Understanding COVID-19-related Burnout in Qatar's Community Pharmacists using the Job Demands-Resources Theory

Community pharmacists are one of the most accessible front-liners against the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient education, exposure to pandemic demands and prolonged stressors such as risk of infection increases their risk of burnout. Using the Job Demands-Resources theory, this research aims to identify factors affecting community pharmacists' COVID-19-related burnout, their coping strategies against it, and recommendations on interventions to mitigate it. This is a qualitative study in which Qatar community pharmacists, with informed consent, took part in semi-structured focus groups/interviews which were recorded, transcribed, and analyzed using inductive/deductive analysis. Twelve themes emerged from six focus groups, six dyadic interviews and mini focus groups, and four individual interviews. The contributing factors to community pharmacist' burnout were identified as practical job demands, and emotional demands such as fear of infection. However, government and workplace-specific resources, pharmacists' personal characteristics such as resiliency and optimism, as well as implementation of coping strategies, reduced their stress and burnout. This is the first study to explore the contributing factors to community pharmacists' COVID-19-related burnout using the job-demands resource model. In turn, individual, organizational, and national recommendations can be made to mitigate burnout in community pharmacists during the pandemic

Use of the job demands-resource model to understand community pharmacists’ burnout during the COVID-19 pandemic

BackgroundCommunity pharmacists are one of the most accessible healthcare providers during the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient education, exposure to the pandemic demands and prolonged stressors increase their risk of burnout. ObjectivesUsing the Job Demands-Resources model, this study aims to understand the factors that led to community pharmacists’ burnout and to identify their coping strategies and perceived recommendations on interventions to mitigate burnout during the COVID-19 pandemic. MethodsA qualitative phenomenological approach was used with focus groups and interviews of community pharmacists in Qatar who were recruited using purposeful, convenience, and snowballing sampling methods. Interviews were conducted between February and April 2021, were audio-recorded and transcribed verbatim. Using thematic analysis methodology, manual inductive and deductive (based on the model) codes from the interviews were used for synthesis of themes. 11 themes emerged from six focus groups, six dyadic interviews and mini focus groups, and four individual interviews with community pharmacists. ResultsThe contributing factors to community pharmacists’ burnout have been identified as practical job demands, and emotional demands including fear of infection. On the other hand, government and workplace-specific resources, personal characteristics such as resiliency and optimism, as well as the implementation of coping strategies, have reduced their stress and burnout. ConclusionsThe use of the Job Demands-Resources model was appropriate to identify the contributing factors to community pharmacists’ burnout during the COVID-19 pandemic. Based on these factors, individual, organizational, and national strategies can be implemented to mitigate burnout in community pharmacists during the pandemic and future emergencies.This work was supported by a student grant (grant number QUST-1-CPH-2021-14) from Qatar University Office of Research and Graduate Studies. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Qatar University

Physiological Changes and Interactions Between Microbiome and the Host During Pregnancy

In recent years, it has become clear that microbiome play a variety of essential roles in human metabolism, immunity, and overall health and that the composition of these microbiome is influenced by our environment, diet, weight, hormones, and other factors. Indeed, numerous physiological and pathological conditions, including obesity and metabolic syndrome, are associated with changes in our microbiome, referred to as dysbiosis. As a result, it is not surprising that such changes occur during pregnancy, which includes substantial weight gain and significant changes in metabolism and immune defenses. The present review relates physiological changes during pregnancy to alterations in the microbial composition at various sites, including the gut, oral cavity, and vagina. Pregnancy has been linked to such microbial changes, and we believe that, in contrast to certain disease states, these microbial changes are vital for a healthy pregnancy, probably through their influence on the mother’s immunological, endocrinological, and metabolic status.This research was funded by Qatar National Research Fund (QNRF), grant number UREP26-104-3-044

Metagenomic Analysis of Oral Microbiome during pregnancy

Pregnancy is a dynamic physiological process associated with significant hormonal, immune and metabolic changes to support the growth and development of the fetus. Several studies have highlighted the role of gut microbiota during pregnancy1. The composition of gut microbiota changes dramatically during the course of pregnancy with an increase in Proteobacteria and Actinobacteria, a decline in butyrate-producing bacteria and a reduction in bacterial richness at the end of pregnancy2. These modifications were anticipated to favour the increased metabolic demand during pregnancy, which will, in turn, support healthy fetal growth3. Gut microbiota has also been suggested to contribute to weight gain during pregnancy via increased absorption of glucose and fatty acids, induction of catabolic pathways, increased fasting-induced adipocyte factor secretion, and stimulation of the immune system2, 4. The oral cavity houses the second most diverse microbiota after the gut harbouring over 700 species of bacteria. Oral microbiota plays a crucial role in maintaining oral homeostasis, protecting the oral cavity and preventing disease development5. Little is known about the role of the oral microbiome during pregnancy. One study examined changes in oral microbiota during pregnancy on Japanese women and found that the total viable microbial counts were higher during pregnancy, as were levels of the pathogenic bacteria Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Candida6. Several studies have also found correlations between oral infections and pregnancy complications, further suggesting mechanisms connecting the oral microbiome with the state of pregnancy7. The Qatari Birth Cohort (QbiC) was successfully developed in July 2018 by Qatar Biobank. It is an epidemiological study that aims to assess the synergetic role of environmental exposure and genetic factors in the development of chronic disease. It monitors the health of women throughout their pregnancy and after birth. The present study is designed to explore changes in the salivary microbiome, using high throughput sequencing during pregnancy and to explore key microbial clades involved in pregnancy

Opinions and experiences on the provision of care to people with mental illnesses: a qualitative study with Doctor of Pharmacy graduates after a rotation in psychiatry.

Pharmacists are vital to optimizing therapy of people with mental illnesses. Limited knowledge, lack of confidence, and mental health-related stigma can lead to pharmacists' reluctance in the provision of pharmaceutical care to this population. Advanced pharmacy practice experiences (APPE) in mental health have been reported as valuable learning opportunities to overcome these challenges. This study aimed to explore PharmD graduates' perceived preparedness, attitudes, beliefs, and opinions on influencing factors for the provision of pharmaceutical care to people with mental illnesses after completing an APPE rotation in psychiatry. All PharmD graduates who had completed a rotation in psychiatry were invited to participate in semi-structured interviews. An interview guide was developed based on a literature review. A total of 11 PharmD graduates agreed to participate in the interviews, which were recorded, transcribed, and analysed inductively using thematic analysis and following a phenomenological approach. Five themes were identified: Prior familiarity to mental health, opinions on the rotation, views on stigma, rotation's areas of improvement, and the positive impact of the rotation on practice. Although participants started the psychiatric rotation with low confidence and a sense of apprehension, they described their experience as unique, eye-opening, and insightful. Familiarity with mental health conditions before the rotation were perceived as a challenge to achieving full confidence in mental health care provision. For the most part, the APPE in psychiatry was viewed as a positive opportunity for enhancing the PharmD graduates' insight, knowledge, and skills for pharmaceutical care provision to people with mental illnesses