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Treatment of Nausea During Pregnancy – Results from a Multinational, Cross-sectional, Internet-based Study
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64 Thompson2, P.A. Routledge2, 1School of Pharmacy and Pharmaceutical Sciences, Cardiff University,, 2School of Medicine, Cardiff University and, 3Welsh Medicines Resource Centre, Cardiff, Wales UK To obtain and evaluate pharmacy and medical students’ views on therapeutics and prescribing interprofessional education (IPE). Methods: Anonymous self-complete questionnaires were provided to medical and pharmacy students (n¼393) who participated in therapeutics and prescribing IPE sessions (2012/13). The session was developed and facilitated by medical and pharmacy faculty. Semistructured interviews were used to obtain more detailed views from students using non-purposive and convenience sampling. Audio-recorded interviews were transcribed. Data were analysed using content analysis. University ethics committee approval was obtained. Results: 380 completed questionnaires were received (97% response), 200 from medical and 177 from pharmacy students (3 did not state). The most frequently reported positive aspects from both groups were working with another profession (n¼212), therapeutics knowledge (195), medicines history-taking (138) and learning a new approach (121). The most common suggestions for improvements were allocation of partners (73), more preparation prior to session (70), clinical scenarios (45), additional sessions (42) and additional cases (25). Following questionnaire data analysis, semistructured interviews were conducted with 14 students. The interview data supported the findings but provided additional insight. Many respondents reported the potential advantage for current and future IP working, ‘I think they appreciate what we [pharmacists] do a bit more now because of the session’ (P), ‘I think working with a pharmacy student was good, we kind of complemented each other in our knowledge’ (M), ‘I think the main purpose of the session was to make us aware really that pharmacists are important too’ (M) and “we will be working with them in the future, so it was a good start working with them now” (P). Conclusion: The combination of methods has identified with sufficient detail what works well and what needs amendment. Work has already started on making future changes and discussions are underway on increasing IPE in both curricula. Travelling with Multiple Medicines: A Source of Medication Error and non-Adherent ‘Forgetting’ J. Tudball1,2, K. Ryan2, E. Manias3, L. Smith1, 1Faculty of Pharmacy, University of Sydney, Sydney, Australia, 2 Dept of Nursing and Midwifery, Latrobe University, Melbourne, Australia, 3Dept of Nursing, University of Melbourne, Melbourne, Australia One commonly cited reason for medication non-adherence and errors is ‘forgetting’ to take medicines. Research has identified the difficulty of remembering
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to take medicines whilst away from home, yet little indepth research exists that explores people’s own perspectives. This study examined the experiences of people taking multiple medicines to improve understanding of their daily use and management. Methods: Participants were 34 Australians taking 5+ prescription or over-the-counter medicines, recruited through GPs, pharmacies, e-newsletters, consumer organisations and snowballing. Semi-structured narrative interviews explored: multiple medicines use, medicines management, maintaining usual life, and messages for others taking multiple medicines. Interviews were videoand/or audio-recorded and transcribed verbatim. Constant comparative thematic analysis was conducted. Results: Travel was a key reason for forgetting to take medicines and making mistakes. Overseas travel and complex regimens posed particular challenges, such as crossing international datelines and maintaining medication routines when other daily routines were suspended. Packing medicines was complex, time-consuming and vulnerable to mistakes. The main challenges in travelling with medicines included: packing the correct doses for the period of travel; storage; availability of medicines at destination; language barriers; access to health services. Effective strategies for travelling with multiple medicines came with experience and knowledge gained from mishaps. Conclusions: People who take multiple medicines face challenges adhering to their medication regimen when travelling and devise many useful strategies from which others can learn. Patient’s experiences of travelling with multiple medicines can be informative for the community pharmacist who receives customer requests for advice about travelling with medicines, and from outof-town customers with medication concerns. Treatment of Nausea During Pregnancy – Results from a Multinational, Cross-sectional, Internet-based Study K. Heitmann1, L. Holst2, C. Maltepe3, A. Lupattelli4, H. Nordeng4, 1Department of Global Public Health and Primary Care and Centre of Pharmacy, University of Bergen, Bergen, Norway, 2The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Toronto, Canada, 3Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway, 4Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway No study has yet investigated the factors related to treatment of nausea during pregnancy in several countries simultaneously. This study aimed to describe differences in self-reported nausea in pregnancy and patterns of medicine use for nausea across regions, and investigate characteristics and beliefs about medicines of women treating nausea. Methods: This cross-sectional study used data from an internet-based questionnaire simultaneously distributed
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Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
within the period 1-Oct-2011 to 29-Feb-2012 in several countries in five regions; Western, Northern and Eastern Europe, North and South America and Australia. Pregnant women and women with a child aged %1 year were eligible to participate. Data was analysed using IBM SPSS Statistics 20. The study was approved by the relevant Ethics Boards in each country, whenever applicable. Preliminary Results: In total, 9,459 women were included, whereof 6,941 (73.4%) had experienced nausea during pregnancy. Both the prevalence of nausea and its treatment varied between regions. Of these women, 1,913 (27.6%) had used some form of treatment against nausea. Conventional medicines were used against nausea by 1,274 (18.4%) of the women, and herbal medicines by 568 (8.2%) women. Region of residence and folic acid use are factors that were significantly associated with use of treatment in general, and also with use of both conventional and herbal medicines. However, the factors’ influence varied according to type of treatment. Compared to untreated women both users of conventional and herbal medicines showed significant differences according to beliefs about medicines. Women who had nausea did also show a high burden of co-morbidity. Preliminary Conclusions: Regional differences of both the extent of nausea and its treatment were identified. Users of conventional or herbal medicines both differed from untreated women with regard to region of residence, folic acid use and beliefs about medicines. Understanding these factors could form an International basis for treatment strategies.
Understanding Treatment Experiences of Long-Term Users of Antidepressant Medications R. Singh1, J. Calmes1, M. Montagne2, 1University of Wyoming 1000 E. university Ave. Dept. 3375., Laramie, WY 820702, USA, 2MCPHS University 179 Longwood Ave. Boston, MA 02115 To understand the treatment experiences of patients, including perceptions on antidepressant effect, changes in personality, dependency, and addiction. Overall goal is to use this study to identify themes/variables for larger studies on patterns of antidepressant medication use. Methods: A cross sectional, descriptive, mixed method study design was used. In June 2007, 45 adults were interviewed using an interview guide. The instrument consisted of four sections: demographic characteristics, depression and medication history, antidepressant drug taking behaviors, and antidepressant drug effects. IRB approval was obtained. Quantitative analyses were performed using SPSSÒ. Qualitative analysis is currently being done for open ended questions using thematic analysis via NVIVO 10Ò qualitative software. Results: Almost all (93.3%) patients felt that their antidepressants had made their depression better. A slight majority (53.3%) of patients perceived a change in
their personality as a result of their use of antidepressants. Regarding their perceptions of the necessity of antidepressant use, 31% stated their use was their choice while 69% stated it was a necessity. The majority (63.6%) felt they were dependent on their antidepressant, but 88.6% felt they were not addicted to the medication. Preliminary qualitative analysis shows that patients were able to identify how the antidepressant helped them and to describe clearly the effects of not taking antidepressants. Patient perceptions of expectations and effects from antidepressants changed over time with use. It was interesting to note that most patients agreed that they were dependent but not addicted to their depression medication. Lastly, when asked about plans on continuing medications, most patients indicated that they would be taking antidepressants “till the day I die”. Conclusions: This study provided pilot information to help develop tailored intervention to improve long term antidepressant adherence. Such information will help health care professionals improve depression treatment and as a result lead to better caring of depressed patients’ needs.
University student's views on the self-prescribing of “study drugs” J.M. Traulsen, M.A. Petersen, L.S. Norgaard The purpose of this study is to understand the nonmedical use of prescription stimulants among university students in New York City and Copenhagen. The interest in this topic grows out of an increasing focus on medical enhancement and the use of prescription drugs for non-medical purposes in the field of social pharmacy. Methods: This study is based on ethnographic fieldwork. Methods include participant observation during two university semesters; one in Copenhagen and one in New York City as well as 80 in-depth interviews conducted with 20 students in New York and 15 students in Copenhagen. Results: The use of prescription stimulants – for purposes of cognitive enhancement turns out to be complex. The respondents use these drugs for better concentration, increased energy, and for motivational purposes. Risks and side-effects of the drugs do not appear to worry most users. As a matter of fact the respondents legitimize the use of the drugs by referring to others who use the same drugs on an everyday basis for treating ADHD. A major finding is that students consider it safe to use study drugs even though they have had no contact with health-care professionals regarding their use. Conclusions: Although the extent and scope of the use of ADHD medicines for non-medical purposes among university students is not known, this study suggests that it is increasing in Europe and North America and has largely become normalized in New York City. This study highlights the need for both quantitative and
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to take medicines whilst away from home, yet little indepth research exists that explores people’s own perspectives. This study examined the experiences of people taking multiple medicines to improve understanding of their daily use and management. Methods: Participants were 34 Australians taking 5+ prescription or over-the-counter medicines, recruited through GPs, pharmacies, e-newsletters, consumer organisations and snowballing. Semi-structured narrative interviews explored: multiple medicines use, medicines management, maintaining usual life, and messages for others taking multiple medicines. Interviews were videoand/or audio-recorded and transcribed verbatim. Constant comparative thematic analysis was conducted. Results: Travel was a key reason for forgetting to take medicines and making mistakes. Overseas travel and complex regimens posed particular challenges, such as crossing international datelines and maintaining medication routines when other daily routines were suspended. Packing medicines was complex, time-consuming and vulnerable to mistakes. The main challenges in travelling with medicines included: packing the correct doses for the period of travel; storage; availability of medicines at destination; language barriers; access to health services. Effective strategies for travelling with multiple medicines came with experience and knowledge gained from mishaps. Conclusions: People who take multiple medicines face challenges adhering to their medication regimen when travelling and devise many useful strategies from which others can learn. Patient’s experiences of travelling with multiple medicines can be informative for the community pharmacist who receives customer requests for advice about travelling with medicines, and from outof-town customers with medication concerns. Treatment of Nausea During Pregnancy – Results from a Multinational, Cross-sectional, Internet-based Study K. Heitmann1, L. Holst2, C. Maltepe3, A. Lupattelli4, H. Nordeng4, 1Department of Global Public Health and Primary Care and Centre of Pharmacy, University of Bergen, Bergen, Norway, 2The Motherisk Program, Division of Clinical Pharmacology and Toxicology, The Hospital for Sick Children, University of Toronto, Toronto, Canada, 3Department of Pharmacy, School of Pharmacy, University of Oslo, Oslo, Norway, 4Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway No study has yet investigated the factors related to treatment of nausea during pregnancy in several countries simultaneously. This study aimed to describe differences in self-reported nausea in pregnancy and patterns of medicine use for nausea across regions, and investigate characteristics and beliefs about medicines of women treating nausea. Methods: This cross-sectional study used data from an internet-based questionnaire simultaneously distributed
e58
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
within the period 1-Oct-2011 to 29-Feb-2012 in several countries in five regions; Western, Northern and Eastern Europe, North and South America and Australia. Pregnant women and women with a child aged %1 year were eligible to participate. Data was analysed using IBM SPSS Statistics 20. The study was approved by the relevant Ethics Boards in each country, whenever applicable. Preliminary Results: In total, 9,459 women were included, whereof 6,941 (73.4%) had experienced nausea during pregnancy. Both the prevalence of nausea and its treatment varied between regions. Of these women, 1,913 (27.6%) had used some form of treatment against nausea. Conventional medicines were used against nausea by 1,274 (18.4%) of the women, and herbal medicines by 568 (8.2%) women. Region of residence and folic acid use are factors that were significantly associated with use of treatment in general, and also with use of both conventional and herbal medicines. However, the factors’ influence varied according to type of treatment. Compared to untreated women both users of conventional and herbal medicines showed significant differences according to beliefs about medicines. Women who had nausea did also show a high burden of co-morbidity. Preliminary Conclusions: Regional differences of both the extent of nausea and its treatment were identified. Users of conventional or herbal medicines both differed from untreated women with regard to region of residence, folic acid use and beliefs about medicines. Understanding these factors could form an International basis for treatment strategies.
Understanding Treatment Experiences of Long-Term Users of Antidepressant Medications R. Singh1, J. Calmes1, M. Montagne2, 1University of Wyoming 1000 E. university Ave. Dept. 3375., Laramie, WY 820702, USA, 2MCPHS University 179 Longwood Ave. Boston, MA 02115 To understand the treatment experiences of patients, including perceptions on antidepressant effect, changes in personality, dependency, and addiction. Overall goal is to use this study to identify themes/variables for larger studies on patterns of antidepressant medication use. Methods: A cross sectional, descriptive, mixed method study design was used. In June 2007, 45 adults were interviewed using an interview guide. The instrument consisted of four sections: demographic characteristics, depression and medication history, antidepressant drug taking behaviors, and antidepressant drug effects. IRB approval was obtained. Quantitative analyses were performed using SPSSÒ. Qualitative analysis is currently being done for open ended questions using thematic analysis via NVIVO 10Ò qualitative software. Results: Almost all (93.3%) patients felt that their antidepressants had made their depression better. A slight majority (53.3%) of patients perceived a change in
their personality as a result of their use of antidepressants. Regarding their perceptions of the necessity of antidepressant use, 31% stated their use was their choice while 69% stated it was a necessity. The majority (63.6%) felt they were dependent on their antidepressant, but 88.6% felt they were not addicted to the medication. Preliminary qualitative analysis shows that patients were able to identify how the antidepressant helped them and to describe clearly the effects of not taking antidepressants. Patient perceptions of expectations and effects from antidepressants changed over time with use. It was interesting to note that most patients agreed that they were dependent but not addicted to their depression medication. Lastly, when asked about plans on continuing medications, most patients indicated that they would be taking antidepressants “till the day I die”. Conclusions: This study provided pilot information to help develop tailored intervention to improve long term antidepressant adherence. Such information will help health care professionals improve depression treatment and as a result lead to better caring of depressed patients’ needs.
University student's views on the self-prescribing of “study drugs” J.M. Traulsen, M.A. Petersen, L.S. Norgaard The purpose of this study is to understand the nonmedical use of prescription stimulants among university students in New York City and Copenhagen. The interest in this topic grows out of an increasing focus on medical enhancement and the use of prescription drugs for non-medical purposes in the field of social pharmacy. Methods: This study is based on ethnographic fieldwork. Methods include participant observation during two university semesters; one in Copenhagen and one in New York City as well as 80 in-depth interviews conducted with 20 students in New York and 15 students in Copenhagen. Results: The use of prescription stimulants – for purposes of cognitive enhancement turns out to be complex. The respondents use these drugs for better concentration, increased energy, and for motivational purposes. Risks and side-effects of the drugs do not appear to worry most users. As a matter of fact the respondents legitimize the use of the drugs by referring to others who use the same drugs on an everyday basis for treating ADHD. A major finding is that students consider it safe to use study drugs even though they have had no contact with health-care professionals regarding their use. Conclusions: Although the extent and scope of the use of ADHD medicines for non-medical purposes among university students is not known, this study suggests that it is increasing in Europe and North America and has largely become normalized in New York City. This study highlights the need for both quantitative and