Tele-pharmacy perception, knowledge and associated factors among pharmacy students in northwest Ethiopia: an input for implementers

BACKGROUND

Tele-pharmacy is a subset of telemedicine in which pharmacies use telecommunication technology to provide patient care. Tele-pharmacy can improve pharmaceutical care service delivery by reducing medication errors, improving access to health professionals and facilities in remote and rural areas, and minimizing adverse drug events. However, there is limited evidence regarding future pharmacists' knowledge and perceptions of the Tele-pharmacy system in Ethiopia. As a result, this study aimed to assess tele-Pharmacy perception, knowledge and associated factors among pharmacy students in Northwest Ethiopia.

METHODS

An institutional-based cross-sectional study was conducted among 376 pharmacy students in Northwest Ethiopia between July 15 and August 27, 2022. A pre-tested self-administered questionnaire was used to collect data. The data were entered using Epi info version 7.0 and analyzed using SPSS version 25. Descriptive statistics, bivariable and multivariable logistic regression analysis were used to describe pharmacy students' knowledge and perceptions of Tele-pharmacy and identify associated factors. An adjusted odds ratio (OR) and a p-value with a 95% confidence interval (CI) were calculated to declare statistical significance.

RESULTS

From a total of 352 participants, about 32.4% with [95% CI (27%-37%)] and 48.6% with [95% CI (43%-54%)] had good knowledge and a positive perception toward Tele-pharmacy, respectively. Being age group of 26-30 (AOR = 0.35, 95% CI: 0.17-0.68), being male (AOR = 2.38, 95% CI: 1.26-4.49), Having a CPGA of > 3.5 (AOR = 2.28, 95% CI: 1.24-4.19), Taking basic computer training (AOR = 2.00, 95% CI: 1.17-3.39), Management support (AOR = 1.84, 95% CI: 1.06-3.19) were found to be significantly associated with pharmacy students' knowledge of Tele-pharmacy. Similarly, having access to electronic devices (AOR = 3.80, 95% CI: 1.81-7.97), training related to pharmacy information systems (AOR = 6.66, 95% CI: 3.34-13.29), availability of guidelines (AOR = 2.99, 95% CI: 1.62-5.50) were found to be significantly associated with pharmacy students' perceptions of Tele-pharmacy.

CONCLUSION

This study found that pharmacy students have limited knowledge and perceptions of the Tele-pharmacy system. A continuing Tele-pharmacy training package, incorporating pharmacy information system guidelines as part of their education, and providing managerial support could be recommended to improve pharmacy students' knowledge and perception of Tele-pharmacy.

[Xanthogranulomatous pyelonephritis presenting as a Grawitz tumor in a 21-year-old female patient. Case report] ]

Xanthogranulomatous pyelonephritis is a chronic inflammatory disease of the kidney characterized by destruction and replacement of the renal parenchyma with granulomatous tissue containing lipid-filled macrophages. The disease affects mainly elders, more frequent females and is difficult to differentiate it from renal neoplasms by standard diagnostic imaging methods. This case report confirms it.

Chronic ischaemia of the ileal neobladder: clinical manifestations and management

Recently, bladder replacement with intestinal reservoir is becoming more common as urinary diversion in a selected group of patients after radical cystectomy. Complications occurred in two patients, 2 and 7 months, respectively, after successful radical cystoprostatectomy and reconstruction of the ileal neobladder, due to chronic ischaemic changes of the latter. Their clinical manifestations and management are discussed. Some of the possible potential mechanisms responsible for ischaemic changes of the reservoir are reviewed.

Advantages of converting incontinent to continent urinary diversion

A modified Mainz pouch with catheterizable stoma was constructed in six patients who had originally undergone incontinent urinary diversion by ureteroileostomy 7 to 22 years previously for bladder exstrophy or neurogenic bladder with total urinary incontinence. The surgical technique differed from the standard as follows: after stomal excision, the preexisting ileal loop was detubularized and combined with additional ileal and colonic segments for pouch construction. In patients in whom the original ureteroileal anastomoses were patent and the contrast medium refluxed freely to the upper urinary tract during loopography, the ureters were not reimplanted but kept intact. In all patients the ileal valve was connected as stroma to the umbilicus. In addition, two patients underwent construction of a standard Mainz pouch. One had had primary ureterosigmoidostomy and the other one ureterostomies, 10 and 3 months previously, respectively. The urodynamic characteristics of the reservoir were normal in all. In six ureteropelvic units dilation improved significantly and in two patients the bilateral loop-ureter reflux diminished. Long-term follow-up (up to 45 months) showed no further impairment of the kidneys.

[Complications of continent urinary diversion]

Continent urinary diversion over its advantages, in comparison with incontinent urinary diversion, has serious complications. The authors analyse results and complications, which they registered in 26 patients 10-50 (average 20) months after supravesical continent urinary diversion. The commonest complications were in connection with the continent mechanism, these lead in 8 patients to urinary incontinence. Other serious complications were reservoir perforation during catheterisation in 3 and development of stones in the reservoir in 2 patients. All these major complications necessitated reoperation.

[Advantage of conversion of a uretero-ileostomy to a continent reservoir]

The authors refer their own experience in conversion of incontinent urinary diversion to a continent one. In 6 patients with ureteroileostomy they constructed continent reservoir. Reservoirs were formed from isolated ileocecal segment of the intestine together with the previous ileal loop. Continence was ensured by construction of a valve by method of ileal intussusception. After operation patients were followed-up clinically, biochemically and urodynamically, their subjective feelings and objective findings were analysed. Serious early or late complications were not registered during follow-up.