Psychosocial factors associated with pharmacists' end-of-life medication counseling and dispensing.

OBJECTIVE: In 2015, California legalized physician-assisted suicide through passing the End of Life Option Act (ELOA). This study aimed to identify and describe the psychosocial factors associated with pharmacists' intention to counsel and dispense end-of-life medications. METHODS: Data were collected using a 51-item questionnaire that was mailed to 2,000 registered community pharmacists in California. The study collected data on TPB constructs (attitude, subjective norm [SN], and perceived behavioral control [PBC]), behavioral and control beliefs, perceived obligation, and demographic and practice characteristics. Hierarchical linear regression was used to identify the factors associated with the pharmacists' intention. RESULTS: A total of 353 responses (19.4% response rate) were received from respondents with an average age of 50.4 ± 14.8 years. Most of the respondents were women (53.1%) and religious (56.4%). Most pharmacies did not currently stock ELOA medications (n = 197, 56.1%), and most pharmacists had never been presented with an ELOA prescription in their practice (n = 319, 90.4%). The pharmacists had a positive intention (mean = 8.24 ± 4.6, range: 2-14), attitude (mean = 17.15 ± 6.9, range: 4-28), SN (mean = 1.1 ± 4.5; range: -9 to 9), and PBC (mean = 1.85 ± 3.5; range: -6 to 6) to dispense ELOA medications. Attitude (ß = 0.570, P < 0.001), SN (ß = 0.238, P < 0.001), and perceived obligation were statistically significant predictors of the pharmacists' intention to dispense ELOA medications for patients with a valid prescription but PBC (ß = 0.022, P = 0.531) was not. CONCLUSION: Interventions to promote pharmacists' counseling and dispensing of ELOA medications should focus on developing strong intention. Improving pharmacists' attitude, SN, and perceived obligation is critical to increasing their willingness to dispense ELOA medications.

Pharmacists' spiritual care perspectives and experiences: Qualitative findings from a statewide survey.

OBJECTIVE: Pharmacists are encouraged to provide whole-person care. Because holistic care is conceptualized as including spiritual care (SC), this study investigated the experiences and perspectives of pharmacists regarding SC in pharmacy practice. METHODS: Data for this cross-sectional, qualitative study were collected from a survey mailed to 1000 randomly selected registered pharmacists in California in 2019. The data reported here are the responses to open-ended questions eliciting information about the last time the pharmacists provided SC to a patient, indicators that a patient needs spiritual assistance, and religious beliefs thought to be harmful. The data were content-analyzed by 2 investigators. RESULTS: Although 215 pharmacists responded to the survey, only 141 responded to the open-ended questions. Most of the respondents were women (58%), Christian (70%), religious (73%), attended religious services (78%), and practiced in an urban setting (56%). The themes observed indicated that these pharmacists prayed with, and for, patients; talked to patients about God and religion; referred patients to spiritual services; were sensitive to patients' spiritual or religious beliefs; and listened to patients' expressions of spirituality. Some respondents, however, avoided religious conversations and requests; some also reported unwillingness to provide SC to patients. The pharmacists had limited education, knowledge, and awareness about SC. CONCLUSIONS: The pharmacists in this sample reported diverse perspectives about SC that ranged from acceptance to rejection of SC in patient care. Pharmacists are not fully engaged in providing SC because of several challenges, including limited education and training on SC. Scholarly inquiry is needed to examine how pharmacists can best provide SC in pharmacy practice.

Pharmacists' perspectives about spiritual care: A state-wide survey.

BACKGROUND: Patients' religious and spiritual beliefs affect their health behaviors, health outcomes, and interactions with health care providers. Incorporating spiritual support in clinical care contributes positively to patient health outcomes. No known studies have explored spiritual care (SC) within the context of pharmacy practice. OBJECTIVE: To examine pharmacist perspectives about SC, the frequency with which SC is incorporated in pharmacy practice, and the ways that pharmacists provide SC. METHODS: Data were collected using a cross-sectional statewide survey. The 57-item questionnaire was mailed to 1000 randomly selected registered pharmacists in California in 2019. Descriptive statistics, Pearson correlation, independent samples t test, and chi-square tests were used to analyze the data. RESULTS: Most of the 215 respondents were female (57.5%); the average length of work experience was 23.3 years (SD = 14.4). Just over half practiced in an urban setting (51.1%); similarly, half worked with terminally ill patients (50.2%). Most of the respondents were "somewhat" to "very spiritual" (77.8%) and "somewhat" to "very religious" (64.3%). Most pharmacists agreed that pharmacists should know about patients' spiritual concerns that may relate to their health (60.5%), that they should practice in a spiritually sensitive manner (73.4%), and that addressing patients' spiritual concerns improved their mental and physical health (76.7%). Respondents "rarely" to "very often or always" prayed privately for a patient (63.8%) and talked to patients about a spiritual and/or religious topic (51.2%), encouraged a patient to pray (49.3%), referred patients to their clergy or religious leader (39.5%), and prayed with a patient (33.5%). The frequency of spiritual services provided by pharmacists differed by their own spirituality, religiosity, and perception of institutional support (P < 0.05). CONCLUSION: Most of the respondents were spiritual and religious and believed that spirituality is important for their patients. Thus, some provided SC to their patients. Future research is warranted to examine ethically appropriate strategies for pharmacists to provide SC.

California Dentists' Opinions of the Interface Between Oral and Overall Health.

This cross-sectional study investigated California dentists' knowledge and opinion of the interface between oral and overall health. A questionnaire and cover letter explaining the purpose of the study were mailed to 1,100 randomly selected California licensed general dentists. The survey measured dentists' knowledge and opinions of the interface between oral and overall health as well as their recommendations for strengthening this interface. Dentists believed that there was minimal interface between oral and overall health care.

Attitudes of Nursing Facilities' Staff Toward Pharmacy Students' Interaction with its Residents.

OBJECTIVE: All Appalachian College of Pharmacy second-year students undertake the longitudinal geriatric early pharmacy practice experiences (EPPE) 2 course, which involves interacting with geriatric residents in two nursing facilities over two semesters. The study investigated the nursing staff's perceptions about the rotation and the pharmacy students' interaction with nursing facility residents. STUDY DESIGN: Cross-sectional study. SETTING: Academic setting. PARTICIPANTS: 63 nursing facility staff. INTERVENTIONS: A 10-item attitude survey administered to nursing staff. MAIN OUTCOME MEASURES: Nursing staff attitude toward pharmacy students' interaction with geriatric residents during the course. RESULTS: Sixty-three responses were received (84% response rate). Most respondents were female (95.2%), who occasionally interacted with pharmacy students (54.8%) and had worked at the facilities for an average of 6.8 years (standard deviation [SD] = 6.7) years. Staff reported that pharmacy students practiced interacting with geriatric residents and nursing facility staff, learned about different medications taken by residents as well as their life as a nursing facility resident. In addition, the student visits improved the mood of residents and staff's understanding of medicines, among others. Staff suggested that students spend more time with their residents in the facility as well as ask more questions of staff. CONCLUSION: The nursing facility staff generally had favorable attitudes about pharmacy students' visits in their nursing facility. Nursing facility staff noted that the geriatric rotation was a great learning experience for the pharmacy students.

Examination of the use of complementary and alternative medicine in Central Appalachia, USA.

INTRODUCTION: A growing number of people in the USA and worldwide use complementary and alternative medicine (CAM). CAM usage has been reported to differ by region. Little is known about the usage of CAM, especially among the Appalachian region population. The aim of this study is to evaluate the usage of CAM among adults in Central Appalachia. METHODS: A 23-question survey was distributed to 250 participants seeking free medical care at remote area medical events held in Wise County, Virginia in July 2012 and in Buchanan County, Virginia in October 2012. The questions on the survey addressed various aspects concerning CAM: forms of treatment used, frequency of use, main reasons for using CAM, and where they obtained their CAM therapies. The survey also collected demographic characteristics of the respondents. Subjects were asked to complete a two-page survey while waiting for service. RESULTS: A total of 192 (76.8%) responses were useful and complete. About 56% of the CAM users were female and 55% had an annual gross income of less than $20,000. About 49% had used CAM therapies in the past, of which 58% used CAM therapies at least once a month. Respondents used CAM because it worked well (n=52; 27%), had less side effects (n=45; 23%), and was affordable (n=43; 22%). CAM therapies were used mainly to address back pain (n=23; 15.6%), general health and wellbeing (n=22; 14.9%), depression and anxiety (n=11; 7.5%), and general pain (n=11; 7.5%), among others. Having a primary care provider, current level of education, and gross annual income were significantly associated with CAM use (p<0.001). Most respondents (n=94; 85%) were comfortable telling their doctor or other medical personnel about their use of CAM therapies. CONCLUSION: The prevalence of CAM usage among people in the Central Appalachia region was high, and higher than the national average. Most respondents were comfortable sharing their CAM usage information with their healthcare providers. More research is needed to further understand the factors underpinning CAM usage by the Central Appalachia population.

Adverse childhood experiences among California student pharmacists.

Introduction: Adverse childhood experiences (ACEs) are associated with higher mental and physical illness and substance use disorders in adulthood. However, little is known about the prevalence of ACEs among student pharmacists and the factors associated with exposure. Our objective was to determine the prevalence of ACEs, resilience, and maladaptive coping strategies among student pharmacists in California. Methods: Student pharmacists from 14 California pharmacy schools completed a 24-item online survey in 2020. This survey instrument comprised the ACEs questionnaire and collected data on the students' demographic characteristics, coping strategies, and resilience. Results: Most respondents were Asian/Pacific Islander (n = 186, 61.0%), female (n = 216, 70.8%), and aged between 25 and 31 years (n = 154, 50.7%). Many (n = 137, 44.9%) students had more than 1 ACE exposure; 66 students (21.6%) had more than 3 ACEs. Many students indicated that they were diagnosed or suspected to be diagnosed with a mental health condition (n = 105, 34.4%) and agreed/strongly agreed that they struggled to manage the workload of pharmacy school (n = 119, 39.9%). Respondents with higher ACE scores (> 3) were more likely to report struggling with managing the workload of pharmacy school, have or suspect having a mental health condition, drink alcohol in the last 12 months, and/or have multiple sexual partners than students with lower ACE scores. Discussion: More than 1 in 5 student pharmacists in this study were exposed to more than 3 ACEs. The student pharmacists' ACE exposure was associated with higher likelihood of mental health conditions and high-risk health behaviors. Further studies are needed to investigate this topic among student pharmacists.

Investigating pharmacy students' attitudes toward nursing facility patients after a geriatric rotation.

OBJECTIVE: To investigate pharmacy students' attitudes toward nursing facility patients and nursing facilities after completing a geriatric rotation. DESIGN: A cross-sectional post-test 20-item survey. SETTING: An academic institution and two nursing facilities. PARTICIPANTS: Nursing facility patients and second-year Appalachian College of Pharmacy students. INTERVENTIONS: Students in Early Pharmacy Practice Experience 2 geriatric course. OUTCOME MEASURES: Students' attitudes toward nursing facility patients and nursing facilities (14 items). RESULTS: Of 138 students, 91.4% completed the survey following their geriatric rotation. Most students had positive attitudes toward nursing facility patients and nursing facilities on all 14 items. For example, students thought, "most older people are pleasant to be with" (mean = 3.88 ± 1.1). About 98% of students had adequate knowledge of geriatrics. Age, gender, marital status, and relationship with grandparents were not associated with students' attitudes (P ≯ 0.05). CONCLUSION: Pharmacy students had positive attitudes toward elderly patients and nursing facilities and adequate knowledge of geriatrics after completing the geriatric rotation.

Pharmacy students' perceived barriers to spiritual care: A qualitative study.

Background: Spiritual care (SC) is an important component of whole person care, a goal that many pharmacists embrace. Knowledge about barriers to incorporating SC in pharmacy practice may allow understanding of how to increase its provision. Objectives: The objective of the study was to investigate pharmacy students' perceived personal and professional barriers to incorporating SC in pharmacy practice. Methods: Second-year pharmacy students (n = 62) who attended a required class lecture on SC in healthcare responded to three open-ended questions that explored beliefs about SC in pharmacy practice. Students' responses were thematically analyzed using NVivo. Results: Most (68%) of the students were female; 34% were Asian American. Students identified the following barriers to incorporating SC: limited or lack of time for SC, lack of supervisor and company support for SC, discordant pharmacist-patient spiritual beliefs, discomfort with talking about spirituality, lack of knowledge about spirituality and SC, personal factors, patient refusal of SC, fear of offending patients by discussing spirituality, and pharmacy environment. Conclusion: Major barriers to SC include lack of time for SC, lack of supervisor and company support for SC, and discordant pharmacist-patient spiritual beliefs. Future studies should be conducted to investigate these and other barriers to SC in pharmacy practice.

Pharmacy students' attitudes and beliefs about spirituality and spiritual care in professional education in Zimbabwe.

INTRODUCTION: A majority of Zimbabweans are religious and/or spiritual. Spirituality and spiritual care (SC) are important parts of patient care. The study's objective was to investigate pharmacy students' attitudes/beliefs about spirituality and SC in pharmacy education and practice in Zimbabwe. METHODS: This cross-sectional descriptive nationwide study gathered data from pharmacy students at the University of Zimbabwe (UZ) and Harare Institute of Technology. The 38-item survey measured students' spirituality and SC perspectives and their religious and demographic characteristics. RESULTS: Most respondents were Christian (89%), female (54%), and attended the UZ (63%). Slightly over half agreed/strongly agreed that they "would like to undertake coursework that will make them competent in providing SC to patients" (52%), SC education would improve their clinical performance (51%), and education that promotes spiritual well-being or integration will make them more empathetic and compassionate practitioners (63%). Pharmacy students also believed that more education on spirituality should be given to pharmacy students (48%), SC is an important part of pharmacy practice (74%), "discussing patients' spiritual or religious beliefs can improve the pharmacist-patient relationship" (74%), and anticipated to incorporate spirituality into professional practice upon graduation (50%). CONCLUSIONS: Most pharmacy students in Zimbabwe considered themselves spiritual/religious and had positive perceptions about spirituality and SC in pharmacy education and practice. There was a positive association between students' personal religiosity and their beliefs about SC. Students anticipated that SC would be incorporated into their education and future professional practice and indicated they wanted more education and training to feel competent in SC.

An exploratory qualitative study of pharmacy student perspectives of implicit bias in pharmacy practice.

INTRODUCTION: Implicit biases can contribute to unfair treatment in healthcare and exacerbate healthcare disparities. Little is known about the implicit biases that exist within pharmacy practice and their behavioral manifestations. The purpose of this study was to explore pharmacy student perspectives about implicit bias in pharmacy practice. METHODS: Sixty-two second-year pharmacy students attended a lecture on implicit bias in healthcare and engaged in an assignment designed to explore their thoughts about how implicit bias manifests or may manifest within pharmacy practice. Students' qualitative responses were content analyzed. RESULTS: Students reported several examples in which implicit bias may emerge in pharmacy practice. Various forms of potential bias were identified including bias associated with patients' race, ethnicity, and culture, insurance/financial status, weight, age, religion, physical appearance and language, lesbian, gay, bisexual, transgender, queer/questioning and gender identity, and prescriptions filled. Students identified several potential implications of implicit bias in pharmacy practice including unwelcoming non-verbal behavior on the part of providers, differences in time devoted to interacting with patients, differences in empathy and respect, inadequate counseling, and (un)willingness to provide services. Students also identified factors that could precipitate biased behaviors such as fatigue, stress, burnout, and multiple demands. CONCLUSIONS: Pharmacy students believed that implicit biases manifested in many different ways and were potentially associated with behaviors that resulted in unequal treatment in pharmacy practice. Future studies should explore the effectiveness of implicit bias trainings on reducing the behavioral implications of bias in pharmacy practice.

Effectiveness of an analogy-containing video project to reinforce pharmacy students' learning of kidney physiology.

BACKGROUND AND PURPOSE: Kidney physiology is one of the most difficult topics covered in health professions education. This study examined the effectiveness of an analogy-containing video project to reinforce pharmacy students' knowledge of kidney physiology. EDUCATIONAL ACTIVITY AND SETTING: Students were assigned in groups to create a video that used analogy to explain kidney physiology processes. Survey responses, a rubric, and an objective test were used to assess the project's effectiveness. FINDINGS: Students generated various analogies, such as making tea or coffee, cars and roads, and the college application process to explain kidney physiology. Most of the submitted videos successfully met all criteria in the rubric. All students believed that the project was effective, to varying degrees, in reinforcing their knowledge. Weak to moderate positive correlations were found between time spent on the project and perceived effectiveness of use of analogy to accomplish most of the learning objectives investigated. Students reported that the project engaged both lower- and higher-order cognitive skills. Quiz score analysis showed higher average scores of students on physiology-related questions compared to non-physiology items. Notably, this improvement was most marked for bottom-performing students. About 60% of students recommended the use of videos as a class assignment, but only 50% believed that they should be used as an alternative to quizzes. SUMMARY: An analogy-containing video project effectively reinforced student learning of kidney physiology. Further studies are needed to verify the effectiveness of this technique compared to other didactic and learning approaches.

Effect of social influences on pharmacists' intention to report adverse drug events.

OBJECTIVES: To identify the groups or individuals that influence pharmacists' decision making to report adverse drug events (ADEs), determine the differences in social influence or subjective norm between intenders and nonintenders, and determine the relationship between subjective norm toward reporting serious ADEs and practice and demographic characteristics. DESIGN: Nonexperimental cross-sectional study. SETTING: Texas during June and July 2009. PARTICIPANTS: 1,500 Texas pharmacists. INTERVENTION: As part of a larger survey, 3 and 18 items were used to assess pharmacists' intentions and subjective norm, respectively, to report serious ADEs to the Food and Drug Administration (FDA). MAIN OUTCOME MEASURE: Pharmacists' subjective norm toward reporting serious ADEs. RESULTS: The survey had a response rate of 26.4% (n = 377). Most pharmacists intended to report serious ADEs that they would encounter (15.87 ± 4.22 [mean ± SD], possible range 3-21, neutral = 12). The mean subjective norm scores were moderately high and positive (28.75 ± 9.38, 1-49, 16), indicating that the referents had a moderate influence on pharmacists regarding reporting serious ADEs to FDA. FDA had the greatest (34.82 ± 12.16) and drug manufacturers the lowest (21.55 ± 13.83) social influence. The most important salient referents (important others) in pharmacists' decisions to report serious ADEs were FDA, patients, pharmacy associations, pharmacy managers/bosses, and hospitals and hospital groups. Gender (female equals higher), pharmacists' years of experience (negative correlation), and knowledge of ADE reporting (positive correlation) were associated with subjective norm. CONCLUSION: Pharmacists had a moderately high subjective norm, suggesting that ADE reporting intentions is influenced by others and that the opinions of others are of great importance in pharmacists' intentions regarding ADE reporting. The main drivers of subjective norm were FDA, patients, pharmacy associations, and managers/bosses.

Pharmacist reporting of serious adverse drug events to the Food and Drug Administration.

OBJECTIVE: To identify barriers to and facilitators of pharmacist reporting of serious adverse drug events (ADEs) to the Food and Drug Administration (FDA). METHOD: Two focus groups consisting of practicing pharmacists were held in Austin, TX, in 2009. The following open-ended questions were used in the focus groups: (1) What do you think would make it easier to report serious ADEs to the FDA? (2) What do you think would make it more difficult to report serious ADEs to the FDA? A content analysis was performed on the generated transcripts. RESULTS: 13 pharmacists practicing in hospital and community settings in Texas participated. Pharmacists identified 27 barriers to and facilitators of reporting serious ADEs to FDA. Lack of patients' complete medical histories and lack of time were the barriers most frequently cited. Knowledge and awareness of ADEs and ADE reporting emerged as important factors that would facilitate reporting serious ADEs to FDA. CONCLUSION: These findings highlight the factors that facilitate and/or inhibit pharmacist reporting of serious ADEs to FDA. Improved knowledge of ADEs and ADE reporting would facilitate reporting behaviors, while lack of time, lack of complete patient medical histories, and lack of compensation issues serve as important barriers to reporting. Interventions are needed to address these factors.

Main challenges facing the pharmaceutical sector in Buchanan County, Virginia: a pilot study.

INTRODUCTION: Little is known about the challenges facing the pharmaceutical sector in rural counties in the USA. The aim of this pilot study is to determine the main challenges facing the pharmaceutical sector and suggestions for improving the sector in Buchanan County, a poor and marginalized county in Central Appalachia, Virginia. METHODS: This cross-sectional study used the drop-by survey based on the first step of the modified Delphi Interview Technique. A convenience sample of healthcare professionals in Buchanan County were asked to complete a self-administered survey instrument between May and August 2011. RESULTS: A total of 16 healthcare professionals including six pharmacists completed the survey. The respondents had worked for an average of 13.4 (SD=10.7) years in the County (range: 1-33 years). The main challenges facing the pharmaceutical sector were drug abuse (n=11), doctor shopping by patients (n=9), early refills (n=7) and drug shortage (n=6). Respondents suggested increased patient education by pharmacists (n=6) and better coordination and communication between pharmacy and doctor (n=6) to improve the pharmaceutical sector in the County. CONCLUSIONS: Drug abuse, doctor shopping, early refills and drug shortage are the main challenges facing the pharmaceutical sector in Buchanan County. Concerted efforts are required to solve these problems. More research is required to confirm these findings.

Effect of an introductory pharmacy practice experience geriatric rotation on pharmacy students' learning outcomes: a qualitative study.

OBJECTIVE: All second-year pharmacy students at Appalachian College of Pharmacy (ACP) undertake the early pharmacy practice experiences (EPPE) II. EPPE II is an introductory pharmacy practice experience (IPPE) geriatric course/rotation that occurs over two semesters during the second year. During the course, students are introduced to long-term care/geriatric patients through visits with their assigned patient for an hour each week for 24 weeks. The aim of this study is to evaluate the effect of the EPPE II rotation on students' attitudes toward nursing facility patients (mostly geriatric) and long-term care. STUDY DESIGN: Cross-sectional study. SETTING: Academic site. PARTICIPANTS: Fifty-five second-year Doctor of Pharmacy students at ACP. INTERVENTIONS: All ACP students enrolled in the EPPE II course are required to write a one- to two-page reflective essay during the spring term in which they describe the development of their relationship with their patient over time. Students were asked to submit their essays to faculty investigators for use in this study after completing the course. These essays were independently analyzed for content and categorized into themes by two faculty raters. MAIN OUTCOME MEASURES: Student learning outcomes. RESULTS: A total of 55 students voluntarily submitted their reflective essays for inclusion in the study. Most students had positive opinions about the rotation. Overall, students felt that the rotation was rewarding, valuable, worthwhile, and life-changing. Students cited many aspects that they learned from the course: life lessons, what real patient care involves, how to build patient relationships, and disease states and drugs, among others. Most students indicated that they developed a close relationship with their patients and enjoyed visiting with them in the nursing facility. CONCLUSION: Many students enjoyed visiting with their nursing facility patients and developed a personal relationship with them. Students also learned many aspects as individuals and as future pharmacists.

Perspectives about Spiritual Care in Pharmacy Practice: A Community-based Survey.

Background: Addressing religious and spiritual needs are important components of holistic healthcare. Little is known about the general public's perspectives about pharmacists providing spiritual care (SC). Objectives: To explore how community members perceive, experience, and desire pharmacist-provided SC. Method: IRB approval was obtained for this observational, cross-sectional study. Adults receiving COVID-19 vaccinations at an immunization clinic completed an investigator-designed 33-item online survey. The survey measured respondents' perspectives about and experiences with pharmacist-provided SC, as well as demographic characteristics. Results: Of the respondents (n = 261), 57% were female and 46% were Hispanic/Latino. Most (59%) agreed that their religion/spirituality would be important to them if they were ill; 64% also agreed that it would be helpful for a pharmacist to know about patients' religious/spiritual beliefs pertaining to their healthcare, and 60% agreed that pharmacists should provide SC to patients who request it. While 96% indicated that they had never talked to a pharmacist about a spiritual or religious matter related to their health or medication, 96% also indicated that no pharmacist had asked to pray with them. These results are contextualized perhaps by the finding that 76% reported having no professional relationship with a pharmacist. Conclusion: Respondents often reported an openness to receiving SC from pharmacists. Most respondents, however, had not received SC from a pharmacist. Future studies should be conducted to better understand patient preferences for pharmacist-provided SC.

An online survey to describe pharmacy student spirituality and spiritual care perspectives.

INTRODUCTION: Little is known about student pharmacists' perspectives of spirituality and spiritual care (SC) in pharmacy education and practice. The purpose of this study was to examine student pharmacists' perspectives about spirituality and incorporating SC in pharmacy education and practice. METHODS: Student pharmacists were recruited from two private pharmacy schools in California, one religiously-affiliated and one non-religiously affiliated. A faculty member at each school invited student pharmacists via email or through Zoom (Zoom Video Communications) chat to complete the 37-item online survey through an embedded link. The investigator-designed survey was comprised of 22 items inquiring about spirituality and SC as well as several items assessing demographic and religious characteristics. RESULTS: Participants included 470 student pharmacists (87.2% response rate) who were 28.9 ± 5.7 years old on average. Half of the respondents (50.5%) attended the non-religiously affiliated university. Most of the respondents were female (67%), Christian (67.8%), spiritual (79.2%), and religious (75.2%). They "agreed" or "strongly agreed" that: "understanding patients' spiritual beliefs is an important part of pharmacy practice" (83%), "I would pray with my patients as a pharmacist" (54.8%), "it is appropriate for a pharmacist to have spiritual or religious conversations with patients" (52.9%), and "it is appropriate for a pharmacist to pray with and for patients who request it" (66.9%). These beliefs were positively correlated with self-reported religiosity and spirituality. CONCLUSIONS: Most students considered themselves spiritual and religious and felt that spirituality and learning about SC were important. The respondents' SC perspectives were associated with their religiosity and spirituality.

Influence of attitudes on pharmacists' intention to report serious adverse drug events to the Food and Drug Administration.

AIM: To investigate the influence of pharmacists' attitudes on intention to report serious adverse drug events (ADEs) to the Food and Drug Administration (FDA). METHODS: This cross-sectional study used a mail survey to collect data from hospital and community pharmacists practicing in Texas, United States. Three and 16 items were used to measure intention and attitudes, respectively, using a seven-point bipolar scale. Pharmacists' demographic and practice characteristics, and past reporting were also measured. RESULTS: The response rate was 26.4% (n= 377/1500 pharmacists). Most pharmacists intended (n= 297, 78.8%) to report serious ADEs that they will encounter to the FDA through MedWatch. Overall, pharmacists held favourable attitudes towards reporting serious ADEs (mean = 24.5, SD = 6.7, possible range 1-49, neutral = 16). Pharmacists intending to report serious ADEs had more favourable attitudes than those who did not (P < 0.001). About 90% of the pharmacists believed that reporting serious ADEs would improve patient safety. However, 72.6% indicated that reporting serious ADEs was time consuming and over half (55.5%) of the respondents believed that reporting serious ADEs disrupted the normal workflow. Non-intenders held stronger beliefs that ADE reporting would disrupt the normal workflow and was time consuming compared with intenders. Years of experience, number of hours worked and practice setting were associated with pharmacists' attitudes towards reporting (P < 0.05). CONCLUSIONS: Most pharmacists held moderately favourable attitudes and high intentions toward reporting serious ADEs to the FDA. This study's findings contribute to an increased understanding of individual factors that influence pharmacists' attitude and intention towards reporting serious ADEs to the FDA.

Texas pharmacists' knowledge of reporting serious adverse drug events to the Food and Drug Administration.

OBJECTIVES: To assess Texas pharmacists' knowledge of adverse drug event (ADE) reporting to the Food and Drug Administration (FDA) and to determine demographic and practice characteristics associated with this knowledge. DESIGN: Cross-sectional descriptive study. SETTING: Austin, TX, in June and July 2009. PARTICIPANTS: 377 pharmacists practicing in hospital and community settings. INTERVENTION: Survey instrument mailed to participants. MAIN OUTCOME MEASURES: Scores on an eight-item test were used to assess pharmacists' knowledge about ADE reporting to FDA. Pharmacists' demographic and practice characteristics, as well as past reporting, were also measured. RESULTS: 1,500 surveys were mailed and 377 usable responses were obtained (26.4% response rate). Most (67.9%) pharmacists had never reported ADEs to FDA. A majority of pharmacists (65.7%) reported having inadequate knowledge about ADE reporting. Pharmacists had low knowledge scores on ADE reporting, and the pass rate for all items ranged from 56.7% to 96.0%. Pharmacists' age (r = -0.106, P = 0.042) and years of experience (-0.134, P = 0.010) were negatively correlated with knowledge levels, whereas hours worked by pharmacists was positively correlated with knowledge levels (0.130, P = 0.012). Mean knowledge levels differed by practice setting, job title, and area/setting of primary place of employment (P < 0.001). CONCLUSION: Texas pharmacists have knowledge gaps concerning ADE reporting to FDA. Pharmacists need more education, awareness, and training on ADE reporting, especially regarding reportable ADEs, how to report, and what constitutes a good report.