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Advances in pharmacy practice have transformed the role of a pharmacist from traditional dispensing to more patient-centered care practices. Apart from the traditional dispensing practices, pharmacists are currently assigned to provide pharmaceutical care services focusing on identifying medication-related problems, taking a medication history, patient interviewing, and designing an evidence-based care plan. The advancement of the pharmacist's role to be part of the health care team to maximise the health care provided to the patient should be met with restructuring the pharmacy education and assessment from being focused only on medicine compounding, selling, and dispensing to include pharmaceutical care provision. Undergraduate pharmacy education has changed tremendously over the years, evidenced by the shift from a customer-based approach to a patient-centered approach using different clinical learning and examinations models such as Objective Structured Clinical Examination (OSCE). OSCE exam is considered a powerful and valuable tool for evaluating pharmacy students' clinical performance. During the COVID-19 pandemic, pharmacy education and examination are globally affected. Many pharmacy schools are confronting surpassing challenges to sustain education during the COVID-19 pandemic. The global experiences of academics and healthcare instructors in delivering emergency remote teaching, ensuring purposeful experiential pharmacy student placements, communicating and supporting the displaced or isolated pharmacy students are considered an accelerating opportunity for new models of pharmacy education. Therefore, this chapter aims to have an overview of pharmacy education during the COVID-19 pandemic, the challenges to online pharmacy education, and the impact of the COVID-19 pandemic on pharmacy learning and education. Also, to have an overview about conducting OSCE clinical examination during COVID-19;the online OSCE exam preparation, set up, implementation, and assessment during COVID-19. Finally, to describe what can happen in the future to the online pharmacy student clinical education, OSCE assessment, and examination. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Aims: Vaccination uptake is the principal focus of the world-wide response to the COVID-19 pandemic. Vaccine hesitancy remains a critical issue. Our aim was to ascertain rates and reasons for vaccine hesitancy in people with breast cancer (BC) in Australia. Method(s): Between June and October 2021, an anonymous online survey was conducted among people with solid organ cancer treated at nine Australian treatment centres. Data collected included demographics and clinical characteristics. Vaccine hesitancy and related beliefs were assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale (OCVCCS), and the Disease Influenced Vaccine Acceptance Scale-Six. Descriptive statistics, chi-squared and linear regression were used. Results for the BC subgroup are reported. Result(s): The BC subgroup (N = 986, mean age 58.4 years, 99% female) comprised 36.6% of the responses in the solid cancer population (N = 2691). Most (76%) were treated at metropolitan centres and 64% were receiving ongoing treatment. Early BC was more commonly reported than metastatic BC (77% vs. 23%). Overall, 82% self-reported at least one COVID-19 vaccine dose. Unvaccinated participants were more likely to diagnosed with BC for a shorter time (<2 years (22.1%) vs >=2 years (14.5%), p = 0.003). Participants with metastatic BC were more likely to be unvaccinated and report greater disease-related vaccine concerns and hesitancy, when compared with participants with early BC (all p < 0.05). When compared with participants with all other solid cancers, participants with BC reported more negative attitudes towards COVID-19 vaccine side-effects (OCVCCS Side-Effects subscale mean scores: 5.19 (SD 1.91) vs. 5.46 (SD 1.82), p < 0.001). Conclusion(s):Despite a relatively high rate of self-reported vaccination, people with BC reported lower vaccine confidence when compared with all other solid cancers. A better understanding of these inequalities, and strategies to address vaccine confidence in people with BC, particularly those with metastatic BC, should be developed.
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Aims: People with haematological malignancies (HM) are at increased risk of severeCOVID-19 infection and death due to underlying immune deficiency and impaired vaccine responses. FromMarch 2021,COVID- 19 vaccination was offered to patients with HM, as part of the Australian COVID-19 vaccination rollout program. This study sought to ascertain whether vaccine hesitancy was a barrier to optimal vaccine uptake and explored the attitudes of people with HM towards COVID-19 vaccination. Method(s): Between June and October 2021, an online survey was distributed to adults with HM at nine Australian health services. The survey collected sociodemographic and clinical characteristics, and attitudes towards COVID-19 and COVID-19 vaccination using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford COVID-19 Vaccine Confidence and Complacency Scale, and the Disease Influenced Vaccine Acceptance Scale-Six (DIVAS-6). Result(s): Of the 869 survey participants (mean age 64.2 years, 43.6% female), 741 (85.3%) reported receiving at least oneCOVID-19 vaccine dose. Unvaccinated status was significantly associated with younger age, English as a non-dominant language, and shorter duration since diagnosis. Participants who were female or spoke English as their nondominant language reported more negative attitudes towards vaccine side-effects. Unvaccinated participants were more likely to report greater concerns about the vaccine impacting on their HM and treatment (DIVAS-6 Vaccine Vulnerability subscale score: B (SE) = 2.71 (0.35), p < 0.001). They were also more likely to report greater vaccine complacency (DIVAS-6 Disease Complacency subscale score: B (SE) = 1.79 (0.28), p < 0.001). Conclusion(s): People with HM reported high vaccine uptake, however, participantswho are recently diagnosed with malignancy, female, younger age or for whom English is a non-dominant language may benefit from targeted education strategies to address their vaccine concerns. Clinicians are well-positioned to address their patients' specific vaccine concerns and support the decision-making process, particularly with the need for COVID-19 vaccine boosters.
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Background: Adults and childrenwith cancer are susceptible to severe SARS-CoV-2 disease. Vaccination is protective;data beyond initial response and regarding effect of booster doses are lacking in cancer patients. Method(s): The SerOzNET study assesses SARS-CoV-2 vaccine response in haematological and solid cancer patients aged 5 and older. Patients are recruited pre dose 1 and receive standard BNT162b2 (Pfizer) or ChadOx1-S (AstraZeneca) vaccine. Blood is taken at baseline and after each dose. Neutralizing antibody (NAb) titre, absolute antibody titre (Abbott), T cell response (IFN-gamma) and epigenetics are analysed. Clinical data are collected. Patients are followed for up to 3 months beyond dose 5. Result(s): 105 children (64% haem, 36% solid cancers) and 399 adults (35% haem, 65% solid cancers) were enrolled. In adults, NAb response rate increased after dose 3 (Post 2: 40% haem, 87%solid;Post 3:70%haem,97%solid). Post dose 2, predictors of nonresponse were ChadOx1-S vaccine (OR 3 p = .02), haem cancer (OR 14 p < .001), ECOG >=1 (OR 2.6 p = .01) and steroids (OR 5 p = .01). Post dose 3, only haem cancer predicted non-response (OR 16). IFN-gamma response is available for a subset, detectable in 41/90 (46%) postdose 1, 78/96 (81%) post-dose 2 and 35/42 (83%) post-dose 3;without significant difference between haem and solid cancer. In children, NAb response post dose 2 is available for 50 patients. Response rate between haem (19/31, 61%) and solid patients (13/19, 68%) was similar. IFN-gamma response post dose 2 was also similar: (14/22, 63%) vs solid patients (12/14, 85%) (p = .25). Analysis is ongoing. Conclusion(s): Response to two doses of SARS-CoV-2 vaccine is suboptimal in patients with cancer. The third priming dose is integral, with significantly higher response rates observed. 36% of children did not develop neutralizing antibodies post dose 2;subsequent doses are likely to be important for young patients.
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Background: COVID-19 disease is more severe in unvaccinated cancer patients compared with the general population. There is limited data regarding clinical efficacy of vaccination in these patients. Method(s): SerOzNET (ACTRN12621001004853) is a prospective observational cohort study of adults and children with cancer receiving COVID-19 vaccination. The primary endpoint is serological response. An important secondary endpoint is outcome of COVID-19 infection after vaccination. We report self- and clinician reported COVID-19 infections. Result(s): Of 395 adults (20 years +), 74 (19%) reported COVID-19 infection over mean duration on study of 259 days. 71 (97%) had received 2 vaccine doses, 51 (69%) received 3+ doses. 21 (28%) had antiviral treatment. 62 (84%) had symptoms, 7 (9%) required hospitalisation, 0 required ICU admission or died due to COVID-19. Of 113 children/adolescents (5-19 years), 31 (27%) reported COVID-19 infection over mean duration on study of 215 days. 28 (90%) had received 2 vaccination doses, and 12 (39%) received 3+ doses. 23 (74%) had symptoms, 8 (25%) required hospitalisation, 2 (6%) had antiviral therapy, 0 required ICU admission or died due to COVID-19. Pediatric pts with COVID-19 infection had increased risk of hospitalisation compared with adults (p=0.03). Hematological cancer pts had non-significant but numerically higher rates of hospitalisation (Table). [Formula presented] Conclusion(s): Pts with cancer are likely to be exposed to COVID-19, with infection rates similar to the wider population. Vaccination appears to protect against ICU admission in cancer patients. However, 9% of adults and 25% of children with cancer required hospitalisation for COVID-19, demonstrating increased severity of symptoms compared to the general population. Higher rates of infection and hospitalisation in pediatric pts may be partly attributable to the lower proportion of children who had received a 3rd vaccination dose at the time of infection. Clinical trial identification: ACTRN12621001004853. Legal entity responsible for the study: Monash Health. Funding(s): Cancer Australia (Australian Federal Government) Victorian Cancer Agency (Victorian State Government, Australia) Leukaemia Foundation (Foundation, Australia). Disclosure: All authors have declared no conflicts of interest. Copyright © 2022
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Introduction People with blood cancers are prioritised to receive COVID-19 vaccination. However, it is unclear how prevalent vaccine hesitancy is in this group. This analysis investigated vaccine uptake and vaccine hesitancy in people with blood cancers in Australia. Methods An online survey was conducted at nine health services in Australia from June to October 2021. Participant demographics and vaccination status were recorded. Vaccine hesitancy was assessed using the Oxford COVID-19 Vaccine Hesitancy Scale (OHS). Regression was used to examine whether clinico-demographic factors predicted the OHS score and vaccination status. Results Of the 869 participants, the mean age was 64.2 years, and 43.6% (n = 379) were female. A high proportion of participants had received at least one COVID-19 vaccine dose (85.3%, n = 741). Increasing age, speaking English as a first language, attending a regional health service, longer time since diagnosis and not currently receiving treatment were associated with being vaccinated. Participants who reported higher vaccine hesitancy were younger in age, more likely to have vocational qualifications and speak English as a second language. Conclusions There is a high rate of vaccination uptake in patients with blood cancers. However, younger patients and patients from culturally and linguistically diverse backgrounds appear to have lower vaccination uptake rates and higher levels of vaccine hesitancy. Tailored counselling may reduce the risk of adverse events due to COVID-19 infection.
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Background: People with cancer are at higher risk of serious illness and death from COVID-19 infection. We investigated the differences in COVID-19 vaccine uptake and attitudes in people with various solid organ and hematological malignancies. Methods: An online survey of adult patients with cancer attending eight health services across four states in Australia, was conducted from June to September 2021. Demographics, cancer history and vaccination status were recorded. Only completed surveys were analysed. Variables were compared with chi-squared and multivariable analysis using logistic regression. Vaccine hesitancy was assessed using the Oxford COVID-19 Vaccine Hesitancy Scale, the Oxford Vaccine Confidence and Complacency Scale, and the Monash Disease Vaccine Acceptance Scale. T-test analysis was used to examine relationships between the scales and groups. Results: There were 2997 evaluable responses;53.2% female, 61.8% from metropolitan areas, 27.5% with metastatic solid organ disease and 50.6% on current anti-cancer treatment. Patients with GI cancers comprised 13.5% (n = 405), compared with hematological 28.4%, breast 24.6%, genitourinary 14.1% and other cancer types 19.4%. Vaccination rates were significantly lower for respondents with GI cancers compared to other cancer types (71.6% v 79.3%;p< 0.001). Significant differences in the GI cancer population compared to all others were: more males (p < 0.001), lower level of education (p= 0.001), fewer reporting English as first language (p = 0.02) and shorter time since cancer diagnosis (p < 0.001). These remainedsignificant after logistic regression. Among GI cancer respondents, factors associated with being vaccinated compared to unvaccinated included: older age (p < 0.001), higher education level (p = 0.03) and English as first language (p = 0.01). There was no significant difference in the scales measuring vaccine hesitancy, confidence and complacency, for the GI cancer population compared to other cancers. As expected, there were significant differences in all scales comparing vaccinated to unvaccinated respondents with GI cancers. Conclusions: In our large, contemporary survey, Australians with GI cancers report lower COVID19 vaccine uptake compared with patients with other cancer types. We identified demographic and disease related characteristics that contribute to these differences. Interventions and targeted communication are required for people with GI cancers to maximise vaccination uptake in this medically vulnerable group.
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Background: The COVID-19 pandemic has had widespread and drastic impacts on healthcare delivery across the world, aside from the direct effects of the virus itself. Patients in rural areas represent a particularly vulnerable population who may be heavily impacted by changes to healthcare provision. Griffith is a regional city in New South Wales, Australia with a fortnightly outpatient outreach hematology service provided by visiting hematologists travelling by plane from St Vincent's Hospital in Sydney. Hematologists were abruptly unable to continue regular in-person visits to Griffith after the COVID-19 pandemic caused flight disruptions and travel bans in April 2020. Rapid shifts to telemedicine consultations for remote specialist patient management were imposed due to the travel changes, supported by a pre-existing hematology-specific integrated and unified electronic health record between the two sites as previously reported1. This system offered the ability to continue the safe prescribing, monitoring and multidisciplinary management of haematology patients including those with malignant diseases. Aims: To review the impacts of the COVID-19 pandemic on a rural hematology outreach service, including on clinical service activity and patient transfer rates to the metropolitan tertiary referral centre. Methods: We reviewed the Griffith hematology outreach service activity for the 12 month period before and following the COVID-19 pandemic began significantly impacting rural Australian health services by causing flight cancellations and reliance on telemedicine reviews alone. Data was collected for the time periods April 2019-March 2020 and April 2020- March 2021 inclusive [remaining data to be presented]. Clinical service activity and patient admission rates to the metropolitan tertiary referral centre were assessed. Results: Prior to the pandemic, an average of 39 patients were seen in the Griffith clinic each month, compared to an average of 47 per month after the change to telemedicine, Figure 1. The number of new patient consultations performed increased over time, from 64 new patient reviews to 79 from April 2020. The St Vincent's Hospital hematology clinic service was similarly able to sustain it's activity with increases seen in both total and new patient reviews, increasing by 12% and 15% respectively. There was no increase seen in the number of hematology patients from the Griffith region needing treatment at the tertiary referral centre due to disruptions in care. In the 12 months prior to the service disruption (April 2019- March 2020), 18 patients were treated or required hematological investigation at the tertiary referral centre at St Vincent's Hospital in Sydney, compared to nine patient over the 10 month period following. Summary/Conclusion: We demonstrate how a rural outreach hematology service was able to continue with minimal disruption after the COVID-19 pandemic caused an abrupt transition to exclusively remote patient reviews and chemotherapy management. The use of an integrated digital platform shared between the two sites allowed the remote telehealth service to be maintained. Significant increases in rural patients requiring transfer or admission to the tertiary referral centre in Sydney were not seen. With continued uncertainty and unpredictable flight changes, we demonstrate long term and sustainable adjustments are feasible and necessary to serve rural populations from potentially detrimental changes to already fragile health services.
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The study explores the impacts of fear emotions on technology adoption by teachers and students during the COVID-19 pandemic. Mobile learning (ML) has been considered an educational, social platform in private and public higher education institutes. Since several fears are connected with COVID-19, this study's key hypotheses are related to how COVID-19 influences Mobile Learning (ML) adoption. Educators, teachers, and students may face some common types of fear in the course of the coronavirus pandemic, such as fear of losing social relationships, fear of educational loss and failure, and fear because of the lockdown of the family in the prevailing circumstances. Different theoretical models, named Expectation-Confirmation Model (ECM) and Technology Acceptance Model (TAM), are combined to develop an integrated model for this study. The proposed model was analyzed with the development of a questionnaire survey. The survey served as a data collection instrument to collect data from students of the University of Sharjah in Sharjah city in the United Arab Emirates (UAE). Three hundred twenty undergraduate students participated in the study. The collected data was evaluated using the partial least squares-structural equation modeling (PLS-SEM). The significant predictors revealed by experimental results included perceived fear, perceived ease of use, expectation confirmation, satisfaction, and perceived usefulness, explaining the intention to use the mobile learning platform. According to our study, teaching and learning can be benefitted to a great extent by the adoption of mobile learning (ML) during this pandemic for educational purposes;however, this process may be negatively affected by the fear of future educational results, fear of losing social relations and fear of stressful family situations. Therefore, appropriate student evaluation may be conducted to overcome the emotional distress caused by the pandemic effectively. © 2021 by the authors;licensee Growing Science, Canada.
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The lack of treatment options for COVID-19 has raised many concerns among populations worldwide, which has led to many attempts to find alternative options to prevent the transmission of the disease or to alleviate the progression of the infection, including focusing more on preventive measures (to prevent transmission to other individuals) and the use of natural products and herbal extracts to increase immunity and decrease the probability of getting infected. This study explored the knowledge of the population of the Kingdom of Saudi Arabia (KSA) about COVID-19 preventive measures and their belief about the consumption of herbal products for the prevention of COVID-19 infection. A total of 5,258 individuals participated in this study. Participants' knowledge about the appropriate COVID-19 preventive measures in terms of handwashing procedures, self-quarantine and social distancing was moderate, with a mean score of 5.5 (SD: 1.7) out of 10 (representing around 55.0% of the total score). About 22.1% (n = 1,161) of the participants reported that they have used herbal products or nutritional supplements during the pandemic period, to protect themselves from the disease. Social media and the Internet (39.4%, n = 372) were the main motivators for the participants to try herbal products. Vitamin C was the most commonly used food supplement to increase immunity and reduces the chance of contracting COVID-19. Our study demonstrated that the general population in Saudi Arabia has a moderate level of knowledge about COVID-19 transmission and preventive measures. A considerable proportion of the population reported the use of herbal products or food supplements in order to protect themselves from the disease. Policymakers are suggested to provide further educational campaigns that increase population knowledge about the disease transmission routes and preventive measures. In addition, the use of herbal products should be evidence-based to ensure patient safety.