National survey of pharmacists, intern pharmacists and pharmacy students in Australia: the nature and extent of stress and well-being.

OBJECTIVES: A national survey of the Australian pharmacy workforce was conducted to determine the extent to stress experienced, the extent to which it is work-related, how stress is managed, the barriers to getting help and how well prepared the workforce is for stressful situations. There were three objectives: provision of guidance on possible interventions; provision of a baseline for further studies; and provision of information to the Australian Health Practitioner Regulation Authority (AHPRA). METHODS: An online survey incorporating the 10-item Perceived Stress Scale was developed, piloted and launched in October 2016. Pharmacy-related organisations alerted their members to the voluntary survey. Popular pharmacy social media was used. Responses were analysed using SPSS and Excel. The a priori for significance was P < 0.05. KEY FINDINGS: In relation to the nature and extent of stress in the workforce and work-life balance, information provided by 1246 respondents out of a workforce of 29 819 revealed high levels of stress (PSS-10 score 20.1 ± 7.3), with those under 30 years of age and/or with 10 years or less in the pharmacy workforce reporting the highest levels. Just under half the respondents reported dissatisfaction with their work-life balances. CONCLUSIONS: Workplace stress is high, particularly among younger members of the workforce. Professional pharmacy associations, schools of pharmacy at Australian universities and AHPRA have been alerted to this issue. The survey should be repeated reasonably soon to determine if any of the key characteristics have changed, particularly if interventions are made to reduce the occurrence of workplace-related stress.

Patient expectations and willingness to use primary care pharmacy services in the United Arab Emirates.

OBJECTIVES: No previous studies have investigated patients' expectations of, or interest in, using primary care pharmacy services in the UAE. The study investigated primary care services that patients would use if they were provided through community pharmacies. METHODS: A questionnaire was developed in English and translated to Arabic. Participants were asked to rate their likelihood of using future primary care services on a three-point Likert-type scale (very likely-unlikely). Services included screening for disease, monitoring of disease control, health advice and referral, lifestyle and preventive care, supply of printed information, counselling on medication use and side effects, patient record keeping, and pharmacist intervention in chronic disease. The questionnaire was distributed to patrons of public places by hand to eligible participants: ≥21 years, taking at least one scheduled prescription medication and having adequate Arabic or English proficiency. KEY FINDINGS: Areas of most interest were as follows: the pharmacist explaining how to use medications (Median = 3, interquartile range (IQR) = 1), the pharmacist advising on side effects of medications (Median = 3, IQR = 1), receiving advice on how to use devices (Median = 3, IQR = 1) and receiving printed information about medications (Median = 3, IQR = 1). Participants were least supportive of pharmacists keeping medication records (Median = 2, IQR = 1) and intervening in chronic disease management (Median = 2, IQR = 1). Participants anticipated a caring professional service by pharmacists and a pharmacy layout that allows private communication. CONCLUSIONS: Participants were interested in accessing enhanced primary care services by community pharmacists. Participants were more supportive of receiving information about medications, help in self-management and monitoring, and advice about disease prevention than management of chronic disease.

Physicians' attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates.

OBJECTIVES: This study aims to explore physicians' views of pharmacists' roles in providing primary care services through community pharmacies in the United Arab Emirates (UAE). METHODS: A qualitative approach involving semi-structured interviews conducted one-to-one or in group discussions was employed. The interviews explored participants' views of pharmacists' primary care services including screening and monitoring of disease, health advice, referral, lifestyle and preventive care, supply of printed information, counselling on medications, patient record keeping, and pharmacist intervention in chronic disease management. Data were analysed using the Framework approach. KEY FINDINGS: Fifty-three physicians participated; 27 were interviewed individually and 26 participated in five group discussions. Four major themes were identified: competence, business orientation, territorial control and service delivery. Participants were supportive of verbal counselling about medications, checking for drug dosing, interactions, duplications and errors, and keeping patient medication profiles. Physicians generally did not favour pharmacists' involvement in screening or monitoring of disease, providing information about diseases, diagnosis or long-term management of disease, or intervention directly with patients, mainly due to perceived lack of competence, territorial encroachment and business orientation of community pharmacy. CONCLUSIONS: Despite some reservations, participants showed support for pharmacist involvement in providing primary care services, provided certain quality and territorial issues were addressed. Understanding physicians' attitudes will facilitate interventions to enhance the contribution of community pharmacists to primary care in the UAE, and possibly in other regions with similar healthcare systems.

Assessing patient satisfaction with community pharmacy in the UAE using a newly-validated tool.

BACKGROUND: Patient satisfaction has become an integral component of the quality of healthcare services. It has been used for the purpose of performance assessment, reimbursement, and quality management of health service delivery. It has been suggested that patient satisfaction could be a predictor of health-related behavior. OBJECTIVES: To develop and validate a tool for use within the Arabic context to assess patient satisfaction. To assess patient satisfaction with current community pharmacy services in the UAE using the validated tool. METHODS: A systematic process was used to develop an assessment tool that could be used within the Arabic context and establish its validity and reliability. Survey participants assessed their satisfaction with the services based on a 5-point Likert-type scale: Poor = 1, Fair = 2, Good = 3, Very good = 4, Excellent = 5. The anonymous questionnaire was distributed over a 5-month period to eligible participants in public places such as malls and shopping markets, in various emirates across the UAE. Those who were 21 years or older, taking at least one scheduled (regular) medication and having adequate Arabic or English language proficiency were included. RESULTS: The instrument comprised four dimensions: Information, Relationship, Accessibility and Availability. Participants required more information about medications and self-management (Mean = 2.49 ± 1.19). Measures of competence, i.e., care, interest, time, confidence and trust, could also be improved (Mean = 3.05 ± 1.07). Accessibility scores measuring physical, geographical and financial items were lowest (Mean = 2.80 ± 1.33). Overall scores on availability of medications indicated relative satisfaction with this dimension (Mean = 3.51 ± 0.7). CONCLUSIONS: This study is the first to use a patient satisfaction tool specifically developed for the Arabic context. Patient satisfaction scores in all dimensions were significantly lower than published data, suggesting patients have unmet expectations of community pharmacy services in the UAE. Stakeholders could utilize this information to help in the design and delivery of improved services that could lead to increased demand.

Community pharmacy services in the United Arab Emirates.

OBJECTIVES: To identify the type and frequency of services provided through community pharmacies in the United Arab Emirates (UAE). METHODS: A survey was conducted using an anonymous questionnaire distributed by hand to 700 community pharmacies. Items included information about the pharmacists and pharmacies, type of products sold, type and extent of enhanced services provided and perceived barriers to providing these services. KEY FINDINGS: Most pharmacies provided a wide range of medicinal and non-medicinal products. The frequency with which services were provided was assessed on a scale of 1 (never) to 5 (always). Enhanced professional services were not provided to a large extent in most pharmacies. Fewer than one-third (29%) reported they always supplied printed information to patients (mean = 3.37, 95% confidence interval = 3.23-3.52); fewer than one-third (28%) counselled patients on a regular basis (3.25, 3.09-3.40); nearly two-thirds (62%) reported monitoring patients' adherence to therapy at least sometimes (2.96, 2.81-3.10). Most pharmacies (92%) in the UAE did not routinely keep patient records (2.09, 1.96-2.32). While just over a quarter of respondents claimed that they always reported medication errors (27%) and adverse drug reactions (28%), these activities were not often performed in around 40% of pharmacies. CONCLUSIONS: This is the first study to explore the type and extent of professional services provided through community pharmacies in the UAE and provides baseline data critical to inform the development of strategies to improve the quality of community pharmacy services.

Pharmacy access to the emergency contraceptive pill: a national survey of a random sample of Australian women.

BACKGROUND: The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women's knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP. STUDY DESIGN: A cross-sectional study, using a computer-assisted telephone interview (CATI) survey conducted with a national random sample of 632 Australian women aged 16-35 years. RESULTS: Most women had heard of the ECP (95%) and 26% had used it. The majority of women agreed with pharmacy availability of the ECP (72%); however, only 48% were aware that it was available from pharmacies without a prescription. About a third (32%) believed the ECP to be an abortion pill. The most common reason for not using the ECP was that women did not think they were at risk of getting pregnant (57%). Logistic regression showed that women aged 20-29 years (OR 2.58; CI: 1.29-5.19) and 30-35 years (OR 3.16; CI: 1.47-6.80) were more likely to have used the ECP than those aged 16-19 years. Women with poor knowledge of the ECP were significantly less likely to have used it than those with very good knowledge (OR 0.28; CI: 0.09-0.77). Those in a de facto relationship (OR 2.21; CI: 1.27-3.85), in a relationship but not living with the partner (OR 2.46; 95% CI 1.31-4.63) or single women (OR 2.40; CI: 1.33-4.34) were more likely to have used the ECP than married women. CONCLUSIONS: Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.

Provision of the emergency contraceptive pill without prescription: attitudes and practices of pharmacists in Australia.

BACKGROUND: As 5 years have elapsed since the emergency contraceptive pill (ECP) was made available without prescription in Australia, information was sought about the current attitudes and practices of pharmacists in relation to their increased role in ECP provision. STUDY DESIGN: A mail survey was implemented; questionnaires were distributed to 750 pharmacies across Australia during 2008-2009. Descriptive statistics were calculated and multiple logistic regression was used to examine factors associated with declining to dispense ECP. RESULTS: Response rate was 29%. Most pharmacists used a protocol to guide ECP dispensing (77.3%) and the majority had declined ECP provision (75.1%) in certain circumstances. Many usually counselled where confidentiality could be assured (62.8%), and agreed that it is a pharmacist's role to counsel on regular contraception (81.9%). Factors significantly associated (p ≤.05) with dispensing practices included pharmacists' attitudes towards acceptability of advance prescription, their age, gender and pharmacy accessibility. CONCLUSIONS: New information about Australian pharmacists' current attitudes and practices towards ECP dispensing was identified. Pharmacists had stronger, more conservative attitudes than overseas pharmacists; however, the issues that emerged were similar to those reported overseas. To address these, revised training for local pharmacists is recommended.

Frequency and characteristics of hospital admissions associated with drug-related problems in paediatrics.

AIM: To determine the frequency of paediatric hospital admissions associated with drug-related problems (DRPs) at two Australian hospitals. METHODS: The investigator and ward pharmacists prospectively screened eligible patients. A multidisciplinary panel reviewed data and established causality, preventability and clinical significance classifications. RESULTS: Over 22 weeks of data collection, a total of 11,564 patients were admitted, 2933 met eligibility criteria. Of those eligible, 127 [4.3%, 95% confidence interval (CI) 3.6, 5.0] were judged to have hospital admissions associated with DRPs. Direct costs associated with DRPs identified totalled pounds 100,707. Of the 81 cases assessed for preventability, 46.9% were deemed preventable. CONCLUSIONS: This research has provided information on the nature and characteristics of paediatric DRPs associated with hospital admissions.

Dosing information for paediatric patients: are they really "therapeutic orphans"?

OBJECTIVES: To review the approved product information (PI) of prescription medicines to determine the extent and nature of information available on paediatric dosing and the availability of paediatric dosage formulations in Australia. METHODS: The PIs for all prescription medicines listed in the Australian Monthly Index of Medical Specialties (MIMS) were reviewed. Dosing information for each PI was categorised according to age groupings. PIs claiming suitability for use in paediatric patients were reviewed for information on the availability of paediatric dosage forms. MAIN OUTCOME MEASURES: Proportion of PIs providing paediatric dosing information; availability of dosage forms suitable for children. RESULTS: A total of 1497 PIs were reviewed. The proportions, for each age group, of PIs with inadequate paediatric dosing information were: < 1 month (80.5%), 1-3 months (79.1%), 3 months-2 years (77.5%), 2-6 years (73.2%), and 6-12 years (71.6%). The proportions, for each age group, of PIs that gave specific paediatric dosing information but did not provide a paediatric dosage form were: < 1 month (26.5%), 1-3 months (25.1%), 3 months-2 years (23.3%), 2-6 years (21.9%), and 6-12 years (24.0%). CONCLUSIONS: The PIs for many prescription products listed in MIMS do not adequately detail paediatric doses. Many medicines for which specific paediatric dosing information is given are not available in dosage forms appropriate for children.