临床试验相关人员进行调查分析。结果：合计收到191份问卷,其中有效问卷183份,有效率95.8%。临床试验中常见方案设计与医院常规操作相违背（61.20%）、知情同意书信息填写有误/不规范（34.97%）、访视超窗（38.80%）、试验数据/报告填写/修改不规范（55.74%）、试验用药品相关管理记录不完整（36.61%）、AE/SAE漏报（40.44%）等问题,以及GCP培训、质控力度、研究团队、申办方质量管理体系建设等都是影响药物临床试验质量的关键因素。结论：加强药物临床试验参与各方的培训、提高GCP认知是保障临床试验整体质量的有力措施。     

部分发达国家药学专业学生实训制度对我国的启示

目的：研究发达国家药师注册前的实训制度,为我国探索建立执业药师实训制度提供经验借鉴和理论基础。方法：采用文献研究法,深入比较美国、加拿大、英国、新加坡四国的药师实训制度和体系,并分析我国的药学教育和药师制度现状。结果：从实训内容和考核方式两个方面分析总结了四国的实训特点,并结合我国实际情况对实训制度的建立提出了建议。结论：应当重视实训的作用,明确实训目标;认真设计实训大纲,开展有针对性的实训;严格实训考核,充分发挥指导教师的作用。