Engaging consumers in wise use of over-the-counter medications in Taiwan: Development and evaluation of a structured medication counseling approach

A Qualitative Approach to Exploring Workflow and Cost Factors of Dispensing Services in Community Pharmacies in Taiwan

Purpose

This study aimed to thoroughly document the process and cost factors involved in dispensing services within a community pharmacy.

Methods

Using a cross-sectional design, this study incorporated a pragmatic and descriptive qualitative approach to outline pharmacists' viewpoints on providing dispensing services in community settings. A purposive sampling was employed to recruit pharmacists from geographically different community pharmacies, spanning from March to July 2022. Semi-structured interviews with direct content analysis were conducted through face-to-face interactions to gather firsthand insights into pharmacists' professional dispensing services. The data underwent analysis through descriptive and in vivo coding techniques to categorize, define, and label themes, thereby identifying key steps and cost components in the prescription dispensing process. The qualitative data management software, MAXQDA 2020, was utilized for data management and maintenance.

Results

Ten community pharmacists participated in the study, cooperatively completing the interview process. Of these, 7 were male and 3 were female, with age ranging from 29 to 62 years. The average length of pharmacy practice experience was 11.4 years. The study revealed six integral steps in the dispensing process: (1) receiving and clarifying legality and completeness of prescriptions, (2) profiling and verifying patient prescriptions, (3) preparing prescription labels and containers, (4) dispensing right medications with right quantity, (5) inspecting dispensing accuracy, (6) handing over medications and providing counseling. Along with these processes, pharmacists emphasized that pharmacy manpower, representing a substantial portion of the associated costs, determines the success and quality of the dispensing service. Additionally, rental, utilities, consumables, and physical equipment were identified as other important cost factors associated with carrying out pharmacy dispensing services.

Conclusion

The study offers a comprehensive understanding of the dispensing service workflow within community pharmacies. The findings may inform key stakeholders and policymakers about required resources for enhancing and sustaining quality dispensing services for the public in Taiwan.

Chemical composition, antinociceptive and anti-inflammatory effects in mice of the essential oil of Psidium cattleyanum Sabine leaves

ETHNOPHARMACOLOGICAL RELEVANCE

One of the native species of the genus most often mentioned by traditional people is Psidium cattleyanum Sabine, which is used mostly to treat disorders of the respiratory, genitourinary, and digestive systems. These symptoms are mainly treated by the decoction of the leaves. Additionally, there are gaps in the in vivo and toxicity investigations of this species.

AIM OF THE STUDY

The aim of this study was evaluate antinociceptive and anti-inflammatory potential of essential oil from P. cattleyanum leaves in vivo.

MATERIALS AND METHODS

Gas chromatography-mass spectrometry (GC/MS) was used to examine the essential oil of P. cattleyanum. The acute toxicity test was then done with a 2000 mg/kg dosage. The oil at 50, 100, and 200 mg/kg orally, as well as the reference medications Morphine 10.0 mg/kg IP and/or Indomethacin 20.0 mg/kg IP, were tested using nociception (abdominal writhing, formalin, and tail immersion) and inflammatory models (paw edema and peritonitis).

RESULTS

The phytochemical assay showed a high concentration of β-caryophyllene (46.68%) and α-caryophyllene (10.81%). In the in vivo assays, P. cattleyanum essential oil proved to be an important antinociceptive agent, reaching 76.96% inhibition of abdominal writhing with acetic acid and 67.12% in the formalin assay. An increase in latency time in the tail test was also reported. In the test with carrageenan, the oil showed significant inhibition compared to the control. A decrease in the migration of leukocytes was also reported in the group treated with P. cattleyanum, reaching 60.49% at the dose of 200 mg/kg.

CONCLUSIONS

The essential oil from the leaves of P. cattleyanum has anti-inflammatory and antinociceptive action and has potential for application in the pharmaceutical and food industry.

Effects of a blended multimedia teaching approach on self-efficacy and skills in over-the-counter medication counselling versus a lecture-based approach: protocol for a prospective cohort study of undergraduate students from a pharmacy school in Taiwan

INTRODUCTION

Addressing communication skills in pharmacy curricula is one of the effective tactics to equip future pharmacists with better skillsets for medication counselling. To achieve this, blended teaching of PowerPoint slides and videos holds great potential for undergraduate pharmacy education majors by integrating multimedia and performance feedback into instruction. This study will develop a blended teaching programme featuring didactic lectures with video-based materials to improve students' self-efficacy and skills in medication counselling.

METHODS AND ANALYSIS

This study applies critical principles and effects outlined in multimedia learning by Richard Mayer et al to develop teaching materials and perform skill evaluation for two undergraduate cohorts (class of 2025 and 2026) enrolled in Introduction to Community Pharmacy separately in 2022 and 2023. Students will receive different teaching approaches to medication counselling. In the control cohort (ie, class of 2025), students will receive a 4-week PowerPoint slides-based instruction in communication skills. We will develop six videos illustrating common scenarios of over-the-counter (OTC) medication counselling in community pharmacies. In the intervention cohort (ie, class of 2026), students will receive a 3-week PowerPoint slides-based instruction and a week-long video-based instruction in communication skills. A pre-and-post survey will be administered to evaluate students' self-efficacy in OTC counselling. In addition, each student will be evaluated through one-on-one role-playing with standardised patients in the final to demonstrate their skills in OTC counselling. A structured checklist will be used to assess students' counselling skills. T-tests will be applied to examine differences in self-efficacy of OTC counselling. Multivariate regression analyses will determine which teaching approach better facilitates the development of self-efficacy and performance in OTC counselling.

ETHICS AND DISSEMINATION

The Research Ethics Committee of the National Taiwan University Hospital approved this study. The findings will be shared with pharmacy educators and contribute to existing instructional methods to facilitate the competence of pharmacy students in OTC counselling.

Mapping Real-World Data to Self-Reported Information to Explore Determinants of Location Selection for Community Pharmacies in Taiwan

Background

Easy and adequate access to community pharmacies is key to eliminating primary barriers to the utilization of medicines and healthcare services. The location of community pharmacies is important for patients and providers when choosing and opening a pharmacy, but only a handful of studies investigate factors associated with the geographical distribution of pharmacies. This study aimed to identify decisive factors for location selection when starting a pharmacy among districts/townships in Taiwan.

Methods

This cross-sectional mixed mode study employed an explanatory sequential design, beginning with a quantitative analysis of national datasets, and followed by a qualitative analysis of structured interviews. The national data were extracted from the Taiwan government database of 2020, and the qualitative interviews were conducted with 10 community pharmacists through a snowball sampling in 2021. A multiple linear regression was conducted to identify salient predictors of the number of community pharmacies in each of the 368 districts/townships in Taiwan, including population density, median annual household income, number of physician offices, area, and proportion of female residents of each district/township. Ten chief pharmacists were interviewed to share viewpoints on the decision-making process of their selection of current pharmacy practice sites. Inductive thematic analysis was performed to extract factors pertinent to location selection for pharmacy operations and services.

Results

Confirmed by quantitative and qualitative data, population density, numbers of physician offices, median annual household income, pharmacy operation type, and type of retail locations are key determinants for site selection in considering opening a new community pharmacy.

Conclusion

The study uncovers salient factors associated with the choice of community pharmacy location in Taiwan and proposes the adequate number of physician offices that a community pharmacy can collaborate with. In addition, pharmacists should prudently consider if their preferred service features match the needs of residents.

Exploration of changes in pharmacy students' perceptions of and attitudes towards professionalism: outcome of a community pharmacy experiential learning programme in Taiwan

BACKGROUND

A powerful way to nurture and strengthen professionalism is by accruing practice-based experiences. However, few studies in Taiwan have evaluated the impacts of experiential learning programmes on pharmacy students' views on professionalism - the core of quality healthcare practices and services. This study aimed to measure changes in perceptions of and attitudes towards professionalism among third-year pharmacy students following an introductory-intermediate experiential learning course.

METHODS

A single-group pre- and postcourse comparative study using a self-administered survey was conducted in 2017. Pharmacy students in their third year of a six-year programme were eligible to participate in this study. We used a 28-item questionnaire with a 10-point Likert-type scale to assess students' professionalism. Among them, 10 items were employed to assess students' perceived importance of professionalism in pharmacy practice, and another 18 items adapted from the Pharmacy Professionalism Instrument were used to evaluate students' attitudes towards pharmacy professionalism. An independent t test was performed to compare the differences in students' anonymous survey responses before and after the course, with an a priori level of statistical significance of 0.05.

RESULTS

Fifty-two pharmacy students participated in the study. They showed significant improvement in three tenets of professionalism, namely, altruism (p = 0.035), accountability (p = 0.026), and duty (p = 0.002), after completing the 5-week experiential course.

CONCLUSIONS

Pharmacy students' attitudes towards professionalism were modifiable by purposely designed experiential learning programme in the community setting. Such experiences may help socialize students with positive attitudes towards altruism, accountability, and duty.