Assessing the impact of public insurance on healthcare utilization and mortality: A nationwide study in China

We investigate the effects of a significant health insurance expansion in rural China known as the New Cooperative Medical Scheme (NCMS). Our analysis is based on a nationwide dataset spanning from 2004 to 2011. We find that the NCMS effectively increases healthcare utilization, particularly inpatient admissions, and reduces the incidence for infectious diseases. In addition to the increased healthcare utilization, the reduction in the incidence for infectious diseases can be attributed to improved health knowledge and health behavior, both of which are associated with the expansion of insurance coverage. Our findings affirm the importance of insurance coverage in safeguarding low-income individuals from the adverse health consequences linked to infectious diseases.

Different experiences of weight management and physical activity during pregnancy - a qualitative study of women and healthcare professionals in Australia

OBJECTIVE

Pregnancy is often described as a pivotal life stage for women, where regular contact with health professionals may play an important role in lifestyle awareness. This study explored the knowledge, practices, and beliefs of health professionals and pregnant women regarding physical activity and weight management during the antenatal period.

METHODS

A qualitative study was undertaken in southeastern Australia using individual interviews. Recruitment sought women of gestation >12 weeks, experiencing an uncomplicated pregnancy (n = 6), and antenatal health professionals including midwives (n = 4) and an obstetrician (n = 1). Data were analysed using Interpretive Phenomenological Analysis.

RESULTS

Three major themes emerged: (1) women rely on multiple sources of pregnancy-related healthy lifestyle information; (2) discussions around healthy lifestyle behaviours are low priority and often inconsistent; and (3) lifestyle-related topics perceived as sensitive make some conversations and actions difficult.

CONCLUSIONS

Pregnant women expressed gaps in lifestyle-related knowledge and education being provided by health professionals. In turn, health professionals expressed difficulty discussing sensitive topics such as weight with pregnant women and had limited knowledge of pregnancy-specific physical activity guidelines. The themes generated by this study may form the foundation for further research to inform clinical policy and practice regarding advice in antenatal care.

In Search of a Gold Standard Tool for Assessing Knowledge of Stroke: A Systematic Review

BACKGROUND

Knowledge of stroke is essential to empower people to reduce their risk of these events. However, valid tools are required for accurate and reliable measurement of stroke knowledge. We aimed to systematically review contemporary stroke knowledge assessment tools and appraise their content validity, feasibility, and measurement properties.

METHODS

The protocol was registered in PROSPERO (CRD42023403566). Electronic databases (MEDLINE, PsycInfo, CINAHL, Embase, Scopus, Web of Science) were searched to identify published articles (1 January 2015-1 March 2023), in which stroke knowledge was assessed using a validated tool. Two reviewers independently screened titles and abstracts prior to undertaking full-text review. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methods guided the appraisal of content validity (relevance, comprehensiveness, comprehensibility), feasibility, and measurement properties.

RESULTS

After removing duplicates, the titles and abstracts of 718 articles were screened; 323 reviewed in full; with 42 included (N = 23 unique stroke knowledge tools). For content validity, all tools were relevant, two were comprehensive, and seven were comprehensible. Validation metrics were reported for internal consistency (n = 20 tools), construct validity (n = 17 tools), cross-cultural validity (n = 15 tools), responsiveness (n = 9 tools), reliability (n = 7 tools), structural validity (n = 3 tools), and measurement error (n = 1 tool). The Stroke Knowledge Test met all content validity criteria, with validation data for six measurement properties (n = 3 rated "Sufficient").

CONCLUSION

Assessment of stroke knowledge is not standardised and many tools lacked validated content or measurement properties. The Stroke Knowledge Test was the most comprehensive but requires updating and further validation for endorsement as a gold standard.

Knowledge, Attitude and Practice Among Palestinian Healthcare Workers in the Gaza Strip Towards Hepatitis B: Cross-sectional survey

Objectives

Healthcare workers are at high risk of contracting hepatitis B virus (HBV). This survey aimed to identify the gaps and strengths in the knowledge, attitudes and practices of healthcare workers towards HBV to drive appropriate health interventions.

Methods

This cross-sectional study was conducted between March and April 2022. A convenience sample of three at-risk healthcare professions from the major health facilities in Gaza was surveyed. A 40-item self-administered questionnaire was used. Statistical data analysis was conducted using Statistical Package for Social Sciences version 25 to obtain descriptive and inferential statistics via various nonparametric, correlation and regression tests (with P <0.05).

Results

A total of 447 healthcare workers participated in the study. Overall, 105 of the participants (23.5%) demonstrated poor knowledge (below 14/20 points) of HBV, 284 (63.5%) had moderate knowledge (14-17 points) and 58 (13%) showed good knowledge. The majority (n = 367, 82.1%) expressed an excellent attitude. Finally, 287 (64.2%) demonstrated a good level of practice regarding HBV infection. A history of needlestick injury was reported by 233 (52.1%) participants, 170 (73.3%) of whom reported taking appropriate preventive actions after exposure.

Conclusion

The majority of the participants demonstrated overall good knowledge regarding HBV infection. Nonetheless, significant gaps remain in the different aspects of the knowledge, attitude and practice construct that require appropriate awareness campaigns to further limit the spread of this preventable viral infection.

Knowledge, attitudes and practices regarding children with ICU-acquired weakness in pediatric intensive care unit among chinese medical staff: a cross-sectional survey

BACKGROUND

ICU-AW (Intensive Care Unit Acquired Weakness) is characterized by significant muscle weakness and can be caused by a variety of factors, including immobility, medication use, and underlying medical conditions.ICU-AW can affect critically ill children who have been hospitalized in the PICU for an extended period of time.The knowledge, attitude and practice level of ICU-AW of PICU medical staff directly affect the treatment of critically ill children with ICU-AW.The aim to this study was to explore the knowledge, attitudes, and practices of Chinese medical staff regarding critically ill children with intensive care unit-acquired weakness (ICU-AW) and related factors.

METHODS

A Knowledge, Attitudes, and Practices (KAP) Questionnaire regarding critically ill children with ICU-AW was distributed to a stratified sample of 530 pediatric intensive care unit (PICU) healthcare workers. The questionnaire consisted of 31 items-with scores of 45, 40, and 40 for each dimension and a total score of 125.

RESULTS

The mean total score of Chinese PICU healthcare workers for the KAP questionnaire regarding children with ICU-AW was 87.36 ± 14.241 (53-121), with mean total knowledge, attitudes, and practices scores of 30.35 ± 6.317, 30.46 ± 5.632, and 26.54 ± 6.454, respectively. The population distribution indicated that 50.56%, 46.04%, and 3.4% of healthcare workers had poor, average, and good scores, respectively. Multiple linear regression showed that gender, education, and hospital level classification influenced the KAP level of PICU healthcare workers regarding critically ill children with ICU-AW.

CONCLUSIONS

Overall, PICU healthcare workers in China have an average KAP level about ICU-AW, and the gender and education level of PICU healthcare workers, as well as the classification of hospitals where they work, predict the KAP status of healthcare workers regarding children with ICU-AW. Therefore, healthcare leaders should plan and develop specific training programs to improve the KAP level of PICU healthcare workers.

[Evaluation of the Knowledge of Women of Childbearing Age with Epilepsy about the Impact of Their Disease in Contraception, Pregnancy and Breastfeeding: A Multicenter Cross-Sectional Study]

INTRODUCTION

The interaction of antiseizure medication with contraceptives, its potential teratogenicity and implications in pregnancy and breastfeeding are aspects to consider in the neurological care of women with epilepsy of childbearing age. To ensure the commitment in therapeutic decisions and the appropriate planning of maternity, it is essential that women are informed about the implications of their disease in these domains. The main aim of this study was to assess the knowledge of women of childbearing age with epilepsy concerning the impact of epilepsy in contraception, pregnancy and breastfeeding. As secondary aims we defined (1) the demographic, clinical and therapeutic characterization of this group of patients, (2) the identification of variables that correlated with the level of knowledge of women with epilepsy, and (3) the identification of preferential methods to acquire new knowledge about epilepsy.

MATERIAL AND METHODS

The study was observational, cross-sectional and multicentric, and was carried out in five hospitals of the Lisbon metropolitan area. After identifying all women of childbearing age with epilepsy followed in the epilepsy clinic of each center, we applied an electronic questionnaire based on a non-systematic review of the literature.

RESULTS

One hundred and fourteen participants were validated, with a median age of 33 years. Half of the participants were on monotherapy, and the majority had no seizures in the last six months. We identified important gaps in the participants' knowledge. Sections about complications and administration of antiseizure medication during pregnancy were the ones with the worst results. None of the clinical and demographic variables correlated with the final questionnaire score. Having had a previous pregnancy and the desire to breastfeed in a future pregnancy were positively correlated with the performance in breastfeeding section. Face-to-face discussion during medical outpatient visits was selected as the preferential method to learn about epilepsy, and the internet and social media were the least preferred ones.

CONCLUSION

The knowledge of women of childbearing age with epilepsy in the Lisbon metropolitan area concerning the impact of epilepsy in contraception, pregnancy and breastfeeding seems to have significant gaps. Medical teams should consider engaging in patient education particularly during outpatient clinics.

Knowledge and practices about taeniasis/cysticercosis complex within the framework of the national plan for its elimination in Colombia, 2019

The taeniasis/cysticercosis complex (TCC) belongs to the group of neglected infectious diseases with a multifactorial transmission that includes hosts such as humans and pigs of the parasitic tapeworm (Taenia solium) and environmental factors. This study represents the first phase of the National and Cross-sectoral Plan for TCC Elimination.

OBJECTIVES

To obtain data about knowledge and practices in relation to the TCC from knowledge, attitudes, and practices (KAP) surveys applied in two pilot localities for building a baseline of the potential risk factors related to identification, prevention, and control of TCC in Colombia.

METHODS

A descriptive cross-sectional survey from October to November in 2019 was carried out using a structured questionnaire and random sampling by single-stage conglomerates in the municipalities of Mahates, Bolívar (n=152) (Atlantic Region) and Mercaderes, Cauca (n=152) (Andean Region).

RESULTS

Respondents in Mahates showed moderate knowledge about TCC compared to those in Mercaderes, however, risky practices were identified in both places (consumption of pork with cysts and defecation in places other than the bathroom or latrine). Deficiency in infrastructure and failure in basic services were observed as potential risk factors for TCC transmission in both municipalities.

CONCLUSION

Based on the framework of the National and Cross-sectoral Plan for TCC Elimination, adequate knowledge on identification, prevention, and control of the disease must be reinforced; cultural and ecological differences should be considered when designing communication and knowledge transmission tools. We consider that major investment should be made in improving basic services and creating sustainable modernized pig farming in Mahates and Mercaderes.

Knowledge, attitudes, and practice of dentists on Minimal Intervention Dentistry: a systematic review and meta-analysis

OBJECTIVES

To evaluate the knowledge, attitudes, and practice (KAP) of dentists on Minimal Intervention Dentistry (MID).

DATA

Cross-sectional studies that analyzed KAP outcomes on MID principles were included.

SOURCES

Eight databases (Cochrane, DOSS, Embase, LILACS, PsycINFO, PubMed, Scopus, and Web of Science) and the grey literature were searched on January 2022.

STUDY SELECTION

Two independent reviewers selected the included studies, initially by screening titles and abstracts and, finally, by full-text reading. The methodological quality of studies was assessed by using the Joanna Briggs Institute Critical Assessment Checklist for Prevalence Studies. Proportion meta-analysis was conducted using a random effect model for data analysis. Cochran's Q test was used to assess the heterogeneity and the I² statistic for evaluation of true variation due to heterogeneity.

RESULTS

Of 2,079 studies initially identified, twelve were included in the systematic review. Twenty-four statements about MID were included in the meta-analysis, based on data from ten studies (n=1728 participants). The pooled proportion of knowledge on MID was 75.66% (95%CI: 69.33 - 81.48; p<0.01; I²: 97%; Tau2: 0.0456) and of attitudes and practice was 47.95% (95%CI: 38.55 - 57.43; p<0.01; I²: 98%; Tau2: 0.0743). The higher prevalences rates were in the "knowledge" field, and the lowest was in "attitudes and practice".

CONCLUSIONS

The findings suggest that the knowledge of dentists on MID topics is acceptable, and the attitudes and practices need improvements. The studies lacked uniformity in methods and there is still a need for more studies to elucidate the KAP of dentists worldwide.

CLINICAL SIGNIFICANCE

Understanding the cognizance and the way oral healthcare professionals are treating dental caries is the first step to expanding the minimal intervention evidence into a dental practice. The final goal is to change the practice and make Minimal Intervention Dentistry the standard of care for dental caries worldwide.

REGISTRATION

PROSPERO CRD42021257518.

Knowledge and Risk Behaviors Regarding Human Immunodeficiency Virus Transmission among Portuguese Healthcare Students

BACKGROUND

Human immunodeficiency virus (HIV), the agent responsible for acquired immunodeficiency syndrome, remains a worldwide public health problem. Therefore, this study aimed to assess Portuguese healthcare students' knowledge of HIV, identify risk behaviors for HIV transmission, and assess the frequency of HIV testing and its dissemination by general practitioners.

METHODS

A cross-sectional observational study was conducted using an anonymous questionnaire published online. The questionnaire was administered to Portuguese healthcare students who voluntarily agreed to participate in the study after clarifying its objectives and procedures.

RESULTS

Most students were aware of the three main HIV transmission routes; however, 66.3% were unaware of the level A recommendation for HIV screening in adolescents and adults. In addition, 59.6% of the students were never informed by their general practitioner about HIV screening tests or risk behaviors for HIV transmission. Of the sample, 78.9% had never been tested for HIV infection. Of the 74.6% of sexually active students, 82.0% had or had already had unprotected sex (without a condom). Men showed riskier sexual behaviors than women. None of the inquiries reported intravenous drug use, and most students (69.9%) never shared personal objects.

CONCLUSION

General practitioners and awareness campaigns need to alert and disseminate HIV screening tests. Sexual health and risk behaviors should be addressed more frequently in schools to educate this population because prevention is the best strategy against HIV transmission/contraction.

Experiences in Using KoBo Collect and KoBo Toolbox in a Cross-Sectional Dog Population and Rabies Knowledge and Practices Household Survey in the Philippines

We used KoBo Collect and KoBo Toolbox as an electronic data capture platform for a dog population and rabies knowledge and practices community survey in the Philippines. It has allowed for easy design and deployment of an electronic form with minimal technical knowledge from the investigators. Using this platform allowed for shorter training for data collectors, minimal errors during data collection, and faster turn-around time for data cleaning and analysis.

Factors associated with knowledge, attitudes and preventive practices towards COVID-19 in health care professionals in Lima, Peru

Background: Nowadays, we are facing a disease caused by SARS-CoV- 2, known globally as COVID-19, which is considered a threat to global health due to its high contagiousness and rapid spread. Methods: Analytical cross-sectional study in 302 health professionals. An online questionnaire consisting of questions about knowledge, attitudes and practices (KAP) towards COVID-19 was applied. Socio- demographic, occupational and comorbidities factors were explored. Simple and multiple logistic regression models were used to identify factors associated with KAP. Results: Of the total, 25.2%, 31.5% and 37.4% had high levels of knowledge, preventive practices and risk perception attitudes respectively. Being married aOR=6.75 CI(1.46-31.2) p=0.014, having a master's degree aOR=0.4, CI(0.21-0.80) p=0.009, having a working day with less than ten hours ORa=0.49 CI(0.25-0.95) p=0.036 and obesity aOR=0.38 CI (0.15-0.95) p=0.039 were associated with a low level of knowledge of COVID-19. The variables associated with preventive practices were being over the age of 50 aOR=0.52 CI(0.27-0.98) p=0.007, working in the hospitalization area aOR=1.86 CI(1.08-3.18) p= 0.018 and having comorbidities such as arterial hypertension aOR=0.28 CI(0.081-0.99) p=0.02 and obesity aOR=0.35 CI(0.14-0.83) p=0.019. In relation to negative attitudes towards COVID-19, it was found that physical contact with patients with a confirmed diagnosis aOR=1.84 CI (1.14-2.97) p=0.006 and having asthma aOR=2.13 CI(1.081-4.22) p=0.029 were associated with these attitudes. Conclusion: Our study revealed that health professionals have an insufficient level of knowledge of COVID-19. This is why we recommend implementing strategies such as health literacy programs among health care workers. Thus, they can help develop positive.

Factors associated with knowledge, attitudes and preventive practices towards COVID-19 in health care professionals in Lima, Peru

Background: Nowadays, we are facing a disease caused by SARS-CoV-2, known globally as COVID-19, which is considered a threat to global health due to its high contagiousness and rapid spread. Methods: Analytical cross-sectional study in 302 health professionals. An online questionnaire consisting of questions about knowledge, attitudes and practices (KAP) towards COVID-19 was applied. Socio-demographic, occupational and comorbidities factors were explored. Simple and multiple logistic regression models were used to identify factors associated with KAP. Results: Of the total, 25.2%, 31.5% and 37.4% had high levels of knowledge, preventive practices and risk perception attitudes respectively. Being married (aOR=6.75), having a master's degree (aOR= 0.41), having a working day with less than ten hours (ORa=0.49) and obesity (aOR=0.38) were associated with a low level of knowledge of COVID-19. The variables associated with preventive practices were being over the age of 50 (aOR=0.52), working in the hospitalization area (aOR=1.86) and having comorbidities such as arterial hypertension (aOR=0.28) and obesity (aOR=0.35). In relation to negative attitudes towards COVID 19, it was found that physical contact with patients with a confirmed diagnosis (aOR=1.84) and having asthma (aOR=2.13) were associated with these attitudes. Conclusion: Being married, having a master's degree, working less than ten hours were associated with having a low level of knowledge of COVID-19. Being older than 50, working in the hospitalization area were associated with preventive practices. Physical contact with COVID-19 patients was associated with negative attitudes.

Factors associated with knowledge, attitudes and preventive practices towards COVID-19 in health care professionals in Lima, Peru

Background: Nowadays, we are facing a disease caused by SARS-CoV-2, known globally as COVID-19, which is considered a threat to global health due to its high contagiousness and rapid spread. Methods: Analytical cross-sectional study in 302 health professionals. An online questionnaire consisting of questions about knowledge, attitudes and practices (KAP) towards COVID-19 was applied. Socio-demographic, occupational and comorbidities factors were explored. Simple and multiple logistic regression models were used to identify factors associated with KAP. Results: Of the total, 25.2%, 31.5% and 37.4% had high levels of knowledge, preventive practices and risk perception attitudes respectively. Being married aOR=6.75 IC(1.46-31.2) p=0.014, having a master's degree aOR=0.4, IC(0.21-0.80) p=0.009, having a working day with less than ten hours ORa=0.49 IC(0.25-0.95) p=0.036 and obesity aOR=0.38 IC (0.15-0.95) p=0.039 were associated with a low level of knowledge of COVID-19. The variables associated with preventive practices were being over the age of 50 aOR=0.52 IC(0.27-0.98) p=0.007, working in the hospitalization area aOR=1.86 IC(1.08-3.18) p= 0.018 and having comorbidities such as arterial hypertension aOR=0.28 IC(0.081-0.99) p=0.02 and obesity aOR=0.35 IC(0.14-0.83) p=0.019. In relation to negative attitudes towards COVID-19, it was found that physical contact with patients with a confirmed diagnosis aOR=1.84 IC (1.14-2.97) p=0.006 and having asthma aOR=2.13 IC(1.081-4.22) p=0.029 were associated with these attitudes. Conclusion: Our study revealed that health professionals have an insufficient level of knowledge of COVID-19. This is why we recommend implementing strategies such as health literacy programs among health care workers. Thus, they can help develop positive attitudes towards the acquisition of self-care habits at work that, in turn, improve their confidence so that health care workers can provide adequate care for their patients and protect themselves.

Public knowledge, beliefs, psychological responses, and behavioural changes during the outbreak of COVID-19 in the Middle East

Objective:

To evaluate the knowledge, believes, psychological and behavioural impact of COVID-19 on the general population in the Middle East, exploring how it impacted public lives.

Methods:

A descriptive cross-sectional online survey was sent to a convenience sample in the Middle East through social media (Facebook and WhatsApp) between 16^th of June and 30^th of June 2020. The questionnaire was designed to collect the demographic, participant’s source of information regarding COVID-19, knowledge and believes about COVID-19, the psychological consequences of COVID-19, impact of COVID-19 on participant’s behaviour. The final version of the questionnaire was further tested for content validity by experts in the field.

Results:

A total of 2,061 participants completed the survey, with the majority being females (n=1394, 67.6%), from urban areas (n=1896, 92%) and the majority were from countries of The Levant (n=1199, 58.1%), followed by the Arabian Peninsula (n=392, 19.1%), Iraq (n=300, 14.6%) and Egypt (n=138, 6.7%). Few participants (3.0%) reported to have been infected and many (n=1847, 89.6%) were committed to quarantine at home. Social media platforms were the most common sources of information (41.2%). Many (63%) believed that COVID-19 is a biological weapon and were afraid of visiting crowded places (85%). The majority avoided public facilities (86.9%) such as prayer places and believed that the news about COVID-19 made them anxious (49.5%).

Influenza vaccination during the coronavirus pandemic: intention to vaccinate among the at-risk population in the Central Catalonia Health Region (VAGCOVID)

BACKGROUND

Influenza is a major public health issue, with the primary preventive measure being an annual influenza vaccination. Nevertheless, vaccination coverage among the at-risk population is low. Our understanding of the behaviour of the influenza virus during the SARS-CoV-2 coronavirus pandemic is limited, meaning influenza vaccination is still recommended for individuals at risk for severe complications due to influenza infection. The aim of the study is to determine the intention to vaccinate against seasonal influenza among the at-risk population in the 2020-21 campaign during the SARS-CoV-2 pandemic and to analyse the factors which influence such intention.

METHODS

Cross-sectional telephone survey of adults (aged over 18) with risk factors in central Catalonia where the need for the Seasonal Influenza Vaccine (SIV) was recommended.

RESULTS

A total of 434 participants responded to the survey, 43.3% of whom intended to be vaccinated against influenza for the 2020-2021 influenza season, 40.8% had no intention to be vaccinated and 15.9% were uncertain or did not express their opinion. The intention to get vaccinated against influenza is associated with having dependents, the individual's perception of the risk of being infected with influenza and the perceived risk of transmission to dependents. It is also associated with age, whether the individual had received influenza vaccine the previous season or any other season before. The best predictors of the intention to vaccinate are the individual's perception of the risk of catching influenza and whether the individual had been vaccinated in the previous season.

CONCLUSIONS

Intention to vaccinate can be a good predictor of individual behaviour in relation to vaccination. During the current SARS-CoV-2 pandemic many individuals are hesitant to influenza vaccination. In order to improve influenza vaccination coverage in people included in risk groups, it is necessary to promote educational actions, especially among those who express doubts.

Determinants of COVID-19 vaccine acceptance in a high infection-rate country: a cross-sectional study in Russia

Background:

COVID-19 vaccine development is proceeding at an unprecedented pace. Once COVID-19 vaccines become widely available, it will be necessary to maximize public vaccine acceptance and coverage.

Objective:

This research aimed to analyze the predictors of COVID-19 vaccine acceptance in Russia.

Methods:

A cross-sectional online survey was conducted among Russian adults from September 26^th to November 9^th, 2020. Predictors of the intent to take up COVID-19 vaccination were explored using logistic regression.

Results:

Out of 876 participants, 365 (41.7%) would be willing to receive the vaccine if it became available. Acceptance increased for a vaccine with verified safety and effectiveness (63.2%). Intention to receive the COVID-19 vaccine was relatively higher among males (aOR=2.37, 95% CI 1.41-4.00), people with lower monthly income (aOR=2.94, 95%CI 1.32-6.57), and with positive trust in the healthcare system (aOR=2.73, 95% CI 1.76-4.24). The Russian people were more likely to accept the COVID-19 vaccine if they believed that the vaccine reduces the risk of virus infection (aOR=8.80, 95%CI 5.21-14.87) or relieves the complications of the disease (aOR=10.46, 95%CI 6.09-17.96). Other barriers such as being unconcerned about side-effects (aOR=1.65, 95%CI 1.03-2.65) and the effectiveness and safety of the vaccination (aOR=2.55, 95%CI 1.60-4.08), also affected acceptance.

Conclusions:

The study showed the usefulness of the health belief model constructs in understanding the COVID-19 vaccination acceptance rate in the Russian population. This rate was influenced by sociodemographic and health-related characteristics, and health beliefs. These findings might help guide future efforts for policymakers and stakeholders to improve vaccination rates by enhancing trust in the healthcare system.

Community pharmacists' use, perception and knowledge on dietary supplements: a cross sectional study

Background:

Pharmacists are commonly tasked with recommending the appropriate dietary supplement and advising the patients of their correct and safe use. Previous research, conducted on pharmacy students, showed that they did not always use the evidence based sources of information, with personal use identified as a significant predictor influencing the decision to recommend a supplement.

Objectives:

To compare use, perceptions and knowledge of dietary supplements of pharmacists with different years of work experience and to explore factors that could influence their recommendation of supplements.

Methods:

A questionnaire based cross-sectional study was conducted on Croatian community pharmacists in September 2017. The questionnaire explored pharmacists’ demographic characteristics, use, perceptions and knowledge of dietary supplements. Pharmacists (N=102) were divided in two groups based on their work experience: P0 (<10 years) and P1 (≥10 years).

Results:

All included pharmacists had high knowledge scores without differences between groups (P0=10, IQR 9-12 vs P1=11, IQR 9-12, expressed as median and interquartile range (IQR), p=0.275). Less experienced pharmacists perceived there was less research conducted on the dietary supplements compared to their more experienced counterparts (P0=1, IQR 1-2 vs P1=2, IQR 2-3, expressed as median and interquartile range, p<0.001). Groups differed in sources used when choosing the appropriate supplement with P0 using higher quality sources such as systematic reviews in comparison to P1 (32.1% vs 8.7%, p=0.004). Pharmacists’ decision to recommend a dietary supplement was influenced by their personal use (odds ratio 0.216, 95%CI 0.068:0.689, p=0.01) and work experience (odds ratio 0.154, 95%CI 0.045:0.530, p=0.003).

Conclusions:

Pharmacists did not use the high quality sources when recommending dietary supplements and their decision to recommend the supplement was not based on objective evaluation of evidence. Further education about the practice of evidence-based pharmacy is necessary, with special emphasis on senior pharmacists who might have missed that aspect during their formal education.

Mixed Methods Study of Patient and Primary Care Provider Perceptions of Chronic Pain Treatment

OBJECTIVE

A mixed-method study involving patient focus groups and survey of primary care providers (PCPs) sought to compare perspectives about chronic pain (CP) and its treatment. Our goal was to identify needs and barriers for facilitating patient-centered care.

METHODS

Two focus groups of CP patients from a single academic medical center explored interactions with PCPs and their understandings, experiences, and expectations of CP treatment. They were also asked their opinions about self-assessment/communication tools. We compared themes with survey data from two PCP research networks.

RESULTS

CP patients understand opioid risks and fear PCP judgement and condescension, while sensing PCP fear and avoidance of opioid prescribing. PCPs are dissatisfied with their ability to provide optimal CP care, despite feeling that patients are generally satisfied with their clinic visits. Evaluation tools, especially assessment of functional activities, are favorably viewed by all, but deemed time prohibitive.

CONCLUSION

Patients' understanding of opioid risks, desire for attention on functional goals and behavioral treatment may be greater than PCPs perceive. Such gaps in understanding and attitudes, if recognized, could support high-quality communication and interventional strategies.

PRACTICE IMPLICATIONS

These findings guide patient-PCP communication toward alignment of treatment goals and enhanced coordination of care.

Attitudes towards COVID-19 vaccination, vaccine hesitancy and intention to take the vaccine

BACKGROUND

The pandemic is at a paradoxical stage, with vaccine roll out initiated but a significantly elevated level of infection and death. Hope for recovery lies in high equitable vaccine uptake.

OBJECTIVE

The study aimed to: i) explore attitudes and factors influencing attitudes, towards the COVID-19 vaccine amongst people living in Malta, ii) identify the reasons as to why individuals are unsure or unwilling to take the vaccine.

METHODS

Two consecutive, short, anonymous online surveys using social media platforms were used to gather data from adult individuals. The first study was open to residents in Malta, while the second study invited international participation. Study 1 consisted of 17 questions inspired by the Theories of Planned Behaviour and Reasoned Action. Study 2 asked participates whether they were willing, unwilling or unsure of taking the vaccine and their reasons for being unsure or unwilling.

RESULTS

A total of 2,529 individuals participated in Study 1 and 834 in Study 2. In both studies respondents were predominantly female having a tertiary education. Over 50% declared that they were willing to take the vaccine, with males being more willing (t=5.83, df=1164.2, p<0.00005). Opinions of significant others- family and friends (r=0.22, p<0.005) and health professionals (r=0.74, p<0.005) were associated with willingness to take the vaccine. Vaccine hesitancy was present in the study population with 32.6% being unsure and 15.6% declaring that they were not willing to take the vaccine. Females were more likely to be unsure (Chi-squared=14.63, df=4, p=0.006). Lack of vaccine safety was the main reason cited for unwillingness to take the vaccine. Predictors for willingness to take the vaccine were: i) The belief that the COVID-19 vaccine will protect the health of the people who take it; ii) Valuing the advice of health professionals regarding the effectiveness of COVID-19 vaccine; iii) Having taken the influenza vaccine last year and; iv) Encouraging their elderly parents to take the vaccine.

CONCLUSIONS

COVID-19 vaccination information campaigns should promote group strategies, focusing on emphasising the safety of the vaccine and offer reassurance, especially to women.

Knowledge of bladder cancer in the French population: results of the EDIFICE 6 survey

OBJECTIVE

To assess awareness of bladder cancer (BCa) in France.

METHODS

The French nationwide observational survey EDIFICE 6 was conducted online (26 June-28 July 2017) in 12,046 individuals (age, 18-69 years). The present analysis focuses on laypersons' knowledge of the severity and frequency of BCa, signs and symptoms, associated risk factors and screening tests. Quantitative data were expressed as means and standard deviation, and categorical data as percentages.

RESULTS

Analyses were conducted on 11,313 questionnaires. Among the top five acknowledged risk factors for BCa, tobacco was ranked as having the second lowest impact (5.9/10 [2.5]). Only 28% of the study population were aware that active tobacco smoking is a major risk factor for BCa (rating ≥8/10); 61% of the study population was unaware of the existence of any signs or symptoms of BCa, and 69% was not able to cite any of the most widely used diagnostic tests.

CONCLUSIONS

We found that the French population has a poor knowledge of BCa risk factors, early signs and diagnostic tests. Effective prevention of BCa requires dissemination of clear information and prevention messages to the lay population, focusing particularly on tobacco consumption and early signs of the disease.

Pharmacist's attitudes and knowledge of pharmacogenomics and the factors that may predict future engagement

BACKGROUND

While pharmacists are well positioned to implement pharmacogenomic testing in healthcare systems, uptake has been limited.

OBJECTIVE

The primary objective of this survey was to determine how post-graduate education and training influences pharmacist's knowledge and attitudes of pharmacogenomic testing.

METHODS

Survey questions were developed by the study team, and responses were collected electronically using REDCap™. The electronic survey was sent to all pharmacists (n=161) within a large, multi-state healthcare system by email.

RESULTS

A total of 75 (47%) respondents completed all aspects of the survey. The majority of respondents were female (60%), worked in acute care settings (57%), were full-time employees (80%), and worked in an urban area (85%), with many graduating in or after 2010 (43%). For post-graduate education, 36% of respondents completed a Post-Graduate Year One Residency (PGY-1), and 27% had a board certification. Those that completed a PGY-1 residency were significantly more likely to have received formal training or education on pharmacogenomics than those who had not. They also assessed their own knowledge of pharmacogenomic resources and guidelines higher than those without PGY-1 training. More recent graduates were also significantly more likely to have received formal training or education on pharmacogenomics. Additionally, pharmacists who completed a PGY-1 residency were more likely to respond favorably to pharmacogenomics being offered through pharmacy services. Pharmacists with board certification were more comfortable interpreting results of a pharmacogenomic test than those without board certification.

CONCLUSIONS

Pharmacists who have completed a PGY-1 residency or received board certification appear more comfortable with interpretation and implementation of pharmacogenomic testing.

Exploring Australian pharmacists' perceptions and attitudes toward codeine up-scheduling from over-the-counter to prescription only

Objective:

Explore the perceptions, attitudes and experiences of pharmacists relating to the up-scheduling of low dose codeine containing analgesics and the impact on pharmacy practice.

Methods:

A mixed design method was used consisting of an anonymous online questionnaire survey to quantitatively capture broad pre-scheduling change perceptions paired with a series of in-depth post-scheduling semi-structured interviews to provide a qualitative picture of the impact of codeine up-scheduling on pharmacy practice in Australia.

Results:

A total of 191 pharmacists completed the quantitative survey and 10 participated in the in-depth interview. The majority of respondents supported the decision to up-schedule over-the-counter combination products containing codeine to some degree. Three main themes emerged from the data: pharmacists’ perceptions of the codeine up-scheduling decision, preparing for the up-schedule and impact of the up-schedule on pharmacy practice. Pharmacists were concerned about the impact of up-scheduling on the pharmacy business, patient access to pain relief and the diminishment of their professional role.

Conclusions:

There were diverse perceptions, preparedness and impact on practice regarding the up-scheduling of low dose codeine products. Further research should be conducted to gauge if and how these perceptions have changed over time and to identify whether pain is being managed more effectively post codeine up-scheduling.

Why African Americans say "No": A Study of Pharmacogenomic Research Participation

Objective

To identify reasons for nonparticipation by African Americans in cardiovascular pharmacogenomic research.

Design

Prospective, open-ended, qualitative survey.

Setting

Research staff approached patients eligible for the Discovery Project of The African American Cardiovascular pharmacogenomics CONsorTium in the inpatient or outpatient setting at four different institutions during September and October 2018.

Participants

Potential Discovery Project participants self-identified as African American, aged >18 years, were on one of five cardiovascular drugs of interest, and declined enrollment in the Discovery Project.

Main Outcome Measures

Reasons for nonparticipation.

Methods

After declining participation in the Discovery Project, patients were asked, "What are your reasons for not participating?" We analyzed their responses using a directed content analytic approach. Ultimately, responses were coded into one of nine categories and analyzed using descriptive statistics.

Results

Of the 194 people approached for the Discovery Project during an eight-week period, 82 declined participation and provided information for this study. The most common reason for refusal was concern about the amount of blood drawn (19.5%). The next most common reasons for refusal to participate included concerns about genetic testing (14.6%) and mistrust of research (12.2%). Across study sites, significantly more patients enrolled in the inpatient than outpatient setting (P<.001). Significantly more women and younger individuals declined participation due to concerns about genetic testing and too little compensation (P<.05).

Conclusions

Collection of blood samples and concerns about genetic testing are obstacles for the recruitment of African Americans to pharmacogenomics studies. Efforts to overcome these barriers to participation are needed to improve representation of minorities in pharmacogenomic research. Enrolling participants from inpatient populations may be a solution to bolster recruitment efforts.

Knowledge of the audiological effects, symptoms and practices related to personal listening devices of health sciences students at a South African university

OBJECTIVE

This study aimed to determine the knowledge of first year health sciences students at a South African university regarding hearing loss and symptoms attributable to personal listening devices and their practices concerning the use of personal listening devices.

METHOD

This was a cross-sectional study carried out using an anonymous self-administered questionnaire.

RESULTS

Of 336 students, 269 (80.1 per cent) completed the questionnaire. While most participants could identify symptoms that could be caused by extensive use of personal listening devices, almost 30 per cent did not know that it could cause permanent hearing loss. Personal listening devices were used by 90.7 per cent of participants, with 77.8 per cent having used them for more than five years. Use was at a high volume in 14.9 per cent of participants and for more than 2 hours per day in 52.7 per cent.

CONCLUSION

The findings indicate the need for an educational programme to inform students as to safe listening practices when using personal listening devices.

A comprehensive view of knowledge and osteoporosis status among type 2 diabetes mellitus in Malaysia: A cross sectional study

Background:

osteoporosis and diabetes mellitus are highly prevalent diseases that have potentially devastating effects on health and socioeconomic status.

Objective:

The aims of this study were to assess: 1) the level of osteoporosis knowledge among T2DM patients; 2) the correlation, associations or differences of demographic characteristics, diabetes-related variable, as well as, lipid and blood pressure profiles with osteoporosis knowledge; and 3) the correlation between T-score measurement using quantitative ultrasound scan (QUS) and osteoporosis knowledge.

Methods:

A cross-sectional study design was chosen, where data was collected using a self-report structured questionnaire using osteoporosis knowledge - Malay version questionnaire (OKT-M) among T2DM patients. Furthermore, the clinical data regarding the patients were collected retrospectively from the hospital medical record after patient interview was completed.

Results:

The average age of the patients was 62.67 (SD 9.24) years (ranged from 33 to 87 years). Males (231, 51.30%) slightly outnumbered females. Among the racial distribution, the proportion of Chinese patients (204, 45.30%) was higher than Malay (127, 28.20%) and Indian patients (119, 26.40%). In addition, more than three quarters (343, 76.20%) of patients had poor glycaemic control. The average OKT-M total score, OKT-M Exercise subscale and OKT-M Calcium subscale were 12.55 (SD 4.06), 8.60 (SD 2.89) and 8.40 (SD 3.36), respectively. Only 33.30% of the T2DM patients were found to have high level of osteoporosis knowledge. There was a lack of identification and recognition of osteoporosis risk factors. There were significant differences or associations between osteoporosis knowledge and education level, monthly income, employment status, family history of fracture, smoking habit, alcoholic status, insulin use, therapy type and diastolic blood pressure. In addition, significant and positive correlations were found between T-scores and OKT-M total score (n=450, rs= 0.244, P=0.000), OKT-M Exercise subscale (n=450, rs= 0.219, P=0.000) and OKT-M Calcium subscale (n=450, rs=0.199, P=0.000) among T2DM patients (all Ps<0.05).

Conclusions:

Overall, the study results showed a valuable insight into the knowledge toward osteoporosis, as well as its relation to the bone loss among T2DM patients. It is important to understand the basics of osteoporosis prevention behaviours such as adequate calcium intake and regular exercise which are essential to build and maintain healthy bones throughout life among T2DM.

Evaluation of vitamin B12 monitoring in patients on metformin in urban ambulatory care settings

Background:

Previous studies linked metformin use to vitamin B12 deficiency and demonstrated that the prevalence of vitamin B12 monitoring remains low.

Objective:

This study aimed to assess the occurrence of monitoring vitamin B12 levels in a diverse population.

Methods:

This was a retrospective chart review of adult patients with type 2 diabetes on metformin doses ≥ 1000 mg for ≥ 6 months at five Federally Qualified Health Centers (FQHC) and one Program of All-Inclusive Care for the Elderly (PACE). Charts were reviewed for occurrence of monitoring vitamin B12 levels in the past 5 years. Data collected included patient demographics, laboratory data, other potential vitamin B12 level lowering agents, active prescription for vitamin B12 supplementation, concomitant diabetes medications and metformin total daily dose.

Results:

Of the 322 patients included, 25% had a vitamin B12 level measured in the previous five years. Among the patients with a vitamin B12 level, 87.7% were within the normal range (>350 pg/mL), 11.1% were low (200-300 pg/mL), and only one patient (1.2%) was deficient (<200 pg/mL). These patients were older (69.2 vs. 56.4, p<0.001); more likely to be white (56.8% vs. 37.8%, p=0.04); and more likely to use proton pump inhibitors (34.6% vs. 20.7%, p=0.02) and vitamin B12 supplementation (27.2% vs. 4.6%, p<0.001). Vitamin B12 monitoring differed between the FQHC (15.2%) and PACE (97.4%) sites (p<0.001). Each greater year of age was associated with a 5% increased odds of vitamin B12 monitoring (a OR: 1.05; 95% CI: 1.02-1.08).

Conclusions:

The majority of patients seen at the FQHC sites did not have vitamin B12 levels monitored, however, most of the patients who were monitored had normal vitamin B12 levels, which may warrant extending the monitoring time. This finding may also support monitoring patients who have additional risk factors for vitamin B12 deficiency such as concurrent medication use with other vitamin B12 lowering agents or clinical symptoms of deficiency such as peripheral neuropathy. Future studies are needed to determine appropriate frequency of monitoring.

Evaluation of an interprofessional naloxone didactic and skills session with medical residents and physician assistant learners

Background

The CDC has reported 399,230 opioid-related deaths from 1999-2017. In 2018, the US surgeon general issued a public health advisory, advising all Americans to carry naloxone. Studies show that enhanced naloxone access directly reduces death from opioid overdose. Despite this, health care professional learners report low knowledge and confidence surrounding naloxone. Therefore, it becomes critical that medical education programs incorporate didactic and experiential sessions improving knowledge, skills and attitudes regarding harm reduction through naloxone.

Objectives

1. Describe the components and evaluation of a replicable and adaptable naloxone didactic and skills session model for medical providers; 2. Report the results of the evaluation from a pilot session with family medicine residents and physician assistant students; and 3. Share the session toolkit, including evaluation surveys and list of materials used.

Methods

In July 2017, a literature search was completed for naloxone skill training examining best practices on instruction and evaluation. A training session for family medicine residents and physician assistant learners was designed and led by University of Cincinnati College of Medicine and College of Pharmacy faculty. The same faculty designed a pre and post session evaluation form through internal review on elements targeting naloxone knowledge, attitude, and self-efficacy.

Results

The training session included one hour for a didactic and one hour for small group live skills demonstration in four methods of naloxone administration (syringe and ampule, nasal atomizer, branded nasal spray and auto injector). Forty-eight participants showed statistically significant (p<0.05) improvement in knowledge (67.5% to 95.9%), attitudes (71.2% to 91.2%), and self-efficacy (62.1% to 97.8%) from pre to post assessment. Forty-four of 48 participants agreed that the pace of the training was appropriate and that the information will be of use in their respective primary care practices. Supply costs for the session were USD 1,200, with the majority being reusable on subsequent trainings.

Conclusions

Our study of a naloxone didactic and skills session for primary care trainees demonstrated significant improvements in knowledge, self-efficacy, and attitudes. It provides an adaptable and efficient model for delivery of knowledge and skills in naloxone administration training. The pilot data suggest that the training was efficacious.

Knowledge, attitude, practice, and clinical recommendation toward infection control and prevention standards among nurses: A systematic review

BACKGROUND

The purpose of this study was to systematically review the literature to describe nurses' knowledge and practice of and attitude toward infection control and prevention standards.

METHODS

In the present systematic review, 4 electronic databases were searched from the inception of databases through March 2018. Quality of included studies was assessed using the Hoy tool.

RESULTS

Eighteen studies conducted on 4,577 employed nurses and nursing students entered the final stage. Results indicated that nurses in most studies had adequate knowledge (n = 10, 40%-90%) and positive attitude (n = 4, 37%-100%). However, most studies reflected average and poor nursing practices with regard to adherence to infection control and prevention standards. The most frequent recommendations proposed for improving nurses' knowledge, attitude, and practice included periodic training via scientific conferences and relevant practical courses (n = 12), combining up-to-date theoretical and practical programs (n = 6), and training at the beginning of hospital employment (n = 4).

CONCLUSIONS

The results of the present study indicate that although nurses in most studies had adequate knowledge of and positive attitude toward health care-associated infections, because of average and poor practices, they need systematic and integrated implementation of the presented recommendations.

Perceptions in the community about the use of antibiotics without a prescription: Exploring ideas behind this practice

Objective:

The use of antibiotics without prescription is common in Colombia as well as in other developing countries. The objective of this study is to explore the attitudes and motivations associated with the use of antibiotics without prescription.

Methods:

Focus group sessions were held with residents of Bogotá. Different socioeconomic groups were approached to identify possible differences of opinion. A semi-structured interview guide was used to guide the discussion, with thematic analysis used to identify central themes.

Results:

In total, 21 people, aged between 25 and 50 years participated in four focus groups. The results suggest that the use of antibiotics without prescription is common practice. The main reasons included barriers to access to prescribed medications due to limited health insurance. Even those with adequate access to health insurance report being willing to use a treatment without a prescription if they have confidence in its effectiveness. The relationship with the physician is important, but pharmacy storekeepers are also highly trusted. While some participants understood that antibiotics can cure infections but cause serious adverse events, several misconceptions about antibiotics therapy were identified. These included a lack of knowledge of resistance transmissibility among communities.

Conclusions:

The results have implications for interventions aimed at reducing inappropriate use of antibiotics, highlighting i) how lack of access to timely care creates an incentive to self-prescribe, ii) the key role that pharmacy storekeepers play in the Colombian healthcare system and the need to include them in interventions, and iii) the misconceptions about inappropriate use of medications that need to be addressed by educational programs. These findings provide insights to other countries where antibiotics misuse is also a problem.

Pharmacists' immunization experiences, beliefs, and attitudes in New Brunswick, Canada

Background:

The expansion of pharmacist scope of practice to include provision of immunizations has occurred or is being considered in various countries. There are limited data evaluating the experiences of Canadian pharmacists in their role as immunizers.

Objective:

To describe the experiences of pharmacists in the Canadian province of New Brunswick as immunizers, including vaccines administered and perceived barriers and facilitators to providing immunizations.

Methods:

An anonymous, self-administered, web-based questionnaire was offered via email by the New Brunswick Pharmacists’ Association to all its members. The survey tool was adapted, with permission, from a tool previously used by the American Pharmacists Association and validated using content validity and test-retest reproducibility. Pharmacist reported immunization activities and perceived facilitators and barriers to providing immunization services were assessed.

Results:

Responses from 168 (response rate of 26%) were evaluable. Approximately 90% of respondents worked in community practice full time, 65% were female and 44% were practicing for 20 or more years. Greater than 75% reported administering: hepatitis A and B, influenza, and zoster vaccines. The majority of respondents felt fully accepted (agreed or strongly agreed) as immunization providers by patients, local physicians, and the provincial health department (97%, 70%, and 78%, respectively). Most commonly reported barriers were: lack of a universally funded influenza immunization program, insufficient staffing and space, and concerns around reimbursement for services.

Conclusions:

Pharmacists in New Brunswick, Canada are actively participating in the provision of a variety of immunizations and felt fully supported by patients and other healthcare providers. Barriers identified may provide insight to other jurisdictions considering expanding the role of pharmacists as immunizers.

Swedish patients' trust in the bioequivalence of interchangeable generics. What factors are important for low trust?

Background:

Generic substitution (GS), is a cost-containment strategy meant to contain pharmaceutical expenditure without compromising health objectives. In order to shape GS into a policy that is both efficient and safe it is crucial to understand which factors are most important for patients’ trust in GS.

Objective:

To assess Swedish patients’ level of trust in the bioequivalence of cheap and expensive generic medicines, and the association between trust and various factors.

Methods:

A cross-sectional study was conducted. Questionnaires were handed out at 12 community pharmacies in Sweden, selected through stratified sampling, between March and April 2015. The questionnaire included seven socio-demographic questions in addition to 18 items divided into three sections: the ‘views on generic medicine’-scale, information on and prior experiences of GS, financial aspects and change of color/name. Odds Ratios (ORs) were estimated applying adjusted logistic regression analyses with trust in the bioequivalence of generic medicines used as outcome variable and various factors as predictors.

Results:

A total of 719 patients participated (response rate 85.7%). The results show that 70.7% of the respondents’ trust that cheap and expensive interchangeable generic medicines are equal. Of the respondents 36.0% considered the change in appearance and 40.8% the change in names to complicate adherence. Lower trust in the bioequivalence of generic medicines were associated with being female (aOR=1.82, 95%CI 1.20:2.75, p<0.01), patients perceiving that changes in product name and appearance make adherence more complicated (aOR=2.18, 95%CI 1.48:3.19, p<0.001), disagreeing in that GS saves money for me (the customer) (aOR=2.68, 95%CI 1.58:4.55, p<0.001) or that GS saves money for society (aOR=3.21, 95%CI 1.46:7.08, p<0.01).

Conclusions:

Seven out of ten respondents had trust in the bioequivalence of generic medicines, and one in three considered GS to complicate adherence. Four factors were associated with lower trust in GS, i.e. female gender, agreeing that changes in product name and appearance complicates adherence, disagreeing in that GS saves money for me or disagreeing in that GS saves money for the society. Low trust in GS needs to be addressed, not least in the communication between health professionals and patients.

Health promotion of bowel cancer and breast cancer screening in community pharmacies: Pharmacists' perceptions of their role, knowledge and confidence

Objectives:

To identify community pharmacists’ perceptions of their role, knowledge and confidence in relation to bowel cancer and breast cancer screening health promotion.

Methods:

This was a mixed-methods study with community pharmacists and key informants in the Metro South Health (MSH) region of Brisbane, Queensland, Australia. In Part 1, quantitative data was collected from community pharmacists via an electronic survey. In Part 2, qualitative data was collected from community pharmacists and key informants via in-depth interviews. This paper reports the findings of community pharmacists’ perceptions of their role, knowledge and confidence to promote bowel cancer and breast cancer screening in community pharmacies.

Results:

A total of 27 community pharmacists (13 males, 14 females) completed the survey. Most (71%) either ‘agreed’ or ‘strongly agreed’ discussing health advice, such as cancer screening, with their consumers was valuable and integral to their broader role. An average of 60% described their confidence as ‘average’ or ‘good’ when discussing bowel and breast cancer screening and prevention with consumers. In eight knowledge questions about bowel and breast cancer and cancer screening, an average of 82% of community pharmacists responded with correct answers (range 52% to 100%). Community pharmacists were consistently more confident and knowledgeable about bowel cancer services than breast cancer services. Five (5) community pharmacists participated in in-depth interviews. The interview findings supported the quantitative findings. Most community pharmacists described their confidence to promote bowel cancer and breast cancer screening as moderate, and consistently reflected they felt more knowledgeable and confident about bowel cancer topics than breast cancer topics.

Conclusions:

Overall, this research supports the feasibility of promoting bowel cancer screening in community pharmacies. It suggests further training is warranted for community pharmacists to increase their knowledge of breast cancer and their confidence in promoting breast cancer referral and screening services. It highlights the important role community pharmacists have in increasing engagement in the national bowel cancer and breast cancer screening programs, and in potentially decreasing the mortality rates of these cancers.

Knowledge, practice and attitudes regarding antibiotics use among Lebanese dentists

Objectives:

Explore antibiotic use, assess conformity with evidence-practice guidelines, and describe knowledge and attitudinal factors among Lebanese dentists.

Methods:

National cross-sectional telephonic survey, using a standardized questionnaire addressing demographic, educational and professional data, usual antibiotics prophylactic and curative prescription pattern and influential factors, knowledge concerning antibiotics use in selected patient-populations, and attitude regarding antimicrobial resistance. Analyses used descriptive statistics, and bivariate analysis to observe predictors of higher knowledge.

Results:

the overall response rate for the study was around 21%. 322 dentists participated. On average, 17.51% of consultations resulted in antibiotic use; previous antibiotic experience mostly influenced prescriptions (81.3%). Referral of pregnant and lactating women and cardiac patients, when antibiotics are needed, was high (26.9%, 28.5% and 79.4%, respectively). Macrolides were the dominant first-line antibiotics in penicillin allergy (47.4%). Penicillins were most common for pregnant and lactating women. Penicillins (95.0%), 2g (63.9%), and 1 hour pre-procedure (34%) were the main components of prophylaxis for cardiac patients. Prophylactic and curative use varied widely; few dentists exhibited guideline-conform prescriptions. Mean knowledge scores of prophylaxis for cardiac and non-cardiac patients, and antibiotics’ side effects were predominantly poor (46.75±14.82, 39.21±33.09 and 20.27±18.77, respectively over 100). Practicing outside Beirut, undergraduate qualification in Lebanon, and post-graduate qualification predicted higher knowledge. 75.9% acknowledged the contribution of dentistry-based prescribing to antibiotic resistance and 94.7% knew at least one cause of resistance.

Conclusions:

Dentists show positive attitude towards antimicrobial resistance. Yet, they lack uniformity in antibiotic stewardship. Poor knowledge and guideline-incongruent prophylactic and therapeutic prescribing are observed. Development of targeted interventions is needed to promote judicious antibiotic use within Lebanese dentistry.

Assessing pet owner and veterinarian perceptions of need for veterinary compounding services in a community pharmacy setting

Background:

Pets, pet owners (referred to as clients in veterinary medicine and throughout this article), veterinarians, and community pharmacies may all benefit from veterinary compounding services provided in community pharmacies, but the benefits of this service are not well-documented in the literature.

Objectives:

This study identified perceived benefits and barriers and evaluated the need for veterinary compounding services in community pharmacies; it also evaluated current business practices related to veterinary compounding services.

Methods:

A cross-sectional survey was administered to three groups: 1) clients who filled a pet prescription at a study pharmacy, 2) clients who had not filled pet prescriptions, and 3) local veterinarians. Eligible participants were 18 or older; clients must have owned a pet in the past five years. The surveys collected demographic information and assessed benefits, barriers, need, and business practices regarding veterinary compounding services. Demographics were evaluated through descriptive statistics. Responses to Likert-scale items were compared between groups using the Mann-Whitney U test. Qualitative responses were assessed for emerging themes.

Results:

One hundred eighteen clients and 15 veterinarians participated in the study. Seventy-two of 116 clients (62%) and eight of 10 veterinarians (80%) agreed that clients would benefit from veterinary compounds provided in community pharmacies. Only 40% of veterinarians agreed that community pharmacists have the knowledge to compound pet medications, compared to 67% of clients (P=0.010). Similarly, 47% of veterinarians agreed that community pharmacists have the skills to compound pet medications, compared to 72% of clients (P=0.016). Forty-eight of 118 clients (41%) would travel 10 miles or more out of their way for veterinary compounding services at community pharmacies.

Conclusions:

This study assessed client and veterinarian perceptions of veterinary compounding service benefits, barriers, and need in community pharmacies. Clients identified more opportunities for veterinary compounding services in community pharmacies when compared to veterinarians. Both groups identified a need for veterinary compounding services and agreed community pharmacies providing these services would benefit pets and clients.

Knowledge of pharmacists and parents towards antibiotic use in pediatrics: a cross-sectional study in Lebanon

Objectives

to assess the knowledge of both parents and community pharmacists regarding antibiotics use and resistance in pediatrics in Lebanon.

Methods

A cross-sectional study was conducted between June and August 2017 in community pharmacies. A pre-established questionnaire targeting knowledge of parents and pharmacists regarding antibiotics use/misuse was carried out. An index of knowledge was computed to assess factors associated with good knowledge on antibiotics use/misuse.

Results

The study showed that 28.7% of pharmacists did not know which factors may contribute to antimicrobial resistance. Concerning the misuse of antibiotics, pharmacists blamed at first parents (90.1%), at second level physicians (72.8%), and third themselves (59.4%). Furthermore, pharmacists believed that the socioeconomic problems of the country (86.1%), the level of resistance to the molecule of choice (80.8%), the lack of consultation time (71.2%) and the lack of national guidelines/recommendations (66.3%) might be additional factors contributing to antimicrobial resistance. In case of acute otitis media, the majority of pharmacists chose the correct treatment, dose and duration according to international guidelines; this was in contrast to the results obtained in case of pharyngitis. Female pharmacists had a significantly higher knowledge score compared to their male counterparts (ORa=2.51). Half of parents (42.6%) declared that antibiotics act against both viruses and bacteria, 55.9% still believe that the presence of fever requires the administration of antibiotics, 50% didn't know the consequences of antibiotics misuse, 58.4% said that it is okay to give their child antibiotics without a physician's advice or based on a pharmacist's recommendation, and 66.7% trusted the pharmacist in the antibiotic prescription. Parents with a university level of education or a master's degree had significantly better knowledge compared to illiterate ones (ORa=9.04 and ORa=16.46, respectively).

Conclusions

Based on the results obtained, it would be necessary to implement educational campaigns in order to increase awareness on antibiotics misuse and resistance in pediatrics.

Paediatric antimicrobial stewardship and safe prescribing: an assessment of medical staff knowledge and behaviour

Objective

Determine baseline knowledge of antimicrobial stewardship, and safe prescribing among junior medical officers, monitor their level of participation in interactive education during protected teaching time and assess day-to-day prescribing behaviours over the subsequent 3-month period.

Methods

A voluntary and anonymous survey of all non-consultant level medical officers was conducted with the use of an audience response system during mandatory face-to-face orientation sessions at a tertiary paediatric hospital. Routine prescribing audits monitored compliance with national and locally derived quality use of medicines indicators.

Results

Eighty-six percent of medical officers participated by responding to at least one question (171/200). Response rate for individual questions ranged between 31% and 78%. Questions that addressed adverse drug reactions, documentation and monitoring for empiric antibiotics and the error-prone abbreviations IU and U were correctly answered by over 90% of participants. Other non-standard and error-prone abbreviations were less consistently identified. In practice, 68% of patients had complete adverse drug reaction documentation (113/166). Error-prone abbreviations were identified on 5% of audited medication orders (47/976), approximately half included a documented indication and intended dose.

Conclusions

Participants demonstrated a good understanding of safe prescribing and antimicrobial stewardship. Audits of prescribing identified potential discrepancies between prescribing knowledge and behaviours.

Pharmaceutical care in community pharmacies in Jordan: a public survey

OBJECTIVE

This study aims to assess the views and attitudes of the general public towards the current role of pharmacists in Jordan.

METHODS

This study is a cross-sectional quantitative questionnaire-based study. After a thorough literature review on public perspectives of pharmaceutical care services, a draft questionnaire was designed. This questionnaire was examined and discussed in a focus group of invited public members and was amended accordingly to reach the final draft. The questionnaire was administered using a structured interview technique in which members of the public were asked a series of questions by a trained pharmacist. The study took a place over a period of six months, from January to June 2013. Individuals were recruited from urban and rural areas of Jordan.

RESULTS

A total of 1214 respondents were interviewed during the study. Of the respondents, 67.8% were female. Most of the respondent were married (64%) and had a university degree (88.5%). Approximately half of the respondents (55.1%) had no previous knowledge of pharmaceutical care. A relative majority of respondents considered the most important activity performed by pharmacists to be dispensing medications (46.2%), followed by patient counseling (34.6%). The majority of respondents (86.4%) believed that pharmacists have a role in providing healthcare services, and 68% of respondents reported that in order to serve their needs, a pharmacist must consider the patient's needs and engage patients in determining medication timing and options.

CONCLUSIONS

The plurality of respondents believed in the importance of pharmacists in providing pharmaceutical care services. However, respondents expected much from pharmacists and felt that their current role was unsatisfying.

Awareness and Acceptance of HIV Pre-exposure Prophylaxis among Medical Personnel and Men Who Have Sex with Men in Korea

BACKGROUND

We aimed to investigate the awareness of human immunodeficiency virus (HIV) infection among high-risk individuals, including men who have sex with men (MSM) and medical personnel (MP) in Korea through a cross-sectional survey, identify possible obstacles hindering their access to pre-exposure prophylaxis (PrEP).

METHODS

In 2016, the first questionnaire survey was sent to randomly selected MSM and MP. To compare the changes in attitudes and knowledge of MSM, a second questionnaire survey was conducted in August 2017.

RESULTS

More than half of MSM (61.3% in 2016, 88.6% in 2017) were aware of PrEP. However, MP who offered PrEP had less knowledge regarding PrEP (23.4%). The background knowledge and experience with PrEP among MSM and MP in this survey was low (3.4% in 2016 and 5.7% in 2017, 1.9% in MP). The major obstacles that MSM reported were lack of insurance coverage (29% in 2016 and 32% in 2017), concern regarding adverse effects of PrEP (19% and 21%), and risk of exposing HIV-positive status to other people (15% and 18%). Among MP, lack of knowledge regarding the efficacy of PrEP was the most common obstacle (30%), followed by lack of insurance coverage (22%), and concern regarding adverse effects (20%).

CONCLUSION

Our study showed that PrEP is required among MSM in Korea; however, most MP were not aware of PrEP. Lack of insurance coverage and knowledge regarding PrEP were major hindrances in the access to PrEP; therefore, further studies on how to make PrEP information more accessible are needed to help prevent HIV infection.

Baseline knowledge of potential pet toxins: a survey of pharmacists

Background:

Consumer expenditures on their family pets are rapidly increasing, part of which can be attributed to prescription and OTC medications. In turn, community pharmacies are seeking and receiving an increased number of prescriptions for animals. Community pharmacists’ ability to safely care for animal patients is relatively unexplored. Human medications, their normal dosing and even medication excipients could be lethal in some animal patients.

Objective:

The overarching objective of this study was to assess pharmacists’ baseline knowledge of potential pet poisons.

Methods:

The sample consisted of licensed pharmacists registered with the North Carolina Board of Pharmacy. The Pet Toxins Survey (PTS), a survey consisting of 25 potential pet toxins, was administered during October and November 2015. Analyses consisted of calculating descriptive statics (including graphical summaries to test for normality), and inferential statistics (two-tailed t-tests and ANOVAs) to compare responses across demographic variables.

Results:

A 6.3% response rate was obtained. After selecting either a dog or a cat to establish a frame of reference, participants in this study were able to correctly identify 15 of the 25 listed items as toxic to a pet (60% accuracy). Participants did not express adequate concern for the ingestion of several potential toxins. This includes potential excipients found in medication formulations such as xylitol, tea tree oil and caffeine. Female participants and those age 50 years and older were more likely to indicate concern for each potential toxin. There was no significant difference observed in responses based on the pharmacists’ work setting.

Conclusions:

The findings of this investigation suggest that pharmacists are deficient in their understanding of veterinary toxicology. Given the rise of community pharmacists caring for animal patients, it’s paramount that pharmacists be able to confidently distinguish potential pet toxins from non-toxins. It is also important that pharmacists receive a better understanding of what exposures require immediate action and what action should be taken.

A qualitative exploration of hypertensive patients' perception towards quality use of medication and hypertension management at the community level

Objective

This study aimed to explore hypertensive patients' perspectives on quality use of medication and issues related to hypertension management at the community level in Malaysia.

Methods

Focus groups discussion was employed in this qualitative study. A total of 17 hypertensive patients were purposively recruited. Three focus group discussions with semi-structured interview were carried out at Flat Desa Wawasan, Penang. All the conversations were audio recorded, transcribed verbatim and thematically analysed.

Results

Three major themes were developed, including medication adherence among hypertensive patients, self-management of hypertension and patients' knowledge towards hypertension. Poor medication adherence was found and different strategies were taken to overcome the barriers towards adherence. Use of herbal and traditional therapies was perceived as alternative method in controlling blood pressure instead of taking antihypertensive medication. The participants were found to have poor knowledge on side effect and mechanism of action of hypertensive medication.

Conclusions

The misconception about the side effect of antihypertensive medication has led to poor adherence among the participants. Lack of knowledge on targeted blood pressure level has led to poor blood pressure monitoring among the participants. Health awareness program and counselling from health care professional should be advocated among the hypertensive patients in addressing the above gaps.

Awareness of the implementation of the Falsified Medicines Directive among pharmaceutical companies' professionals in the European Economic Area

BACKGROUND

The Falsified Medicines Directive (FMD) is a response of the European Union to the increasing number of falsified medicines present in the legal supply chain within the Member States of the community. Effective implementation of the new regulations will depend on the effective cooperation of all parties involved in the distribution of medicinal products including the managers of pharmaceutical companies.

OBJECTIVE

The objective of the study was to examine awareness of the Implementation of the FMD among pharmaceutical company professionals in the European Economic Area.

METHODS

Sampling was conducted using a method called purposive sampling. An appropriate research tool in the form of an original questionnaire was made available to the respondents in electronic form. During the period from January 2016 to June 2016, 1,496 e-mail messages were sent. The response rate was 17.37%.

RESULTS

The study included 99 women (39.3%) and 153 men (60.7%). In the study group, 95.7% of people had heard of FMD. Doctors had rarely heard about the falsified medicine directive when compared to pharmacists (p=0.0063), people working in the pharmaceutical industry (p=0.0014), and respondents with a different professional profile (p=0.0114). In the study group, 89.6% of people were aware of the role of National Medicines Verification Organization in the process of implementing the provisions of FMD into the national system of distribution of medicinal products. The number of the respondents who knew the deadline for the implementation of FMD was significantly higher in the study population, i.e. 91.9% (p=0.0001). Both the younger respondents and those with lower level of education were less aware of the time requirements posed to national regulators (p=0.0003, p=0.0023, respectively).

CONCLUSIONS

Awareness of the regulations related to the implementation of the FMD, although relatively high among pharmaceutical company professionals in the EEA, is still insufficient.

Awareness of physicians and pharmacists of aldosterone antagonists in heart failure and myocardial infarction in Jordan

Objective:

to evaluate physicians and clinical pharmacists’ awareness and practices regarding use of aldosterone antagonists in heart failure (HF) and post-myocardial infarction (MI).

Methods:

First, we reviewed the prescription of aldosterone antagonists among 408 patients presenting to the cardiology clinic at a major hospital in Jordan. Second, physicians and pharmacists working in cardiovascular departments completed a questionnaire related to use of aldosterone antagonists in HF and post-MI.

Results:

Thirty patients (7.59%) were eligible for aldosterone antagonist; only 4 received them at discharge (13.3%). The survey was completed by 153 professionals (response rate 76.12%). About 72.1% of participants were aware of studies regarding use of aldosterone antagonists post-MI and in HF. Moreover, 10.45%/53.6% of participants strongly agreed/agreed that these agents are useful in normotensive post-MI and HF patients. Spironolactone was the most prescribed drug by 92.1% of participants. About 41.8% of participants reported use of spironolactone in post-MI and HF. With respect to guidelines, only 39.2% of participants agreed that adding spironolactone to standard therapy in HF is recommended, and 48.3% agreed on adding it directly post-MI. Clinical pharmacists and cardiologists were generally more aware of guidelines than pharmacists, cardiac surgeons and residents/fellows.

Conclusions:

there is an under-use of aldosterone antagonists in HF and post-MI patients, and a lack of detailed awareness of current guidelines among health care providers. Dissemination of evidence-based guidelines and usage protocols may improve management of post-MI and HF.

Communication About Sexual Matters With Women Attending a Danish Fertility Clinic: A Descriptive Study

Introduction

Several studies have shown that sexuality is an important aspect of life. Nevertheless, sexual matters are only rarely discussed between patients and doctors. Other studies have suggested that women undergoing fertility treatment compose a group of patients with low satisfaction in their sexual life.

Aim

To investigate how women at a fertility clinic desire and experience communication about sexual matters with doctors and to investigate the sexual function of these women.

Methods

A cross-sectional self-administered questionnaire survey of women attending a Danish fertility clinic over 4 months was performed. Descriptive statistics were calculated and presented as frequencies.

Main Outcome Measure

Communication about sexual matters with doctors included the women’s comfort, preferred and actual frequency of discussion, and initiation of the conversation. Sexual function included participants’ sexuality during the past year including certain sexual difficulties.

Results

Of the 201 participating women in the survey, most felt comfortable discussing sexual matters with doctors and preferred gynecologists for such discussions. There was a greater desire for communication than what was actually experienced by the women, and most wanted to initiate the conversation themselves. The women were less satisfied with their sexual life compared with a national control group, and they experienced sexual difficulties more often.

Conclusion

There is an unmet desire of women in fertility treatment for discussing sexual matters, and greater communication on this subject needs to be clinically implemented.

Eldridge KE, Giraldi A. Communication About Sexual Matters With Women Attending a Danish Fertility Clinic. A Descriptive Study. Sex Med 2017;5:e196–e202.

Assessment of health seeking behaviour and self-medication among general public in the state of Penang, Malaysia

Background:

Patients’ behaviour in making decisions regarding health is currently changing from passive recipients to recipients who play an active role in taking action to control their health and taking self-care initiatives.

Objectives:

This study was conducted to evaluate the health seeking behaviour among general public and its associated factors; and to evaluate the medicine taking behaviour in public and the practice of self-medication.

Methods:

A cross-sectional study was undertaken among general public in Penang Island, Malaysia. A convenience sampling of 888 participants successfully completed the survey. Self-administered questionnaires were distributed among the residents in the north east of Penang Island.

Results:

This study showed that most of the participants chose to consult the physician when they experience any health problems (66.7%), followed by self-medication (20.9%). The first action for consulting the physician was significantly predicted by Malay respondents and retired people (OR 3.05, 95% CI 1.04-8.89). The prevalence of self-medication was 54%. The practice of self-medication was significantly associated with Chinese participants, educated people, people with alone living status and people with more self-care orientation.

Conclusion:

Increasing the awareness of the public about the rational choice of getting medical assistance is a very important issue to control their health. A health education program is needed to increase the awareness about the use of medicines among the general public and to enable them to make the right decisions relating to health problems.

Knowledge, Attitude and Practices (KAP) Regarding Chronic Complications of Diabetes among Patients with Type 2 Diabetes in Dhaka

BACKGROUND

To reduce morbidity and mortality, awareness regarding diabetes and its complications is necessary. This study aimed at assessing the level of knowledge, attitude, and practices (KAP) regarding complications of diabetes mellitus among patients with type 2 diabetes in Dhaka, Bangladesh.

METHODS

A cross-sectional study was carried out recruiting patients with diabetes from the outpatient department of BIRDEM hospital in Dhaka. Overall, 425 patients with diabetes were enrolled in this study. A pretested questionnaire was filled by the interviewer with face to face interview. Levels of KAP were determined by calculating the scores. Multivarable linear regression was used to determine significant predictors for knowledge, attitude, and practices.

RESULTS

On average, the level of knowledge, attitude, and practices were 9.2 (out of 14), 7.9 (out of 13), and 16.9 (out of 27), respectively. Age and gender were significant predictors of knowledge and attitude. Females had better level of knowledge and attitude compared to males (βs = 0.55 and 1.24, respectively). Patients with graduate degrees and above compared to illiterates reported significantly greater knowledge and practice (βs = 1.27 and 1.44, respectively), after adjustments for covariates. Educational program was the most important significant predictor of KAP. Higher duration of diabetes (β = 0.07) and positive marital status (β = 1.21) had influenced better practice.

CONCLUSIONS

Lack of knowledge, poor attitude, and inadequate practice were found in this surveyed communinty. Level of education and educational program on diabetes were the most significant contributing factors. The current study suggests the need of structured educational programs on diabetes and its complications on a regular basis to assist patients in living a productive life.

Models and theories of prescribing decisions: A review and suggested a new model

To date, research on the prescribing decisions of physician lacks sound theoretical foundations. In fact, drug prescribing by doctors is a complex phenomenon influenced by various factors. Most of the existing studies in the area of drug prescription explain the process of decision-making by physicians via the exploratory approach rather than theoretical. Therefore, this review is an attempt to suggest a value conceptual model that explains the theoretical linkages existing between marketing efforts, patient and pharmacist and physician decision to prescribe the drugs. The paper follows an inclusive review approach and applies the previous theoretical models of prescribing behaviour to identify the relational factors. More specifically, the report identifies and uses several valuable perspectives such as the ‘persuasion theory - elaboration likelihood model’, the stimuli–response marketing model’, the ‘agency theory’, the theory of planned behaviour,’ and ‘social power theory,’ in developing an innovative conceptual paradigm. Based on the combination of existing methods and previous models, this paper suggests a new conceptual model of the physician decision-making process. This unique model has the potential for use in further research.

Provider and patient perception of psychiatry patient health literacy

Background:

Inadequate health literacy in adults is a nationwide issue that is associated with worse health outcomes. There is a paucity of literacy regarding rates of inadequate health literacy in psychiatric populations.

Objective:

The aim of the study was to identify an existing tool that would easily identify patients who had inadequate health literacy, so that a targeted intervention could be performed. Secondarily we attempted to compare rates of inadequate health literacy with providers’ perception of patients’ health literacy.

Methods:

We assessed health literacy in a psychiatric population by administering the Brief Health Literacy Survey (BHLS). Additionally, all psychiatry residents, psychiatrists, nurse practitioners, pharmacists, and social workers were surveyed to assess their perception of patient health literacy. Differences between patient health literacy and provider expectations of patient health literacy were compared.

Results:

Inadequate health literacy was identified in 31 out of 61 patients (50.8%) using 2 questions from the BHLS. Only 9 (29%) of patients who were identified as having inadequate health literacy were identified by both BHLS questions. In contrast, almost 100% of providers identified their patients, in general, as having inadequate health literacy.

Conclusions:

These results identify a higher rate of health literacy in a psychiatric inpatient population than in the general population. However, providers at this institution likely over-identify health literacy. This highlights the need for a health literacy tool that can easily target patients with inadequate health literacy for an intervention.

Assessment of attitudes and practices of young Malaysian adults about antibiotics use: a cross-sectional study

Objective:

The present study was aimed to evaluate the practices and attitudes of young Malaysian adults towards the use of antibiotics, and to determine the socioeconomic factors associated with the antibiotic use.

Methods:

A survey was carried in Cheras community by approaching a conveniently selected sample of 480 participants. A pre-tested questionnaire was used for data collection.

Result:

Of 480 participants approached, 400 agreed to participate in this study, giving a response rate of 83.3%. The study results showed that 42.75% of the participants exhibited poor attitudes towards antibiotic usage. Chinese race and high income were significantly associated with the positive attitudes towards antibiotic usage. It is shown that the practice of the participants towards antibiotics was relatively poor. The majority of participants agreed that they do not consult a doctor for minor illnesses (64%). The main reason for not consulting a doctor was the high fees of consultation (34.25%) and the inconvenience of visit (29.25%). However, a large proportion of respondents (77.5%) agreed that there is a need to enhance antibiotic education among public.

Conclusion:

The study results identified some crucial gaps in the attitudes and practices of Cheras community about the use of antibiotics. Thus, improving the public knowledge and changing their attitude towards antibiotic use along with proper interventions to regulate the ease of their availability would play a significant role for the effective use of antibiotics in the community.

Consumer views on safety of over-the-counter drugs, preferred retailers and information sources in Sweden: after re-regulation of the pharmacy market

BACKGROUND

The availability of over-the-counter drugs (OTCs) has increased in Sweden since a re-regulation of the pharmacy market in 2009, through which non-pharmacy retailers became permitted to provide certain OTCs.

OBJECTIVE

To examine the adult general public's views on safety, purchasing and information channels, storage and disposal of OTCs in Sweden, three years after the re-regulation of the pharmacy market.

METHODS

A questionnaire study in 2012-13 in a stratified, random sample of all inhabitants in Sweden ≥ 18 years old.

RESULTS

Totally 8,302 people (42%) answered the questionnaire. Seven percent found OTCs completely harmless regardless of how they are being used, 18% felt they should be used only on health professionals' recommendation. Differences in how OTCs are perceived were however found with regards to respondents' country of birth, family type, educational level and income. The pharmacy was still the preferred OTC drug retailer by 83% of the respondents and preferred information source by 80% Reasons for preferred retailers were primarily due to out of habit (45%), counseling provided (35%), the product range (34%) and the confidence in staff (27%). Analgesics are the most common OTCs to have at home (90%). The bathroom cabinet is the primary site for storage (42%) and 16% throw their OTC leftovers in the trash.

CONCLUSIONS

The study population does not consider OTCs as harmless regardless of how they are used, but on the other hand feels they should not be taken on health professionals' recommendation only. The pharmacy is still the preferred retailer and information source, and there is room for further improvement in the storage and disposal of OTCs. A return of OTC drug leftovers to the pharmacy should be further encouraged. Due to several limitations, great caution should however be observed when generalizing the results to the adult population of Sweden.

Public knowledge, attitudes and practices regarding antibiotic use in Kosovo

Background:

Antimicrobial resistance is becoming a major public health challenge worldwide, caused primarily by the misuse of antibiotics. Antibiotic use is closely related to the knowledge, attitudes and behaviour of a population.

Objective:

The objective of this study was to assess the level of knowledge, attitudes and practices about antibiotic use among the general public in Kosovo.

Methods:

A cross-sectional face-to-face survey was carried out with a sample of 811 randomly selected Kosovo residents. The methodology used for this survey was based on the European Commission Eurobarometer survey on antimicrobial resistance.

Results:

More than half of respondents (58.7%) have used antibiotics during the past year. A quarter of respondents consumed antibiotics without a medical prescription. The most common reasons for usage were flu (23.8%), followed by sore throat (20.2%), cold (13%) and common cold (7.6%). 42.5% of respondents think that antibiotics are effective against viral infections. Almost half of respondents (46.7%) received information about the unnecessary use of antibiotics and 32.5% of them report having changed their views and behaviours after receiving this information. Health care workers were identified as the most trustworthy source of information on antibiotic use (67.2%).

Conclusion:

These results provide quantitative baseline data on Kosovar knowledge, attitudes and practice regarding the use of antibiotic. These findings have potential to empower educational campaigns to promote the prudent use of antibiotics in both community and health care settings.