Social media guidelines: recommendations for the development of undergraduate pharmacy student guidelines.

Background and Objective: The ubiquitous nature of social media (SoMe) involves merging of personal-professional personas. Healthcare organisations publish guidance on how to use social media responsibly. However, inappropriate use of social media continues to be evident amongst undergraduate pharmacy students with potential implications for their fitness to practise. There is evidence of a lack of understanding of how online behaviour, or e-professionalism, relates to the student code of conduct. There remains a need within the pharmacy undergraduate student population for guidance which will be similarly acceptable and directly applicable to their context. Objective: to develop peer-group designed recommendations for pharmacy student SoMe guidelines. Design: Qualitative, activity-based focus groups were conducted based on a topic guide informed by existing literature and a previous study by the research team. The topic guide also formed the framework for thematic data analysis. The study was approved by university Ethical Review Committee. Results: Focus groups were conducted across four Master of Pharmacy (MPharm) stages (S1: n=10; S2: n=5; S3: n=8; S4: n=6). All except one participant (n=29) were aged under 24 with near equal male:female ratio (n=15:14). The majority of participants did not use SoMe guidelines despite daily SoMe use, but rather used personal judgement to decide on appropriate SoMe content. Some elements of existing guidance were seen as valuable but lacked balance of content/tone and examples of appropriate SoMe behaviours. There was no agreement on 'appropriate behaviours' however general concerns emerged around guidance impinging personal personas and impacting perceptions of e-professionalism. Conclusion: Social media guidelines for undergraduate pharmacy students should address concerns surrounding eprofessionalism. These should include examples of good practice, yet should contain clear 'points for practice' in a simple, user-friendly format alongside a lecture or video presentation. Whilst students were aware of profession-specific guidance, student-specific guidance was viewed as beneficial to support undergraduate students, in particular with the blurred boundaries between personal-professional personas. The results of this study have been used to inform the delivery of SoMe support for students within the MPharm course. Further work is being undertaken to explore the definition of appropriate online behaviours and provision of guidance as part of doctoral studies

An exploration of factors influencing health managers' acceptance of eHealth services in the Kingdom of Saudi Arabia.

Kingdom of Saudi Arabia (KSA) is a country with one of the largest land masses and difficult geographical terrain in the Middle East. The accessibility of advanced health services, especially for people in rural areas, has been considered one of the main health challenges. Health services across the country are accessible through three categories of providers. The Ministry of Health (MOH) which is the dominant health provider responsible for 60% of all health services and facilities. Private health sector and other government run health authorities are the providers for the remaining 40%. Many initiatives to embrace technology in healthcare were launched by the MOH to advance the level of acceptance. One of the initiatives was the ambitious eHealth national strategy which was launched in 2011 to govern eHealth projects across the country and set consistent standards, policies, and procedures for the practice activities. This study is sponsored by the MOH as part of a bigger plan to involve stakeholders in the digital transformation

Community pharmacist clinical portal enabled access to aspects of patients' primary and secondary care EHR: exploring the general public's views in NHS Tayside.

Background and Objective: Community pharmacist access to aspects of patients' primary and secondary care electronic healthcare records (EHR) was piloted in NHS Tayside, Scotland. While policy makers and pharmacists are largely in favour of community pharmacist access, and there is an unmet service need based on GP workforce-workload evidence, the general public's perspectives of pharmacist EHR access had yet to be explored in Scotland. Objective: to determine the general public's perspectives of community pharmacist EHR access in NHS Tayside. Design: A survey methodology using paper-based questionnaires posted to a random sample of the general public in NHS Tayside (March-May 2017). Quantitative data were analysed using descriptive statistics (IBM SPSS version_21_). The study was approved by university Ethical Review Committee. Results: Of 1000 surveys distributed, 205 returned, (27 undeliverable), providing a response rate of 21%. Although some were unsure (23%; n = 47/203), most indicated their community pharmacist would be better able to recognise problems with medicines/healthcare given access to patients' EHR (63%; n = 127/203), knew why each medicine was prescribed (74%; n = 150/203), and thought that a long-term condition would make access to patient records essential (73%; n = 148/203). Few respondents were against/were non-committal on community pharmacists having read or read-and-write access to EHR. For example, the Emergency Care Summary (ECS) (13%; n = 27/201) where, if access were permitted, respondents preferred that consent should not be required on each and every occasion: ECS (73%; n = 148/203). Many felt access to patients' EHR would mean the pharmacist was better informed so could provide better care (68%; n = 136/200) and that mistakes were less likely to happen (71%; n = 142/200). Conclusion: Findings from this survey recognised community pharmacists could contribute more to improving patient care and safety, as part of the wider healthcare team, if they were better informed through access to patients' EHR. Enabling treatment of common clinical conditions in community pharmacy brings benefits to patients while reducing pressure on GP appointments. While there remain areas of uncertainty, and this is a small albeit representative sample from one area in Scotland, this study demonstrates support for community pharmacist access to patients' EHR with a preference for a simplified consent process

廣東的土紙業

中國的製紙術，發明了二千多年。但是她今日的製紙法，有許多地方，依然與西方各國，大大相反。製紙手續雖然所差無幾，原理幾乎是一樣，但是說到速率，中國紙工，看見外國製紙要快到可驚，正如西洋紙工，看見中國製紙，慢得好笑。然而中國製紙，雖然是慢，製品種類，雖然不多，但是看一看這種手工製紙法之精微完善，製成紙張之華麗齊一，恐怕無論那一個人，免不得發生一種欽佩羨慕底情緒

General public awareness and views of community pharmacy in Scotland: the 'first port of call' study.

The recently published ‘Achieving Excellence in Pharmaceutical Care: a Strategy for Scotland’ urges community pharmacy (CP) to make itself the ‘first port of call’ for healthcare advice. The aim of this research is to explore the Scottish general public's awareness of CP services and their openness to consider CP their ‘first port of call’ for healthcare advice

Scottish adherence to antihypertensive medication in the elderly: promoting evidence-based community pharmacy services.

Background and Objective: Detection and treatment of hypertension continues to be a major public health challenge affecting between 30 and 45% of the general population, increasing steeply with age. Many studies have shown the benefit of antihypertensive agents in improving clinical outcomes. However, their effectiveness is dependent on persistent adherence to prescribed medication. Objectives (1) to assess adherence to antihypertensive medication; (2) to examine patient-specific factors associated with antihypertensive medication adherence among Scottish adults aged 65 years plus. Design: Pre-registration pharmacy trainees (pre-regs) undertaking postgraduate placement-in-practice based in community pharmacies across Scotland were invited to take part. Each pre-reg invited and consented up to 15 patients (aged 65 plus; at least one prescribed medication) presenting with a prescription which indicated treatment for hypertension, to take part in a telephone interview. Pre-regs added pharmacy dispensing data to a paper-based structured data collection tool for later online data entry. The structured interview focused on patient's beliefs about medicines and medication adherence. The study had NHS ethical approval. Results: Of the 130 pre-regs working in community pharmacy in Scotland 92% (n=119) took part with a patient-participant response rate of 75% (n=1332). 94% of respondents always-or-often strive to follow doctor's instructions and have a strict routine for use of their regular medicines. 87% rarely-or-never get confused about their medicines. 78% of respondents believed their medication prevented them becoming ill; unpleasant side effects were reported by 8%. 93% said taking medication did not disrupt their life. Respondents had visited a medical practice twice in previous 6 months. 69% reported normal blood pressure. 49% of respondents had previously smoked daily; 13% currently smoke. Conclusion: The SAAME study provides strong evidence of patients adhering to antihypertensive medication, also a model for promoting evidenced-based community pharmacy services: public health data year-on-year; raise the profile of clinical research in community pharmacy services. Feedback suggests pharmacies have concerns about telephone interviews preventing calls coming in so would prefer the option of face-to-face interviews; also direct online entry of data, and; online consent forms for the pre-regs. Future research is planned around evaluating pre-reg engagement, training needs, impact on community pharmacy based tutors and staff

An initial exploration of the perceptions of preparedness to practise among Saudi Arabian trained hospital pharmacists

Background: There is a dearth of literature on perceptions of preparedness to practise, which explores the extent to which educational institutions prepare their students to fulfil their professional role. Objective: The aim of this study was to explore perceptions of preparedness to practise among Saudi Arabian pharmacy graduates working in hospital. Method: Face-to-face, semi-structured interviews were conducted with ten hospital pharmacists based in four hospitals in the Eastern Province of Saudi Arabia who had qualified within the last five years from a Saudi Arabian School of Pharmacy. Interviews focused on expectations of hospital practise, perceptions of preparedness and challenges encountered, and reflections on how to better prepare students. Interviews were audio-recorded, transcribed and analysed thematically by two independent researchers using the Framework Approach. Results: Five key themes were identified: expectations versus reality of practise; issues relating to university course; practice related training; adapting to the work environment; and proposed improvements to undergraduate education. Participants were generally disappointed to find practise was not as expected. University training was largely didactic, with skills such as critical thinking not being sufficiently developed. Where practice related training was provided, it was variable in length and content. Cultural issues, most notably working in a mixed sex environment, were also considered to impact preparedness. Suggested improvements included greater focus on skills development and structured training placements. Conclusions: Participants experiences in university, and experiential placements varied greatly and were perceived to impact greatly on preparedness to practise. Further multiple perspective exploration of perceptions of preparedness to practise is warranted

An evaluation of mental health clinical pharmacist prescribers within primary care medical practices in NHS Highland.

Background: A pilot has been conducted during which a specialist mental health clinical pharmacist prescriber (SMHCPP) consulted with patients by appointment at one of two GP Practices. Purpose: To evaluate the SMHCPP delivered pharmaceutical care to patients with anxiety disorders and/or depression in NHS Highland. Methods: Both pharmacists handed out a study pack to patients. Patient study packs included a questionnaire based on the CARE Measure plus 5-point Likert scale attitudinal statements all subject to statistical analysis. Ethical approval had been gained. Results: Eleven of 70 surveys were returned (response rate 16%) with an even gender split. Most were employed (n=9). Wellbeing was good (n=3), fair (n=6) or poor (n=2). All (n=11) thought the pharmacist excellent at 'making you feel at ease', 'really listening', 'being interested in you as a whole person', 'showing care and compassion', 'being positive', 'explaining things clearly'. Most said the pharmacist was excellent at 'letting you tell your story' (n=10), 'fully understanding your concerns' (n=10), 'helping you take control' (n=9) and 'making a plan of action with you' (n=8). All (n=11) strongly agreed/agreed they were 'confident that a pharmacist will prescribe as safely as a GP' also that they wanted their 'pharmacist and doctor to work together to make sure I am receiving the best treatment'. However, 'given the choice, I prefer to consult a GP rather than a pharmacist' half (n=5) were unsure, some strongly agreed (n=1)/agreed (n=1) but others strongly disagreed (n=2)/disagreed (n=2). Conclusions: Overall, this small sample from a difficult to reach population were positive about care they received from the SMHCPP