Australian pharmacists' perceptions and practices in travel health

Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area

Knowledge, attitudes, and practices of Australian oncology health professionals on complementary medicines

Background: Approximately half of people with cancer are using complementary and alternative medicine (CAM), presenting safety concerns due to potential interactions with conventional cancer treatment. Oncology staff have a role to play in ensuring the safe use of CAMs and so, this study examined their knowledge, attitudes, and practices regarding CAMs. Aim: This study aimed to assess the knowledge, attitudes, and practices of Australian doctors, nurses, and pharmacists regarding CAM use in oncology. Method: Members of three national oncology professional associations took part in an online questionnaire, which determined their knowledge, attitudes, and practices regarding CAM. Results: Ninety-nine completed surveys were obtained from nine doctors, 70 nurses, and 20 pharmacists. Most respondents (68.4%) felt that they did not have adequate knowledge of CAMs to respond to patients' questions. Assessment of attitudes found respondents generally believed that CAMs have a complementary role in oncology but indicated their concerns for the safety of patients. Respondents indicated in practice they would discuss CAMs with less than half of patients (40.6%), with a lack of scientific data and guidelines for CAM use presenting significant barriers to these discussions. Conclusion: Our study suggests that oncology health professionals' knowledge of CAMs potentially leads to a lack of confidence in providing advice to patients and concerns for patient safety. This impacts their discussion of CAMs and lack of disclosure from patients about their use of CAMs. Education on CAMs in oncology would assist in increasing professionals' confidence in discussing these therapies, leading to increased patient disclosure of CAMs and safer treatment decision making for people with cancer

Perspectives of Complementary and Alternative Medicine use by cancer patients in a regional hospital in North Queensland, Australia

Objectives: This study aimed to investigate CAMs used, and reasons for and disclosure of this use by cancer patients in a regional hospital in North Queensland, Australia. Methods: Patients attending the Day Oncology Unit of the Townsville University Hospital were invited to participate in a self-completed questionnaire or telephone interview regarding perspectives of their CAM use. Data were analysed using descriptive statistics and chi-squared and independent t-tests were performed to allow comparison between the responses by CAM users and non-users. Results: 102 completed questionnaires were used in the analysis, where 40.2 % of respondents were found to be using some form of CAM. Cannabis, magnesium, and massage were the most prominent therapies used, with cannabis use in cancer, not commonly reported in prior literature. The main reasons given for using CAM were to treat symptoms of cancer, side-effects of treatment or to improve general health. Two-thirds of these respondents disclosed their CAM use to health professionals mostly to obtain a professional opinion or due to concerns of interactions with cancer treatment. CAM users were statistically more likely to have used CAM prior to their cancer diagnosis and have lower emotional wellbeing than non-users. Non-CAM users indicated that a lack of knowledge of CAM or concerns regarding interactions with cancer treatment were the most popular reasons for not adopting these therapies. Conclusion: While lower than the averages of previously published CAM use, our study highlights that there is still a significant group of cancer patients in the North Queensland region using CAMs

An Examination of Celtic Craft and the Creative Consciousness as a Contribution to Marketing Creativity

Examination of the Celtic craft sector identifies a creative form of marketing which has its foundations in imagination, intuition and innovation, rather than the linear prescriptions of formal marketing frameworks and language which still dominate contemporary marketing management texts. The creative marketing competencies identified in the sector are also grounded within a wider creative marketing paradigm where experimental forms of marketing are encouraged, postmodern ideals are embraced and artistic philosophy and practice encouraged. The controlled Saxon influenced Marketing Establishment is challenged by the freer, more creative fringe of Celtic marketing as the avant garde

Assessing the Travel Health Knowledge of Australian Pharmacists

Worldwide, the numbers of travellers are increasing, with pharmacists having the potential to play a significant role in the provision of pre-travel health services to a large number of these travellers. However, studies examining whether pharmacists have the travel health knowledge to provide these services are limited. This study thus aimed to explore the travel health knowledge of Australian pharmacists. Surveys assessing pharmacists’ knowledge of travel health were distributed through the Pharmaceutical Society of Australia and community pharmacies for self-completion. Overall, the travel health knowledge of participants was found to be good. However, although the majority of participants were aware of the common causes of morbidity and mortality in travel health, some slightly overestimated the prevalence of malaria and were less knowledgeable about the global distribution of some diseases. Most participants also demonstrated an ability to give appropriate advice on the management of traveller’s diarhoea, the selection of appropriate items for inclusion in travel first aid kits, vaccinations, and malarial chemoprophylaxis for travellers visiting endemic areas. This study highlights that Australian pharmacists have the knowledge to deliver travel health advice, with the potential to improve both access and outcomes for travellers

Pharmaceutical care model to assess the medication-related risks of travel

Background: People are at greater risk of health problems when travelling and a significant number of travel-related health problems are associated with the effects of travel on pre-existing chronic diseases. Medications play a key role in the management of these conditions. However, there is a notable lack of research evaluating the potential medication-related risks associated with travel.\ud \ud Objective: To apply a systematic pharmaceutical care model developed to evaluate potential pharmaceutical risks (PPRs) and pharmaceutical care issues (PCIs) in travellers.\ud \ud Setting: Adult travellers leaving Cairns International Airport, Australia, for an international destination.\ud \ud Method: A cross-sectional survey using semi-structured interviews, including a systematic medication history, followed by the application of a pharmaceutical care model to evaluate each participant for PPRs and PCIs. \ud \ud Main outcome measure: Evaluation of standard clinical and travel-related PPRs and PCIs. \ud \ud Results: Medications for chronic diseases were being taken by 47.7% of the 218 travellers interviewed. Although 75.2% of participants presented with no PPRs, a total of 274 PCIs were identified across 61.5% of the participants, with an average of 2.04 PCIs per participant. The most prevalent PCIs related to the inadequate precautions taken by some travellers visiting malaria-endemic regions. Although 91 participants recognised that they were travelling to malaria-endemic regions, 65.9% of these participants were not using malarial chemoprophylaxis, and only 16.5% were using chemoprophylaxis that fully complied with standard recommendations. The second most prevalent PCI was the need for 18.8% of participants to be educated about their medications. Other PCIs identified have the potential to increase the risk of acute, travel-related conditions, and complicate the care of travellers, if they inadvertently became unwell while overseas. \ud \ud Conclusion: PPRs and PCIs were not identified in all participants. However, the impact of many of the identified medication-related issues could be substantial to the traveller. This study represents the novel application of a pharmaceutical care model to identify potential PPRs and PCIs in travellers that may not be identified by other pre-travel risk assessment methods

Knowledge, attitudes and practices of health professionals toward complementary and alternative medicine in cancer care–a systematic review

Background: Cancer patients’ disclosure rate of their complementary and alternative medicine (CAM) use to health professionals is low, mainly attributed to health professionals’ attitude toward CAM. Thus, we aimed to identify and compare the knowledge, attitudes and practices of doctors, nurses and pharmacists regarding CAM use in cancer patients. Method: The databases AMED, CINAHL, Embase, Emcare, Medline, PubMed, Scopus and Web of Science were searched for surveys of health professionals published between 2008 and 2020. Results: The knowledge of CAM in cancer care was generally poor for all three professions in the included studies, although how knowledge was assessed showed large variability. Doctors were found to dismiss or discourage CAM use out of concerns for side-effects and interactions. Nurses were generally positive and supportive toward CAM use by cancer patients. Pharmacists were neutral toward CAM, but believed they should be a reliable source of information for patients. All professions felt a major barrier to discussions with patients about CAMs was a lack of evidence of their safety and efficacy. Studies of all three professions also showed a general desire for more education regarding CAM. Conclusions: The review suggests that doctors, nurses and pharmacists may lack appropriate knowledge to inform CAM use in a cancer care setting, which determines their attitude, influences practice and potentially impacts patient outcomes. Our findings indicate that increased access to research-based education on CAM would strengthen health practitioners’ confidence in discussing CAM with cancer patients, which would lead to more disclosure and safer therapeutic decision making

Complementary and alternative medicine use in cancer: a systematic review

Background and purpose: Complementary and alternative medicine (CAM) use in cancer is increasing. The purpose of this study was to systematically review the literature to determine demographic profiles and prevalence and reasons for use in cancer patients. Methods: In this systematic review, the databases OVID, PubMed, and Scopus were searched for studies on CAM use in cancer between 2009 and June 2018. Results: The results showed that an average of 51% of cancer patients used CAM. Common independent demographic characteristics associated with CAM use were younger, female cancer patients, having higher education, earning a higher income and having previously used CAM. Frequent reasons for use, grouped into themes were shown to be to influence their cancer and general health and to treat complications of the cancer or therapy. Conclusion: The review provides an insight and will serve to better inform health professionals on how this population is using CAM

Australian pharmacists' perceptions and practices in travel health

Worldwide, pharmacists are playing an increasing role in travel health, although legislation and funding can dictate the nature of this role, which varies from country to country. The aim of this study was to explore the current and potential future practices in travel health for pharmacists in Australia, as well as the perceived barriers, including training needs, for the provision of services. A survey was developed and participation was sought from a representative sample of Australian pharmacists, with descriptive statistics calculated to summarise the frequency of responses. A total of 255 participants, predominantly female (69%), below 50 years (75%) and registered less than 30 years completed the survey. Although over two-thirds (68%) provided travel-related advice in their current practice, the frequency of advice provision was low (less than 2 travellers per week) and limited to responding to travellers questions. Although Australian pharmacists are currently unable to administer travel vaccines and prescription only medications without prescription, they still consider travel health to be an appropriate role and that their clients would seek travel health advice from pharmacies if offered. Currently, key roles for Australian pharmacists are advising travellers who do not seek advice from other practitioners, reinforcing the advice of other health practitioners and referring travellers needing vaccinations and antimalarials. In order to expand these services, the barriers of workload, time, staffing and the need for training in travel health need to be addressed. In summary, the travel health services provided by pharmacies in Australia still have a way to go before they match the services offered by pharmacies in some other countries, however Australian pharmacist are keen to further develop their role in this area