Swedish patients’ trust in the bioequivalence of interchangeable generics. What factors are important for low trust?

Background: Generic substitution (GS), is a cost-containment strategy meant to contain pharmaceutical expenditure without compromising health objectives. In order to shape GS into a policy that is both efficient and safe it is crucial to understand which factors are most important for patients’ trust in GS. Objective: To assess Swedish patients’ level of trust in the bioequivalence of cheap and expensive generic medicines, and the association between trust and various factors. Methods: A cross-sectional study was conducted. Questionnaires were handed out at 12 community pharmacies in Sweden, selected through stratified sampling, between March and April 2015. The questionnaire included seven socio-demographic questions in addition to 18 items divided into three sections: the ‘views on generic medicine’-scale, information on and prior experiences of GS, financial aspects and change of color/name. Odds Ratios (ORs) were estimated applying adjusted logistic regression analyses with trust in the bioequivalence of generic medicines used as outcome variable and various factors as predictors. Results: A total of 719 patients participated (response rate 85.7%). The results show that 70.7% of the respondents’ trust that cheap and expensive interchangeable generic medicines are equal. Of the respondents 36.0% considered the change in appearance and 40.8% the change in names to complicate adherence. Lower trust in the bioequivalence of generic medicines were associated with being female (aOR=1.82, 95%CI 1.20:2.75, p<0.01), patients perceiving that changes in product name and appearance make adherence more complicated (aOR=2.18, 95%CI 1.48:3.19, p<0.001), disagreeing in that GS saves money for me (the customer) (aOR=2.68, 95%CI 1.58:4.55, p<0.001) or that GS saves money for society (aOR=3.21, 95%CI 1.46:7.08, p<0.01). Conclusions: Seven out of ten respondents had trust in the bioequivalence of generic medicines, and one in three considered GS to complicate adherence. Four factors were associated with lower trust in GS, i.e. female gender, agreeing that changes in product name and appearance complicates adherence, disagreeing in that GS saves money for me or disagreeing in that GS saves money for the society. Low trust in GS needs to be addressed, not least in the communication between health professionals and patients

Factors associated with pharmacy students' attitudes towards learning communication skills – A study among Nordic pharmacy students

Introduction: Good communication skills are essential for pharmacy students to help patients with their medicines. Students' attitudes towards communication skills learning will influence their willingness to engage in communication training, and their skills when dealing with patients later on in their professional life. Objective: The aim of this study was to explore Nordic pharmacy students' attitudes to communication skills learning, and the associations between those attitudes and various student characteristics. Method and materials: A cross-sectional questionnaire-based study was conducted in 11 Nordic pharmacy schools between April 2015 and January 2016. The overall response rate for the final study population was 77% (367 out of 479 students). Pharmacy students who had fulfilled all mandatory communication training and most of their pharmacy practical experience periods were included. The communication skills attitudes scale was the main outcome. Linear regression models were fitted with the outcome variable and various student characteristics as the predictors, using generalized estimating equations to account for clustering within pharmacy schools. Results: Nordic pharmacy students in general have moderately positive attitudes towards learning communication skills. Positive attitudes towards learning communication skills among pharmacy students were associated with being female (βadjusted 0.42, 95% CI 0.20 to 0.63, p < 0.001), following a newer pharmacy training program (βadjusted 0.81, 95% CI 0.63 to 0.98, p < 0.001), having higher self-rated need for communication skills improvement (βadjusted 0.50, 95% CI 0.30 to 0.71, p<0.001) and believing one’s communication skills are not the result of personality (βadjusted −0.24, 95% CI −0.44 to −0.04, p=0.017). Conclusion: The study provides important information for faculty members responsible for curriculum improvements and teachers to refine their teaching of communication skills. From this, the teaching can be better tailored to suit different students. The students' chances of being able to effectively help patients in the future will be increased by that

Nordic Pharmacy Schools’ Experience in Communication Skills Training

Objective: To assess communication skills training at Nordic pharmacy schools and explore ways for improvement. Methods: E-mail questionnaires were developed and distributed with the aim to explore current practice and course leaders’ opinions regarding teaching of patient communication skills at all the 11 master level Nordic (Denmark, Finland, Iceland, Norway and Sweden) pharmacy schools. The questionnaires contained both closed- and open-ended questions. Results: There was a variation of patient communication skills training among schools. In general, communication skills training was included in one to five courses (mode 1); varied in quantity (6-92 hours); had low use of experiential training methods; and had challenges regarding assessments and acquiring sufficient resources. However, some schools had more focus on such training. Conclusion: The results show room for improvement in patient communication skills training in most Nordic pharmacy schools and give insights into how to enhance communication skill building in pharmacy curricula. Suggestions for improving the training include: early training start, evidence-based frameworks, experiential training, and scaffolding