Online interviews for the selection of applicants for admission into an entry to practice program in pharmacy: Relationship to performance and student perspectives.

INTRODUCTION: Admissions processes for entry-to-practice pharmacy programs across North America vary in the types of information used to decide which students to admit. The use of online interviews emerged at our program as an option to assess basic communication skills and personal traits to supplement traditional achievement measures such as prerequisite course grade point average (GPA) and admissions letters. METHODS: Student cumulative grade, year-by-year grade, and some grades from selected classes were correlated with the interview score for three years of consecutive cohorts. Linear regression was used to explore relationships. A survey was completed by students to understand their views on the use of the online interview process. RESULTS: There was no relationship seen between the compiled GPA and the interview score. The survey data revealed a strong preference for online compared to face-to-face interviews, with high student agreement that the interviews provide a good opportunity to demonstrate general communication skills. An assessment of the strength of the relationships of interview scores with a set of program GPA outcomes showed limited predictive utility. Scores weakly correlated with performance in communications and skills courses. CONCLUSIONS: Online interviews were preferred over in-person interviews by most students. The lack of strong significant correlations between interview scores and grades suggests that use be judiciously applied in the overall admissions decision-making process.

An evaluation of Alberta pharmacists' practices, views and confidence regarding prescription drug abuse and addiction within their practice setting.

BACKGROUND: Pharmacists play an important role in managing patients with prescription drug abuse and addiction (PDAA). The objective of this study was to explore Alberta pharmacists' practices, views and confidence in the management of patients at risk of or living with PDAA in their practice setting. METHODS: A 26-question online questionnaire was distributed to 4261 pharmacists across Alberta, of whom 656 (15%) participated. The questionnaire consisted of 17 multiple-choice, 6 multipart and 3 free-response questions. Questionnaire responses were collected and analyzed in Qualtrics. RESULTS: Sixty-six percent (n = 408) of pharmacists indicated that PDAA was prevalent in their practice setting, with 55% (n = 340) of respondents encountering more than 6 patients with suspected or known PDAA a month. Thirty-five percent (n = 198) of pharmacists indicated they were moderately confident at identifying patients with potential PDAA. However, 41% (n = 235) of the pharmacists indicated that they only discuss PDAA with identified patients less than half of the time. Pharmacists lacked confidence in their ability to discuss PDAA treatment options with their patients as well as collaborate with addiction treatment facilities. Lack of training or knowledge in PDAA (48%) and uncertainty of how to initiate discussion or effectively communicate with patients about PDAA (39%) were identified as barriers that significantly or very significantly hindered respondents from managing PDAA in their practice. CONCLUSIONS: Although many pharmacists are moderately confident in identifying patients with potential PDAA, several barriers hinder intervention. Providing pharmacists with additional training and resources may better equip them to manage PDAA within their practice settings. Can Pharm J (Ott) 2019;152:xx-xx.

Impact evaluation of a school-based oral health program: Kuwait National Program.

BACKGROUND: This study evaluated the relationship between enrolment in a school-based oral health prevention program (SOHP) and: 1) children's dental health status and oral health-related quality of life (OHRQoL), and 2) mothers' oral health (OH) knowledge, attitude, practice, and OHRQoL. METHODS: This cross-sectional study, in the Kuwait Capital, included 440 primary school children aged 11 to 12 years and their mothers. Participants were classified into two groups: SOHP and non-SOHP. The SOHP group had been enrolled in the prevention program for at least 3 years: children had twice-a-year applications of fluoride varnish and fissure sealants if needed; mothers had, at least, one oral health education session. The non-SOHP group had negative consents and had not been exposed to the prevention program activities. Dental examinations were performed at schools using portable dental units. Caries experience was determined using the decayed (D/d), missing (M/m), and filled (F/f) teeth (T/t)/surface (S/s) indices. Children's OHRQoL was assessed using a self-administered validated Child Perceptions Questionnaire 11-14 (CPQ11-14). Mothers' OH knowledge, attitude, practice, and OHRQoL were also assessed. After Bonferroni correction, a p-value of less than 0.05 was considered statistically significant for caries experience measures while a p-value of less than 0.013 was considered statistically significant for OHRQoL subscales and mothers' OH knowledge, attitude, practice, and OHRQoL. RESULTS: Mean (SD) DT/dt, DMFT/dmft and DMFS/dmfs were 1.41 (1.66), 2.35 (2.33), and 4.41 (5.86) for SOHP children, respectively. For non-SOHP children, the means were 2.61 (2.63), 3.56 (3.05), and 7.24 (7.78), respectively. The difference between the SOHP and non-SOHP was statistically significant (p <  0.001). Children enrolled in the program had a higher number of sealed and restored teeth. No significant differences were found in CPQ11-14 scores or subscale scores between the two groups. No significant difference in mothers' OH knowledge, attitude, practices or OHRQoL was found between SOHP and non-SOHP groups (P > 0.013). CONCLUSION: Enrolment in the SOHP prevention services was associated with a positive impact on children's caries level with no significant impact on mothers' knowledge, attitude, practice, or OHRQoL.

Financial remuneration is positively correlated with the number of clinical activities: an example from diabetes management in Alberta community pharmacies.

OBJECTIVE: To determine whether use of a compensation plan to remunerate pharmacists for clinical pharmacy services was associated with the number of diabetes management activities provided. METHODS: Alberta pharmacists were asked about compensation plan use and frequency they provide a list of 80 diabetes management activities. KEY FINDINGS: A total of 168 community pharmacists responded to the survey. When compensation plan use, diabetes-specific training, practice characteristics and additional authorizations were incorporated into a factorial ANOVA, pharmacists who used the compensation plan reported a mean of 42.9 (95% CI 39.4 to 46.4) diabetes management activities, while those who did not reported a mean of 29.9 (95% CI 21.4 to 38.4) activities (P = 0.016). CONCLUSIONS: After considering other important influencing factors, use of the compensation plan is positively correlated with the number of diabetes management activities pharmacists provided.

Exploring Electronic Medical Record and Self-Administered Medication Risk Screening Tools in a Primary Care Clinic.

BACKGROUND: Electronic medical record (EMR) screening for indicators of medication risk could improve efficiency in identifying primary care clinic patients in need of clinical pharmacist care compared with patient self-reporting. OBJECTIVES: To (a) compare the performance of an EMR medication risk assessment questionnaire (MRAQ) with a self-administered (SA) MRAQ and (b) explore each tool's ability to predict indicators of health behavior, health status, and health care utilization. METHODS: A prospective cohort study was conducted with 143 adults who attended an academic family medicine center and were taking ≥ 2 medications. All participants completed the 10-item SA-MRAQ, Morisky Medication Adherence Scale, Chew's health literacy screener, Stanford Health Distress Scale, and SF-36 overall rating of health. A blinded investigator completed the EMR-MRAQ and a chart review to ascertain 6 months of health care utilization. Outcome measures included the following: (a) scores from the 5- and 10-item SA-MRAQs and 5-item EMR-MRAQ; (b) sensitivity and specificity to determine the accuracy of the 5-item EMR versus the 5-item SA risk scores; (c) correlations between risk assessments and health behavior/status scales; and (d) area under the receiver operator curve to determine how well a high-risk score predicted health care utilization. RESULTS: The 5-item SA-MRAQ, the 5-item EMR-MRAQ, and the 10-item SA-MRAQ categorized 52.9% (55/104), 69.2% (99/143), and 17.6% (18/102) of participants as high risk, respectively. For the 104 participants who completed both 5-item MRAQ tools, the EMR-MRAQ had a sensitivity of 81.8% and specificity of 49.0% in detecting a high-risk SA-MRAQ score. Both 5-item risk assessments showed weak correlations with health distress and overall health, while the 10-item SA-MRAQ additionally showed weak correlations with medication adherence. The EMR-MRAQ was most effective in predicting all-cause emergency room visits/hospitalization (c-statistic = 0.69; 95% CI=0.57-0.81) and high clinic utilization (≥ 4 visits per 6 months; c-statistic = 0.77; 95% CI = 0.69-0.85). The EMR-MRAQ had high sensitivities but low specificities for these health care utilization outcomes, respectively (82.6% and 33.3%; 88.9% and 42.7%). CONCLUSIONS: This pilot study suggests that EMR-MRAQ screening has high sensitivity but low specificity in comparison with self-reporting and was able to discriminate between those who would and would not experience health care utilization outcomes. These results justify further development and validation of an automated EMR-based tool to predict patient-important consequences of medication-related problems. DISCLOSURES: This work was funded by the Canadian Society of Hospital Pharmacists Research and Education Foundation, which had no role in the analysis or interpretation of data or the decision to submit the manuscript for publication. The authors have no conflict of interests, potential or otherwise, to report. Makowsky had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design were contributed by Makowsky and Cor. Makowsky and Wong collected the data, and data interpretation was performed by Makowsky, Cor, and Wong. The manuscript was written by Makowsky and was critically reviewed for intellectual content by Makowsky, Cor, and Wong.

Factors Affecting Number of Diabetes Management Activities Provided by Pharmacists.

BACKGROUND: Legislative changes since 2007 have given Alberta pharmacists additional authorizations and new practice settings, which should enhance provision of clinical services to patients. This study examined whether these changes are related to the number of diabetes management activities provided by pharmacists. METHODS: Cross-sectional surveys of Alberta pharmacists were conducted in 2006 and 2015. Both questionnaires contained 63 diabetes management activities, with response options to indicate how frequently the activity was provided. Respondents were grouped by survey year, practice setting, diabetes-specific training and additional authorizations. The number of diabetes management activities provided often or always were compared among groups by using analysis of variance. RESULTS: Data from 128 pharmacists participating in the 2006 survey were compared with 256 pharmacists participating in the 2015 survey; overall mean age was 41.6 (±10.9) years, 245 (64%) were women, mean duration of practice was 16.1 (±11.8) years, 280 (73%) were community pharmacists, 75 (20%) were certified diabetes educators (CDEs), and 100 (26%) had additional prescribing authorization (APA). Pharmacists provided a mean of 28.7 (95% CI 26.3 to 31.2) diabetes management activities in 2006 and 35.2 (95% CI 33.4-37.0) activities in 2015 (p<0.001). Pharmacists who were CDEs provided significantly more activities compared to other pharmacists (p<0.001). In 2015, working in a primary care network and having APA were also associated with provision of more activities (p<0.05 for both comparisons). CONCLUSIONS: Pharmacists provided more diabetes management activities in 2015 than in 2006. The number of diabetes management activities was also associated with being a CDE, working in a primary care network or having APA.

Impact of dental health on children's oral health-related quality of life: a cross-sectional study.

BACKGROUND: To assess the impact of children's dental health status (DHS) on their oral health-related quality of life (OHRQoL). METHODS: Participants were 11- and 12-year-old children attending public schools in the Kuwait Capital Region. Children's DHS was evaluated by clinical examinations and presented using decayed, missed, filled teeth/surface (DMFT/dmft, DMFS/dmfs); restorative (RI), plaque (PI); and pulp, ulcers, fistula, abscess (PUFA) indices. Children's OHRQoL was assessed using Child's Perception Questionnaire 11-14 (CPQ11-14). Means (SD) and frequencies were used for data description. Different factors were analyzed as predictors of OHRQoL by logistic regression analysis. RESULTS: A total of 440 children aged 11-12 years (50.7 % females) participated in this cross-sectional study. Mean (SD) DMFT/dmft, RI, PI, and PUFA scores were 2.91(2.75), 0.21 (0.34), 3.59 (1.63), 0.31 (0.85), respectively. The mean total CPQ11-14 was 20.72 (16.81). Mean scores of oral-symptoms, functional-limitations, emotional and social well-being were 4.26 (3.32), 5.40 (4.92), 5.48 (6.15), and 5.33 (6.05), respectively. Children with more than four fillings were 95 % less likely to have had oral symptoms than those with no fillings. Children with a DMFT/dmft of 2-3 were 2.8 times more likely to have functional limitation than those with a DMFT/dmft of 0, while children with a DMFT/dmft of more than 4 were 4.4 times more likely to experience limitations. Having two or three non-cavitated lesions reduced the odds of having functional-limitation by 58 %. Children with more than four missing teeth were 45 % more likely to experience emotional stress. Having more than four fissure sealants reduced the odds of having emotional stress by 46 %. CONCLUSIONS: The increase in the number of carious teeth was associated with a limitation in oral functions. Preventive treatment had a positive impact on children's emotional well-being and restorative treatments improved their oral function.

Administration Technique and Acceptance of Inhaler Devices in Patients With Asthma or COPD.

BACKGROUND: Correct technique and patient acceptance of inhalation devices for lung disease influence successful long-term management. Patient ability to use the proper technique may differ depending on the device as well as patient factors. OBJECTIVES: The objectives of our study are to measure self-reported level of acceptability of inhaler devices in community settings and compare correct use of inhaler devices using a novel scale for measuring appropriate inhaler technique. METHODS: This prospective observational study enrolled patients from 3 different practice sites with asthma and/or chronic obstructive pulmonary disease (COPD) who were using an inhaler device. In addition to describing the samples' overall acceptability and correct use scores for the different inhalers, acceptability and correct use scores were compared based on patient characteristics. RESULTS: A total of 161 patients completed the study. The results show that acceptability was lowest for the pressurized metered dose inhaler (pMDI) with a spacer (S); effective use was best demonstrated with pMDI and poorest with pMDI-S. Older patients were found to be more accepting of the HandiHaler device than younger patients. Patients reporting taking more inhaled drugs were found to be more accepting of the pMDI-S than those taking fewer drugs. Finally, patients reporting taking more inhaled drugs demonstrated less-effective use of the HandiHaler device than patients taking fewer drugs. CONCLUSION: Pulmonary disease duration does not ensure improved use for all inhalers; patients taking more drugs demonstrate less-effective use for some devices. Assessment of patient acceptance and factors that predict the ability to use a device should be considered to individualize therapy.

Evaluation of an injection training and certification program for pharmacy students.

OBJECTIVE: To evaluate an injection training and certification program for third-year (P3) pharmacy students, and to measure the impact of students' administration of immunizations at an influenza clinic on their knowledge, skills, and competence in immunization. DESIGN: A repeated measures design was used to assess students' injection skills across the injection training and certification program and the influenza clinic. A repeated measures design was also used to evaluate students' self-reported knowledge, experience, and confidence. ASSESSMENT: Postcertification and during influenza clinic comparisons showed significant improvement in students' knowledge, experience, and confidence after taking part in the influenza clinic. University staff members and students indicated in a survey that they were satisfied with the clinic services provided by pharmacy students. CONCLUSION: The injection training and certification program and the university influenza clinic were effective in enhancing and fostering student skills development.