Pharmacist-led medication-related needs assessment in rural Ghana

Access to both essential and non-essential medications is increasing worldwide. While increased drug access is a positive development, many countries lack the infrastructure for appropriate distribution, administration, and monitoring of drug therapy. The objective of this study was to assess medication and pharmacy-related needs in the rural Ashanti Region of Ghana and to determine barriers of achieving optimal health outcomes in this region. Qualitative domains and associated themes were identified by observations from integration into community culture and from conduction of semi-structured interviews with local community leaders, health workers, or those with knowledge of health-related issues. Eight semi-structured interviews were completed and four thematic domains were identified; access to care, resource shortages, medication safety, and education/training. Barriers and challenges identified under each thematic domain included (but were not limited to) availability of clean water sources, shortages of medications and diagnostic equipment, financial considerations, misunderstanding of medication indications and directions for use, and shortages of qualified pharmacy or dispensary staff. Most respondents also expressed a need for continuing education and training of healthcare personnel. It can be concluded that there is a need for development of health services related to medications. Locally supported interventions and future research should focus on barriers and challenges identified from the thematic domains

Key challenges for implementing a Canadian-based objective structured clinical examination (OSCE) in a Middle Eastern context

Globalization of medical education is occurring at a rapid pace and many regions of the world are adapting curricula, teaching methods, and assessment tools from established programs. In the Middle East, the use of Objective Structured Clinical Examinations (OSCEs) is rare. The College of Pharmacy at Qatar University recently partnered with the University of Toronto and the Supreme Council of Health in Qatar to adapt policies and procedures of a Canadian-based OSCE as an exit-from-degree assessment for pharmacy students in Qatar. Despite many cultural and contextual barriers, the OSCE was implemented successfully and is now an integrated component of the pharmacy curriculum. This paper aims to provide insight into the adoption and implementation process by identifying four major cultural and contextual challenges associated with OSCEs: assessment tools, standardized actors, assessor calibration, and standard setting. Proposed solutions to the challenges are also given. Findings are relevant to international programs attempting to adapt OSCEs into their contexts, as well as Canadian programs facing increasing rates of cultural diversity within student and assessor populations

Setting the agenda for clinical pharmacy in Qatar: thematic and content analyses of news media headlines

Public awareness of the role of pharmacists and availability of pharmacy services in Qatar is low. As per agenda-setting theory, mass media may be contributing toward this problem by selecting and disseminating headlines and stories according their own objectives and not those of the profession. The objective of this study was to examine the agenda set by mass media organizations in Qatar pertaining to the profession of pharmacy and to determine the frequency of professional identifiers that appear within news headlines. Publicly available news headlines published between November 2016 and November 2018 were obtained from local news websites. Thematic analysis was performed using agenda-setting theory to explore how the public's agenda was set for pharmacy practice in Qatar. Content analysis was used to determine the proportion of headlines that contained a professional identifier linking the news report to the pharmacy profession. A total of 81 headlines were included in the analysis. The agenda for pharmacy practice in Qatar was set according to two themes: achievement and outreach/engagement. Achievement related to awards, use of new technologies, interprofessional education, and novel student training accomplishments. Outreach/engagement reported student and pharmacist involvement upon completion of a health awareness event. Approximately half (47%) of headlines contained a professional identifying word linking the headline to the profession of pharmacy. The findings of this study demonstrate that the mass media's agenda for the pharmacy profession in Qatar does not inform the public of pharmacist's services or expanded scopes of practice. Furthermore, a lack of professional identifiers within headlines likely limits the public's agenda of pharmacist roles. The pharmacy profession must work collaboratively with news media to better align the public's agenda with pharmacists' roles and services

Evaluation of Qatari and Canadian Pharmacy Students Learning Together about Cultural Competency using Videoconference Educational Activities

Background: Pharmacists are under pressure to provide patient centered care within increasingly culturally diverse settings. Pharmacy schools play an important role in educating learners regarding culture and its impact on patient care. Objectives: The objectives of this study were to determine if a novel cultural competency learning activity, which involved students from two culturally and ethnically different pharmacy schools learning together using videoconference education activities, improved: (1) student knowledge and confidence pertaining to cultural competency concepts, (2) attitudes and perceptions towards being a culturally competent pharmacist, and (3) academic performance related to cultural competency case studies. Methods: Pharmacy students from Qatar University in Doha, Qatar (n=25) and the University of Saskatchewan in Saskatoon, Canada (n=85) participated in a cultural competency activity comprised of small group work on a patient case study, followed by tutorial discussions. Some Canadian students (n=31/85) worked collaboratively (via video conference) with the students from Qatar. The evaluation used a convergent mixed methods design comprised of: (1) a pre and post session survey measuring student knowledge and confidence; (2) pre and post session student self-reflections; and, (3) student academic performance on care plans and an observed structured clinical exam (OSCE). Results: The survey identified small but statistically significant (p<0.05) improvements in knowledge and confidence with respect to 11 of the 12 questionnaire items in the students from Canada and 2 of the 12 items in the students from Qatar. The self-reflections found that 44.4% (n=36/81) of students who completed the pre and post reflective questions reported a change in knowledge and attitudes regarding cultural competency, but a reason for the change was not evident. Student grades on the cultural competency care plans and the OSCE were not different between the students who worked collaboratively across the two schools compared with those who did not. Conclusion: The cultural competency student activity showed small improvements in pharmacy student knowledge, attitudes and confidence, but did not affect academic performance. Future research in this area could utilize a greater diversity of methodological approaches, including a focus on student self-reflection and qualitative assessment, to better capture student competency.   Type: Original Researc

Structured Multi-Skill Assessment (SMSA) in pharmacy: A contextual adaptation for authentic assessment for colleges of pharmacy and beyond

There is a need for a contextual adaptation model of the Objective Structured Clinical Examination (OSCE) procedures and assessment methods into diverse contexts with great cultural diversity that is both affordable and achievable. This manuscript aims to describe the principles, organizational structure and theoretical framework of the Structured Multi-Skill Assessment (SMSA), a modified version of the OSCE and a performance-based assessment method developed at the Qatar University College of Pharmacy (QU CPH) that addresses contextual and cultural considerations when used in undergraduate pharmacy curricula

Evidence-based healthcare practice in Qatar: A need to move forward

Evidence-based medicine (EBM) is considered the gold standard approach to therapeutic decision-making in modern medicine. It was first described in the 1990s as a way to improve patient outcomes by promoting rational therapeutic decision-making through translation of high quality clinical studies. 1 It was originally defined as the conscientious, explicit, and judicious use of the best available evidence to make decisions regarding the care of individual patients. 1 By translating results of high quality clinical trials into the therapeutic management of patients, better outcomes can be achieved. 2 Additionally, it allows for standardized therapeutic management of disease and evaluation using audit and feedback. The practice of EBM goes hand on hand with individual clinical expertise and the use of available evidence. The five steps of evidence-based practice are summarized in Table 1. 3 The initial step in the process involves the creation of a specific clinical question, commonly referred to as a PICO (Patient or Problem, Intervention, Comparator, Outcomes) question. Using the elements contained within the PICO question, a systematic search of available evidence would then occur (Step 2). Subsequently, critical appraisal of identified literature occurs with assessment for relevance, internal quality, interpretation of findings and applicability to the patient or problem defined by the original clinical question (Step 3). Finally, the practitioner makes an informed decision based on the evidence identified and appraised (Step 4). While these steps complete the EBM process for patient care, a final stage of evaluation and feedback may occur by auditing individual clinician's practices to benchmark evidence-based practice among peers (Step 5).qscienc

A Course-based Cross-Cultural Interaction among Pharmacy Students in Qatar and Canada

Objective. To develop, implement, and evaluate a course-based, cross-cultural student interaction using real-time videoconferencing between universities in Canada and Qatar. Design. A professional skills simulation practice session on smoking cessation was run for students in Qatar (n=22) and Canada (n=22). Students role played cases in small group situations and then interacted with colleagues from the other country regarding culturally challenging situations and communication strategies. Assessment. Students were assessed on analytical content and communication skills through faculty member and peer evaluation. Cultural competency outcomes were assessed using a postsession survey. Overall, 92.3% of respondents agreed that learning was enhanced through the cross-cultural exchange, and 94.9% agreed that insight was gained into the health-related issues and needs of people from another culture. Conclusion. A course-based, cross-cultural interaction was an effective method to incorporate cultural competency principles into student learning. Future initiatives should increase direct student interaction and focus on culturally sensitive topics

Changes in student perceptions after a semester-long interprofessional education activity in Qatar

AbstractObjectivesInterprofessional education (IPE) is rapidly becoming integrated into university accreditation standards worldwide. However, the impact of IPE on student learning and practice is largely unknown in the Middle East. This report describes a semester-long IPE course-based activity and evaluates student perceptions towards professional roles.MethodsPharmacy and Human Nutrition students from Qatar University completed a 15-week IPE activity that required students to work in groups to complete two assignments after an introductory event. The data were collected during meetings with students and faculty about their overall experience and course assignments. Perceptions regarding professional roles were determined by a pre- and post-reflection questionnaire.ResultsAfter completion of the assignments, fourteen students (37%) noted changed perceptions of themselves, as well as of the other healthcare profession. Twelve of fourteen (86%) noted changes regarding perceptions of the roles of the other healthcare profession, while 2/14 (14%) noted changes regarding perception of their own professional roles. Three of fourteen (21%) reported that their changed perceptions towards IPE were unfavourable. These changed perceptions largely focused on specialised roles of the respective professions.ConclusionsA semester-long IPE experience was deemed beneficial in a Middle Eastern context. Future events and research should focus on fostering collaboration and interprofessional communication to enhance student attitudes and eventual preparation for interprofessional practice

Blood glucose control for patients with acute coronary syndromes in Qatar

Background: Blood glucose is known to be elevated in patients presenting with acute coronary syndromes. However a gap in knowledge exists regarding effective management strategies once admitted to acute care units. It is also unknown what factors (if any) predict elevated glucose values during initial presentation. Objectives: Objectives of the study were to characterize blood glucose control in patients admitted to the cardiac care unit (CCU) in Qatar and to determine predictive factors associated with high glucose levels (>10mmol/l) on admission to the CCU. Setting: All data for this study were obtained from the CCU at Heart Hospital in Doha, Qatar. Method: A retrospective chart review was completed for patients admitted to the CCU in Qatar from October 1st, 2012 to March 31st, 2013, of which 283 were included. Baseline characteristics (age, gender, nationality, medical history, smoking status, type of acute coronary syndrome), capillary and lab blood glucose measurements, and use of insulin were extracted. Time spent in glucose ranges of 10mmol/1 was calculated manually. Univariate and multivariate logistic regression were performed to assess factors associated with high glucose on admission. The primary analysis was completed with capillary data and a sensitivity analysis was completed using laboratory data. Main outcome measure: Blood glucose values measured on admission and throughout length of stay in the CCU. Results: Capillary blood glucose data showed majority of time was spent in the range of >10mmol/l (41.95%), followed by 4–8mmol/l (35.44%), then 8–10mmol/l (21.45%), and finally 10mmol/l on admission (p<0.05) in a univariate analysis but only diabetes remained significant in a multivariate model (OR 23.3; 95% CI, 11.5–47.3). Conclusion: Diabetes predicts high glucose values on hospital admission for patients with ACS and patients are not being adequately controlled throughout CCU stay.Open Access funded by King Saud University. UREP Grant #UREP 13-060-3-014 from the Qatar National Research Fund (a member of Qatar Foundation)