Under-Reporting of Adverse Drug Reactions in Finland and Healthcare Professionals’ Perspectives on How to Improve Reporting

Background: Adverse drug reaction (ADR) reporting has been studied relatively extensively in all the Nordic countries besides Finland, but no definitive solution to decrease under-reporting has been found. Despite many similarities in reporting, the most notable difference compared to other Nordic countries is that ADR reporting is completely voluntary in Finland. Purpose: The purpose was to examine if voluntary reporting influences healthcare professional (HCP) ADR reporting, why HCPs do not report all suspected ADRs, how could reporting be enhanced, and do we need to develop the process for collecting ADR follow-up (F/U) information from HCPs. Methods: An open and anonymous questionnaire was developed and made available online at the e-form portal of the University of Helsinki. Trade and area unions distributed the questionnaire to their respective member physicians, nurses, and pharmacists. Two independent coders performed the content analysis of answers to open-ended questions. Results: A total of 149 responses was received. Two fifths (38%) of the HCPs confirmed that they had not always reported suspected ADRs. The main reason for not reporting was that the ADR was already known. HCPs who had no previous ADR reporting experience did not report ADRs mainly because it was not clear how to report them. Seriousness (chosen by 76%) and unexpectedness of the reaction (chosen by 64%) were the most actuating factors in reporting an ADR. Only 52% of the HCPs had received ADR reporting training and only 16% of the HCPs felt that they had enough information about reporting. Most HCPs felt that ADR F/U requests are justified, and these requests did not affect their ADR reporting willingness. Conclusions: As in other Nordic countries, ADR under-reporting occurs also in Finland despite differences in reporting guidance. ADR reporting rate could be enhanced by organizing recurring training, information campaigns, and including reporting reminders to the patient information systems that HCPs use. Training should primarily aid in recognizing ADRs, educate in how to report, and promote a reporting culture among HCPs

A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children

Oral drug administration to pediatric patients is characterized by a lack of age-appropriate drug products and the off-label use of medicines. However, drug administration practices at hospital wards is a scarcely studied subject. The aim of this study was to explore the oral drug administration practices at pediatric hospital wards, with a focus on experiences and challenges faced, methods used to mitigate existing problems, drug manipulation habits, perceptions about oral dosage forms and future needs of oral dosage forms for children. This was a qualitative study consisting of focus group discussions with physicians, nurses and clinical pharmacists in a tertiary university hospital with the objective of bringing forward a holistic view on this research topic. These healthcare professionals recognized different administration challenges that were classified as either dosage form-related or patient-related ones. A lack of depot formulations developed especially for children as well as oral pediatric dosage forms of drug substances currently available as intravenous dosage forms was recognized. The preferred oral dosage forms were oral liquids and orodispersible tablets. Patient-centered drug administration practices including factors facilitating drug administration both at hospital wards and at home after patient discharge were identified. Among all healthcare professionals, the efficient cooperation in drug prescribing and administration as well as in educating the child’s caregivers in correct administration techniques before discharge and improving the overall discharge process of patients was emphasized. This study complements the prevalent understanding that new dosage forms for children of varying ages and stages of development are still needed. It also brings a holistic view on different aspects of oral drug administration to pediatric patients and overall patient-centered drug administration practices

Fostering Performance in Hands-On Laboratory Work with the Use of Mobile Augmented Reality (AR) Glasses

The learning of laboratory skills is essential in science education, but students often get too little individual guidance in this area. Augmented reality (AR) technologies are a promising tool to tackle this challenge and promote students’ high-level learning and performance in science laboratories. Thus, the purpose of this study was (1) to design an AR-assisted learning environment to support individual knowledge construction, (2) to investigate students’ learning processes and learning outcomes and (3) to examine the usability of the system. Pharmacy students (n = 16) were assigned to experimental (n = 10) and control (n = 6) groups and performed the same laboratory work together with pre- and post-tests. The experimental group worked with AR glasses that provided additional support and timely guidance during the work with additional info-screens, questions related to choosing correct reagents and laboratory tools and think-aloud questions, whereas the control group worked in a traditional laboratory context. The results showed that AR was more effective in fostering performance in the science laboratory compared to traditional laboratory instruction and prevented most of the mistakes. The AR group considered the guidance and feedback provided by AR to be beneficial for their learning. However, no apparent differences were found in tasks measuring students’ understanding of the content knowledge. Thus, an AR environment embedded with supportive tools could partly replace the teacher in science teaching laboratories by providing individual and timely guidance for the students

Design and Usability Testing of an Augmented Reality (AR) Environment in Pharmacy Education—Presenting a Pilot Study on Comparison between AR Smart Glasses and a Mobile Device in a Laboratory Course

An essential feature of pharmacy education is the teaching of theoretical knowledge with the support of practical work in the laboratory. When properly utilized, laboratory activities have the potential to enhance students’ achievement, conceptual understanding, and positive attitudes towards learning. In this pilot study, an augmented reality (AR) environment was designed and introduced for teaching laboratory skills in pharmacy education at the university level. The AR environment was used by pharmacy students (n = 36), featuring gate questions, information screens, Quick Response codes, think-aloud questions, and instant feedback. The environment was utilized with smart glasses and mobile devices with the aim of comparing the support to students’ performance. User experience was evaluated through self-efficacy beliefs and anxiety towards the technology. As a result, students found the environment a useful supplement to traditional laboratory teaching. Smart glasses and mobile devices were both accepted with great positivity but neither being clearly preferred over the other. Smart glasses were noted to provide sufficient feedback in the right stages of work. In contrast, mobile devices promoted the learning process more than the smart glasses. The self-efficacy results for mobile device use were higher, especially related to device handling and operating the AR environment. The pilot study gives educators valuable insights on the usability of AR technology in guiding laboratory tasks, although future work should involve larger and more diverse samples, as well as different learning tasks

Fostering Performance in Hands-On Laboratory Work with the Use of Mobile Augmented Reality (AR) Glasses

The learning of laboratory skills is essential in science education, but students often get too little individual guidance in this area. Augmented reality (AR) technologies are a promising tool to tackle this challenge and promote students’ high-level learning and performance in science laboratories. Thus, the purpose of this study was (1) to design an AR-assisted learning environment to support individual knowledge construction, (2) to investigate students’ learning processes and learning outcomes and (3) to examine the usability of the system. Pharmacy students (n = 16) were assigned to experimental (n = 10) and control (n = 6) groups and performed the same laboratory work together with pre- and post-tests. The experimental group worked with AR glasses that provided additional support and timely guidance during the work with additional info-screens, questions related to choosing correct reagents and laboratory tools and think-aloud questions, whereas the control group worked in a traditional laboratory context. The results showed that AR was more effective in fostering performance in the science laboratory compared to traditional laboratory instruction and prevented most of the mistakes. The AR group considered the guidance and feedback provided by AR to be beneficial for their learning. However, no apparent differences were found in tasks measuring students’ understanding of the content knowledge. Thus, an AR environment embedded with supportive tools could partly replace the teacher in science teaching laboratories by providing individual and timely guidance for the students

A Focus Group Study about Oral Drug Administration Practices at Hospital Wards—Aspects to Consider in Drug Development of Age-Appropriate Formulations for Children

Oral drug administration to pediatric patients is characterized by a lack of age-appropriate drug products and the off-label use of medicines. However, drug administration practices at hospital wards is a scarcely studied subject. The aim of this study was to explore the oral drug administration practices at pediatric hospital wards, with a focus on experiences and challenges faced, methods used to mitigate existing problems, drug manipulation habits, perceptions about oral dosage forms and future needs of oral dosage forms for children. This was a qualitative study consisting of focus group discussions with physicians, nurses and clinical pharmacists in a tertiary university hospital with the objective of bringing forward a holistic view on this research topic. These healthcare professionals recognized different administration challenges that were classified as either dosage form-related or patient-related ones. A lack of depot formulations developed especially for children as well as oral pediatric dosage forms of drug substances currently available as intravenous dosage forms was recognized. The preferred oral dosage forms were oral liquids and orodispersible tablets. Patient-centered drug administration practices including factors facilitating drug administration both at hospital wards and at home after patient discharge were identified. Among all healthcare professionals, the efficient cooperation in drug prescribing and administration as well as in educating the child’s caregivers in correct administration techniques before discharge and improving the overall discharge process of patients was emphasized. This study complements the prevalent understanding that new dosage forms for children of varying ages and stages of development are still needed. It also brings a holistic view on different aspects of oral drug administration to pediatric patients and overall patient-centered drug administration practices