ALBERT

Description: Little is known about health professions students’ awareness and attitudes regarding public health in the United States. Therefore, the purpose of this study was to assess medical and pharmacy students’ knowledge and interest in the Healthy People initiative as well as perceptions of public health content in their curricula. An electronic survey was distributed in March 2021 in seven schools across Ohio; participation was incentivized through a USD 5 donation to the Ohio Association of Foodbanks to aid in COVID-19 relief efforts (maximum USD 1000) for each completed survey. A total of 182 medical students and 233 pharmacy students participated (12% response rate). Less than one-third of respondents reported familiarity with Healthy People and correctly identified the latest edition. However, nearly all respondents agreed public health initiatives are valuable to the American healthcare system. Almost all students expressed a desire to practice interprofessionally to attain public health goals. Both medical and pharmacy students recognized core public health topics in their curricula, and nearly 90% wanted more information. These findings indicate that the majority of medical and pharmacy students in Ohio believe public health initiatives to be important, yet knowledge gaps exist regarding Healthy People. This information can guide curricular efforts and inform future studies of health professions students.

Description: Vancomycin-resistant enterococci (VRE) account for a large proportion of hospital-acquired infections. Determining optimal treatment of VRE urinary tract infections (UTIs) is challenging. The purpose of this study was to determine if a difference in efficacy or safety exists between linezolid and non-linezolid treatments for VRE UTIs. This retrospective cohort evaluated patients admitted between 1 June 2012–30 November 2017 who were treated for VRE UTI. Patients must have had at least one sign, symptom, or laboratory confirmation of UTI to be included. The primary endpoint of this study was difference in clinical cure between linezolid and non-linezolid treatment options. Secondary endpoints included 30-day recurrence, 30-day infection-related readmission, inpatient mortality, infection-related hospital length of stay (LOS), and time to appropriate therapy. A total of 45 patients (33 linezolid and 12 non-linezolid) were included. Clinical cure occurred in 71.4% linezolid and 58.3% non-linezolid (p = 0.476). No patients had a 30-day infection-related readmission or 30-day recurrence. Of the 45 patients, 6 (13.3%) patients died during admission, and 5 of those deaths were in the linezolid group (p = 1.000). No significant difference was found for clinical cure between linezolid and non-linezolid treatment options for VRE UTIs.

Description: Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on available international literature and published research have been discussed. Three categories were developed by the authors for summarising review findings as follows: ‘benefiting the patient’, ‘making well-informed decision’, and ‘follow up assessment’ as pre-intervention, through-intervention, and post-intervention aspects, respectively. PRN medicines management is mainly intertwined with the ethical tenets of beneficence, nonmaleficence, dignity, autonomy, justice, informed consent, and error disclosure. It is a dynamic process and needs close collaboration between healthcare professionals especially nurses and patients to prevent unethical practice.

Description: Job satisfaction reflects pharmacists’ evaluation of their current work experiences, while career satisfaction is an evaluation of how satisfied pharmacists are with their profession across various jobs. The objectives of this article were to measure career satisfaction and specific facets of current-job satisfaction of U.S. pharmacists, compare satisfaction across genders, and examine the determinants of career satisfaction. This study was based on self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 422 men and 315 women. Within each gender, pharmacists’ career satisfaction was modeled using ordinary least squares as a function of three sets of variables: personal characteristics, earnings and workweek, and other job-related variables. Female pharmacists exhibited higher levels of contentment with their careers than their male counterparts. Their career-satisfaction levels were not affected by age, marital status, annual earnings, or average workweek, covariates that systematically influenced male pharmacists’ career satisfaction. Job satisfaction substantially affected pharmacists’ long-term career satisfaction. Male and female pharmacists responded differently to stimuli, so a uniform set of work-related incentives may not be effective for both genders. Initiatives perceived by male practitioners as increasing satisfaction may be adversely perceived by female practitioners, and vice-versa.

Description: Background: Although pharmacy literature suggests that pharmacists have a positive attitude towards older adults, there is a paucity of studies that have measured pharmacists’ knowledge or attitudes towards older people. The purpose of our study was to assess the knowledge and attitudes of hospital pharmacists toward older adults. Methods: An electronic survey was distributed over two months to clinical hospital pharmacists across the province of Alberta, Canada. The survey was composed of two validated tools, the Palmore Facts of Aging Quiz (PFAQ) and Kogan’s Attitude toward Old People Scale (KOPS). PFAQ is scored from 0 (poor knowledge) to 25 (high knowledge) and KOPS from 34 to 204, with higher than 119 indicating a positive attitude. Results: A total of 153 pharmacists completed the survey (response rate of 24%). The mean age was 39 (SD 10.8) years; the average years practiced was 15 (SD 11), and the majority of respondents (n = 65) reported that 〉50% of patients in their practice were geriatrics. The mean correct responses on the PFAQ were 18.8 (SD 2.6). KOPS had a mean score of 156.8 (SD 14), with only one pharmacist score falling below 119, indicating a negative attitude. There was a statistically significant, positive correlation between attitudes and knowledge (r = 0.38, p 〈 0.05), as well as the increasing age of the respondents (r = 0.18, p = 0.03). The remaining measured categories (i.e., gender, years of pharmacy practice) had no significant effect. Conclusion: Clinical hospital pharmacists in Alberta have a positive attitude toward geriatric patients, as well as a satisfactory knowledge of older adults.

Description: Background: Community pharmacist-led interventions are effective in improving health outcomes; however, their impact in improving preconception and pregnancy health is not clear. This study evaluated the effectiveness of community pharmacist-led interventions which aimed to improve health outcomes of preconception and pregnant women. Methods: A systematic review of the literature, consistent with PRISMA guidelines, was performed. Five electronic databases were searched up to February 2021. Results: Four studies, three in pregnant women and one in preconception women, were identified. The studies focused on improving micronutrient status and smoking cessation. The studies increased knowledge about, and use of, iron supplements, and improved iron status and smoking cessation rates in pregnant women, while improving knowledge regarding, and increasing the use of, preconception folic acid. The studies were ranked as weak to moderate quality. Conclusion: This review provides preliminary evidence for the potential benefit of community pharmacist-led interventions to improve the health of women before and during pregnancy.

Description: Validation studies of pain interference instruments used among student pharmacists are rare yet essential for understanding their appropriate use and interpretation in pharmacy education and practice. This study conducted validation and reliability assessments of a five-item Pain Interference Scale previously administered to student pharmacists. Construct validity was assessed using Rasch analysis. Unidimensionality was measured using: point-biserial measure correlations; percent of raw variance explained by items; difference between expected; variance modeled by items; and Rasch model fit. To assess scale functioning, response frequency distribution, observed average and sample expected logit distribution, Andrich logit distribution, item separation, and item reliability were assessed. Visual examination of the Item-Person Map determined content validity. Items explained 64.2% of data raw variance. The difference between raw variance modeled and observed was 0.6. Point-biserial measure correlations were 〉0.77. Item mean-square infits were 0.7–1.3 while outfit measures were 0.72–1.16. There were 〉10 responses per response category, response frequency and Andrich thresholds progressively advanced, and observed average and sample expected logits advanced monotonically, Andrich logits = −2.33–1.69, item separation = 2.61, and item reliability = 0.87. Item probability curves indicated response categories were minimally yet adequately distinct. Cronbach’s alpha = 0.93. The Item-Person Map had a ceiling effect indicating content gaps. In conclusion, the pain interference instrument has acceptable construct validity yet contains content gaps. Additional difficult items should be added to the instrument to better capture pain interference among student pharmacists.

Description: In March 2020, a national lockdown in Saudi Arabia due to the pandemic forced all educational institutions to complete their academic year via online education. This study aims to explore pharmacy students’ perceptions and assess their attitude towards online education during the lockdown. A cross-sectional self-administered survey was designed to collect responses of pharmacy students (from one college of pharmacy in Saudi Arabia) from December 2020 through January 2021. A total of 241 students completed the survey. Students’ responses indicated that they had easy access to the technology, online skills, motivation and overall favorable acceptance for online learning and examinations. There was a significant difference in the mean scores between the students from different years of study (p = 0.013) related to technology access, and the male students were in significantly more favor of online examinations than female students (p = 0.009). The majority of the students indicated that the lockdown had no or negative impact on their learning and training. Students have general acceptance for online education delivery due to more technology access and online skills. More research should explore the factors affecting and the extent of the impact of online education on student learning and training.

Description: The South African Pharmacy Council (SAPC) regulates undergraduate pharmacy education and pharmacy practice. The SAPC Good Pharmacy Practice manual describes the role of pharmacists in maternal and child health (MCH) in line with the recommendation of international health regulatory bodies. However, baseline study findings in 2017 supported literature from around the world that indicated a need for curriculum review and integration to address the knowledge and skills gap in pharmacists’ MCH training. This paper describes the development and implementation of an integrated framework for MCH training across the four years of a Bachelor of Pharmacy program. The intervention included didactic lectures, skills practical on infant growth assessment, and an experiential learning component at primary health care clinics and pharmacies. Knowledge and skills assessment on contraception, maternal and antenatal care, and neonatal and child care were carried out pre, eight weeks post, and two years post intervention using the same questionnaire. ANOVA and post hoc analyses showed that participants’ knowledge and skills increased post intervention but decreased significantly two years later except in contraception where students experienced longitudinal integration of the MCH component. Generally, participants performed above the university average except in maternal and antenatal care.

Description: Despite reported benefits of pharmacy trainees (e.g., pharmacy students, pharmacy residents) in hospital settings, limited research on the impact of these trainees has been conducted in rural primary care. To explore the potential benefits and impact of pharmacy trainees practicing in a supervised collaborative rural primary care setting, a retrospective chart review was conducted. Drug therapy problems (DTPs) were classified using the Pharmaceutical Care Network Europe (PCNE V9) system. Valuation was measured using a validated tool developed by Overhage and Lukes (1999). Over 16 weeks on a part-time basis, pharmacy trainees (n = 3) identified 366 DTPs during 153 patient encounters. The most common causes for DTPs were related to patient transfers and the need for education. Drug level interventions carried out directly by trainees under supervision accounted for 13.1% of total interventions. Interventions that required prescriber authorization had an acceptance rate of 83.25%, 25% higher than previous acceptance rates found in urban primary care settings. About half (51%) of the interventions proposed and made by pharmacy trainees were classified as significant or very significant, suggesting these trainees added significant value to the pharmacy service provided to rural community residents. This study suggests that pharmacy trainees can be effective resources and contribute meaningfully to patient care in a collaborative rural primary care team setting.