The effects of Andrographis paniculata (Burm.f.) Nees on the pharmacokinetics and pharmacodynamics of midazolam in healthy volunteers

Andrographis paniculata (Burm.f.) Nees has been widely used for centuries in Asia for the treatment of common coldand diarrhea. Although it was previously reported to inhibit cytochrome P450 in vitro, the potential to cause herb-druginteraction has been questioned. The purpose of this study was to evaluate the effects of A. paniculata on the pharmacokineticsand pharmacodynamics of midazolam, a CYP3A4 probe drug, in normal healthy volunteers. The study was anopen-label, randomized, 2-phase crossover design with a 2-weeks washout period. Twelve healthy male volunteers received4 capsules of 250 mg A. paniculata 3 times a day orally for 7 days. Midazolam plasma concentration time profiles werecharacterized after a single oral dose of 7.5 mg midazolam on the day before and after A. paniculata medication. Pharmacodynamicsof midazolam were also evaluated. The results demonstrated that pretreatment with A. paniculata did not changemean pharmacokinetic parameters (Cmax, Tmax, AUC0-12, AUC0-”, T1/2, Cl/F) of oral midazolam. Since midazolam is the mostsensitive substrate for CYP3A4, thus, herb-drug interaction caused by CYP3A4 inhibition after A. paniculata in healthyvolunteers was considered not clinically relevant. However, A. paniculata potentiated the effect of midazolam in loweringblood pressure and pulse rate. Therefore, co-administration of A. paniculata with midazolam should be warranted

Does a transition in education equate to a transition in practice?: Thai stakeholder’s perceptions of the introduction of the Doctor of Pharmacy programme

BackgroundPharmacy education and pharmacy practice are facing remarkable changes following new scientific discoveries, evolving patient needs and the requirements of advanced pharmacy competency for practices. Many countries are introducing or undertaking major transformations in pharmacy education. The Thai pharmacy curriculum has been changed from a 5-year BPharm and a 6-year PharmD to only a 6-year PharmD programme. Curriculum change processes usually involve stakeholders, including both internal and external educational institutions, at all levels. This study aims to understand the experiences and perceptions of stakeholders regarding the transition to an all-PharmD programme in Thailand.MethodsSemi-structured interviews were conducted in Thailand with 130 stakeholders (e.g., policy makers, pharmacy experts, educators, health care providers, patients, students and parents) from August-October 2013. The interviews were audio recorded, transcribed verbatim and analysed using an inductive thematic analysis.ResultsThree main themes were derived from the findings: 1. influences on curriculum change (e.g., the needs of pharmacists to provide better patient care, the US-Thai consortium for the development of pharmacy education); 2. perceived benefits (e.g., improve pharmacy competencies from generalists to specialists, ready to work after graduation, providing a high quality of patient care); and 3. concerns (e.g., the higher costs of study for a longer period of time, the mismatch between the pharmacy graduates’ competency and the job market’s needs, insufficient preceptors and training sites, lack of practical experience of the faculty members and issues related to the separate licenses that are necessary due to the difference in the graduates’ specialties).ConclusionsThis is the first study to highlight the issues surrounding the transition to the 6-year PharmD programme in Thailand, which was initiated due to the need for higher levels of competency among the nation’s pharmacists. The transition was influenced by many factors. Many participants perceived benefits from the new pharmacy curriculum. However, some participants were concerned about this transition. Although most of the respondents accepted the need to go forward to the 6-year PharmD programme, designing an effective curriculum, providing a sufficient number of qualified PharmD preceptors, determining certain competencies of pharmacists in different practices and monitoring the quality of pharmacy education still need to be addressed during this transitional stage of pharmacy education in Thailand

Hospital pharmacists’ perceptions of the suitability of doctor of pharmacy graduates in hospital settings in Thailand

BACKGROUND: Thai pharmacy education has moved to an all Doctor of Pharmacy (PharmD) programme. However, there has been no previous research about the perceptions regarding the suitability of PharmD graduates employed in hospital settings, which is the major pharmacy workforce in Thailand. METHODS: A cross-sectional survey questionnaire was distributed to 180 hospital pharmacists at the 2013 Association of Hospital Pharmacy (Thailand) conference. This study aimed to explore Thai hospital pharmacists’ perceptions concerning the suitability of the PharmD graduates employed in hospital settings and the competency differences between the Bachelor of Pharmacy (BPharm) and PharmD graduates. Descriptive statistics were used to present the participants’ demographics and their perceptions. An inductive thematic analysis was used to analyse the open-ended written answers. RESULTS: Ninety-eight valid responses were included in the data analysis (response rate of 55.6 %). The majority of the respondents (76.5 %) felt that the PharmD graduates were suited for the hospital setting and addressed its need for more professionals working in pharmaceutical care and with multi-disciplinary teams. Approximately 55 % of respondents agreed that there were competency differences between the BPharm and PharmD graduates. Major themes emerged in response to the open-ended written answers showing that PharmD graduates had high competency in patient care services and readiness to work, particularly in large hospitals, due to their training to work in specialised areas (e.g., special clinics, ward rounds). However, PharmD graduates require more training in health promotion and humanistic skills and need the system to promote the role of PharmD in pharmaceutical care. CONCLUSIONS: PharmD graduates were suited for hospital settings. However, there were concerns regarding the suitability of the PharmD graduates for the community hospital and primary care hospital settings because of their insufficient training in health promotion and disease prevention. Half of the respondents perceived PharmD graduates as having higher competencies in clinical activities and being more prepared to work than BPharm graduates. However, the other half of the respondents perceived the competency of both pharmacy qualifications as being similar, as PharmD graduates provide non-clinical activities similar to BPharm graduates due to the high workload in dispensing services and the shortage of hospital pharmacists, which prevent PharmD graduates from providing direct pharmaceutical care services. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12909-015-0471-6) contains supplementary material, which is available to authorized users

A transition from the BPharm to the PharmD degree in five selected countries

This review focuses on the studies and opinions around issues of transition from the BPharm to the PharmD degree in the U.S., Japan, South Korea, Pakistan and Thailand.The transition to the clinically orientated PharmD degree in many countries was seen to be a means of developing the profession. However, some countries have both clinically-oriented and pharmaceutical sciences-oriented PharmD programme that are designed to meet the needs of their countries. Each country created a different process to handle the transition to an all-PharmD programme, but mostly had the process of school accreditation mandated by the regulatory bodies. The main barrier to the transition in most of the countries was the issue of educational quality. A set of indicators is needed to measure and monitor the impact/outcome of the PharmD degree.Each country has different needs due to the different contexts of health care systems and the scope of pharmacy practice. In order to increase their chances of benefiting from the new programme, academic leaders should critically assess their countries’ needs before deciding to adopt a PharmD programme

Are we on the right track? Answers from a national survey of Thai graduates’ perceptions during the transition to the 6-year PharmD program

Purpose: To serve the higher demands of pharmaceutical services, pharmacy education in Thailand has shifted from 5-year BPharm program to 6-year PharmD program with two specialization tracks: pharmaceutical care (PC) and industrial pharmacy (IP). This study aimed to compare the perceptions regarding professional competencies, pharmacy profession, and planned workplace between graduates with 5-year BPharm and 6-year PharmD and between those with PC and IP specialty.Methods: A cross-sectional national survey using a paper–pencil self-administered questionnaire was distributed to all new graduates attending the pharmacy licensure examination in March 2015.Results: Of all 1,937 questionnaires distributed, 1,744 were returned and completed (90% response rate). Pharmacy graduates rated highest on their competencies in professional ethics, followed by PC services and system management. They rated low confidence in medication selection procurement and pharmaceutical industry competencies. The 6-year PharmD graduates showed higher confidence in ethics and professional pride than the 5-year BPharm graduates. Graduates with PC specialty rated higher perceived competency in PC, system management, primary care, and consumer protection domains, while the IP graduates were superior in IP and medication selection and procurement domains, and most graduates (PC and IP) intended to work mainly in a hospital or a community pharmacy. Hospital was preferred for the PC graduates, and the IP graduates were more likely to work in pharmaceutical industry, regulation and consumer protection, sales and marketing, and academia.Conclusion: With some gaps still to be filled, the transition from 5-year BPharm to 6-year PharmD program with specialty tracks gave extra confidence to graduates in their specialty competencies and professional pride, leading to differences in preferred workplace. The findings of this study reflect that Thai pharmacy education continues to adjust to the needs of the society and the changing health care environments. Longitudinal monitoring to observe this transition is needed for both curriculum adjustment and competency of the graduates

Payom Wongpoowarak

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Additional file 2: of Hospital pharmacists’ perceptions of the suitability of doctor of pharmacy graduates in hospital settings in Thailand

Differences among the competency standard guidelines for licensure examination of the 5-year BPharm, the 2008 Announced 6-year PharmD programme and the 2012 Announced 6-year PharmD programme [14–17]. (DOCX 29 kb