Emergency pharmacy workforce views and experience related to the provision of pharmaceutical care during mass gathering events: the FIFA World Cup Qatar 2022™ experience

Purpose

This study aimed to explore emergency pharmacy workforce perspectives and experiences in providing pharmaceutical care during mass gathering events (i.e., FIFA World Cup Qatar 2022™).

Methods

A qualitative methodology was employed using focus groups discussions. Emergency pharmacists across Hamad Medical Corporation were invited to participate using a combination of purposive and snowball sampling. Focus groups were audio-recorded, transcribed verbatim, and validated. Inductive thematic analysis was undertaken to generate key themes and subthemes.

Results

Four focus groups were conducted which included 21 participants and generated five major themes. Whilst participants had mixed opinions in relation to their preparedness to practice during the World Cup, they perceived their experience as successful and smooth. The primary perceived facilitators were management support, mobile medical units, and high public health awareness. The main highlighted barriers were related to staff insufficiency, medications availability, and cultural and language challenges. Participants recommended pharmacist's role identification in mass gatherings, development of pharmacy action plan, and offering simulation training and pharmacy-specific training.

Conclusion

Despite the perceived barriers, pharmacists reported positive views in relation to their experience in providing pharmaceutical care during mass gatherings. Future research should focus on the development of theory-driven action framework for pharmacy departments to adopt during mass gatherings.

Mental Health Prescribers' Perceptions on the Use of Pharmacogenetic Testing in the Management of Depression in the Middle East and North Africa Region

Objective

A wide variety of commercial pharmacogenetic (PGx) tools are available worldwide to guide treatment selection for depression based on individuals' genetic profiles. However, the use of genetic testing to inform psychiatric care has faced challenges due to the limited training and education for mental health clinicians. The aim of this study was to explore the knowledge, level of engagement, and perspectives on the use of PGx testing when making depression management decisions among practicing psychiatrists within the Middle East and North Africa (MENA) region.

Methods

This is a qualitative study using semi-structured interviews. Consenting psychiatrists were interviewed through an online platform (Skype^TM or Microsoft Teams^TM). Interviews were audio recorded, transcribed, and thematically analyzed with the assistance of NVivo^® software.

Results

Eighteen interviews from 12 countries have been conducted. Analysis of the current interviews produced five major themes including: (1) Overall perceptions and attitudes; (2) Knowledge and awareness; (3) Education, training, and professional experience; (4) Facilitators and barriers; and (5) Ethical dilemmas. These themes support the notion that there is limited, mostly basic, education, knowledge, and training regarding genetic testing in the management of depression, although there is significant interest and willingness in the part of prescribers to adopt this strategy in their practice.

Conclusion

The findings of the study suggest that psychiatrists practicing in the MENA region appear to be interested in implementing PGx testing when managing people with depression. However, it is also important to recognize that this cannot be achieved unless more supporting strategies are implemented within their current health system environment.

Translating and piloting a cardiovascular risk assessment and management online tool using mobile technology

Background

Cardiovascular disease (CVD) risk assessment and management (RAM) services face many challenges and barriers in the community. Mobile technology offers the opportunity to empower patients and improve access to health prevention strategies to overcome these barriers. However, there is limited information on the availability and use of CVDRAM-related mobile technology in the Arabic language.

Objectives

To pilot test an Arabic version of a CVDRAM application among potential end-users accessing community pharmacy services in Qatar.

Methodology

Translation of an established cardiovascular risk calculator (EPI·RxISK™) into the Arabic language was conducted. The English/Arabic version of the calculator was tested by potential end-users, consisting of a sample of community pharmacists (CRxs) and members of the public (MOP) accessing community pharmacy services. Semi-structured interviews were conducted based on the quality attributes of the Mobile Application Rating Scale (MARS). Data were analyzed using deductive content analysis.

Results

A total of 10 CRxs and 5 MOP were interviewed. Five themes emerged to describe the EPI·RxISK™ calculator: Engagement, Functionality, Attractiveness, Education, and Responsiveness. For the most part, positive subthemes were associated with each of these themes. The functionality and educational themes had some negative subthemes.

Conclusion

End-users of the EPI·RxISK™ calculator had mostly positive descriptors that were aligned with all five quality attributes of the web and mobile applications.

Effect of Pharmacogenetic-Based Decision Support Tools in Improving Depression Outcomes: A Systematic Review

OBJECTIVE

Evidence supporting the utility of pharmacogenetic (PGX) tests in depression is scarce. The main objectives of this study were to summarize, update, and assess the quality of the available evidence regarding PGX testing in depression as well as estimating the impact of using PGX testing tools in depression outcomes in the Middle East/North Africa (MENA) region.

METHODOLOGY

Scientific databases were systematically searched from inception to June 30, 2020 for systematic reviews and randomized controlled trials (RCTs) assessing the clinical utility of PGX tests in the treatment of depression. Meta-analyses only and RCTs that were included in eligible systematic reviews were excluded. The quality of the eligible studies was assessed using the Crowe Critical Appraisal Tool (CCAT).

RESULTS

Six systematic reviews and three RCTs met the inclusion criteria and were included in this study. The results of the systematic reviews provided weak evidence on the efficacy of PGX testing, especially in patients with moderate-severe depression at 8 weeks. In addition, there was a lack of evidence regarding safety outcomes. Newer RCTs with better quality showed clinical promise regarding efficacy outcomes, especially in patients with gene-drug interactions. No evidence was found regarding PGX testing impact in the MENA region.

CONCLUSION

This systematic review is an update and summary of the available literature on the clinical utility of PGX testing in depression. The findings of this study demonstrate that PGX testing prior to treatment initiation or during the course of therapy may improve efficacy outcomes. Further studies are warranted to assess the impact of PGX testing on safety outcomes.

Perspectives of Healthcare Professionals Toward Interprofessional Collaboration in Primary Care Settings in a Middle Eastern Country

Background

Primary healthcare (PHC) setting is regarded as a central pillar to the healthcare system as it tends to be the first point of contact for patients. Interprofessional collaboration between healthcare professionals (HCP) in PHC settings remains unexplored in the Middle East.

Aim

The objective of this study was to explore the perspectives of HCP in PHC centers towards interprofessional collaboration and to identify the facilitators and the barriers to collaborative practice.

Methods

A cross-sectional, web- and paper-based survey involving HCP in PHC centers was conducted in Qatar. Descriptive statistics as well as Student's t-test and One Way ANOVA test were performed to determine statistical differences in Readiness for Interprofessional Learning (RIPLs) scores between demographic groups.

Results

Overall, 1415 participants out of a potential 2500 HCP practicing in Qatar completed the survey (response rate, 56.6%). HCP generally indicated a positive attitude and readiness towards interprofessional collaboration. Furthermore, physicians had slightly more positive readiness towards understanding their professional identity than other healthcare professionals. Participants with previous interprofessional collaboration or interprofessional education experiences exhibited greater, but non-significant positive attitudes toward interprofessional collaboration compared to those without previous experiences. Identified barriers and facilitators included are conceptual rather than structural. Facilitating factors included HCP readiness and perceived benefit of interprofessional collaboration effectiveness in the work setting, increased professional satisfaction, respect between healthcare professions, appreciation of others' contribution, leadership, and institutional support. Top perceived barriers included leadership and support, time commitment, and resources constraints.

Conclusion

HCP in PHC settings have demonstrated the willingness and readiness to engage in interprofessional collaboration. Recent reforms within the PHC setting consist of promoting interprofessional teams and collaborative culture. However, it is imperative to provide training and education to foster and support interprofessional collaborative practices.