The humanistic and economic burden of juvenile idiopathic arthritis in the era of biologic medication.

Juvenile idiopathic arthritis (JIA) is a poorly understood, heterogeneous, incurable, inflammatory syndrome. Long-term outcomes are uncertain, and this painful condition can result in lifelong disability. JIA is associated with considerable financial and humanistic burden for those affected and the healthcare system. Early diagnosis and effective treatment are indicated to optimise outcomes. Modern treatment aims to achieve remission and preserve joint function by using disease-modifying antirheumatic drugs (DMARDs) early. DMARDs can be classified as conventional/traditional or biologic. Biologic medications may be more effective but cost approximately ten times more than traditional DMARDs. Decision-makers in healthcare are increasingly comparing the cost and consequences of alternative treatment strategies to guide resource allocation decisions. There have been few economic evaluations to date to guide medicines optimisation in JIA. This systematic review highlights the lack of existing evidence relating to the humanistic and economic burden of JIA in the era of biologic medication.

Personal development planning: first-year Master of Pharmacy students' engagement with, and attitudes towards, reflective self-assessment.

OBJECTIVES: The aims of this study were to determine whether first-year Master of Pharmacy (MPharm) students would engage with an activity similar to pharmacists' continuing professional development, and to explore attitudes surrounding this task. METHODS: A paper version of the Royal Pharmaceutical Society of Great Britain's electronic template for recording continuing professional development was developed. Students were asked to use this paper version to record the planning, action and evaluation carried out while completing a written assignment. The records were assessed to determine any reflective self-assessment contained in the evaluation section, and whether this reflection related to the specified learning outcome and the planning and action stages. Six focus groups were run, during which the students discussed their reaction to completing these records. The study was carried out during the first semester with first-year undergraduate MPharm students in the School of Pharmacy and Pharmaceutical Sciences at the University of Central Lancashire in the UK. KEY FINDINGS: It was found that few students appeared to engage fully with the whole recording process. During focus-group sessions competence to self-assess was raised as an issue by students, and the value of the reflective process was questioned. Some students did recognize the value of undertaking and recording reflective self-assessment. CONCLUSIONS: It appears that undergraduate students need a more gradual introduction to the process of reflective self-assessment. We suggest that the findings are linked to students' previous education experience and conclude there is a need for students to be encouraged to take ownership of their undergraduate learning, to gain confidence in self-assessment and to increase the value they place on reflection.