Ingunn Björnsdottir

Medication use in pregnancy: a cross-sectional, multinational web-based study

Objectives Intercountry comparability between studies on medication use in pregnancy is difficult due to dissimilarities in study design and methodology. This study aimed to examine patterns and factors associated with medications use in pregnancy from a multinational perspective, with emphasis on type of medication utilised and indication for use. Design Cross-sectional, web-based study performed within the period from 1 October 2011 to 29 February 2012. Uniform collection of drug utilisation data was performed via an anonymous online questionnaire. Setting Multinational study in Europe (Western, Northern and Eastern), North and South America and Australia. Participants Pregnant women and new mothers with children less than 1 year of age. Primary and secondary outcome measures Prevalence of and factors associated with medication use for acute/short-term illnesses, chronic/long-term disorders and over-the-counter (OTC) medication use. Results The study population included 9459 women, of which 81.2% reported use of at least one medication (prescribed or OTC) during pregnancy. Overall, OTC medication use occurred in 66.9% of the pregnancies, whereas 68.4% and 17% of women reported use of at least one medication for treatment of acute/short-term illnesses and chronic/long-term disorders, respectively. The extent of self-reported medicated illnesses and types of medication used by indication varied across regions, especially in relation to urinary tract infections, depression or OTC nasal sprays. Women with higher age or lower educational level, housewives or women with an unplanned pregnancy were those most often reporting use of medication for chronic/long-term disorders. Immigrant women in Western (adjusted OR (aOR): 0.55, 95% CI 0.34 to 0.87) and Northern Europe (aOR: 0.50, 95% CI 0.31 to 0.83) were less likely to report use of medication for chronic/long-term disorders during pregnancy than non-immigrants. Conclusions In this study, the majority of women in Europe, North America, South America and Australia used at least one medication during pregnancy. There was a substantial inter-region variability in the types of medication used.

Patterns and factors associated with low adherence to psychotropic medications during pregnancy; a cross-sectional, multinational web-based study

No previous studies have explored how closely women follow their psychotropic drug regimens during pregnancy. This study aimed to explore patterns of and factors associated with low adherence to psychotropic medication during pregnancy.

Insights about health-related quality of life in cancer patients indicate demands for better pharmaceutical care

Objectives To highlight the health-related quality of life scale scores for Saudi patients with different types of cancer, to get understanding and foundation for improvements. To suggest suitable plans for quality of life improvement based on study outcome. The role of oncology pharmacy will be stressed. Methods A cross-sectional descriptive study was conducted at a tertiary regional hospital using the European Organization for Research and Treatment of Cancer QLQ-C30 questionnaire. Attendees were patients diagnosed with any type of cancer and eligible for active anticancer treatment and/or palliative care. Results Quality of life was evaluated for 87 participants. Most of patients were aged between 51 and 60 years; and 50% had active treatment with chemotherapy. Patients seemed to perform well with respect to average scores in both the symptoms and the functional health status scales. The mean score for the global quality of life scale was 47.2 ± 27.1, while the range of mean scores for the five function subscales was 59.0 ± 27.1 to 81.6 ± 13.8, indicating average level of general wellbeing with above average to high level of functional health status, while >50% of the patients met the operational criterion having less severe symptoms. Outpatients generally had somewhat higher scores as compared to hospitalized patients. Conclusion The general quality of life seemed satisfactory, but there is still need to improve care. Based on results from other studies, oncology pharmacists’ roles are essential to improve quality of life through treatment counseling, follow-up on drug support therapy, stress on patient’s education through specific programs, review and update the local guidelines, and conduct more research.

Exhibiting caution with use of big data: The case of amphetamine in Iceland's prescription registry

Background: Data from large electronic databases are increasingly used in epidemiological research, but golden standards for database validation remain elusive. The Prescription Registry (IPR) and the National Health Service (NHS) databases in Iceland have not undergone formal validation, and gross errors have repeatedly been found in Icelandic statistics on pharmaceuticals. In 2015, new amphetamine tablets entered the Icelandic market, but were withdrawn half a year later due to being substandard. Return of unused stocks provided knowledge of the exact number of tablets used and hence a case where quality of the data could be assessed. Objective: A case study of the quality of statistics in a national database on pharmaceuticals. Methods: Data on the sales of the substandard amphetamine were obtained from the Prescription Registry and the pharmaceuticals statistics database. Upon the revelation of discrepancies, explanations were sought from the respective institutions, the producer, and dose dispensing companies. Results: The substandard amphetamine was available from 1.9.2015 until 15.3.2016. According to NHS, 73990 tablets were sold to consumers in that period, whereas IPR initially stated 82860 tablets to have been sold, correcting to 74796 upon being notified about errors. The producer stated 72811 tablets to have been sold, and agreed with the dose dispensing companies on sales to those. The producers numbers were confirmed by the Medicines Agency. Conclusion: Over‐registration in the IPR was 13.8% before correction, 2.7% after correction, and 1.6% in the NHS. This case provided a unique opportunity for external validation of sales data for pharmaceuticals in Iceland, revealing enormous quality problems. The case has implications regarding database integrity beyond Iceland.

Nordic Pharmacy Students’ Opinions of their Patient Communication Skills Training

Objective. To describe Nordic pharmacy students’ opinions of their patient communication skills training (PCST), and the association between course leaders’ reports of PCST qualities and students’ perceptions of their training. Secondary objective was to determine what factors influence these associations. Methods. A cross-sectional questionnaire-based study was performed. The various curricula were categorized into three types (basic, intermediate and innovative training) and students were divided into three groups according to the type of training they had received. Multivariable logistic regression models were fitted with different opinions as outcomes and three types of training as exposure, using generalized estimation equations. Results. There were 370 students who responded (response rate: 77%). Students within the innovative group were significantly more likely to agree that they had received sufficient training, and to agree with the assertion that the pharmacy school had contributed to their level of skills compared to students in the basic group. Conclusion. There appears to be an association between larger and varied programs of training in patient communication skills and positive attitudes toward this training on the part of the students, with students reporting that they received sufficient training, which likely enhanced their skills.

Nordic Pharmacy Schools’ Experience in Communication Skills Training

Objective. To assess communication skills training at Nordic pharmacy schools and explore ways for improvement. Methods. E-mail questionnaires were developed and distributed with the aim to explore current practice and course leaders’ opinions regarding teaching of patient communication skills at all the 11 master level Nordic (Denmark, Finland, Iceland, Norway and Sweden) pharmacy schools. The questionnaires contained both closed- and open-ended questions. Results. There was a variation of patient communication skills training among schools. In general, communication skills training was included in one to five courses (mode 1); varied in quantity (6-92 hours); had low use of experiential training methods; and had challenges regarding assessments and acquiring sufficient resources. However, some schools had more focus on such training. Conclusion. The results show room for improvement in patient communication skills training in most Nordic pharmacy schools and give insights into how to enhance communication skill building in pharmacy curricula. Suggestions for improving the training include: early training start, evidence-based frameworks, experiential training, and scaffolding.

Pharmacy internship in the Nordic countries – Status and future

This educational workshop is a reoccurring opportunity to address best practices, content, assessment methods and research projects from pharmacy internship courses in the Nordic countries, providi ...

Perception of the Professional Knowledge of and Education on the Medical Technology Products among the Pharmacists in the Baltic and Nordic Countries—A Cross-Sectional Exploratory Study

With increased development of medical technology (MT), new challenges emerge related to education and training of pharmacists and other healthcare specialists. Currently, only a few universities in the EU promote MT education and research. Objectives: The aim of this study was to evaluate the current status, views on, and need for the education on MT for the pharmacy students and practicing pharmacists in the Baltic and Nordic countries. Methods: The representatives of higher education institutions and community/hospital pharmacists from six Baltic and Nordic countries participated in a qualitative cross-sectional exploratory internet-based study from May to October 2014. Results: Approximately two-third of the respondents considered professional knowledge about MT products important for pharmacists, but half of them had never participated in any MT courses. More practicing pharmacists than representatives of academia underlined the need for increased MT education for pharmacy students in the future. Conclusions: The pharmacists in the Baltic and Nordic countries consider the professional knowledge about MT as pertinent in their education and work. The limited number and status of MT courses available today, however, is a major concern among both pharmacy students and practicing pharmacists in these countries. In the future, increasing education combining theory and practice about MT products would be one possible solution to overcome this challenge.

Legal cognitive requirements impact on pharmacy practice and patient outcomes

Some aspects of the dispensing process,such as finding the right product to dispense orlabel, can be done by a robot. Nevertheless, thedispensing can also include important clinical andcognitive elements, i.e. identifying clinical errorsand undertaking interventions to optimize patientoutcomes. In those situations a pharmacist’s pro-fessional competence and judgment is needed toensure optimal outcome and patient safety. Wealso know that pharmacists’ individual dispensingpractice varies regarding i.e. kinds and amount ofprescription interventions undertaken.