The experiences of pharmacists during the global COVID-19 pandemic: A thematic analysis using the jobs demands-resources framework

"We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response

INTRODUCTION

Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future.

AIM(S)

To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response.

METHOD

11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis.

RESULTS

Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives.

CONCLUSIONS

The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.

Social robots counselling in community pharmacies - Helping or harming? A qualitative study of pharmacists' views

Background

Welfare technological solutions such as social robots attempt to meet the growing needs of the healthcare sector. Social robots may be able to respond to the shortage of pharmaceutical personnel at community pharmacies. However, there is a lack of previous studies regarding the use of social robots for medication counselling purposes in a pharmacy setting.

Objectives

The objective of this qualitative study was to explore pharmacists' views on the potential role of social robots in medication counselling.

Methods

Pharmacists, purposively sampled based on having recent experience of counselling customers in community pharmacies in Finland, first acted as customers interacting with the social robot in a simulated setting, before taking part in a focus group where their perspectives were explored. The focus group discussions were conducted in October and November 2022. The qualitative data was transcribed and analysed using reflexive thematic analysis.

Results

The number of participants was eight in total. A main theme of how the robot may either help or harm concerning medication safety within a pharmacy setting was identified. The six sub-themes found, according to pharmacists' views on robot counselling in community pharmacies, are context, digital competence, customer integrity, interaction, pharmacists' professional role and human skills.

Conclusions

According to the study findings, pharmacists experience that the social robot can offer a potential complement to a human pharmacist. The robot is seen as beneficial with respect to certain customer groups and in the light of personnel shortages, and may in the future add to trust, equality, freedom of choice and multilingualism, among other things, in the customer service situation at community pharmacies, thus improving medication safety.

A narrative review of the well-being and burnout of U.S. community pharmacists

OBJECTIVES

The purpose of this narrative review is to summarize the literature on well-being and burnout among community pharmacists in the U.S. and provide recommendations for future research.

METHODS

Relevant literature was identified by searching PubMed for combinations of keywords such as "burnout" and "well-being" combined with "pharmacists." Titles and abstracts were reviewed for relevancy, and full text articles were reviewed when applicable.

RESULTS

While burnout is defined by its 3 core symptoms of emotional exhaustion, depersonalization, and low personal accomplishment, well-being is more challenging to define and measure, which has led to it being less studied. Community pharmacists faced high rates of burnout, low quality of life (QOL), and extreme fatigue prior to the COVID-19 pandemic, a situation that has likely only worsened. Factors such as workload, the type of community pharmacy, the level of education or training of the pharmacist, and stress may be some of the contributors to high rates of burnout. Clinician burnout may be related to high rates of mental health disorders seen in pharmacists, may impact patient safety and satisfaction, and may affect productivity and costs to employers and the healthcare system overall. There has been no research into interventions or strategies to support well-being and reduce burnout among community pharmacists, but having a workplace that is perceived as supporting well-being may have some impact. Recommendations for future research include the following: (1) define well-being, (2) explore why various factors support well-being or contribute to burnout, (3) determine the impact of community pharmacists experiencing well-being or burnout, and (4) develop strategies to support well-being and reduce burnout that are specific to community pharmacy.

CONCLUSION

There is a sparsity of evidence regarding community pharmacist well-being and burnout. Further research is needed to generate the evidence needed to support interventions that are specific to the unique work setting of community pharmacists.

Unmasking the Unrecognized: Exploring Registered Pharmacy Technicians' Stressors During COVID-19 Through a Demands-Resources Inquiry and Looking Ahead

Canadian registered pharmacy technicians (RPTs) were vital in supporting pharmacy operations during the pandemic. However, they have received little attention during or pre-pandemic. This study aimed to identify and understand the stressors experienced by Canadian RPTs during the pandemic and gain insights on lessons learned to help improve the profession. Through a descriptive qualitative design, virtual semi-structured focus groups were conducted with RPTs who were recruited through various sampling methods across Canada. Data were inductively analyzed and then deductively; themes were categorized using the Job Demands-Resources (JD-R) model. We reached data saturation after 4 focus group sessions with a total of 16 participants. As per the JD-R model, job demands included: (1) increased work volume and hours to meet patient demand; (2) drug shortages and managing prescriptions increased due to influx of orders coinciding with restricted access to medications; (3) fear of the unknown nature of COVID-19 met with frequent change in practices due to protocol changes and ineffective communication; and, (4) the pandemic introduced several factors leading to increased staff shortages. Themes pertaining to resources included: (1) poor incentives and limited access to well-being resources; (2) limited personal protective equipment delaying work operations; (3) and a general lack of knowledge or appreciation of the profession impacting work morale. Lessons learned from the pandemic were also provided. Overall, our findings revealed an imbalance where RPTs experienced high job demands with limited resources. Improved leadership within pharmacies, including improved communication between team members, is required. Furthermore, efforts to highlight and recognize the work of RPTs to the public is important to help improve enrollment, especially with their recent scope of practice expansion.

A survey of pharmacists' perception of the work environment and patient safety in community pharmacies during the COVID-19 pandemic

Background

Community pharmacies have changed during the COVID-19 pandemic, and new routines have been introduced to address the needs of customers and staff and to reduce the risk of spreading infection. Burnout has been described among staff possibly due to a changed working climate. However, little research has focused on the pandemic's effect on patient safety in community pharmacies.

Objective

To examine pharmacists' perceptions of the impact of the COVID-19 pandemic on workload, working environment, and patient safety in community pharmacies.

Methods

A survey was distributed to all Swedish community pharmacists, constituting a census study. Questions regarding the pharmacists' perception of the impact of the pandemic on workload, working environment, and patient safety were included. Respondents were asked to provide comments on their working situation. Quantitative results were analysed using descriptive statistics, and comments were analysed using qualitative content analysis.

Results

The response rate was 41% (2034 responses). Most pharmacists (62%) considered the workload to be increased during the pandemic while work environment deteriorated (physical work environment was considered worse by 47% of respondents while psychosocial work environment was considered worse by 59%). Despite this, many respondents (55%) believed that patient safety was not affected. Neither having had COVID-19 nor being afraid of contracting it, influenced these perceptions in any substantial way. Findings were consistent regardless of education, professional role, number of years in community pharmacies, or special assignments in the pharmacies. According to the respondents, the communication within pharmacy companies during the pandemic was inadequate.

Conclusions

The impact of the pandemic on working conditions is in line with previous findings but the effect on patient safety needs further studies. The respondents felt the management had a limited understanding of the conditions during the pandemic, which stresses the importance of good and clear communication during a crisis.

Australian community pharmacists' experiences during the COVID-19 pandemic

OBJECTIVES

Community pharmacists have played an important role in providing services for their community during the COVID-19 pandemic. In this study, the purpose is to present the attitudes and experiences of Australian pharmacists regarding the COVID-19 pandemic.

METHODS

A qualitative semi-structured interview explored community pharmacist experiences during the initial COVID-19 lockdown. Thematic analysis of transcribed interviews was conducted to investigate the experiences of pharmacists.

KEY FINDINGS

Interviews were conducted with 15 pharmacists from different regional areas and states of Australia. In the study, five main themes were developed: COVID-19 practice complications; pharmacy practice changes; difficult patient interactions; worsened mental well-being and coping strategies; and career dissatisfaction. Pharmacists stated that an increase in workload, shortage of supplies and frequent COVID-19 management updates increased pressure on their duties. The negative customer interactions during COVID-19 lockdown adversely affected some pharmacists' mental health and career satisfaction.

CONCLUSIONS

Community pharmacists are subject to multiple factors affecting their practice, impairing their mental well-being and triggering them to reconsider their career choice. It is important to provide support to community pharmacists to help improve their well-being and workplace satisfaction.

Impact of the Novel CoronaviruS (COVID-19) on Frontline PharmacIsts Roles and ServicEs: INSPIRE Worldwide Survey

Background: Pharmacy has been recognized as a vital healthcare profession during the COVID-19 pandemic. The primary objective of the INSPIRE Worldwide survey was to determine the impact of COVID-19 on pharmacy practice and pharmacists’ roles around the world. Methods: A cross-sectional online questionnaire with pharmacists who provided direct patient care during the pandemic. Participants were recruited through social media, with assistance from national and international pharmacy organizations between March 2021–May 2022. The questionnaire was divided into (1) demographics, (2) pharmacists’ roles, (3) communication strategies, and (4) practice challenges. The data were analyzed using SPSS 28, and descriptive statistics were used to report frequencies and percentages. Results: A total of 505 pharmacists practicing in 25 countries participated. The most common role that pharmacists undertook was responding to drug information requests (90%), followed by allaying patients’ fears and anxieties about COVID-19 (82.6%), and addressing misinformation about COVID-19 treatments and vaccinations (80.4%). The most common challenges were increased stress levels (84.7%), followed by medication shortages (73.8%), general supply shortages (71.8%), and inadequate staffing (69.2%). Conclusions: Pharmacists within this study were significantly impacted by the COVID-19 pandemic and took on new or adapted roles (e.g., providing COVID-specific information, managing patients’ emotions, and educating on public health measures) to meet the needs of their communities. Despite, the significant challenges (e.g., increased stress, supply chain challenges, addressing misinformation, and staffing shortages) faced by pharmacists, they continued to put their patients’ needs first and to provide pharmacy services.

Pharmacists' Mental Health during the First Two Years of the Pandemic: A Socio-Ecological Scoping Review

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the pandemic on pharmacists' mental health and their antecedents using three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies included primary research articles that examined the mental health antecedents and outcomes among pharmacists during the first two years of the pandemic. We used the Social Ecological Model to categorize antecedents per outcome. The initial search yielded 4165 articles, and 23 met the criteria. The scoping review identified pharmacists experiencing poor mental health during the pandemic, including anxiety, burnout, depression, and job stress. In addition, several individual, interpersonal, organizational, community, and policy-level antecedents were identified. As this review revealed a general decline in pharmacists' mental health during the pandemic, further research is required to understand the long-term impacts of the pandemic on pharmacists. Furthermore, we recommend practical mitigation strategies to improve pharmacists' mental health, such as implementing crisis/pandemic preparedness protocols and leadership training to foster a better workplace culture.

A photovoice study on community pharmacists' roles and lived experiences during the COVID-19 pandemic

BACKGROUND

Community pharmacists were the face of the health response to the unprecedented COVID-19 pandemic. Their pivotal role during the pandemic has been widely recognized, as they adapted to continue to provide a higher level of care to their patients.

OBJECTIVE

The objective of this study was to gain a deeper understanding of frontline pharmacists' lived experiences of the COVID-19 pandemic and its impact on their roles.

METHODS

Photovoice, a visual research method that uses participant-generated photographs to articulate their experiences, was used with semi-structured interviews to explore pharmacists' lived experiences. Frontline community pharmacists who provided direct patient care during the COVID-19 pandemic in Alberta, Canada were recruited. Participants were asked to provide 3-5 photos that reflected on how they see themselves as a pharmacist and/or represents what they do as a pharmacist. Data analysis incorporated content, thematic and visual analysis and was facilitated using NVivo software. A published conceptual framework model was used as the foundation of the analysis with care taken to include new concepts. Ethics approval was obtained from the University of Alberta health research ethics board.

RESULTS

Interviews were conducted with 21 participants and they 71 photos. This study advanced the conceptual framework model presented in a scoping review, of what was made visible (pharmacists' information, public health, and medication management roles) and what was invisible but made visible by the pandemic (pharmacists' leadership roles). It was revealed through the reflective nature of this study the important leadership role pharmacists have in their communities.

CONCLUSIONS

This study highlighted the work of community pharmacists responding to the COVID-19 pandemic through their information, public health, medication management, and leadership roles. Their experiences also made visible the cost their work had on them as they did more to adapt and continually respond as the pandemic evolved. Pharmacists recognized their role as leaders in their practice and communities.

The "affected" pharmacist and the "business as usual" pharmacist: Exploring the experiences of pharmacists during COVID-19 through cluster analysis

BACKGROUND

The global coronavirus disease 2019 (COVID-19) pandemic has necessitated considerable changes in the delivery of pharmacy services, with pharmacists experiencing increasing demands and a high rate of burnout. The ability to categorize pharmacists based on their burnout risk and associated factors could be used to tailor burnout interventions.

OBJECTIVE

This study aimed to identify subgroups (profiles) of pharmacists and use these profiles to describe interventions tailored to improve pharmacist's well-being.

METHODS

A survey was disseminated to pharmacists working in Australia during April and June 2020. The survey measured demographics, burnout, and psychosocial factors associated with working during COVID-19. A two-step cluster analysis was used to categorize pharmacists based on burnout and other variables.

RESULTS

A total of 647 survey responses contained data that were used for analysis. Participants were mostly female (75.7%) and working full time (65.2%). The final cluster analysis yielded an acceptable two-cluster model describing 2 very different pharmacist experiences, using 10 variables. Cluster 2 (representing 53.1% of participants) describes the "affected" pharmacist, who has a high degree of burnout, works in community pharmacy, experiences incivility, is less likely to report sufficient precautionary measures in their workplace, and has had an increase in workload and overtime. In contrast, cluster 1 (representing 46.9% of participants) describes the profile of a "business as usual" hospital pharmacist with the opposite experiences. Interventions focused on the "affected" pharmacist such as financial support to employ specialized staff and equitable access to personal protective equipment should be available to community pharmacists, to reduce the risk to these frontline workers.

CONCLUSION

The use of cluster analysis has identified 2 distinct profiles of pharmacists working during COVID-19. The "affected" pharmacist warrants targeted interventions to address the high burnout experienced in this group.

Behind the Counter: Exploring Pharmacists' Stressors and Lessons Learned During the Pandemic in Ontario, Canada

Background

The onset of the COVID-19 pandemic has contributed to increased stress among healthcare professionals. Among these healthcare providers are Ontario pharmacists, who are facing new and pre-existing challenges and new stressors since the pandemic.

Objectives

This study aimed to understand the stressors and lessons learned by Ontario pharmacists during the pandemic through their lived experiences.

Methods

In this descriptive qualitative study, we conducted semi-structured one-on-one interviews with Ontario pharmacists virtually to learn about their stressors and lessons learned during the pandemic. Interviews were transcribed verbatim, then analyzed using thematic analysis.

Findings

We reached data saturation after 15 interviews and identified 5 main themes: (1) Communication/miscommunication with the public and other care providers; (2) high workload due to staff shortage and low appreciation/acknowledgement; (3) mismatch in market demand and supply; (4) informational gaps pertaining to the COVID-19 pandemic along with rapid protocol changes; and (5) lessons learned to improve the future of pharmacy practice in Ontario.

Discussion

Our study helped us gain a better understanding of the stressors pharmacists faced, their contributions, and the opportunities that arose due to the pandemic.

Conclusion

Drawing on these experiences, this study provides recommendations to improve pharmacy practice and increase preparedness for future emergencies.

The COVID conversations: A content analysis of Canadian pharmacy organizations' communication of pharmacists' roles and services during the COVID-19 pandemic

Background

The COVID-19 pandemic presented a unique challenge for pharmacists as they navigated information scarcity on the frontlines while being identified as information experts. Alberta pharmacists looked to their professional organizations for direction regarding what their roles should be in a crisis. The objective of this study was to explore pharmacists' roles and services and how they were communicated by pharmacy organizations during the first year of the COVID-19 pandemic.

Methods

The study used a conventional content analysis method to explore the online communication of relevant pharmacy organizations for Alberta pharmacists. Five organization websites (National Association of Pharmacy Regulatory Authorities, Canadian Pharmacists Association [CPhA], Canadian Society of Hospital Pharmacists [CSHP], Alberta College of Pharmacy [ACP] and the Alberta Pharmacists' Association [RxA]) were examined to identify and catalogue publicly accessible documents that communicated pharmacists' roles and services during the first year of the pandemic for Alberta pharmacists.

Results

A total of 92 documents were collected from CPhA (60), CSHP (2), ACP (26) and RxA (4). While most documents communicated information about pharmacists' roles in public health, patient care and drug and personal protective equipment supply, more than one-third of the documents (32/92, 34.8%) required contextual information to interpret the communication. There was an observed shift in the communication after the first 6 months, becoming more direct in its messaging and context.

Conclusion

These pharmacy organizations communicated information for pharmacists' roles and services to provide direction and guidance in the ever-changing context of the COVID-19 pandemic for Alberta pharmacists. Their communication became clearer and more direct as the pandemic progressed, requiring less inference to understand the intended message.

Pharmacy Workplace Wellbeing and Resilience: Themes Identified from a Hermeneutic Phenomenological Analysis with Future Recommendations

This study applied a hermeneutic phenomenological approach to better understand pharmacy workplace wellbeing and resilience using respondents' written comments along with a blend of the researchers' understanding of the phenomenon and the published literature. Our goal was to apply this understanding to recommendations for the pharmacy workforce and corresponding future research. Data were obtained from the 2021 APhA/NASPA National State-Based Pharmacy Workplace Survey, launched in the United States in April 2021. Promotion of the online survey to pharmacy personnel was accomplished through social media, email, and online periodicals. Responses continued to be received through the end of 2021. A data file containing 6973 responses was downloaded on 7 January 2022 for analysis. Usable responses were from those who wrote an in-depth comment detailing stories and experiences related to pharmacy workplace and resilience. There were 614 respondents who wrote such comments. The findings revealed that business models driven by mechanized assembly line processes, business metrics that supersede patient outcomes, and reduction of pharmacy personnel's professional judgement have contributed to the decline in the experience of providing patient care in today's health systems. The portrait of respondents' lived experiences regarding pharmacy workplace wellbeing and resilience was beyond the individual level and revealed the need for systems change. We propose several areas for expanded inquiry in this domain: (1) shared trauma, (2) professional responsibility and autonomy, (3) learned subjection, (4) moral injury and moral distress, (5) sociocultural effects, and (6) health systems change.

Influence of job environment on the online teaching anxiety of college teachers in the online teaching context: The mediating role of subjective well-being

Background

Online education has been conducted widely in higher education in recent years. While online teaching brings many opportunities, it also poses numerous challenges and issues. This is especially true for college teachers, for whom teaching is considered to be a profession with a high level of burnout and anxiety. The large-scale application of online teaching methods has put teachers in an even more challenging context, which may lead to teaching anxiety affecting their mental health. In online teaching contexts, the question of what factors affect college teachers' online teaching anxiety is worth exploring to help reduce their online teaching anxiety so as to promote their work performance. In this study, therefore, we conducted a survey of college teachers to develop a model of job environment (job demands and job resources), subjective well-being, and online teaching anxiety, and to explore the influences of job environment and subjective well-being on their online teaching anxiety, as well as the mediating effects of subjective well-being between job environments and online teaching anxiety.

Method

Of the 1,060 college teachers who participated, 524 were male (49.4%) and 536 were female (50.6%). An online questionnaire was sent to the teachers in January, 2022. Online teaching anxiety, subjective well-being, and job environment scales were adapted and developed. Descriptive analysis, reliability and validity analysis, and structural equation modelling were used to analyse the collected data.

Results

The study model showed an adequate fit (χ² = 440.983, RMSEA = 0.070, GFI = 0.942, AGFI = 0.914, NFI = 0.949, and CFI = 0.956), confirming the relationships of job demands and online teaching anxiety (β = 0.310, p < 0.001), job resources and online teaching anxiety (β = - 0.086, p < 0.01), job demands and subjective well-being (β = - 0.411, p < 0.001), job resources and subjective well-being (β = 0.204, p < 0.001), and subjective well-being and online teaching anxiety (β = - 0.435, p < 0.001). Meanwhile, the results also proved the effects of the mediating role of subjective well-being between job demands (95% CI = [- 0.138, - 0.225]), job resources (95% CI = [- 0.119, - 0.064]), and online teaching anxiety. The model accounted for 33.8% (f ² = 0.401) of online teaching anxiety.

Conclusion

The results of this study indicated that it is important to reduce job demands and increase job resources to alleviate college teachers' online teaching anxiety to maintain good mental health; while maintaining a high level of college teachers' subjective well-being is also helpful for promoting their work performance. Furthermore, the indirect effects of job demands and job resources on online teaching anxiety mediated by college teachers' subjective well-being were also significant.