Exploring healthcare providers' perspectives on virtual care delivery: insights into telemedicine services.

BACKGROUND: The rapid advancement of technology has led to a concurrent advancement of telemedicine, that is the delivery of medical services over a long distance using technological methods. The consistently growing numbers of COVID-19 cases warranted the use of telemedicine as an alternative method of care-delivery. This study aims to evaluate perceptions of healthcare services provided virtually among healthcare providers (HCPs) in Kuwait and to assess their acceptance and intention to implement such services. METHODS: An exploratory mixed methods design was conducted, where in phase one HCPs' perceptions towards telemedicine were explored through an online questionnaire and the quantitative data were summarized by descriptive analysis using SPSS. Scores for usefulness and for attitude toward the use of telemedicine were calculated. Then semi-structured interviews were conducted in phase two and the qualitative data were analyzed thematically. RESULTS: In phase one, 421 HCPs answered the questionnaire. In terms of telemedicine knowledge, 15.4% of HCPs had previously used telemedicine technology and 39% already knew about it. Additionally, 42.3% preferred to use telemedicine, and 88.5% had a moderate to high usefulness score. Telemedicine's ease of use was perceived positively. Attitude median score was 73 with an IQR of 16 (63-79). Half of the participants intend to use telemedicine. In phase two, twenty-two interviews were conducted resulting in six themes; HCPs' acceptance of telemedicine, facilitators and motives for telemedicine implementation, skills and training required to conduct telemedicine, barriers limiting the use of telemedicine, strategies to overcome the barriers, and benefits of telemedicine. CONCLUSION: Most of the HCPs favor telemedicine integration into Kuwait's healthcare system as their perceptions of telemedicine were overall positive, paving the way to develop implementation strategies.

The Association of Professional Burnout and Turnover Intentions Among Intensive Care Units Physicians: A Cross-Sectional Study.

Intensive Care Units (ICU) workers work in highly stressful conditions that make them prone to professional burnout, which can lead to high turnover rates. This study explores professional burnout levels among ICU workers in Kuwait general governmental hospitals (GGHs), their turnover intentions, and the correlation factors. A cross-sectional self-administered survey study was conducted. Professional burnout level was measured using the Copenhagen Burnout Inventory (CBI), while turnover intention was measured using the Turnover Intention Scale (TIS-6). Data were analyzed using STATA software, and descriptive, correlative, and comparative analyses were performed. Eighty-nine ICU physicians filled out the questionnaire. Most of the participants were males, married, non-Kuwaiti nationals, with 10 to 20 years of experience, and the mean age of respondents was 39.2. The total professional burnout score was high was 54.7 (17.6). There were high total average scores for the personal and work-related domains. Participants who were younger than 35 years of age and graduated before 5 to 10 years had higher levels of professional burnout compared to other groups. More than half of the sample expressed their intention to leave their current job as an ICU physician. However, no association was found between turnover intentions and levels of burnout. High levels of professional burnout of turnover intentions were seen among ICU physicians in Kuwait. Policies should be adopted to reduce and mitigate professional burnout among ICU physicians and increase their retention. Future research should further investigate professional burnout among ICU staff, the associated factors, and its relation to their turnover intention.

Patient satisfaction of primary care services in Gulf Cooperation Council Countries: A scoping review.

Patient satisfaction (PS) is an essential element in evaluating and improving healthcare systems. Few studies have gathered evidence about patient satisfaction with primary care (PC) services in the Gulf Cooperation Council (GCC) countries. Therefore, it is important to review the existing literature examining PS with PC services in the GCC countries. This scoping review was conducted for primary data studies published between 2000 to March 2022. Out of 4461 screened articles, 37 met the inclusion criteria. Most studies were conducted in Saudi Arabia and were of cross sectional methodology. PS with primary care in the GCC is affected by multiple provider-related and patient-related factors and users are generally satisfied with the service provided. Future research should focus on the effects of the factors that were not explored and validate the existing results.

Development and Refinement of a Matrix Competency Framework, with Associated Entrustable Professional Activities, to Support Initial Pharmacy Education in Kuwait.

The development of competency frameworks serves as the foundation for the development of competency-based education. It is vital to develop a country-specific framework to address the specific needs of the local population for pharmacy services. This study aimed to describe the development process of a competency framework for undergraduate pharmacy education in Kuwait with a unique matrix structure. The process started with the development of guiding principles for curriculum revision and implementation, as well as the identification of global educational outcomes. This process was followed by: (A) a needs assessment with key stakeholders; (B) development of the initial competency framework; and (C) refinement of the framework. Qualitative data were thematically analyzed to identify the main competency domains that students need to perform the identified entrustable professional activities (EPAs). Five population needs were identified by the needs assessment, with 17 EPAs suggested to fulfill those needs. In addition, 11 competency domains were identified. The initial competency framework was created as a 3 × 8 matrix, with 3 professional and 8 transversal competency domains. Refinement of the framework resulted in the removal of redundancies and the development of a global behavior competency profile. The development of a matrix competency framework and associated EPAs for Kuwait serves as a foundation for preparing pharmacists to fulfill local population needs and expanding the scope of practice in the country.

Transforming pharmacy practice in Kuwait.

In the last few decades, pharmacy services have expanded to fulfil the need for more complex health needs from population worldwide. Moving from 'product-centred' to a 'patient-centred' profession, pharmacists are required to master more professional competencies to deliver high quality pharmaceutical services to their patients and community. In Kuwait pharmacy practice has long been identified as a sector yet to be developed. With the announcement of the 'new Kuwait vision 2035' planning for pharmacy practice and workforce development and improvement has become imperative. Academic, professional, and regulatory bodies have collaborated to shape the future of pharmacy profession in the country. The approach described here reflects the initial steps for transforming and advancing the pharmacy profession in Kuwait.

Population perceptions of health care services provided virtually (telehealth): a cross-sectional study.

BACKGROUND: In the era of the Coronavirus Disease 2019 (COVID-19) pandemic, health care systems wish to harness the advantage of distant care provision to transcend barriers to access health care facilities. This study aims to investigate general population perceptions (acceptance, comfort, perceived ease of use and perceived quality of care) toward telehealth. METHODS: A cross-sectional survey was conducted using a validated online questionnaire. The questionnaire investigated the general population's familiarity and experience with virtual provision of health care (telehealth) in Kuwait. Descriptive statistics and multivariate analysis were performed. RESULTS: A total of 484 responses were received. Of those, 65% (N = 315) showed high acceptance of telehealth of which 73.5% (N = 119) were comfortable using it and 48.2% (N = 78) perceived themselves capable of utilizing its systems. Multivariate analysis showed that participants with moderate or high comfort score and those who perceived equal quality of care received from Virtual Visits (VV) are more likely to accept a virtual call from their health care provider compared to those with low comfort score (odds ratio (OR): 4.148, 95% confidence interval (CI): 1.444-11.91, P = 0.008, OR: 20.27, 95% CI: 6.415-64.05, P < 0.0001, OR: 2.585, 95% CI: 1.364-4.896, P < 0.004, respectively). CONCLUSIONS: Perceptions of telehealth were overall positive, indicating a tendency to accept the implementation of such technology.

An evidence-led review of the FIP global competency framework for early career pharmacists training and development.

BACKGROUND: The International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) for early career pharmacists is an evidence-driven guide for pharmacist professional development. First published in 2012, the FIP GbCFv1 contains a structured assembly of competencies for pharmacists in four broad areas: pharmaceutical public health; pharmaceutical care; organisation and management; and professional/personal. FIP is committed to support the advancement of pharmacy around the world, and in light with the expansion of the type of services that pharmacists may provide to their patients and the advances in technology and therapeutics, revising and updating the GbCF is imperative. OBJECTIVE: The aim of this project was to revise and update the first published iteration of the FIP GbCFv1 (2012) to ensure currency and continued relevance. METHODS: This is a qualitative study that employed four rounds E-Delphi method. A group of international experts (n = 29) was convened to revise the GbCFv1 through an iterative approach with repeated and synchronised rounds of analysis and revision focusing on the currency of the competency areas and associated behavioural statements. The revision was conducted between January to August 2020. RESULTS: The number of behavioural statements increased from 100 to 124 behavioural statements, with 23 competency domains, but remain structured within the competency clusters. Three new competencies were added to the GbCF (emergency response, digital literacy, and interprofessional collaboration) and one competency was renamed from self-management to leadership and self-regulation. CONCLUSIONS: The process undertaken to revise the GbCFv1 are described, resulting in a valid and transnationally relevant GbCFv2. In the GbCFv2, the number of competencies and associated behavioural statements increased due to important additions including emergency response, digital literacy, interprofessional collaboration and an expansion of leadership and self-regulation. This process provides an assurance of relevancy and currency for a 'fit for purpose' early career competency development framework for global implementation.

Adopting global tools for the advancement of pharmacy practice and workforce in Saudi Arabia.

Background: The continuing expansion of the pharmacist's role necessitates continuous evaluation of current practice to identify strategies for improvements. The International Pharmaceutical Federation (FIP) has developed tools to support stakeholders in identifying development needs and planning advancement strategies. The aim of this research was to utilise the FIP Global Competency Framework, version 2 (GbCF v2), and FIP Development Goals (DGs) to evaluate competencies related to pharmacy practice in Saudi Arabia, and to understand the strategies needed to develop and improve the current practice. Methods: The study involved four phases. Phase 1 involved translation of the FIP GbCF v2 into the Arabic language. Phase 2 was a consensus panel validation to establish the initial relevance of the competencies to current practice. Phase 3 included a national survey distributed to all registered pharmacists in Saudi Arabia. The final phase was conducted through mapping 'not relevant' competencies to FIP DGs to identify priorities. Results: The translation phase yielded a bilingual framework that could be utilized by pharmacists in Saudi Arabia. The initial validation phase identified 61 behavioral statements (from 124 in the GbCF v2) as 'highly relevant' or 'relevant' to pharmacy practice. Findings from the national survey identified a list of 'not relevant' competencies that could highlight gaps in current practice. The final mapping phase generated a list of three FIP DG priorities: DG5 (competency development), DG8 (working with others) and DG11 (impact and outcomes). Conclusion: The study indicated that competencies in the GbCF v2 were relevant to pharmacists practicing in the country. However, some competencies were perceived as 'not relevant' to current practice and these highlighted gaps in the current practice that need attention. Mapping 'not relevant' competencies to FIP DGs should be used as a starting point towards developing strategies, systems, and protocols to advance pharmacy practice in Saudi Arabia.

Expert consensus for a national essential antidote list: E-Delphi method.

Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. In order to assist hospitals to reduce costs and improve patient care, an essential antidote list can be used as an initial foundation for securing sufficient antidote availability at healthcare institutions. The aim of our study is to generate a nationally relevant essential antidote list for emergency care hospitals in Kuwait using the e-Delphi method by establishing consensus through a multidisciplinary expert group of healthcare providers. An electronic survey with 47 essential antidotes was developed. The e-Delphi method was used, with three rounds of voting, to determine expert consensus on an essential antidote list for hospitals in Kuwait. A purposive sample of healthcare professionals from governmental and private hospitals were selected for this study (n = 30). Consensus was gained if ≥75% of the expert panel agreed on the inclusion of the antidote, without any strong disagreements. Round 1 of the e-Delphi resulted in 41 antidotes reaching consensus and seven new antidotes suggested by the expert panel. Round 2 had two antidotes (out of seven newly suggested ones) reaching consensus. Round 3 was a confirmatory round, where the expert group agreed on their previous rounds' opinions. This resulted in the development of an essential antidote list with 43 antidotes. The optimal approach for ensuring adequate availability of antidotes is continuous monitoring of local poisoning incidence and antidote requirements through collaborations between academic researchers and emergency care clinicians. The development of an essential antidote list, with expert consensus, is one of the initial steps in securing a foundation for appropriate provision of antidotes at all healthcare institutions. This is the first study that the authors are aware of that demonstrates that the e-Delphi technique can consolidate recommendations of experts in emergency medicine to provide a list of essential antidotes.

Evolving to Objective Structured Clinical Exams (OSCE): Transitional experience in an undergraduate pharmacy program in Kuwait.

BACKGROUND: Objective Structured Clinical Exams (OSCEs) can assess professional competencies in a structured manner and facilitate objective evaluation of clinical performance. With limited data from the Eastern Mediterranean region, this study aims to describe the development, implementation, and evaluation of OSCEs for final year pharmacy students in Kuwait. The study also aims to compare students' performance in two academic years (2015-2016 and 2016-2017). METHODS: The design, implementation, and evaluation of the competency-based OSCE followed a 3-phase systematic evidence-based approach. The development phase involved establishing an OSCE working group to develop a blueprint and scoring rubrics and to organise assessors and standardised patient/physician training. The implementation phase involved conducting formative and summative OSCEs. The evaluation phase involved undertaking student and staff perception surveys. RESULTS: The overall students' OSCE scores for the academic years 2015-2016 and 2016-2017 were (median (interquartile range)) (71.6%, 32.2) and (60.0% (30.7)) and respectively (p < 0.0001). The average students' performance score was high in stations covering 'patient consultation and diagnosis' competency (71.4% (95% CI: 66.7-73.3)) and lower in stations covering 'monitoring of medicine therapy' competency (50.0% (95% CI: 33.3-66.7)). Students perceived stations covering 'monitoring medicines therapy' and 'assessment of medicine' as difficult. However, staff perceived stations related to 'patient consultation and diagnosis' competency as the easiest. Students reported that the OSCE was a positive experience as it provided them an opportunity to practice real life scenarios in a safe learning environment. CONCLUSION: The OSCE helped to identify the level of competency of students prior to graduation and areas to improve in the curriculum.

Using a global systematic framework tool to guide the advancement of the pharmacy workforce education and training on a national level.

BACKGROUND: Systematic education and training strategies play a critical role in preparing a competent pharmacy workforce to meet the evolving healthcare needs of nations. Reports have shown that investing in healthcare workers' education and training not only has a positive impact on employment rates and economic growth but also results in measurable improvement in health and population outcomes. The goal of this study was to evaluate the use of globally validated workforce goals as a guide to the planning and advancement of the Kuwait pharmacy workforce's education and training. METHODS: A mixed-approach qualitative study involving representatives of key stakeholders was conducted. Focus group interviews were carried out with pharmacists with patient and non-patient facing roles (N = 33). In addition, semi-structured interviews with the three main pharmacy Continuing Professional Development (CPD) providers in the country were conducted. Data were analysed using a framework analysis method. Interviews were transcribed verbatim and data were analysed and coded using MAXQDA-12. The International Pharmaceutical Federation Workforce Development Goals (FIP WDGs) were used as the framework for data analysis. RESULTS: Participants' responses highlighted three main priorities: the importance of initial and post-graduation needs-based education (WDG 2), the need for competency development and competency frameworks (WDG 5), and the crucial role of active policy and regulations that would enforce the profession development (WDG 9). Investing in competency development was seen the top priority for the pharmacy workforce in Kuwait. CONCLUSION: This study provided insights into areas in need of systematic development for pharmacy workforce in Kuwait including foundation training for early career pharmacists, competency development and competency frameworks, and policies and regulations that would enforce the profession development. In addition, the use of the FIP WDGs framework was found to offer a framing device to better understand and identify priorities and needs for pharmacy workforce development.

Competency development for pharmacy: Adopting and adapting the Global Competency Framework.

BACKGROUND: With current accelerated changes in the role of the pharmacists across different sectors, evidence-based developmental tools are needed to re-define the scope of practice for early career pharmacists (foundation level) and to support pharmacists' career development. This study aimed to develop a foundation competency framework for pharmacists in Kuwait using the International Pharmaceutical Federation (FIP) Global Competency Framework (GbCF) in an adopt and adapt approach. METHODS: A 4-phase adopt and adapt approach was followed to develop the Kuwait Foundation Competency Framework (KFCF). Phase one involved translating the FIP GbCF, into Arabic using parallel translation. Phase two utilises 2 consensus panels validation involving pharmacists from public and private sectors. Phase three involved a national survey to all registered pharmacists in Kuwait. The final phase involved focus groups with pharmacists and a consensus panel validation with key policy and decision makers in the pharmacy practice and education sectors in Kuwait. Qualitative data were thematically analysed, while quantitative data were analysed using IBM SPSS Statistics for Windows. RESULTS: The translation phase yielded a bilingual framework that could be utilised by pharmacists in Kuwait. The initial validation phase identified 70 behavioural statements (out of the GbCF's 100) as 'highly relevant' or 'relevant' to pharmacy practice in Kuwait. Findings from the national survey identified a list of behaviours that could be adapted in Kuwait context as well as competencies that were perceived as least relevant to Kuwait practice. The final validation phase generated a list of 98 behavioural statements to be included in the KFCF along with recommendations and an action plan to facilitate the adaptation of the framework. CONCLUSION: This study presents the first bilingual (Arabic/English) pharmacy foundation competency framework that builds on the FIP GbCF. The KFCF could be utilised as a developmental tool to support pharmacists' performance at foundation level.

The Development and Evaluation of a Structured Continuing Professional Development Programme for Pharmacists in Kuwait: A Feasibility Study.

Continuous education and training play a critical role in preparing a competent pharmacy workforce to meet the healthcare needs of the public. This study aimed to evaluate the effectiveness and feasibility of implementing a structured Continuing Professional Development (CPD) training programme for pharmacists in Kuwait. Twenty-one practicing pharmacists participated in the programme. This study evaluated the programme's effectiveness and feasibility by analysing data from three sources: (1) two focus group interviews, (2) CPD records collected in May and November 2019, and (3) online survey responses collected at the middle and end of the programme. Findings from this study showed that implementing a structured CPD programme is feasible and could positively impact pharmacists' practice. A guiding competency framework and continuous feedback from programme instructors added valuable support for pharmacists during the programme, and facilitated an impactful translation of education into practice. This study provides the first data on pharmacists' CPD in Kuwait and serves as a starting point for future education plans, studies, and transformational actions pertaining to pharmacy workforce education and training.

Multidisciplinary academic perspectives during the COVID-19 pandemic.

To date, the outbreak of the novel coronavirus (COVID-19) has infected more than 5 million people and caused around 350 000 deaths globally. In most countries, the world as we knew it came to a sudden stop and this led to the biggest shift of employees to remotely conduct their work. Academic institutions were extensively affected, as teaching and assessment activities were hampered, and graduation ceremonies were cancelled. In addition, there was an imminent disruption in academic and research activities including face-to-face conferences and conventions. Among many challenges, academics had to grapple to remain engaged professionally and socially with students and colleagues. Digital technology being an integral part of life has become essential for connectivity and communication. In this commentary, multidisciplinary academics from Kuwait and Saudi Arabia share perspectives and experiences in adapting to the COVID-19 reality. From healthcare sciences to engineering, and from business to education, this paper highlights the role academics play in combating professional and social challenges during COVID-19.

Availability of Antidotes in Kuwait: A National Audit.

BACKGROUND: Effective management of poisoning requires adequate stocking of antidotes in hospitals that provide emergency care. Antidote stocking represents a major challenge to hospitals all over the world, including Kuwait. OBJECTIVE: This study aimed to evaluate antidote stocking in public and private hospitals that provide emergency care in Kuwait. METHODS: A cross-sectional study using a self-administered questionnaire was conducted from January to December 2018. The questionnaire was designed to assess immediate and non-immediate availability of 41 antidotes in 6 public and 13 private hospitals in Kuwait that provided emergency care. The questionnaire was provided to the pharmacy departments of these hospitals, which were asked to report the availability of antidotes and the reasons for non-availability. Descriptive statistics were used to report demographical data and independent t-test analysis was used to analyze continuous variables. RESULTS: All of the six public hospitals in Kuwait and eight private hospitals returned the completed questionnaires. Among the 14 hospitals surveyed, none had a complete stock of all essential antidotes. The mean (standard deviation [SD]) availability of immediate antidotes in public hospitals was 79.6% (32.6%) compared to 52.1% (44.4%) in private hospitals. Moreover, the mean (SD) availability of non-immediate antidotes was 64.5% (37.7%) in public hospitals compared to 14.7% (22.8%) in private hospitals. CONCLUSIONS: Public and private hospitals in Kuwait have suboptimal stocks of essential antidotes. There is an urgent need to develop expert consensus guidelines to assist hospitals to reduce costs and improve patient care by adequately stocking essential antidotes.

Motivations, career aspiration, and learning experience of students in the pharmacy program at Kuwait University: A tool to guide curriculum development.

PURPOSE: To determine students' motivating factors in the choice of pharmacy, career aspirations, and perceptions about learning experiences in the current pharmacy curriculum. ACTIVITY: A descriptive cross-sectional survey of pharmacy students was performed at Kuwait University FINDINGS: The most common reason to pursue pharmacy was that they were not admitted to medicine or dentistry (40.5%). About half of students were seeing themselves employed in hospital pharmacies immediately after graduation. Over two-thirds of respondents 'agreed' or 'strongly agreed' that the pharmacy program developed their problem-solving skills (78.5%) and improved their communication skills (66.4%). Students also admitted that the teaching staff seemed more interested in testing memorization (72.5%), that feedback on student work was usually provided in the form of grades (66.4%), and that the workload is putting a lot of pressure on them (88%). SUMMARY: The survey identifies key elements that needs to be improved in the next iteration of the program (entry-level PharmD).

Pharmacists' Attitudes and Role in Diabetes Management in Kuwait.

OBJECTIVES: The objectives of this study were to measure pharmacists' attitudes toward management of diabetes, identify current levels of pharmacy service provided to patients with diabetes, and identify barriers for further provision of diabetes-related services. SUBJECTS AND METHODS: A descriptive, cross-sectional study was conducted on a sample of 198 pharmacists working in primary and secondary health care settings in one health region of Kuwait using a pretested self-administered questionnaire. Descriptive statistics, correlations, and comparative analysis were performed. RESULTS: The response rate was 84.4% (n = 168). Respondents had overall positive attitudes toward management of diabetes. Pharmacists regularly provided their patients with counseling on the appropriate time to administer their medications; however, services related to hypoglycemia and management of comorbid diseases were rarely provided. A negative correlation was found between the positive overall diabetes-related attitudes and pharmacists' involvement in providing the following diabetes-related services: glucose monitoring (r = -0.25, p = 0.001), comorbid disease management (r = -0.243, p = 0.001), and healthy living choices (r = -0.237, p = 0.002). The perception that some physicians and patients have of pharmacists as dispensers only was identified as the most important barrier to providing diabetes-related services. CONCLUSION: Pharmacists have positive diabetes-related attitudes; however, they provide limited diabetes-related services to their patients. Barriers to provision of pharmacy services to patients with diabetes should be addressed to enable optimum patient care delivery.

Implementation and evaluation of a workshop on patient counseling about antidiabetic medications for final-year pharmacy students.

OBJECTIVE: To implement an interactive workshop for final-year pharmacy students on patient counseling about antidiabetic medications and to assess its impact on knowledge and self-reported confidence of students in counseling. SUBJECTS AND METHODS: The workshop was organized for all final-year pharmacy students (n = 27) during the academic year 2011-2012. It included various teaching and learning activities: interactive lectures, group work and role-playing. Pre-/postworkshop questionnaires were used to assess the impact of the workshop on students' knowledge about medications and attitudes to patient counseling, respectively. The workshop and the teaching activities were evaluated using an evaluation sheet. Data were analyzed using SPSS version 17. Paired Student's t test was used to compare the results of pre-/postintervention instruments. Statistical significance was accepted at a p value of <0.05. RESULTS: The mean ± standard deviation of the pre- and postworkshop knowledge questionnaire scores were 47.9 ± 17.6% and 70.7 ± 18.6%, respectively (p < 0.05), indicating that the workshop significantly improved students' knowledge about antidiabetic medications. It also had significant effects on students' self-reported confidence in communicating effectively with patients and counseling them on antidiabetic medications. All participants strongly agreed that the workshop was very useful. The case discussion in small groups was ranked as the most preferred learning method by the students. CONCLUSION: This workshop was successful in improving knowledge and self-reported confidence of pharmacy students in counseling patients about antidiabetic medications. Adapting the use of engaging teaching methods allowed the students to become active, independent and self-directed learners and thus enhanced their confidence in providing pharmaceutical care to patients.