Risk Minimization Measures in Off-Label Drug Use: A Survey of Community Pharmacists in Malaysia

2020 ◽  
Vol 15 (3) ◽  
pp. 181-189
Author(s):  
Omotayo Fatokun
Keyword(s):  
Informed Consent ◽  
Drug Use ◽  
Perceived Risk ◽  
Adverse Drug Events ◽  
Community Pharmacists ◽  
Risk Minimization ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label ◽  
Written Informed Consent

Background: While off-label drug use is common and sometimes necessary, it also presents considerable risks. Therefore, measures intended to prevent or reduce the potential exposure to off-label risks have been recommended. However, little is known about community pharmacists’ beliefs regarding these measures in Malaysia. Objectives: This study examined community pharmacists’ beliefs towards risk minimization measures in off-label drug use in Malaysia and assessed the relationship between perceived risk of off-label drug use and beliefs towards risk minimization measures. Methods: A cross-sectional survey was conducted among 154 pharmacists practicing in randomly selected community pharmacies in Kuala Lumpur and the State of Selangor, Malaysia. Results: The majority agreed or strongly agreed that adverse drug events from the off-label drug should be reported to the regulatory authority (90.9%) and the off-label drug should only be used when the benefit outweighs potential risks (88.3%). Less than half (48.1%) agreed or strongly agreed that written informed consent should be obtained before dispensing off-label drugs and a majority (63.7%) agreed or strongly agreed that the informed consent process will be burdensome to healthcare professionals. Beliefs towards risk minimization measures were significantly associated with perceived risk of off-label drug use regarding efficacy (p = 0. 033), safety (p = 0.001), adverse drug rection (p = 0.001) and medication errors (p = 0.002). Conclusion: The community pharmacists have positive beliefs towards most of the risk minimization measures. However, beliefs towards written informed consent requirements are not encouraging. Enhancing risk perception may help influence positive beliefs towards risk minimization measures.

Unlicensed and off-label drug use in hospitalized children in Croatia: a cross-sectional survey

2012 ◽  
Vol 68 (7) ◽  
pp. 1073-1077 ◽  
Author(s):  
Goran Palčevski ◽  
Nataša Skočibušić ◽  
Vera Vlahović-Palčevski
Keyword(s):  
Drug Use ◽  
Hospitalized Children ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Off Label

scholarly journals Knowledge, attitude, and practices (KAPs) of Community pharmacists regarding COVID-19: A cross-sectional survey in two provinces of Pakistan

2021 ◽  
pp. 1-23
Author(s):  
Khayal Muhammad ◽  
Muhammad Saqlain ◽  
Gul Muhammad ◽  
Ataullah Hamdard ◽  
Muhammad Naveed ◽  
...  
Keyword(s):  
Online Survey ◽  
Good Practice ◽  
Community Pharmacists ◽  
Vital Role ◽  
Good Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Validated Questionnaire ◽  
Knowledge Age ◽  
Good Attitude

Abstract The coronavirus disease 2019 (COVID-19) is a global pandemic having no therapy and pharmacists being a part of the healthcare system had a vital role in the management of COVID-19. The purpose of this study is to assess the knowledge, attitude, and practices (KAPs) of community pharmacists (CPs) regarding COVID-19. An online survey was conducted among 393 CPs in two provinces of Pakistan during the lockdown period. A validated questionnaire (Cronbach alpha, 0.745) was used for data collection. All statistical analysis was analyzed by using SPSS version 21. Among 393 participants, 71.5% (n=281) had good knowledge, 44% (n=175) positive attitude and 57.3% (n=225) had good practice regarding COVID-19. Social media (45.29%, n=178) was reported as the main source to seek information of COVID-19. Good knowledge, age ≥ 26 years and Ph.D. degree level were the substantial determinants (p= <0.05) of a good attitude. Similarly, community pharmacist who had an experience of >5 years, hold a Ph.D. degree, good knowledge and good attitude had higher odds of good practice as compared to reference categories (p= <0.05). In short, majority of CPs had good knowledge, but had a poor attitude and practice towards the COVID-19. Standard-structured educational and counselling programs for CPs regarding COVID-19 are needed for effective management.

scholarly journals Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 154
Author(s):  
Sisira Donsamak ◽  
Marjorie C. Weiss ◽  
Dai N. John
Keyword(s):  
Respiratory Infections ◽  
Acute Diarrhoea ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Educational Interventions ◽  
Community Pharmacies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Case Vignettes ◽  
A Chain

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes. A cross-sectional survey of community pharmacists across Thailand was conducted using a self-administered questionnaire including nine case vignettes with three conditions, namely upper respiratory infections (URIs), acute diarrhoea and simple wounds. A total of 208 questionnaires were completed and analysed (20.8% response rate). In response to vignettes relating to URIs, 50.8% of pharmacist recommendations were not in accordance with antibiotic guidelines. Inappropriate recommendations for diarrhoea and wound cases were 20.8% and 16.7%, respectively. A higher proportion of younger pharmacists, those with less experience, Pharm. D. graduate pharmacists, employee pharmacists and those pharmacists who worked in a chain pharmacy were more likely to recommend appropriate antibiotic treatment in response to the vignettes (p < 0.05). These findings will be useful to promote educational interventions for community pharmacists regarding common infectious disease management in order to improve appropriate antibiotic use.

A Survey of Neonatal Nurses on Mydriatic Regimens Used in Neonatal Retinopathy of Prematurity Eye Examinations

2021 ◽  
Author(s):  
Lisa Kremer ◽  
David Reith ◽  
Natalie J. Medlicott ◽  
Mary J. Sime ◽  
Liza Edmonds ◽  
...  
Keyword(s):  
New Zealand ◽  
Adverse Effects ◽  
Retinopathy Of Prematurity ◽  
Adverse Drug Events ◽  
Preterm Neonates ◽  
Eye Drops ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Aotearoa New Zealand ◽  
Adult Dose

Objective This study was aimed to determine mydriatic regimen(s) used in neonatal units in Aotearoa New Zealand (NZ) and Australia and to estimate the frequency of adverse drug events following mydriatic administration in preterm neonates. Study Design A cross-sectional survey was sent to neonatal nursing staff listed in the Australian and New Zealand Neonatal Network contact list. Participants were asked to state what mydriatic regimen they use, and to estimate the frequency of adverse drug events when eye drops were administered for retinopathy of prematurity eye examinations (ROPEE). Results Thirteen different mydriatic regimens were identified; phenylephrine 2.5% and cyclopentolate 0.5% (1 standard drop of each) was the most commonly used regimen. Two of the regimens exceeded adult doses and five regimens included a mydriatic that is equivalent to an adult dose. Following mydriatic instillation, the three most common adverse effects were apnea, tachycardia, and periorbital pallor. Conclusion Low-concentration single-microdrop regimens are currently in use and resulting in successful ROPEE, yet doses exceeding adult doses are in use throughout Aotearoa NZ and Australian units. We know from this dataset that neonates are experiencing unwanted and potentially preventable, adverse effects associated with mydriatics, and every effort should be made to minimize this risk. Key Points

scholarly journals Knowledge, perceptions and practices of pharmacists regarding generic substitution in China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e051277
Author(s):  
Jinghan Qu ◽  
Wei Zuo ◽  
Shaohong Wang ◽  
Liping Du ◽  
Xin Liu ◽  
...  
Keyword(s):  
Generic Substitution ◽  
Generic Drugs ◽  
Community Pharmacists ◽  
Sampling Technique ◽  
Knowledge Score ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Factors Affecting ◽  
True Value

ObjectiveTo evaluate pharmacists’ knowledge, perceptions and practices towards generic substitution in the 11 pilot locations in China.DesignAn online cross-sectional survey using questionnaires was conducted. A convenience sampling technique was implemented to recruit pharmacists.Setting and participantsThe study took place in medical institutions of 11 pilot locations that participated in the pilot national centralised procurement programme in 2019. Two thousand two hundred and ninety-one pharmacists including hospital pharmacists or community pharmacists based on health-systems or clinics participated in the study.ResultsMost of the participants had the good knowledge of requirements for evaluating the quality and efficacy of generic drugs (n=2118; 92.4%), and the definition of generic drugs (n=2078; 90.7%). In terms of perceptions, 67.3% of respondents were of the opinion that generic drugs are equally as effective as the brand-name drugs, and 69.0% of respondents were of the opinion that generic drugs are as safe as brand equivalents. A high percentage of participants supported the policy of generic substitution (n=1634; 71.4%). A significant positive correlation was demonstrated between total knowledge score and total perception score (ρ=0.267; p<0.001). Efficacy, safety and the direction of national policies and hospital regulations were the main factors affecting pharmacists’ willingness to dispense generic drugs.ConclusionsThe study identified gaps in respondents’ knowledge and perceptions of generic substitution. Pharmacists who are more knowledgeable in generic drugs tend to hold a more supportive attitude towards generic substitution. Although it appeared that pharmacists in China have largely accepted generic substitution, they still have concerns regarding the reliability and quality of generic drugs. The current issues need to be addressed for the realisation of the true value of generic drugs as part of the country’s healthcare cost-containment strategy as well as the implementation of generic substitution policy in China.

scholarly journals Validation of the Copenhagen Burnout Inventory in Pharmacists

2021 ◽  
Vol 12 (2) ◽  
pp. 4
Author(s):  
Olajide O. Fadare ◽  
Michael Andreski ◽  
Matthew J. Witry
Keyword(s):  
Logistic Regression ◽  
Community Pharmacists ◽  
Measurement Model ◽  
Criterion Validity ◽  
Work Life ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Work Related ◽  
Valid Instrument ◽  
Practice Methods

Objectives: This study aimed to 1) determine the validity of the Copenhagen Burnout Inventory (CBI) for use in the assessment of burnout in a sample of pharmacists using confirmatory factor analysis (CFA), and 2) use the CBI items and other measures of work-life to assess burnout in pharmacists employed in various types of practice. Methods: A cross-sectional survey was administered to a sample of 2,582 pharmacists in a single Midwestern US state. The survey included the three subscales of the CBI, each of which measures personal, work-related, and patient-related dimensions of burnout. Other items included demographics, practice type, workload, and work-life balance. CFA was used to measure fit, and Cronbach’s alpha was used to assess reliability. Correlation was used to assess criterion validity of the CBI. Logistic regression and bivariate analyses were used to assess pharmacist burnout based on demographics. Results: Following the removal of 2 items from the measurement model, a 17-item 3-factor CBI was found to possess satisfactory psychometric properties for use in pharmacists. The CBI correlated with measures of work-life demonstrating criterion validity. A logistic regression showed that younger pharmacists and community pharmacists experience higher burnout than older pharmacists and clinical pharmacists. Community pharmacists also more often reported high workloads and poorer work-life integration. Both community and clinic pharmacists desired more time providing patient care services and less time dispensing. Conclusion: The CBI is a psychometrically reliable and valid instrument for assessing burnout in pharmacists. Younger pharmacists and community pharmacists warrant attention due to their higher degree of burnout.

scholarly journals Common Barriers, Attitudes, and Practices of Veterinary Practitioners Regarding Antimicrobial Resistance and Stewardship in Chattogram, Bangladesh

2021 ◽  
Vol 2 (1) ◽  
pp. 72-80
Author(s):  
Md. Sahidur Rahman ◽  
Nazifa Rafa
Keyword(s):  
Antimicrobial Resistance ◽  
Perceived Risk ◽  
Categorical Variables ◽  
Local Market ◽  
Large Animal ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Attitudes And Practices ◽  
Severity Of The Disease ◽  
Antimicrobial Treatments

Abstract The perceived risk of antimicrobial-resistant pathogens creates the necessity for understanding the role of the prescriber groups. Hence, we conducted a cross-sectional survey among veterinary practitioners to assess their understanding regarding antimicrobial prescribing and the issue of antimicrobial resistance (AMR) in livestock. We collected responses from 100 veterinarians engaged in the large animal, poultry, and pet animal care practices. Proportions were calculated for categorical variables and the results were visualized. We revealed two key barriers: a lack of enough information and of training on the proper prescription of antimicrobials. Prescribing a wide variety of antimicrobials and doing incomplete courses of antimicrobial treatments were two very important causes pointed out by the respondents for the development of antimicrobial resistance. A number of highest-priority critically important antimicrobials (HP-CIAs) of human health were found to be used by veterinary practitioners. In addition to clinical features like types of organisms and severity of the disease, the availability of drugs in the local market and the economic conditions of farmers have the potential to influence the decisions of veterinarians in prescribing antimicrobials. The professional development of veterinarians and the maintenance of strong coordination are crucial to ensure the proper engagement of veterinarians as the front-line fighters for tackling the AMR issue.

scholarly journals Community Pharmacists’ Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services

2021 ◽  
Vol 18 (20) ◽  
pp. 10735
Author(s):  
Ali Mofleh Alshahrani ◽  
Mona Y. Alsheikh
Keyword(s):  
Reproductive Health ◽  
Sex Education ◽  
Professional Education ◽  
Sexual And Reproductive Health ◽  
Community Pharmacists ◽  
Reproductive Health Services ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Positive Attitudes ◽  
Patient Health

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists’ soft skills, clear policies and authorization for offering this type of service are also needed.

scholarly journals Improved ascertainment of modes of HIV transmission in Ukraine indicates importance of drug injecting and homosexual risk

2020 ◽  
Author(s):  
Kostyantyn Dumchev ◽  
Marina Kornilova ◽  
Roksolana Kulchynska ◽  
Marianna Azarskova ◽  
Charles Vitek
Keyword(s):  
Drug Use ◽  
Survey Data ◽  
Hiv Transmission ◽  
Significant Degree ◽  
Injecting Drug Use ◽  
Behavioral Risk ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mode Of Transmission ◽  
Homosexual Transmission

Abstract Background It is important to understand how HIV infection is transmitted in the population in order to guide prevention activities and properly allocate limited resources. In Ukraine and other countries where injecting drug use and homosexuality are stigmatized, the information about mode of transmission in case registration systems is often biased. Methods We conducted a cross-sectional survey in a random sample of patients registered at HIV clinics in seven regions of Ukraine in 2013-2015. The survey assessed behavioral risk factors and serological markers of viral hepatitis B and C. We analyzed the discrepancies between the registered mode of transmission and the survey data, and evaluated trends over three years. Results Of 2,285 participants, 1,032 (45.2%) were females. The proportion of new HIV cases likely caused by injecting drug use based on the survey data was 59.7% compared to 33.2% in official reporting, and proportion of cases likely acquired through homosexual transmission was 3.8% compared to 2.8%. We found a significant decrease from 63.2% to 57.5% in the proportion of injecting drug use-related cases and a steep increase from 2.5 to 5.2% in homosexual transmission over three years. Conclusions The study confirmed the significant degree of misclassification of HIV mode of transmission among registered cases. The role of injecting drug use in HIV transmission is gradually decreasing, but remains high. The proportion of cases related to homosexual transmission is relatively modest, but is rapidly increasing, especially in younger men. Improvements in ascertaining the risk factor information are essential to monitor the epidemic and to guide programmatic response.

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