Monica Zolezzi

The prevalence of novel psychoactive substances (NPS) use in non-clinical populations: a systematic review protocol

BackgroundNovel psychoactive substances (NPS) are new narcotic or psychotropic drugs that are not controlled by the United Nations drug convention that may pose a serious public health threat due to their wide availability for purchase on the internet and in so called “head shops.” Yet, the extent of their global use remains largely unknown. The aim of this study is to conduct a systematic review of the prevalence of NPS use in non-clinical populations.MethodsThis is a systematic review of observational studies. Embase, MEDLINE, PubMed, Cumulative Index to Nursing and Allied Health (CINAHL), Cochrane Library, Lilacs, Scopus, Global Health, PsychINFO, Web of Science, and the World Health Organization (WHO) regional databases will be searched for eligible prevalence studies published between 2010 and 2016. Data from cross-sectional studies that report the prevalence of NPS use (one or more types) in participants (of any age) from censuses or probabilistic or convenience samples will be included. Data will be extracted from eligible publications, using a data extraction tool developed for this study. Visual and statistical approaches will be adopted instead of traditional meta-analytic approaches.DiscussionThis review will describe the distributions of various types of prevalence estimates of NPS use and explore the impact of different population groups and study-related and tempo-geographical variables on characteristics of these distributions over the period of 2010 to 2016.Systematic review registrationPROSPERO CRD42016037020

Healthcare professionals’ perspectives on a mental health educational campaign for the public

Objective: To explore barriers and facilitators in implementing an educational campaign in mental health for the public in Qatar. Design: Qualitative study. Setting: Healthcare facilities across Qatar were used as the setting. Methods: Semi-structured interviews were conducted with 35 healthcare providers from a variety of professions, including physicians, pharmacists, nurses, dietitians, psychologists and administrators. Results: Findings indicate that these healthcare providers support the concept of public mental health education but feel that several factors need to be considered before any educational campaign is undertaken. A public mental health education campaign should target improving the public’s mental health literacy as well as describing appropriate pathways to mental health care. Health care providers believe such educational campaigns should be started in schools so that mental health awareness can have a positive influence from a young age. The social media were viewed as a suitable platform to deliver positive messages relating to mental health to the public. Any educational campaign in mental health should consider the cultural context with which it is being delivered. In conclusion, healthcare providers appeared to have similar views on the importance of public mental health education but differed in their opinions of the challenges faced. Conclusion: Consideration of the message intended and how it is delivered should be addressed as part of a successful public mental health educational campaign.

Provision of health /disease screening and medication monitoring /management in New Zealand community pharmacies

Access to health /disease screening (HDS) and medication monitoring /management (MM) services in New Zealand has traditionally been through general practitioners. While government and professional organisations are supportive of greater community pharmacy involvement, there has been little research on the extent of current provision or of the views of community pharmacists in this area.

Perceived Preparedness of Health Care Students for Providing Cardiovascular Disease Risk Assessment and Management

Early assessment and management of risk factors is known to have significant impact in preventing cardiovascular disease (CVD) and its associated burden. Cardiovascular disease risk assessment and management (CVDRAM) is best approached by teamwork across health care professionals. This study aimed at assessing health care students’ (HCSs) knowledge about the parameters needed for estimating CVD risk, their self-assessed preparedness/confidence and perceived barriers for the provision of CVDRAM services through a survey administered to third and fourth year pharmacy, medical, and nursing students in Qatar. Although all student cohorts achieved similar knowledge scores, less than half (n = 38, 47%) were able to identify all of the six main risk factors necessary to estimate absolute CVD risk, and a third (32%) were unable to identify total cholesterol as an independent risk factor necessary to estimate CVD risk. Training on the use of CVD risk assessment tools differed among the three student cohorts. All student cohorts also perceived similar levels of preparedness in CVDRAM. However, pharmacy students reported the highest preparedness/confidence with the use of the latest CVDRAM guidelines. The majority of statements listed under the barriers scale were perceived by the students as being moderate (median score = 3). Poor public acceptance or unawareness of importance of estimating CVD risk was the only barrier perceived as a major by nursing students. Future integration of interprofessional educational (IPE) activities in the CVDRAM curricula of HCSs may be a suitable strategy to minimize barriers and foster collaborative practice for the provision of CVDRAM services in Qatar.

Stigma associated with mental illness: perspectives of university students in Qatar

Background Stigma in relation to mental illness is one of the main factors inhibiting people from seeking help. Studies have been undertaken looking into the knowledge, attitudes, and beliefs (KAB) about mental illness among residents in Qatar; however, none have looked specifically at students in higher education. The aim of this study was to understand the KAB toward mental illness among students at a Qatari university and determine if there are any differences based on gender, nationality, and college type. Methods A convenience sample of students from all genders, colleges, and nationalities was approached to participate in a survey that consisted of four sections: demographic, beliefs, attitudes, and help-seeking and treatment preferences associated with mental illness. Chi-square testing was performed to test for differences in the distribution of proportions of our primary outcomes (students’ beliefs, attitudes, and help-seeking and treatment preferences). Results A total of 282 students completed the survey. The majority of the participating students were females (59.3%), non-Qataris (64.3%), and enrolled in science-based colleges (62.7%). Beliefs reflecting poor mental health literacy, such as “medications to treat mental illness can cause addiction”, “mental illness is not like any other illness”, or that “mental illness is a punishment from God”, were reported by a majority of students (84.4%, 56.7%, and 50.2%, respectively). Stigmatizing attitudes that were endorsed by a majority of students included believing that people with mental illness cannot have regular jobs (60.2%), that people with mental illness are dangerous (65.7%), and that they would not marry someone with a mental illness (88.9%). Additionally, 33.6% of students indicated they would be ashamed to mention if someone in their family or they themself, had a mental illness. A vast majority of students (86.3%) indicated to prefer family and friend’s support as treatment options. Significant differences in KAB about mental illness between genders, colleges, and college type were found only for a few items. Conclusion The findings of this study suggest that a high percentage of students reported KAB about mental illness, that are considered stigmatizing. Students’ KAB about mental illness was consistent with that reported by the general population in Qatar. Nevertheless, the sample was small and as such, larger studies from a randomly selected population are needed to confirm these findings.

Development of a college-level assessment framework in line with international accreditation standards: A Middle Eastern perspective

INTRODUCTION Accreditation of international pharmacy programs by North American and European accrediting bodies is becoming increasingly popular. Practices regarding assessment and evaluation are especially highlighted in accreditation standards and many programs around the world do not currently have coordinated approaches to meet assessment expectations. This article describes the process of developing a comprehensive assessment framework at our institution and provides discussion regarding facilitators and barriers for those attempting to do the same. METHODS A coordinator of Assessment and Accreditation was appointed by the Dean. This person subsequently formed an Assessment Committee consisting of faculty, student, and administrative support membership. This committee developed the assessment framework through a review of published and online literature, in addition to extraction of key assessment points from accreditation standards. These data were then categorized according to major domains informed by the literature review and subcategorized based on components to be assessed using consensus techniques. RESULTS A comprehensive assessment framework was developed consisting of three domains (programmatic assessment, academics, and engagement/satisfaction). The components relating to programmatic assessment included vision/mission and accreditation standards; academics consisted of program learning outcomes, final cumulative assessment, and course and curriculum assessments; and engagement/satisfaction consisted of students, faculty/staff, and other stakeholders. CONCLUSION An assessment framework guided by accreditation standards can coordinate assessment plans and support program quality.

Impact of Pharmacist Interventions in Patients with Dyslipidemia: A Systematic Review

Purpose: To determine the effect of pharmacistled interventions in dyslipidemia on clinical and process outcomes. Methods: Search: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, International Pharmaceutical Abstracts, HealthSTAR, Pascal, MEDLINE In-Process & Other Non-Indexed Citations, CINAHL Plus with Full Text, Health-Source: Nursing Edition, Academic Search Complete, BIOSIS Previews, Science Citation Index Expanded and Social Sciences Citation Index were searched from their inception to September 2008. Where possible an RCT filter was used. Article screening and selection: Inclusion criteria were: 1) RCTs and 2) pharmacist-provided pharmaceutical care, either independently or as part of a health care team or a collaborative agreement (team-directed) with other health care providers. There were no restrictions on language, sample size, study duration or practice setting. Quality assessment: Risk of bias was assessed using the Cochrane Collaborations Risk of Bias tool and studies were judged as low, high or unclear risk of bias. Data Extraction: Data extraction was performed by 2 independent reviewers using a standardized data collection form. Outcomes: The primary outcome was absolute reduction in LDL cholesterol. Secondary outcomes included proportion of patients at target, initiation/modification of lipid therapy, compliance with lipid therapy, health-related quality of life and patient satisfaction. Data Analysis: Data were analyzed using a random effects model with analysis based on the Der-Simonian-Laird method. Calculations included odds ratio for dichotomous data and weighted mean difference (WMD) or standardized mean differences for continuous data. Subgroup analyses or meta-regression were conducted to investigate possible sources of heterogeneity. An indirect comparison of pharmacist-directed versus pharmacist collaborative care interventions was done. Sensitivity analysis was performed based on risk of bias. Results: A total of 8422 articles were retrieved from the search. From these, 114 articles were selected for full review, and 12 articles were included. The overall difference in LDL (n = 543 patients) was not statistically significant (WMD −0.09 mmol/L, 95% CI −0.23, 0.04). The difference in total cholesterol was statistically significant (WMD −0.16, 95% CI −0.30, −0.02). Patients followed by a pharmacist were 3 times more likely to be at target (OR 2.9, 95% CI 1.1–7.5) and 2 times more likely to have their cholesterol measured (OR 2.4, 95% CI 1.6–3.6). Conclusions: Pharmacist interventions in a variety of settings have an impact on the lowering of total cholesterol. Patients receiving interventions that included pharmacist care were more likely to be at target and have their lipid panel measured. The types of interventions provided by pharmacists vary in terms of setting and components.

Stigma associated with mental illness and its treatment in the Arab culture: A systematic review

Background: Mental health has not had the same public profile as physical health. This has contributed to the stigma associated with mental illness and to its treatments. Research investigating how the traditions and values amongst those with an Arab heritage contribute to stigmatizing beliefs, attitudes or actions in the provision of mental healthcare has not been widely reported. Aim: To systematically review the literature and summarize the findings of studies reporting stigmatizing beliefs, actions and attitudes toward treatment of people with mental illness in the Arab population. Methods: PubMed, Ovid, Psycharticles and Embase were used to identify original studies of non-institutionalized Arab adults or children reporting findings relevant to stigma toward mental illness. A manual search of the bibliography of all selected original studies was also undertaken. Independent data extraction was performed by two reviewers, who then met to compare data and reach consensus. Findings were classified as stigmatizing beliefs, actions or attitudes toward mental health treatments. Results: A total of 33 articles were retrieved for full review. Those utilizing qualitative methodology provided insight into the many ways mental illness is viewed and defined among those with an Arab heritage. Among the studies using quantitative methodology, most compared stigmatizing beliefs, attitudes toward mental health treatments or stigmatizing actions among different Arab populations, some also investigated correlations between characteristics of the Arab population tested with stigmatizing beliefs, actions and attitudes toward mental health treatments. Findings from studies undertaken in Qatar reported greater stigmatizing beliefs, actions or attitudes toward mental health treatments among Qatari versus non-Qatari Arabs. Conclusion: A large diversity in the stigmatizing beliefs, actions and attitudes toward treatment of mental illness within the Arab population were identified. The influence of cultural variations on stigma should be explored further and used to tailor anti-stigma interventions in this population.

Geriatric education in schools of pharmacy: Students’ and educators’ perspectives in Qatar and Canada

INTRODUCTION Older adults constitute the largest population admitted to hospitals due to chronic diseases, which requires appropriate prescribing of medications and comprehensive pharmaceutical care. The views and perspectives of students and educators can inform curriculum review in geriatric education in pharmacy schools. METHODS A cross sectional online survey containing 34 questions covering the areas of curriculum content and perceived needs for geriatric education was administered to students, faculty members, and preceptors. Data analysis included descriptive and inferential statistics. RESULTS The majority of participants indicated that their pharmacy school offered geriatric education. Pharmacokinetic/Pharmacodynamic Considerations in the Elderly was the topic most frequently reported to be covered in the geriatric curricula. Significantly more use of small groups discussions for delivering the geriatric curriculum was reported by respondents in Qatar than in Canada. Experiential geriatric education was available in both countries, although duration of rotations were reported to be longer in Canada than in Qatar. The majority of respondents perceived that students were moderately prepared for providing geriatric care. DISCUSSION This is the first study conducted to explore the current state of geriatric education in a pharmacy school in the Middle East in comparison with a well-established Canadian pharmacy curricula. CONCLUSION Both pharmacy schools studied offer a compulsory course on special populations that includes a similar geriatric curriculum. Future surveys should investigate how geriatric content in the pharmacy curricula is being evaluated.

Comparing student self-assessments of global communication with trained faculty and standardized patient assessments

BACKGROUND AND PURPOSE Assess the reliability of first year pharmacy student assessments completed by faculty members in comparison with a standardized patient (SP), and student self-assessments during a structured educational module on communication. EDUCATIONAL ACTIVITY AND SETTING Pharmacy students completed four stations focused on communication with an SP. During each encounter, students completed a self-assessment and were evaluated by a faculty member and a trained SP. A five point Likert scale was used to evaluate student performance. Faculty assessments were compared against all others. A Pearson correlation coefficient for total scores was used and a Cohens kappa was used to compare inter-rater reliability. Agreement and correlation was performed with student results categorized into poor, adequate, and exceptional performance based on faculty evaluation. FINDINGS Twenty-four students participated. In all stations, student self-assessments were graded higher than corresponding faculty and SP assessments. Agreement between faculty, SP, and self-assessment was fair to slight (k < 0.4) for all comparisons but only significant (p < 0.05) between the faculty and self-assessment. After categorization, there was a small, non-significant correlation between faculty and self-assessment (r = 0.13, p = 0.21) and moderate and significant correlation between faculty and SP (r = 0.32, p = 0.001). Categorized inter-rater agreement was fair for all comparisons (k < 0.2) and only significant (p < 0.05) between faculty and SP assessment. DISCUSSION Pharmacy students in their first professional year assess their communication skills more positively than other evaluators. Further instruction for students and reflection may be required to build understanding of global assessment in communication. SUMMARY There is high incongruity between student self-assessment and faculty appraisal.