Lezley-Anne Hanna

'First, Do No Harm': Factors that Influence Pharmacists Making Decisions about Over-the-Counter Medication A Qualitative Study in Northern Ireland

AbstractBackground: Little is known about how community pharmacists make decisions about which over-the-counter (OTC) medication to supply to a patient and the role of clinical evidence in making those decisions. Objective: To explore factors that influence product selection by the pharmacist and the role of evidence-based practice in this decision. Methods: In this qualitative study, community pharmacists registered in Northern Ireland and recruited via advertising and various qualitative sampling techniques, participated in face-to-face, semi-structured interviews (June 2007–September 2007) to discuss issues around OTC medication, including the use of evidence, how they judged a product to be effective, and their views on evidence-based medicine and its application to OTC medication. All interviews were digitally recorded, fully transcribed and analysed using the principles of constant comparison. Results: Twenty-six pharmacists participated in interviews. Safety was the overarching consideration for pharmacists when making decisions. The subordinate themes were product, patient and professional factors. In terms of the product subordinate theme, use or consideration of evidence was secondary in the selection of OTC medicines. Pharmacists considered the potential for harm in the first instance and if the product was deemed safe, although lacking any evidence for effectiveness, the product was supplied. In relation to patient factors, it emerged that pharmacists were influenced by patient demand for a particular OTC product and wanted to meet patient expectations, provided that the requested product was judged to be safe. Similarly, professional factors such as ethical considerations (primarily in relation to safety) and respecting patient choice also influenced decision making. However, pharmacists recognized the conflict between professional requirements to practise according to evidence-based principles and patient demands. Conclusion: This study suggests that pharmacists considered safety above all other factors when recommending OTC products to patients, and evidence of effectiveness was seldom considered when selling OTC medicines. If evidence-based practice is to influence this type of decision, pharmacists need to use the evidence that is available and be prepared to discuss evidence with patients.

Using debate to teach pharmacy students about ethical issues.

Objective. To create, implement, and evaluate debate as a method of teaching pharmacy undergraduate students about ethical issues. Design. Debate workshops with 5 hours of contact with student peers and facilitators and 5 hours of self-study were developed for second-year pharmacy students. Student development of various skills and understanding of the topic were assessed by staff members and student peers. Assessment. One hundred fifty students completed the workshops. The mean score for debating was 25.9 out of 30, with scores ranging from 23.2 to 28.7. Seventy percent of students agreed that the debates were a useful teaching method in the degree program. Conclusion. A series of workshops using debates effectively delivered course content on ethical issues and resulted in pharmacy students developing skills such as teamwork, peer assessment, communication, and critical evaluation. These findings suggest that pharmacy students respond favorably to a program using debates as a teaching tool.

The influence of evidence-based medicine training on decision-making in relation to over-the-counter medicines: a qualitative study

To explore the role of evidence of effectiveness when making decisions about over‐the‐counter (OTC) medication and to ascertain whether evidence‐based medicine training raised awareness in decision‐making. Additionally, this work aimed to complement the findings of a previous study because all participants in this current study had received training in evidence‐based medicine (unlike the previous participants).

Developing Entrepreneurial Skills in Pharmacy Students

Objective. To create, implement, and evaluate a workshop that teaches undergraduate pharmacy students about entrepreneurship. Design. Workshops with 3 hours of contact time and 2 hours of self-study time were developed for final-year students. Faculty members and students evaluated peer assessment, peer development, communication, critical evaluation, creative thinking, problem solving, and numeracy skills, as well as topic understanding. Student evaluation of the workshops was done primarily via a self-administered, 9-item questionnaire. Assessment. One hundred thirty-four students completed the workshops. The mean score was 50.9 out of 65. Scores ranged from 45.9 to 54.1. The questionnaire had a 100% response rate. Many students agreed that workshops about entrepreneurship were a useful teaching method and that key skills were fostered. Conclusion. Workshops effectively delivered course content about entrepreneurship and helped develop relevant skills. This work suggests students value instruction on entrepreneurship.

Associations between Achievement Goal Orientations and Academic Performance Among Students at a UK Pharmacy School

Objective. To ascertain goal orientations of pharmacy students and establish whether associations exist between academic performance, gender, or year of study. Methods. Goal orientations were assessed using a validated questionnaire. Respondents were categorized as high or low performers based on university grades. Associations and statistical significance were ascertained using parametric and nonparametric tests and linear regression, as appropriate. Results. A response rate of 60.7% was obtained. High performers were more likely to be female than male. The highest mean score was for mastery approach; the lowest for work avoidance. The mean score for work avoidance was significantly greater for low performers than for high performers and for males than for females. First-year students were most likely to have top scores in mastery and performance approaches. Conclusion. It is encouraging that the highest mean score was for mastery approach orientation, as goal orientation may play a role in academic performance of pharmacy students.

First-Year Pharmacy Students’ Views on Their Chosen Professional Career

Objective. To investigate what factors influenced students to study pharmacy and determine in which sector they hoped to gain employment, both in the short and longer term. Methods. First-year pharmacy students (n=124) were invited to complete a paper-based, self-administered questionnaire consisting of 4 sections. Descriptive statistics and nonparametric tests were conducted. Results. One hundred (96.8% response rate) students completed the questionnaire (22.5% male; 77.5% female). Key influential factors for choosing pharmacy included: enjoyment of science at school, a desire to improve people’s health and wellbeing, and to work in health care. Career aspirations were to work in a hospital or in community practice rather than in industry or academia. Conclusions. Students choose pharmacy as a career primarily for altruistic and clinical reasons. This research provides information for pharmacy schools about the career aspirations of students and data from future pharmacists is potentially helpful to pharmacy professional organizations and potential employers.

A Questionnaire Study to Investigate Stress among Future Pharmacists by Gender and Year Group

Background: This work aimed to ascertain future pharmacists’ stressors and stress-coping practices. Methods: Queens’ University Belfast Year 2 and 4 pharmacy students were invited to participate in an ethically approved, pre-piloted questionnaire study. Section A was the 10-item Perceived Stress Scale, Sections B and C related to stressors and stress-coping mechanisms, and Section D gathered non-identifiable demographic information. Data analysis largely took the form of descriptive statistics. Results: A response rate of 94.2% (213/226) was obtained. The mean Perceived Stress Scale score was 19.94 [standard deviation (SD) 6.37], with females having a higher mean score than males (20.55 SD 5.67 versus 18.16 SD 7.42). Common general stressors were career choice, employment opportunities, and finance. Common degree-specific stressors were particular assessments (objective structured clinical examinations and one-off written examinations) and the amount of course material. Popular stress-coping practices included getting emotional support from friends and family and using self-distractions. Conclusion: Stress appears to be an issue among these future pharmacists, and potentially more so for females. While the main stressors are unsurprising, this UK data enables comparisons to be made and helps inform support mechanisms within the university.

What, Where and When? Using Google Trends and Google to investigate patient needs and inform Pharmacy Practice

The aim was to provide a comprehensive overview (using pertinent examples) of the various ways that Google Trends and Google data could inform pharmacy practice. The objectives were to: examine what type of information people search for in relation to a common class of medicines; ascertain where people are directed to (websites) following an initial search for a medicine or medical condition; and establish information about when they search.

Launching and evaluating a mobile phone app to provide contemporary, evidence-based advice about self-treatable conditions.

Rationale, aims and objectives : As government-funded healthcare provisions are stretched to their limits, it is important that healthcare professionals provide evidence-based advice about minor ailments to facilitate people’s abilities to self-treat these conditions effectively and appropriately, given that self-care is one of the many components of person-centered healthcare. Unfortunately, despite the expanding over-the-counter (OTC) medicines market, there have been doubts cast about advice given by UK community pharmacists. Indeed, research conducted with pharmacists revealed that evidence of effectiveness was a secondary consideration when making decisions about OTC recommendations. We aimed to address these concerns and support decision-making by providing high quality, evidence-based, information about self-treatable conditions and over-the-counter consultations through a mobile phone app. Method: There were 4 main stages, namely: (1) app development (content and design); (2) piloting (use-testing); (3) publication on Apple and Android stores and marketing of the app and, finally, (4) an evaluation (using analytical data obtained through the app content management system, feedback obtained via email, the star-rating and reviews posted on Google Play and Apple stores and comments obtained at events. Additionally, following ethical approval and piloting, we invited 100 people, representing different groups within the pharmacy profession in Northern Ireland, to complete an evaluation questionnaire. Results: Since launching the project in February 2017, there have been over 5000 downloads, 68,453 sessions of use and the app has received a 5-star rating on both Apple and Google Play stores. Positive feedback has centred on the material being relevant and up-to-date, that it facilitates quick access to information in the workplace and is easy to navigate and that it is a good training tool. Future suggestions for improvement include expanding the number of conditions and providing self-assessment questions to help students prepare for professional examinations. Conclusions: The app appears to have had a positive impact on OTC consultations, but it is still evolving to ensure its usefulness in practice is maximised.

Assessment of Chinese students’ progression and perceptions in blended team-based learning approach at an international college in China

Blended team-based learning (TBL) as a major component of an undergraduate course was implemented at a UK joint college in China. The core components of TBL were introduced in the course for Chinese students and their academic performance and course evaluation data with blended TBL approach was compared with solely flipped classroom and traditional lecture-based courses. Students’ perceptions regarding traditional learning and TBL were investigated and compared through the use of an online perceptual learning style preference questionnaire. Students ranked blended TBL as a superior method of learning in comparison with didactic lecturing style. Higher data retention and classroom performance was achieved within blended TBL course compared to traditional learning style. Students’ perceptions and performance suggested that blended TBL can benefit non-native English speaker students, who are studying in a remote campus, where English language is not the first spoken language and provided positive feedback on their preparedness may help them to develop higher reasoning skills.