The Use of a Pressure-Indicating Sensor Film to Provide Feedback upon Hydrogel-Forming Microneedle Array Self-Application In Vivo.

PURPOSE: To evaluate the combination of a pressure-indicating sensor film with hydrogel-forming microneedle arrays, as a method of feedback to confirm MN insertion in vivo. METHODS: Pilot in vitro insertion studies were conducted using a Texture Analyser to insert MN arrays, coupled with a pressure-indicating sensor film, at varying forces into excised neonatal porcine skin. In vivo studies involved twenty human volunteers, who self-applied two hydrogel-forming MN arrays, one with a pressure-indicating sensor film incorporated and one without. Optical coherence tomography was employed to measure the resulting penetration depth and colorimetric analysis to investigate the associated colour change of the pressure-indicating sensor film. RESULTS: Microneedle insertion was achieved in vitro at three different forces, demonstrating the colour change of the pressure-indicating sensor film upon application of increasing pressure. When self-applied in vivo, there was no significant difference in the microneedle penetration depth resulting from each type of array, with a mean depth of 237 µm recorded. When the pressure-indicating sensor film was present, a colour change occurred upon each application, providing evidence of insertion. CONCLUSIONS: For the first time, this study shows how the incorporation of a simple, low-cost pressure-indicating sensor film can indicate microneedle insertion in vitro and in vivo, providing visual feedback to assure the user of correct application. Such a strategy may enhance usability of a microneedle device and, hence, assist in the future translation of the technology to widespread clinical use.

The Resilience of Final-Year Pharmacy Students and Aspects of the Course They Found to Be Resilience-Building.

Background: This work aimed to investigate final year pharmacy students' resilience (as determined by the CD-RISC-25 tool), whether students considered certain aspects of the course to be resilience-building, and the role of the university in developing this attribute. Methods: Following ethical approval and an invitation to participate, data were collected from consenting students at Queen's University Belfast via a pre-piloted paper-based questionnaire. Descriptive statistics were performed. To ascertain significant differences (p < 0.05) by gender, the Welch Two Sample t-test was used for the CD-RISC-25 mean scores and the Mann-Whitney U Test and Chi-squared test for Section B data. Results: The response rate was 80.61% (79/98). The mean CD-RISC-25 score for males was higher (not significantly) than the female mean score (70.39 versus 67.18, p = 0.2355, possible score range 0−100). While 93.67% (74/79) considered the School has a responsibility to develop resilience, <20.00% availed of the free resilience building events. Activities deemed to help build resilience included being able to make mistakes in a safe environment and needing to achieve a high grade to pass assessments. Conclusions: Resilience levels among future pharmacists at Queen's University Belfast should be improved going forward. A strategy, developed in light of conducting this research (from one institution), will now be implemented to enhance the curriculum with regard to resilience building opportunities.

Veganism: Are future pharmacists ready to provide advice?

INTRODUCTION: In addition to advising about diets, nutritional deficiencies, and supplements, pharmacists should be confident discussing medicine-related issues that may arise from people adopting veganism, including checking about animal-derived pharmaceutical product excipients, formulation processes, and determining whether vegan-friendly alternatives exist. Thus, this study aimed to investigate pharmacy students' knowledge and views about veganism. METHODS: Given veganism's increasing popularity and relevance to pharmacy practice, students enrolled in their last year of the undergraduate master of pharmacy degree program at Queen's University Belfast participated in this voluntary study. The questionnaire was given out at an obligatory workshop (only non-identifiable data were requested). Students were scored on veganism knowledge (22 true/false statements) with other analysis about views being largely descriptive in nature. RESULTS: Ninety-two out of 101 (91.1%) completed the questionnaire. Only one reporting being vegan. Mean knowledge score (possible range of 0-22) was 16.59 (±2.43). Only 37% (34/92) reported feeling confident discussing veganism with patients or other healthcare professionals and 40.2% (37/92) deemed they could establish whether a medical product is vegan-friendly. A minority (4.3%) considered they had received adequate training on veganism. A greater proportion of males than females considered that vegans are too forceful with their beliefs (74.2% vs. 51.7%). CONCLUSIONS: This study presents the first description of pharmacy students' knowledge and opinions on veganism (from a single institution only). The reported gap in educational provision and lack of confidence needs to be investigated and addressed to enhance patient-centered care.

Future Pharmacists' Opinions on the Facilitation of Self-Care with Over-the-Counter Products and Whether This Should Remain a Core Role.

BACKGROUND: The aim was to investigate pharmacy students' views on the role of the pharmacist in facilitating self-care with over-the-counter (OTC) medicines, particularly in light of new roles, and establish personal practice. METHODS: Final year pharmacy students at Queen's University Belfast were invited to participate. Data were collected via a pre-piloted questionnaire, distributed at a compulsory class (only non-identifiable data were requested). Descriptive statistics were performed, and non-parametric tests were employed for inferential statistical analysis (responses by gender). RESULTS: The response rate was 87.6% (78/89); 34.6% (27/78) males and 65.4% (51/78) females. Over a third [34.6% (27/78)] reported using OTC medicines about once a month. All appreciated the importance of an evidence-based approach to optimize patient care. Most [(96.2% (75/78)] deemed OTC consultations should remain a fundamental responsibility of pharmacists and 69.2% (54/78) thought OTC consultations have the potential to be as complex as independent pharmacist prescribing. Females felt more confident recommending OTC emergency contraception than males (p = 0.002 for levonorgestrel and p = 0.011 for ulipristal acetate). Many [61.5% (48/78)] considered more medicines should not be deregulated from prescription-only status. CONCLUSIONS: Data from this single institution suggests that enabling self-medication is an important part of practice but there were confidence issues around deregulations.

Topic Analysis of UK Fitness to Practise Cases: What Lessons Can Be Learnt?

Background: Fitness to practise (FtP) impairment (failure of a healthcare professional to demonstrate skills, knowledge, character and/or health required for their job) can compromise patient safety, the profession's reputation, and an individual's career. In the United Kingdom (UK), various healthcare professionals' FtP cases (documents about the panel hearing(s) and outcome(s) relating to the alleged FtP impairment) are publicly available, yet reviewing these to learn lessons may be time-consuming given the number of cases across the professions and amount of text in each. We aimed to demonstrate how machine learning facilitated the examination of such cases (at uni- and multi-professional level), involving UK dental, medical, nursing and pharmacy professionals. Methods: Cases dating from August 2017 to June 2019 were downloaded (577 dental, 481 medical, 2199 nursing and 63 pharmacy) and converted to text files. A topic analysis method (non-negative matrix factorization; machine learning) was employed for data analysis. Results: Identified topics were criminal offences; dishonesty (fraud and theft); drug possession/supply; English language; indemnity insurance; patient care (including incompetence) and personal behavior (aggression, sexual conduct and substance misuse). The most frequently identified topic for dental, medical and nursing professions was patient care whereas for pharmacy, it was criminal offences. Conclusions: While commonalities exist, each has different priorities which professional and educational organizations should strive to address.

What, where and when? Using Google Trends and Google to investigate patient needs and inform pharmacy practice.

OBJECTIVES: The aim was to provide a comprehensive overview (using pertinent examples) of the various ways that Google Trends and Google data could inform pharmacy practice. The objectives were to: examine what type of information people search for in relation to a common class of medicines; ascertain where people are directed to (websites) following an initial search for a medicine or medical condition; and establish information about when they search. METHODS: The methodology differed depending on whether Google Trends or Google was being interrogated, but the search domain was always limited to the United Kingdom. Google Trends was queried, typically for a 5-year time frame, and data downloaded for many search inputs relating to medical conditions (self-treatable and non-self-treatable) and medicines (bought over-the-counter and prescribed). Google was queried and data collected for searches related to 'antibiotics'. KEY FINDINGS: Google Trends revealed a previously unknown seasonality pattern for irritable bowel syndrome. Related searches for 'antibiotics' revealed a high level of interest in the appropriateness of concomitant alcohol consumption and queries about what antibiotics are. Largely, people were being directed to reputable websites following their initial search input about a prescription-only medicine. However, searches for over-the-counter medicines were more likely to lead to commercial domains. CONCLUSIONS: This is one of the first studies to investigate use of Google Trends and Google in a pharmacy-specific context. It is relevant for practice as it could inform marketing strategies, public health policy and help tailor patient advice and counselling.

UK Pharmacy Students' Opinions on Mental Health Conditions.

Objective. To determine future pharmacists' opinions on mental health conditions and investigate the influence of gender. Methods. Final-year Master of Pharmacy students at Queen's University Belfast completed a paper-based questionnaire. Section A of the questionnaire was adapted from a United Kingdom public opinion questionnaire on mental health. Section B gathered non-identifiable demographic data. Descriptive statistics were undertaken. Mann-Whitney U and Chi-square tests were used for gender comparisons. Results. An 89% (97/109) response rate was obtained. Most survey respondents considered that pharmacological and non-pharmacological measures were beneficial in the management of mental health conditions (89% and 96%, respectively) and that people with mental illness had the same rights to jobs as anyone else (82%). However, only 57% of the respondents felt confident discussing mental health issues with patients and 36% deemed university training to be satisfactory. Males were more likely than females to "agree strongly" or "agree slightly" that they would not want to live next door to someone who has been mentally ill. Conclusion. While some positive opinions were evident, more work is needed to prepare future pharmacists for roles within mental health care teams.

A Questionnaire Study to Investigate Stress among Future Pharmacists by Gender and Year Group.

BACKGROUND: This work aimed to ascertain future pharmacists' stressors and stress-coping practices. METHODS: Queens' University Belfast Year 2 and 4 pharmacy students were invited to participate in an ethically approved, pre-piloted questionnaire study. Section A was the 10-item Perceived Stress Scale, Sections B and C related to stressors and stress-coping mechanisms, and Section D gathered non-identifiable demographic information. Data analysis largely took the form of descriptive statistics. RESULTS: A response rate of 94.2% (213/226) was obtained. The mean Perceived Stress Scale score was 19.94 [standard deviation (SD) 6.37], with females having a higher mean score than males (20.55 SD 5.67 versus 18.16 SD 7.42). Common general stressors were career choice, employment opportunities, and finance. Common degree-specific stressors were particular assessments (objective structured clinical examinations and one-off written examinations) and the amount of course material. Popular stress-coping practices included getting emotional support from friends and family and using self-distractions. CONCLUSION: Stress appears to be an issue among these future pharmacists, and potentially more so for females. While the main stressors are unsurprising, this UK data enables comparisons to be made and helps inform support mechanisms within the university.

An investigation of final year pharmacy students' moral reasoning ability, and their views on professionalism and fitness to practice panel determinations: A questionnaire study.

BACKGROUND AND PURPOSE: The aim was to establish pharmacy students' moral reasoning ability and obtain their views on professionalism and fitness to practice (FtP) determinations involving pharmacists. EDUCATIONAL ACTIVITY AND SETTING: Following ethical approval and piloting, final year pharmacy students at Queen's University Belfast (QUB) (n=119) were invited to participate in a questionnaire study. Section A was a validated moral reasoning assessment tool [Defining Issues Test (DIT2); five moral dilemmas], Section B was FtP cases and professionalism. Distribution occurred at a compulsory class. DIT2 data were scored by the University of Alabama. Descriptive statistics and non-parametric tests were used with significance level set at 0.05 a priori. FINDINGS: The response rate was 94.1% (112/119) and the 'DIT2 P score mean' (postconventional schema) was 25.21±14.10. Almost all [(98.2% (110/112)] fully understood the term "professionalism" and 83.9% (94/112) considered it reasonable for a professional code to apply always (within university and out socializing). Differences in opinions existed depending on what the FtP case related to. Students were significantly more likely to consider a 12-month suspension 'very lenient' or 'lenient' for a pharmacist's personal use of illicit drugs compared with theft of money/cosmetics (42.0% versus 64.3%; p=0.031). There were no significant differences between male and female responses/scores and no strong correlations between DIT2 scores and FtP/professionalism responses. DISCUSSION AND SUMMARY: Pharmacy students appeared to understand professionalism and accepted being bound by a code. A level of discrimination between the FtP cases was evident. Moral reasoning ability was lower than expected for future healthcare professionals (see manuscript) requiring attention.

First-Year Pharmacy Students' Views on Their Chosen Professional Career.

Objective. To investigate what factors influenced students to study pharmacy and determine in which sector they hoped to gain employment, both in the short and longer term. Methods. First-year pharmacy students (n=124) were invited to complete a paper-based, self-administered questionnaire consisting of 4 sections. Descriptive statistics and nonparametric tests were conducted. Results. One hundred (96.8% response rate) students completed the questionnaire (22.5% male; 77.5% female). Key influential factors for choosing pharmacy included: enjoyment of science at school, a desire to improve people's health and wellbeing, and to work in health care. Career aspirations were to work in a hospital or in community practice rather than in industry or academia. Conclusions. Students choose pharmacy as a career primarily for altruistic and clinical reasons. This research provides information for pharmacy schools about the career aspirations of students and data from future pharmacists is potentially helpful to pharmacy professional organizations and potential employers.

Pharmacy students' use and views on over-the-counter (OTC) medicines: a questionnaire study.

INTRODUCTION: The role of the pharmacist centers on ensuring the safe and effective use of medicines, including over-the-counter (OTC) medicines. It is important to ascertain pharmacy students׳ use and opinions on OTC medicines, given that they are the pharmacists of the future and that this market continues to expand. This study aimed to investigate Queen׳s University Belfast (QUB) final-year pharmacy students׳ use and views on OTC medicines. Scarce work has been conducted in this area to date. METHODS: Following ethical approval and a pilot study, all students (n = 155) were invited to participate in a self-completed questionnaire (n = 20 questions), distributed at a mandatory class. Descriptive statistics and non-parametric tests (Chi-squared and Mann-Whitney U test) were used for data analyses. RESULTS: The response rate was 99.4% (154/155). The majority (153/155) reported using OTC medicines; the key consideration during personal product selection was effectiveness. Most [96.1% (147/153)] were in agreement that safety was the over-riding concern during OTC consultations. While 96.1% (149/155) considered that using an evidence-based approach improved the quality-of-patient care, 68.0% (104/153) would be prepared to sell a product that lacks evidence of effectiveness, provided it would not cause harm. CONCLUSIONS: The importance of evidence of effectiveness was acknowledged, yet many students in this study were prepared to recommend unproven products. Further strategies are required at QUB to ensure this routine consideration alongside safety in practice.

Views of pharmacy graduates and pharmacist tutors on evidence-based practice in relation to over-the-counter consultations: a qualitative study.

RATIONALE, AIMS AND OBJECTIVES: Health care services offered to the public should be based on the best available evidence. We aimed to explore pharmacy tutors' and trainees' views on the importance of evidence when making decisions about over-the-counter (OTC) medicines and also to investigate whether the tutor influenced the trainee in practice. METHODS: Following ethical approval and piloting, semi-structured interviews were conducted with pharmacy graduates (trainees) and pharmacist tutors. Transcribed interview data were entered into the NVivo software package (version 10), coded and analysed via thematic analysis. RESULTS: Twelve trainees (five males, seven females) and 11 tutors (five males, six females) participated. Main themes that emerged were (in)consistency and contradiction, confidence, acculturation, and continuation and perpetuation. Despite having an awareness of the importance and potential benefits, an evidence-based approach did not seem to be routinely or consistently implemented in practice. Confidence in products was largely derived from personal use and patient feedback. A lack of discussion about evidence was justified on the basis of not wanting to lessen patient confidence in requested product(s) or possibly negating the placebo effect. Trainees became acculturated to 'real-life' practice; university teaching and evidence was deemed less relevant than meeting customer expectations. The tutor's actions were mirrored by their trainee resulting in continuation and perpetuation of the same professional attitudes and behaviours. CONCLUSIONS: Evidence appeared to have limited influence on OTC decision making. The tutor played a key role in the trainee's professional development. More work could be performed to investigate how evidence can be regarded as relevant and something that is consistently implemented in practice.

Developing Entrepreneurial Skills in Pharmacy Students.

Objective. To create, implement, and evaluate a workshop that teaches undergraduate pharmacy students about entrepreneurship. Design. Workshops with 3 hours of contact time and 2 hours of self-study time were developed for final-year students. Faculty members and students evaluated peer assessment, peer development, communication, critical evaluation, creative thinking, problem solving, and numeracy skills, as well as topic understanding. Student evaluation of the workshops was done primarily via a self-administered, 9-item questionnaire. Assessment. One hundred thirty-four students completed the workshops. The mean score was 50.9 out of 65. Scores ranged from 45.9 to 54.1. The questionnaire had a 100% response rate. Many students agreed that workshops about entrepreneurship were a useful teaching method and that key skills were fostered. Conclusion. Workshops effectively delivered course content about entrepreneurship and helped develop relevant skills. This work suggests students value instruction on entrepreneurship.

Associations between Achievement Goal Orientations and Academic Performance Among Students at a U.K. Pharmacy School.

OBJECTIVE: To ascertain goal orientations of pharmacy students and establish whether associations exist between academic performance, gender, or year of study. METHODS: Goal orientations were assessed using a validated questionnaire. Respondents were categorized as high or low performers based on university grades. Associations and statistical significance were ascertained using parametric and nonparametric tests and linear regression, as appropriate. RESULTS: A response rate of 60.7% was obtained. High performers were more likely to be female than male. The highest mean score was for mastery approach; the lowest for work avoidance. The mean score for work avoidance was significantly greater for low performers than for high performers and for males than for females. First-year students were most likely to have top scores in mastery and performance approaches. CONCLUSION: It is encouraging that the highest mean score was for mastery approach orientation, as goal orientation may play a role in academic performance of pharmacy students.

Using debate to teach pharmacy students about ethical issues.

OBJECTIVE: To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues. DESIGN: Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers. ASSESSMENT: One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program. CONCLUSION: A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool.

Use and views on social networking sites of pharmacy students in the United kingdom.

Objective. To investigate students' use and views on social networking sites and assess differences in attitudes between genders and years in the program.Methods. All pharmacy undergraduate students were invited via e-mail to complete an electronic questionnaire consisting of 21 questions relating to social networking.Results. Most (91.8%) of the 377 respondents reported using social networking Web sites, with 98.6% using Facebook and 33.7% using Twitter. Female students were more likely than male students to agree that they had been made sufficiently aware of the professional behavior expected of them when using social networking sites (76.6% vs 58.1% p=0.002) and to agree that students should have the same professional standards whether on placement or using social networking sites (76.3% vs 61.6%; p<0.001).Conclusions. A high level of social networking use and potentially inappropriate attitudes towards professionalism were found among pharmacy students. Further training may be useful to ensure pharmacy students are aware of how to apply codes of conduct when using social networking sites.

The influence of evidence-based medicine training on decision-making in relation to over-the-counter medicines: a qualitative study.

OBJECTIVES: To explore the role of evidence of effectiveness when making decisions about over-the-counter (OTC) medication and to ascertain whether evidence-based medicine training raised awareness in decision-making. Additionally, this work aimed to complement the findings of a previous study because all participants in this current study had received training in evidence-based medicine (unlike the previous participants). METHODS: Following ethical approval and an e-mailed invitation, face-to-face, semi-structured interviews were conducted with newly registered pharmacists (who had received training in evidence-based medicine as part of their MPharm degree) to discuss the role of evidence of effectiveness with OTC medicines. Interviews were recorded and transcribed verbatim. Following transcription, all data were entered into the NVivo software package (version 8). Data were coded and analysed using a constant comparison approach. KEY FINDINGS: Twenty-five pharmacists (7 males and 18 females; registered for less than 4 months) were recruited and all participated in the study. Their primary focus with OTC medicines was safety; sales of products (including those that lack evidence of effectiveness) were justified provided they did no harm. Meeting patient expectation was also an important consideration and often superseded evidence. Despite knowledge of the concept, and an awareness of ethical requirements, an evidence-based approach was not routinely implemented by these pharmacists. Pharmacists did not routinely utilize evidence-based resources when making decisions about OTC medicines and some felt uncomfortable discussing the evidence-base for OTC products with patients. CONCLUSIONS: The evidence-based medicine training that these pharmacists received appeared to have limited influence on OTC decision-making. More work could be conducted to ensure that an evidence-based approach is routinely implemented in practice.

Pharmacy students' views of faculty feedback on academic performance.

OBJECTIVE: To investigate students' views on and satisfaction with faculty feedback on their academic performance. METHODS: A 41-item survey instrument was developed based on a literature review relating to effective feedback. All pharmacy undergraduate students were invited via e-mail to complete the self-administered electronic questionnaire relating to their views on feedback, including faculty feedback received to date regarding their academic performance. RESULTS: A response rate of 61% (343/561) was obtained. Only 32.3% of students (107/331) agreed that they were satisfied with the feedback they received; dissatisfaction with examination feedback was particularly high. The provision of faculty feedback was perceived to be variable in terms of quality and quantity. CONCLUSIONS: There are some inconsistencies relating to provision of feedback within the MPharm degree program at Queen's University Belfast. Further work is needed to close the gap between student expectations and the faculty's delivery of feedback on academic performance.

Pharmacists' attitudes towards an evidence-based approach for over-the-counter medication.

BACKGROUND: With increasing deregulation of prescription-only medicines and drive for self-care, pharmacists have greater scope to manage more conditions. This brings added responsibility to be competent healthcare professionals who deliver high quality evidence-based patient care. OBJECTIVE: This study sought to establish pharmacists' attitudes towards an evidence based approach for over-the-counter medication. SETTING: Pharmacists working in community pharmacies across Northern Ireland. METHOD: Following ethical approval, a pre-piloted, self-completed questionnaire was distributed to all community pharmacies in Northern Ireland (n = 529) in September 2008. The development of the questionnaire was largely informed by the findings of a previous qualitative study. It consisted of six sections (mainly closed questions) covering factors that influence decisions regarding over-the-counter medication, recently deregulated prescription-only medicines, medications that lack evidence of effectiveness, knowledge of evidence-based practice, evidence-based practice with over-the-counter medication and demographic information. On receipt of questionnaires, responses to the closed questions were imported into SPSS(®) (version 17.0) for analysis which largely took the form of descriptive statistics. Chi-square and the Mann-Whitney U test were used for association between responses and demographic information with an a priori level of less than 0.05 (P < 0.05) set as significant. MAIN OUTCOME MEASURE: Pharmacists' attitudes and opinions in relation to decision making about over-the-counter medication and evidence of effectiveness were measured. RESULTS: A 39.5% (209/529) response rate was achieved. Most pharmacists [191/208 (91.8%)] 'strongly agreed' or 'agreed' that safety was the over-riding concern when dealing with over-the-counter medication. While 88.3% (181/205) 'strongly agreed' or 'agreed' that they were familiar with the concept of evidence-based practice, only 38.0% (78/205) 'strongly agreed' or 'agreed' they knew how to critically appraise research papers. Furthermore, less than a quarter [49/205 (23.9%)] appeared to be familiar with the work of the Cochrane Collaboration. Most [188/207 (90.8%)] 'strongly agreed' or 'agreed' that regardless of evidence of effectiveness, cough medicines were an important management option. CONCLUSION: Safety was the primary concern when making decisions about over-the counter medicines. Pharmacists lacked knowledge of evidence-based practice and considered medicines which lacked evidence of effectiveness to have an important role in self-care. These factors present barriers to the widespread implementation of evidence-based practice.