Community Pharmacists' Knowledge Regarding Donepezil Averse Effects and Self-Care Recommendations for Insomnia for Persons with AD

Pharmacists' Knowledge and Practice of Issues Related to Using Psychotropic Medication in Elderly People in Ethiopia: A Prospective Cross-Sectional Study

Purpose

This study is aimed at assessing pharmacists' knowledge and practice of issue related to usage of psychotropic medications in elderly people, in Gondar town Northwest, Ethiopia.

Methods

A cross-sectional study was conducted among pharmacists working in community, health center, and hospital pharmacies in Gondar town from March 1 to May 30, 2020. A total of 73 medication retail outlets (40 pharmacies and 33 drug stores) were included in this study. Pharmacy personnel's knowledge and practice were assessed using self-administered validated questionnaires. Binary and multivariable logistic regression analyses were used to assess the association between different variables. P < 0.05 was used to declare the association.

Result

A total of 144 pharmacists were included in the study; the mean age was 30.13 (SD ±5.87), ranging from 20 to 55years. The mean knowledge score was 7.789 (SD ±2.98), and 75 (52.1%) of them had poor knowledge. The mean practice score was 2.32 ± 0.912 (mean ± SD), and 77 (53.5%) of the respondents had poor practice. All participants had not taken on-the-job training about psychotropic medication. Work experience (P < 0.029) and personal monthly income (P < 0.046) were significantly associated with pharmacists' knowledge. There was a significant association between work experience and practice level (P < 0.043).

Conclusion

The knowledge and practice of pharmacy personnel were low for issues related to the use of psychotropic medication in the elderly. This result indicates the need for training for pharmacists on pharmacotherapy of psychotropic medication.

The M1 muscarinic acetylcholine receptor subtype is important for retinal neuron survival in aging mice

Muscarinic acetylcholine receptors have been implicated as potential neuroprotective targets for glaucoma. We tested the hypothesis that the lack of a single muscarinic receptor subtype leads to age-dependent neuron reduction in the retinal ganglion cell layer. Mice with targeted disruption of single muscarinic acetylcholine receptor subtype genes (M₁ to M₅) and wild-type controls were examined at two age categories, 5 and 15 months, respectively. We found no differences in intraocular pressure between individual mouse groups. Remarkably, in 15-month-old mice devoid of the M₁ receptor, neuron number in the retinal ganglion cell layer and axon number in the optic nerve were markedly reduced. Moreover, mRNA expression for the prooxidative enzyme, NOX2, was increased, while mRNA expression for the antioxidative enzymes, SOD1, GPx1 and HO-1, was reduced in aged M₁ receptor-deficient mice compared to age-matched wild-type mice. In line with these findings, the reactive oxygen species level was also elevated in the retinal ganglion cell layer of aged M₁ receptor-deficient mice. In conclusion, M₁ receptor deficiency results in retinal ganglion cell loss in aged mice via involvement of oxidative stress. Based on these findings, activation of M₁ receptor signaling may become therapeutically useful to promote retinal ganglion cell survival.

Continuing pharmacy education practices in geriatric care among pharmacists in the Upper Midwest

OBJECTIVES

To summarize select continuing pharmacy education (CPE) topics and hours related to geriatric care completed by community, hospital/clinic, and long-term care (LTC)/consultant pharmacists in the previous 12 months, whether pharmacy workplace influenced topic selection or completion, and to describe CPE sources used by community versus hospital/clinic pharmacists.

DESIGN

Cross-sectional survey (2017).

SETTING AND PARTICIPANTS

Licensed pharmacists in North Dakota, South Dakota, Minnesota, Iowa, and Nebraska with primary practice settings in community pharmacies, hospitals, or clinics or those practicing as consultant pharmacists.

MAIN OUTCOME MEASURES

CPE on geriatric-related topics and hours completed in the previous 12 months, CPE providers and sources used, and differences in CPE topic completion and CPE providers and sources by primary pharmacy practice setting.

RESULTS

Pharmacists' response rates for states ranged from 10.5% to 17.1%. Pharmacists (n = 1082) reported limited completion of geriatric-related topics. Almost one-third completed CPE credit in Alzheimer disease (AD) but fewer than 20% of pharmacists in selected age-related chronic diseases (e.g., Parkinson disease, dementia with Lewy bodies, epilepsy, vascular dementia, geriatric syndrome). LTC/consultant pharmacists completed significantly more hours in geriatric-related topics compared with other pharmacists. In contrast, diabetes mellitus, hypertension, asthma, and heart failure were completed by 34% to 64% of the pharmacists. Pharmacist's Letter (57.2%), Power-Pak CE (42.4%), conferences, conventions, and symposia (32.5%), and Pharmacy Times (21.8%), were the most used CPE sources. Other sources were used by fewer than 18% of the pharmacists. Online CPE providers used by high numbers of study participants offered limited AD- or dementia-related topics and hours.

CONCLUSION

Findings revealed modest to minimal CPE completion in select geriatric care topics among pharmacists in the Upper Midwest. Completion rates were higher for LTC pharmacists compared with hospital, clinic, and community pharmacists. Only a few CPE sources were heavily used, and those offered minimal CPE in AD/dementia-related care. Given current findings and previous research, current CPE use habits and CPE offerings from major providers and sources seem insufficient for ensuring continued high-quality patient-centered care for growing U.S. aging populations.

Maintaining Vitality: Pharmacists' Continuing Professional Education Decision-Making in the Upper Midwest

Continuing professional education (CPE) plays an important role in continuing professional development of pharmacists for providing quality pharmaceutical care but also to maintain professional and organizational vitality and meet changing community/population needs. The study objective was to describe and understand factors of importance in selection of CPE credit hours among Upper Midwest pharmacists. A cross-sectional study of licensed pharmacists (n = 1239) in Iowa, Minnesota, Nebraska, North Dakota, and South Dakota included completion of a questionnaire on demographics and CPE decision-making. Factor analysis, t-test, and multivariate analyses were performed using Stata 10.1. Pharmacists placed greatest importance on maintaining licensure (mean = 2.72/3.00), personal interest (mean = 2.57), and self-improvement (mean = 2.42). Community/population need (mean = 1.83) was rated as slightly more important (p < 0.01) by retail/community pharmacists, females, and those with a Doctor of Pharmacy degree or pharmacy residency while business growth/development (mean = 1.33) was rated slightly more important (p < 0.01) by retail/community pharmacists. Despite findings that neither community/population need nor business development were among the most important factors in pharmacists’ CPE selection, there exists significant potential for pharmacists to utilize CPE to maintain professional and organizational vitality in the labor market, but more importantly to ensure continued provision of quality pharmaceutical care and patient education.