Assessing the Workplace Cyberloafing Behavior among Pharmacists in Pakistan.

Objective: After the commencement of the Internet and the popularity of various electronic devices, cyberloafing has become prevalent in the workplace regardless of professional type, demographic characteristics, and country. Individuals use the Internet for work-irrelevant purposes during work hours, which is believed to have a controversial role in work productivity. However, rare studies have paid attention to the prevalence of cyberloafing behavior among Pakistan pharmacists. Considering pharmacists' essential role in the health sector, this study investigates the prevalence of cyberloafing activities among workplace pharmacists in Pakistan. Methods: This cross-sectional survey was conducted among 242 registered pharmacists in Pakistan between October 2021 and February 2022 with a structured self-administered online questionnaire. The final sample consisted of 200 valid responses after screening. Data were processed through exploratory factor analysis and confirmatory factor analyses. Pearson Chi-square analysis was also used to test the correlation between factors. Findings: Descriptive analysis shows that pharmacists spend more time on sharing-related activities and least on gambling/gaming-related activities in the workplace. All the items' Cronbach's alpha values range from 0.923 to 0.927. The analysis indicates that (60%) pharmacists have intermediate Internet skills. The results also suggest that age, Internet usage, and work area have a strong relationship with cyberloafing behaviors which also, in turn, are linked with their perceived Internet skills. This study has important practical implications for pharmacy management in Pakistan. Conclusion: Cyberloafing behavior is prevalent among Pakistan pharmacists. Our findings could inspire how managers and all other relevant stakeholders could improve the pharmacy system in Pakistan.

Development and validation of the General Rehabilitation Adherence Scale (GRAS) in patients attending physical therapy clinics for musculoskeletal disorders.

BACKGROUND: Non-adherence to physical therapy ranges from 14 to 70%. This could adversely affect physical functioning and requires careful monitoring. Studies that describe designing and validation of adherence measuring scales are scant. There is a growing need to formulate adherence measures for this population. The aim was to develop and validate a novel tool named as the General Rehabilitation Adherence Scale (GRAS) to measure adherence to physical therapy treatment in Pakistani patients attending rehabilitation clinics for musculoskeletal disorders. METHODS: A month-long study was conducted in patients attending physical therapy sessions at clinics in two tertiary care hospitals in Karachi, Pakistan. It was done using block randomization technique. Sample size was calculated based on item-to-respondent ratio of 1:20. The GRAS was developed and validated using content validity, factor analyses, known group validity, and sensitivity analysis. Receiver operator curve analysis was used to determine cut-off value. Reliability and internal consistency were measured using test-retest method. Data was analyzed through IBM SPSS version 23. The study was ethically approved (IRB-NOV:15). RESULTS: A total of 300 responses were gathered. The response rate was 92%. The final version of GRAS contained 8 items and had a content validity index of 0.89. Sampling adequacy was satisfactory, (KMO 0.7, Bartlett's test p-value< 0.01). Exploratory factor analysis revealed a 3-factor model that was fixed and confirmed at a 2-factor model. Incremental fit indices, i.e., normed fit index, comparative fit index and Tucker Lewis index, were reported > 0.95 while absolute fit index of root mean square of error of approximation was < 0.03. These values indicated a good model fit. The value for Cronbach (α) was 0.63 while it was 0.77 for McDonald's (ω), i.e., acceptable. Test-retest reliability coefficient was 0.88, p < 0.01. Education level was observed to affect adherence (p < 0.01). A cut-off value of 12 was identified. The sensitivity and accuracy of the scale was 95%, and its specificity was 91%. CONCLUSION: The scale was validated in this study with satisfactory results. The availability of this tool would enhance monitoring for adherence as well as help clinicians and therapists address potential areas that may act as determinants of non-adherence.

Development and validation of a novel rheumatoid arthritis knowledge assessment scale in Pakistani patients with rheumatoid arthritis.

AIM: Rheumatoid arthritis (RA) is a chronic progressive disabling disease that mainly affects joints. Studies documenting Pakistani patients' knowledge regarding RA disease are lacking and there is a need for such endeavor. The purpose of this study was to develop and validate a novel research tool to document patient knowledge about RA disease. METHODS: A novel research instrument known as the rheumatoid arthritis knowledge assessment scale (RAKAS) which consisted of 13 items, was formulated by a rheumatology panel and used for this study. This study was conducted in rheumatology clinics of three tertiary care hospitals in Karachi, Pakistan. The study was conducted in March-April 2018. Patients were recruited using a randomized computer-generated list of appointments. Sample size was calculated based on item-to-respondent ratio of 1:15. The validities, factor structure, sensitivity, reliability and internal consistency of RAKAS were assessed. The study was approved by the institutional Ethics Committee. RESULTS: A total of 263 patients responded to the study. Content validity was 0.93 and response rate was 89.6%. Factor analysis revealed a 3-factor structure. Fit indices, namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI) and root mean square of error approximation (RMSEA) were calculated with satisfactory results, that is, NFI, TLI and CFI > 0.9, and RMSEA < 0.06. Internal consistency (α) was 0.62, that is, acceptable. All items had a high discrimination index, that is, >19 and difficulty index <0.95. Sensitivity and specificity of RAKAS were above 90%. The tool established construct and known group validities. CONCLUSION: A novel tool to document disease knowledge in patients with RA was formulated and validated.

Translation and validation of the English version of the general medication adherence scale (GMAS) in patients with chronic illnesses.

Objective: This study aimed to translate the General Medication Adherence Scale (GMAS) into English language and validate it in patients suffering from chronic illnesses. Methods: A 1-month study (January 2018) was conducted in a random sample of patients suffering from chronic illnesses who visited the outpatient departments of four tertiary healthcare facilities in Karachi, Pakistan. Translation of the tool and its content, as well as face validity, was carried out. Factor structure was explored (i.e. exploratory and partial confirmatory factor analyses were carried out) and fit indices were calculated for model fitting. Test-re-test reliability and internal consistency were analyzed. Validity of GMAS-English was established by convergent, discriminant, and concurrent validity analysis. Sensitivity analysis was conducted. Data was analyzed through SPSS version 23. The study was ethically approved by concerned authorities (Letter# NOV:15). Results: The GMAS was translated into English language by standard procedure. Factor analysis indicated a 3-factor model. Fit indices, namely normed fit index, Tucker Lewis index, comparative fit index, and root mean square of error approximation, were calculated with satisfactory results (i.e. NFI, TLI, and CFI > 0.9 and RMSEA < 0.08). Internal consistency (α) was 0.82. A high response rate of 91.6% was reported. GMAS-English established convergent, discriminant, and concurrent validities. The tool was sensitive (>75%) in screening patients with partial-to-low adherence based on their education level. Conclusion: The tool was translated in English language and demonstrated adequate internal consistency. The results indicate that GMAS-English is a valid and reliable tool to measure medication adherence in patients with chronic illness.

A qualitative study investigating perceived barriers to medication adherence in chronic illness patients of Karachi, Pakistan.

OBJECTIVE: The study aimed to perceived barriers to medication adherence in patients with chronic illnesses.. METHODS: A qualitative study was conducted in a tertiary care hospital in Karachi in September 2017, using grounded theory and inductive approach. Interviews were conducted using a checklist in Urdu language from patients of chronic illnesses determined based on medicines dispensed from the out-patient pharmacy in hospital. Interviews were recorded, transcribed verbatim, translated in English and validated. The translated quotations were analysed using a qualitative analysis software, and thematic analysis was conducted. Codes were generated and analysed by semantic linkages and network analysis using ATLAS.ti qualitative research software. RESULTS: Of the 16 patients interviewed, 8(50%) were males and 8(50%) were females. Barriers to medication adherence identified were patient behaviour (intentional and un-intentional non-adherence), comorbidity and pill burden, cost-related non-adherence, and low patient knowledge. The last barrier was associated with the rest. CONCLUSIONS: Counselling has the potential to increase patient knowledge regarding medication use, and active pharmacist-physician collaboration can improve medication adherence..