1
|
Tan PL, Loh TJ, Chan SY. A Pilot Study on Pharmacists' Knowledge, Attitudes and Practices towards Medication Dysphagia via Asynchronous Online Focus Group Discussion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2858. [PMID: 36833554 PMCID: PMC9956395 DOI: 10.3390/ijerph20042858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 02/03/2023] [Accepted: 02/04/2023] [Indexed: 06/18/2023]
Abstract
Medication dysphagia (MD) refers to difficulty swallowing oral medications. To cope, patients may inappropriately modify or skip medications, leading to poorer outcomes. Little is known about healthcare professionals' (HCPs') perspectives in managing MD. This study investigated pharmacists' knowledge, attitudes, and practices (KAP) in caring for patients with MD. An asynchronous online focus group was pilot tested in seven pharmacists, with up to two questions posted daily on an online platform over 15 days. Thematic analysis of the transcripts revealed five interrelated themes: (1) knowledge about MD; (2) management of MD; (3) expectations of patient proactivity; (4) desire for objectivity; (5) professional roles. The findings provided insight into pharmacists' KAP and may be incorporated into a full-scale study involving various HCPs.
Collapse
Affiliation(s)
| | | | - Sui Yung Chan
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117559, Singapore
| |
Collapse
|
2
|
Speechly C, Stenhouse R, Berman Y, Barlow-Stewart K, Fleming J, Petrie D, Culling B. Genetic counselors, patients', and carers' views on an Australian clinical genetics service information system. J Genet Couns 2021; 30:1440-1451. [PMID: 33866647 DOI: 10.1002/jgc4.1412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 11/07/2022]
Abstract
The Genetic Information System (GIS) is an Australian database of family genetic information. This health information technology system has been used by all 31 publicly operated clinical genetics services across New South Wales (NSW) and the Australian Capital Territory (ACT) for over a decade. As these services are separated geographically, the linkage engendered by the GIS facilitates the services to operate as a virtual state-wide service. This study aimed to explore the views of genetic counselors, patients, and carers on the use and storage of family genetic information in the GIS. Data were collected using audio-recorded semi-structured telephone interviews with genetic counselors experienced with using the GIS and focus groups with past patients/carers of the services. Using thematic analysis, four themes were identified from genetic counselor participant interviews (n = 12): (a) Shared information is valuable; (b) inconsistent data entry provides a challenge; (c) perceived need for the GIS to be current and integrated with other health systems; and (d) future challenges and strategies for the GIS. Three themes were identified following three focus groups with consumer participants (n = 14): (a) access to family genetic information provides a 'clearer picture'; (b) support, but caution, concerning use of information for relatives' health care; and (c) stewardship of family information. Genetic counselors and consumers identified similar advantages and privacy concerns regarding the sharing of family genetic information and all participants wanted patients/carers to be better informed about the GIS early in the genetic counseling process. Consumers were reassured by genetics health professionals' stewardship of their information, but surprised the GIS was not available nationally or for private geneticists or certain non-genetic specialists. These findings may inform further development of the GIS and other clinical genetic databases and lead to increased patient/carer knowledge through education and resource development.
Collapse
Affiliation(s)
- Catherine Speechly
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Rachael Stenhouse
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Yemima Berman
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia.,Department of Clinical Genetics, Royal North Shore Hospital, St Leonards, NSW, Australia
| | - Kristine Barlow-Stewart
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | - Jane Fleming
- Faculty of Medicine and Health, Northern Clinical School, University of Sydney, St Leonards, NSW, Australia
| | | | - Bronwyn Culling
- Clinical Applications Support, Service Delivery, eHealth NSW, Chatswood, NSW, Australia
| |
Collapse
|
3
|
Stefansdottir V, Skirton H, Johannsson OT, Olafsdottir H, Olafsdottir GH, Tryggvadottir L, Jonsson JJ. Electronically ascertained extended pedigrees in breast cancer genetic counseling. Fam Cancer 2018; 18:153-160. [PMID: 30251169 DOI: 10.1007/s10689-018-0105-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
A comprehensive pedigree, usually provided by the counselee and verified by medical records, is essential for risk assessment in cancer genetic counseling. Collecting the relevant information is time-consuming and sometimes impossible. We studied the use of electronically ascertained pedigrees (EGP). The study group comprised women (n = 1352) receiving HBOC genetic counseling between December 2006 and December 2016 at Landspitali in Iceland. EGP's were ascertained using information from the population-based Genealogy Database and Icelandic Cancer Registry. The likelihood of being positive for the Icelandic founder BRCA2 pathogenic variant NM_000059.3:c.767_771delCAAAT was calculated using the risk assessment program Boadicea. We used this unique data to estimate the optimal size of pedigrees, e.g., those that best balance the accuracy of risk assessment using Boadicea and cost of ascertainment. Sub-groups of randomly selected 104 positive and 105 negative women for the founder BRCA2 PV were formed and Receiver Operating Characteristics curves compared for efficiency of PV prediction with a Boadicea score. The optimal pedigree size included 3° relatives or up to five generations with an average no. of 53.8 individuals (range 9-220) (AUC 0.801). Adding 4° relatives did not improve the outcome. Pedigrees including 3° relatives are difficult and sometimes impossible to generate with conventional methods. Pedigrees ascertained with data from pre-existing genealogy databases and cancer registries can save effort and contain more information than traditional pedigrees. Genetic services should consider generating EGP's which requires access to an accurate genealogy database and cancer registry. Local data protection laws and regulations have to be addressed.
Collapse
Affiliation(s)
- V Stefansdottir
- Department of Genetics and Molecular Medicine, Landspitali - National University Hospital, Hringbraut, 101, Reykjavik, Iceland.,Department of Biochemistry and Molecular Biology, Univ. of Iceland, Reykjavik, Iceland
| | - H Skirton
- Faculty of Health and Human Sciences, Plymouth University, Plymouth, UK
| | - O Th Johannsson
- Department Of Medical Oncology, Landspitali - National University Hospital, Reykjavik, Iceland
| | - H Olafsdottir
- Department of Genetics and Molecular Medicine, Landspitali - National University Hospital, Hringbraut, 101, Reykjavik, Iceland
| | - G H Olafsdottir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland
| | - L Tryggvadottir
- Icelandic Cancer Registry, Icelandic Cancer Society, Reykjavik, Iceland.,Faculty of Medicine, Univ. of Iceland, Reykjavik, Iceland
| | - J J Jonsson
- Department of Genetics and Molecular Medicine, Landspitali - National University Hospital, Hringbraut, 101, Reykjavik, Iceland. .,Department of Biochemistry and Molecular Biology, Univ. of Iceland, Reykjavik, Iceland. .,Genetical Committee of the University of Iceland, Reykjavik, Iceland.
| |
Collapse
|