Hospital and community pharmacists' perception of the scope, barriers and challenges of pharmacy practice-based research in Nigeria

Pharmacists' Understanding and Attitudes Toward Pharmaceutical Care in Saudi Arabia

Background It has been proposed that pharmacy practice moves from product-focused to patient-focused. The major goals of pharmaceutical care are to improve the patient's quality of life, approve the safety of drug therapy, and seek to enhance the quality of life related to the patient's health within reasonable financial constraints. One of the biggest issues facing Saudi Arabia's healthcare system is including a pharmacist in the healthcare team who uses the most up-to-date pharmaceutical services and cares for the patient with medical and nursing care. This study aims to assess the opinions and knowledge concerning pharmaceutical care of hospital pharmacists working in three major governmental hospitals in the Al-Qassim region. Methodology A descriptive cross-sectional survey using an anonymous, structured, validated, and pilot-tested questionnaire of hospital pharmacists was utilized to address the study's objectives. The data were collected in four weeks between November and December 2021 from three major governmental hospitals in the Al-Qassim region. Data were analyzed using the SPSS software version 24 (IBM Corp., Armonk, NY, USA), and the associations between variables were evaluated. Results The survey was completed by 130 of the 160 pharmacists during the four-week study period (the overall response rate was 81%). The majority of those who responded were Saudi males, and only 19 (14.6%) participants had more than 15 years of practice. The majority of pharmacists had favorable opinions on providing pharmaceutical care. Overall, 122 (93.9%) respondents knew what pharmaceutical care meant. Most pharmacists (120, 92.3%) agreed to always counsel the patient on how to use their medications. Nearly half of the pharmacists (58, 45.0%) lacked knowledge about the clinical disease states, and 108 (83.0%) pharmacists knew how to obtain information. Conclusions Pharmacists reported a positive attitude regarding pharmaceutical treatment. Awareness and attitudes concerning pharmaceutical treatment were associated with a variety of demographic parameters, including gender, years of experience, and place of employment, to name a few. They reported that they were willing but concerned about their clinical expertise and ability to communicate effectively. Therefore, pharmacists should be permitted to enroll in programs that teach them how to provide pharmacological care.

Involvement of pharmacy students in scientific research activities in Vietnam

INTRODUCTION

Scientific research is a crucial section of health-related student education to ensure the competence of graduates. This study is the first to explore attitudes on research, willingness and motivation to conduct research, and barriers preventing this amid pharmacy students in Can Tho, Vietnam.

METHODS

A cross-sectional online survey was performed on undergraduate pharmacy students (years four and five) from three public and private universities in Can Tho, Vietnam between April and May 2021.

RESULTS

Of the 576 respondents, the majority accredited the significance of conducting research to the field of pharmacy (85.9%) with the motivation of improving the profession (81.6%). Public university respondents were more than twice as likely to have a positive attitude toward research (odds ratio [OR] = 2.88, 95% CI = 1.32-6.27) and be willing to conduct research (OR = 5.73, 95%CI = 3.5-9.37) than their private university counterparts. Very good or excellent academic performance was associated with a positive attitude (OR = 3.09, 95% CI = 1.46-6.53), willingness (OR = 3.2, 95%CI = 1.7-6.03), and increased motivation (OR = 2.42, 95% CI = 1.26-4.64) toward conducting research compared to respondents with average or lower academic performance. A lack of experience (63.5%), knowledge and skills (46%), and research training (51.7%) were the most common personal and systemic barriers to conducting research.

CONCLUSIONS

Most students reported having a positive attitude and strong motivation toward research. These findings revealed an opportunity for pharmacy policymakers and educators to utilize national strategy to improve pharmacy education and the profession.

Community pharmacists’ attitudes toward practice-based research and their perceived utilization of scientific evidence

Background

Enhancing the contribution of practicing pharmacists into scientific evidence via practice-based research (PBR) is crucial in maintaining high-quality clinical practice and healthcare delivery. Involving community pharmacists in PBR can potentially can also help break barriers to the utilization of the current best evidence in everyday pharmacy practice. The impact of pharmacists’ attitude towards PBR on their utilization of current best evidence in pharmacy practice is understudied.

Objectives

The aim of the study was to investigate the impact of community pharmacists’ attitudes toward PBR on their utilization of current best evidence, barriers for conducting PBR in clinical practice were also investigated.

Methods

In this cross-sectional study, 169 community pharmacists working across Jordan filled a questionnaire to assess their attitudes towards PBR, barriers to PBR, and their utilization of the current best evidence in clinical practice.

Results

Pharmacists in this study showed a positive attitude toward PBR (attitude mean score >3.5). A positive attitude towards PBR was associated with high utilization of the best current scientific evidence. We also investigated several barriers to PBR and their association with utilization those included; the lack of perceived benefits, lack of institutional support, and lack of self-engagements of community pharmacists to PBR. The lack of perceived benefit was found to be negatively associated with pharmacists’ utilization of the current best scientific evidence.

Conclusion

In this study, pharmacists’ utilization of current best evidence was found to be significantly impacted by their attitude toward PBR. The current study findings highlight the importance of supporting, promoting, and facilitating PBR among community pharmacists which can potentially enhance their utilization of the current best evidence in their everyday pharmacy practice.

Assessing readiness for research: a pilot study of Indonesian pharmacists

Objectives

Readiness is a key factor that influences pharmacists’ willingness to get involved in research, thus promoting evidence-based pharmacy practice. While the data are lacking, this study aimed to assess readiness for research, as well as the associated demographic and attitudinal characteristics of pharmacists in a range of healthcare settings in East Java Province, Indonesia.

Methods

A questionnaire was administered to all pharmacists in a public hospital in Malang (n = 55), pharmacists from primary health centre (PHCs) (n = 63) and community pharmacies (n = 100) in Surabaya in 2017. The questionnaire consisted of three sections: (1) demographic characteristics, (2) attitudinal aspects and (3) readiness for research. Descriptive analysis was used to summarise the data. Spearman correlation tests determined the correlations between ‘demographic characteristics’ or ‘attitudinal aspects’ versus ‘readiness’.

Key findings

A total of 142 pharmacists responded which comprised hospital pharmacists (n = 46), community pharmacists (n = 51) and PHC pharmacists (n = 45), giving response rates ranged from 51.0% to 83.6%. Approximately half of the participating pharmacists demonstrated adequate ‘readiness’ to research [mean 2.53 ± 0.7 (range 0–4)]. Compared with hospital or PHC pharmacists, community pharmacists showed lower ‘readiness’ to research (mean 2.76 ± 0.71 versus 2.53 ± 0.66 versus 2.31 ± 0.68, respectively; P = 0.005). Two demographic characteristics positively correlated with ‘readiness’, that is, prior research training (rs = 0.217; P = 0.010) and prior research experience (rs = 0.221; P = 0.008). Meanwhile, all ‘attitudinal aspects’ were found to be positively correlated with research ‘readiness’ (all P-values <0.001).

Conclusions

Findings from this study provide baseline data to develop strategies to optimise the involvement of pharmacist practitioners in research, thus enhancing evidence-based pharmacy practice and quality use of medications in Indonesia.

Postgraduate pharmacist development- an evaluation of Jordanian pharmacist experiences to inform and shape an evidence-based professional development policy

Building capacity for developing skills as leadership, teamwork, and continuous academic support has become essential for fulfilling a successful pharmacy career. This study aims to assess Jordanian pharmacists' views on professional development, namely: the continuous education infrastructure, strategies and programs for personal development, leadership skills, incentive schemes, drug information resources and digital services. As well as exploring options for better academic support delivered to pharmacists. To capture participant's views, an online validated and reliable survey was developed. Non-probability sampling design was used. Participants were qualified pharmacists working at Royal Medical Services (RMS) and Community Pharmacists (CP). Comparison and descriptive statistics were used to report the results. A total of 271 pharmacists participated, 144 from RMS (8% more than the needed sample) and 127 CP (7% more than the needed sample). There was a strong desire amongst both RMS and PC groups for continuous educational training particularly in the following areas, first: Advanced counselling and communication skills (means = 8.99±0.145, CI 95% = 3.70-4.28 and 9.37±0.096, CI 95% = 4.18-4.56). Second: Personal development skills (mean = 8.92±0.142, CI 95% = 3.64-4.20 and 9.02±0.145, CI 95% = 3.73-4.30). Third, Pharmaceutical health promotion (mean = 8.05±0.180, CI 95% = 2.70-3.41 and 8.57±0.159, CI 95% = 3.26-3.89). Only 19.4% and 18.1% of the RMS and CPs respectively reported the presence of a written policy for personal development and leadership in their workplace. There were few incentives for pharmacists to participate in research. Few pharmacists used the available drug information and toxicology centers. The professional and continuous personal development of pharmacists support an evolving healthcare system. This study emphasizes the need for a tailored and documented postgraduate educational strategy, personal development, and leadership skills training in Jordan. Implementing a well-defined scheme of incentives should be encouraged to engage pharmacists in continuous professional development programs and pharmaceutical research. Such strategy and training should enhance both professional and personal performance.

Perceptions, Expectations, and Experience of Physicians About Pharmacists and Pharmaceutical Care Services in Pakistan: Findings and Implications

Background: Optimal collaboration between pharmacists and other healthcare professionals such as physicians is integral in implementing pharmaceutical care. However, there are concerns regarding the role of pharmacists, especially among low- and middle-income countries. This study explored the perceptions, expectations, and experience of physicians working in various hospital settings of Punjab, Pakistan, about pharmacists and their roles.

Methods: A self-administered questionnaire consisting of four sections was administered from October to December 2020. Descriptive and inferential statistics such as Kruskal-Wallis and Mann-Whitney tests were used for data analysis using SPSS.

Results: Six hundred and seventy-eight physicians participated in this study with a response rate of 77.9%. Most of the physicians reported minimal to no interaction with pharmacists (n = 521, 76.8%). However, more than three-quarters of physicians (n = 660, 97.3%) accepted pharmacists as evidence-based sources of drug information. In addition, many physicians (n = 574, 84.7%) strongly agreed that pharmacists should attend patient care rounds to respond promptly to questions related to patient medication. A limited number of physicians (n = 124, 18.3%) assumed that pharmacists were advising their patients regarding the judicial use of their drugs. Median expectation and experience score had a significant association with age, experience, and education of physicians (P < 0.05).

Conclusions: The perception of physicians was positive toward certain roles of pharmacists, coupled with high expectations. However, their experience was low, with most of the activities of pharmacists due to inadequate interprofessional coordination.

Pharmacists' background, interests, barriers, self-perceived competence and confidence to design and undertake pharmacy practice-based research in the GCC geographic area

BACKGROUND

The absence of ability and certainty to design and undertake pharmacy practice-based research (PPBR) was a major issue among pharmacists worldwide as reported in previous literature, despite them having an interest in conducting PPBR. Therefore, this study aimed at highlighting the research background of the Gulf Cooperation Council (GCC) pharmacists which are the six Arab states of the Arabian Gulf, and examining barriers to conducting PPBR. In addition, to determine the self-perceived level of competence and confidence when planning and conducting PPBR.

METHODS

This is a descriptive, cross-sectional questionnaire-based study, performed among pharmacists working in the GCC countries (i.e. Saudi Arabia, United Arab Emirates, Kuwait, Bahrain, Oman and Qatar). A pre-validated questionnaire was distributed to a convenience sample, via distribution of 500 research participation cards to conference attendees. These cards a quick response (QR) code, which should be scanned via mobile phone, to direct all readers to the online survey. All pharmacist delegates attending the conference (i.e. the Saudi International Pharmaceutical Sciences Annual National Conference (SIPHA) and Dubai International Pharmaceuticals and Technologies Conference and Exhibition (DUPHAT) in 2020 and who are working in one of the GCC co. untries as pharmacists were considered. The data were analysed using the Statistical Package for the Social Sciences (SPSS) and Excel software.

RESULTS

Two hundred and fourteen pharmacists were included. Seventy percent of the pharmacists had past PPBR background. Confidence and competence of pharmacists for research skills in regard to employing appropriate inferential statistical test, choosing software for statistical analysis, drafting a comprehensive plan for data analyses and determining appropriate sample size were weak. Highest competence and confidence were seen in preparing a presentation and searching the literature. Pharmacists with previous research experience (K-W: p = 0.001) and training (K-W: p = 0.003) had an overall ability to conduct PPBR. In addition, they had more interest in conducting PPBR (MWU = 3061.500, z = - 4.126, p = 0.000) and in learning about how to do so (MWU = 8698, z = - 1.898, p = 0.050).

CONCLUSIONS

Pharmacists practicing in the GCC geographic area realized the importance of planning and conducting PPBR and were more confident and competent to undertake and contribute to PPBR, except for skills related to statistical analysis. Therefore, training programmes especially for biostatistics and data analysis are mandatory to enhance pharmacists' research capabilities.

Sierra Leonean doctors' perceptions and expectations of the role of pharmacists in hospitals: a national cross-sectional survey

Background The effective implementation of pharmaceutical care requires pharmacists' collaboration with other healthcare providers, especially doctors. However, doctor's perceptions and expectations may not be in line with the tasks and responsibilities of pharmacists. Objectives We aim to explore doctors' expectations and perceptions of pharmacists while working together in a multi-disciplinary team in Sierra Leone. Setting Twelve public hospitals in Sierra Leone. Method A national cross-sectional survey was conducted between July and September 2018. Anonymous self-administered questionnaires were distributed to all doctors at randomly selected public hospitals. Data were analyzed in Excel and SPSS using descriptive and inferential statistics, and a p > 0.05 was taken as statistically significant. Main outcome measure Doctors' perceptions and expectations towards pharmacists role in patient care. Results A total of 119 out of 150 questionnaires were returned. Doctors hold a mixed perception of pharmacists. The majority of medical doctors believed that pharmacists are vital (n = 98; 82.4%) as they provide services that foster better patients outcomes (n = 78; 65.6%). However, about half (n = 58; 48.8%) expressed uncertainty or perceived pharmacists as incompetent in providing clinical pharmacy services. Our findings also showed a large proportion of doctors expect pharmacists to review medication order (n = 110; 92.4%) for appropriateness and monitoring patients' response to therapy and possible adverse drug effects (n = 112; 92.2%). M ore than three quarters (n = 104, 87.4%) were in favour of collaborating with pharmacists in the process of developing patients' treatment plans. Doctors (n = 116; 97.5%) were of the view that doctor-pharmacist collaborations can be improved by developing trust relationships through dialogue. No demographic characteristics were independently associated with doubt in pharmacist clinical competence. Conclusion Reservations regarding pharmacists' clinical competency still prevail amongst medical doctors. Conversely, they view pharmacists as crucial players in the healthcare delivery system in Sierra Leone. Doctors also have high expectations of pharmacists in terms of contributing to better patient outcomes and therefore wish to collaborate. Possible interventions to settle doctors' discontent regarding pharmacists may include fostering interprofessional training, practice, and constructive dialogue.

The New Era of Pharmacists in Ambulatory Patient Care

Pharmacy is evolving from a product-oriented to a patient-oriented profession. This role modification is extremely healthy for the patient, the pharmacist, and other members of the health-care team. However, the evolution will present pharmacists with a number of new challenges. Now, more than in the past, pharmacists must make the acquisition of contemporary practice knowledge and skills a high priority, to render the level of service embodied in the concept of pharmaceutical care. Pharmacy educators' organizations and regulatory bodies must all work together to support pharmacists as they assume expanded health-care roles. Pharmacy and the healthcare industry must work to ensure that the pharmacist is compensated justly for all services. But before this can happen it will be necessary for pharmacy to demonstrate value-added to the cost of the prescription. Marketing of the purpose of pharmacy in the health-care morass and of the services provided by the pharmacist is needed to generate an appropriate perceived value among purchasers and users of health-care services. Pharmacists should view themselves as dispensers of therapy and drug effect interpretations as well as of drugs themselves. Service components of pharmacy should be identified clearly to third party payers and be visible to consumers, so that they know what is available at what cost and how it may be accessed. In the future, pharmacy services must be evaluated on patient outcome (i.e., pharmaceutical care) rather than the number of prescriptions dispensed, and pharmacy must evolve toward interpretation and patient consultation, related to the use of medication technologies.

Factors Associated With an Interest in Practice-Based Research Among Pharmacists in Nigeria

Background: Practice-based research (PBR) is employed in the pharmacy profession to improve the quality and efficiency of health care delivery. Although widely practiced in developed countries, it is rarely used in developing countries, including Nigeria. Objectives: To determine the factors associated with Nigerian pharmacists’ interest in PBR. Methods: This is a cross-sectional study utilizing an online survey. Pharmacists currently practicing in Nigeria were invited to participate. A hyperlink to the online questionnaire was shared with members of relevant professional bodies via Facebook, WhatsApp, and Twitter. Reminders were sent to facilitate a high response rate. Factors associated with pharmacists’ interest in PBR were determined using multiple logistic regression. Results: Two hundred and three completed responses were received from the survey. The majority, 94.6% (192), expressed an interest in PBR and believed that it would enhance their pharmacy practice and role in patient care. The multivariable analysis showed that pharmacists’ interest in publishing their research findings in peer-reviewed journals (odds ratio = 0.004, 95% confidence interval = 0.00-0.05, P < .001) and their knowledge of the professional relevance of research pertaining to their area of practice within the health care system (odds ratio = 0.02, 95% confidence interval = 0.00-0.47, P = .015) were found to be independent predictors of pharmacists’ interest in PBR. Conclusion: There is an interest in PBR among practicing pharmacists in Nigeria. The provision of evidence-based pharmaceutical services in Nigeria will be enhanced by interventions that encourage the conduct of research and publication of research findings, and by improving knowledge of the professional relevance of PBR in pharmacy practice areas.

Lebanese community-based pharmacists' interest, practice, knowledge, and barriers towards pharmacy practice research: A cross-sectional study

Objective

To assess the interest, knowledge, practice and barriers of Lebanese community-based pharmacists towards research, and to examine factors associated with interest.

Methods

A cross-sectional survey, conducted between January and May 2017, enrolled community pharmacists using a proportionate random sample of community pharmacies in the five districts of Lebanon, using the list of pharmacies provided by the Lebanese Order of Pharmacists. In the absence of validated questionnaires to answer our objectives, we created a questionnaire based on previous research. The questionnaire was modified based on the experiences and issues raised during focus groups with research active pharmacists and research oriented community pharmacists.

Results

A total of 399 pharmacists was enrolled. The results showed that 231 (72%) were conscious about the important role of research in the community pharmacy setting whereas only 5.6% considered it not important. Over two-thirds (68.5%) of the pharmacists declared being interested in participating in research. There was a statistical difference in the percentage of correct answers between auto-declared and corrected responses for all terms, with all p < 0.001.The most reported barrier was lack of time during hours of work (90.9%), followed by the lack of pharmacy staff (73.7%), lack of financial resources (68.9%), patient's lack of education and resistance to participation (64.8%), and lack of support (63.8%). Age (aOR = 0.92), years of experience (aOR = 1.06), and having been involved in research (aOR = 3.17) were associated with higher interest in research. Having studied in Lebanon (aOR = 3.63), having received previous research courses (aOR = 11.12) and being interested in research (aOR = 2.74) were associated with having participated in research projects during their professional experience.

Conclusion

Lebanese pharmacists have the good will to conduct and participate in research, but are lacking knowledge; this issue needs to be addressed vividly. Addressing the identified barriers could improve the research output of Lebanese community pharmacists.

Attitude, perception, willingness, motivation and barriers to practice-based research: A cross-sectional survey of hospital pharmacists in Lahore, Punjab, Pakistan

Background and objectives

Practice-based research (PBR) is of pivotal importance for hospital pharmacists which not only up-grades the profession but also improves the patient care. This study aimed to evaluate the attitude, perception, willingness, motivation and barriers to PBR among hospital pharmacists in Pakistan.

Methods

A descriptive, cross sectional study design was employed. Data were collected between 1^st December, 2017 and 1^st March, 2018 from 130 hospital pharmacists employed in 41 hospitals of Lahore, Pakistan. A survey instrument comprising of six sections was designed to determine the attitude, perception, willingness, motivation and barriers to PBR. Data were analyzed by using Statistical Package for Social Sciences (IBM SPSS Statistics for Windows, version 21.0, Armonk, NY: IBM Corp.). The normality of the data was determined through Shapiro-Wilks and Kolmogorov-Smirnov tests. Independent Samples Mann-Whitney U Test and Independent Samples Kruskal-Wallis Test were carried out to test if there were differences among the characteristics of the hospital pharmacists. Logistic regression analysis was used to figure out the factors associated with attitude, perceptions, willingness and motivation towards PBR. A p-value <0.05 was used for statistical significance of differences.

Results

A total of 141 pharmacists were approached. Among them, 130 responded to the survey (response rate 92%). Out of a maximum score i.e., 5 (100%) the respondents obtained a median score of 4 (IQR = 0) for attitude, perception and motivation towards PBR; whereas, a median score of 4 (IQR = 1) was obtained for willingness thus demonstrating fair positive attitude, good perceptions, increased motivation and willingness towards PBR. The most common barrier limiting the pharmacists’ participation in PBR was lack of time (23.8%) followed by lack of incentives (16.2%) and lack of support (14.6%). Results of the logistic regression analysis revealed that hospital pharmacists practicing in the inpatient settings had 4.56 times more positive attitude towards PBR (OR = 4.56, 95%CI = 1.07─19.42, p-value = 0.040) as compared to those practicing in the outpatient settings. The male hospital pharmacists (OR = 8.86, 95%CI = 1.15–53.74, p-value = 0.017), those practicing in the outpatient (OR = 23.51, 95%CI = 2.04─271.53, p-value = 0.011) and inpatient settings had increased motivation towards PBR (OR = 12.24, 95%CI = 1.61─94.66, p-value = 0.016).

Conclusion

Despite the presence of several barriers, the respondents had fair positive attitude, good perceptions, increased motivation and willingness towards PBR which is a promising finding.

Nigerian pharmacists' self-perceived competence and confidence to plan and conduct pharmacy practice research

Background

Recent studies have revealed that pharmacists have interest in conducting research. However, lack of confidence is a major barrier.

Objective

This study evaluated pharmacists' self-perceived competence and confidence to plan and conduct health-related research.

Method

This cross sectional study was conducted during the 89th Annual National Conference of the Pharmaceutical Society of Nigeria in November 2016. An adapted questionnaire was validated and administered to 200 pharmacist delegates during the conference.

Result

Overall, 127 questionnaires were included in the analysis. At least 80% of the pharmacists had previous health-related research experience. Pharmacist's competence and confidence scores were lowest for research skills such as: using software for statistical analysis, choosing and applying appropriate inferential statistical test and method, and outlining detailed statistical plan to be used in data analysis. Highest competence and confidence scores were observed for conception of research idea, literature search and critical appraisal of literature. Pharmacists with previous research experience had higher competence and confidence scores than those with no previous research experience (p<0.05). The only predictor of moderate-to-extreme self-competence and confidence was having at least one journal article publication during the last 5 years.

Conclusion

Nigerian pharmacists indicated interest to participate in health-related research. However, self-competence and confidence to plan and conduct research were low. This was particularly so for skills related to statistical analysis. Training programs and building of Pharmacy Practice Research Network are recommended to enhance pharmacist's research capacity.