Consumer Likelihood to Seek Information on OTC Medicines.

There is concern as to whether the public use OTC (over-the-counter) medicines with due diligence. The objective was to quantify the likelihood and extent people would seek information on OTC medicines in relation to 10 non-medicine products as a surrogate of the importance consumers place on them. Citizens of one Canadian province estimated the likelihood and extent (scale of 1 to 10) they would search for information when considering a purchase. The survey had two lists-a MIXED products list (5 OTC medicine categories and 10 non-medicine products) and an OTC MEDICINES list (15 categories). Five hundred and seventy-five surveys were obtained (response rate 19.2 percent). The average age was 63.0 years and 61.6 percent were female. The mean search likelihood for the 15 products on the MIXED list ranged from 2.2 to 7.4. There was more intention to search for information involving OTC medicines (mean = 5.0) than non-medicine products (mean = 4.1). There was a weak positive correlation in search likelihood relative to OTC medicine familiarity. This study revealed that the likelihood of searching for information prior to purchase is not particularly robust. With a plethora of information currently available to consumers, motivation to access it is what may need attention.

Ranking of Curricular Content by Pharmacy Students and Community Pharmacists.

A cross-sectional survey was conducted to determine the relative rankings of 17 key components in an undergraduate program. The degree of discrepancy between curricular content and that of student and pharmacist expectations was also of interest. An online questionnaire was emailed to both groups in one Canadian province. Respondents considered four questions related to the nature and adequacy of education they did receive (pharmacists) or should receive (students) and the relative importance of key topic areas (along 11-point scales). The response rate was 31.0 (students) and 10.8 percent (pharmacists). As expected, both students and pharmacists identified therapeutics and patient counselling as critical focal points for the program, while the importance of compounding was mixed. Most topics were deemed as best handled during the didactic program, with students seeing greater value in learning a larger portion of two skills (injection training and managerial duties) post-graduation. In conclusion, discrepancies were indeed found. For students, topics such as injection training and minor ailment prescribing were perceived as receiving too little attention, while communication, pharmaceutical sciences, and professionalism received too much attention. In a significant departure in perspective, pharmacists rated communication, ethical decision-making, and professionalism almost two points higher than did students.

Prevalence and Correlates of Self-Medication Practices for Prevention and Treatment of COVID-19: A Systematic Review.

It has been suggested that the COVID-19 pandemic led to an increase in self-medication practices across the world. Yet, there is no up-to-date synthesized evidence on the prevalence of self-medication that is attributable to the pandemic. This study aimed to conduct a systematic literature review on the prevalence and correlates of self-medication for the prevention and treatment of COVID-19 globally. The review was registered with the PROSPERO database. Searches were conducted following PRISMA guidelines, and relevant articles published between 1 April 2020 and 31 March 2022 were included. Pooled prevalence rate was conducted using the Meta package in R. A total of 14 studies from 14 countries, which represented 15,154 participants, were included. The prevalence of COVID-19-related self-medication ranged from 3.4-96%. The pooled prevalence of self-medication for this purpose was 44.9% (95% CI: 23.8%, 68.1%). Medications reported by studies for self-medication were antibiotics (79%), vitamins (64%), antimalarials (50%), herbal and natural products (50%), analgesics and antipyretics (43%), minerals and supplements (43%), cold and allergy preparations (29%), corticosteroids (14%), and antivirals (7%). The prevalence of self-medication with antibiotics is concerning. More public health education about responsible self-medication amidst the COVID-19 pandemic and future pandemics is required to mitigate the rising threat of antimicrobial resistance.

Improving pharmacy performance through market orientation and the implementation of expanded pharmacy services.

This study seeks to extend the limited knowledge of market orientation's effects in retail pharmacy. Specifically, this study explores market orientation's role in the implementation of expanded pharmacy services and resulting performance implications among Canadian retail pharmacies. The results of the structural equation model showed that market orientation directly influenced the implementation of expanded pharmacy services and professional performance. The implementation of expanded pharmacy services was linked to professional performance and ultimately furthered financial performance. This study highlights the importance of how a market-oriented strategy and a pharmacy's decision to implement expanded pharmacy services can increase the dual objectives of the retail pharmacy.

Financial Incentive Required for Pharmacy Students to Accept a Post-Graduation Position in Rural and Undesirable Pharmacy Settings.

Background: It has been estimated that in 2018, 20% of pharmacy students were unemployed following graduation. However, many pharmacy positions go vacant each year, with the majority of these positions existing in rural areas. Methods: Pharmacy students completed a one-time, anonymous, online questionnaire. Measures of interest included: subject characteristics and preference in a variety job offers. Discrete Choice Experiment methodology of questionnaire design was used and Conditional Logit models were conducted to analyze the data to determine the financial incentive required for pharmacy students to take a post-graduate job with particular traits. Conclusions: A total of 283 students completed questionnaires from Iowa, North Dakota, South Dakota, Saskatchewan, and Manitoba. The majority of subjects were female, P3 students, and from a non-rural hometown. American students would need to be paid an additional $18,738 in salary to practice in a rural area, while Canadian students would require an additional $17,156. Canadian respondents would require an additional $7125 in salary to work in a community pharmacy with a low level of patient interaction compared to a community position with a large amount of patient interaction. Overall, pharmacy student preferences in post-graduation job attributes vary significantly between states and provinces.

Community pharmacists' experiences with the Saskatchewan Medication Assessment Program.

BACKGROUND: The Saskatchewan Medication Assessment Program (SMAP) is a publicly funded community pharmacy-based medication assessment service with limited previous evaluation. The purpose of this study was to explore community pharmacists' experiences with the SMAP. METHODS: Online, self-administered questionnaire that consisted of a combination of 53 Likert scale and free-text questions. All licensed pharmacists who were practising in a community pharmacy setting in Saskatchewan were eligible to participate. RESULTS: Response rate was 20.3% (n = 228/1124). Most respondents agreed that the SMAP is achieving all of its intended purposes. For example, 89.7% agreed that the SMAP improved medication safety for patients who receive the service. Most pharmacists enjoyed performing the assessments (84.6%) and were confident in their ability to identify drug-related problems (88.3%). Pharmacists reported lack of time, patients having difficulty coming to the pharmacy and restrictive eligibility criteria as the top barriers to the SMAP. Good teamwork, employer support and personal professional commitment were the top recognized facilitators. Respondents made several suggestions to improve the SMAP in the free-text areas of the questionnaire. CONCLUSIONS: Community pharmacists in Saskatchewan were positive and confident about performing medication assessments, and most agreed that the SMAP is achieving all of the intended purposes. Respondents also identified several barriers to providing SMAP services, which have resulted in specific recommendations that should be addressed to improve the program.

Providing mindfulness meditation for patients with depression and anxiety in a community pharmacy: A pilot study.

OBJECTIVE: The objective of this study was to assess the impact of mindfulness meditation offered in a community pharmacy on patients with current anxiety or a history of anxiety, depression, or both. SETTING: Community pharmacy clinical space located in a grocery store. PRACTICE DESCRIPTION: An 8-week, once-per-week mindfulness meditation program for patients with anxiety or depression. PRACTICE INNOVATION: A pharmacist provided mindfulness meditation within the clinical space in a community pharmacy. EVALUATION: PHQ-9 and GAD-7 were used to assess prestudy and poststudy depression and anxiety severity, respectively. Items pertaining to participant demographics and experience in the program were also included. RESULTS: Twelve participants completed the study requirements. Three-quarters of participants experienced a reduction in the severity of their depression or anxiety, and no participant experienced an increase in the severity of his or her condition. CONCLUSION: Findings from this study indicated that a mindfulness meditation program delivered in a community pharmacy and provided by a pharmacist for patients with depression or anxiety, or both, can result in a reduction in severity of their conditions for participants.

Student perceptions of an experiential education clinic within a pharmacy school.

BACKGROUND AND PURPOSE: Pharmacy schools would benefit from new models of experiential education. The University of Saskatchewan (Canada) recently opened a patient care clinic called the Medication Assessment Centre (MAC) as new experiential education model. The purpose of this paper is to describe the structure and function of the MAC and to report program evaluation data. EDUCATIONAL ACTIVITY AND SETTING: The MAC is a unique application of an existing experiential education model in that it is an pharmacist-run ambulatory clinic (which is common) that is physically located on campus amongst the classrooms and supervised by pharmacy faculty (which is unique). Students are all required to participate in the clinic on a regular basis, in between lectures, throughout the four years of the pharmacy program. FINDINGS: Students were invited to participate in one of five focus groups to assess the value of the experience. Transcripts were analyzed using thematic analysis, and the results identified strong satisfaction amongst students. The overall themes fell into three categories: (1) aspects that students liked, (2) aspects that students found challenging, and (3) positive impact on student learning. Previously published studies have found strong support for the MAC amongst patients and physicians. SUMMARY: Students felt that a faculty supervised experiential education clinic that is physically located within their pharmacy school was a valuable learning experience. This paper provides a description of how the MAC has been integrated into an existing pharmacy curriculum, which may be valuable to schools contemplating a similar addition to existing experiential learning.

Student Perceptions of Learning Through an International Comparison.

Objective. To broaden pharmacy students' international perspectives through a teaching and learning method involving international comparison. Design. Four topics within a pharmacy law and practice course were taught in-person by collaborating faculty members representing two international perspectives (Australian and Canadian). The assessed learning objective was for students to be able to synthesize an international comparative analysis that reflected an international perspective. Assessment. Approximately 70% (n=44) of the class completed an online survey instrument that explored students' perceptions of their own learning. Six domains of inquiry represented in the questionnaire included knowledge development, international perspective, future prospects, personal enjoyment, assessment method, and overall learning experience. Quantitative and qualitative survey results reflected students' strong support for all statements of inquiry. Conclusions. The method involving international comparison, a classroom teaching collaboration and knowledge management using compare-contrast strategy positively influenced student perceptions in a range of ways and was effective in raising international perspectives in the pharmacy curriculum.

Public Education Campaigns to Transform Perceptions of Pharmacists: Are They Worth the Investment?

Recent public opinion polls consistently rank pharmacists as highly trusted health care professionals, but the reasoning for this ranking continues to remain vague and inconclusive. One possible explanation for this high ranking is that it is due in part to the limited expectations the public has of the profession. To gather comparative "before" and "after" data for this study, a self-administered, 33-item paper questionnaire was disseminated to 382 postsecondary (undergraduate) business students in a classroom setting. The questionnaire was designed to assess respondents' baseline perceptions toward (1) the pharmacy profession, in general, and (2) a prerecorded video of a simulated patient-pharmacist counseling session. Most respondents initially reported a "Poor/Fair" understanding of pharmacist education and training (52.1%), what to expect when having a prescription dispensed (55.5%), the content of a counseling session (49.7%), and pharmacist scope of practice (55.5%). After viewing the educational video, the number of respondents who reported a "Poor/Fair" understanding dropped to less than 5%; the majority of respondents reported a "Very Good/Excellent" understanding of pharmacist education and training (63.1%), what to expect when having a prescription dispensed (56.0%), the content of a counseling session (66.4%), and pharmacist scope of practice (60.5%). Results of this study demonstrated that using a public education-type video to increase public awareness for the pharmacy profession and pharmacist counseling duties significantly impacted respondents' knowledge and perception of value toward the profession and of pharmacist counseling.

A Qualitative Assessment of the Practice Experiences of Certified Diabetes Educator Pharmacists.

OBJECTIVE: To describe the practice experiences of Certified Diabetes Educator (CDE) pharmacists in Saskatchewan and determine what impact the CDE designation has had on their personal practices. METHODS: A qualitative research approach was used. All pharmacists in Saskatchewan were e-mailed about the study, and eventually, a purposive sampling method was used to select a range of CDE pharmacists. Semistructured, in-person interviews were performed. An interview guide was developed to assess the work activities performed, the benefits of becoming a CDE and the challenges and resultant solutions that optimize their CDE designations. All interviews were transcribed verbatim and coded using deductive thematic analysis to identify the main themes that described the experiences of respondents, with the aid of QSR NVivo. RESULTS: A total of 14 CDE pharmacists from various communities and work settings chose to participate. All of the participants indicated they were engaging in increased diabetes-related activities since becoming CDEs. All participants indicated they were happy with their decisions to become CDEs and described numerous benefits as a direct result of achieving this designation. Although some solutions were offered, participants still face challenges in optimizing their role as CDEs, such as devoting enough time to diabetes management and remuneration for providing diabetes services. CONCLUSIONS: CDE pharmacists in Saskatchewan report performing enhanced diabetes-related activities subsequent to becoming CDEs and that obtaining this designation has had a positive impact on their personal practices. A larger, cross-country study is necessary to determine whether these results are consistent amongst all pharmacists in Canada.

Redesign of a required undergraduate pharmacy management course to improve student engagement and concept retention.

OBJECTIVE: To change the structure of a required pharmacy management course to make it more interactive and engaging for students. DESIGN: The course is a required component of undergraduate curriculum and is completed over 2 semesters during the students' third year. Changes included requiring students to lead classroom discussions and complete a business plan in groups. ASSESSMENT: A questionnaire centering on methods of delivery, course content, and outcomes was distributed in 2 academic years, with 74.7% of students responding. Even though the redesigned course required more time, there was strong support for the course among students because they realized the content contributed to their learning. CONCLUSION: A major course redesign is a big commitment by faculty members, but if done through consultations with former and current students, it can be rewarding for all involved. Students overwhelmingly embraced the changes to the course as they realized the restructuring and the resulting increase in workload were necessary to raise the relevance of the course to their future professional practice.

Patient awareness of specialized diabetes services provided in community pharmacies.

BACKGROUND: Community pharmacists are increasingly seeking advanced certification in various clinical areas, including diabetes. However, it is unclear as to how much patients are aware of this advanced training and how they would like specialized services to be provided. OBJECTIVES: To discern patients' level of awareness and understanding of the Certified Diabetes Educator (CDE) designation, the level of support for CDE pharmacists' services, and if the CDE designation would have any influence on patronage patterns. METHODS: A convenience sample of people with diabetes was asked to complete a self-administered questionnaire at 1 of 10 community pharmacies. Questionnaires were completed and returned in a self-addressed envelope. Descriptive statistics were performed, followed by post hoc analysis including principal component analysis to evidence questionnaire validity and discern latent attitudinal structure. RESULTS: There were 121 completed questionnaires returned (37.1% response rate). Fifty-four percent of respondents reported knowing of the CDE designation, whereas 82% were unaware that pharmacists could become a CDE. On learning of a CDE pharmacist in their community, 59% would likely schedule an appointment, whereas 27% would schedule an appointment if a fee was charged. The 2 constructs emerging from analysis were the patient/pharmacist relationship and pharmacist as CDE. Those who reported a relationship with their pharmacist were more likely to discuss their diabetes with a CDE pharmacist and schedule an appointment if a fee was charged. Respondents who reported a high level of importance of pharmacists as CDEs felt that a CDE pharmacist improves the image of the pharmacy. CONCLUSIONS: There appears to be little awareness that pharmacists may become CDEs. The patient-pharmacist relationship and whether a fee is being charged influence whether respondents' would see a CDE pharmacist. Many indicated that they would be willing to see a CDE pharmacist if they knew one was available, yet it may not be a big enough factor to influence where their prescriptions are filled.

Pharmacy ownership in Canada: implications for the authority and autonomy of community pharmacy managers.

BACKGROUND: In recent years, the number of independently owned pharmacies has declined even as the total number of pharmacies in Canada has increased. With increasing corporate ownership, there is concern that this trend will adversely affect the profession's ability to influence pharmacy practice and practice change. OBJECTIVE: To examine the relationship between ownership type and community pharmacy managers in terms of professional and employer authority, managerial autonomy, decision making, and amount of control. METHODS: This study consisted of a cross-sectional survey of community pharmacy managers in Canada by means of a self-administered postal questionnaire sent to a stratified sample of community pharmacies. Statistical analysis consisted of exploratory factor analysis with reliability testing on identified constructs. Frequencies, 1-way analyses of variance, Scheffe post hoc tests, and general linear modeling were used to determine significant differences among groups based on ownership type. RESULTS: In total, 646 of 1961 questionnaires from pharmacy managers were completed and returned (response rate 32.9%). Respondents rated their authority similarly across ownership types. Autonomy, decision-making capabilities, and control needed to carry out the professional role appear most limited among corporate respondents and, to a lesser extent, franchise managers. CONCLUSIONS: Pharmacy managers currently perceive a high level of authority; but with limited autonomy among corporate managers, it is unclear whether this authority is sufficient to prevent the subordination of both patient and professional interests to financial interests.

Influence of ownership type on role orientation, role affinity, and role conflict among community pharmacy managers and owners in Canada.

BACKGROUND: Ownership of community pharmacies is increasingly being controlled by a relatively small number of corporate entities. The influence of this ownership type should not be ignored, because ownership has the ability to impact pharmacy practice. OBJECTIVES: To examine the relationship between ownership type and community pharmacy managers with regard to role orientation, role affinity, and role conflict. METHODS: This study consisted of a cross-sectional survey of community pharmacy managers in Canada by means of a self-administered postal questionnaire sent to a stratified sample of community pharmacies. Statistical analysis consisted of exploratory factor analysis with reliability testing on identified constructs. Frequencies, 1-way analyses of variance, and Scheffe post hoc tests were used to determine significant differences among groups, including ownership structure, on each of the constructs. RESULTS: A total of 646 completed questionnaires were received (32.9% response rate). Most of the respondents were males (60.8%), with slightly less than half of the respondents identifying their practice type as an independent pharmacy (44.6%). There were 5 multi-item scale constructs (professional orientation, business orientation, professional affinity, business affinity, and role conflict) arising from the data, which were analyzed against the pharmacy ownership structure (independent, franchise, corporate) independent variable. Analysis revealed significant differences for 3 of the 5 constructs; however, no differences were seen regarding the 2 professionally focused constructs. CONCLUSIONS: Community pharmacy managers/owners are generally oriented to their professional role; however, those working in a corporate pharmacy environment are less oriented to their business role when compared with those working in an independent or franchise pharmacy environment. Further research is needed to identify different practice cultures that may exist in various practice settings and the extent to which these cultures attract or define the managers working in them.

Perceptions of Saskatchewan community pharmacists regarding a prior-authorization program.

BACKGROUND: In 1999, Saskatchewan Health authorized pharmacists to initiate exception drug status (EDS) requests, also known as prior authorization (PA). Before 1999, only those licensed to prescribe medications were authorized to initiate EDS requests. A pharmacist who submits an EDS request must obtain a patient diagnosis from the physician or agent of the physician; a diagnosis presented by the patient is insufficient. OBJECTIVE: To obtain pharmacists' opinions about the benefits of the PA program of the Saskatchewan drug Plan and to identify factors associated with pharmacist-initiated EDS requests. METHODS: A census survey of community pharmacy managers was conducted via a self-administered postal questionnaire in the province of Saskatchewan, Canada, in the fall of 2004. The survey questionnaire was addressed to pharmacy managers, some of whom may have delegated the response to a staff pharmacist. Pharmacy managers or their delegates were asked to respond on behalf of all pharmacists in their pharmacies. RESULTS: A response rate of 82.6% was achieved (275/333). A majority of respondents agreed that the province's PA program (EDS) benefited patients (87.3%) and the Saskatchewan drug Plan (82.5%), whereas only 33.4% of respondents agreed that the EDS program benefited pharmacists. Pharmacists' ability to obtain the requisite information (87.6%) and to contact the prescribing physician (87.3%), as well as patient-centered concerns such as the patient's ability to pay for the prescription (85.1%), were the most important factors. The time required by the pharmacist to initiate the request was not important relative to other factors. community pharmacies reported receipt of an average of 36.4 prescriptions for restricted and nonformulary drugs per week, of which 22 were submitted for PA coverage, 17 by the pharmacy and 5 by the pharmacy at the request of the physician. CONCLUSION: The results of this study indicate that community pharmacists in Saskatchewan acknowledge that the EdS process is beneficial for their patients. However, pharmacists are burdened by an administrative process in which necessary information, particularly the patient diagnosis, is not readily available.