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1.
J Pharm Pract ; : 8971900231182779, 2023 Jun 14.
Article in English | MEDLINE | ID: mdl-37315554

ABSTRACT

Background: Without specific pharmaceutical knowledge in specialist areas such as Human Immunodeficiency Virus (HIV) management, pharmacists may lack the ability and confidence to provide optimal pharmaceutical care and optimization of outcomes. Objective: To develop a pharmacy-specific, foundational HIV education and assessment package, and assess impact on pharmacist knowledge and confidence. Methods: A foundational HIV education package with assessment was developed. Participants' baseline knowledge and self-reported confidence in HIV management were determined via an anonymous online questionnaire. Only participants who completed the pre-education questionnaire were then provided access to the self-paced, online education package. Participants completed a second questionnaire after completion of the package at a time of their choosing, within 2 months of the first questionnaire completion. Both questionnaires were similar in knowledge difficulty and addressed similar clinical domains. Mean differences in knowledge and confidence levels were analyzed, with further subgroup analyses of knowledge categories. Results: A total of 57 pharmacists completed both questionnaires. HIV knowledge was higher post-education compared with pre-education (mean correct score of 83.7% and 56.5% respectively, P < .001). The mean self-rated confidence of pharmacists in managing medications of people living with HIV, was higher post-education (73.3%) compared with pre-education (33.9%) (P < .001). Conclusion: The use of a pharmacy-specific, foundational HIV management education package significantly increased pharmacist knowledge in HIV management and improved self-reported confidence in the management of this specialty area. Future studies should assess the sustained impact of educational materials on pharmacist knowledge and confidence and investigate translation into improved outcomes for people living with HIV.

2.
Soc Psychiatry Psychiatr Epidemiol ; 58(2): 287-298, 2023 Feb.
Article in English | MEDLINE | ID: mdl-35661229

ABSTRACT

BACKGROUND: Prevalence of depression and anxiety in people with cystic fibrosis (PwCF) and their caregivers is high, however, results have been inconsistent. This systematic review and meta-analysis aimed to estimate the prevalence of depression and anxiety in PwCF and their caregivers and explore sources of heterogeneity. METHOD: MEDLINE, EMBASE, CINAHL plus and PsychINFO databases were searched from inception to January 2021. Studies were included if a specific psychometric tool (PT) to assess depression or anxiety (rather than quality of life) was used and did not involve a transitory patient state. Random-effects models were applied due to high anticipated heterogeneity and I2 estimates were calculated. Sources of heterogeneity were explored through subgroup comparisons. The presence of small-study effects was investigated visually using funnel plots and statistically using the Egger test. RESULTS: A total of 94 articles (48 full-text publications, 46 abstracts) were included. Depression prevalence in adolescents aged 12-18 years (n = 2386), adults (n = 9206) and caregivers (n = 6617) were 18.7% (95% CI 12.8-25.3%, I2 = 89.2%), 27.2% (95% CI 23.6-31%, I2 = 90.4%), and 32.8% (95% CI 27.9-37.9%, I2 = 90.3%), respectively. Anxiety prevalence in adolescents aged 12-18 years (n = 2142) was 26% (95% CI 19.6-33%, I2 = 86.4%), 28.4% (95% CI 25-31.9%, I2 = 85%) for adults (n = 8175), and 38.4% (95% CI 30.8-46.2%, I2 = 94.6%) for caregivers (n = 5931). Prevalence differed by the PT used and study location. DISCUSSION: This comprehensive analysis found the prevalence of depression and anxiety in PwCF and their caregivers to be high, supporting recommendations for regular screening. Choice of PT significantly influenced prevalence, indicating a need for future studies to identify the optimal PT for each CF population to identify those most at risk.


Subject(s)
Cystic Fibrosis , Depression , Adult , Adolescent , Humans , Depression/epidemiology , Quality of Life , Caregivers , Prevalence , Cystic Fibrosis/epidemiology , Anxiety/epidemiology
3.
J Pharm Pract ; 35(6): 903-910, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34013814

ABSTRACT

BACKGROUND: Pharmacists routinely interpret and optimize tobramycin dosing for people with cystic fibrosis (PwCF). OBJECTIVES: To determine the impact of tobramycin therapeutic drug monitoring (TDM) education on pharmacist dose recommendations, and to explore nurses' and medical doctors' perceptions toward pharmacist-led TDM charting. METHODS: This study involved 3 phases: a 12-month retrospective audit of PwCF prescribed tobramycin to identify the appropriateness of pharmacists' dose recommendations, a pharmacist tobramycin educational intervention utilizing a voiceover presentation with pre- and post-online tobramycin TDM assessment (involving multiple choice pharmacokinetics and case-based scenario questions), and a cross-sectional survey of respiratory nurses' and doctors' perceptions toward pharmacist-led TDM charting. The pharmacists' dose recommendations, in the audit and case-based questions, were considered appropriate if subsequent levels achieved the targeted area under the curve (AUC). RESULTS: Audit results revealed that 44.4% of the 277 pharmacist dose recommendations identified were appropriate. The pre- and post-interventional assessments were completed by 51 and 52 pharmacists, respectively. Post intervention, correct scores were significantly higher than pre-intervention, evident in both the pharmacokinetics (median score 75% vs 100%; P = 0.048) and case-based scenario (median score 60% vs 90%; P < 0.0001) questions. Of the 54 nurses and medical doctors surveyed, 92.6% supported the implementation of pharmacist-led tobramycin charting. CONCLUSION: The study demonstrated an increased accuracy and appropriateness of pharmacists' tobramycin pharmacokinetics knowledge and TDM dose recommendations post-educational intervention and highlighted nurses' and medical doctors' support of pharmacist-led tobramycin TDM charting.


Subject(s)
Cystic Fibrosis , Pharmacists , Humans , Tobramycin , Cystic Fibrosis/drug therapy , Cross-Sectional Studies , Retrospective Studies
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