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Ng R, El-Den S, Collins JC, Stewart V, McMillan SS, Hu J, Wheeler AJ, O'Reilly CL. Exploring the implementation of a novel community pharmacist-led support service for people living with severe and persistent mental illness. Res Social Adm Pharm 2024:S1551-7411(24)00082-2. [PMID: 38467520 DOI: 10.1016/j.sapharm.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Community pharmacists are well-placed to promote and provide mental health medication management services. However, literature evaluating the impact of pharmacy services in supporting people living with severe and persistent mental illness (SPMI) is currently limited. An individualised, goal-oriented pharmacist-led support service that focused on improving the physical and mental health of consumers living with SPMI, namely the PharMIbridge intervention, was provided to consumer participants as part of the PharMIbridge Randomised Controlled Trial (RCT). OBJECTIVE(S) To explore the experiences of the participants who delivered and supported the implementation of the PharMIbridge intervention and propose ideas and supports needed for broader implementation and sustainability of pharmacist-led support services for people living with SPMI. METHODS Interviews and focus group discussions were undertaken with PharMIbridge pharmacists and mentors, respectively. Audio-recordings were de-identified and transcribed verbatim. Data analysis was conducted using an iterative, inductive approach. The key themes identified were furthered divided into subthemes. Subthemes were then mapped to the EPIS (Exploration, Preparation, Implementation and Sustainment) framework. RESULTS Data were collected from one focus group involving six RCT mentors and 16 semi-structured interviews with community pharmacists. Five overarching themes emerged: "Training needs", "Pharmacist integration within the healthcare system", "Environmental factors", "Attitudes and behaviour" and "Pharmacy operations". Twelve subthemes were mapped to EPIS phases "Preparation", "Implementation" and "Sustainment" and EPIS constructs "Outer" context, "Inner" context and "Bridging" factors. CONCLUSION Adequate remuneration and supports to encourage healthcare professional collaboration are necessary to establish and sustain functioning, integrated pharmacy mental health services. A shift in pharmacy business and workflow models is necessary to support community pharmacies to implement mental health services. In addition, there is a need to promote psychological support services to ensure that pharmacists are well supported while delivering pharmacy mental health services.
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Affiliation(s)
- Ricki Ng
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Victoria Stewart
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
| | - Sara S McMillan
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
| | - Jie Hu
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Centre for Mental Health and Menzies Health Institute Queensland, Griffith University, Brisbane, Australia; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
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Yazdi FB, Barraclough F, Collins JC, Chen J, El-Den S. Stakeholder perspectives on electronic prescribing in primary care: A scoping review. J Am Pharm Assoc (2003) 2024:102054. [PMID: 38401837 DOI: 10.1016/j.japh.2024.102054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/31/2024] [Accepted: 02/19/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND Electronic prescribing (e-prescribing) provides a convenient, efficient, paperless mechanism for the legal transfer of prescriptions between service users, prescribers, and dispensers. There have been advances in e-prescribing processes and increased uptake of e-prescribing globally, in recent years. OBJECTIVE To explore stakeholder perspectives on e-prescribing in primary care settings. METHODS A scoping review was conducted by systematically searching Medline, EMBASE, Scopus, and International Pharmaceutical Abstracts databases, using the key concepts "primary care", "e-prescribing", and "perspectives". Publications were selected by screening for eligibility against inclusion and exclusion criteria, whereby any publication written in English exploring e-prescribing in primary care settings from the perspective(s) of at least one type of stakeholder was eligible for inclusion. Following a systematic screening process, relevant data were extracted, collated, and synthesized. RESULTS Two thousand publications were identified and systematically screened, rendering 44 publications (e.g., primary research articles, abstracts) eligible for inclusion in this review. Most publications reported on studies conducted in the USA, the UK, and Europe and explored the views of pharmacists, pharmacy technicians, and pharmacy staff. Barriers to e-prescribing included system design and technical issues, lack of adequate training and communication issues between stakeholders. Enablers for e-prescribing included time savings, convenience, and increased legibility of prescriptions. CONCLUSIONS This review highlights many benefits of e-prescribing such as time efficiency, convenience, increased legibility, and less mishandling. Despite this, key barriers to e-prescribing within primary care settings were also recognized, including system design, technical issues, and lack of adequate training. As such, forcing functions, prescription tracking technologies, and better training have been identified as potential ways to address these barriers. While some negative experiences were reported, stakeholders were generally satisfied and had positive experiences with e-prescribing.
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Stewart V, McMillan SS, Hu J, Collins JC, El-Den S, O’Reilly CL, Wheeler AJ. Are SMART goals fit-for-purpose? Goal planning with mental health service-users in Australian community pharmacies. Int J Qual Health Care 2024; 36:mzae009. [PMID: 38381655 PMCID: PMC10880889 DOI: 10.1093/intqhc/mzae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/15/2023] [Accepted: 02/12/2024] [Indexed: 02/23/2024] Open
Abstract
Goal planning is an important element in brief health interventions provided in primary healthcare settings, with specific, measurable, achievable, realistic/relevant, and timed (SMART) goals recommended as best practice. This study examined the use of SMART goals by Australian community pharmacists providing a brief goal-oriented wellbeing intervention with service-users experiencing severe and persistent mental illnesses (SPMIs), in particular, which aspects of SMART goal planning were incorporated into the documented goals. Goal data from the PharMIbridge Randomized Controlled Trial (RCT) were used to investigate how community pharmacists operationalized SMART goals, goal quality, and which SMART goal planning format aspects were most utilized. Goals were evaluated using the SMART Goal Evaluation Method (SMART-GEM) tool to determine how closely each documented goal met the SMART criteria. Goals were also categorized into five domains describing their content or purpose. Descriptive analysis was used to describe the SMART-GEM evaluation results, and the Kruskal-Wallis H test was used to compare the evaluation results across the goal domains. All goals (n = 512) co-designed with service-users (n = 156) were classified as poor quality when assessed against the SMART guidelines for goal statements, although most goals contained information regarding a specific behaviour and/or action (71.3% and 86.3%, respectively). Less than 25% of goals identified how goal achievement would be measured, with those related to lifestyle and wellbeing behaviours most likely to include measurement information. Additionally, the majority (93.5%) of goals lacked details regarding monitoring goal progress. Study findings raise questions regarding the applicability of the SMART goal format in brief health interventions provided in primary healthcare settings, particularly for service-users experiencing SPMIs. Further research is recommended to identify which elements of SMART goals are most relevant for brief interventions. Additionally, further investigation is needed regarding the impact of SMART goal training or support tools on goal quality.
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Affiliation(s)
- Victoria Stewart
- Centre for Mental Health, Griffith University, Mt Gravatt, QLD 4122, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
| | - Sara S McMillan
- Centre for Mental Health, Griffith University, Mt Gravatt, QLD 4122, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Claire L O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW 2050, Australia
| | - Amanda J Wheeler
- Centre for Mental Health, Griffith University, Mt Gravatt, QLD 4122, Australia
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Faculty of Health and Behavioural Sciences, University of Auckland, Auckland 1142, New Zealand
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. Simulated psychosis care role-plays for pharmacy curricula: a qualitative exploration of student experiences. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02598-7. [PMID: 38103057 DOI: 10.1007/s00127-023-02598-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 11/20/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Mental Health First Aid (MHFA) training is embedded in various tertiary healthcare curricula. However, opportunities for students to practise their newly acquired MHFA skills before entering the clinical practice workforce are lacking. The purpose of this study was to explore pharmacy students' experiences of MHFA training and post-MHFA simulated psychosis care role-plays. METHODS Final-year pharmacy students received MHFA training, after which they were invited to participate in simulated patient role-plays with trained actors, whilst being observed by peers, pharmacy tutors and mental health consumer educators (MHCEs). Immediately after each role-play, the role-playing student engaged in self-assessment, followed by performance feedback and debrief discussions with the tutor, MHCE and observing peers. All MHFA-trained students were invited to participate in audio-recorded focus groups to explore their experiences. Audio-recordings were transcribed verbatim and thematically analysed. RESULTS MHFA training was delivered to 209 students, of which 86 participated in a simulated patient role-play as a role-player and the remaining students observed. Seven focus groups were conducted with 36 students (mean duration 40 min, SD 11 min). Five themes emerged: scenario reactions, realistic but not real, mental health confidence, MHFA skills application, feedback and self-reflection. CONCLUSION Students enjoyed the post-MHFA simulated psychosis care role-plays, which provided opportunities to apply and reflect on their newly-acquired MHFA skills in a safe learning environment. These experiences enhanced students' confidence to support people in the community, experiencing mental health symptoms or crises, and could be an add-on to MHFA training in the future.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia.
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, NSW, Australia
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Chen J, El-Den S, Pham L, O’Reilly CL, Collins JC. Healthcare professionals' knowledge, confidence and attitudes in relation to psychosis care: A systematic review. Int J Soc Psychiatry 2023; 69:1856-1868. [PMID: 37691420 PMCID: PMC10685701 DOI: 10.1177/00207640231194490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND Psychosis is a mental disorder that, despite its low prevalence, causes high disease and economic burden. Inadequate knowledge, lack of confidence and stigmatising attitudes of healthcare professionals (HCPs) may lead to suboptimal care. AIM To review the literature exploring HCPs' knowledge, confidence and attitudes in relation to psychosis care. METHOD A systematic search was undertaken across three databases (MEDLINE, Embase, PsycINFO) using a search strategy encompassing the concepts: 'healthcare professionals', 'knowledge, attitude, and confidence in care' and 'psychotic illnesses and symptoms' to identify relevant records published from 1st January 2002 to 18th March 2022. Results were screened against predetermined inclusion and exclusion criteria by title and abstract, followed by full text. Data were extracted into tables and synthesised narratively. RESULTS Initially, 7,397 studies were identified. Following two-stage screening, 24 studies were eligible for inclusion. Of these studies, 16 explored attitudes, four explored knowledge and attitudes, one explored knowledge, one explored confidence, one explored attitudes and confidence in care and one explored all three constructs. Most HCPs in the included studies demonstrated stigmatising attitudes towards people with psychosis. Furthermore, certain HCPs, including nurses and general practitioners, demonstrated low levels of knowledge, while psychiatrists, occupational therapists, psychologists and nurses had low levels of confidence in caring for people with psychosis. Conversely, positive attitudes were also observed in some HCPs resulting from having acquaintances with lived experience of psychosis. The need for additional education and training to improve HCPs' knowledge and confidence in relation to caring for people living with psychosis was identified. CONCLUSIONS Most attitudes identified were negative and stemmed from stigma, while some were positive due to HCPs' compassion and familiarity with psychosis. The level of knowledge and confidence identified were mostly suboptimal, and so further research is required to develop and evaluate tailored interventions to address this gap.
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Affiliation(s)
- Jenny Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Claire L O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Collins JC, Hu J, McMillan SS, O'Reilly CL, El-Den S, Kelly F, Spinks J, Riley T, Wheeler AJ. Medication-related problems identified by community pharmacists: a descriptive case study of two Australian populations. J Pharm Policy Pract 2023; 16:133. [PMID: 37919809 PMCID: PMC10621197 DOI: 10.1186/s40545-023-00637-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/13/2023] [Indexed: 11/04/2023] Open
Abstract
BACKGROUND Medication-related problems (MRPs) contribute significantly to preventable patient harm and global healthcare expenditure. Vulnerable populations, including Indigenous Australians (please note that the use of the term 'Indigenous' in this paper includes all Aboriginal and Torres Strait Islander people and acknowledges their rich traditions and heterogenous cultures.) and people living with severe and persistent mental illness (SPMI), may be at increased risk of MRPs. Pharmacist-led medication reviews can identify MRPs for targeted action. OBJECTIVE To characterize MRPs identified and recommendations made by community pharmacists during medication reviews conducted with Indigenous Australians and people living with SPMI. METHODS Participants were recruited through two Australian trials testing the feasibility and/or effectiveness of novel community pharmacist-led interventions, the Indigenous Medication Review Service (IMeRSe) feasibility study (June 2018-July 2019) and Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (September 2020-December 2021). Trained community pharmacists conducted medication reviews responsive to the cultural and health needs of participants. MRPs, MRP severity and pharmacist recommendations were documented and classified using an established classification system (DOCUMENT). MRP severity was assessed by pharmacists and an independent assessor. Data were analysed descriptively, and paired t-tests were used to compare severity ratings. RESULTS Pharmacists identified 795 MRPs with 411 participants across both trials (n = 255 IMeRSe, n = 156 PharMIbridge). Non-adherence to medication was the most common (n = 157, 25.1%) and second-most common (n = 25, 14.7%) MRP in IMeRSe and PharMIbridge, respectively. Undertreatment was the second-most common MRP in the sample of Indigenous Australians (n = 139, 22.2%), and reports of toxicity/adverse reactions were most common in people living with SPMI (n = 41, 24.1%). A change in pharmacotherapy was the most frequent recommendation made by pharmacists (40.2% and 55.0% in IMeRSe and PharMIbridge, respectively). Severity ratings varied, with the majority being 'Mild' or 'Moderate' in both groups. Significant differences were found in the severity rating assigned by trial pharmacists and the independent assessor. CONCLUSIONS Community pharmacists identified a range of MRPs experienced by two at-risk populations, most commonly non-adherence and toxicity or adverse reactions, when conducting medication reviews and proposed diverse strategies to manage these, frequently recommending a change in pharmacotherapy. These findings highlight the opportunity for more targeted approaches to identifying and managing MRPs in primary care and tailored community pharmacist-led interventions may be of value in this space. TRAIL REGISTRATION Australian and New Zealand Clinical Trial Registry records (IMeRSe ACTRN12618000188235 registered 06/02/2018 & PharMIbridge ACTRN12620000577910 registered 18/05/2020).
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Affiliation(s)
- Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Fiona Kelly
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Jean Spinks
- Centre for Business and Economics of Health, The University of Queensland, Brisbane, QLD, Australia
| | - Toni Riley
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Building N70, Nathan Campus, Nathan, Brisbane, QLD, 4111, Australia.
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia.
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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Strowel C, Raynes-Greenow C, Pham L, Carter S, Birkness K, Moles RJ, O'Reilly CL, Chen TF, Raduescu C, Murphy A, Gardner D, El-Den S. Perinatal depression screening in community pharmacy: Exploring pharmacists' roles, training and resource needs using content analysis. Int J Clin Pharm 2023; 45:1212-1222. [PMID: 37792255 PMCID: PMC10600310 DOI: 10.1007/s11096-023-01647-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/04/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Perinatal depression (PND) screening is often recommended in primary care settings, which includes the community pharmacy setting. However, there is limited research exploring pharmacists' perspectives on their roles in screening for perinatal mental illness. AIM This study aimed to explore pharmacists' views of pharmacists' roles in PND screening, as well as training and resource needs for PND screening in community pharmacy settings. METHOD A questionnaire including three open-ended questions focusing on pharmacists' perspectives of their role in PND screening, their training, and resource needs in this area, was disseminated to pharmacists across Australia via professional organisations and social media. Each open-ended question was separately analysed by inductive content analysis. Subcategories were deductively mapped to the Theoretical Framework of Acceptability. RESULTS Responses (N = 149) from the first open-ended question about pharmacists' roles in PND screening resulted in three categories (PND screening in primary care settings will support the community, community pharmacy environment, and system and policy changes) and ten subcategories. Responses to question two on training needs (n = 148) were categorised as: training content, training length, and training delivery while responses about resource needs (n = 147) fell into three categories: adapting community pharmacy operating structures, pharmacist-specific resources, and consumer-specific resources. CONCLUSION While some pharmacists were accepting of a role in PND screening due to pharmacists' accessibility and positive relationships with consumers, others had concerns regarding whether PND screening was within pharmacists' scope of practice. Further training and resources are needed to facilitate pharmacists' roles in PND screening, referral and care.
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Affiliation(s)
- Clara Strowel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephen Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | | | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Corina Raduescu
- The University of Sydney Business School, University of Sydney, Sydney, NSW, 2050, Australia
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS, Canada
| | - David Gardner
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Stewart V, McMillan SS, Hu J, Collins JC, El-Den S, O'Reilly C, Wheeler AJ. Refining a taxonomy of goals planned between mental health consumers and community pharmacists. Res Social Adm Pharm 2023; 19:1391-1397. [PMID: 37468372 DOI: 10.1016/j.sapharm.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 06/13/2023] [Accepted: 07/12/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND People living with severe and persistent mental illnesses are more likely to experience co-morbid health conditions. Health-related behavior change can be promoted by the use of goal planning within community pharmacy settings. OBJECTIVES To trial and refine a recently developed taxonomy to categorize goals co-designed between community pharmacists and people living with severe and persistent mental illnesses. This study also compared the data to the previously published taxonomy data to determine if the taxonomy could be applied across a range of mental health conditions. METHODS The published goal taxonomy was refined using data from a cluster randomized controlled trial (PharMIbridge). Community pharmacists provided an individualized support service using goal planning with people living with severe and persistent mental illnesses. Goals were categorized using the existing taxonomy and inconsistencies were used to modify and refine the taxonomy. Additionally, participant characteristics and categorization of goals were compared with results from the previous study. RESULTS 512 goals were reported by 158 consumer participants and categorized into five domains that included a diverse range of health behaviors (e.g., relationships, diet). Minor refinements to the taxonomy were made by replacing, adding or removing categories/descriptors. CONCLUSIONS Significant overlap between the goals of participants and the existing taxonomy was found, supporting the application of the taxonomy across different mental health conditions.
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Affiliation(s)
- Victoria Stewart
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia.
| | - Sara S McMillan
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia
| | - Jie Hu
- Centre for Mental Health, Griffith University, Australia; Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Australia; School of Pharmacy and Medical Sciences, Griffith University, Australia; Faculty of Health and Behavioural Sciences, University of Auckland, New Zealand
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Gide DN, El-Den S, Lee YLE, Gisev N, Ou K, O'Reilly CL. Community pharmacists' acceptability of pharmacist-delivered depression screening for older adults: a qualitative study. Int J Clin Pharm 2023; 45:1144-1152. [PMID: 37081167 PMCID: PMC10600303 DOI: 10.1007/s11096-023-01581-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/22/2023] [Indexed: 04/22/2023]
Abstract
BACKGROUND Late-life depression often goes underdiagnosed and undertreated, affecting the quality of life of older adults. Pharmacists are well-placed to identify older adults who may be at risk of depression by using appropriate screening tools. AIM To explore community pharmacists' acceptability of performing late-life depression screening in Australian community pharmacies. METHOD Semi-structured interviews with community pharmacists were conducted to gauge their perceptions regarding delivering depression screening services for older adults. Data analysis was conducted using an iterative, inductive approach. Key themes were identified, which were further explored and divided into subthemes. Subthemes were categorised as either barriers or facilitators. Each subtheme was mapped to the Capability, Opportunity, Motivation-Behaviour model by classifying whether they impacted pharmacists' capability, opportunity, or motivation regarding depression screening. RESULTS Fifteen pharmacists were interviewed, 12 of whom were female and 11 of whom practised in a metropolitan area. Four key themes were identified including: training needs, environmental factors, pharmacists' roles, and organisational support, which were further divided into 13 subthemes. Three subthemes were mapped to Capability, seven to Opportunity and three to Motivation. Barriers included lack of resources and lack of remuneration, while facilitators included training, pharmacists' accessibility, and rapport with consumers. CONCLUSION The findings of this study demonstrate that while community pharmacists found depression screening for older adults in community pharmacies to be an acceptable service, there remains a need for the development of funding schemes and standardised guidelines for pharmacist-delivered depression screening for older adults.
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Affiliation(s)
- Duha N Gide
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia.
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
| | - Yee Lam Elim Lee
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Kevin Ou
- Pharmaceutical Society of Australia, Sydney, NSW, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Building Number A15, Science Rd Camperdown, Sydney, NSW, 2006, Australia
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Ung TX, O'Reilly CL, Moles RJ, El-Den S. Co-designing psychosis simulated patient scenarios with mental health stakeholders for pharmacy curricula. Int J Clin Pharm 2023; 45:1184-1191. [PMID: 37505347 PMCID: PMC10600032 DOI: 10.1007/s11096-023-01622-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Pharmacists need knowledge and confidence to support people living with mental illness. Evidence-based educational materials for pharmacy students to provide psychosis care is limited. AIM To co-design, content validate and pilot-test, with mental health stakeholders, simulated patient scenarios to educate and assess students in providing psychosis care. METHOD Mental health consumers were invited to co-design three simulated patient scenarios (first-episode psychosis, carer of someone living with schizophrenia, non-adherence to antipsychotics), guided by published and psychometrically-tested materials. A panel of mental health stakeholders participated in two rounds of content validation (RAND/UCLA appropriateness model). Round 1 involved individual survey completion to calculate item content validity index (I-CVI) for relevance/clarity, content validity ratio for essentiality and overall scale content validity index (S-CVI/Ave and S-CVI/UA) scores for each scenario. Scores analyses and feedback comments informed revisions. Round 2 involved a panel meeting to discuss revisions and finalise content. The scenarios were then pilot-tested with pharmacy students. RESULTS Two consumers participated in co-design, nine stakeholders in content validation. All items showed excellent content validity for relevance/clarity. Eleven items were revised for essentiality, discussed, then re-rated at the panel meeting for consensus. The scenarios were pilot-tested with pharmacy students (n = 15) and reported to be realistic and relevant to future practice, contributing to students' confidence in supporting people experiencing mental health symptoms or crises. CONCLUSION Partnering with mental health stakeholders has enabled co-design of authentic, content valid educational materials for pharmacy students to provide psychosis care, in preparation for future provision of mental health support.
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Affiliation(s)
- Tina X Ung
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia.
| | - Claire L O'Reilly
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
| | - Rebekah J Moles
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
| | - Sarira El-Den
- School of Pharmacy, The University of Sydney, Pharmacy and Bank Building A15, Science Rd, Camperdown, Sydney, NSW, 2006, Australia
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Collins JC, Ng R, McMillan SS, Hu J, O’Reilly CL, Wheeler AJ, El-Den S. Psychological distress in community-dwelling individuals living with severe and persistent mental illness. Int J Soc Psychiatry 2023; 69:1327-1334. [PMID: 36938949 PMCID: PMC10523820 DOI: 10.1177/00207640231160102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
OBJECTIVES To explore psychological distress levels, using the validated Kessler 6 (K6), as well as the relationship between demographics and K6 scores, and incidence of mental health crises in a cohort of community-dwelling people living with severe and persistent mental illness (SPMI). METHODS People living with SPMI taking antipsychotic or mood stabiliser medications were recruited from Australian community pharmacies between September 2020 and Februrary 2021 and completed an electronic survey, including the K6 scale. Pharmacists were interviewed and supplied written reports with details of the consultation when participants obtained 'very high' (⩾19/30) K6 scores. Records were reviewed and coded by an independent coder. Multivariate linear regression was used to determine predictors of K6 scores. RESULTS The median K6 score was 16/30 (IQR = 11,21; range = 6-30). Younger age, unemployment and multimorbid mental health diagnoses were significant predictors of higher K6 scores (p < .01; R2 = .24). Fifty-nine (39.3%) consumers scored ⩾19, of which 25/59 (42.4%) were reported to be exhibiting signs of psychological distress and none were experiencing mental health crises. CONCLUSION People living with SPMI have high levels of psychological distress as measured by the K6. Further work is needed to understand the prevalence, extent, precipitating factors and impact of psychological distress in people living with SPMI.
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Affiliation(s)
- Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Ricki Ng
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Sara S McMillan
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Claire L O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
| | - Amanda J Wheeler
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
- Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
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Taing MW, Choong J, Suppiah V, El-Den S, Park JS, McCullough M, Teoh L. A Cross-Sectional Survey Exploring Australian Pharmacists' and Students' Management of Common Oral Mucosal Diseases. Pharmacy (Basel) 2023; 11:139. [PMID: 37736911 PMCID: PMC10514864 DOI: 10.3390/pharmacy11050139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND Oral mucosal conditions are commonly experienced in the general population and can have a negative impact on one's quality of life. This study evaluated the ability of Australian pharmacists and final-year pharmacy students to recognise and manage these common oral mucosal diseases through the use of case vignettes. METHODS Australian pharmacists and final-year pharmacy students were invited through social media, university learning management systems, or email to complete an online questionnaire consisting of six case vignettes covering topics relating to common oral mucosal presentations. RESULTS A total of 65 pharmacists and 78 students completed the questionnaire. More than 50% of the participants reported having seen all types of oral mucosal presentations, except for denture stomatitis, in their practice. The provision of best practice recommendations was reported by only 14%, 15%, 8%, and 6% of the participants for geographic tongue, hairy tongue, angular cheilitis, and denture-associated stomatitis, respectively, whereas 82% offered an appropriate anti-viral treatment for cold sore and 33% provided the best practice recommendations for oral thrush. CONCLUSION This study emphasised the importance of further developing and integrating best practice oral healthcare training programs specifically tailored to the Australian pharmacy profession.
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Affiliation(s)
- Meng-Wong Taing
- School of Pharmacy, The University of Queensland, Brisbane, QLD 4102, Australia;
| | - Joshua Choong
- School of Pharmacy, The University of Queensland, Brisbane, QLD 4102, Australia;
| | - Vijayaprakash Suppiah
- Clinical and Health Sciences, University of South Australia, Adelaide, SA 5001, Australia;
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Joon Soo Park
- UWA Dental School, The University of Western Australia, Nedlands, WA 6009, Australia;
| | - Michael McCullough
- Melbourne Dental School, University of Melbourne, Carlton, VIC 3053, Australia; (M.M.); (L.T.)
| | - Leanne Teoh
- Melbourne Dental School, University of Melbourne, Carlton, VIC 3053, Australia; (M.M.); (L.T.)
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Ng R, O'Reilly CL, Collins JC, Roennfeldt H, McMillan SS, Wheeler AJ, El-Den S. Mental Health First Aid crisis role-plays between pharmacists and simulated patients with lived experience: a thematic analysis of debrief. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1365-1373. [PMID: 36928545 PMCID: PMC10423112 DOI: 10.1007/s00127-023-02443-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE Healthcare professionals, including pharmacists, can recognise and assist people experiencing mental health crises. Despite this, little is known about how pharmacists assist and engage with people presenting with signs and symptoms of mental health crises. This study aimed to (i) examine pharmacists' mental health crisis assessment language during simulated patient role-plays (SPRPs) and (ii) explore participants' experiences of participating in SPRPs of Mental Health First Aid (MHFA) scenarios. METHODS Fifty-nine MHFA-trained pharmacy staff participated in audio-recorded SPRPs of three crisis scenarios enacted by a mental health consumer educator (MHCE). Post-SPRP, pharmacy staff members (including role-playing and observing participants), engaged in reflective debrief discussions with the facilitator and MHCEs. Debrief discussions were transcribed verbatim and analysed using inductive thematic analysis and suicide assessment language was explored. RESULTS The majority of role-playing pharmacists asked about suicidal ideation using appropriate, direct language (n = 8). Qualitative analyses of debrief discussions yielded four themes: (i) Relationship with the consumer, (ii) Verbal and non-verbal communication, (iii) Challenges with crisis assessment, which included difficulties associated with initiating conversations about suicide and mania, and (iv) Reflective learning. CONCLUSION While pharmacists demonstrated the appropriate suicide assessment language post-MHFA training, pharmacists felt uncomfortable initiating conversations around suicide and lacked confidence during crisis assessments. SPRPs provided pharmacists with opportunities to reflect on and practice MHFA skills in a safe learning environment. Future research exploring how MHFA training and SPRPs impact pharmacists' ability to provide MHFA in real-world settings is warranted.
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Affiliation(s)
- Ricki Ng
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia.
| | - Claire L O'Reilly
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Jack C Collins
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, Australia
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Nathan Campus, Griffith University, Nathan, Australia
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
- Centre for Mental Health, Griffith University, Brisbane, Australia
| | - Sarira El-Den
- Faculty of Medicine and Health, Pharmacy and Bank Building A15, The University of Sydney School of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW, 2006, Australia
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Ung TX, El-Den S, Moles RJ, O'Reilly CL. The Use of Mental Health Simulation in Pharmacy Practice and Education: A Systematic Review. Am J Pharm Educ 2023; 87:100058. [PMID: 37316135 DOI: 10.1016/j.ajpe.2023.100058] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/30/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES To explore how mental health simulation has been used in the context of pharmacy practice and education, specifically what types of simulation techniques have been used, and which mental health-related content has been simulated. FINDINGS A literature search retrieved 449 reports, from which 26 articles pertaining to 23 studies were eligible for inclusion. Most studies were conducted in Australia. The most common type of simulation utilized was live simulated/standardized patient, followed by pre-recorded scenarios, role-play, and auditory simulation. While many study interventions included content relating to multiple mental illnesses and included activities other than simulation, the most simulated mental health content was enacting a person living with depression (with or without suicidal thoughts), mental health communication, followed by stress-induced insomnia, then hallucinations. Key outcomes from included studies were significantly improved student outcomes such as mental health knowledge, attitudes, social distance, and empathy scores, as well as highlighting the potential to further improve the mental healthcare skills of community pharmacists. SUMMARY This review demonstrates a varied use of techniques to simulate mental health in pharmacy practice and education. Future research is suggested to consider other simulation methods such as virtual reality and computer simulation, and to investigate how lesser-simulated mental health content such as psychosis could be incorporated. It is also recommended that future research provides greater detail on the development of the simulated content, such as involving people with lived experience of mental illness and mental health stakeholders in the development process to improve the authenticity of simulation training.
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Affiliation(s)
- Tina X Ung
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia.
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Sydney, New South Wales, Australia
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15
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O'Reilly CL, McMillan SS, El-Den S, Collins JC, Hu J, Ng R, Stewart V, Pham L, Webb F, Roennfeldt H, Segrott R, Loller H, Wheeler AJ. Implementing a randomised controlled trial through community pharmacies to support people living with severe and persistent mental illness: Lessons learnt during the COVID-19 pandemic. Contemp Clin Trials 2023:107246. [PMID: 37257726 PMCID: PMC10225334 DOI: 10.1016/j.cct.2023.107246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/18/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023]
Abstract
Public health orders were introduced in many countries, including Australia, during the COVID-19 pandemic to reduce the spread of the virus. However, for many people this led to an exacerbation of mental health symptoms, particularly those living with severe or persistent mental illness (SPMI). Additionally, the conduct of clinical research was severely impacted during the pandemic, with many difficulties encountered in the conduct of clinical trials. This paper describes the COVID-related impacts experienced during the implementation of a randomised controlled trial (RCT) testing the effectiveness of a community pharmacist-led support service for people living with SPMI in Australia (the PharMIbridge RCT), and the strategies used to successfully implement the RCT. Australian public health orders led to interstate border closures, stay-at-home orders and work-from-home requirements, resulting in necessary changes to allow for the continuation of the RCT including; changes to trial regions, transferring some training materials online while delaying face-to-face (F2F) training components, delays in pharmacy and consumer recruitment, encouraging telehealth service delivery and extensions to timelines with existing funding. Having a solution-focussed and flexible approach, while still ensuring critical trial protocol elements were adhered to, such as providing opportunities for F2F skills-based training for pharmacists, as well as F2F site visits from researchers and mentors to support trial implementation, resulted in high pharmacy and consumer participant retention through to trial conclusion. Future planning for RCTs should consider possible pandemic-related risks and rapid responses from approval bodies to ensure researchers can be agile and adapt to ensure successful trial completion.
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Affiliation(s)
- Claire L O'Reilly
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia; Centre for Mental Health, Griffith University, Brisbane, QLD, Australia; School of Pharmacy and Medical Sciences, Griffith Health, Griffith University, Gold Coast, QLD, Australia
| | - Sarira El-Den
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jack C Collins
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Ricki Ng
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Victoria Stewart
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia; Centre for Mental Health, Griffith University, Brisbane, QLD, Australia
| | - Lily Pham
- The University of Sydney, School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Fleur Webb
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia; Centre for Mental Health, Griffith University, Brisbane, QLD, Australia; Centre for Psychiatric Nursing, University of Melbourne, Melbourne, VIC, Australia
| | - Rebecca Segrott
- National Secretariat, The Pharmacy Guild of Australia, Barton, ACT, Australia
| | - Hannah Loller
- The Pharmaceutical Society of Australia, Deakin, ACT, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia; Centre for Mental Health, Griffith University, Brisbane, QLD, Australia; Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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Bhutkar R, El-Den S, O'Reilly CL, Collins JC. The impact of COVID-19 on clinical research at Australian and New Zealand universities: A qualitative study. Collegian 2023:S1322-7696(23)00049-5. [PMID: 37360918 PMCID: PMC10165013 DOI: 10.1016/j.colegn.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/28/2023] [Accepted: 05/03/2023] [Indexed: 06/28/2023]
Abstract
Background The COVID-19 pandemic resulted in the implementation of social distancing measures, travel restrictions, and infection control measures that introduced a myriad of disruptions in the conduct of clinical research worldwide. As a result, many aspects of clinical research were variably impacted. Aim To explore the impact of the first 18 months of the COVID-19 pandemic on clinical research across accredited nursing, pharmacy, and medicine program providers in Australian and New Zealand universities. Methods Representatives from all program providers across Australian and New Zealand universities, with publicly available contact information, were invited to participate in this qualitative study, whereby semi-structured interviews were completed with participants who held senior research or leadership positions within their institution. Interviews were transcribed verbatim and inductively analysed using thematic content analysis. Findings Interviews were conducted with 16 participants between August and October 2021. Two major themes were identified (Immediate Research Impact and Broader Research Impact) with six subthemes: Prioritisation, Continuation, and Dissemination of Research; Modifications to Research; Funding and Changes to Research Focus; Collaboration; Research Workforce; Context-specific Impacts. Discussion The impact on clinical research in Australian and New Zealand universities included changes to data collection methods, a perceived decreased quality of research, changes to collaboration, neglect of basic disease research, and loss of the research workforce. Conclusion This study highlights the impact of the COVID-19 pandemic on clinical research within the Australian and New Zealand university context. Implications of these impacts should be considered to ensure long-term sustainability of research and preparedness for future disruptions.
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Affiliation(s)
- Renu Bhutkar
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia
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Bhutkar R, Collins JC, O’Reilly CL, El-Den S. Guidance on the Conduct of Clinical Research within OECD Countries during the Early Stages of the COVID-19 Pandemic: A Systematic Review. Pharmacy (Basel) 2023; 11:pharmacy11010015. [PMID: 36649025 PMCID: PMC9844363 DOI: 10.3390/pharmacy11010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In response to the COVID-19 pandemic, member countries of the Organisation for Economic Co-operation and Development (OECD) rapidly published guidance regarding the conduct of clinical research. A systematic review was conducted to explore the recommendations issued in relation to the commencement, continuation and termination of clinical research during the early phases of the pandemic. METHODS Searches consisting of the terms "COVID-19", "clinical research", and "guidance", were conducted in PubMed, Embase, MEDLINE, Trip, Guidelines International Network, and Google in April-May 2021 (up to 4 May 2021). Data were extracted from guidance published from OECD member countries and mapped to inductively-developed categories. RESULTS 9419 references were systematically screened, resulting in the inclusion of 46 publications from 27 OECD countries. Thirty-three sources made recommendations regarding monitoring, risk-benefit assessments and information technology. There was limited specific recommendations made in relation to personal protective equipment (PPE) in the included guidance. Findings demonstrate that guidance differed by publication date demonstrating the rapidly evolving environment within which research was conducted. Importantly, many organisations opted to endorse existing guidance published by the United States' Food and Drug Administration and the European Medicines Agency rather than develop their own recommendations. CONCLUSIONS Given the rapidly evolving nature of the pandemic, particularly in the early stages, findings demonstrate the global response in relation to clinical research conduct, thereby providing important insights for future public health emergencies.
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Carter SR, Collins JC, Hu J, O’Reilly CL, Wheeler AJ, McMillan SS, El-Den S. Confirmatory Factor Analysis of the Kessler-6 Psychological Distress (K6) Scale in a Community Sample of People Living with Severe and Persistent Mental Illness: a Bifactor Model. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-022-00981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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Nguyen W, Moles R, O'Reilly C, Robinson J, Brand-Eubanks D, Kim A, Collins JC, El-Den S. Observed behaviours and suicide assessment language post-Mental Health First Aid training in Australia and the United States: a mixed methods study using discourse analysis. BMC Med Educ 2022; 22:838. [PMID: 36471288 PMCID: PMC9720991 DOI: 10.1186/s12909-022-03920-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 11/23/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Mental Health First Aid (MHFA) training teaches participants how to respond to mental health crises, including suicide. Little is known about the impact of training on participants' observed MHFA behaviours. This exploratory study aimed to compare MHFA-trained Australian and US student pharmacists' performance and suicide assessment language during simulated patient role-play (SPRP) assessments. METHODS Student pharmacists (n = 265) completed MHFA training and participated (n = 81) in SPRPs with simulated patients (SP) who were people with lived experience of mental illness. Each SPRP was marked by three raters (student, tutor and SP). One-way ANOVA, chi-squared tests and independent samples t-tests were used to compare scores and pass/fail rates, where appropriate. Transcribed audio-recordings of suicide assessments underwent discourse analysis. A chi-squared test was conducted to investigate the differences in how suicide assessment language was coded across six discursive frames ('confident'/'timid', 'empathetic'/'apathetic', and 'direct'/'indirect'). RESULTS Three raters assessed 81 SPRPs, resulting in quantitative analysis of 243 rubrics. There were no significant differences between student pharmacists' mean scores and pass/fail rates across countries. Overall, both cohorts across Australia and the US performed better during the mania scenario, with a low failure rate of 13.9 and 19.0%, respectively. Most students in both countries passed their SPRP assessment; however, 27.8% did not assess for suicide or used indirect language during suicide assessment, despite completing MHFA training. Australian student pharmacists demonstrated, more direct language (76.9% versus 67.9%) and empathy (42.3% versus 32.1%) but less confidence (57.7% versus 60.7%) compared to US student pharmacists, during their suicide assessment; however, these differences were not statistically significant. CONCLUSIONS Findings indicate most MHFA-trained student pharmacists from Australia and the US can provide MHFA during SPRPs, as well as assess for suicide directly, empathetically and confidently. This exploratory study demonstrates the importance of practicing skills post-training and the need for further research exploring participants' hesitance to assess for suicide, despite training completion.
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Affiliation(s)
- William Nguyen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Rebekah Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Jennifer Robinson
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Damianne Brand-Eubanks
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Anne Kim
- College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA
| | - Jack C Collins
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
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Pham L, Moles RJ, O’Reilly CL, Carter S, Raynes-Greenow C, Chen TF, Raduescu C, Randall S, Bloomfield J, Strowel C, Murphy A, Gardner D, El-Den S. Perinatal Women's Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study. Int J Environ Res Public Health 2022; 19:16295. [PMID: 36498368 PMCID: PMC9738857 DOI: 10.3390/ijerph192316295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Internationally, 20% of women experience perinatal depression (PND). Healthcare providers including general practitioners and midwives are critical in providing PND screening and support; however, the current workforce is unable to meet growing demands for PND care. As accessible and trusted primary healthcare professionals, pharmacists could provide PND care to complement existing services, thereby contributing to early detection and intervention. This study aimed to explore perinatal women's views of community pharmacist-delivered PND screening and care, with a focus on their attitudes towards and acceptability of PND screening implementation in community pharmacy. Semi-structured interviews with women (n = 41) were undertaken, whereby interview data were transcribed verbatim and then inductively and thematically analysed. Five overarching themes emerged; "patient experience with existing PND support and screening services"; "familiarity with pharmacists' roles"; "pharmacist visibility in PND screening care"; "patient-pharmacist relationships" and "factors influencing service accessibility". Themes and subthemes were mapped to the Consolidated Framework for Implementation Research. Findings highlight participants' generally positive attitudes towards community pharmacist-delivered PND screening and care, and the potential acceptability of such services provided pharmacists are trained and referral pathways are established. Addressing perceived barriers and facilitators would allow community pharmacist-delivered PND screening and care to support existing PND care models.
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Affiliation(s)
- Lily Pham
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Rebekah J. Moles
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Claire L. O’Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Stephen Carter
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Timothy F. Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Corina Raduescu
- The University of Sydney Business School, University of Sydney, Sydney, NSW 2050, Australia
| | - Sue Randall
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Jacqueline Bloomfield
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Clara Strowel
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2050, Australia
| | - Andrea Murphy
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - David Gardner
- College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
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21
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Hu J, McMillan SS, Theodoros T, Collins JC, El-Den S, O’Reilly CL, Wheeler AJ. Psychotropic medication use in people living with severe and persistent mental illness in the Australian community: a cross-sectional study. BMC Psychiatry 2022; 22:705. [PMID: 36380352 PMCID: PMC9667665 DOI: 10.1186/s12888-022-04324-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Psychotropic polypharmacy and high-dose prescribing may play a role in therapy, however, with associated risks. The aim of this study was to describe current prescribing practices and use of four psychotropic medication groups (antipsychotics, antidepressants, mood stabilisers and benzodiazepines), focusing on polypharmacy (across and within groups) and high-dose prescribing in adults experiencing severe and persistent mental illness (SPMI) in the Australian community. METHODS 318 people taking psychotropic medication for SPMI had a medication review undertaken by a community pharmacist. Participants were recruited as part of an RCT from three Australian states/territories between September 2020-July 2021. All psychotropic medication and daily doses were recorded and reviewed for alignment with current clinical guidelines. Univariate and multiple logistic regression models investigated factors associated with antipsychotic, antidepressant, and mood stabiliser polypharmacy, and antipsychotic and antidepressant high-dose therapy. Variables included age, gender, geographic location, self- reported mental illness(es), hospital admission(s) in previous 6-months and prescriber type. RESULTS 806 psychotropic medications were prescribed for the 318 participants. Mood stabiliser polypharmacy was recorded in 19.0% of participants prescribed mood stabilisers; antipsychotic polypharmacy in 18.4% of participants prescribed antipsychotics; antidepressant polypharmacy in 11.3% of those prescribed antidepressants; and three participants (5.1%) were prescribed two benzodiazepines concurrently. Almost 18.6% of the cohort was receiving high-dose treatment; 18 participants were prescribed high-dose antipsychotics and 39 high-dose antidepressants, with two participants prescribed both. Adjusted logistic regression for polypharmacy found male gender, psychiatrist as sole prescriber, or multiple prescribers, were associated with antipsychotic polypharmacy. The adjusted model for high-dose therapy found psychiatrist as sole prescriber was significantly associated with antipsychotic and antidepressant high-dose prescribing. CONCLUSION Psychotropic polypharmacy was common in this community cohort experiencing SPMI. Whilst polypharmacy is not always inappropriate, it is a complex construct with potential benefits alongside potential risks. Benefits and harms need to be balanced however this practice is not supported by clear guidance to assist health practitioners. This study highlights the important need for regular medication reviews and strengthened communication between consumers and all healthcare professionals involved in community mental health care, to support safe and effective use of psychotropic medications.
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Affiliation(s)
- Jie Hu
- grid.1022.10000 0004 0437 5432Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Sara S McMillan
- grid.1022.10000 0004 0437 5432Menzies Health Institute Queensland, Griffith University, Brisbane, Australia ,grid.1022.10000 0004 0437 5432School of Pharmacy and Medical Sciences, Griffith University, Brisbane, Australia ,grid.1022.10000 0004 0437 5432Centre for Mental Health, Griffith University, Nathan campus, 4111 Brisbane, Australia
| | - Theo Theodoros
- grid.1003.20000 0000 9320 7537University of Queensland Faculty of Medicine, Brisbane, Australia ,Metro South Mental Health Services, Brisbane, Australia
| | - Jack C Collins
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health, The University of Sydney School of Pharmacy, University of Sydney, Sydney, Australia
| | - Sarira El-Den
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health, The University of Sydney School of Pharmacy, University of Sydney, Sydney, Australia
| | - Claire L O’Reilly
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health, The University of Sydney School of Pharmacy, University of Sydney, Sydney, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia. .,Centre for Mental Health, Griffith University, Nathan campus, 4111, Brisbane, Australia. .,Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
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22
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El-Den S, Lee YLE, Gide DN, O'Reilly CL. Stakeholders' Acceptability of Pharmacist-Led Screening in Community Pharmacies: A Systematic Review. Am J Prev Med 2022; 63:636-646. [PMID: 35688723 DOI: 10.1016/j.amepre.2022.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Community pharmacists are among the most accessible healthcare providers. Community pharmacist-led screening may facilitate the early detection of illnesses/medical risk factors, optimizing health outcomes. However, it is important to assess the acceptability of screening services to ensure uptake by key stakeholders. The aim of this review was to explore the acceptability of community pharmacist-led screening by all stakeholders (i.e., patients, pharmacists, and other healthcare professionals) and identify the methods used to evaluate the acceptability of screening. METHODS A systematic search was conducted in Embase, MEDLINE, International Pharmaceutical Abstracts, and Scopus in April 2020 since inception. Studies that explored the acceptability of pharmacist-led screening for any risk factor/medical condition(s) within community pharmacies were included. RESULTS A total of 44 studies met the inclusion criteria. A total of 17 studies identified community pharmacies as appropriate screening locations. Seven studies reported that patients were comfortable with participating in pharmacist-led screening. Eight studies explored acceptability from the perspective of medical practitioners and other healthcare professionals, with 6 reporting high recommendation acceptance rates and/or acceptability of pharmacist-led screening. Barriers to pharmacist-led screening included time and privacy constraints, whereas adequate remuneration was considered an important enabler. DISCUSSION Community pharmacist-led screening appears to be acceptable to patients, pharmacists, and other healthcare professionals. However, no uniform psychometrically sound measure of acceptability was used consistently across studies, rendering comparisons difficult and showing the need for future research exploring the psychometric properties of acceptability measures. Findings, including barriers and enablers to pharmacist-led screening, are important to consider when providing screening services in community pharmacies.
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Affiliation(s)
- Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Yee Lam Elim Lee
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Duha N Gide
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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23
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Ng R, El-Den S, Stewart V, Collins JC, Roennfeldt H, McMillan SS, Wheeler AJ, O'Reilly CL. Pharmacist-led interventions for people living with severe and persistent mental illness: A systematic review. Aust N Z J Psychiatry 2022; 56:1080-1103. [PMID: 34560826 DOI: 10.1177/00048674211048410] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE People living with severe and persistent mental illness experience poorer physical health, often due to medication and preventable lifestyle factors, and exacerbated by barriers to accessing healthcare services. Pharmacists are well-positioned to improve the physical and mental health of this population. However, little is known about pharmacists' current practices when providing services to this population nor the impact of pharmacist-led interventions on consumer health outcomes. We undertook a systematic review to identify, describe and assess the effectiveness of pharmacist-led interventions for supporting people living with severe and persistent mental illness and the impact on consumer outcomes. METHODS MEDLINE, Embase, PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses were searched between January 1990 and April 2020. Full-text studies exploring pharmacist-led interventions in any setting for people living with severe and persistent mental illness were included. A risk of bias assessment was conducted. RESULTS A total of 37 studies were included. More than half of the pharmacist interventions were multifaceted. The most common components of pharmacist-led interventions included education and/or patient counselling, providing recommendations to healthcare professionals and conducting medication reviews. Multifaceted interventions demonstrated improvements in clinical outcomes, whereas single interventions focused mostly on consumer-reported outcomes. The methodological quality of included studies was moderate-to-high risk of bias and there was considerable heterogeneity in the study design, interventions described, and outcomes reported. CONCLUSION There is evidence that pharmacist-led interventions improve consumer-reported and clinical outcomes for people living with severe and persistent mental illness. Pharmacists are capable and have a role in supporting people living with severe and persistent mental illness, either individually or as interprofessional collaborators with other healthcare professionals. Future research should attempt to better understand which particular intervention components have the greatest impact and also evaluate the implementation and long-term sustainability of such interventions.
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Affiliation(s)
- Ricki Ng
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Victoria Stewart
- School of Health Sciences and Social Work, Griffith University, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jack C Collins
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Helena Roennfeldt
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,Centre for Psychiatric Nursing, The University of Melbourne, Melbourne, VIC, Australia
| | - Sara S McMillan
- Health Systems Menzies Health Institute Queensland, School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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24
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Tran S, Smith L, El-Den S, Carter S. The Use of Gamification and Incentives in Mobile Health Apps to Improve Medication Adherence: Scoping Review. JMIR Mhealth Uhealth 2022; 10:e30671. [PMID: 35188475 PMCID: PMC8902658 DOI: 10.2196/30671] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 09/19/2021] [Accepted: 12/13/2021] [Indexed: 12/24/2022] Open
Abstract
Background Emerging health care strategies addressing medication adherence include the use of direct-to-patient incentives or elements adapted from computer games. However, there is currently no published evidence synthesis on the use of gamification or financial incentives in mobile apps to improve medication adherence. Objective The aim of this scoping review is to synthesize and appraise the literature pertaining to the use of mobile apps containing gamification or financial incentives for medication adherence. There were two objectives: to explore the reported effectiveness of these features and to describe and appraise the design and development process, including patient involvement. Methods The following databases were searched for relevant articles published in English from database inception to September 24, 2020: Embase, MEDLINE, PsycINFO, CINAHL, and Web of Science. The framework by Arksey and O’Malley and the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist guided this scoping review. Using a systematic screening process, studies were included if incentives or game features were used within mobile apps to specifically address medication adherence. An appraisal using risk of bias tools was also applied to their respective study design. Results A total of 11 studies from the initial 691 retrieved articles were included in this review. Across the studies, gamification alone (9/11, 82%) was used more than financial incentives (1/11, 9%) alone or a combination of the two (1/11, 9%). The studies generally reported improved or sustained optimal medication adherence outcomes; however, there was significant heterogeneity in the patient population, methodology such as outcome measures, and reporting of these studies. There was considerable variability in the development process and evaluation of the apps, with authors opting for either the waterfall or agile methodology. App development was often guided by a theory, but across the reviewed studies, there were no common theories used. Patient involvement was not commonly evident in predevelopment phases but were generally reserved for evaluations of feasibility, acceptance, and effectiveness. Patient perspectives on gamified app features indicated a potential to motivate positive health behaviors such as medication adherence along with critical themes of repetitiveness and irrelevance of certain features. The appraisal indicated a low risk of bias in most studies, although concerns were identified in potential confounding. Conclusions To effectively address medication adherence via gamified and incentivized mobile apps, an evidence-based co-design approach and agile methodology should be used. This review indicates some adoption of an agile approach in app development; however, patient involvement is lacking in earlier stages. Further research in a generalized cohort of patients living with chronic conditions would facilitate the identification of barriers, potential opportunities, and the justification for the use of gamification and financial incentives in mobile apps for medication adherence.
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Affiliation(s)
- Steven Tran
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lorraine Smith
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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25
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Pham L, Moles RJ, O’Reilly CL, Carrillo MJ, El-Den S. Mental Health First Aid training and assessment in Australian medical, nursing and pharmacy curricula: a national perspective using content analysis. BMC Med Educ 2022; 22:70. [PMID: 35093037 PMCID: PMC8800543 DOI: 10.1186/s12909-022-03131-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 01/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Suicide is among the leading causes of death among people aged 15 to 29 worldwide. Healthcare professionals interact with people at risk of suicide regularly, yet mental health and crisis first aid training is lacking in curricula. Mental Health First Aid (MHFA) training teaches crucial communication and crisis first aid skills and is increasingly recognised as integral to healthcare education. This study aimed to explore the extent of, as well as barriers and enablers to MHFA training delivery and assessment in Australian medical, nursing and pharmacy curricula. METHODS All accredited Australian medical, nursing and pharmacy program providers were identified through Australian Health Practitioner Regulation Agency and National Boards websites and invited to participate in a semi-structured interview. A purpose-designed interview guide explored if and how MHFA training was delivered and assessed in curricula, as well as perceptions of and barriers and enablers to MHFA training. Interview recordings were transcribed verbatim, allowing for deductive content analysis to compare MHFA training provision across programs. RESULTS Of 75 invited program providers, 36 (48%; 13 medical, 13 nursing and 10 pharmacy) participated, of which 15 representatives (42%; six medical, two nursing and six pharmacy) reported providing MHFA training to students. Differences in mandating training, year level of students completing training, type of training delivered and source of MHFA instructors were identified. Barriers to MHFA implementation included perceived adequacy of existing curricula, lack of funding and time, while facilitators included perceived benefit and availability of funding. CONCLUSION MHFA training is provided to more than one third of medical, nursing and pharmacy students in Australia. Increased funding may facilitate the integration of MHFA as a minimum standard of mental health training for future healthcare professionals. Further research exploring the effectiveness of MHFA in improving behaviours and its impact on patient outcomes is warranted. TRIAL REGISTRATION This study was approved by the University of Sydney Human Research Ethics Committee [Project number: 2020/087].
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Affiliation(s)
- Lily Pham
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Rebekah Jane Moles
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Claire Louise O’Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
| | - Mary Joy Carrillo
- School of the Arts and Media, Faculty of Arts and Social Sciences, The University of New South Wales, Robert Webster Building G14 Room 312, Kensington, NSW 2052 Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, A15 Pharmacy and Bank Building, Science Rd, Camperdown, NSW 2006 Australia
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26
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Stewart V, McMillan SS, Hu J, Ng R, El-Den S, O'Reilly C, Wheeler AJ. Goal planning in mental health service delivery: A systematic integrative review. Front Psychiatry 2022; 13:1057915. [PMID: 36601527 PMCID: PMC9807176 DOI: 10.3389/fpsyt.2022.1057915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Goal planning is routinely employed in mental health service delivery to identify priorities for treatment and support the achievement and evaluation of outcomes. Previous systematic reviews of the literature have focused on the use of goal planning in a range of physical and cognitive disability settings, but there is a lack of information regarding how goal planning is used in mental healthcare. AIMS This systematic integrative review aimed to understand the types of goals, effectiveness of goal planning, the experience of goal planning and barriers and facilitators to effective goal planning in mental healthcare settings. METHODS Five databases were systematically searched using key terms related to mental health AND goal planning. The search was supplemented through citation chaining. Due to the heterogeneity of the studies, a narrative synthesis approach to data analysis was undertaken. RESULTS Fifty-four studies were identified through the search of the literature following the PRISMA guidelines. Data was systematically extracted and thematically organized. There was a high level of heterogeneity among the studies, originating from a range of countries and with diverse characteristics and focus. Four themes emerged from the data analysis and included: (i) goal planning as a central aspect of interventions; (ii) types of goals planned; (iii) factors that influenced goal planning and/or attainment; and (iv) collaboration and concordance in goal planning. CONCLUSION This review found some support for the use of goal planning to improve outcomes in mental healthcare although there was no identified standardized approach to the use of goal planning. Individualized, recovery-oriented and collaborative goal planning was recommended but not always used in practice. Further research to understanding the most appropriate skills and training needed to support collaborative and effective goal planning is needed. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/prospero/], identifier [CRD42020220595].
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Affiliation(s)
- Victoria Stewart
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.,Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Sara S McMillan
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.,Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jie Hu
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD, Australia.,Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Ricki Ng
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Claire O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Amanda J Wheeler
- Centre for Mental Health, Griffith University, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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27
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Carter SR, Ng R, El-Den S, Schneider CR. A patient-reported experience measure for community pharmacy including development of a short-form: The perceived service quality scale. Res Social Adm Pharm 2021; 18:3369-3378. [PMID: 34857482 DOI: 10.1016/j.sapharm.2021.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/15/2021] [Accepted: 11/24/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND The perceived service quality scale (pSQS) is a patient-reported experience measure (PREM) previously developed for measuring perceived service quality (pSQ) in community pharmacies. While measuring pSQ is feasible, further psychometric evaluation of the pSQS is warranted. In addition, the length of the 20-item pSQS may lead to fatigue among patients. It remains to be determined whether a short form of the pSQS has acceptable psychometric properties. OBJECTIVES The aim of this study was to psychometrically test the pSQS with a specific focus on making scoring recommendations and developing a short form pSQS with acceptable psychometric properties. METHODS Participants were recruited either in community pharmacies or via an online panel to complete a questionnaire including the pSQS. Confirmatory factor analyses (CFA) were conducted using robust statistics, including tests of factorial invariance. Alternative models were tested including a bifactor model. Spearman's correlation was used to conduct test-retest analyses on responses obtained one month apart. RESULTS Data were analysed from 319 participants recruited in-store and 303 participants recruited online, 86 participants providing test-retest reliability. Tests of factorial invariance indicated that the pSQS is stable across settings. The most parsimonious and best-fitting solution was obtained with a 19-item bifactor model with 5 factors plus a "general" factor. Factor scores obtained from the "general" factor explained sufficient variance and are unlikely to be excessively biased in regression models. A short-form 6-item scale (pSQ-SF6) demonstrated acceptable psychometric properties and similar predictive capacity to the original pSQS for patient loyalty intentions. Test-retest analyses indicated acceptable reliability for pSQS and PSQ-SF6. CONCLUSION This study confirms that the pSQS has acceptable psychometric properties including temporal stability. It is recommended that a 19-item pSQS be used to obtain a comprehensive overview of patients' pSQ. The short-form pSQ-SF6 is suitable as a community pharmacy PREM.
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Affiliation(s)
- Stephen R Carter
- School of Pharmacy, Pharmacy and Bank Building (A15), Science Road, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Ricki Ng
- School of Pharmacy, Pharmacy and Bank Building (A15), Science Road, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Sarira El-Den
- School of Pharmacy, Pharmacy and Bank Building (A15), Science Road, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Carl R Schneider
- School of Pharmacy, Pharmacy and Bank Building (A15), Science Road, The University of Sydney, Sydney, NSW, 2006, Australia
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28
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Abstract
Mental illnesses cause significant disease burden globally, with medicines being a major modality of treatment for most mental illnesses. Pharmacists are accessible and trusted healthcare professionals who have an important role in supporting people living with mental illness. This commentary discusses the role of pharmacists in mental healthcare, as part of multidisciplinary teams, the current evidence to support these roles, and the training, remuneration and policy changes needed to recognize these roles and embed pharmacists as core members of the mental healthcare team.
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Affiliation(s)
- Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Jack C Collins
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Timothy F Chen
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
| | - Claire L O'reilly
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney. Sydney, NSW (Australia).
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29
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Nguyen W, O'Reilly CL, Moles RJ, Robinson JD, Brand-Eubanks D, Kim AP, El-Den S. A systematic review of patient interactions with student pharmacists in educational settings. J Am Pharm Assoc (2003) 2021; 61:678-693.e3. [PMID: 34483057 DOI: 10.1016/j.japh.2021.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/10/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Patients may contribute to various aspects of student pharmacists' education within clinical, experiential and educational settings. There is an emerging body of literature describing and evaluating the contribution of patients to health care education; however, little is known about patients' contribution to pharmacy education specifically within educational settings. OBJECTIVE To explore the evidence relating to the involvement of patients in the education of student pharmacists, in terms of the nature, extent, and outcomes of their contribution. METHODS A systematic literature search was undertaken within Embase, MEDLINE, Education Resources Information Center, International Pharmaceutical Abstracts, PubMed, PsycINFO, CINAHL, and Scopus databases from inception to April 10, 2020. Inclusion criteria included primary research studies reporting on the active involvement of patients in pharmacy education, within an educational setting. Quality assessment appraisal for the included studies was conducted using the Mixed Methods Appraisal Tool. RESULTS Twelve studies were eligible for inclusion in this systematic review. Nine studies explored the use of patients as educators providing valuable insight about their lived experience. Six studies involved patients in question-and-answer sessions, providing students with opportunities to inquire about their lived experience in relation to medicines, health care, and medical conditions. Studies that reported on students' learning outcomes demonstrated improvements in communication skills, deeper understanding of patients' lived experience particularly relating to mental illness, and increased confidence in providing care for patients. Among patients, participation in the educational process led to greater satisfaction, empowerment, and knowledge from sharing personal experiences. There were no clinical outcomes measured among patients participating in the included studies. The 5 nonrandomized quantitative studies ranged from low to moderate levels of quality, the 4 mixed-methods studies were of low quality, and the 3 qualitative studies were of high quality. CONCLUSION The involvement of patients in the education of student pharmacists was found to benefit both patients and students. Student-specific outcomes included development of communication skills and new insights about patients' lived experience. Further research is needed to better understand the long-term impact of patient involvement in pharmacy education, in terms of students' learning outcomes and clinical outcomes among patients.
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30
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Abstract
In 2008, Apple and Android launched their Application or "App" stores. Since then, there has been a growing interest in using mobile apps for improving medication adherence. However, research on the efficacy of apps, in terms of improved medication adherence and clinical outcome and/or patient-related outcome measures (PROMs) is scarce. The objective of this research was to systematically review the impact of apps on consumers' medication adherence and to determine the effect on clinical outcome and/or PROM(s). A systematic literature search was conducted to identify publications aimed at improving medication adherence published from January 2008 to April 2018. All studies were assessed for risk of bias using either the Risk Of Bias In Non-randomized Studies-of Interventions or the revised tool for Risk of Bias in randomized trials tool, depending on study design. Eleven randomized controlled trials (RCTs) and 10 non-RCTs were included. All 11 RCTs showed improvements in adherence; however, only seven reported statistically significant improvements in at least one adherence measure. Nine RCTs also demonstrated improvements in clinical outcome/PROM(s), of which five were statistically significant, whereas two RCTs did not report on clinical outcome/PROM(s). Only two studies using non-RCT study designs showed statistically significant improvements in all measures of adherence and clinical outcome/PROM(s). The risk of bias was moderate or serious for all included studies. Even though the use of an app may improve adherence, it is difficult to draw conclusions regarding the impact of apps on medication adherence due to the high degree of heterogeneity across studies, from the methodological design to the features of the app and the measure of adherence.
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Affiliation(s)
- Ricki Ng
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Stephen R Carter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
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McMillan SS, Hu J, El-Den S, O'Reilly CL, Wheeler AJ. Pharmacy participation in dental and oral health care: a scoping review protocol. JBI Evid Synth 2021; 19:1651-1658. [PMID: 33394620 DOI: 10.11124/jbies-20-00209] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The aim of the review is to identify and describe the characteristics and associated outcomes of dental and oral health advice and support provided by members of the pharmacy profession. Research exploring the role, attitudes, and knowledge of pharmacists, pharmacy students, and support staff relating to dental and oral health care, as well as stakeholder perceptions, will also be examined. INTRODUCTION With the increasing prevalence of dental and oral health disorders and resource constraints within health care systems, other avenues for oral health promotion and care provision are warranted. Pharmacists, as primary care professionals working across various practice settings, could play a significant role in promoting good oral health. Yet, there is limited insight about the role, attitudes, and knowledge of members of the pharmacy profession towards dental and oral health care, as well as what stakeholders, such as consumers and other health care professionals, think about their role in this context. INCLUSION CRITERIA Any full-text publication that describes outcomes related to pharmacist, pharmacy assistant, or student involvement, knowledge, or attitudes towards dental or oral health care in any setting, and stakeholder perspectives of this role, will be included. Reviews, protocols, and commentaries will be excluded, as will studies specifically focused on smoking cessation or that do not describe the related health promotion activity. METHODS Articles published in English will be sought from health and educational databases with no date restrictions, with additional references identified via snowballing using citations and reference lists. Data searching and screening processes will follow JBI methodology, involving two independent reviewers, and data extraction presented in a narrative form.
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Affiliation(s)
- Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,School of Pharmacy and Pharmacology, Griffith University, Gold Coast, QLD, Australia
| | - Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.,Faculty of Medical and Health Sciences, Auckland University, Auckland, New Zealand
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Stewart V, McMillan SS, Roennfeldt H, El-Den S, Ng R, Wheeler AJ. Exploring goal planning in mental health service delivery: a systematic review protocol. BMJ Open 2021; 11:e047240. [PMID: 34059514 PMCID: PMC8169485 DOI: 10.1136/bmjopen-2020-047240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Goal planning is widely recognised as an integral part of mental health service delivery and an important element in supporting recovery. Goal planning identifies priorities for treatment through discussion and negotiation between service users and health practitioners. Goal planning enhances motivation, directs effort, and focuses the development of strategies and treatment options to improve recovery outcomes and promote service users' ownership of the recovery process. While goal planning is a common practice in mental health settings, evidence regarding its impact on treatment outcomes is lacking. This paper outlines a protocol for a systematic review that aims to explore the types of goals planned, experiences of service users and practitioners, and the effectiveness of goal planning as a mental health intervention. METHODS AND ANALYSIS A systematic search will be conducted during March 2021 by searching Medline, CINAHL, Embase, Scopus and PsycINFO electronic databases to answer the following questions: (1) What types of goals are being developed within mental healthcare?; (2) What is the evidence for the effectiveness of goal planning on health and well-being for mental health service users?; (3) What are the experiences of mental health service users and their treating healthcare practitioners in relation to goal planning?; and (4) What are the barriers and facilitators to effective goal planning in mental health settings? Two independent researchers will screen the articles, selecting literature that meets criteria. All literature, regardless of study design that involves adult participants, with a mental illness and reporting on goal planning will be considered for inclusion. Data will be extracted from all eligible articles regardless of study design and summarised in a table. Appropriate quality assessment and data synthesis methods will be determined based on included study designs. ETHICS AND DISSEMINATION No ethics approval is required. The results will be disseminated through peer-reviewed publications and conference presentations. PROSPERO REGISTRATION NUMBER CRD42020220595.
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Affiliation(s)
- Victoria Stewart
- School of Human Services and Social Work, Griffith University, Meadowbrook, Queensland, Australia
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
| | - Sara Sinclair McMillan
- School of Pharmacy and Pharmacology, Griffith University Faculty of Health, Gold Coast, Queensland, Australia
| | - Helena Roennfeldt
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- Centre for Psychiatric Nursing, The University of Melbourne, Carlton, Victoria, Australia
| | - Sarira El-Den
- Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Ricki Ng
- Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Amanda J Wheeler
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- Faculty of Health and Medical Sciences, The University of Auckland, Auckland, New Zealand
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Hu J, McMillan SS, El-Den S, O'Reilly CL, Collins JC, Wheeler AJ. A scoping review of pharmacy participation in dental and oral health care. Community Dent Oral Epidemiol 2021; 50:339-349. [PMID: 33893672 DOI: 10.1111/cdoe.12651] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES To explore the scope of dental and oral health care (DOHC) provided by the pharmacy profession and associated outcomes, and attitudes of pharmacy staff and other key stakeholders about pharmacy involvement in this context. METHODS A scoping review of full-text articles describing outcomes related to pharmacy staff/student involvement in, knowledge of or attitudes towards DOHC in any setting, and stakeholder perspectives was conducted. Articles written in English were searched for using PubMed, EMBASE, EBSCO, International Pharmaceutical Abstracts, Education Resources Information Centre, Web of Science, Google Scholar, and ProQuest for Dissertations and Theses. No date restrictions were used. Key outcomes were mapped: role and practice, knowledge and attitudes, and training and education. RESULTS Seventy studies met the inclusion criteria: 49 were conducted in developed countries; 60 were quantitative in design; and 38 involved community pharmacy settings only. Pharmacists and pharmacy support staff commonly managed DOHC inquiries (n = 13), including the provision of advice and products with or without a further referral. Integrated pharmacist-led services in dental settings (n = 4) showed improved prescribing and quality use of medicines but low community pharmacy referrals were identified in studies involving mystery shoppers with potential oral cancer (n = 7). DOHC promotion programmes delivered by pharmacy staff and collaborations with dentists were limited. There was interest from the pharmacy profession for a role in DOHC; however, knowledge gaps were reported and needs for further training identified. Consumer participant DOHC outcomes were not reported. CONCLUSIONS Community pharmacists and pharmacy staff were interested in an expanded role in DOHC; however, this scoping review identified lack of knowledge and sub-optimal practice as potential barriers. Research on development, implementation and evaluation of DOHC-related services and practice by pharmacy staff was scarce. Further evidence of consumer-related oral health outcomes and their perceptions of the role of pharmacy is needed.
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Affiliation(s)
- Jie Hu
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,School of Pharmacy and Pharmacology, Griffith University, Gold Coast, Qld, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Jack C Collins
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,Faculty of Medical and Health Sciences, Auckland University, Auckland, New Zealand
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Carter S, Ng R, El-Den S, Schneider C. Low perceived service quality in community pharmacy is associated with poor medication adherence. Patient Educ Couns 2021; 104:387-394. [PMID: 32788130 DOI: 10.1016/j.pec.2020.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 06/26/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Community pharmacists are highly accessible healthcare professionals, whose regular contact with patients provides ongoing opportunities to improve medication safety and promote medication adherence. This study investigates whether patients who experience low service quality in community pharmacies are less adherent to their regular medications. METHODS Eight Australian pharmacies were recruited, 5 self-identified as having a price promotion business strategy and 3 with a service-focused business strategy. Patients taking regular prescribed medicines who had previously attended the pharmacy completed e-surveys in-store with measures of perceived service quality (pSQ) and self-reported adherence. Multivariate regression using multilevel modelling with bootstrapping was used to explore the relationships between variables. RESULTS Surveys were completed by 319 respondents. Attending pharmacies with a price promotion business strategy was predictive of lower pSQ and poor medication adherence. The between-pharmacy slope of the relationship between pSQ and adherence was 2.25 (with 95 % confidence intervals = 1.50, 2.86) and was highest in pharmacies with lowest pSQ. CONCLUSION This study highlights that when patients experience low service quality, in community pharmacies they are more likely to report poor adherence to their regular prescribed medicines. PRACTICE IMPLICATIONS Community pharmacies need to be designed and managed to allow pharmacists to provide high levels of patient-centred care.
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Affiliation(s)
- Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia.
| | - Ricki Ng
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
| | - Carl Schneider
- School of Pharmacy, Faculty of Medicine and Health, University of Sydney, Australia
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Collins JC, Schneider CR, El-Den S, Moles RJ. Self-care–seeking behaviors in the community pharmacy: A cross-sectional exit survey of Australian consumers. J Am Pharm Assoc (2003) 2020; 60:827-834. [DOI: 10.1016/j.japh.2020.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 04/17/2020] [Accepted: 04/24/2020] [Indexed: 11/24/2022]
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Wheeler AJ, O'Reilly CL, El-Den S, Byrnes J, Ware RS, McMillan SS. Bridging the gap between physical and mental illness in community pharmacy ( PharMIbridge): protocol for an Australian cluster randomised controlled trial. BMJ Open 2020; 10:e039983. [PMID: 32709657 PMCID: PMC7380878 DOI: 10.1136/bmjopen-2020-039983] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/20/2020] [Accepted: 05/21/2020] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION There is a significant life expectancy gap attributable to physical comorbidities for people living with severe and persistent mental illness (SPMI) compared with the general population. Medications are a major treatment for SPMI management and physical illnesses, hence pharmacists are well positioned to support mental healthcare and comorbidities. The randomised controlled trial (RCT) aim is to evaluate effectiveness of an individualised, pharmacist led, support service for people experiencing SPMI focusing on medication adherence and physical comorbidity management, compared with standard care (a medication-management service; MedsCheck). METHODS AND ANALYSIS: PharMIbridge is a cluster RCT, whereby community pharmacies in four Australian regions will be randomised (1:1 ratio), to either Intervention Group (IG) or Comparator Group (CG). All IG and CG pharmacy staff will receive Blended-Mental Health First Aid training. Additionally, IG pharmacists will receive further training on medication adherence, goal setting, motivational interviewing, managing physical health concerns and complex issues relating to psychotropic medication. CG pharmacists will not receive additional training, and will provide standard care (MedsCheck). The primary outcome will be change in participants medication adherence for psychotropic medication over 6-months. Using mixed-effects logistic regression model and a cluster size of 48 pharmacies, a total of 190 participants will need to be recruited to each arm to find a statistically significant difference in medication adherence. Secondary outcomes will be changes in factors associated with cardiometabolic risk and quality of life, emphasising physical and psychological well-being; medication-related problems; adherence to other prescribed medication; pharmacists knowledge, confidence and ability to support people experiencing SPMI; and effects on healthcare utilisation. A within RCT-based economic evaluation comparing the intervention with standard care will be undertaken. ETHICS AND DISSEMINATION The protocol and pharmacist training programme received Griffith University Human Research Ethics Committee approval (HREC/2019/473 and HREC/2019/493 respectively). Results will be published in peer-reviewed journals and available at the Sixth Community Pharmacy Agreement website (http://6cpa.com.au/about-6cpa/). TRIAL REGISTRATION NUMBER ANZCTR12620000577910.
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Affiliation(s)
- Amanda J Wheeler
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medical and Health Sciences, Auckland University, Auckland, New Zealand
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Joshua Byrnes
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Sara S McMillan
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- School of Pharmacy and Pharmacology, Griffith University, Gold Coast, Queensland, Australia
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El-Den S, McMillan SS, Wheeler AJ, Ng R, Roennfeldt H, O'Reilly CL. Pharmacists' roles in supporting people living with severe and persistent mental illness: a systematic review protocol. BMJ Open 2020; 10:e038270. [PMID: 32665350 PMCID: PMC7359051 DOI: 10.1136/bmjopen-2020-038270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Severe and persistent mental illness (SPMI) can significantly impact a person's social, personal and professional life. Previous studies have demonstrated pharmacists' roles in mental healthcare; however, limited studies to date have focused on pharmacists' roles in providing healthcare services, specifically, to people living with SPMI. The aim of this systematic review is to explore the pharmacists' roles in providing support to people living with SPMI. METHODS AND ANALYSIS A systematic search will be conducted in Medline, Embase (Ovid), PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses to identify potentially relevant primary research for inclusion. This will be guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist for systematic reviews. All primary research publications regardless of study design exploring or reporting on pharmacists' involvement in supporting people living with SPMI will be considered for inclusion. A tabular summary will be completed using data extracted from each included publication. Data synthesis and quality assessment methods will be chosen based on included study designs. ETHICS AND DISSEMINATION The results will be published in a peer-reviewed journal and used to inform the development of a pharmacist-specific training package to support people living with SPMI. PROSPERO REGISTRATION NUMBER CRD42020170711.
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Affiliation(s)
- Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sara S McMillan
- School of Pharmacy and Pharmacology, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
| | - Amanda J Wheeler
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- Faculty of Health and Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Ricki Ng
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helena Roennfeldt
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- The University of Melbourne Centre for Psychiatric Nursing, Carlton, Victoria, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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El-Den S, Moles R, Choong HJ, O'Reilly C. Mental Health First Aid training and assessment among university students: A systematic review. J Am Pharm Assoc (2003) 2020; 60:e81-e95. [PMID: 32019720 DOI: 10.1016/j.japh.2019.12.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 12/17/2019] [Accepted: 12/22/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To explore the literature describing the delivery and assessment of Mental Health First Aid (MHFA) training among university students. DATA SOURCES The databases MEDLINE, PreMEDLINE, CINAHL, EMBASE, ERIC, and PsycINFO were searched to identify publications describing MHFA training and assessment among university students since 2000. STUDY SELECTION All studies, regardless of design, that described the delivery and assessment of MHFA training among university students, at any level, were included in this systematic review. DATA EXTRACTION The discipline and level of students; the version, length, and integration of MHFA training; and the constructs used to assess students post-MHFA training were extracted from each study. RESULTS Of the initial 1662 records, 12 were included. Eight studies were conducted in Australia, 3 in the United States, and 1 in the United Kingdom. Most students were enrolled in health care or social work degree programs across all years of their program with 4 studies involving pharmacy students. Three studies described integrating compulsory MHFA training for university students. Most studies reported on the delivery of the Standard or Adult version of MHFA training; no study reported on MHFA for Tertiary Students. Post-MHFA training, students were assessed on mental health knowledge, literacy, intentions, confidence, stigma, and skills application. Only 2 studies described assessment methods involving direct observation of behaviors, whereas the rest relied on self-reported measurements. CONCLUSION Despite the spread of MHFA to over 25 countries and the availability of tertiary student-specific training, the studies included in this systematic review were conducted in only 3 countries and mainly involved Standard and Adult MHFA training. Most assessments relied on self-reported measures. Future studies involving different versions of MHFA training, and the exploration of novel competency-based assessment methods among a diverse range of students from different countries are warranted.
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El-Den S, Schneider C, Mirzaei A, Carter S. How to measure a latent construct: Psychometric principles for the development and validation of measurement instruments. International Journal of Pharmacy Practice 2020; 28:326-336. [DOI: 10.1111/ijpp.12600] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022]
Abstract
Abstract
Measurement instruments are used to collect data about respondents. In social pharmacy, measurement instruments are often used to measure latent constructs, such as attitudes, among healthcare professionals and patients. This paper aims to describe the fundamental aspects of designing and validating instruments, which aim to measure latent constructs. The main focus of this manuscript is to describe the considerations and processes relating to exploratory and confirmatory factor analyses, when used to develop measures of latent psychosocial constructs. However, it also presents a detailed summary of the current evidence and suggestions for item generation and sample selection, as well as, an in-depth description of approaches to content and face validation. Suggestions for further reading are also provided.
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Affiliation(s)
- Sarira El-Den
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Carl Schneider
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Ardalan Mirzaei
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
| | - Stephen Carter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
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Boukouvalas E, El-Den S, Murphy AL, Salvador-Carulla L, O'Reilly CL. Exploring Health Care Professionals' Knowledge of, Attitudes Towards, and Confidence in Caring for People at Risk of Suicide: a Systematic Review. Arch Suicide Res 2020; 24:S1-S31. [PMID: 30856366 DOI: 10.1080/13811118.2019.1586608] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Health care professionals are paramount to the prevention and management of suicidal thoughts and behaviors. Confidence in caring for people at risk of suicidal thoughts and behaviors is influenced by knowledge of and attitudes towards suicide. This systematic review aimed to explore health care professionals' knowledge of and attitudes towards suicide, as well as, their confidence in caring for people at risk of suicidal thoughts and behaviors. A systematic search of 4 electronic databases over 10 years was conducted. Following retrieval of 1,723 abstracts, 46 primary research publications were included, involving both cross-sectional (n = 27) and intervention study designs (n = 19). Knowledge of, attitudes towards, and confidence in caring for people at risk of suicidal thoughts and behaviors were explored among primary health care professionals, specialists, and health care students. The influence of training and education, type of health care professional, country of practice, and prior experience with suicide were highlighted among included studies. Health care professionals' knowledge of, attitudes towards and confidence in caring for people at risk of suicide are complex, interrelated constructs that shape their behaviors and may impact patient outcomes. Suicide training and education is necessary within health care curricula and as part of health care professionals' continuing professional development.
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Lee L, El-Den S, Horne R, Carter SR. Patient satisfaction with information, concerns, beliefs and adherence to topical corticosteroids. Patient Educ Couns 2019; 102:1203-1209. [PMID: 30928342 DOI: 10.1016/j.pec.2019.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Revised: 12/14/2018] [Accepted: 01/24/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Adherence to topical corticosteroids (TCS) for inflammatory skin conditions is sub-optimal. This Australian study aimed to test the hypothesis that patients who are more satisfied with the level of information they receive about TCS, are less concerned about using TCS and more adherent to healthcare professionals' instructions. METHODS Individuals who were prescribed or had used TCS in the past month were invited to complete an online cross-sectional survey. Reliability and validity of multi-item scales were tested using confirmatory factor analysis. Self-reported adherence to TCS was measured with MARS-5. Multivariate regression with mediation analyses was used to explore relationships between variables. RESULTS Mediation analyses of 195 survey (64.4%) responses was performed. Overall satisfaction with information about TCS action and usage (SIMS-AU) (mean = 60.7%) was higher than potential concerns (SIMS-PC) (mean = 48.2%). Analysis revealed that the SIMS subscales were highly correlated (α = 0.57, p < 0.05). Higher overall SIMS scores were predictive of stronger beliefs that TCS was beneficial, fewer concerns about TCS and better adherence. CONCLUSION Being more satisfied with TCS information was associated with having more favourable disposition towards TCS and higher adherence. PRACTICE IMPLICATIONS Healthcare professionals should identity areas of dissatisfaction with medication information and tailor their counselling accordingly.
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Affiliation(s)
- Ling Lee
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Sarira El-Den
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Robert Horne
- Centre for Behavioural Medicine, UCL School of Pharmacy, University College, London, United Kingdom
| | - Stephen R Carter
- School of Pharmacy, University of Sydney, Sydney, New South Wales, Australia.
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El-Den S, O’Reilly CL, Murphy AL, Salvador-Carulla L, Boukouvalas E. A systematic review of healthcare professionals’ knowledge, attitudes and confidence in relation to suicide. Res Social Adm Pharm 2019. [DOI: 10.1016/j.sapharm.2019.03.088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Perinatal depression (PND) screening is encouraged in healthcare settings. We aimed to develop and content validate a basic PND knowledge questionnaire for use among pharmacists and potentially other primary healthcare professionals (HCPs). A six-item questionnaire was developed. Twenty-five perinatal mental health experts were invited to participate in content validation by completing the questionnaire and assessing its content validity. A content validity index (CVI) score above 0.8 was indicative of content validity. Expert comments may inform items' deletion or revision. Between November 2016 and February 2017, ten experts participated. For five out of six items, the CVI score was 0.9 or 1.0. Two experts selected "I think none are correct" for one item regarding the onset of postpartum depression. Comments reflected the lack of consensus in the literature surrounding onset periods and prevalence rates and informed minor modifications to three of six questions and seven of 24 response options. The CVI for the questionnaire was 0.83.Content validation of a questionnaire measuring basic PND knowledge resulted in modifications. Comments about PND onset and prevalence indicated the need for consistency when defining and measuring these constructs. This questionnaire may be used among pharmacists and other HCPs.
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Affiliation(s)
- Sarira El-Den
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - Claire L O'Reilly
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
| | - David M Gardner
- b Department of Psychiatry , Dalhousie University , Halifax , Nova Scotia , Canada
| | - Andrea L Murphy
- c College of Pharmacy, Dalhousie University , Halifax , Nova Scotia , Canada
| | - Timothy F Chen
- a School of Pharmacy , The University of Sydney , Camperdown , New South Wales , Australia
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El-Den S, O'Reilly CL, Chen TF. Development and Psychometric Evaluation of a Questionnaire to Measure Attitudes Toward Perinatal Depression and Acceptability of Screening: The PND Attitudes and Screening Acceptability Questionnaire (PASAQ). Eval Health Prof 2018; 42:498-522. [PMID: 30265131 DOI: 10.1177/0163278718801434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Prior to implementing perinatal depression (PND) screening, health-care professionals' acceptability of screening and their attitudes toward PND should be explored. We aimed to develop and psychometrically evaluate a questionnaire measuring PND attitudes and screening acceptability. A 31-item questionnaire was developed based on published questionnaires and a systematic review on PND screening acceptability. Principal components analysis with direct oblimin rotation was used to determine construct validity. Reliability of the resulting components was explored using Cronbach's α. Pharmacists (N = 153) were recruited from the Australian Association of Consultant Pharmacy. The scree plot and parallel analysis indicated a six-component solution. Due to cross-loadings (<.2 difference) and low loadings (<.445), it was necessary to delete 7 items. The six components explored PND screening acceptability, screening readiness, stigma, attitudes toward treatment efficacy, medication counseling responsibility, and the effect PND has on others. The six components explained 59.8% of the variance. Item loadings ranged from .445 to .880. Cronbach's α for each component ranged from .45 to .86. The construct validity and internal consistency reliability of the PND attitudes and screening acceptability questionnaire have been explored. Future measurements of these constructs using uniform, psychometrically sound scales may facilitate comparisons across studies.
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Affiliation(s)
- Sarira El-Den
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Claire L O'Reilly
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
| | - Timothy F Chen
- Faculty of Pharmacy, The University of Sydney, Camperdown, New South Wales, Australia
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El-Den S, Chen TF, Moles RJ, O'Reilly C. Assessing Mental Health First Aid Skills Using Simulated Patients. Am J Pharm Educ 2018; 82:6222. [PMID: 29606711 PMCID: PMC5869753 DOI: 10.5688/ajpe6222] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 03/08/2017] [Indexed: 05/11/2023]
Abstract
Objective. To evaluate mental health first aid (MHFA) skills using simulated patients and to compare self-reported confidence in providing MHFA with performance during simulated patient roleplays. Methods. Pharmacy students self-evaluated their confidence in providing MHFA post-training. Two mental health vignettes and an assessment rubric based on the MHFA Action Plan were developed to assess students' observed MHFA skills during audio-recorded simulated patient roleplays. Results. There were 163 students who completed the MHFA training, of which 88% completed self-evaluations. There were 84% to 98% of students who self-reported that they agreed or strongly agreed they were confident providing MHFA. Postnatal depression (PND) and suicide vignettes were randomly assigned to 36 students. More students participating in the PND roleplay took appropriate actions, compared to those participating in the suicide role-play. However, more students participating in the suicide role play assessed alcohol and/or drug use. Ten (71%) participants in the PND roleplay and six (40%) in the suicide roleplay either avoided using suicide-specific terminology completely or used multiple terms rendering their inquiry unclear. Conclusion. Self-evaluated confidence levels in providing MHFA did not always reflect observed performance. Students had difficulty addressing suicide with only half passing the suicide vignette and many avoiding suicide-specific terminology. This indicates that both self-reported and observed behaviors should be used for post-training assessments.
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Affiliation(s)
- Sarira El-Den
- The University of Sydney, New South Wales, Australia
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El-Den S, O’Reilly CL, Chen TF. Does Mental Health First Aid training affect MPharm students’ literacy, knowledge and attitudes towards perinatal depression? A pre-test/post-test pilot study. Res Social Adm Pharm 2016. [DOI: 10.1016/j.sapharm.2016.05.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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