Impact of the Novel CoronaviruS (COVID-19) on Frontline PharmacIsts Roles and ServicEs: INSPIRE Worldwide Survey.

BACKGROUND: Pharmacy has been recognized as a vital healthcare profession during the COVID-19 pandemic. The primary objective of the INSPIRE Worldwide survey was to determine the impact of COVID-19 on pharmacy practice and pharmacists\u27 roles around the world. METHODS: A cross-sectional online questionnaire with pharmacists who provided direct patient care during the pandemic. Participants were recruited through social media, with assistance from national and international pharmacy organizations between March 2021-May 2022. The questionnaire was divided into (1) demographics, (2) pharmacists\u27 roles, (3) communication strategies, and (4) practice challenges. The data were analyzed using SPSS 28, and descriptive statistics were used to report frequencies and percentages. RESULTS: A total of 505 pharmacists practicing in 25 countries participated. The most common role that pharmacists undertook was responding to drug information requests (90%), followed by allaying patients\u27 fears and anxieties about COVID-19 (82.6%), and addressing misinformation about COVID-19 treatments and vaccinations (80.4%). The most common challenges were increased stress levels (84.7%), followed by medication shortages (73.8%), general supply shortages (71.8%), and inadequate staffing (69.2%). CONCLUSIONS: Pharmacists within this study were significantly impacted by the COVID-19 pandemic and took on new or adapted roles (e.g., providing COVID-specific information, managing patients\u27 emotions, and educating on public health measures) to meet the needs of their communities. Despite, the significant challenges (e.g., increased stress, supply chain challenges, addressing misinformation, and staffing shortages) faced by pharmacists, they continued to put their patients\u27 needs first and to provide pharmacy services

Public perceptions of coronary events risk factors: a discrete choice experiment

Objectives: To assess public perceptions of coronary heart disease (CHD) risk factors. Design: Discrete choice experiment questionnaire. Setting: Six provincial centres in Northern Ireland. Participants: 1000 adults of the general public in Northern Ireland. Primary and secondary outcomes: The general public's perception of CHD risk factors. The effect of having risk factor(s) on that perception. Results: Two multinomial logit models were created. One was a basic model (no heterogeneity permitted), while the other permitted heterogeneity based on respondents' characteristics. In both models individuals with very high cholesterol were perceived to be at the highest risk of having a coronary event. Respondents who reported having high cholesterol perceived the risk contribution of very high cholesterol to be greater than those who reported having normal cholesterol. Similar findings were observed with blood pressure and smoking. Respondents who were male and older perceived the contribution of age and gender to be lower than respondents who were female and younger. Conclusions: Respondents with different risk factors perceived such factors differently. These divergent perceptions of CHD risk factors could be a barrier to behavioural change. This brings into focus the need for more tailored health promotion campaigns to tackle CHD

RxIALTA: evaluating the effect of a pharmacist-led intervention on CV risk in patients with chronic inflammatory diseases in a community pharmacy setting: a prospective pre–post intervention study

Objective To evaluate the effect of a pharmacist-led intervention on CV risk in patients with inflammatory conditions.Methods Design Prospective pre–postintervention.Setting 17 community pharmacies across Alberta.Population Adults with inflammatory conditions (rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, gout, systemic lupus erythematosus, psoriasis vulgaris) who had at least one uncontrolled risk factor (A1C, blood pressure, LDL-cholesterol or current tobacco users).Intervention All patients enrolled in the study received: physical and laboratory assessment, individualised CV risk assessment and education regarding this risk, treatment recommendations, prescription adaptation and prescribing where necessary to meet treatment targets, regular communication with the patient’s treating physician(s) and regular follow-up with all patients every month for 6 months.Outcomes Primary: change in estimated CV risk (risk of a major CV event in the next 10 years) after 6 months. Secondary: change in individual risk factors (blood pressure, LDL-cholesterol, A1C and tobacco cessation) over a 6-month period.Results We enrolled 99 patients. The median age was 66.41 years (IQR 57.64–72.79), More than half of them (61%) were female and more than three-quarters (86%) were Caucasians. After adjusting for age, sex and ethnicity and centre effect, there was a reduction of 24.5% in CV risk (p<0.001); including a reduction of 0.3 mmol/L in LDL-c (p<0.001), 10.7 mm Hg in systolic blood pressure (p<0.001), 1.25% in A1C (p<0.001). There was a non-significant trend towards tobacco cessation.Conclusion This is the first study on CV risk reduction in patients with inflammatory conditions in a community pharmacy setting. RxIALTA provides evidence for the benefit of pharmacist care on global cardiovascular risk reduction as well as the individual cardiovascular risk factors in patients with inflammatory conditions.Trial registration number NCT03152396

Pharmacists’ Perceptions of Their Professional Role: Insights into Hospital Pharmacy Culture

ABSTRACTBackground: Numerous studies have demonstrated the positive impacts of pharmacists on patient outcomes. To capitalize on these positive impacts, hospital pharmacy organizations around the world are now calling on pharmacists to shift their focus from distribution of medications to patient outcomes. This new emphasis is consistent with the vision statement for the profession of pharmacy in Canada, as set out in the Blueprint for Pharmacy: "Optimal drug therapy outcomes for Canadians through patient-centred care". Given the ambitious nature of this statement and these goals, it is essential to understand what pharmacists currently think of their practice.Objective: To conduct a qualitative and semiquantitative analysis of hospital pharmacists' perceptions of their role in patient care.Methods: A researcher posing as a University of Alberta student who was studying how health professionals use language to describe what they do contacted the pharmacy departments of all hospitals in Alberta. The "top-of-mind" approach was used in asking hospital pharmacists 2 questions: (1) How many years have you been practising pharmacy? (2) In 3 or 4 words (or phrases), from your perspective could you please tell me, "What does a pharmacist do"? These techniques were used to minimize the impact of social desirability bias. Content analysis was used to categorize hospital pharmacists' responses into 4 broad categories: patient-centred, drug-focused, drug distribution, and ambiguous.Results: A total of 103 phone calls were made to hospital pharmacies, and 85 pharmacists contacted in this way were willing to participate in the survey. Hospital pharmacists provided 333 individual responses to the question about their activities. Of these, 79 (23.7%) were patientcentred, 98 (29.4%) were drug-focused, and 82 (24.6%) were in the drug-distribution category. Ambiguous responses accounted for the remaining 74 (22.2%).Conclusion: Aspects of care categorized as other than patient centred should not be construed as unimportant. However, the fact that they were reported in this survey more frequently than patient-centred aspects suggests that hospital pharmacists in Alberta may have not fully embraced the concept of patient-centred care as outlined in the Blueprint for Pharmacy.RÉSUMÉContexte : De nombreuses études ont montré les influences positives des pharmaciens sur les résultats thérapeutiques. Pour tirer parti de ces influences positives, les organismes de pharmacie hospitalière à l'échelle planétaire demandent donc aux pharmaciens de passer d'une pratique axée sur la distribution des médicaments à une pratique axée sur les résultats cliniques. Cette démarche est conforme à l'énoncé de vision du Plan directeur pour la pharmacie concernant la profession de pharmacien au Canada: « Procurer aux Canadiens un traitement médicamenteux aux résultats optimaux par des soins axés sur le patient. » Étant donné l'objectif ambitieux sous-tendant cet énoncé et les buts de ce plan, il est impératif de connaître l'opinion qu'ont actuellement les pharmaciens de leur profession.Objectif : Effectuer une analyse qualitative et semi-quantitative des perceptions qu'ont les pharmaciens d'hôpitaux de leur rôle dans les soins aux patients.Méthodes : Un chercheur s'est fait passer pour un étudiant de l'Université de l'Alberta qui étudiait comment les professionnels de la santé utilisaient le langage pour décrire leur travail. Le chercheur a communiqué avec les services de pharmacie d'hôpitaux de l'Alberta et a demandé aux pharmaciens de répondre spontanément aux questions suivantes : 1) Depuis combien d'années exercez-vous la pharmacie? 2) De votre point de vue, pourriez-vous me dire en trois ou quatre mots (ou expressions) « Qu'est-ce que fait un pharmacien? ». Ces techniques visaient à réduire tout biais induit dans une réponse par le désir de plaire. L'analyse du contenu a servi à classer les réponses de chaque pharmacien d'hôpital dans les quatre grandes catégories de pratique suivantes : axée sur le patient, axée sur les médicaments, axée sur la distribution des médicaments ou réponse ambiguë.Résultats : Le chercheur a téléphoné en tout à 103 pharmacies d'hôpital et 85 pharmaciens ainsi joints ont accepté de participer au sondage. Les pharmaciens d'hôpitaux ont fourni 333 réponses individuelles à la question concernant leurs activités. De ces réponses, 79 (23,7 %) étaient classées dans la catégorie de pratique axée sur le patient, 98 (29,4 %) à celle axée sur les médicaments et 82 (24,6 %) à celle axée sur la distribution des médicaments. Le reste des réponses, soit 74 (22,2 %), tombaient dans la catégorie ambiguë.Conclusion : Les aspects des soins classés dans une autre catégorie que ceux axés sur le patient ne doivent pas être interprétés comme étant sans importance. Cependant, le fait qu'ils aient été mentionnés durant ce sondage plus souvent que les aspects des soins axés sur le patient porte à croire que les pharmaciens d'hôpitaux en Alberta pourraient ne pas avoir complètement adhéré au concept des soins axés sur le patient tel qu'il est décrit dans le Plan directeur pour la pharmacie

Factors associated with anxiety and depression among patients with chronic obstructive pulmonary disease

Objectives: This study investigated factors associated with anxiety and depression in COPD outpatients. Methods: A cross-sectional study of 702 COPD outpatients from two major Jordanian hospitals using the Hospital Anxiety and Depression Scale (HADS) was conducted. Results: Significant associations were found with gender (Anxiety OR: 5.29, 95%CI: 2.38–11.74; Depression OR: 0.20, 95%CI: 0.08–0.51), disease severity (Anxiety OR: 2.97, 95%CI: 1.80–4.91; Depression OR: 15.95, 95%CI: 5.32–52.63), LABA use (Anxiety OR: 16.12, 95%CI: 8.26–32.26; Depression OR: 16.95, 95%CI: 8.33–34.48), medication count (Anxiety OR: 0.73, 95%CI: 0.59–0.90; Depression OR: 0.51, 95%CI: 0.40–0.64), mMRC score (Anxiety OR: 2.41, 95%CI: 1.81–3.22; Depression OR: 2.31, 95%CI: 1.76–3.03), and inhalation technique (Anxiety OR: 0.95, 95%CI: 0.93–0.97; Depression OR: 0.92, 95%CI: 0.90–0.95). Other factors associated with anxiety included high income, urban living, diabetes, hypertension, LAMA use, and fewer COPD medications. Depression was also linked with heart disease, increased age, and longer disease duration. Conclusion: The prevalence of anxiety and depression among COPD patients necessitates targeted interventions. Future research that recruits a more diverse sample in multiple sites and establishes the cause-effect relationship between the study predictors and outcome could provide a more robust conclusion on factors associated with anxiety and depression among COPD patients

Quantifying the cost of single-use minims and multidose bottles for eye drops in routine ophthalmic practice: A multicentre study

Objective: To compare costs between two different eye drop delivery modalities: multidose bottles and single-use minims.Design: Retrospective cohort study.Methods: Monthly dilating eye drop costs and quantities (tropicamide 1%, phenylephrine 2.5%, cyclopentolate 1%) were studied over a 2-year period between April 2013 and March 2015 at 2 tertiary ophthalmic centres (Royal Alexandra Hospital [RAH, Edmonton] and Rockyview General Hospital [RGH, Calgary]). In April 2014, RAH switched its dilating eye drop practice from predominantly multidose bottles to single-use minims, whereas RGH continued using predominantly multidose bottles. Eye drop volume and total and per-patient eye drop costs were quantified at RAH before switching (pre-intervention) and after (post-intervention) using an interrupted time-series analysis with RGH as a control. A counterfactual analysis was also performed. Significance was obtained using independent t-testing.Results: After switching to single-use minims, RAH experienced changes in the following: an increase in single-use minims as a proportion of total eye drop utilization (from 5.6% to 89.1%; p = 0.001), an increase in total eye drop cost by $2117 per month (95$1354-$2880; p \u3c 0.001), an increase in per-patient costs by$984 per 1000 patients per month (95% CI, $674-$1293). Contrastingly, RGH did not experience similar changes. Ultimately, the cost of switching to single-use minims was $22 481 (95$7830-$31 336) over a 12-month period.Conclusions: If safe eye drop practices are enforced via proper protocols, the use of multidose bottles may be a more cost-effective option than single-use minims for routine clinical practice

Evaluating the impact of patient-reported outcome measures on depression and anxiety levels in people with multiple sclerosis: a study protocol for a randomized controlled trial

Abstract Background Multiple sclerosis (MS) is a chronic disease affecting multiple functional aspects of patients’ lives. Depression and anxiety are common amongst persons with MS (PwMS). There has been an interest in utilizing patient-reported outcome measures (PROMs) to capture and systematically assess patient’s perceptions of their MS experience in addition to other clinical measures, but PROMs are not usually collected in routine clinical practice. Therefore, this study aims to systematically incorporate periodic electronically administered PROMs into the care of PwMS to evaluate its effects on depression and anxiety. Methods A randomized controlled trial will be conducted with patients allocated 1:1 to either intervention or conservative treatment groups. Patients in the intervention group will complete PROMs at the start of the study and then every 6 months for 1 year, in addition to having their MS healthcare provider prompted to view their scores. The conservative treatment group will complete PROMs at the start of the study and again after 12 months, and their neurologist will not be able to view their scores. For both groups, pre-determined critical PROM scores will trigger an alert to the patient’s MS provider. The difference in change in Hospital Anxiety and Depression Scale score between the intervention and conservative treatment groups at 12 months will be the primary outcome, along with difference in Consultation Satisfaction Questionnaire and CollaboRATE scores at 12 months, and proportion and type of healthcare provider intervention/alerts initiated by different PROMs as secondary outcomes. Discussion This study will determine the feasibility of utilizing PROMs on an interval basis and its effects on the psychological well-being of PwMS. Findings of this study will provide evidence on use of PROMs in future MS clinical practice. Trial registration This trial is registered at the National Institutes of Health United States National Library of Medicine, ClinicalTrials.gov NCT04979546 . Registered on July 28, 2021