Perspectives of pharmacy students in Qatar toward interprofessional education and collaborative practice: a mixed methods study.

In an IPE environment, students are expected to have better understanding of the roles, responsibilities, and contribution of other health care professions to enhance interprofessional working and collaboration with an end result of improving patient-centred and team-based care. Although many studies have investigated students' attitudes, very few employ a mixed methods design and hardly are from Middle Eastern countries. A two-staged sequential explanatory mixed method design was used to comprehensively capture the perspectives of pharmacy students toward IPE and collaborative practice. A quantitative survey was conducted as the first stage of the study, followed by an in-depth discussion of these perspectives through a qualitative phase by conducting two focus groups. For the quantitative surveys, the overall response rate was 102/132 (77%) for pharmacy students in Qatar. This was followed by two focus groups with a total of 27 participants from senior and junior students. In exploring the qualitative data, three main themes were identified in relation to the pharmacy students' perspectives. These were on the pharmacy students' perception on the enablers (professional related benefits, patient-related benefits and current positive influences), barriers (previous IPE experiences, educational related issues and current working practices and processes), and recommendations to implementing IPE and collaborative practice (future IPE and pharmacy profession). Overall, the results demonstrate a strong readiness and positive perception by pharmacy students toward IPE and collaborative practice. This study has highlighted different dimensions in pharmacy students' perceptions. It also provided a useful insight into the readiness of pharmacy students in a Middle Eastern university. Students are seeking more IPE experiences formally incorporated into their curriculum and hence educators should capitalise on these positive and enthusiastic attitudes to identify the most effective means for delivering IPE and inform curricula planning. Collaborative practice-ready graduates will produce better-educated professionals delivering higher quality care. Please note that the name of this document 'Middle Eastern perspectives of pharmacy students toward interprofessional education and collaborative practice: a mixed methods study.' differs slightly from the published version

Perspectives of practising pharmacists towards interprofessional education and collaborative practice in Qatar.

Background: Healthcare is provided by a variety of different professionals, including pharmacists who are integral members of the team, and all are expected to work collaboratively to provide quality care. Little is known about the perceptions of pharmacists in Qatar towards interprofessional collaboration. Positive attitudes towards interprofessional education are essential to successful implementation of interprofessional collaboration. Therefore, to develop effective collaboration strategies in practice settings, it was essential to survey the attitudes of practising pharmacists towards collaboration. Objective: To explore the awareness, views, attitudes and perceptions of practising pharmacists in Qatar towards interprofessional education and collaborative practice. Setting: Community, hospital and primary healthcare settings in Qatar. Methods: This was a two-staged sequential explanatory mixed method design. It utilised a quantitative survey (Stage 1), based on a modified version of the Readiness for Interprofessional Learning Scale. This was followed by a qualitative stage, utilising focus groups (Stage 2). Main outcome measures: (1) Qatar pharmacists' attitudes towards interprofessional education and collaborative practice; (2) Practising pharmacists' perspectives in relation to enablers, barriers and recommendations regarding interprofessional education and collaborative practice. Results: 63% of the practising pharmacists (n = 178) responded to the survey. Three focus groups followed (total n = 14). High scores indicating readiness and positive attitudes towards interprofessional education were reported for pharmacists working in hospital, community and primary healthcare settings. Qualitative analysis identified three overarching themes in relation to the enablers, barriers and recommendations for practising pharmacists working collaboratively. The enabling themes were: professional and patient related benefits, and current positive influences in Qatar; the barriers were patients' negative perceptions; the status of the pharmacy profession and current working practices and processes; the recommendations related to improving patients' perceptions about pharmacists and enhancing the status of pharmacy profession in Qatar. The findings from this study highlighted two major observations: the lack of existence of collaborative practice and hierarchy and power play. Conclusion Pharmacists demonstrated willingness and readiness to develop interprofessional learning and collaborative practice with significant steps already taken towards improving collaborative working practices in different care settings

A comprehensive systematic review of pharmacy perspectives on interprofessional education and collaborative practice.

Introduction:- Pharmacists are key professionals in the collaborative working process and are integral members of the healthcare team. However, there is paucity of information regarding their perspectives towards interprofessional education (IPE) and collaborative practice. Aims:- The aim of this systematic review is to synthesize, summarise and evaluate the quality of the quantitative and qualitative literature related to the perspectives of pharmacy students, pharmacy faculty and practising pharmacists toward IPE and collaborative practice. The perspectives included their views, experiences and attitudes with a special focus on their perceived benefits and challenges in relation to IPE and collaborative practice. Methods:- An integrated mixed method systematic review was conducted. Four electronic databases were searched for articles published in English between 2000 and 2015. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the studies. Results:- Twenty-nine articles were identified meeting the selection criteria from the first initial search of 8512 articles. Seventeen articles (59%) targeted pharmacy students, 11 articles (38%) focused on practising pharmacists and 1 study (3%) was related to pharmacy faculty. The majority of studies were conducted in the United States (n = 13), were published in the last five years (83%, n = 24) and employed quantitative methods (52%, n = 15). The two commonly used survey instruments to measure the perspectives were: different versions of the RIPLS (35%, n = 6) and the IEPS scale (35%, n = 6). Fourteen of the 29 studies were rated as low quality (MMAT = 25%), eight studies were rated as average quality (MMAT = 50%), four were rated as high quality (MMAT 75%) and three were rated as very poor quality (MMAT 0%). No studies were rated with 100% MMAT quality. Overall, the findings suggest that pharmacy students, practicing pharmacists and faculty valued interprofessional education and collaborative practice and had positive attitudes towards it. Five main findings have been identified from this review: heterogeneity in reporting IPE research, traditional professional image of the pharmacist, lack of longitudinal follow-up, lack of IPE research on faculty and paucity in mixed method studies in terms of quality and numbers. Conclusions:- These findings will provide an opportunity to stakeholders and policy makers to develop and implement IPE activities that are meaningful, comprehensive and unique. Sustained efforts are required not just in undergraduate curricula but also in healthcare settings to improve and promote an interprofessional culture at individual and organisational level

Pharmacy students' attitudes toward pharmaceutical care in Qatar

Objectives: The study objectives were to investigate Qatar pharmacy students' attitudes toward pharmaceutical care (PC), to identify the factors that influence their attitudes, and to recognize their perceived barriers for PC provision. Methods: A cross-sectional and online survey of Qatar pharmacy students was conducted. Results: Over 4 weeks, 46 surveys were submitted (88% response rate). All respondents agreed that the pharmacist's primary responsibility is to prevent and resolve medication therapy problems. Most respondents believed that PC provision is professionally rewarding and that all pharmacists should provide PC (93% and 91% of respondents, respectively). Highly perceived barriers for PC provision included lack of access to patient information (76%), inadequate drug information sources (55%), and time constraints (53%). Professional year and practical experience duration were inversely significantly associated with four and five statements, respectively, out of the 13 Standard Pharmaceutical Care Attitudes Survey statements, including the statements related to the value of PC, and its benefit in improving patient health and pharmacy practitioners' careers. Conclusion: Qatar pharmacy students had positive attitudes toward PC. Efforts should be exerted to overcome their perceived barriers.Scopu

Pharmacy academics' perspectives toward interprofessional education prior to its implementation in Qatar: a qualitative study.

Background: The aim of this study was to explore the perspectives of faculty members and academic administrators, at Qatar University College of Pharmacy, towards interprofessional education (IPE) and collaborative practice by identifying enablers, barriers and resources needed to implement IPE within the pharmacy curriculum. Methods: A qualitative methodology was employed using focus groups discussions. Two focus groups were conducted, one focus group with faculty members (n = 5) and another focus group with academic administrators (n = 5) at Qatar University College of Pharmacy. Focus groups were audio recorded and transcribed verbatim by an independent experienced transcriber and validated by the study principal researcher. Thematic analysis was undertaken to generate key themes and subthemes. Results: The study participants highlighted a number of enablers and challenges encountered as a result of the initial IPE events, for integrating IPE into the pharmacy curriculum. Many provided recommendations and suggestions for effective implementation of IPE. Analysis of the results focused on three main categories: enablers, barriers and recommendations. Overall, seven major themes were identified: 1) intrinsic enabling factors (initial IPE experiences, cross-appointed faculty, accreditation); 2) extrinsic enabling factors (national policy & legislation and advances in pharmacists’ role); 3) student related benefits (roles & responsibilities and agents for change); 4) student hindering factors (student engagement, perceptions & attitudes and gender issues); 5) partnering academic institutions (logistical issues, familiarity with other curricula and commitment); 6) practice environment (hierarchy, healthcare professionals’ attitude and lack of collaborative practice) and 7) IPE delivery (dedicated structure, IPE curriculum and extrinsic support). Conclusion: Pharmacy academics had positive perceptions towards IPE suggesting a high level of support and readiness to pursue IPE and an opportunity for pharmacy academics to drive the IPE agenda forward in Qatar. However, a number of challenges were reported. These are important to consider to ensure the development of effective strategies for the integration and enhancement of IPE and collaborative practice

Interprofessional education in the Arabic-speaking Middle East: perspectives of pharmacy academics.

The current status of interprofessional education (IPE) in Arabic Middle Eastern countries is largely unexamined and there is a need to assess IPE and collaborative practice in these countries. As faculty attitudes towards IPE are believed to be one of the main factors that affect the successful integration of IPE into the different healthcare curricula, this article aims to explore the attitudes and views of pharmacy academics in Arabic-speaking Middle Eastern countries towards IPE and collaborative practice. The findings from this article are part of a larger study investigating pharmacy’s perspectives of IPE and collaborative practice in Qatar and the Middle East. An online survey which included three validated scales was used to gather information from pharmacy academics at 89 pharmacy schools in 14 countries. The response rate was 107 out of 334 (32%) and the majority of the respondents were from Jordan, Qatar, Lebanon, and Saudi Arabia. Statistical analysis was completed descriptively as well as inferentially using a series of independent t-tests. Overall pharmacy academics had positive attitudes towards IPE. The majority of the respondents, 90.8% (n=99), perceived IPE to be important. Age, likelihood to engage in IPE, and years of IPE experience were the factors that were related to faculty members’ attitudes towards IPE. Highly perceived barriers for implementing IPE included cultural challenges for each profession, scheduling common courses, and activities in addition to limited resources. The study findings indicated that pharmacy academics in the Middle East are ready to pursue IPE. These results can serve as impetus for implementing IPE in Middle Eastern countries

Prescribing patterns of antihypertensive medications: A systematic review of literature between 2010 and 2020

Background: Hypertension has affected over 1.13 billion people worldwide in 2015 and it's one of the most preventable risk-factors for morbidity and mortality. Antihypertensives significantly reduce cardiovascular risks. Several studies on antihypertensives' prescribing patterns were conducted worldwide, and guidelines were developed on hypertension management. However, no systematic reviews were conducted globally to synthesize the evidence from these studies. This review aims to evaluate antihypertensives' prescription patterns, and adherence to international guidelines for hypertension management worldwide. Methods: Full-text antihypertensives' prescribing patterns evaluation studies were included. Reviews, commentaries, guidelines, and editorials were excluded. Various databases were searched including PubMed, Embase, and others. Studies were limited to English only and to articles published from (01/01/2010) to (20/03/2020). Crowe Critical Appraisal Tool (CCAT) was used for quality assessment. Results: The most commonly prescribed antihypertensives as monotherapy in adult patients with no comorbidities were ACEIs/ARBs (Angiotensin converting enzyme inhibitors/Angiotensin receptor blockers), followed by CCBs (Calcium channel blockers), and BBs (Beta Blockers). Most commonly prescribed dual combinations were thiazide diuretics+ACEIs/ARBs, BBs + CCBs and CCBs+ACEIs/ARBs. Among diabetic patients, the most common agents were ACEIs/ARBs. Among patients with heart diseases, CCBs were prescribed frequently. While patients with kidney diseases, CCBs and ARBs were most prescribed. Of the 40 studies included in the review, only four studies directly assessed the prescribing patterns of antihypertensives in adherence to clinical practice guidelines. And only two studies confirmed adherence to guidelines. Furthermore, the quality of the majority of studies was moderate (50%), while 25% of articles were reported as either high or low quality. Conclusion: This review revealed that there are areas for improvement for prescribing practices of antihypertensives in concordance with the latest evidence and with clinical practice guidelines.This work was supported by a student grant (grant number QUST-2-CPH-2020-20 ) 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.Scopu

A Middle Eastern journey of integrating Interprofessional Education into the healthcare curriculum: a SWOC analysis

Interprofessional education (IPE) is an emerging concept in the Middle East with a number of health professional degree programs continually striving to meet international accreditation requirements to enhance the quality of education and ensure high standards are maintained. Using the College of Pharmacy at Qatar University (CPH QU) as a model, this article describes the IPE initiatives coordinated through the College's IPE Committee, with representation from fourteen programs at four Healthcare institutions: Qatar University; Weill Cornell Medical College in Qatar; the University of Calgary in Qatar; and the College of North Atlantic in Qatar. These activities are based on the model proposed by the University of British Columbia across the different pharmacy professional years. Learning objectives for these initiatives were selected from the IPE shared competency domains and competency statements developed for Qatar context. A meeting with six faculty members, who have been instrumental to designing and executing the IPE activities in the previous 2 years, was convened. Faculty members reflected on IPE activities and collaborations with other participating programs. A structured SWOC (Strengths, Weaknesses, Opportunities, Challenges) framework was used to guide discussion. The discussion was recorded and notes were taken during the meeting. Raised points were categorized into each SWOC category for the final analysis. Implementation of IPE program is a major undertaking with a number of challenges that require invested time to overcome. This article highlights the importance of incorporating IPE into healthcare curricula to graduate students ready for collaborative practice in the workforce. Learning objectives for IPE initiatives need to be based on shared competency domains. When developing and implementing an IPE program it is necessary to align activities under a strong theoretical framework. This should be done under the leadership of an IPE steering group or committee to oversee the integration of IPE into the healthcare curriculum. The article presents many lessons learned through IPE implementation that are relevant to other academic institutions keen to incorporate IPE into their programs and also provides a successful model for integrating IPE into healthcare curricula

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

Public attitudes towards community pharmacy in Arabic speaking Middle Eastern countries: A systematic review

BackgroundOver the last few years, pharmacy practice in the Arab regions of the Middle East has started to change and develop. There have been small but promising steps to recognize the importance of extending community pharmacists’ roles to meet the expanding public healthcare demands. ObjectivesThis systematic review aims to identify, synthesize and assess the quality of the literature in the Middle East concerning public attitudes on community pharmacist role and services and in relation to public perceptions on strategies to improve pharmacy services and the image of community pharmacist. MethodsA systematic search of 11 electronic databases was conducted to identify all published relevant studies from inception till January 2020. Data was extracted using a designed and tested tool. Studies were assessed for quality using Crowe Critical Appraisal Tool. ResultsThe final study results included 36 studies of which 31 adopted a cross-sectional-survey-based design. Included studies were published between 2004 and 2019. Most studies were done in Saudi Arabia (n = 11) or the United Arab Emirates (UAE) (n = 10). We identified four overarching themes across included studies 1) Use of Community Pharmacies; 2) Attitudes towards Community Pharmacist role; 3) Attitudes towards Current Community Pharmacy Services and 4) Strategies to Improve Community Pharmacy Practice. The most common reason for visiting a community pharmacy was to purchase a prescription or over-the counter-medication. The most common factors that affected patients’ choice of a particular pharmacy included convenient pharmacy location, availability of a good range of products or medicines, friendliness of the pharmacy staff and convenient pharmacy opening hours. There was a general public perception of community pharmacist as a business oriented person. Expectations of pharmacist duties included treatment of minor health ailments, consultation on over-the-counter medications and parapharmaceutical products, and accuracy checking of dispensed medications. Overall satisfaction with community pharmacy varied between the studies and ranged from 33% to 67.1%. Most commonly reported recommendations to improve pharmacy practice were provision of diagnostic, screening and monitoring services, keeping patient records in the pharmacy, advice on minor illness and provision of a private area for consultation. Seven articles were considered of low quality and 13 articles were considered of high quality. ConclusionsWhile the public in the Middle East has a good understanding of the basic duties of a community pharmacist, there is lack of awareness of advanced pharmaceutical services. Decision makers in Middle Eastern countries should set strategies to improve community pharmacist professional image and competence beyond medication dispensing.This work was funded by Qatar University, Qatar Student Grant (QUST-1-CPH-2019-4)