Education Satisfaction among Pharmacy Graduates in Sweden.

Education satisfaction is considered important for development of a professional identity and to increase learning. The aim was to investigate and compare education satisfaction over time among pharmacists who have graduated from the pharmacy programs at Umeå University, Sweden. Data concerning education satisfaction were collected using an alumni survey of pharmacists who graduated between 2015 and 2018. This was compared with pharmacists graduating between 2006 and 2014. The majority of the pharmacy graduates were very satisfied with their education (96%) and thought that the programs gave them a clear professional identity (92%). No differences in education satisfaction between graduation years 2015 and 2018 and 2006 and 2014 were found. A majority of the graduates considered that the knowledge and skills acquired during their education were useful in their present job (83%). Of the graduates who thought that the studies gave them a clear professional identity, a higher proportion were satisfied with their job (p < 0.001) and thought that their work duties reflected their studies (p = 0.005). Exploring education satisfaction may help educators to further develop the education and to better prepare the students for their professional working life.

Job Satisfaction among Swedish Pharmacists.

Understanding the role of pharmacists' job satisfaction is important because a lack of job satisfaction might have negative impacts on patient care and safety. The aim of this cross-sectional study was to explore and compare job satisfaction among pharmacists graduating from the pharmacy programs at Umeå University, Sweden. Data concerning job satisfaction and associated factors were collected using an alumni survey conducted among pharmacists graduating between 2015 and 2018. Ethical committee approval is not required for this type of study in Sweden. A majority (92.6%) of the pharmacy graduates were female. A majority of the graduates (91.4%) were satisfied with their job most of the time or all of the time, which was similar to a previous investigation among pharmacists graduating between 2006 and 2014. High access to continuous professional development (CPD) was associated with higher job satisfaction (odds ratio (OR): 18.717 (95% confidence interval (CI): 1.685-207.871)). In total, 65.6% considered access to CPD to be high (i.e., satisfactory to very good). Variables like gender, age, employee category, workplace, years since graduation, and income did not affect job satisfaction. Knowledge regarding job satisfaction will enable employers to respond to employees' needs, decrease turnover, and improve the work environment.

Swedish Pharmacy Students' Expectations and Perceptions of Their Education and Future Pharmacy Profession.

Distance education is becoming more and more common, and today distance education is well established within academic settings. The aim was to investigate first-year pharmacy students' expectations and perceptions of web-based pharmacy programs and of their future profession. Furthermore, student characteristics were compared over time. A questionnaire was distributed to all first-year students admitted to the pharmacy programs at Umeå University in 2017. The students were asked questions about their background, motives for choosing pharmacy education, and their expectations and perceptions of their education and profession. Factors of most importance when choosing the education were: the education is interesting, leads to an interesting job, and is web-based. The students' expectations of the education were high, and they want to learn as much as possible and be well prepared for their future profession. Regarding the students' perception of their future profession, three themes were identified: to help other people, professional development, and employment related issues. Student characteristics have changed over the years, suggesting that the web-based pharmacy education and the flexibility it entails attracts other groups of students today compared with when the programs started.

Assessment of potentially inappropriate medications using the EU (7)-PIM list and the Swedish quality indicators.

Background Several tools to evaluate the appropriateness of prescriptions have been developed over the years. Objective To compare the prevalence of potentially inappropriate medication (PIM) among elderly, using the European Union (EU) (7)-PIM list and the Swedish quality indicators. Secondary objectives were to investigate factors associated with the use of PIMs using the two tools. Setting Medical ward in a hospital in Northern Sweden. Methods Medical records for patients aged ≥ 65 years admitted to the medical ward were reviewed by clinical pharmacists from September to November 2015 and from February to April 2016. PIMs were identified through the abovementioned identification tools. Main outcome measure Prevalence of PIMs. Results Of 93 patients, 18.3% had one PIM according to the Swedish quality indicators. The most common PIM class was non-steroidal anti-inflammatory drugs and diclofenac was one of the most commonly prescribed PIMs. According to the EU (7)-PIM list, 45.2% of the study population was prescribed one or more PIMs. The most common PIM class was hypnotic and sedative drugs, and the most frequently prescribed PIM was apixaban. No significant associations between PIMs and different factors were found using either identification tool. Conclusion The prevalence of PIMs was relatively low in the study sample according to the Swedish guidelines but high according to the EU (7)-PIM list. Different evaluation tools might give inconclusive results, but it is still important to continuously evaluate the need for PIMs in older patients in order to improve drug treatment and to decrease the risk of adverse drug reactions.

Who enrols and graduates from web-based pharmacy education - Experiences from Northern Sweden.

INTRODUCTION: As a response to the shortage of prescriptionists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was introduced at Umeå University in 2003. This study explored who is likely to enrol and graduate from the web-based bachelor program and whether the program has addressed the shortage of prescriptionists in rural Northern Sweden. METHODS: Data from three different sources were included in this study; the initial cohort including students admitted to the program in 2003 (survey), the entire cohort including all people admitted to the program between 2003 and 2014 (university's admissions data) and the alumni cohort including graduates who participated in an alumni survey in 2015. RESULTS: A typical student of the web-based pharmacy program is female, over 30 years of age, married or in a de-facto relationship and has children. Furthermore, the students graduating before 2009 were more likely to live in Northern Sweden compared to those graduating later. DISCUSSION AND CONCLUSION: The results indicate that the introduction of a web-based bachelor of pharmacy program at Umeå University was to some extent able to address the shortage of prescriptionists in Northern Sweden. Web-based education may potentially help address the maldistribution of health professionals by providing flexible education opportunities.

Physicians' perspectives on clinical pharmacy services in Northern Sweden: a qualitative study.

BACKGROUND: In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy services (CPSs) in hospital settings have not been widely implemented and regional differences exist in the uptake of these services. Physicians' attitudes toward CPSs and collaborating with clinical pharmacists may facilitate or hinder the implementation and expansion of the CPSs and the role of the clinical pharmacist in hospital wards. The aim of this study was to explore physicians' perceptions regarding CPSs performed at hospital wards in Northern Sweden. METHODS: Face-to-face semi-structured interviews were conducted with a purposive sample of nine physicians who had previously worked with clinical pharmacists between November 2014 and January 2015. Interviews were digitally recorded, transcribed and analysed using a constant comparison method. RESULTS: Different themes emerged regarding physicians' views of clinical pharmacy; two main interlinked themes were service factors and pharmacist factors. The service was valued and described in a positive way by all physicians. It was seen as an opportunity for them to learn more about pharmacological treatment and also an opportunity to discuss patient medication treatment in detail. Physicians considered that CPSs could improve patient outcomes and they valued continuity and the ability to build a trusting relationship with the pharmacists over time. However, there was a lack of awareness of the CPSs. All physicians knew that one of the pharmacist's roles is to conduct medication reviews, but most of them were only able to describe a few elements of what this service encompasses. Pharmacists were described as "drug experts" and their recommendations were perceived as clinically relevant. Physicians wanted CPSs to continue and to be implemented in other wards. CONCLUSIONS: All physicians were positive regarding CPSs and were satisfied with the collaboration with the clinical pharmacists. These findings are important for further implementation and expansion of CPSs, particularly in Northern Sweden.

Pharmacists' satisfaction with their work: Analysis of an alumni survey.

BACKGROUND: The level of job satisfaction among practicing pharmacists is important because it has been found to affect job performance and employee turnover. The Swedish pharmacy market has undergone major changes in recent years, and little is known about pharmacists' job satisfaction. OBJECTIVES: The objective of this study was to investigate the level of job satisfaction and associated factors among graduates from the web-based pharmacy programs at Umeå University. METHODS: Job satisfaction of pharmacists was measured as part of an alumni survey conducted with those who graduated from the pharmacy programmes between 2006 and 2014. Data analysis included descriptive statistics, and logistic regression was used to explore factors affecting job satisfaction. RESULTS: The total number of graduates who completed the survey was 222 (response rate 43%.) The majority of respondents were female (95%), and most were employed at a community pharmacy (85%). The mean age was 39.7 years. The majority of graduates (91%) were satisfied with their job "most of the time" or "all of the time", and 87% of the respondents would "definitely" or "maybe" choose the same career again. The multivariate analysis showed that increasing years in the current position (OR: 0.672 (0.519-0.871)) was associated with lower job satisfaction. Older age (OR: 1.123 (1.022-1.234)), the perception that the knowledge and skills acquired during university education is useful in the current job (OR: 4.643 (1.255-17.182)) and access to continuing professional development (OR: 9.472 (1.965-45.662)) were associated with higher job satisfaction. CONCLUSION: Most graduates from the web-based pharmacy programmes were satisfied with their current job. Access to continuing professional development seems to be important for the level of job satisfaction among pharmacists.

Students' Satisfaction with a Web-Based Pharmacy Program in a Re-Regulated Pharmacy Market.

In response to the shortage of pharmacists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was established at Umeå University in 2003. In 2009, the Swedish pharmacy market was re-regulated from a state monopoly to an open market, but it is unknown what impact this has had on education satisfaction. The objectives of this study were to examine the level of satisfaction among graduates from a web-based pharmacy program and to describe what subjects and skills students would have liked more or less of in their education. A secondary objective was to compare the level of satisfaction before and after the Swedish pharmacy market was re-regulated. A cross-sectional survey was conducted in 2015 with all alumni who had graduated from the pharmacy program between 2006 and 2014 (n = 511), and responses to questions about graduates' satisfaction with the program were analyzed (n = 200). Most graduates (88%) agreed or strongly agreed that the knowledge and skills acquired during their education were useful in their current job. The graduates stated that they would have wanted more applied pharmacy practice and self-care counselling, and fewer social pharmacy and histology courses. Further, 82% stated that they would start the same degree program if they were to choose again today, and 92% agreed or strongly agreed that they would recommend the program to a prospective student. Graduates were more likely to recommend the program after the re-regulation (p = 0.007). In conclusion, pharmacy graduates were very satisfied with their education, and no negative effects of the re-regulation could be observed on program satisfaction.

Chitosan-Based Nanomedicine to Fight Genital Candida Infections: Chitosomes.

Vaginal infections are associated with high recurrence, which is often due to a lack of efficient treatment of complex vaginal infections comprised of several types of pathogens, especially fungi and bacteria. Chitosan, a mucoadhesive polymer with known antifungal effect, could offer a great improvement in vaginal therapy; the chitosan-based nanosystem could both provide antifungal effects and simultaneously deliver antibacterial drugs. We prepared chitosan-containing liposomes, chitosomes, where chitosan is both embedded in liposomes and surface-available as a coating layer. For antimicrobial activity, we entrapped metronidazole as a model drug. To prove that mucoadhesivness alone is not sufficient for successful delivery, we used Carbopol-containing liposomes as a control. All vesicles were characterized for their size, zeta potential, entrapment efficiency, and in vitro drug release. Chitosan-containing liposomes were able to assure the prolonged release of metronidazole. Their antifungal activity was evaluated in a C. albicans model; chitosan-containing liposomes exhibited a potent ability to inhibit the growth of C. albicans. The presence of chitosan was crucial for the system's antifungal activity. The antifungal efficacy of chitosomes combined with antibacterial potential of the entrapped metronidazole could offer improved efficacy in the treatment of mixed/complex vaginal infections.

Using a Virtual Tablet Machine to Improve Student Understanding of the Complex Processes Involved in Tablet Manufacturing.

Objective. To develop and implement a virtual tablet machine simulation to aid distance students' understanding of the processes involved in tablet production. Design. A tablet simulation was created enabling students to study the effects different parameters have on the properties of the tablet. Once results were generated, students interpreted and explained them on the basis of current theory. Assessment. The simulation was evaluated using written questionnaires and focus group interviews. Students appreciated the exercise and considered it to be motivational. Students commented that they found the simulation, together with the online seminar and the writing of the report, was beneficial for their learning process. Conclusion. According to students' perceptions, the use of the tablet simulation contributed to their understanding of the compaction process.

Palmitoylethanolamide for the treatment of pain: pharmacokinetics, safety and efficacy.

Palmitoylethanolamide (PEA) has been suggested to have useful analgesic properties and to be devoid of unwanted effects. Here, we have examined critically this contention, and discussed available data concerning the pharmacokinetics of PEA and its formulation. Sixteen clinical trials, six case reports/pilot studies and a meta-analysis of PEA as an analgesic have been published in the literature. For treatment times up to 49 days, the current clinical data argue against serious adverse drug reactions (ADRs) at an incidence of 1/200 or greater. For treatment lasting more than 60 days, the number of patients is insufficient to rule out a frequency of ADRs of less than 1/100. The six published randomized clinical trials are of variable quality. Presentation of data without information on data spread and nonreporting of data at times other than the final measurement were among issues that were identified. Further, there are no head-to-head clinical comparisons of unmicronized vs. micronized formulations of PEA, and so evidence for superiority of one formulation over the other is currently lacking. Nevertheless, the available clinical data support the contention that PEA has analgesic actions and motivate further study of this compound, particularly with respect to head-to-head comparisons of unmicronized vs. micronized formulations of PEA and comparisons with currently recommended treatments.

Chitosan in mucoadhesive drug delivery: focus on local vaginal therapy.

Mucoadhesive drug therapy destined for localized drug treatment is gaining increasing importance in today's drug development. Chitosan, due to its known biodegradability, bioadhesiveness and excellent safety profile offers means to improve mucosal drug therapy. We have used chitosan as mucoadhesive polymer to develop liposomes able to ensure prolonged residence time at vaginal site. Two types of mucoadhesive liposomes, namely the chitosan-coated liposomes and chitosan-containing liposomes, where chitosan is both embedded and surface-available, were made of soy phosphatidylcholine with entrapped fluorescence markers of two molecular weights, FITC-dextran 4000 and 20,000, respectively. Both liposomal types were characterized for their size distribution, zeta potential, entrapment efficiency and the in vitro release profile, and compared to plain liposomes. The proof of chitosan being both surface-available as well as embedded into the liposomes in the chitosan-containing liposomes was found. The capability of the surface-available chitosan to interact with the model porcine mucin was confirmed for both chitosan-containing and chitosan-coated liposomes implying potential mucoadhesive behavior. Chitosan-containing liposomes were shown to be superior in respect to the simplicity of preparation, FITC-dextran load, mucoadhesiveness and in vitro release and are expected to ensure prolonged residence time on the vaginal mucosa providing localized sustained release of entrapped model substances.

Pectosomes and chitosomes as delivery systems for metronidazole: the one-pot preparation method.

Mucoadhesive liposomes offer a potential for improved residence time of liposomal systems targeting contact with mucosal tissues, such as in buccal, oral, colon, and vaginal drug delivery. Most of the currently available methods rely on the coating of preformed liposomes by various mucoadhesive polymers. The aim of this study was to develop novel mucoadhesive system by the one-pot preparation method. The pectin- and chitosan-containing liposomes, namely pectosomes and chitosomes, were prepared by the modified solvent injection method. In order to optimize this novel delivery system, we used pectins and chitosans of both high and low degree of esterification/deacetylation (DE/DD), respectively. Sonication was applied to reduce the original vesicle size. All vesicles were characterized for their size, zeta potential, metronidazole entrapment, and stability. Both pectosomes and chitosomes were found to entrap more metronidazole than conventional plain liposomes. Preliminary data indicate that the polymer is present on the liposomal surface, embedded within inner liposomal bilayers, and entrapped inside the aqueous compartment. The next step in the evaluation of this system is the testing of its mucoadhesiveness.

Evaluation of a sieve classification method for characterization of low-dose interactive mixtures.

This study investigated a sieve classification method for evaluating carrier materials and particle size fractions, which could be a valuable tool in the early development of pharmaceutical dosage forms containing low-dose interactive mixtures. When developing new products based on interactive mixtures, it is essential to ensure that the drug particles are successfully deagglomerated and have adhered to the carrier particles. In this study, the effect on the demixing potential (DP) of low-dose interactive mixtures was assessed for various carrier particle sizes and surface textures. The model drug used was sodium salicylate and the tested carriers were lactose, mannitol, and isomalt. The results showed that the lowest DPs, i.e. the most mechanically stable mixtures, were obtained with lactose. Furthermore, for interactive mixtures, small carrier particles and/or a narrow carrier particle size range are essential for obtaining a low DP and high homogeneity. Calculation of the DP provided a reliable estimate of the quality of the low-dose interactive mixtures used in this study.