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Robert A, Johnmark N, Radiana KM, Haulat K, Ivan S, Rajab K, Ebong K. Evaluating the role of intern pharmacists in pharmaceutical care in hospitals in Uganda. J Pharm Policy Pract 2024; 17:2320282. [PMID: 38476502 PMCID: PMC10930095 DOI: 10.1080/20523211.2024.2320282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background In Uganda, there is limited adoption of pharmaceutical care in hospitals due to pharmacist shortages and limited collaboration among healthcare professionals. Intern pharmacists are deployed annually to assist in patient care to address pharmacist shortages. Objectives Evaluate intern pharmacist's extent of involvement in pharmaceutical care activities, assess facilitators and barriers, and explore healthcare professionals' perceptions, attitudes, and opinions on implementation of pharmaceutical care. Methods A mixed-method concurrent study was carried out for four months. We conducted an online survey among 107 intern pharmacists from 26 hospitals, including National Referral, Regional Referral, Private Not-For-Profit, and General hospitals; predictors of extent of involvement were identified using linear regression models, using STATA 14. 24 key informants (nurses, prescribers, pharmacists) from five hospitals were interviewed; themes were developed using a deductive thematic analysis approach. Results Intern pharmacists had a median (Interquartile range[IQR]) age of 25 years (25-27) and 74.7% were male. About half (54.1%) of key informants were female and had a median (IQR) of 10 years (4.0-15.5) of professional experience. Interns focused on patient counseling, lacked documentation, and showed positive attitudes, and knowledge. Key informants supported implementation, but prescribers expressed dissatisfaction with interns' performance. Conclusion Enhancing pharmacy internship and training through developing policies and guidelines on pharmaceutical care practice, improving working conditions, and mentorship can address gaps impeding pharmaceutical care implementation by intern pharmacists.
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Affiliation(s)
- Agaba Robert
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | - Ndinawe Johnmark
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | | | - Kiiza Haulat
- Pharmaceutical Society of Uganda, Pharmacum Care Uganda Project, Kampala, Uganda
| | - Segawa Ivan
- Epidemiology Unit, School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Kalidi Rajab
- Department of Pharmacy, Makerere University, Kampala, Uganda
| | - Keren Ebong
- Department of Pharmacy, Mulago National Referral Hospital, Kampala, Uganda
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Fleckner J, Pettus K, Vallath N, Pastrana T. Systematic Review on Barriers to Access Opioid Analgesics for Cancer Pain Management from the Health Worker Perspective. J Pain Palliat Care Pharmacother 2023; 37:324-335. [PMID: 37773586 DOI: 10.1080/15360288.2023.2257674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/02/2023] [Indexed: 10/01/2023]
Abstract
The increasing incidence of oncological diseases creates a corresponding need for effective cancer pain management (CPM). The lack of access to and availability of opioid analgesics in most countries leads to avoidable suffering. This systematic review aims to identify barriers to accessing opioids, as described in literature that reflects the perspective of health-care workers. A systematic literature search was performed in May 2018 and updated in December 2022, using search terms related to "cancer pain," "opioid analgesics," "access," and "health-care personnel." Medline, Embase, and PsycInfo were searched. Forty-two studies met the inclusion criteria. Principal barriers that have hindered licit access to medical opioids include regulatory, systemic, educational, patient-related, and societal. These barriers are rooted in a lack of adequate education about the importance and significance of appropriate CPM. Barriers were often mutually reinforcing. A interdisciplinary approach is required to overcome them. This research contributes to the important global health issue of unduly limited access to opioid analgesics. It provides interdisciplinary solutions in terms of guidelines to ensure that governments respect, protect, and fulfill the right to the highest attainable standard of health, which includes the relief of severe pain.
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Affiliation(s)
- Josephine Fleckner
- Department of Palliative Medicine, Medical Faculty, RWTH University Aachen, Aachen, Germany
| | - Katherine Pettus
- International Association for Hospice and Palliative Care (IAHPC), Houston, Texas, USA
| | - Nandini Vallath
- Department of Palliative Medicine, St. John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Tania Pastrana
- Department of Palliative Medicine, Medical Faculty, RWTH University Aachen, Aachen, Germany
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Chawla RL, Gadge NP, Ronad S, Waghmare A, Patil A, Deshmukh G. Knowledge, Attitude and Perception Regarding Artificial Intelligence in Periodontology: A Questionnaire Study. Cureus 2023; 15:e48309. [PMID: 38058340 PMCID: PMC10697475 DOI: 10.7759/cureus.48309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2023] [Indexed: 12/08/2023] Open
Abstract
INTRODUCTION The utilization of artificial intelligence (AI) and machine learning (ML) models has brought about a significant transformation in the manner in which periodontists gather information, evaluate associated risks, develop diverse treatment alternatives, anticipate and diagnose dental conditions that compromise periodontal health. The principal objective of this prospective study was to examine periodontists' understanding and acceptance of the application of AI in the realm of periodontology. MATERIALS AND METHODS This observational study was conducted on 275 participants based on questionnaire using Google Forms. These forms were pre-validated and subsequently circulated among periodontists in Maharashtra via various social media platforms. The study, in its entirety, comprised four open-ended questions on participants' demographics and 14 closed-ended questions, all of which were presented to the participants in English. These questions aimed to elicit participants' awareness, knowledge, attitudes, and perspectives regarding emerging applications of AI in the field of periodontology. To analyze the collected data, researchers employed the widely utilized Statistical Package for Social Sciences (SPSS) version 22.0. RESULT A 75% response rate was achieved and 68% of the respondents were female. 62% periodontists were aware of AI; however, only 24% were aware of its working principles. Most respondents agreed with the use of AI in periodontal diagnosis; however, they disagreed with the use of AI in predicting clinical attachment loss (69%). 80-82% respondents felt that AI should be a part of postgraduate training and should be implemented in clinical practice. However, most periodontists do not use AI for diagnostic or research purposes. 49% periodontists felt that AI does not have better diagnostic accuracy than periodontists, and therefore cannot replace them in the future. CONCLUSION Most periodontists possessed a reasonable level of understanding regarding the utilization of AI in the domain of periodontology and expressed a desire to incorporate it into their diagnostic and treatment planning processes for periodontal conditions. Additional endeavors must be undertaken to enhance periodontists' awareness concerning the effective implementation of AI within their professional practice, with the aim of facilitating personalized treatment planning for their respective patients. It is postulated that the integration of AI will augment the likelihood of achieving favorable outcomes within the realm of periodontology.
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Affiliation(s)
- Ruhee L Chawla
- Periodontics, Jawahar Medical Foundation ACPM Dental College, Dhule, IND
| | - Nidhi P Gadge
- Periodontics, Jawahar Medical Foundation ACPM Dental College, Dhule, IND
| | - Sunil Ronad
- Prosthodontics, Jawahar Medical Foundation ACPM Dental College, Dhule, IND
| | - Alka Waghmare
- Periodontics, Jawahar Medical Foundation ACPM Dental College, Dhule, IND
| | - Aarti Patil
- Periodontics, Jawahar Medical Foundation ACPM Dental College, Dhule, IND
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Alshehri AM, Almogbel YS, Alonazi RE, Alshehri WM, Alkhelaifi HA, Almutairi SA, Alenazi OS, Alali AZ. Pharmacists' Knowledge and Intention to Provide Palliative Care Services in Saudi Arabia: Using the Theory of Planned Behaviour. Healthcare (Basel) 2023; 11:2173. [PMID: 37570413 PMCID: PMC10418381 DOI: 10.3390/healthcare11152173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 06/17/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Providing palliative care to patients with life-threatening illnesses requires multidisciplinary efforts from different healthcare providers. Identifying the attitude, knowledge, and intentions of pharmacists to provide this service in Saudi Arabia is essential. Therefore, this study aimed to identify the palliative care knowledge, intentions, attitudes, subjective norms, and perceived behavioural control of pharmacists and what factors predict their intentions. Cross-sectional questionnaires based on the theory of planned behaviour were distributed to pharmacists in hospitals and community pharmacies. They included items that measured palliative care knowledge, attitudes, intentions, subjective norms, and the perceived behavioural control of pharmacists and identified other sociodemographic and pharmacy-practice-related items. In total, 131 pharmacists completed the questionnaires, showing an average score on palliative knowledge (8.82 ± 1.96; range: 1-14), strong intentions (5.84 ± 1.41; range: 1-7), positive attitudes (6.10 ± 1.47; range: 1-7), positive subjective norms (5.31 ± 1.32; range: 1-7), and positive perceived behavioural control (5.04 ± 1.21; range: 1-7). Having completed a pharmacy residency program, working longer hours per week, having a more positive attitude, and perceived stronger subjective norms were significantly associated with a strong intention to provide palliative care services. Therefore, enabling and motivating pharmacists to complete pharmacy residency programs and improve their attitudes could increase their intentions to provide these services.
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Affiliation(s)
- Ahmed M. Alshehri
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Yasser S. Almogbel
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraidah 51452, Saudi Arabia;
| | - Rana E. Alonazi
- Pharmacology Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia;
| | - Waleed M. Alshehri
- Clinical Pharmacy Department, King Fahad Medical City, Riyadh 11525, Saudi Arabia;
| | - Hind A. Alkhelaifi
- Contracts Management Department, National Unified Procurement Company (NUPCO), Riyadh 12251, Saudi Arabia;
| | - Salman A. Almutairi
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Omar S. Alenazi
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
| | - Ali Z. Alali
- Clinical Pharmacy Department, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj 16273, Saudi Arabia; (S.A.A.); (O.S.A.); (A.Z.A.)
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Tanaka R, Satoh Y, Suga Y, Nakagawa J, Miyazaki M, Hagiwara R, Uchida M, Takase H. Japanese Nationwide Comparative Survey of Medication Guidance Provided by Certified and Uncertified Palliative Care Pharmacists. J NIPPON MED SCH 2023; 90:449-459. [PMID: 38246616 DOI: 10.1272/jnms.jnms.2023_90-613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND As members of a medical team, pharmacists are expected to provide optimal patient-centered, evidence-based pharmacotherapy. In Japan, in consideration of the importance of palliative care, a system was initiated for certifying palliative care pharmacists in 2010. However, no studies have evaluated the usefulness of board certification in palliative pharmacy. Therefore, we surveyed the status of medication guidance for the physical and psychological symptoms of patients receiving palliative care and compared the medication guidance provided by certified and uncertified pharmacists. METHODS The survey was conducted in February and March 2022. Pharmacists registered as members of the Japanese Society of Pharmaceutical Palliative Care and Sciences were surveyed by using a web-based questionnaire and 209 pharmacists responded: the certified pharmacist group comprised 123 (58.9%) pharmacists and the uncertified pharmacist group comprised 86 (41.1%) pharmacists. RESULTS The certified pharmacist group provided better and more frequent medication guidance, according to responses to four of the six items related to pain relief. Three items were related to non-pain symptom relief, and one of the four items was related to psychiatric symptom relief (P < 0.05). The study showed that the certified pharmacist group received a better rating than the uncertified pharmacist group for involvement in palliative pharmacotherapy leading to improvement of patient quality of life (P < 0.05). CONCLUSION As compared with uncertified pharmacists, certified pharmacists intervened more proactively and provided a broader range of palliative care.
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Affiliation(s)
- Rei Tanaka
- Department of Pharmacy, Shizuoka Cancer Center
- Faculty of Pharmaceutical Sciences, Tokyo University of Science
| | | | - Yukio Suga
- Department of Clinical Pharmacy and Healthcare Science, Faculty of Pharmacy, Institute of Medical, Pharmaceutical & Health Science, Kanazawa University
| | - Junichi Nakagawa
- Department of Pharmacy, Daisan Hospital, The Jikei University School of Medicine
| | | | | | - Mayako Uchida
- Department of Education and Research Center for Pharmacy Practice, Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts
| | - Hisamitsu Takase
- Department of Pharmacy, Nippon Medical School Tama Nagayama Hospital
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Rendrayani F, Alfian SD, Wahyudin W, Puspitasari IM. Pharmacists' Knowledge, Attitude, and Practice of Medication Therapy Management: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10122513. [PMID: 36554036 PMCID: PMC9778396 DOI: 10.3390/healthcare10122513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Understanding pharmacists' knowledge, attitudes, and practices (KAP) and their perceptions of challenges, barriers, and facilitators towards medication therapy management (MTM) provision are vital in informing the design and implementation of successful service delivery. Thus, this review examined pharmacists' knowledge, attitudes, and practices, and their perceived challenges, barriers, and facilitators to MTM services provision, globally. A systematic search was conducted on 1-31 August 2022 to identify relevant studies on PubMed and EBSCO, supplemented with a bibliographic and a particular hand search. We focused on original research in quantitative survey form with the key concepts of "medication therapy management", "pharmacists", and "knowledge, attitude, practice". We assessed the reporting quality using the Checklist for Reporting of Survey Studies (CROSS). Results are reported narratively and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. From 237 articles identified, 17 studies met the eligibility criteria. Of the included studies, five reported that pharmacists had a considerable level of knowledge, seven suggested a positive attitude among pharmacists, and five revealed that pharmacists had been practicing some MTM elements. Factors associated with pharmacists' KAP may include age, educational degree, additional qualification, income, years of practice, practice setting, and experience in patient care service. The challenges toward MTM provision were related to the pharmacist-patient and pharmacist-physician relationship. Insufficient time, staff, compensation, and training were the barriers, while patients' willingness to participate and educational background were the facilitators of MTM provision. These findings of studies on KAP could help develop an MTM program and design an intervention to improve program effectiveness. Further research focusing on other quantitative and qualitative studies of KAP is needed to obtain a comprehensive approach to MTM provision.
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Affiliation(s)
- Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Sofa Dewi Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Wawan Wahyudin
- Ciloto Health Training Centre, Ministry of Health Republic of Indonesia, Cianjur 43253, West Java, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Correspondence:
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Oji N, Onyeka T, Soyannwo O, Paal P, Elsner F. Perspectives, perceived self-efficacy, and preparedness of newly qualified physicians' in practising palliative care-a qualitative study. Palliat Care 2022; 21:141. [PMID: 35922778 PMCID: PMC9351146 DOI: 10.1186/s12904-022-01028-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dealing with life-limiting illnesses, death, dying and grief, is uncharted territory for medical graduates. It is a field that is heavily influenced by cultural, religio-spiritual and social factors. This adds complexity to palliative and end-of-life-care, which challenges newly qualified physicians and requires the formation of appropriate knowledge, skills, and attitudes in junior doctors. This study aimed to obtain insight into the perspectives, perceived self-efficacy, and preparedness of newly qualified Nigerian physicians in practising palliative care and identify potential variables influencing them. METHODS The study was a cross-sectional, multi-centre survey of newly qualified Nigerian physicians, using semi-structured, in-depth qualitative interviews. The data were analysed by applying content-structuring qualitative content analysis. RESULTS Forty semi-structured interviews were conducted with medical house officers at two tertiary institutions in Nigeria. The perceived self-efficacy and preparedness of newly qualified Nigerian physicians in practising palliative care were reported to be higher in areas of family involvement, and pain and symptom management than in areas of breaking bad news, prognosis, and diagnosing dying. Major influences on the young physicians' perceived self-efficacy and preparedness in practising palliative care were socio-economic circumstances of a resource-limited setting and cultural-religious considerations. In addition, the perceived impact of palliative care education and experience was documented. CONCLUSIONS This study offers valuable insights into the perceived self-efficacy and preparedness of newly qualified physicians and reveals the influence of socio-cultural and socio-economic variables in Nigeria. Evidence of the social, cultural, and religio-spiritual dimensions of palliative care is indispensable for culturally sensitive care. These results could aid in the development of appropriate knowledge, skills, and attitudes in newly qualified physicians through culturally and contextually appropriate palliative care training measures. The results may be applicable to other sub-Saharan African settings and may be used to improve future palliative care education, training, and practice.
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Affiliation(s)
- Nwabata Oji
- Department of Palliative Medicine, Uniklinik RWTH Aachen, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 57, 52074, Aachen, Germany.
| | - Tonia Onyeka
- Department of Anaesthesia / Pain and Palliative Care Unit, College of Medicine, University of Nigeria, Ituku-Ozalla Campus, Enugu, Nigeria
| | - Olaitan Soyannwo
- Hospice and Palliative Care Department, University College Hospital Ibadan, Queen Elizabeth Road, Ibadan, Oyo State, Nigeria
| | - Piret Paal
- Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria
| | - Frank Elsner
- Department of Palliative Medicine, Uniklinik RWTH Aachen, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 57, 52074, Aachen, Germany
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Ivey MF, Vest TA, Zilz DA. The need for increased education and training of pharmacy learners in the care of older, critically ill, and end-of-life patients. Am J Health Syst Pharm 2021; 78:1336-1340. [PMID: 33928343 DOI: 10.1093/ajhp/zxab177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marianne F Ivey
- University of Cincinnati James L. Winkle College of Pharmacy, Cincinnati, OH, USA
| | - Tyler A Vest
- Duke University Hospital, Durham, NC, and University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
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