scholarly journals Factors promoting self-medication and irrational use of opioids in chronic non-malignant pain management in Pakistan: A qualitative in-depth investigation

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i32-i33
Author(s):  
A Iqbal ◽  
L S Toh ◽  
R D Knaggs ◽  
C Anderson
Keyword(s):  
Health Care ◽  
Focus Groups ◽  
Community Pharmacists ◽  
Opioid Analgesics ◽  
Financial Resources ◽  
Extensive Literature ◽  
Medicine Use ◽  
Self Medication ◽  
Middle Income ◽  
Pharmacy Workforce

Abstract Introduction In many Lower and Middle-Income Countries (LMICs) people self-medicate, with non-prescription and prescription drugs both of which are easily available over the counter (1). One of the most common causes for self-medication is chronic pain (2). The role of community pharmacists becomes critical especially in LMICs where medicines are freely available and pharmacists are directly involved in supply of opioid medicines. Unresolved, prolonged chronic non-malignant pain (CNMP) may lead to self-medication with opioid analgesics and can cause irrational use of opioids. The complications of self-medication with opioids are vast in terms of both scarce resources and adverse clinical consequences such as adverse drug reactions, drug interactions and mortality associated with the diversion from intended use of opioid medicines. Self- medication with opioid analgesics in LMICs have not been explored before. Aim This study was designed to explore the factors that might contribute in promoting self-medication and irrational opioid medicine use in CNMP management and exploring potential roles of community pharmacists in stopping/avoiding self-medication with opioids in one LMIC, Pakistan. Method Qualitative interviews involving various stakeholders such as pharmacy policy makers (n=10) and people suffering from CNMP (n=12) were conducted. Additionally, focus groups were conducted with community pharmacists (n=38) and doctors (n=30). A semi-structured interview guide was drafted after an extensive literature review and was used for individual interviews and focus groups for each stakeholder respectively. The study duration was from December 2019 to July 2020. Critical case sampling, a type of purposive sampling, was done in order to promote applicability to other cases. Data was analysed using a CAQDAS software N-vivo 12, using thematic analysis. Ethical approval was obtained. Results Non-availability of community pharmacists in all pharmacies and lack of medication review services are amongst the major factors that are contributing towards self-medication of opioid medicines. Additionally, lack of awareness of people about opioid medicines and absence of strict laws regarding sale of opioid medicines under a valid prescription allows easy availability and promotes aberrant drug seeking behaviour. These factors contribute towards people not seeking professional health care services for the management of CNMP and continue self-medicating with opioid medicines. As a result, they do not get effective analgesic relief and waste limited financial resources. The major themes and sub-themes are presented in Table 1. Conclusion Self-medication with opioid medicines can cause irrational, inappropriate, and ineffective use of medicines and can additionally burden the limited financial resources available for health care needs. This in-depth exploratory study identifies many barriers that can promote self-medication with opioids and recognises a need for a multi-faceted intervention involving community pharmacists to promote rational opioid medicine use. However, major limitations of the proposed intervention identified from this study are the absence of integrated health systems and under-utilisation of community pharmacy workforce. The government needs to invest in infrastructure development, develop new health policies regarding medicine sale and build the role and capacity of pharmacy workforce to perform specialised roles in public safety especially in opioid medicines. References 1. Bennadi D. Self-medication: A current challenge. Journal of basic and clinical pharmacy. 2013;5(1):19. 2. Kaushal J, Gupta MC, Jindal P, Verma S. Self-medication patterns and drug use behavior in housewives belonging to the middle income group in a city in northern India. Indian journal of community medicine: official publication of Indian association of preventive & social medicine. 2012;37(1):16.

scholarly journals Qualitative assessment of patients’ perspectives and needs from community pharmacists in substance use disorder management

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarah Fatani ◽  
Daniel Bakke ◽  
Marcel D’Eon ◽  
Anas El-Aneed
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Treatment Outcomes ◽  
Community Pharmacists ◽  
Health Concern ◽  
Care Providers ◽  
Opioid Agonist ◽  
The Impact

Abstract Background Non-medical use of psychoactive substances is a common harmful behavior that leads to the development of Substance Use Disorders (SUDs). SUD is a significant health concern that causes adverse health consequences and elevates the economic burden on the health care system. SUD treatment plans that utilize a patient-centered approach have demonstrated improved treatment outcomes. It is essential for health care providers, including community pharmacists, to understand patients’ needs and prioritize them. Therefore, this study was conducted to explore the perspective of patients living with SUDs or who used substances non-medically regarding community pharmacist services and the delivery of services in a community pharmacy setting. The study took place in Saskatoon, a small urban center of Saskatchewan, Canada. Methods Qualitative methodology was used for this research inquiry. Four focus groups were conducted, with a total of 20 individuals who had experienced substance use and accessed community pharmacy services. The discussion of the four focus groups was transcribed verbatim and analyzed independently by two researchers. Agreement on the emergent themes was reached through discussion between the two researchers. Results Data analysis resulted in four themes that described participants’ perspectives about community pharmacists. The four emergent themes are: 1) conflicted experiences with community pharmacists, 2) lack of knowledge concerning community pharmacists’ extended services, 3) negative experiences in Opioid Agonist Therapy (OAT) program, and 4) needs from community pharmacists. Conclusion There is significant potential for the patient-pharmacist relationship to address the varying needs of patients who use substances and improve their overall health care experience. Patients who use substances are receptive to pharmacists’ services beyond dispensary; however, respectful communication, provision of drug-related information, and counseling are among the primary demands. Future research should focus on studying the impact of meeting the needs of patients on their treatment outcomes.

scholarly journals Exploring the Potential of Participatory Theatre to Reduce Stigma and Promote Health Equity for Lesbian, Gay, Bisexual, and Transgender (LGBT) People in Swaziland and Lesotho

2018 ◽  
Vol 46 (1) ◽  
pp. 146-156 ◽  
Author(s):  
Carmen H. Logie ◽  
Lisa V. Dias ◽  
Jesse Jenkinson ◽  
Peter A. Newman ◽  
Rachel K. MacKenzie ◽  
...  
Keyword(s):  
Health Care ◽  
Nursing Students ◽  
Focus Groups ◽  
Health Care Providers ◽  
Care Providers ◽  
Stigma Reduction ◽  
Middle Income ◽  
Self Reflection ◽  
Bisexual And Transgender ◽  
Lgbt People

Stigma and discrimination affecting lesbian, gay, bisexual, and transgender (LGBT) people compromise health and human rights and exacerbate the HIV epidemic. Scant research has explored effective LGBT stigma reduction strategies in low- and middle-income countries. We developed and pilot-tested a participatory theatre intervention (PTI) to reduce LGBT stigma in Swaziland and Lesotho, countries with the world’s highest HIV prevalence. We collected preliminary data from in-depth interviews with LGBT people in Lesotho and Swaziland to enhance understanding of LGBT stigma. Local LGBT and theatre groups worked with these data to create a 2-hour PTI composed of three skits on LGBT stigma in health care, family, and community settings in Swaziland (Manzini) and Lesotho (Maseru, Mapoteng). Participants ( n = 106; nursing students, health care providers, educators, community members) completed 12 focus groups following the PTI. We conducted thematic analysis to understand reactions to the PTI. Focus groups revealed the PTI increased understanding of LGBT persons and issues, increased empathy, and fostered self-reflection of personal biases. Increased understanding included enhanced awareness of the negative impacts of LGBT stigma, and of LGBT people’s lived experiences and issues. Participants discussed changes in attitude and perspective through self-reflection and learning. The format of the theatre performance was described as conducive to learning and preferred over more conventional educational methods. Findings indicate changed attitudes and awareness toward LGBT persons and issues following a PTI in Swaziland and Lesotho. Stigma reduction interventions may help mitigate barriers to HIV prevention, treatment, and care in these settings with a high burden of HIV.

scholarly journals A snapshot of the global policies and practices of medicine use reviews by community pharmacist in chronic diseases: a narrative review

2020 ◽  
pp. 1-45
Author(s):  
Naeem Mubarak ◽  
Sarwat Ali Raja ◽  
Tahir Mehmood Khan ◽  
Che Suraya Zin ◽  
Admin
Keyword(s):  
Chronic Diseases ◽  
Community Pharmacists ◽  
High Income ◽  
Narrative Review ◽  
Medicine Use ◽  
Improve Medication Adherence ◽  
Middle Income ◽  
Middle Income Countries ◽  
Medication Therapy ◽  
Policies And Practices

Abstract Medicine use review is a tool to improve medication adherence and safety. The current narrative review was planned to explore global policies and practices of medicine use review by community pharmacists in chronic diseases, its impact and way forward for low- and middle-income countries. Key words, such as ?medicine use review?, ?medication therapy management? and ?community pharmacy? were used for search on PubMed and CINAHL databases for articles published from 2004 to 2019. Medicine use review has opened an avenue of ongoing collaboration between community pharmacists and general practitioners. High-income countries have witnessed a gradual yet cautious adoption of these services through effective policy shift. In terms of practices and impact, the situation in high-income countries was promising where on an average ?type-II? medicine use review was widely in practice and had improved clinical, humanistic and economic outcomes in chronic disease. However, . Continuous....

Qualitative Assessment of Patients’ Perspectives and Needs from Community Pharmacists in Substance Use Disorder Management

2020 ◽  
Author(s):  
Sarah Fatani ◽  
Daniel Bakke ◽  
Marcel D’Eon ◽  
Anas El-Aneed
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Treatment Outcomes ◽  
Substance Use Disorder ◽  
Community Pharmacists ◽  
Health Concern ◽  
Care Providers ◽  
The Impact

Abstract Background: Substance use disorder (SUD) is a major health concern affecting Canadians and their health care system. SUD treatment plans addressing patients’ needs and choices have demonstrated improved treatment outcomes. It is essential for health care providers, including community pharmacists, to understand patients' needs and prioritize them. Therefore, this study explores the perspective of patients living with SUD regarding community pharmacist services and the delivery of care in a community pharmacy setting located in the small urban center of, Saskatoon, Saskatchewan, Canada.Methods: A qualitative methodology was used for this research inquiry. Four focus groups were conducted in Saskatoon, with a total of 20 individuals who had experienced substance use and accessed community pharmacy services. The discussion of the four focus groups was transcribed verbatim and analyzed independently by two researchers. Agreement on the emergent themes was reached through discussion between the two researchers. Results: Data analysis resulted in four themes that described participants' perspectives about community pharmacists. The four emergent themes are: 1) experience of people living with SUD in a community pharmacy, 2) services provided by community pharmacists, 3) the methadone maintenance program, and 4) needs from community pharmacists. Conclusion: There is significant potential for the patient-pharmacist relationship to address the varying needs of patients living with SUD and improve their overall health care experience. Patients who use substances are receptive to pharmacists' services beyond dispensary; however, respectful communication, provision of drug-related information, and counseling are among the primary demands. Future research should focus on studying the impact of meeting the needs of patients on their treatment outcomes.

scholarly journals Perspectives of Survivorship Care Plans Among Older Breast Cancer Survivors: A Pilot Study

2020 ◽  
Vol 27 (1) ◽  
pp. 107327482091720
Author(s):  
Jessica L. Krok-Schoen ◽  
Michelle J. Naughton ◽  
Anne M. Noonan ◽  
Janell Pisegna ◽  
Jennifer DeSalvo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Pilot Study ◽  
Focus Groups ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Survivorship Care Plan ◽  
Survivorship Care ◽  
Care Providers ◽  
Term Care

The Commission on Cancer’s standard 3.3 represents a paradigm shift in the care of cancer survivors, recommending that survivors receive a treatment summary and survivorship care plan (SCPs). A focus on older breast cancer survivors is needed, as they are the majority of the breast cancer population and their experiences and perspectives of SCPs is limited in the literature. This pilot study utilized a mixed methods approach (focus groups and self-report questionnaire data) to gather information on older (≥65 years) breast cancer survivors’ perspectives of their SCPs, cancer survivorship, and communication with their health-care providers. The questionnaire was completed individually by the participants prior to the focus group and contained items on basic demographics and their health status following cancer treatment. The focus groups indicated that only a minority of women actually developed a SCP. Those who developed a SCP in collaboration with their providers valued the personal care and attention received. However, some participants reported poor communication with their providers and within their health-care team, resulting in frustration and confusion. Participants’ suggestions for ideal SCPs included better education and personalization, particularly in appropriate nutrition and exercise, and managing side effects and comorbidities. Lastly, the women believed that additional long-term care resources, such as health coaches, were important in improving their survivorship. These findings provide insight into enhancing the content, communication, and application of SCPs to improve the survivorship experience of older breast cancer survivors.

Prevalence and health care seeking behaviour for sexually transmitted infections among in-school adolescents in Ado-Ekiti, South-Western Nigeria

2016 ◽  
Vol 29 (6) ◽  
Author(s):  
Patrick T. Adegun ◽  
Eyitope O. Amu
Keyword(s):  
Health Care ◽  
Sexually Transmitted Infections ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Self Medication ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Stomach Pain ◽  
Health Care Seeking Behaviour ◽  
Care Seeking Behaviour

Abstract Background: In Nigeria, adolescents are highly vulnerable to sexually transmitted infections (STIs) which have the potential of jeopardising their future reproductive lives if poorly treated. Objective: To determine the prevalence and health care seeking behaviour for STIs among secondary school adolescents in Ado, South-Western Nigeria. Subjects: Male and female adolescents aged 10–19 years. Methods: The study employed a descriptive cross-sectional design. A pre-tested, self-administered, semi-structured questionnaire was used to elicit information from 560 adolescents selected from public and private secondary schools in Ado Local Government Area (LGA) of Ekiti State, using a multistage sampling technique. The data were analyzed using descriptive and inferential statistics. Analyzed data were presented in the form of tables and charts. Results: Two hundred and fifty-one (47.1%) respondents had previous symptoms of STIs. The commonest symptoms among the males were penile discharge (30.5%), painful micturition (30.5%) and stomach pain with swollen testes (25.4%). The commonest symptoms among the females were genital itching (27.6%), genital sores (14.1%) and painful micturition (13.1%). Only 26.7% sought treatment from a health facility; 37.0% did nothing; 15.9% went to patent medicine stores, 10.0% used herbs; the rest did self-medication or prayed. Conclusion: The prevalence of STI symptoms among adolescents in Ado-Ekiti is high but their health care seeking behaviour is poor. Health education about the dangers of untreated STI and the importance of seeking treatment early, targeted at adolescents, should be intensified.

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