Nurses' perceptions of and satisfaction with the use of automated dispensing cabinets at the Heart and Cancer Centers in Qatar: a cross-sectional study.

BACKGROUND: Automated dispensing cabinets (ADCs) were introduced in 2010 and 2012 at the Heart Hospital (HH) and National Center for Cancer Care and Research (NCCCR), both run by Hamad Medical Corporation in Qatar. These medication distribution systems provide computer-controlled storage, dispensing, and tracking of drugs at the point of care in patient care units. The purpose of this study was to assess nurses' perceptions of and satisfaction with the use of ADCs at HH and NCCCR. METHODS: A cross-sectional study was conducted in the two institutions in May and November 2012 using a piloted, validated, online, and anonymous questionnaire. The questionnaire consisted of four parts: nurses' sociodemographic and practice characteristics, 21 questions about their perceptions, one question about their overall satisfaction, and one about the system's ease of use. The self-administered survey was distributed to 503 nurses working at HH and NCCCR over three weeks using Survey Monkey®. RESULTS: The survey response rate was 80 % (n = 403). No significant difference was found in perception scores between the two institutions (p = 0.06). Ninety-four percent (n = 378) of nurses agreed that the medication delivery system allowed them to do their job more safely, and 90 % (n = 363) nurses agreed that they now spent less time waiting for medication from the pharmacy than they did before the ADC system was introduced. Eighty seven percent (n = 349) nurses agreed that they were able to administer medication more efficiently with the ADC system. The overall satisfaction rate (either "very satisfied" or "satisfied") for the two hospitals was 91 %. CONCLUSIONS: The nurses' perceptions of and levels of satisfaction with the ADC system were very good over the 6 months after complete implementation and integration at HH and NCCCR. ADCs appear to increase efficiency in the medication process and should therefore improve the quality of care.

Community pharmacists' attitudes, perceptions, and barriers toward adverse drug reaction reporting in Malaysia: a quantitative insight.

OBJECTIVES: This study was designed to explore awareness and attitudes of community pharmacists toward the national ADR reporting system activities in the northern states of Malaysia. METHODS: A cross-sectional survey using a validated self-administered questionnaire was used in this study. The questionnaire was delivered to all community pharmacists (N = 470) practicing in the four northern states of Malaysia (Perlis, Kedah, Pulau Pinang and Perak) during the study period. RESULTS: A total of 470 survey forms were sent with one wave of reminders. Only 116 pharmacists responded to the survey (response rate of 25.2%). The total number of usable responses was 104 (24.7%). The survey findings revealed that nearly three-quarters of pharmacists (n = 75; 72.1%) were not aware of the pharmacovigilance activities run by the drug regulatory authority in Malaysia. Although more than half (n = 65, 61.5%) of the surveyed pharmacists emphasized the importance of ADR reporting, only 13 pharmacists (12.9%) claimed that they submitted ADR reports to the Malaysia Adverse Drug Reaction Advisory Committee (MADRAC) before this survey. Barriers which prevent community pharmacists from ADR reporting were identified. These included lack of knowledge on how to report (n = 36; 34.7%), the unavailability of reporting forms (n = 44; 42.6%), and ignorance of where the report should be sent to (n = 46; 44.6%). CONCLUSIONS: Despite the unfamiliarity and the common misconceptions, the study results show that community pharmacists in the northern states of Malaysia have a very positive attitude toward the ADR reporting system in the country. However, the study findings highlight the urgent need for special education programs to establish continuous efforts to promote ADR reporting among community pharmacists. Further studies at the national level aimed at identifying and removing barriers that prevent community pharmacists from performing ADR reporting are required.

Assessing quality of a worksite health promotion programme from participants' views: findings from a qualitative study in Malaysia.

BACKGROUND: An assessment of the process and outcomes of a health promotion programme is necessary for the continuous improvement of a programme. OBJECTIVE: To explore the participants' perceptions of the quality and effectiveness of the 'Love Your Heart Programme'. DESIGN: A qualitative study using semi-structured interviews with a purposive sample of participants of the 'Love Your Heart' programme. Interviews were based on an interview guide that grouped questions into four main subgroups: structure, process, immediate outcomes and impact. The interviews were audio-recorded, transcribed verbatim and analysed using the principles of grounded theory. RESULTS: A total of 17 interviews were conducted. The participants were satisfied with the structural aspects of the programme. Different opinions arose regarding the ideal frequency and duration of the programme. The content of the seminars was thought to be too general. There was also a lack of interest in the 'Road to a Healthy Heart' booklet. All of the respondents had positive opinions about the communication skills and attitude of the health educator. The potential advantages and disadvantages of participating in the programme were discussed. Finally, the respondents expressed their satisfaction with the programme and the impact it had on them. DISCUSSION AND CONCLUSIONS: In general, the participants who were interviewed held the programme, and the health educator conducted the programme in high regard. The suggestions that were received can be used to further improve the acceptability and feasibility of the programme.

Counterfeit drug demand: perceptions of policy makers and community pharmacists in Sudan.

BACKGROUND: The counterfeit drug trade has become widespread and has developed into a substantial threat to both the public's health and the pharmaceutical industry. OBJECTIVES: The aim of this study was to seek insights into the determining factors of counterfeit drug purchases among health policy makers and community pharmacists in a developing country. METHODS: In-depth qualitative interviews with Sudanese policy makers and community pharmacists were undertaken in 2 Sudanese states, namely Khartoum and Gadaref. A semistructured interview guide was developed by incorporating information from existing literature. A purposive sample of knowledgeable policy makers and community pharmacists was interviewed. RESULTS: Thematic content analysis of the interviews identified 8 major themes: understanding the term "counterfeit drug," presence of counterfeit drugs in the Sudanese market, vulnerability to counterfeit drugs, price-quality inference, awareness of societal consequences of counterfeit drugs, subjective social norms, difference in vulnerability according to demographic characteristics, and education pertaining to counterfeit drugs. Unaffordability of medicines and desperate need were emphasized by both policy makers and community pharmacists as major influencing factors that increased consumers' vulnerability to counterfeit drugs. CONCLUSIONS: This study concluded that high prices and the unaffordability of medicines have a major role in increasing vulnerability to counterfeit drugs, in addition to lack of knowledge about counterfeiting and the implications of use of these products. Because very limited studies have been conducted in developing countries to explore perceptions about counterfeit drugs, the present study provides information from which policy makers and key stakeholders in the supply chain can benefit.

Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study / ¿Son capaces los farmacéuticos comunitarios sudaneses de prescribir y demostrar los inhaladores de asma los clientes?: un estudio con paciente simulado

Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists' ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden. Objective: To evaluate community pharmacists' practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan. Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum) and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI) (n=105), MDI with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a pharmacist) acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know. Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct) all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an "optimal technique". The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus) either did not know proper technique or were totally unfamiliar with the devices. Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge of proper use of commonly dispensed asthma inhaler devices (AU)

Aunque los farmacéuticos comunitarios se han involucrado en el cuidado de los pacientes con asma, varios estudios han evaluado las capacidades de los farmacéuticos para ilustrar apropiadamente la técnica de inhalación de los diferentes dispositivos. Muchos estudios encararon el uso inapropiado de los inhaladores por pacientes y farmacéuticos, además de su daño clínico, humanístico y económico. Objetivo: Evaluar en los farmacéuticos comunitarios el conocimiento práctico y las habilidades para demostrar la técnica de inhalación apropiada de los dispositivos para asma disponibles en Sudan. Métodos: Se abordó a 300 farmacéuticos comunitarios situados alrededor de 3 hospitales principales de la ciudad de Kartum y de otras 4 provincias, y se evaluaron 4 dispositivos para el asma: Inhaladores dosificadores (MDI) (n=105), MDI con cámara espaciadora (n=83), Turbuhaler (n=61), y Diskus (n=51). Un investigador (farmacéutico) actuó como un paciente simulado. Seleccionaba un dispositivo y pedía al farmacéutico que le demostrase como utilizarlo. El investigador rellenaba un check-list de 9 pasos sobre el uso del inhalador inmediatamente después de abandonar la farmacia. Los pasos esenciales extraídos de la literatura fueron previamente especificados para cada dispositivo. Se crearon 5 categorías de evaluación: técnica óptima; técnica adecuada; técnica pobre; dispositivo totalmente extraño; y no sabía. Resultados: Más de la mitad de los farmacéuticos abordaos con el dispositivo no conocían la técnica óptima de uso (i.e. todos los pasos correctos). Un tercio demostraba pobremente la técnica y solo un farmacéutico fue calificado como capaz de demostrar la "técnica óptima". La mayoría de los farmacéuticos abordados con cámara espaciadora o con inhaladores de polvo seco (Turbuhaler y Diskus) o no sabían la técnica apropiada o desconocían totalmente los dispositivos. Concusión: La mayoría de los farmacéuticos comunitarios, de los que se esperaba que educasen a los pacientes con asma sobre los inhaladores dispensados, carecían de conocimientos básicos sobre el uso apropiado de los inhaladores para asma comúnmente dispensados (AU)

Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study.

UNLABELLED: Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists''ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden. OBJECTIVE: To evaluate community pharmacists' practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan. METHODS: THREE HUNDRED COMMUNITY PHARMACIES LOCATED AROUND THE THREE MAJOR HOSPITALS IN THE CAPITAL CITY (KHARTOUM) AND FOUR OTHER PROVINCES WERE APPROACHED, AND FOUR ASTHMA DEVICES WERE ASSESSED: Metered-dose inhaler (MDI) (n=105), MDI with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a pharmacist) acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know. RESULTS: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct) all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an "optimal technique". The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus) either did not know proper technique or were totally unfamiliar with the devices. CONCLUSIONS: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge of proper use of commonly dispensed asthma inhaler devices.

Pharmacy students' knowledge and perceptions about pharmacovigilance in Malaysian public universities.

OBJECTIVE: To assess senior pharmacy students' knowledge of and perceptions about pharmacovigilance and reporting of adverse drug reactions (ADRs) at 5 public universities in Malaysia. METHODS: A cross-sectional study was conducted between December 1, 2010, and January 31, 2010, using a validated self-administered questionnaire delivered to a sample of 510 final-year (fourth-year) pharmacy students at 5 Malaysian public universities. RESULTS: Four hundred twenty-one (84%) students responded to the survey. About 60% (n = 240) indicated that they had taken courses on the concept of pharmacovigilance during their current pharmacy curriculum. The mean score for knowledge about pharmacovigilance and ADR reporting was 6.9 ± 1.4. There was a significant difference in the mean scores for knowledge about pharmacovigilance across the 5 universities. The majority (82.3%) of respondents felt it was necessary to confirm the causal relationship between the drug and the ADR. About 57.8% (n = 241) of the respondents believed that pharmacy students are competent and capable of reporting ADRs during their clerkships. The majority (87.0%) of respondents perceived that pharmacy students should be taught how to report ADRs. CONCLUSION: The results of this study demonstrate that the majority of final-year pharmacy students in Malaysian public universities have insufficient knowledge about pharmacovigilance and ADR reporting.

Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan / Cualificación, conocimiento y experiencia de los dispensadores que trabajan en farmacias comunitarias en Pakistán

Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan. Objective: The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan. Methods: A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p<=0.05) were performed to find out differences. Results: Out of total sample of 371 pharmacies, 31.8 % (118) were in Islamabad, 32.4 % (120) in Peshawar and 35.8 % (133) were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41) of the respondents knew about OTC (over the counter drugs) which can be sold without prescription while 5.9 % (22) of the respondents were aware of POM (prescription only medicines) which can be only sold on a valid prescription. While 87.6% (325), 88.1% (327), 58.7% (318) and 95.7 % (355) of the respondents did not know the meaning of the dispensing abbreviations such as ‘h.s’, ‘q.d’, ‘sos’ and ‘p.r.n’. The respondents did not know correctly the status of Deltacortil® (Prednisolone), Septran® (Sulfamethoxazole) and Fansidar® (Pyrimethamine and Sulfadoxine) either as OTC or POM in 26.7% (99), 64.2% (238), and 44.5 % (165) of the cases, respectively. There was a significant difference (p≤0.05) in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience. Conclusions: The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively better knowledge regarding storage temperature, prescription terminologies and status of medicines as compared to pharmacy assistants, diploma holders and salesperson (AU)

En Pakistán, las farmacias están gestionadas por una variedad de dispensadores en cuanto a cualificación, conocimiento y experiencia. Objetivo: El estudio trató de documentar el estado del conocimiento, experiencia y cualificación de los dispensadores que trabajan en farmacias comunitarias en Pakistán. Métodos: Se realizó un estudio comparativo transversal en una muestra aleatoria de 371 farmacias en tres ciudades de Pakistán. Para recoger los datos, se desarrolló un cuestionario semi-estructurado y se finalizó con un grupo focal y una prueba piloto. Los datos se codificaron y analizaron utilizando un SPSS versión 16. Se realizaron tests de Kruskal-Wallis and Mann- Whitney tests (p <= 0.05) para identificar las diferencias. Resultados: De la muestra total de 371 farmacias, el 31,8% (118) estaban en Islamabad, el 32,4% (120) en Peshawar y el 35,8% (133) en Lahore. El 50% de los respondentes tenían un conocimiento correcto del rango de temperaturas a las que deben almacenarse los medicamentos. Sólo el 11,1% (41) sabía que los OTC (over-the-counter) pueden venderse sin receta, mientras que el 5,9% (22) era consciente que las POM (medicamentos con receta) que sólo pueden ser vendidos con una receta válida. El 97,6% (325), 88,1% (327), 58,7% (318) y 95,7% (355) de los respondentes no sabía el significado de las abreviaturas de dispensación tales como ‘h.s’, ‘q.d’, ‘sos’ y ‘p.r.n’. Los respondentes no sabían correctamente el estado de Deltacortil® (Prednisolona), Septran® (Sulfametoxazol) y Fansidar® (Pirimetamina y Sulfadoxina) como OTC o POM en el 26,7% (99), 64,2% (238), y 44,5% (165) de los casos, respectivamente. Hubo una diferencia significativa (p≤0.05) en el conocimiento de los dispensadores sobre la temperatura de almacenamiento, terminología de prescripción y estado de los medicamentos cuando tenían diferente nivel de cualificación y experiencia. Conclusiones: El conocimiento y formación generales de los dispensadores que trabajan en farmacias comunitarias en Pakistán es inadecuado. Sin embargo, los farmacéuticos tienen mejor conocimiento en relación a temperatura de almacenamiento, terminologías de prescripción y estado de los medicamentos comparados con los Auxiliares de farmacia, los diplomados y los vendedores (AU)

Qualification, knowledge and experience of dispensers working at community pharmacies in Pakistan.

UNLABELLED: Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan. OBJECTIVE: The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan. METHODS: A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p≤0.05) were performed to find out differences. RESULTS: Out of total sample of 371 pharmacies, 31.8 % (118) were in Islamabad, 32.4 % (120) in Peshawar and 35.8 % (133) were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41) of the respondents knew about OTC (over the counter drugs) which can be sold without prescription while 5.9 % (22) of the respondents were aware of POM (prescription only medicines) which can be only sold on a valid prescription. While 87.6% (325), 88.1% (327), 58.7% (318) and 95.7 % (355) of the respondents did not know the meaning of the dispensing abbreviations such as 'h.s', 'q.d', 'sos' and 'p.r.n'. The respondents did not know correctly the status of Deltacortil® (Prednisolone), Septran® (Sulfamethoxazole) and Fansidar® (Pyrimethamine and Sulfadoxine) either as OTC or POM in 26.7% (99), 64.2% (238), and 44.5 % (165) of the cases, respectively. There was a significant difference (p≤0.05) in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience. CONCLUSIONS: The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively better knowledge regarding storage temperature, prescription terminologies and status of medicines as compared to pharmacy assistants, diploma holders and salesperson.