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Laymouna M, Ma Y, Lessard D, Engler K, Therrien R, Schuster T, Vicente S, Achiche S, El Haj MN, Lemire B, Kawaiah A, Lebouché B. Needs-Assessment for an Artificial Intelligence-Based Chatbot for Pharmacists in HIV Care: Results from a Knowledge-Attitudes-Practices Survey. Healthcare (Basel) 2024; 12:1661. [PMID: 39201222 PMCID: PMC11353819 DOI: 10.3390/healthcare12161661] [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: 07/21/2024] [Revised: 08/14/2024] [Accepted: 08/15/2024] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Pharmacists need up-to-date knowledge and decision-making support in HIV care. We aim to develop MARVIN-Pharma, an adapted artificial intelligence-based chatbot initially for people with HIV, to assist pharmacists in considering evidence-based needs. METHODS From December 2022 to December 2023, an online needs-assessment survey evaluated Québec pharmacists' knowledge, attitudes, involvement, and barriers relative to HIV care, alongside perceptions relevant to the usability of MARVIN-Pharma. Recruitment involved convenience and snowball sampling, targeting National HIV and Hepatitis Mentoring Program affiliates. RESULTS Forty-one pharmacists (28 community, 13 hospital-based) across 15 Québec municipalities participated. Participants perceived their HIV knowledge as moderate (M = 3.74/6). They held largely favorable attitudes towards providing HIV care (M = 4.02/6). They reported a "little" involvement in the delivery of HIV care services (M = 2.08/5), most often ART adherence counseling, refilling, and monitoring. The most common barriers reported to HIV care delivery were a lack of time, staff resources, clinical tools, and HIV information/training, with pharmacists at least somewhat agreeing that they experienced each (M ≥ 4.00/6). On average, MARVIN-Pharma's acceptability and compatibility were in the 'undecided' range (M = 4.34, M = 4.13/7, respectively), while pharmacists agreed to their self-efficacy to use online health services (M = 5.6/7). CONCLUSION MARVIN-Pharma might help address pharmacists' knowledge gaps and barriers to HIV treatment and care, but pharmacist engagement in the chatbot's development seems vital for its future uptake and usability.
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Affiliation(s)
- Moustafa Laymouna
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3S 1Z1, Canada; (M.L.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
| | - Yuanchao Ma
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
- Department of Biomedical Engineering, Polytechnique Montréal, Montreal, QC H3T 1J4, Canada
| | - David Lessard
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Kim Engler
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
| | - Rachel Therrien
- Department of Pharmacy and Chronic Viral Illness Service, Research Centre of the University of Montreal Hospital Centre, Montreal, QC H2X 0A9, Canada
| | - Tibor Schuster
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3S 1Z1, Canada; (M.L.)
| | - Serge Vicente
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3S 1Z1, Canada; (M.L.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Department of Mathematics and Statistics, University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Sofiane Achiche
- Department of Biomedical Engineering, Polytechnique Montréal, Montreal, QC H3T 1J4, Canada
| | - Maria Nait El Haj
- Faculty of Pharmacy, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Benoît Lemire
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Abdalwahab Kawaiah
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
| | - Bertrand Lebouché
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC H3S 1Z1, Canada; (M.L.)
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Infectious Diseases and Immunity in Global Health Program, Research Institute of McGill University Health Centre, Montreal, QC H4A 3S5, Canada
- Chronic Viral Illness Service, Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montreal, QC H4A 3J1, Canada
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Wong JC, Hekimyan L, Cruz FA, Brower T. Identifying Pertinent Digital Health Topics to Incorporate into Self-Care Pharmacy Education. PHARMACY 2024; 12:96. [PMID: 38921972 PMCID: PMC11207556 DOI: 10.3390/pharmacy12030096] [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: 04/30/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
The ever-evolving landscape of digital health technology has dramatically enhanced patients' ability to manage their health through self-care effectively. These advancements have created various categories of self-care products, including medication management, health tracking, and wellness. There is no published research regarding integrating digital health into pharmacy self-care courses. This study aims to identify pertinent digital health devices and applications to incorporate into self-care course education. Digital health limitations, challenges incorporating digital health in self-care pharmacy education, and potential solutions are also reviewed. In conducting this research, many resources, including PubMed, APhA, ASHP, fda.gov, and digital.health, were reviewed in March 2024 to gather information on digital health devices and applications. To supplement this, targeted keyword searches were conducted on topics such as "digital health", "devices", "applications", "technology", and "self-care" across various online platforms. We identified digital health devices and applications suitable for self-care education across eight topics, as follows: screening, insomnia, reproductive disorders, eye disorders, home medical equipment, GI disorders, pediatrics, and respiratory disorders. Among these topics, wellness screening had the most digital health products available. For all other topics, at least three or more products were identified as relevant to self-care curriculum. By equipping students with digital health knowledge, they can effectively apply it in patient care throughout their rotations and future practice. Many digital health products, including telemedicine, electronic health records, mobile health applications, and wearable devices, are ideal for inclusion in pharmacy curriculum as future educational material. Future research is needed to develop the best strategies for incorporating relevant digital health into self-care education and defining the best student-learning strategies.
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Affiliation(s)
- Jason C. Wong
- Pharmacy Practice and Administration, Western University of Health Sciences, Pomona, CA 91766, USA
| | - Luiza Hekimyan
- College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA; (L.H.); (F.A.C.); (T.B.)
| | - Francheska Anne Cruz
- College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA; (L.H.); (F.A.C.); (T.B.)
| | - Taylor Brower
- College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA; (L.H.); (F.A.C.); (T.B.)
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Ciudad-Gutiérrez P, Del Valle-Moreno P, Lora-Escobar SJ, Guisado-Gil AB, Alfaro-Lara ER. Electronic Medication Reconciliation Tools Aimed at Healthcare Professionals to Support Medication Reconciliation: a Systematic Review. J Med Syst 2023; 48:2. [PMID: 38055124 DOI: 10.1007/s10916-023-02008-0] [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: 03/05/2023] [Accepted: 10/30/2023] [Indexed: 12/07/2023]
Abstract
The development of health information technology available and accessible to professionals is increasing in the last few years. However, a low number of electronic health tools included some kind of information about medication reconciliation. To identify all the electronic medication reconciliation tools aimed at healthcare professionals and summarize their main features, availability, and clinical impact on patient safety. A systematic review of studies that included a description of an electronic medication reconciliation tool (web-based or mobile app) aimed at healthcare professionals was conducted. The review protocol was registered with PROSPERO: registration number CRD42022366662, and followed PRISMA guidelines. The literature search was performed using four healthcare databases: PubMed, EMBASE, Cochrane Library, and Scopus with no language or publication date restrictions. We identified a total of 1227 articles, of which only 12 met the inclusion criteria.Through these articles,12 electronic tools were detected. Viewing and comparing different medication lists and grouping medications into multiple categories were some of the more recurring features of the tools. With respect to the clinical impact on patient safety, a reduction in adverse drug events or medication discrepancies was detected in up to four tools, but no significant differences in emergency room visits or hospital readmissions were found. 12 e-MedRec tools aimed at health professionals have been developed to date but none was designed as a mobile app. The main features that healthcare professionals requested to be included in e-MedRec tools were interoperability, "user-friendly" information, and integration with the ordering process.
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Affiliation(s)
- Pablo Ciudad-Gutiérrez
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Paula Del Valle-Moreno
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Santiago José Lora-Escobar
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
| | - Ana Belén Guisado-Gil
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain.
| | - Eva Rocío Alfaro-Lara
- Department of Pharmacy, University Hospital Virgen del Rocio, Av. Manuel Siurot s/n., 41013, Seville, Spain
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Hasan S, AlZubaidi H, Palaian S, AlOmar M, Kheir N, Al Hariri Y, Shanableh S, Gaili A, Kahaleh A. A Telehealth Module and Virtual Objective Structured Clinical Examination of Health Literacy in Pharmacy Education. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2023; 87:100555. [PMID: 37399897 DOI: 10.1016/j.ajpe.2023.100555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 06/05/2023] [Accepted: 06/26/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVE To implement an online health literacy (HL) module and evaluate its impact through virtual Objective Structured Clinical Examination (OSCE) on students' abilities to manage patients with low HL. METHODS Students virtually engaged in several learning activities related to HL, including practicing using HL assessment tools, designing an information booklet suitable for low HL patients, using readability formulas to lower text readability level to ≤ sixth grade, role-playing scenarios related to HL, and undergoing a virtual OSCE. Student performance on course assessments was tested using Spearman's rank-order. Students evaluated their OSCE experience in terms of case content, virtual assessment, and logistics; and effectiveness of the HL module and confidence related to HL. RESULTS A total of 90 students completed the virtual OSCE; the mean score was 8.8 out of 10 (88%), which correlated with similar course assessments. The average score was 3.46 out of 3.7 for the "gathering information" domain (recognizing risk factors and behaviors, assessing HL and adherence, etc.), and 4.06 out of 4.9 for the "patient management" domain (counseling patients on taking medications, focusing on repeating key messages, offering adherence interventions, etc.). Students responded positively regarding case content and virtual assessment, but less favorably regarding logistics. Feedback on effectiveness of the HL module and confidence in managing patients with low HL was positive. CONCLUSION An HL module delivered online was effective in improving student knowledge, abilities, and confidence related to HL. Students achieved high scores in all items in the virtual OSCE, and considered it a measure of communication and clinical skills that is comparable to traditional in-room assessments.
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Affiliation(s)
- Sanah Hasan
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates.
| | - Hamzah AlZubaidi
- University of Sharjah, Department of Pharmacy practice and Pharmacotherapeutics, Sharjah, United Arab Emirates
| | - Subish Palaian
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Muaed AlOmar
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Nadir Kheir
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Yassin Al Hariri
- Department of Pharmacy, Fatima College of Health Sciences, P.O. Box 42162, Al Maqam, Al Ain, United Arab Emirates
| | - Sawsan Shanableh
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Ahmed Gaili
- Ajman University, Department of Clinical Sciences, College of Pharmacy and Health Sciences, Center of Medical and Bio-allied Health Sciences, Ajman, United Arab Emirates
| | - Abby Kahaleh
- Roosevelt University, College of Pharmacy, Schaumburg, IL, USA; American Journal of Pharmaceutical Education, USA
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Alfian SD, Khoiry QA, Andhika A Pratama M, Pradipta IS, Kristina SA, Zairina E, Hak E, Abdulah R. Knowledge, perception, and willingness to provide telepharmacy services among pharmacy students: a multicenter cross-sectional study in Indonesia. BMC MEDICAL EDUCATION 2023; 23:800. [PMID: 37884985 PMCID: PMC10601297 DOI: 10.1186/s12909-023-04790-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 10/19/2023] [Indexed: 10/28/2023]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic accelerated the provision of telepharmacy services. However, little is known about the knowledge, perception, and willingness of pharmacy students as future key players in telepharmacy adoption to provide such a service, particularly in a setting without well-established telepharmacy services before the COVID-19 pandemic. OBJECTIVE With this survey we aimed to assess the level of knowledge, perception, and willingness to provide telepharmacy services and to identify associated factors among pharmacy students in Indonesia. METHODS We applied a multicenter cross-sectional study design with convenience sampling technique among pharmacy students in three public universities in Bandung City, Surabaya City, and Special Region of Yogyakarta, Indonesia. The knowledge, perception, and willingness to provide telepharmacy services were assessed using an online questionnaire. Ordinal regression analysis was performed to determine factors associated with a high knowledge level, whereas binary logistic regression analyses were performed to determine factors associated with a positive perception of telepharmacy services. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. RESULTS Among 313 respondents, 83.4% were female, and the mean age was 20 years. Although only 13.2% showed a high knowledge level, 66.5% showed a positive perception of telepharmacy services and 97.4% were willing to provide telepharmacy services in the future. An increase in age (OR 1.33; 95% CI 1.14-1.54) and being advance in smartphone usage (OR 5.21; 95% CI 2.03-13.42) are associated with an increased likelihood of having a high knowledge level about telepharmacy services. Male students had a lower likelihood of having a positive perception of telepharmacy services than females (OR 0.46; 95% CI 0.24-0.85). CONCLUSION Despite limited knowledge of telepharmacy, the majority of pharmacy students reported a positive perception and willingness to provide telepharmacy services in their future careers. Therefore, telepharmacy practice models must be included as a subject course in the curriculum, better preparing future pharmacists to perform their roles effectively. Furthermore, student-specific factors such as age and expertise in smartphone usage that associated with knowledge and gender that associated with perception should be considered to facilitate telepharmacy adoption in Indonesia.
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Affiliation(s)
- Sofa D Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia.
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia.
- Center for Health Technology Assessment, Universitas Padjadjaran, Jatinangor, Indonesia.
| | - Qisty A Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Mochammad Andhika A Pratama
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Ivan S Pradipta
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Susi A Kristina
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Elida Zairina
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, Indonesia
- Innovative Pharmacy Practice and Integrated Outcome Research (INACORE) Group, Universitas Airlangga, Surabaya, Indonesia
- Center of Excellence for Patient Safety and Quality, Universitas Airlangga, Surabaya, Indonesia
| | - Eelko Hak
- Unit of PharmacoTherapy, -Epidemiology, & -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, the Netherlands
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Jatinangor, Indonesia
- Drug Utilization and Pharmacoepidemiology Research Group, Centre of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Jatinangor, Indonesia
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Jarrett JB, Bratberg J, Burns AL, Cochran G, DiPaula BA, Dopp AL, Elmes A, Green TC, Hill LG, Homsted F, Hsia SL, Matthews ML, Ghitza UE, Wu LT, Bart G. Research Priorities for Expansion of Opioid Use Disorder Treatment in the Community Pharmacy. Subst Abus 2023; 44:264-276. [PMID: 37902032 PMCID: PMC10870734 DOI: 10.1177/08897077231203849] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
In the last decade, the U.S. opioid overdose crisis has magnified, particularly since the introduction of synthetic opioids, including fentanyl. Despite the benefits of medications for opioid use disorder (MOUD), only about a fifth of people with opioid use disorder (OUD) in the U.S. receive MOUD. The ubiquity of pharmacists, along with their extensive education and training, represents great potential for expansion of MOUD services, particularly in community pharmacies. The National Institute on Drug Abuse's National Drug Abuse Treatment Clinical Trials Network (NIDA CTN) convened a working group to develop a research agenda to expand OUD treatment in the community pharmacy sector to support improved access to MOUD and patient outcomes. Identified settings for research include independent and chain pharmacies and co-located pharmacies within primary care settings. Specific topics for research included adaptation of pharmacy infrastructure for clinical service provision, strategies for interprofessional collaboration including health service models, drug policy and regulation, pharmacist education about OUD and OUD treatment, including didactic, experiential, and interprofessional curricula, and educational interventions to reduce stigma towards this patient population. Together, expanding these research areas can bring effective MOUD to where it is most needed.
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Affiliation(s)
- Jennie B. Jarrett
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois Chicago, Chicago, USA
| | - Jeffrey Bratberg
- Department of Pharmacy Practice and Clinical Research, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
| | - Anne L. Burns
- American Pharmacists Association, Washington, DC, USA (retired)
| | - Gerald Cochran
- Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Bethany A. DiPaula
- Department of Practice, Sciences, and Health Outcomes Research, School of Pharmacy, University of Maryland Baltimore, Baltimore, MD, USA
| | | | - Abigail Elmes
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois Chicago, Chicago, USA
| | - Traci C. Green
- COBER on Opioids and Overdose at Rhode Island Hospital and the Warren Alpert Medical School of Brown University, Providence, RI, USA
- Opioid Policy Research Collaborative, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | - Lucas G. Hill
- The University of Texas at Austin, College of Pharmacy, Austin, TX, USA
| | | | - Stephanie L. Hsia
- Department of Clinical Pharmacy, San Francisco School of Pharmacy, University of California, San Francisco, CA, USA
| | - Michele L. Matthews
- Department of Pharmacy Practice, School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA
| | - Udi E. Ghitza
- National Institute on Drug Abuse (NIDA), Center for the Clinical Trials Network (CCTN), Bethesda, MD, USA
| | - Li-Tzy Wu
- Duke University School of Medicine, Durham, NC, USA
| | - Gavin Bart
- Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA
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Hwang M, Chang AK. The effect of nurse-led digital health interventions on blood pressure control for people with hypertension: A systematic review and meta-analysis. J Nurs Scholarsh 2023; 55:1020-1035. [PMID: 36929538 DOI: 10.1111/jnu.12882] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/30/2023] [Accepted: 02/10/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Nurse-led digital health interventions (DHIs) for people with chronic disease are increasing. However, the effect of nurse-led DHIs on blood pressure control and hypertension self-management remains unclear. This study aimed to identify the characteristics of nurse-led DHIs for people with hypertension and compared the effect size of nurse-led DHIs with that of usual care to establish evidence for the development of effective nursing interventions using technologies. DESIGN Systematic review and meta-analysis. METHODS This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews of Intervention (PRISMA) guidelines and registered the protocol in PROSPERO. Studies published from 2000 to August 5, 2021, were searched using the international databases: PubMed; Embase; Cochrane Central Register of Controlled Trials; Web of Science; CINAHL; Korean databases: RISS, KISS, KMBASE; and NDSL. Risk of bias 2.0 was used for evaluating the quality of studies. The primary outcome was blood pressure control. The secondary outcomes were self-management, medication adherence, and diet adherence. Publication bias was assessed using the funnel plot and Egger's regression tests. FINDINGS The systematic review included 26 studies. A meta-analysis of 21 studies was conducted to calculate the effect size and identify heterogeneity among the included studies. In our meta-analysis, we observed that nurse-led DHIs reduced systolic blood pressure by 6.49 mmHg (95% confidence interval [CI]: -8.52 to -4.46, I2 = 75.4%, p < 0.05) and diastolic blood pressure by 3.30 mmHg (95% CI: -4.58 to -2.01, I2 = 70.3%, p < 0.05) when compared with usual care. Concerning secondary outcomes, the effect size on self-management, medication adherence, and diet adherence was 0.98 (95% CI: 0.58 to 1.37, I2 = 63.2%, p < 0.05), 1.05 (95% CI: 0.41 to 1.69, I2 = 92.5%, p < 0.05), and 0.80 (95% CI: 0.17 to 1.42, I2 = 80.5%, p < 0.05), respectively. CONCLUSION Nurse-led DHIs were more effective in reducing blood pressure and enhancing self-management than usual care among people with hypertension. Therefore, as new technologies are being rapidly developed and applied in healthcare systems, further studies and policy support are needed to utilize the latest digital innovations with nursing interventions. CLINICAL RELEVANCE This study could be used to identify that nurse-led interventions may take advantage of real-time communication by employing digital technologies for improving blood control and self-management behaviors such as medication adherence and diet adherence. Using nurse-led DHIs allows nurses to provide patient-centered interventions such as reflecting on patients' needs and shared decision-making without space constraints and limited treatment time.
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Affiliation(s)
- Misun Hwang
- Kyung Hee University, College of Nursing Science, Seoul, Republic of Korea
| | - Ae Kyung Chang
- Kyung Hee University, College of Nursing Science, Seoul, Republic of Korea
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Shah AQ, Noronha N, Chin-See R, Hanna C, Kadri Z, Marwaha A, Rambharack N, Ng JY. The use and effects of telemedicine on complementary, alternative, and integrative medicine practices: a scoping review. BMC Complement Med Ther 2023; 23:275. [PMID: 37533042 PMCID: PMC10394941 DOI: 10.1186/s12906-023-04100-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 07/21/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Telemedicine includes the delivery of health-care services and sharing of health information across distances. Past research has found that telemedicine can play a role in enhancing complementary, alternative, and integrative medicine (CAIM) while allowing the maintenance of cultural values and ancestral knowledge. This scoping review synthesized evidence regarding the use of telemedicine in the context of CAIM. METHODS Following Arksey and O'Malley's scoping review framework, CINAHL, PsycINFO, MEDLINE, EMBASE and AMED databases were searched systematically. The CADTH website was also searched for grey literature. Eligible articles included a CAIM practice or therapy offered through telemedicine, with no restrictions placed on the type of telemedicine technology used. Inductive thematic analysis was conducted to synthesise common themes among the included studies. RESULTS Sixty-two articles were included in this synthesis. The following themes emerged: 1) the practitioner view of CAIM delivered through telemedicine, 2) the patient view of CAIM delivered through telemedicine, and 3) the technological impacts of telemedicine delivery of CAIM. CONCLUSIONS Studies have shown that telemedicine delivery of CAIM is feasible, acceptable, and results in positive health outcomes. Some barriers remain such as the presence of chronic illness and morbidity, inability to form strong patient-provider relationships relative to face-to-face approaches, and technological difficulties. Future intervention research should focus on reducing such barriers, as well as explore which patient population would realize the greatest benefit from CAIM delivered via telemedicine, and the impact of interventions on providers and caregivers.
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Affiliation(s)
- Aimun Qadeer Shah
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Noella Noronha
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Robert Chin-See
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Christina Hanna
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Zeest Kadri
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Amn Marwaha
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Neetu Rambharack
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
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Darnell JC, Lou M, Goldstone LW. Evaluating Change in Student Pharmacists' Familiarity, Attitudes, Comfort, and Knowledge as a Result of Integrating Digital Health Topics Into a Case Conference Series: Cohort Study. JMIR MEDICAL EDUCATION 2023; 9:e43313. [PMID: 37428523 PMCID: PMC10366968 DOI: 10.2196/43313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 04/10/2023] [Accepted: 05/08/2023] [Indexed: 07/11/2023]
Abstract
BACKGROUND The use of technology in health care, often referred to as digital health, has expanded rapidly because of the need to provide remote care during the COVID-19 pandemic. In light of this rapid boom, it is clear that health care professionals need to be trained in these technologies in order to provide high-level care. Despite the growing number of technologies used across health care, digital health is not a commonly taught topic in health care curricula. Several pharmacy organizations have called attention to the need to teach digital health to student pharmacists; however, there is currently no consensus on best methods to do so. OBJECTIVE The objective of this study was to determine if there was a significant change in student pharmacist scores on the Digital Health Familiarity, Attitudes, Comfort, and Knowledge Scale (DH-FACKS) after exposure to digital health topics in a yearlong discussion-based case conference series. METHODS Student pharmacists' initial comfort, attitudes, and knowledge were gathered by a baseline DH-FACKS score at the beginning of the fall semester. Digital health concepts were integrated into a number of cases in the case conference course series throughout the academic year. The DH-FACKS was administered again to students after completion of the spring semester. Results were matched, scored, and analyzed to assess any difference in DH-FACKS scores. RESULTS A total of 91 of 373 students completed both the pre- and postsurvey (response rate of 24%). Using a scale from 1 to 10, the mean student-reported knowledge of digital health increased from 4.5 (SD 2.5) before intervention to 6.6 (SD 1.6) after intervention (P<.001) and the mean self-reported comfort increased from 4.7 (SD 2.5) before intervention to 6.7 (SD 1.8) after intervention (P<.001). There was a significant increase in scores for all 4 elements of the DH-FACKS. The mean familiarity scores increased from 11.6 (SD 3.7) to 15.8 (SD 2.2), out of a maximum of 20 (P<.001). The mean attitudes scores increased from 15.6 (SD 2.1) to 16.5 (SD 1.9), out of a maximum of 20 (P=.001). The mean comfort scores increased from 10.1 (SD 3.9) to 14.8 (SD 3.1), out of a maximum of 20 (P<.001). The mean knowledge scores increased from 9.9 (SD 3.4) to 12.8 (SD 3.9), out of a maximum of 20 (P<.001). CONCLUSIONS Including digital health topics in a case conference series is an effective and approachable way of providing education on important digital health concepts to students. Students experienced an increase in familiarity, attitudes, comfort, and knowledge after the yearlong intervention. As case-based discussions are an important component of most pharmacy and other medical curricula, this method can be easily applied by other programs that wish to give their students practice applying their knowledge of digital health to complex case-based scenarios.
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Affiliation(s)
- Julia C Darnell
- College of Pharmacy, Western University of Health Sciences, Pomona, CA, United States
| | - Mimi Lou
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, United States
| | - Lisa W Goldstone
- Alfred E. Mann School of Pharmacy and Pharmaceutical Sciences, University of Southern California, Los Angeles, CA, United States
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Crilly P, Fletcher J, Chandegra N, Khalefa A, Rouf SKM, Zein M, Kayyali R. Assessing the digital literacy levels of the community pharmacy workforce using a survey tool. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2023; 31:55-61. [PMID: 36472945 DOI: 10.1093/ijpp/riac091] [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: 05/25/2022] [Accepted: 11/01/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the digital literacy of staff in London, UK, community pharmacies and to explore their perceptions about the use of eHealth tools. METHODS The study population was community pharmacy staff (N = 21,346) in Greater London. A survey tool was divided into six sections: Use of the internet; Use of social media; Use of mobile health applications (MHAs); Perception of and practical use of digital health tools; Scenario-based questions and demographics. Responses were analysed in SPSS. Following data collection, Health Education England's (HEE's) Digital Capabilities Framework (DCF) was published. The authors mapped the survey tool retrospectively to the framework. KEY FINDINGS Almost all respondents (98.0%, n = 551/562) used eHealth tools at work, mainly to access medicine information (89.8%, n = 495/551). Almost one-third (31.7%, N = 178/562) used social media regularly, while many (79.4%, N = 446/562) were aware of MHAs. Self-perceived digital literacy indicated that 63.3% (n = 356/562) deemed themselves to be above average. Under 35s rated their digital literacy more highly than over 35s (P < 0.001). HEE's DCF indicated that actual digital literacy was lower than that of self-perceived. Despite the high use of eHealth tools, respondents were reluctant to recommend these to the public for health advice. CONCLUSIONS Community pharmacy staff self-report their digital literacy to be high yet do not use these skills for public health purposes. Furthermore, these self-reported skills appear to be over-estimated. Despite high levels of use of digital tools at work, staff do not use them for public health, therefore, further training to build confidence to better utilise them is recommended.
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Affiliation(s)
- Philip Crilly
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - John Fletcher
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - Nishma Chandegra
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - Asem Khalefa
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - S K M Rouf
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - Mohamed Zein
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
| | - Reem Kayyali
- School of Life Sciences, Pharmacy and Chemistry, Kingston University, Surrey, UK
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11
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Kunow C, Langer B. Using the Simulated Patient Methodology in the Form of Mystery Calls in Community Pharmacy Practice Research: A Scoping Review Protocol. PHARMACY 2023; 11:pharmacy11020047. [PMID: 36961025 PMCID: PMC10037651 DOI: 10.3390/pharmacy11020047] [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: 02/02/2023] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023] Open
Abstract
Community pharmacies (CPs) play a major role in health care delivery. The simulated patient methodology (SPM), which is considered the "gold standard", is recommended for studying CP practice. SPM can be applied in different forms, which include visits and also calls ("mystery calls"). So far, only the role of visits in the investigation of CP practice is known. As the first study worldwide, a systematic map of such reports will be provided, which applies calls in the context of the SPM for the study of CP practice. Reports with the pharmacy staff as the population under study should be included. Reports should be included that conduct an investigation using the SPM in the form of calls to simulate patients and other customers. Reports should be included that examine CP practice as defined by the International Pharmaceutical Federation and the World Health Organization (FIP/WHO). The scoping review methodology will be applied using the associated guidelines from Joanna Briggs Institute (JBI) and PRISMA extension for Scoping Review (PRISMA-ScR). The search will be for both published and unpublished original research in English with transparent information on SPM until the end of 2022. The plan is to search Embase, MEDLINE via PubMed, and Web of Science. Directly afterward, the respective literature collection of the reviewers and the reference lists of suitable international reviews will be searched. This will be followed by a forward and backward snowballing in Google Scholar. For the inclusion of reports, a selection process and for the data extraction a data charting process with the help of variables derived from related reviews and from two SPM-form spanning international guidelines will be performed. The data extracted from the included reports should be synthesized and presented in MS Excel tabular form using the previously determined variables.
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Affiliation(s)
- Christian Kunow
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Brodaer Straße 2, 17033 Neubrandenburg, Germany
| | - Bernhard Langer
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Brodaer Straße 2, 17033 Neubrandenburg, Germany
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12
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Hasan S, Zubaidi HA, Saidawi W. Assessing Pharmacy Student Performance and Perceptions on Counseling Skills Through a Simulated Telehealth Encounter. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2022; 86:8619. [PMID: 34507953 PMCID: PMC10159465 DOI: 10.5688/ajpe8619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 09/03/2021] [Indexed: 05/06/2023]
Abstract
Objective. To describe the implementation of a teleconferencing-based patient counseling role play assessment in a newly developed pharmacy communications course, assess student performance on the role play and compare it with other assessments, and measure student perceptions of and satisfaction with the experience.Methods. Eighteen cases were developed, each belonging to one of three interactions in community pharmacy: filling a new prescription, completing a refill, or handling a request for a nonprescription (ie, over-the-counter [OTC]) medication. A rubric was designed to evaluate each type of interaction. Student scores in various course assessments were tested and scores on the three cases were compared. Students also evaluated their experience and satisfaction of the assessment and effectiveness of the course.Results. Seventy-nine students completed the assessment, achieving a mean score of 17.4/20 (87%). Student scores in the counseling role play were similar among case types and positively correlated with other traditional assessments in the course. Despite internet connectivity issues and heightened student anxiety, 71% of students agreed that the assessment did not affect the quality of their counseling, and 74% agreed that the experience was comparable to traditional assessments. The telehealth activity led to enhanced perceived student knowledge and confidence in interviewing and counseling patients.Conclusion. Students attained high scores that were consistent with other assessments in the course. Students reported that the assessment did not affect the quality of their counseling and felt the setting and context were still authentic. The experience required dedicated preparation and organization but was successful in demonstrating overall student satisfaction and positive perceptions.
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Affiliation(s)
- Sanah Hasan
- Ajman University, Center of Medical and Bio-allied Health Sciences, College of Pharmacy and Health Sciences, Ajman, United Arab Emirates
| | - Hamzah Al Zubaidi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
| | - Ward Saidawi
- University of Sharjah, College of Pharmacy, Sharjah, United Arab Emirates
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13
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Park T, Kim H, Song S, Griggs SK. Economic Evaluation of Pharmacist-Led Digital Health Interventions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11996. [PMID: 36231307 PMCID: PMC9565470 DOI: 10.3390/ijerph191911996] [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: 08/17/2022] [Revised: 09/13/2022] [Accepted: 09/18/2022] [Indexed: 06/16/2023]
Abstract
There has been growing interest in integrating digital technologies in healthcare. The purpose of this study was to systematically review the economic value of pharmacist-led digital interventions. PubMed, Web of Science, and the Cochrane databases were searched to select studies that had conducted economic evaluations of digital interventions by pharmacists for the period from January 2001 to February 2022. Economic evidence from 14 selected studies was synthesized in our analysis. Pharmacists used telephones, computers, web-based interventions, videotapes, smartphones, and multiple technologies for their digital interventions. Prior studies have reported the results of telephone-based interventions to be cost-effective. Alternatively, these interventions were found to be cost-effective when reevaluated with recently cited willingness-to-pay thresholds. In addition, pharmacist-led interventions based on computers, web-based interventions, smartphones, and multiple technologies have been reported to be cost-effective in previous studies. However, videotape-based intervention was found cost-ineffective because there was no significant difference in outcomes between the intervention and the usual care groups. If this intervention had been intensive enough to improve outcomes in the intervention group, favorable cost-effectiveness results could have been obtained. The economic evidence in the previous studies represented short-term economic values. Economic evaluations of the long-term value of digital interventions are warranted in future studies.
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Affiliation(s)
- Taehwan Park
- Pharmacy Administration and Public Health, College of Pharmacy and Health Sciences, St. John’s University, Queens, NY 11439, USA
| | - Hyemin Kim
- College of Pharmacy and Health Sciences, St. John’s University, Queens, NY 11439, USA
| | - Seunghyun Song
- College of Pharmacy and Health Sciences, St. John’s University, Queens, NY 11439, USA
| | - Scott K. Griggs
- Pharmacy Administration, University of Health Sciences and Pharmacy in St. Louis, St. Louis, MO 63110, USA
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14
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White-Williams C, Liu X, Shang D, Santiago J. Use of Telehealth Among Racial and Ethnic Minority Groups in the United States Before and During the COVID-19 Pandemic. Public Health Rep 2022; 138:149-156. [PMID: 36113138 PMCID: PMC9482875 DOI: 10.1177/00333549221123575] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES The COVID-19 pandemic has propelled the use of technology for health care services delivery. Because of inequities in health care and technology access, we investigated the use of telehealth services among racial and ethnic minority groups before and during the COVID-19 pandemic. METHODS For this retrospective study, we examined the electronic health records of privately insured patients in the Healthjump database, provided by the COVID-19 Research Database Consortium. We examined 17.98 million unique visit records of 2.93 million patients from March through December 2019 and 22.17 million records of 3.55 million patients from March through December 2020. We conducted a descriptive analysis and used multiple logistic regression to examine differences in the use of telehealth services among 3 racial and ethnic groups: non-Hispanic White, non-Hispanic Black, and Hispanic people. RESULTS Telehealth visits before and during COVID-19 accounted for 8.3% and 10.9% of total visits, respectively, with a peak of 15.5% in April 2020. Pre-COVID-19, Hispanic patients had a significantly lower monthly utilization rate (5.3%) than non-Hispanic White patients (8.4%, P < .001) and non-Hispanic Black patients (10.4%, P = .001). During the pandemic study period, Hispanic patients were 41% less likely than non-Hispanic White patients to have a telehealth visit, controlling for age and sex. CONCLUSIONS The likelihood of using telehealth was lower among Hispanic patients than among non-Hispanic White and non-Hispanic Black patients during the pandemic. Culturally sensitive measures are needed to support telehealth use among the Hispanic population.
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Affiliation(s)
- Cynthia White-Williams
- Center for Aging Research, Brooks College of Health, University of North Florida, Jacksonville, FL, USA,School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA,Cynthia White-Williams, PhD, MHA, PT, University of Central Florida, School of Global Health Management and Informatics, 12494 University Blvd, Orlando, FL 32816, USA.
| | - Xinliang Liu
- Department of Community and Population Health, Lehigh University, Bethlehem, PA, USA
| | - Di Shang
- Coggin College of Business, University of North Florida, Jacksonville, FL, USA
| | - Jared Santiago
- Center for Aging Research, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
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15
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Muhammad K, Baraka MA, Shah SS, Butt MH, Wali H, Saqlain M, Mallhi TH, Hayat K, Fahelelbom KM, Joseph R, Khan YH. Exploring the perception and readiness of Pharmacists towards telepharmacy implementation; a cross sectional analysis. PeerJ 2022; 10:e13296. [PMID: 35637711 PMCID: PMC9147315 DOI: 10.7717/peerj.13296] [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: 10/19/2021] [Accepted: 03/28/2022] [Indexed: 01/20/2023] Open
Abstract
Background Amid the turbulent nature of the COVID-19 pandemic, telepharmacy has shifted the paradigm of patient care by leveraging digital medicine. Government mandated lockdowns and norms of social distancing have further underscored the need for telepharmacy. Many developed and developing countries implemented such initiatives where pharmacists have provided tele-pharmacy services via telecommunications. However, the implementation and utilization of tele-pharmacy services are quite negligible in resource limited settings due to financial and administrative constraints. This study was aimed to ascertain the perception and readiness of pharmacists working in various sectors of a resource limiting country. Methodology A cross sectional study was carried out in all provinces of Pakistan to explore the perceptions of pharmacists towards telepharmacy implementation through a 35-items study instrument. The collected data was analyzed descriptively and scored accordingly. The chi-square test was used for inferential analysis on pharmacist's perception regarding implementation of tele-pharmacy with their demographics. Results Of 380 pharmacists, the mean age is 27.67 ± 3.67 years with a preponderance of male pharmacists (n = 238, 62.6%). The pharmacists (n = 321, 84.5%) perceived that telepharmacy implementation improves patient's quality of life and decreases patients' visits (n = 291, 76.6%). Overall, pharmacists (n = 227, 59.7%) had negative perception towards benefits of telepharmacy implementation, but pharmacists had positive perception towards eligibility (n = 258, 67.9%), regulatory issues (n = 271, 71.3%) and telepharmacy during pandemic and beyond (n = 312, 82.1%). In chi-square testing gender (p = 0.03) and age (p = 0.03) had a significant association with perception regarding regulatory issues. Among perception regarding telepharmacy during COVID-19 pandemic and beyond age had a significant association (p = 0.03). Among perception regarding eligibility job location of pharmacists had significant association (p = 0.04). Conclusion The majority of pharmacists had a positive perception regarding the eligibility of patients and regulatory issues/legal framework regarding the implementation of tele-pharmacy, as well as its use during the COVID-19 pandemic and beyond. The implementation of tele-pharmacy can play a major role in providing timely and better patient care to remote patient areas and may help in the prevention and treatment of different infectious diseases.
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Affiliation(s)
- Khayal Muhammad
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Northern Cyprus,Faculty of Pharmaceutical Sciences, Abasyn University, Peshawar, KPK, Pakistan
| | - Mohamed A. Baraka
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al-Ain, Abu Dhabi, United Arab Emirates,Clinical Pharmacy Department, College of Pharmacy, Al-Azhar University, Nasr city, Cairo, Egypt
| | - Syed Sikandar Shah
- Department of Clinical Pharmacy, Faculty of Pharmacy, European University of Lefke, Lefke, Cyprus
| | | | - Haytham Wali
- Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Muhammad Saqlain
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia
| | - Khezar Hayat
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmacy, Xi’an Jiaotong University, Xi’an, China
| | - Khairi Mustafa Fahelelbom
- Pharmaceutical Sciences Program, College of Pharmacy, Al-Ain University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Royes Joseph
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Al-Jouf Province, Kingdom of Saudi Arabia
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Virtualized Gamified Pharmacy Simulation during COVID-19. PHARMACY 2022; 10:pharmacy10020041. [PMID: 35448700 PMCID: PMC9027889 DOI: 10.3390/pharmacy10020041] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/24/2022] [Accepted: 03/24/2022] [Indexed: 12/10/2022] Open
Abstract
Extended and immersive gamified pharmacy simulation has been demonstrated to provide transformative learning in pharmacy education, preparing graduates for real-world practice. An international consortium of universities has implemented local adaptations of the Pharmacy Game into their curricula. From early 2020, pharmacy academics modified the delivery of gamified simulation in response to the COVID-19 pandemic, while still aiming to deliver the important learning outcomes of enhanced communication, collaboration, confidence and competence. Australian universities went into full lockdown from March 2020, and the critical gamified simulation at Griffith University was delivered entirely virtually in 2020. An array of synchronous and asynchronous approaches and software platforms was employed, including Microsoft Teams, Forms and Stream plus the online interview platform Big Interview. These allowed for the simulation activities, including dispensing, counselling and clinical cases, to be conducted by students online. In 2021, Griffith University conducted hybrid delivery of its Pharmacy Game, balancing student participation both in person and online. Microsoft Power Apps was added to the hosting platform to enhance the simulation interface, and Power Virtual Agent artificial intelligence chatbots, with natural language processing, were used to enable asynchronous clinical interaction. The combination of learning technologies provided the means to deliver successful gamified simulation in the virtual and hybrid environments while still achieving outstanding learning outcomes from the capstone activity. This paper details the technologies used to virtualize the Australian Pharmacy Game and the analytics available to educators to assess student participation, engagement and performance.
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Digital Health Interventions by Clinical Pharmacists: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010532. [PMID: 35010791 PMCID: PMC8744767 DOI: 10.3390/ijerph19010532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 02/06/2023]
Abstract
Integrating digital interventions in healthcare has gained increasing popularity among clinical pharmacists (CPs) due to advances in technology. The purpose of this study was to systematically review CP-led digital interventions to improve patients' health-related clinical outcomes. PubMed and the Cochrane Database were searched to select studies that had conducted a randomized controlled trial to evaluate clinical outcomes in adults following a CP-led digital intervention for the period from January 2005 to August 2021. A total of 19 studies were included in our analysis. In these 19 studies, the most commonly used digital intervention by CPs was telephone use (n = 15), followed by a web-based tool (n = 2) and a mobile app (n = 2). These interventions were provided to serve a wide range of purposes in patients' outcomes: change in lab values (e.g., blood pressure, HbA1c) (n = 23), reduction in health service use (n = 8), enhancing adherence (n = 6), improvement in drug-related outcomes (n = 6), increase in survival (n = 3), and reduction in health-related risk (e.g., CVD risk) (n = 2). Although the impacts of telephone-based interventions on patients' outcomes were decidedly mixed, web-based interventions and mobile apps exerted generally positive influences. To date, little research has investigated the cost-effectiveness of digital interventions. Future studies are warranted.
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Nau D. The era of telehealth pharmacy practice. J Am Pharm Assoc (2003) 2022. [PMCID: PMC8785965 DOI: 10.1016/j.japh.2021.11.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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19
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Clinical and Humanistic Outcomes of Community Pharmacy-Based Healthcare Interventions Regarding Medication Use in Older Adults: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2021; 9:healthcare9111577. [PMID: 34828622 PMCID: PMC8625440 DOI: 10.3390/healthcare9111577] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/14/2021] [Accepted: 11/15/2021] [Indexed: 11/17/2022] Open
Abstract
This review and meta-analysis aimed to determine the clinical and humanistic outcomes of community pharmacy-based interventions on medication-related problems of older adults at the primary care level. We identified randomized controlled trials (RCTs) examining the impact of various community pharmacy-based interventions from five electronic databases (namely, MEDLINE (Ovid), EMBASE (Ovid), CINAHL, APA PSYInfo, and Scopus) from January 2010 to December 2020. Consequently, we assessed these interventions’ clinical and humanistic outcomes on older adults and compared them with non-intervention. We included 13 RCTs in the current review and completed a meta-analysis with six of them. The included studies had a total of 6173 older adults. Quantitative analysis showed that patient education was significantly associated with an increase in the discontinuation of sedative–hypnotics use (risk ratio 1.28; 95% CI (1.20, 1.36) I2 = 0%, p < 0.00001). Moreover, the qualitative analysis showed that medication reviews and education with follow-ups could improve various clinical outcomes, including reducing adverse drug events, reducing uncontrolled health outcomes, and improving appropriate medication use among the elderly population. However, medication review could not significantly reduce the number of older adults who fall (risk ratio 1.25; 95% CI (0.78, 1.99) I2 = 0%, p = 0.36) and require hospitalization (risk ratio 0.72; 95% CI (0.47, 1.12) I2 = 45%, p = 0.15). This study showed that community pharmacy-based interventions could help discontinue inappropriate prescription medications among older adults and could improve several clinical and humanistic outcomes. However, more effective community pharmacy-based interventions should be implemented, and more research is needed to provide further evidence for clinical and humanistic outcomes of such interventions on older adults.
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Telepharmacy during COVID-19: A Scoping Review. PHARMACY 2021; 9:pharmacy9040183. [PMID: 34842823 PMCID: PMC8628897 DOI: 10.3390/pharmacy9040183] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/30/2021] [Accepted: 11/09/2021] [Indexed: 12/23/2022] Open
Abstract
The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy.
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21
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Singh G, Nesaraj R, Bchara N, Kop B, Leeb A, Nissen L, Peters I, Perry D, Salter S, Lee K. Immunisation provider experiences with an automated short message service-based active surveillance system for monitoring adverse events following immunisation: A qualitative descriptive study. Digit Health 2021; 7:20552076211038165. [PMID: 34616563 PMCID: PMC8488908 DOI: 10.1177/20552076211038165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 07/21/2021] [Indexed: 11/30/2022] Open
Abstract
Objective Currently, active surveillance systems to monitor adverse events following
immunisation are limited to hospitals, and medical and immunisation clinics.
Globally, community pharmacies represent a significant destination for
immunisation services. However, until recently, pharmacies lacked active
surveillance systems. We therefore wished to explore pharmacists’
experiences with SmartVax: an active surveillance system that has recently
been integrated for use in Australian community pharmacies. Specifically, we
wished to explore pharmacists’ perceived (1) benefits of using SmartVax, (2)
areas for improvement in the system, and (3) issues with future/ongoing
access to the system. Methods The present study forms the qualitative arm of a convergent mixed-methods
pilot study. In the present study, we performed semi-structured interviews
with pharmacist immunisers after a 21- to 22-week trial period with
SmartVax. Thematic analysis of interview transcripts was performed
independently by two researchers in QSR NVivo 12, using the framework
method. Results Fifteen participants completed the semi-structured interviews. A broad range
of perceived benefits were cited by participants, including the usability of
SmartVax, the ease of patient follow-up facilitated by the system, and
enhancement to the patient–pharmacist relationship. Participants voiced a
desire for the system to have more granularity and a faster response time in
the report generated for pharmacies. When asked about issues with
future/ongoing access to SmartVax, cost concerns of the system were the
prevailing theme. Conclusions The present study suggests that, among pharmacist immuniser end-users of
SmartVax, the system is perceived to be easy-to-use, facilitates patient
follow-up, and enhances the patient–pharmacist relationship.
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Affiliation(s)
- Gurkamal Singh
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Rachel Nesaraj
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Nicolas Bchara
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Benjamin Kop
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Alan Leeb
- Illawarra Medical Centre, Australia.,SmartVax, Australia
| | - Lisa Nissen
- School of Clinical Sciences, Queensland University of Technology, Australia
| | | | - Danae Perry
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Sandra Salter
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
| | - Kenneth Lee
- Division of Pharmacy, School of Allied Health, The University of Western Australia, Australia
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22
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Frenzel J, Porter A. The Need to Educate Pharmacy Students in Telepharmacy and Telehealth. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8566. [PMID: 34615629 PMCID: PMC8500290 DOI: 10.5688/ajpe8566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/10/2021] [Indexed: 05/22/2023]
Abstract
The global pandemic has dramatically impacted how pharmacists connect with patients. Telepharmacy and telehealth technologies are being used by pharmacists in a multitude of settings to positively influence the health and wellbeing of patients. Having pharmacists that are prepared to deliver services using telepharmacy and telehealth necessitates that Doctor of Pharmacy (PharmD) students receive tele-education. Tele-education topics may include telepharmacy and telehealth, audio and visual technologies, etiquette, law, reimbursement, and privacy and confidentiality. In many cases, the pandemic has required pharmacy programs to incorporate tele-education into curriculums quickly, resulting in limited and underdeveloped experiences for students. Tele-education should be purposefully incorporated into curriculums through a combination of didactic, simulation, and experiential training. Programs should evaluate how tele-education is taught within their curriculum and share those experiences with the Academy as pharmacy graduates will likely be providing patient care services using telepharmacy and telehealth.
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Affiliation(s)
- Jeanne Frenzel
- North Dakota State University, School of Pharmacy, Fargo, North Dakota
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
| | - Andrea Porter
- University of Wisconsin - Madison, School of Pharmacy, Madison, Wisconsin
- Editorial Board Member, American Journal of Pharmaceutical Education, Arlington, Virginia
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23
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Almansour HA, Aloudah NM, Alhawassi TM, Chaar B, Krass I, Saini B. Cardiovascular disease risk prevention services by pharmacists in Saudi Arabia: what do policymakers and opinion leaders think? J Pharm Policy Pract 2021; 14:42. [PMID: 33958004 PMCID: PMC8100751 DOI: 10.1186/s40545-021-00319-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/21/2021] [Indexed: 11/10/2022] Open
Abstract
Background Cardiovascular disease (CVD) is an emerging contributor to national morbidity and mortality in Saudi Arabia. CVD risk prevention services are limited, particularly with an over-utilised public health sector and an under-utilised and under-resourced primary care sector. Globally, there is evidence that community pharmacists can play a key role in CVD prevention within primary care. However, the perspectives of policymakers and opinion leaders are critical to successful translation of evidence into practice. Thus, the aim was to engage policymakers and professional leaders in discussions about implementing high-quality CVD risk prevention services in community pharmacy. Methods Qualitative semi-structured interviews were conducted, audio-recorded and transcribed verbatim. All transcripts were thematically analysed. Results A total of 23 participants (87% male) from government and non-government sectors were interviewed. Of these, almost 65% had pharmacy qualifications. Limited provision of CVD risks preventative services in primary care was acknowledged by most participants and building community pharmacists’ capacity to assist in preventive health services was viewed favourably as one way of improving the status quo. The data yielded four key themes: (1) future pharmacy CVD health service models; (2) demonstrable outcomes; (3) professional engagement and advocacy; and (4) implementability. CVD health services roles (health screening, primary and secondary prevention services), pragmatic factors and tiered models of care (minimal, medium, and comprehensive pharmacist involvement) were discussed. The need for humanistic, clinical, and cost effectiveness outcomes to be demonstrated and active involvement of professional bodies were deemed important for such services to be sustainable. Professional pharmacy governance to develop pharmacy careers and workforce, pharmacy curricular reform and ongoing education were posed as key success factors for novel pharmacy roles. Practice policies, standards, and guidelines were seen as required to adhere to stringent quality control for future pharmacy services provision. Participant’s implementation vision for such services included scalability, affordability, access, adoption and health system reform. Most discussions focused on the need for structural improvement with limited input regarding processes or outcomes required to establish such models. Conclusions Most participants favoured pharmacy-based CVD risk prevention services, despite the variability in proposed service models. However, prior to developing such services, support structures at the health system and health professional level are needed as well as building public support and acceptability for pharmacy services. Supplementary Information The online version contains supplementary material available at 10.1186/s40545-021-00319-6.
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Affiliation(s)
- Hadi A Almansour
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Sydney, NSW, 2006, Australia.
| | - Nouf M Aloudah
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Tariq M Alhawassi
- College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Betty Chaar
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Sydney, NSW, 2006, Australia
| | - Ines Krass
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Sydney, NSW, 2006, Australia
| | - Bandana Saini
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Sydney, NSW, 2006, Australia.,Woolcock Institute of Medical Research, Sydney, NSW, Australia
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24
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Perceptions of community pharmacists to implementing technologies in the workplace: an exploratory study. Int J Clin Pharm 2021; 43:1227-1236. [PMID: 33515134 DOI: 10.1007/s11096-021-01238-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Background The proliferation of different technologies in pharmacies has begun to change the role and work of pharmacists; however, while workplace integration of technologies has been shown to be beneficial, there are still barriers to their implementation. Few studies have investigated pharmacists' perceptions of these technologies. Objective To investigate the views of community pharmacists on the implementation of technologies in pharmacy practice. Setting Community pharmacies in Auckland, New Zealand. Methods Semi-structured interviews were conducted June-September 2018 with a convenience sample of 20 pharmacists. Interviews explored current medication management and technologies used to support this service, experiences with technologies, confidence in learning new technologies, and whether the introduction of technologies could solve any needs in pharmacy practice. Data were analysed using inductive thematic analysis. Main outcome measure Community pharmacists views on pharmacy technologies. Results Four key themes were identified: attitudes to existing medication management technologies, adapting to new technologies, acceptance of technology, and barriers to implementing technology in pharmacies. Pharmacists were accepting of technology to help with medication management and allowing them to provide more patient-centered care. Most pharmacists expressed confidence in using new technologies and viewed technology as a tool to address current limitations in their practice. Barriers to technology were cost, consequences of medication error, fear that technology may replace people, and an over-reliance on technology. Conclusion Community pharmacists made use of several types of technologies to promote medication management, including robotics. While mostly accepting of new technologies to streamline tasks and reduce error, pharmacists highlighted the importance of addressing barriers to technology implementation prior to workplace implementation.
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25
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Paudyal V, Cadogan C, Fialová D, Henman MC, Hazen A, Okuyan B, Lutters M, Stewart D. Provision of clinical pharmacy services during the COVID-19 pandemic: Experiences of pharmacists from 16 European countries. Res Social Adm Pharm 2020; 17:1507-1517. [PMID: 33288420 PMCID: PMC7834718 DOI: 10.1016/j.sapharm.2020.11.017] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 11/25/2020] [Accepted: 11/26/2020] [Indexed: 01/08/2023]
Abstract
Background The pharmacy profession has an important role in the frontline healthcare response to COVID-19 across all settings. Objective This study sought to explore the views and experiences of clinical pharmacists in relation to the provision of clinical pharmacy services during COVID-19. Methods Semi-structured qualitative interviews were conducted with pharmacists working in clinical roles in healthcare settings across Europe. Participants were recruited through professional organisations of clinical and hospitals pharmacists combined with a snowballing technique. The Pharmacy Emergency Preparedness and Response Framework and Disaster Preparedness Framework for pharmacy services were used to generate data which were analysed using the thematic framework method. Results Twenty-two participants from 16 European countries described a range of measures to protect patients, public and healthcare staff against virus transmission including developing and disseminating educational materials. Most described their involvement in aspects of evidence provision such as facilitating clinical trials, gathering and appraising evidence and disseminating clinical information. Many hospital-based pharmacists were reassigned to new roles such as intensive care. Routine clinical services were extensively interrupted and remote forms of communication were used. Most were motivated by a strong sense of professionalism to continue delivering services. A number of facilitators and barriers to prevention, preparedness and response actions were identified which related to uptake of new roles, recognition of pharmacists roles in the healthcare team, information gathering, communication with patients and healthcare professionals, and provision of routine clinical services. Conclusions Participants in this multinational qualitative study described a range of service adaptations and adoption of novel roles to prevent and mitigate the public health impact of the pandemic. The study findings may help to inform governments, public health agencies and healthcare systems in harnessing ongoing service provision and adapt to any future interruptions.
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Affiliation(s)
- Vibhu Paudyal
- School of Pharmacy, University of Birmingham, Birmingham, United Kingdom.
| | - Cathal Cadogan
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Czech Republic; Department of Geriatrics and Gerontology, 1st Faculty of Medicine Charles University, Prague, Czech Republic
| | - Martin C Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Ankie Hazen
- Centre for Pharmacy Postgraduate Education, University of Manchester, Manchester, United Kingdom
| | - Betul Okuyan
- Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Istanbul, Turkey
| | - Monika Lutters
- Clinical Pharmacy, Cantonal Hospital Baden, Baden, Switzerland; Swiss Federal Institute of Technology, Zurich, Switzerland
| | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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26
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Izeogu C, Kalinowski J, Schoenthaler A. Strategies to Improve Adherence to Anti-Hypertensive Medications: a Narrative Review. Curr Hypertens Rep 2020; 22:105. [PMID: 33165652 DOI: 10.1007/s11906-020-01115-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2020] [Indexed: 01/16/2023]
Abstract
PURPOSE OF REVIEW Medication adherence is critical for effective management of hypertension, yet half of patients with hypertension are non-adherent to medications. In this review, we describe and critically evaluate medication adherence interventions published in the past 3 years for patients with hypertension. RECENT FINDINGS We identified 1593 articles and 163 underwent full review, of which 42 studies met the inclusion criteria. Studies were classified into eight categories: simplification of medication regimen (e.g., fixed dose combination pills); electronic Health (eHealth) tools (e.g., text messaging reminders); behavioral counseling (e.g., motivational interviewing); healthcare system changes (e.g., patient-centered medical home); patient education; multicomponent chronic disease management program; home blood pressure monitoring; and financial incentives. Studies utilizing strategies to simplify medication regimens, eHealth tools, patient education, and behavioral counseling were most likely to report positive findings. Interventions targeting patient behavior were more likely to be associated with improvements in medication adherence compared to those targeting providers or the healthcare system. eHealth tools show promise for augmenting behavioral interventions. A major limitation of included trials was short study duration and use of self-report measures of medication adherence. Future research should explore how complex interventions that utilize a combination of evidence-based strategies and target multiple adherence behaviors (e.g., both day-to-day medication taking and long-term persistence) may be efficacious in improving medication adherence.
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Affiliation(s)
- Chigozirim Izeogu
- Department of Population Health, Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York, NY, USA
| | - Jolaade Kalinowski
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Antoinette Schoenthaler
- Department of Population Health, Center for Healthful Behavior Change, New York University Grossman School of Medicine, New York, NY, USA.
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27
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Lee L, Peterson GM, Naunton M, Jackson S, Bushell M. Protecting the Herd: Why Pharmacists Matter in Mass Vaccination. PHARMACY 2020; 8:E199. [PMID: 33114654 PMCID: PMC7712642 DOI: 10.3390/pharmacy8040199] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is ongoing. The unprecedented challenges worldwide implore the urgent development of a safe and effective COVID-19 vaccine. Globally, pharmacists have been delivering important public health services as part of the COVID-19 response. It remains to be seen what role they will play once a vaccine is available. This review examines herd immunity and the potential role of the pharmacy profession in mass vaccination against COVID-19, particularly within the Australian context. AIM A literature review was conducted to review the global development of COVID-19 vaccines, and the Australian healthcare workforce capability and existing policy for mass vaccination and the potential role of the pharmacist. METHOD ScienceDirect, Scopus, The National Centre for Biotechnology Information (NCBI), Wiley Online Library, PubMed, and Google Scholar were used to search for relevant literature using keywords COVID-19, vaccines, immunisation, herd immunity, pandemic, pharmacist and Australian healthcare. RESULTS A large portion of the literature was journal articles, and information from governmental and international bodies such as the World Health Organisation were often referenced. Over 20 million Australians need to be immunised through vaccination or acquire immunity through natural infection for the country to achieve herd immunity for COVID-19. When examining state and territory pandemic plans, pharmacists are underutilised. Modifying legislation to allow pharmacists to administer approved COVID-19 vaccines will enable a trained and skilled workforce to be deployed to increase the rate of mass vaccination. CONCLUSION In preparation for a successful COVID-19 vaccine, the Australian Government must consider various elements in their vaccination policy. This includes the estimated herd immunity threshold, methods of vaccine delivery, vaccine clinic locations, staffing arrangements and training, and strategies for vaccine prioritisation. Pharmacists can and should play a key role in the roll out of mass COVID-19 vaccination.
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Affiliation(s)
- Lois Lee
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (L.L.); (G.M.P.); (M.N.)
| | - Gregory M. Peterson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (L.L.); (G.M.P.); (M.N.)
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7000, Australia;
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (L.L.); (G.M.P.); (M.N.)
| | - Shane Jackson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7000, Australia;
| | - Mary Bushell
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia; (L.L.); (G.M.P.); (M.N.)
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