Different development of general beliefs about medicines during undergraduate studies in medicine,nursing and pharmacy

Objective

To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.

Method

The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.

Results

The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) third-year students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-year medical and pharmacy students saw medicines as more beneficial and less harmful than first-year students did. Experience of medicine use was relevant to general beliefs about medicines.

Conclusion

Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.

Practice implications

It is important to educate future healthcare professionals about the potential effect of beliefs on communication.     

Naturopaths practice behaviour: provision and access to information on complementary and alternative medicines

Background  

The increasing use of complementary and alternative medicines in Australia has generated concern regarding the information on these products available to both healthcare providers and the public. The aim of this study was to examine the practice behaviours of naturopaths in relation to both the provision of and access to information on complementary and alternative medicines (CAM).     

U.S. and Canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review

Background  

Although dietary supplements (DS) are widely sold in pharmacies, the legal, ethical, and practice responsibilities of pharmacists with respect to these products have not been well defined. This systematic review of pharmacists' attitudes, knowledge, and professional practice behaviours toward DS is intended to inform pharmacy regulators' and educators' decision making around this topic.     

Exploring consumer and pharmacist views on the professional role of the pharmacist with respect to natural health products: a study of focus groups

Background  

Natural health products (NHPs) such as herbs, vitamins and homeopathic medicines, are currently available for sale in most Canadian pharmacies. However, most pharmacists report that they have limited knowledge about these products which have been regulated in Canada as a specific sub-category of drugs. In this paper, consumers' and practicing pharmacists' perceptions of pharmacists' professional responsibilities with respect to NHPs are examined.     

Beliefs about medicines and self-reported adherence among pharmacy clients

ObjectivesTo analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables.MethodsThe data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse).ResultsOf the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines.ConclusionsGeneral-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines.Practice implicationsIncreased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.     

Understanding, perceptions and self-use of complementary and alternative medicine (CAM) among Malaysian pharmacy students

Background

Complementary and alternative medicines (CAMs) are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS) in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study.

Methods

A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics.

Results

Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books.

Conclusions

Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to address the gaps in attitudes, knowledge and to improve effectiveness of information seeking behaviour.     

Development of an instrument to assess the impact of an enhanced experiential model on pharmacy students' learning opportunities,skills and attitudes: A retrospective comparative-experimentalist study

Background  

Pharmacy schools across North America have been charged to ensure their students are adequately skilled in the principles and practices of pharmaceutical care. Despite this mandate, a large percentage of students experience insufficient opportunities to practice the activities, tasks and processes essential to pharmaceutical care. The objective of this retrospective study of pharmacy students was to: (1) as "proof of concept", test the overall educational impact of an enhanced advanced pharmacy practice experiential (APPE) model on student competencies; (2) develop an instrument to measure students' and preceptors' experiences; and (3) assess the psychometric properties of the instrument.     

Animal-based folk remedies sold in public markets in Crato and Juazeiro do Norte, Ceará, Brazil

Background  

Human communities consistently develop a detailed knowledge of the therapeutical and medicinal properties of the local flora and fauna, and these folk remedies often substitute medicines produced by the pharmaceutical industry. Animals (and their derived products) are essential ingredients in the preparation of many traditional remedies. The present work prepared an inventory of the animals sold in public markets in the cities of Crato and Juazeiro do Norte, Ceará State, Brazil.     

Patients' satisfaction with information and experiences with counseling on cardiovascular medication received at the pharmacy

Objective

To assess the extent to which patients feel they have received enough information on cardiovascular drugs and experienced counseling at the pharmacy. In addition, to identify factors that are predictors for patient satisfaction with the information received.

Methods

Fifteen community pharmacies participated. New and chronic users of cardiovascular medication received a questionnaire containing sociodemographic and health questions, a measure of satisfaction with information received (SIMS), beliefs about medication (BMQ), and frequency of pharmacy counseling.

Results

Of the 578 respondents, 335 (58%) indicated to be unsatisfied with the information received on 3 or more SIMS items. Patients’ age, beliefs about medication, duration of cardiovascular treatment and use of antithrombotics predicted patients’ satisfaction with information received. Two-thirds of patients reported ‘never’ to have experienced 5 of 8 counseling activities at the pharmacy.

Conclusions

A considerable proportion of patients are unsatisfied with the information received on cardiovascular medication. The majority of patients have only received a limited scope of medication counseling at the pharmacy.

Practice implications

Information and counseling should be tailored to patients’ needs and concerns about cardiovascular medication and the experience patients already have with treatment. Pharmacists could enhance their role in supporting patients using cardiovascular medication.     

Advances in clinical pharmacy education in Germany: a quasi-experimental single-blinded study to evaluate a patient-centred clinical pharmacy course in psychiatry

Background

The pharmacy profession has shifted towards patient-centred care. To meet the new challenges it is necessary to provide students with clinical competencies. A quasi-experimental single-blinded teaching and learning study was carried out using a parallel-group design to evaluate systematically the benefits of clinical teaching in pharmacy education in Germany.

Methods

A clinical pharmacy course on a psychiatric ward was developed and implemented for small student groups. The learning aims included: the improvement of patient and interdisciplinary communication skills and the identification and management of pharmaceutical care issues. The control group participated only in the preparation lecture, while the intervention group took part in the complete course. The effects were assessed by an objective structured clinical examination (OSCE) and a student satisfaction survey.

Results

The intervention group achieved significantly better overall results on the OSCE assessment (46.20?±?10.01 vs. 26.58?±?12.91 of a maximum of 90 points; p <?0.0001).The practical tasks had the greatest effect, as reflected in the outcomes of tasks 1–5 (34.94?±?9.60 vs. 18.63?±?10.24 of a maximum of 60 points; p?<?0.0001). Students’ performance on the theoretical tasks (tasks 6–10) was improved but unsatisfying in both groups considering the maximum score (11.50?±?4.75 vs. 7.50?±?4.00 of a maximum of 30 points; p?<?0.0001). Of the students, 93% rated the course as practice-orientated, and 90% felt better prepared for patient contact. Many students suggested a permanent implementation and an extension of the course.

Conclusions

The results suggest that the developed ward-based course provided learning benefits for clinical skills. Students’ perception of the course was positive. Implementation into the regular clinical pharmacy curriculum is therefore advisable.

     

Understanding pharmacists’ experiences with advice-giving in the community pharmacy setting: A focus group study

Objective

To examine the experiences of community pharmacists providing advice about symptoms and complementary and alternative medicines (CAM).

Methods

Ten licensed pharmacists and 21 student pharmacists working in community settings participated in 4 focus groups to discuss: patients’ questions about symptoms and CAM, comfort level providing advice, and factors prompting physician referrals. Focus group recordings were transcribed verbatim and interpreted using thematic text analysis.

Results

Pharmacists’ dual role as advisors and medical liaisons emerged as primary themes. Participants reported that patients often seek their advice about self-care of symptoms to delay physician visits. Participants were comfortable giving advice; lack of medical history decreased their comfort level. Most were uncomfortable recommending CAM because of the lack of regulation and evidence. Participants suggested that pharmacy curricula expand training on symptom triage, pharmacist–patient communication, and CAM to prepare graduates for employment in community settings.

Conclusion

Student and licensed pharmacists of this study voiced that they are often asked for advice on symptom management, but reported needing training to help provide appropriate advice to patients.

Practice implications

The findings suggest that training strategies could help pharmacists appropriately triage and advise patients seeking self-care advice for their symptoms in the community setting.     

Consumers of natural health products: natural-born pharmacovigilantes?

Background  

Natural health products (NHPs), such as herbal medicines and vitamins, are widely available over-the-counter and are often purchased by consumers without advice from a healthcare provider. This study examined how consumers respond when they believe they have experienced NHP-related adverse drug reactions (ADRs) in order to determine how to improve current safety monitoring strategies.     

Self-medication with over-the-counter drugs and complementary medications in South Australia's elderly population

Background  

A number of surveys have examined use of complementary and alternative medicines (CAM) in Australia. However, there are limited Australian data on use of CAM and over-the-counter (OTC) medicines in the elderly population. The main aims of this study were to examine self-medication practices with CAM and OTC medicines among older Australians and variables associated with their use.     

Linking community pharmacy dispensing data to prescribing data of general practitioners

Background  

Databases are frequently used for pharmacoepidemiological research. However, most of these databases consist either of prescribing, dispensing or administrative data and therefore lack insight in the interaction between the several health professionals around the patient.     

Development and evaluation of an instrument for the critical appraisal of randomized controlled trials of natural products

Background  

The efficacy of natural products (NPs) is being evaluated using randomized controlled trials (RCTs) with increasing frequency, yet a search of the literature did not identify a widely accepted critical appraisal instrument developed specifically for use with NPs. The purpose of this project was to develop and evaluate a critical appraisal instrument that is sufficiently rigorous to be used in evaluating RCTs of conventional medicines, and also has a section specific for use with single entity NPs, including herbs and natural sourced chemicals.     

Herbal medicine: women's views, knowledge and interaction with doctors: a qualitative study

Background  

There is growing concern that serious interactions are occurring between prescribed/over the counter and herbal medicines and that there is a lack of disclosure of herbal use by patients to doctors. This study explores women's perspectives about the safety of herbal remedies, herb-drug interactions and communication with doctors about herbal medicines.     

Effectiveness of contact-based education for reducing mental illness-related stigma in pharmacy students

Background

A strategy for reducing mental illness-related stigma in health-profession students is to include contact-based sessions in their educational curricula. In such sessions students are able to interact socially with a person that has a mental illness. We sought to evaluate the effectiveness of this strategy in a multi-centre study of pharmacy students.

Methods

The study was a randomized controlled trial conducted at three sites. Because it was necessary that all students receive the contact-based sessions, the students were randomized either to an early or late intervention, with the late intervention group not having participated in the contact-based education at the time when the primary outcome was assessed. The primary outcome, stigma, was assessed using an attitudes scale called the Opening Minds Survey for Health Care Providers (OMS-HC).

Results

We initially confirmed that outcomes were homogeneous across study centres, centre by group interaction, p = 0.76. The results were pooled across the three study centres. A significant reduction in stigma was observed in association with the contact-based sessions (mean change 4.3 versus 1.5, t=2.1, p=0.04). The effect size (Cohen’s d) was 0.45. A similar reduction was seen in the control group when they later received the intervention.

Conclusions

Contact-based education is an effective method of reducing stigma during pharmacy education. These results add to a growing literature confirming the effectiveness of contact-based strategies for stigma reduction in health profession trainees.

     

Beliefs about medicines and self-reported adherence among pharmacy clients

OBJECTIVES: To analyse any association between general beliefs about medicines and self-reported adherence among pharmacy clients. Further, to examine general beliefs about medicines by background variables. METHODS: The data were collected by questionnaires including the general section of the Beliefs about Medicines Questionnaire (BMQ), the self-reporting Medication Adherence Report Scale (MARS) and the following background variables: gender, age, education, country of birth and medicine use. The General BMQ measures beliefs about medicines as something harmful (General-Harm), beneficial (General-Benefit) and beliefs about how doctors prescribe medicines (General-Overuse). RESULTS: Of the 324 participating pharmacy clients, 54% were considered non-adherent. An association was found between General-Harm and adherence. Adherent behaviour and higher level of education were associated respectively with more beneficial and less harmful beliefs about medicines. Those born in the Nordic countries regarded medicines as more beneficial. Current users of herbal medicines and non-users of medicines were more likely to believe that doctors overprescribed medicines. CONCLUSIONS: General-Harm was associated with adherence to medication among Swedish pharmacy clients. Country of birth, education and medicine use influenced beliefs about medicines. PRACTICE IMPLICATIONS: Increased awareness of the patient's beliefs about medicines is needed among healthcare providers. We should encourage patients to express their views about medicines in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication.