A cross-sectional study of community pharmacists' self-reported disease knowledge and competence in the treatment of childhood autism spectrum disorder.

BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental disease that can cause significant social, communication, and behavioural challenges. Given the rising prevalence of autism and multiple medication use, healthcare professionals, including community pharmacists, are required to have sufficient ASD knowledge to affect positively the disease prognosis and related comorbidities. AIM: To assess community pharmacists' knowledge of disease and pharmacotherapy of ASD, along with the provision of patient education and counselling provided by, community pharmacists in Turkey. METHOD: This was a descriptive, cross-sectional study conducted among community pharmacists in Turkey using a structured, validated questionnaire to assess ASD knowledge, awareness, and the provision of patient education and counselling by community pharmacists. RESULTS: 486 community pharmacists were included, with a mean age of 39.69 ± 13.10 years, and most (n = 151, 31.1%) in the age range between 20 and 29 years. 96.3% of community pharmacists never had training about ASD. 32.9% of the participants were aware of the medicines for ASD treatment, and 25.7% were aware of the drugs' side effects. The mean overall knowledge about childhood autism among health workers questionnaire (KCAHW) score was 11.83 ± 3.91, and there was a statistically significant KCAHW score difference between other pharmacists and those with ASD training (p = 0.006). CONCLUSION: There is a lack of disease and pharmacotherapy knowledge about childhood ASD among Turkish community pharmacists, particularly about communication impairment, type, onset, and comorbidities, as well as poor knowledge about drug pharmacotherapy and patient counselling services. This potentially creates a barrier to the adequate provision of healthcare to autistic patients.

Exploring the Intention and Hesitancy to Receive a Booster Dose of COVID-19 Vaccine among Patients with Comorbid Disease Conditions Using a Health Belief Model.

Despite the fact that the WHO recommends that adults over the age of 18 have to receive a booster dose of the COVID-19 vaccine. The willingness and intention to accept a booster dose of the COVID-19 vaccine remain major issues among the general population, particularly patients with comorbid disease conditions. The aim of this study was to assess the patterns regarding COVID-19 infection and vaccination, along with the intention and hesitancy to receive a booster dose of the COVID-19 vaccine among patients with comorbid disease conditions in Istanbul, Türkiye. Methods: This was a descriptive, cross-sectional study conducted among patients with comorbid disease conditions using a three-part, structured, validated questionnaire. Vaccine hesitancy from a booster dose of the COVID-19 vaccine was assessed using the Health Belief Model (HBM), based on a 5-point Likert-type scale. Results: The study enrolled 162 participants with a mean age of 57.2 ±â€¯13.3 years. 97% of the respondents received the COVID-19 vaccine. Almost half of respondents (51.2%) reported receiving information about a booster dose of the COVID-19 vaccine. HBM among the participants with comorbidities showed a significant agreement regarding the perceived susceptibility (P < 0.0001), perceived severity (P < 0.0001) and perceived benefits (P < 0.0001) to receive a booster vaccine dose. There was a statistically significant correlation between the intention to receive a booster vaccine dose and education level (university education; P < 0.0001). Conclusion: A vast and significant majority of patients with chronic comorbid disease conditions who received the COVID-19 vaccine reported an intention to receive a booster dose.

Introducción: A pesar de que la OMS recomienda que los adultos mayores de 18 años reciban una dosis de refuerzo de la vacuna contra el COVID-19. La voluntad y la intención de aceptar una dosis de refuerzo de la vacuna COVID-19 siguen siendo problemas importantes entre la población general, en particular los pacientes con enfermedades comórbidas. El objetivo de este estudio fue evaluar los patrones con respecto a la infección y vacunación de COVID-19, junto con la intención y la indecisión de recibir una dosis de refuerzo de la vacuna COVID-19 entre pacientes con enfermedades comórbidas en Estambul, Turquía.Métodos: Este fue un estudio descriptivo transversal realizado entre pacientes con enfermedades comórbidas utilizando un cuestionario validado, estructurado y de tres partes. La vacilación de la vacuna de una dosis de refuerzo de la vacuna COVID-19 se evaluó utilizando el Modelo de creencias de salud (HBM), basado en una escala tipo Likert de 5 puntos.Resultados: El estudio inscribió a 162 participantes con una edad media de 57,2 ±â€¯13,3 años. El 97% de los encuestados recibió la vacuna COVID-19. Casi la mitad de los encuestados (51,2%) informaron haber recibido información sobre una dosis de refuerzo de la vacuna contra la COVID-19. HBM entre los participantes con comorbilidades mostró un acuerdo significativo con respecto a la susceptibilidad percibida (P < 0,0001), la gravedad percibida (P < 0,0001) y los beneficios percibidos (P < 0,0001) para recibir una dosis de vacuna de refuerzo. Hubo una correlación estadísticamente significativa entre la intención de recibir una dosis de vacuna de refuerzo y el nivel educativo (educación universitaria; P < 0,0001).Conclusión: Una gran y significativa mayoría de los pacientes con enfermedades comórbidas crónicas que recibieron la vacuna contra el COVID-19 informaron tener la intención de recibir dosis de refuerzo.

Insights into disease and pharmacotherapy knowledge of Alzheimer's disease among community pharmacists: a cross-sectional study.

OBJECTIVE: To assess the knowledge level and awareness of Alzheimer's disease, including knowledge about the disease, pharmacotherapy, provision of patient education and associated factors among community pharmacists across Turkey and Northern Cyprus. METHODS: This was a descriptive, cross-sectional study conducted among community pharmacists working in Turkey (Group A) and Northern Cyprus (Group B). Disease and pharmacotherapy knowledge of AD were assessed using AD Knowledge Scale (ADKS), and drug treatment (KADT) scale, respectively. RESULTS: Both groups reported a moderate level of knowledge of AD, especially medically-oriented domains, with no significant difference regarding the mean ADKS domains (18.8 ± 2.8 vs. 18.9 ± 3.4; p = .98). Nevertheless, participants from both groups reported a good level of KADT knowledge about AD treatment (p = .03). Group A reported a statistically significant higher level of knowledge about drug interactions compared with Group B (54.6% vs. 45.8%; p = .01), and knowledge about proper information (79.6% vs. 31.8%; p = .02). There was a statistically significant KADT difference correlated with gender, those having a Master degree, more than 5 years of work experience, and those taking AD training courses. CONCLUSION: There is still a lack of knowledge regarding AD reported by moderate ADKS score, especially in medically-oriented domains, which creates a barrier to early provision of care and preventing AD, noted with no difference among community pharmacists across Turkey and Northern Cyprus.

Evaluation of a community-based memory clinic in collaboration with local hospitals to support patients with memory decline.

Objective: This study evaluates the role of a specialised and multidisciplinary healthcare team, including a pharmacist, in providing medication management for patients with mild cognitive impairment (MCI) and dementia, in a memory clinic. Methods: The study analysed the dataset of 102 patients of a geriatric and memory clinic in a rural area of Ontario, Canada. The case histories of the patients were reviewed a week before the clinic day and a pharmacist performed medication reconciliations. During the clinic day, cognitive tests were conducted and outcomes were discussed with the team, to create a care plan and schedule a follow-up within 3, 6 or 12 months. Results: Most patients had an average of 5 prescriptions and 2 non-prescription medications deprescribed, and 57% of patients were started on memory-related medications. A total of 712 medications (p-value 0.001) were deprescribed, with 510 prescriptions and 202 non-prescription items. Out of the 712 deprescribed drugs, 374 were discontinued with no therapeutic substitutions, 202 were reduced in dosage and 136 were switched to a safer alternative. A total of 43 patients showed improved Activities of Daily Living (ADL) performance after 3 and 6 months and 68 patients showed improvement after 12 months. Conclusion: This study highlights the importance of a multidisciplinary approach in addressing drug-therapy problems, medication optimisation, and deprescription in patients with dementia. The presence of a pharmacist in the multidisciplinary team enables impactful medication optimisation and leads to improved patient outcomes. This demonstrates the value of specialised expertise in medication management for patients with dementia.

Impact of an educational training program on pharmacists' documentation practice at a teaching hospital.

OBJECTIVES: This study aims to determine the impact of an educational training program on the quantity and quality of the pharmacists' documentation practice at the Winchester District Memorial Hospital. METHODS: This study is a part of an evaluation for continuous quality improvement, performed applying a pre- and post-test model. The primary endpoint was the number of Pharmacists' Patient-Care Records in patient charts with the listed action codes. Charts of 80 patients were surveyed at three points (two months before and one and three months after the sessions) for 240 charts. Additionally, a pre- and post-educational questionnaire was administered using case scenarios and the Pharmacists' Patient-Care Record code system. RESULTS: The number of charts containing Pharmacists' Patient-Care Records with Action Codes listed is 70%, 73%, and 64% in the first, second, and third chart review rounds, respectively. According to the pre- and post-educational session questionnaire, the average score per pharmacist is 47% and 73%, respectively. CONCLUSION: The initial estimate of the documentation practice is 50% or less, which is an underestimation. Furthermore, the quantity of pharmacists' documentation is not significantly affected by the educational sessions; however, the quality is improved.

An Examination of the Factors Affecting Community Pharmacists' Knowledge, Attitudes, and Impressions About the COVID-19 Pandemic

Objectives: Coronavirus disease-2019 (COVID-19)-related cases and deaths are ongoing throughout the world, but there is still no effective drug in its treatment, and the vaccine supply is not adequate for the global population. It is important that pharmacists have sufficient knowledge and awareness to prevent and control the disease. COVID-19 has been widely covered in the media, which has been a source widely used by healthcare professionals. This study aimed to assess the knowledge, attitudes, and impressions of community pharmacists about COVID-19 and the factors affecting them. Materials and Methods: The questions in this survey were formed using the guideline created by the World Health Organization, a guide composed by the Turkish COVID-19 Scholarly Commission, and data disclosed to the public on the website of the Ministry of Health. The questionnaire was designed with Google forms and then applied to community pharmacists all over Turkey by sharing the survey link. Results: Analyses of 393 questionnaires showed that Ministry of Health/government statements, the internet (scientific sources), and the media were the preferred sources of information (96.7%, 89.6%, and 84%, respectively). "Ways to avoid COVID-19" was the most searched title (96.9%). It was determined that the names of the two drugs most frequently mentioned by the participants to be used in the treatment of COVID-19 in Turkey were hydroxychloroquine and azithromycin (57.5%; 50.1%, respectively). Participants who received information from the media gave less education to patients/customers on personal protection measures against COVID-19 (83.3%) and symptoms of COVID-19 (78.8%); however, their behavior regarding the training of pharmacy personnel was found to be the opposite. It has been determined that about half of the participants (46.6%) mostly trust the Ministry of Health regarding the COVID-19 pandemic. Conclusion: Media and other sources influence the knowledge, behavior and impressions of pharmacists'. Having a high level of knowledge positively affects people's behavior. It is important for pharmacists to have accurate information about COVID-19 and to transfer their knowledge to the community to provide patient education and to prevent/control the spread of COVID-19.

Evaluation of online counselling services based on Turkish web-based pharmacy care setting: A retrospective observational study.

AIMS OF THE STUDY: To determine the types of online pharmacy care services provided by the clinical pharmacists regarding identification of medication-related problems, provision of counselling services for health and disease conditions alongside medications' counselling for patients seeking online consultation about health, medication and lifestyle concerns based on Turkish web-based pharmacy care setting(WPCS). METHODS: A retrospective, descriptive cohort study carried out on patients during their online visiting of Turkish WPCS seeking consultation for diverse kinds of concerns from September 2015 to March 2016. Patients' health and medication data were gathered for assessment of health-, medication- and lifestyle-related concerns. Descriptive analysis and Chi square test were used to analyse study data. Study outcomes included personalised online pharmacy care services regarding identification of medication-related problems, counselling services for health and disease conditions and medications' counselling alongside associations with counselling-related concerns by the WPCS. RESULTS: A total of 350 participants enrolled in this study and the majority of them were women (62.6%). Dermatological and gynaecological conditions represented the majority of disease conditions (51.4%, 44.6%), respectively. Within 1 year, 63.7% of the study participants visited the Turkish WPCS more than three times. Medication- and health-related concerns were reported by 90.8% and 68.3% of the study participants, respectively. Medication side effects (44.1%) and an inappropriate medication timing (31.4%) were the major medication-related problems identified. A total of 477 different counselling services regarding health conditions and 990 counselling regarding medications were provided by the clinical pharmacist through the Turkish WPCS. CONCLUSION: The WPCS could be considered as an additional option for the clinical pharmacist to provide care services regarding identification of medication-related problems, provision of counselling about health and disease conditions alongside different medication counselling to improve health conditions and proper pharmacotherapy management.

Evaluation of satisfaction and internet self-efficacy of inquirers using an internet-based drug information centre.

OBJECTIVES: This study aimed to evaluate the satisfaction level of inquirers of an internet-based drug information centre along with the internet usage abilities and habits of individuals who had previously utilised services from an internet-based drug information centre in Turkey. METHODS: The first 100 individuals who received medication consultancy from the webpage entitled "www.ilacpedia.com" and consented to participate in the study were included in this study. This website is an internet-based drug information centre. Participants' data were collected using a participant data form and the Internet Self-efficacy Scale. RESULTS: The mean age of participants was 37.92 ± 12.32 years (71 female). It was found that 89% of the individuals who received pharmaceutical consultation from the internet-based drug information service believed that the information that they received was enough to solve their problem. The internet self-efficacy scale scores indicated the highest score on the decomposition subscale (20.94 ± 6.18) and the lowest on the communication subscale (9.77 ± 3.57). CONCLUSIONS: The present study revealed that the internet-based drug information service provided by clinical pharmacists contributed positively to users' satisfaction, thus indicating the importance of the involvement of clinical pharmacists in this process.

Quantitative dissection and modeling of the NF-κB p100-p105 module reveals interdependent precursor proteolysis.

The mechanisms that govern proteolytic maturation or complete destruction of the precursor proteins p100 and p105 are fundamental to homeostasis and activation of NF-κB; however, they remain poorly understood. Using mass-spectrometry-based quantitative analysis of noncanonical LTßR-induced signaling, we demonstrate that stimulation induces simultaneous processing of both p100 and p105. The precursors not only form hetero-oligomers but also interact with the ATPase VCP/p97, and their induced proteolysis strictly depends on the signal response domain (SRD) of p100, suggesting that the SRD-targeting proteolytic machinery acts in cis and in trans. Separation of cellular pools by isotope labeling revealed synchronous dynamics of p105 and p100 proteolysis. The generation of p50 and p52 from their precursors depends on functional VCP/p97. We have developed quantitative mathematical models that describe the dynamics of the system and predict that p100-p105 complexes are signal responsive.