Opioid users with comorbid hepatitis C spent more time in agonist therapy: A 6-year observational study in Taiwan

BackgroundHepatitis C virus (HCV) infection is highly prevalent among opioid agonist therapy (OAT) patients, but little is known about long-term OAT use among this population.MethodsSubjects diagnosed as opioid dependence were recruited from Mar. 2006 to Jul. 2008 in a psychiatry center in southern Taiwan with the OAT censored in 2012, and their socio-demographics, drug use characteristics, and markers of blood-borne infection were assessed at entry. Correlates with HCV infection and OAT retention were analyzed by multivariate logistic regression. Retention (OAT utilization) was defined as the in-treatment period of OAT during the 6-year observation period.ResultsA total of 983 patients (88.3% men) were included. The prevalences of HCV and HIV infection were 91.4% and 17.9%, respectively. The mean duration of OAT during the study period was 2.3 ± 0.8 years. Significant correlates with HCV infection were retention of at least three years in OAT (AOR: 4.24, 95%CI: 1.49–12.03), ever sharing injection equipment (AOR: 227.04, 95%CI: 57.22–900.87), not living with family (AOR: 5.54, 95%CI: 1.45–21.16), lower educational attainment (AOR: 2.10, 95%CI: 1.15–3.82) and previous drug offense (AOR: 6.35, 95%CI: 1.69–23.83). Significant correlates with retention were HCV infection (AOR: 2.53, 95%CI: 1.30–4.93) and divorced or separation in marriage (AOR: 0.65, 95%CI: 0.44–0.96).ConclusionsThis six-year observational study revealed a better retention in OAT if opioid-dependent individuals had comorbid hepatitis C. This provided opportunities for OAT patients with HCV infection to obtain medical treatment while staying in an OAT program. Further research could explore the possibility of eradicating comorbid HCV infection among these long-term treatment cases.     

Frequent emergency department presentations among people who inject drugs: A record linkage study

BackgroundPeople who inject drugs (PWID) have been described as frequent users of health services such as emergency departments (EDs), however few studies have described demographic factors, patterns of substance use and previous health service use associated with frequent use of EDs in this population.MethodsUsing a combination of self-reported data from a cohort of PWID and administrative ED data obtained through record linkage, we identified longitudinal factors associated with the use of ED services. Bivariate and multivariate analyses were conducted using negative binomial regression to identify exposures associated with both cumulative ED presentations, and logistic regression to identify exposures of frequent ED presentations (defined as three or more annual presentations).ResultsAmong 612 PWID, over half (58%) presented to EDs at least once and over a third (36%) presented frequently between January 2008 and June 2013. Frequent and cumulative ED presentations were associated with reporting the main drug of choice as cannabis (AOR:1.42, 95%CI:1.07–1.89 and AIRR:2.96, 95%CI:1.44–6.07 respectively) or methamphetamine (AOR:1.62, 95%CI:1.17–2.2 and AIRR:2.42, 95%CI:1.08–5.46 respectively) compared to heroin, and past month use of mental health (AOR:1.42, 95%CI:1.08–1.85 and AIRR:3.32, 95%CI:1.69–6.53 respectively) and outpatient services (AOR:1.47, 95%CI: 1.00–2.16 and AIRR:0.95, 95%CI 1.52–10.28 respectively).ConclusionPWID who are frequent users of EDs are likely to have complex health and substance use-related needs. EDs should actively refer people who present with cannabis and methamphetamine dependence to harm reduction services. Harm reduction services should ensure people referred from EDs are screened for co-occurring mental health conditions and receive adequate support.     

Knowledge and practice of foot self-care among patients with diabetes attending primary healthcare centres in Kuwait: A cross-sectional study

BackgroundDiabetes mellitus is a major public health issue and is the main cause of morbidity and mortality worldwide. At the time of diagnosis, many patients with type 2 diabetes (T2D) have one or two risk factors for diabetic foot diseases, such as diabetic peripheral neuropathy (DPN) and diabetic foot ulcers (DFUs). Patients can overcome such complications through good knowledge and practice of foot self-care. This study aims to evaluate the knowledge and practice of foot care among patients with diabetes mellitus attending primary healthcare centres (PHCs) in Kuwait and to identify those at risk for developing DPN.MethodsA cross-sectional study was conducted using a pre-tested self-administered questionnaire. The questionnaire included questions on demographic characteristics and patients’ knowledge and practices of foot care. Adult patients (aged 21 and above) with a diagnosis of diabetes mellitus for at least 1 year were randomly selected from PHCs located in the five governorates of Kuwait. Data were analysed using SPSS, version 26.ResultsA total of 357 patients participated in this study, giving a response rate of 87.3%. The overall mean knowledge score of foot care was 12.7 ± 2.7 (equals 81.3%). Most patients (n = 283, 79.3%) showed good knowledge. In comparison, less than one-third of patients (n = 110, 30.8%) practiced good foot care. The overall mean score of patients’ practices was 55.7 ± 9.2 (equals 64.0%). Approximately 17.4% of the patients had a higher risk of developing DPN. University students had lower odds of having good knowledge about foot care [OR: 0.19 (95%CI: 0.04–0.86)]. On the other hand, patients who reported having diabetes for a long duration (10 years and above) [OR: 1.88 (95%CI: 1.11–3.18)] and patients who did not have any other comorbidities [OR: 0.49 (95%CI: 0.26–0.90)] had higher odds of having good foot care knowledge. Patients who were on oral hypoglycaemic agents (OHAs) only had lower odds [OR: 0.63 (95%CI: 0.39–1.00)] of practicing good foot care. Patients who reported having diabetes for a duration between 5 to less than 10 years [OR: 1.75 (95%CI: 1.06–2.90)] and those who are on a diet only [OR: 1.76 (95%CI: 1.06–2.94)] had higher odds of practicing good foot care. Patients who were using combination therapy with OHAs and insulin had a higher risk [OR: 2.67 (95%CI: 1.11–6.41)] of developing DPN. On the other hand, patients who reported that they did not have a previous history of foot ulcer had a lower risk of developing DPN [OR: 0.21 (95%CI: 0.09–0.47)].ConclusionThe knowledge of patients with diabetes regarding foot care is rated as good, while their self-practice is considered satisfactory. To improve the foot care knowledge and self-care practice of patients, healthcare providers (HCPs) need to support patients through educational programmes and appropriate training.     

Measurement of the reliability of pharmacy staff and simulated patient reports of non-prescription medicine requests in community pharmacies

BackgroundThe use of simulated patients (SPs) in pharmacy practice research has become an established method to observe practice. The reliability of data reported using this method in comparison to pharmacy staff self-reported behaviour has yet to be ascertained.ObjectiveTo compare the inter-rater agreement of pharmacy staff and SP-reported data to researcher-reported data from audio recordings of SP encounters.MethodsA dataset of 352 audio-recorded SP encounters was generated in March–October 2015 by 61 undergraduate pharmacy students completing SP visits to 36 community pharmacies in Sydney, Australia. Post-visit scores were recorded on data collection forms by SPs. Staff completed self-assessments on identical forms immediately after the encounter. Two-hundred-and-seventy visits were randomly selected as the sample for this study, where the researcher independently scored encounters via audio recordings. Inter-rater agreement was calculated through intra-class correlation (ICC) and weighted kappa analyses.ResultsAnalysis of staff scores returned ICC values of 0.48 (95% CI:0.38–0.56; p < 0.001) for information gathering and 0.63 (95% CI:0.55–0.70; p < 0.001) for total score. Weighted kappa for information rating was 0.30 (95% CI:0.21–0.38; p < 0.001) and 0.43 (95% CI:0.34–0.51; p < 0.001) for overall outcome. ICC values for SPs were 0.91 (95% CI:0.88–0.93; p < 0.001) and 0.90 (95% CI:0.87–0.92; p < 0.001) for information gathering and total scores respectively. Weighted kappa values were 0.44 (95% CI:0.37–0.52; p < 0.001) for information rating and 0.63 (95% CI:0.55–0.70; p < 0.001) for overall outcome.ConclusionPharmacy staff self-reported their behaviour with a poor degree of reliability. Conversely, SPs had a high level of agreement with the researcher scoring from audio recordings. Disagreement for both groups of raters was most apparent in rating the information provided and overall appropriateness of outcome. Future research should investigate this discrepancy between staff-reported behaviour and actual behaviour and consider the implications of this discrepancy in the interpretation of self-reported data.     

Young Aboriginal people in Australia who have never used marijuana in the ‘Next Generation Youth Well-being study’: A strengths-based approach

BackgroundBeing young is a period of experimentation which can lead to increased vulnerability to poor health choices and outcomes. Aboriginal and Torres Strait Islander (Aboriginal) people have a long and strong history of resilience; however, a deficit approach is often taken with messages of poor health and low socioeconomic status. This study takes a strengths-based approach and examines the demographic factors and behaviours associated with never using marijuana among young Aboriginal people in Australia.MethodsOverall, 521 Aboriginal people aged 16–24 years from Western Australia, Central Australia and New South Wales participated in the Next Generation: Youth Wellbeing Study. The baseline survey examined demographics, health-related behaviours and clinical indicators of young Aboriginal people. We calculated the number and proportion of young Aboriginal people who never used marijuana by demographics and behavioural factors. Logistic regression was used to assess the demographic and behavioural factors associated with never using marijuana.ResultsOf the 521 participants, 458 (87.9%) answered the question about marijuana use of which 220 had incomplete demographic or behavioural questions, leaving a final cohort of 301 participants. A total of 174 (57.8%) had never used marijuana. A higher proportion of young Aboriginal people who never used marijuana were younger (16–19 years old), female, queer, single, lived in Central Australia, were students, had never smoked tobacco, had never drank alcohol, never had anxiety and never had depression. Never using marijuana was independently associated with being a parent or carer of a child (Adjusted Odds Ratio (AOR): 2.80, 95% CI: 1.03–7.59, p = 0.043), never smoking tobacco (AOR: 29.73, 95 CI: 13.32–66.37, p < 0.001), never drinking alcohol (AOR: 2.78, 95 CI: 1.12–6.93, p = 0.028), not having anxiety (AOR: 3.49, 95 CI: 1.19–10.23, p = 0.022), and having lower levels of distress (AOR: 2.63, 95 CI: 1.20–5.77, p = 0.016).ConclusionOur study shows that more than half of young Aboriginal people did not use marijuana, smoke, or drink alcohol and that those who had not used marijuana had lower levels of distress.     

Correlates of injecting in an HIV incidence hotspot among substance users in Tijuana,Mexico

BackgroundSubstance use and HIV are growing problems in the Mexico–U.S. border city of Tijuana, a sex tourism destination situated on a northbound drug trafficking route. In a previous longitudinal study of injection drug users (IDUs), we found that >90% of incident HIV cases occurred within an ‘HIV incidence hotspot,’ consisting of 2.5-blocks. This study examines behavioral, social, and environmental correlates associated with injecting in this HIV hotspot.MethodsFrom 4/06 to 6/07, IDUs aged ≥18 years were recruited using respondent-driven sampling. Participants underwent antibody testing for HIV and syphilis and interviewer-administered surveys eliciting information on demographics, drug use, sexual behaviors, and socio-environmental influences. Participants were defined as injecting in the hotspot if they most frequently injected within a 3 standard deviational ellipse of the cohort's incident HIV cases. Logistic regression was used to identify individual and structural factors associated with the HIV ‘hotspot’.ResultsOf 1031 IDUs, the median age was 36 years; 85% were male; HIV prevalence was 4%. As bivariate analysis indicated different correlates for males and females, models were stratified by sex. Factors independently associated with injecting in the HIV hotspot for male IDUs included homelessness (AOR 1.72; 95%CI 1.14–2.6), greater intra-urban mobility (AOR 3.26; 95%CI 1.67–6.38), deportation (AOR 1.58; 95%CI 1.18–2.12), active syphilis (AOR 3.03; 95%CI 1.63–5.62), needle sharing (AOR 0.57; 95%CI 0.42–0.78), various police interactions, perceived HIV infection risk (AOR 1.52; 95%CI 1.13–2.03), and health insurance status (AOR 0.53; 95%CI 0.33–0.87). For female IDUs, significant factors included sex work (AOR 8.2; 95%CI 2.2–30.59), lifetime syphilis exposure (AOR 2.73; 95%CI 1.08–6.93), injecting inside (AOR 5.26; 95%CI 1.54–17.92), arrests for sterile syringe possession (AOR 4.87; 95%I 1.56–15.15), prior HIV testing (AOR 2.45; 95%CI 1.04–5.81), and health insurance status (AOR 0.12; 95%CI 0.03–0.59).ConclusionWhile drug and sex risks were common among IDUs overall, policing practices, STIs, mobility, and lack of healthcare access were correlated with injecting in this HIV transmission hotspot. Although participants in the hotspot were more aware of HIV risks and less likely to report needle sharing, interventions addressing STIs and structural vulnerabilities may be needed to effectively address HIV risk.     

The uptake of foil from needle and syringe provision services and its role in smoking or snorting heroin among people who inject drugs in Scotland

BackgroundIn the UK, legislation was implemented in 2014 allowing needle and syringe provision (NSP) services to offer foil to people who inject drugs (PWID) to encourage smoking rather than injecting. This paper aims to examine the association between foil uptake and smoking or snorting heroin among PWID. This is the first large scale national study to examine foil uptake and smoking or snorting heroin among PWID post legislative change.MethodData from 1453 PWID interviewed via Scotland's Needle Exchange Surveillance Initiative in 2017–2018 were analysed using multivariate logistic regression.ResultsOverall, 36% of PWID had obtained foil from NSP services in the past six months. The odds of smoking or snorting heroin were higher among those who had obtained foil (Adjusted Odds Ratio (AOR) 3.79 (95% CI 2.98–4.82) p<0.001) compared to those who had not. Smoking or snorting heroin was associated with lower odds of injecting four or more times daily (AOR 0.60 (95% CI 0.40–0.90) p = 0.012) and injecting into the groin or neck (AOR 0.57 (95% CI 0.46–0.71) p<0.001) but increased odds of having had a skin and soft tissue infection (SSTI) (AOR 1.49 (95% CI 1.17–1.89) p = 0.001) and having experienced an overdose (AOR 1.58 (95% CI 1.18–2.10) p = 0.002) both in the past year.ConclusionThe promotion of smoking drugs via foil provision from NSP services may contribute to the package of harm reduction measures for PWID alongside the provision of injecting equipment. We found that those in receipt of foil were more likely to smoke or snort heroin, and that smoking or snorting heroin was associated with a lower likelihood of some risky injecting behaviours, namely frequent injecting and injecting into the groin or neck. But it remains uncertain if the provision of foil can lead to a reduction in health harms, such as SSTI and overdose. Future research is needed to understand PWID motivations for smoking drugs, obtaining foil from NSP services, and its uses particularly among polydrug users.     

Assessing the pharmacy students’ knowledge of common medical terms after a curricular change in Saudi Arabia

Medical terminology is the vocabulary used to describe the human body and its conditions; fluency in this language is essential for health care professionals. We examined the level of basic medical terminology understanding among 347 pharmacy students in four different colleges of pharmacy in Saudi Arabia using a newly developed test of 30 multiple choice questions. Students in the relatively new colleges of pharmacy were more likely to have a higher score in the medical terminology test compared to their counterparts from the old college of pharmacy (β = 1.23, 95% CI = 0.16–2.30, P-value = 0.02). Female gender (β = 1.72, 95% CI = 0.57–2.88, P-value = 0.003), and advanced class level (β = 0.84, 95% CI = 0.36–1.32, P-value < 0.001) were also positively associated with high medical terminology test scores. The findings of this study reveal a deficiency in the pharmacy students’ level of understanding of basic medical terms which may necessitate a reintroduction of the medical terminology course into the pharmacy curriculum.     

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.     

Higher smoking prevalence among United States adults with co-occurring affective and drug use diagnoses

IntroductionIndividuals with drug use disorders or affective disorders have higher cigarette smoking prevalence and smoking intensity and are less likely to quit than the general population. We sought to estimate the prevalence of cigarette smoking by drug use and psychiatric diagnoses and to explore to what extent a co-occurring diagnosis was associated with current smoking.MethodsData were derived from the most recent National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III, 2012–2013; n = 36,309). Cigarette smoking status was examined among those with any past-year or lifetime drug use disorders (i.e., alcohol, cannabis, opioid, cocaine) or affective disorders (i.e., mood, anxiety). Diagnoses were assessed using the Diagnostic and Statistical Manual of Mental Disorders criteria (DSM-5).ResultsAdjusting for sociodemographic characteristics, those with drug use disorders (past-year AOR = 3.3, 95% CI: 3.0, 3.6; lifetime AOR = 3.2, 95% CI: 3.0, 3.5) and those with affective disorders (past-year AOR = 1.7; 95%CI: 1.5, 1.8, lifetime AOR = 1.3, 95% CI: 1.2; 1.4), had higher odds of current cigarette smoking compared to individuals with no diagnosis. The odds of current cigarette smoking was significantly higher in individuals with both drug use disorders and affective disorders compared to those with either a drug use or affective disorder or no disorder (past-year AOR = 5.1; 95% CI: 4.3, 5.9, lifetime AOR = 4.3; 95% CI: 3.8, 4.7).ConclusionsApproximately 30% of the population had a past-year drug use or affective disorder, 17% of whom report both. The combination of both diagnoses produced a 1.5 to 3-fold higher correlation with smoking than either alone.     

Expanding the reach of harm reduction in Thailand: Experiences with a drug user-run drop-in centre

BackgroundDespite an ongoing epidemic of HIV among Thai people who inject drugs (IDU), Thailand has failed to implement essential harm reduction programmes. In response, a drug user-led harm reduction centre opened in 2004 in an effort to expand reduction programming in Thailand.MethodsWe examined experiences with the Mitsampan Harm Reduction Centre (MSHRC) among IDU participating in the Mitsampan Community Research Project (Bangkok). Multivariate logistic regression was used to identify factors associated with MSHRC use. We also examined services used at and barriers to the MSHRC.Results252 IDU participated in this study, including 66 (26.2%) females. In total, 74 (29.3%) participants had accessed the MSHRC. In multivariate analyses, MSHRC use was positively associated with difficulty accessing syringes (Adjusted Odds Ratio [AOR] = 4.05; 95% Confidence Interval [CI]: 1.67–9.80), midazolam injection (AOR = 3.25; 95%CI: 1.58–6.71), having greater than primary school education (AOR = 1.88; 95%CI: 1.01–3.52), and was negatively associated with female gender (AOR = 0.20; 95%CI: 0.08–0.50). Forms of support most commonly accessed included: syringe distribution (100%), food and a place to rest (83.8%), HIV education (75.7%), and safer injecting education (66.2%). The primary reason given for not having accessed the MSHRC was “didn’t know it existed.”ConclusionThe MSHRC is expanding the scope of harm reduction in Thailand by reaching IDU, including those who report difficulty accessing sterile syringes, and by providing various forms of support. In order to maximise its benefits, efforts should be made to increase awareness of the MSHRC, in particular among women.     

Artificial intelligence in pharmacy practice: Attitude and willingness of the community pharmacists and the barriers for its implementation

BackgroundArtificial intelligence (AI) is the capacity of machines to perform tasks that ordinarily require human intelligence. AI can be utilized in various pharmaceutical applications with less time and cost.ObjectivesTo evaluate community pharmacists’ willingness and attitudes towards the adoption of AI technology at pharmacy settings, and the barriers that hinder AI implementation.MethodsThis cross-sectional study was conducted among community pharmacists in Jordan using an online-based questionnaire. In addition to socio-demographics, the survey assessed pharmacists’ willingness, attitudes, and barriers to AI adoption in pharmacy. Binary logistic regression was conducted to find the variables that are independently associated with willingness and attitude towards AI implementation.ResultsThe present study enrolled 401 pharmacist participants. The median age was 30 (29–33) years. Most of the pharmacists were females (66.6%), had bachelor’s degree of pharmacy (56.1%), had low-income (54.6%), and had one to five years of experience (35.9%). The pharmacists showed good willingness and attitude towards AI implementation at pharmacy (n = 401). The most common barriers to AI were lack of AI-related software and hardware (79.2%), the need for human supervision (76.4%), and the high running cost of AI (74.6%). Longer weekly working hours (attitude: OR = 1.072, 95% C.I (1.040–1.104), P < 0.001, willingness: OR = 1.069, 95% Cl. 1.039–1.009, P-value = 0.011), and higher knowledge of AI applications (attitude: OR = 1.697, 95%Cl (1.327–2.170), willingness: OR = 1.790, 95%Cl. (1.396–2.297), P-value < 0.001 for both) were significantly associated with better willingness and attitude towards AI, whereas greater years of experience (OR = 20.859, 95% Cl (5.241–83.017), P-value < 0.001) were associated with higher willingness. In contrast, pharmacists with high income (OR = 0.382, 95% Cl. (0.183–0.795), P-value = 0.010), and those with<10 visitors (OR = 0.172, 95% Cl. (0.035–0.838), P-value = 0.029) or 31–50 visitors daily (OR = 0.392, 95% Cl. (0.162–0.944), P-value = 0.037) had less willingness to adopt AI.ConclusionsDespite the pharmacists' positive willingness and attitudes toward AI, several barriers were identified, highlighting the importance of providing educational and training programs to improve pharmacists' knowledge of AI, as well as ensuring adequate funding support to overcome the issue of AI high operating costs.     

Exploring the pharmacy students’ perspectives on off-campus online learning experiences amid COVID-19 crises: A cross-sectional survey

BackgroundThe pandemic of COVID-19 has placed many challenges for pharmacy students’ learning experiences via the online e- system. There is paucity of studies that addresses this in colleges of pharmacies in United Arab Emirates (UAE).ObjectiveWe have explored the preparedness, attitudes, experiences, and barriers/facilitators, and delineated factors that may affect the pharmacy students’ e-learning process amid the COVID-19 crises.MethodsThe current study was cross-sectional, and survey-based (anonymously self-administered) that utilized theoretical domains framework. The survey (multiple statements) was comprised of four domains (based on theoretical domain framework) that has elaborated on the preparedness, attitudes, experiences and barriers for the pharmacy students’ e-learning (all years and interns). The validated (Cronbach Alfa 0.821) and piloted survey posted to the Google form and a link distributed to the pharmacy students. The survey was comprised of four domains (34 statements), distributed as five in preparedness, eleven in attitude, eleven in the experiences, and seven in the barriers/facilitators (theoretical domains framework).Outcome measureThe primary outcome was the total sum of scores of individual statements and each individual four domain of the questionnaire (preparedness, attitude, experiences, and barriers/facilitators).ResultsTwo hundred thirty respondents participated in the survey (230/400, response rate 57.5%), of which 193 were females (83.9%) versus 37 males (16.1%). The mean age (years) was 19.9 ± 1.9 (males 19.8 ± 1.6 and females 20.0 ± 1.9). The mean total score for preparedness Q1 to Q5 (domain maximum score 25); and for the attitude Q6 to Q16 (domain maximum score of 60) were 14.9 ± 3.8 (95% CI 14.4 – 15.4; P < 0.05), 29.5 ± 7.4 (95% CI 28.6 – 30.5; P < 0.05) respectively. While for the experiences Q17 to Q27 (domain maximum score 55); and for the barriers/facilitators Q28 to Q34 (domain maximum score 30) 40.1 ± 8.0 (95% CI 39.1 – 41.1; P < 0.0001), and 20.9 ± 4.9 (95% CI 20.3–21.5;P < 0.05) respectively.ConclusionOur pharmacy students support the use of e-learning in pharmacy education, and seems prepared for the future technology moves in education. The colleges of pharmacies need to conduct further research on versatile innovative models such as virtual learning/artificial intelligence that fits with their students’ perspectives.     

Social injecting and other correlates of high-risk sexual activity among injecting drug users in northern Vietnam

BackgroundSexual risk and STDs are relatively high among injecting drug users (IDUs) in Vietnam. We sought to determine characteristics of sexually active IDUs and correlates of high-risk sexual practices among IDUs in Bac Ninh province in northern Vietnam.MethodsWe used data collected for a community-based cross-sectional pilot study to identify correlates of recent high-risk sex (>1 sex partner and inconsistent/no condom use in the past year). Factors associated with high-risk sex were identified using logistic regression.ResultsAmong 216 sexually active male IDUs, one third (n = 72) had engaged in high-risk sex within the last year. IDUs who reported injecting with others more frequently, having someone else inject their drugs at last injection, sharing needles or sharing any injection equipment were more likely to have reported recent high-risk sex. Factors independently associated with high-risk sexual activity were not injecting oneself [AOR: 2.22; 95% CI (1.09–4.51)], and sharing needles in the past 12 months [AOR: 2.57; 95% CI (1.10–5.99)].ConclusionsIDUs who inject socially and IDUs who share needles are likely to engage in high-risk sexual behaviours and may serve as an important bridge group for epidemic HIV transmission in Vietnam. In addition to messages regarding the dangers of sharing needles and other injection equipment, preventive interventions among newly initiated IDUs should also focus on reducing sexual risk.     

Racial and ethnic disparities in influenza vaccinations among community pharmacy patients and non-community pharmacy respondents

BackgroundSince 2009, pharmacists in all 50 states in the U.S. have been authorized to administer vaccinations.ObjectivesThis study examined racial and ethnic disparities in the reported receipt of influenza vaccinations within the past year among noninstitutionalized community pharmacy patients and non-community pharmacy respondents.MethodsThe 2009 Medical Expenditure Panel Survey was analyzed. The sample consisted of respondents aged 50 years or older, as per the 2009 recommendations by the Advisory Committee on Immunization Practices. Bivariate and multivariate logistic regression analyses were conducted to examine the influenza vaccination rates and disparities in receiving influenza vaccinations within past year between non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks) and Hispanics. The influenza vaccination rates between community pharmacy patients and non-community pharmacy respondents were also examined.ResultsBivariate analyses found that among the community pharmacy patients, a greater proportion of Whites reported receiving influenza vaccinations compared to Blacks (60.9% vs. 49.1%; P < 0.0001) and Hispanics (60.9% vs. 51.7%; P < 0.0001). Among non-community pharmacy respondents, differences also were observed in reported influenza vaccination rates among Whites compared to Blacks (41.0% vs. 24.3%; P < 0.0001) and Hispanics (41.0% vs. 26.0%; P < 0.0001). Adjusted logistic regression analyses found significant racial disparities between Blacks and Whites in receiving influenza vaccinations within the past year among both community pharmacy patients (odds ratio [OR]: 0.81; 95% CI: 0.69–0.95) and non-community pharmacy respondents (OR: 0.66; 95% CI: 0.46–0.94). Sociodemographic characteristics and health status accounted for the disparities between Hispanics and Whites. Overall, community pharmacy patients reported higher influenza vaccination rates compared to non-community pharmacy respondents (59.0% vs. 37.2%; P < 0.0001).ConclusionAlthough influenza vaccination rates were higher among community pharmacy patients, there were racial disparities in receiving influenza vaccinations among both community pharmacy patients and non-community pharmacy respondents. Increased emphasis on educational campaigns among pharmacists and their patients, especially minorities, may be needed.     

Health literacy among patients with poor understanding of prescription drug label instructions in Saudi Arabia

IntroductionThis study conducted to assess the health literacy level among patients who have poor understanding of the medications’ labels in Saudi Arabia.MethodsThis multi-center cross-sectional study was conducted on two phases. In the 1st phase, 511 patients waiting for their medications in the outpatient pharmacies of four major hospitals in Saudi Arabia were interviewed to assess their understanding ability of the labels of five of the commonly prescribed medications. Those participants who misunderstood the medications’ labels were enrolled in the 2nd phase of the study to assess their health literacy level. The validate Arabic Single Item Literacy Screener (SILS) was used to assess the health literacy level.AnalysisThe sample characteristics were described by mean and percentage. Both Chi-square test and logistic regression model were used to figure out the association between health literacy with the main affecting factors.ResultsAlmost 38.6% (n = 197) of the participants in phase-1 misunderstood the medications’ labels. Nearly, 11.2% (n = 22) of them had low health literacy level. Participants who had low education level and low socioeconomic status were more likely to have low health literacy [adjusted odds ratio (AOR) = 2.94; 95% confidence interval (95%CI) (1.03–8.404); P-value = 0.044], [AOR = 5.28; 95%CI (1.118–24.943); P-value = 0.036], respectively.ConclusionLow health literacy was associated with low education level and low socioeconomic status of the patients.