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Design of an Educational Intervention in Portuguese Community Pharmacists to Improve Antibiotics Use
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Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
screening programs have the potential to increase the early detection of depression which may lead to early intervention, and potentially contribute to easing the enormous disease burden associated with depression. Depression Training for Pharmacists Significantly Improves Patients’ Concerns and Feelings about Side Effects Regarding Antidepressant Therapy S. Liekens1, T. Smits2, G. Laekeman1, V. Foulon1, 1KU Leuven, Department of Pharmaceutical & Pharmacological sciences, Leuven Belgium, 2KU Leuven, Institute for Media Studies, Leuven Begium The objective of the SIMCA study was to Study the Impact of structured Medication Counseling on patients starting a new treatment with Antidepressants. Methods: A controlled RCT was set up in the Surplus Pharmacy chain, with 53 pharmacists in the control group (delivered standard care) and 46 in the intervention group (trained to counsel patients with a new prescription for antidepressants with use of pharmacy software). Telephone survey interviews based on validated scales were used to collect data at the start of treatment, after 1 month, 3 months and 6 months of treatment. Patient data were compared between the intervention and control group at the different time points. Mann-Whitney U tests were used to compare the median scores of the different scales between intervention and control group. Results: Significantly more patients, who started treatment with antidepressants for mood disorders and visited an intervention pharmacy were satisfied with the information regarding treatment (p¼ 0.003) and side effects (p¼ 0.014), compared to patients with the same condition who visited control pharmacies. Both after one month and after three months of treatment, significantly fewer patients of the intervention pharmacies had concerns about the negative effects of antidepressants (p¼ 0.026 resp. p¼ 0.004) compared to patients of control pharmacies. After three months of treatment significantly more patients of the intervention pharmacies had positive feelings about side effects of antidepressants (p¼ 0.004) compared to patients of control pharmacies. Conclusion: Structured medication counseling for patients starting a new treatment with antidepressants had a positive impact on patients’ satisfaction with the information regarding treatment and side effects, concerns about the negative effects of antidepressants and feelings about side effects. Design of an Educational Intervention in Portuguese Community Pharmacists to Improve Antibiotics Use Fa´tima Roque1,2,3, Sara Soares2, Anto´nio TeixeiraRodrigues2, Luiza Breitenfeld1, Adolfo Figueiras4, M.T. Herdeiro2,5,6, 1Health Sciences Research Centre, University of Beira Interior (Centro de Investigac¸a˜o em Cieˆncias da Sau´de- CICS/UBI);, 2Centre for Cell Biology, University of Aveiro (Centro de Biologia Celular
- CBC/UA), 3Research Unit for Inland Development, Polytechnic Institute of Guarda (Unidade de Investigac¸a˜o para o Desenvolvimento do Interior - UDI/IPG), Portugal, 4Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiologı´a y Salud Pu´blica - CIBERESP), University of Santiago de Compostela, Spain, 5Centre for Health Technology & Information Systems Research (Centro de Investigac¸a˜o em Tecnologias e Sistemas de Informac¸a˜o em Sau´de CINTESIS/FMUP), Portugal;, 6Health Technology Research Centre (CITS/Cooperativa de Ensino Superior Polite´cnico e Universita´rio - CESPU), Portugal Improve antibiotics use by an educational intervention in community pharmacists towering their attitudes related to microbial resistances and antibiotic misuse. Methods: The study included four phases: (1) a focus group study with community pharmacists; (2) questionnaire design and reliability assessment; (3) a crosssectional study with 1197 pharmacists, and (4) design and implementation of educational intervention, a cluster-randomized controlled trial, with 4 cluster in control group and 4 cluster in intervention group. The study was approved by Portuguese Data Protection Authorities (Comissa˜o Nacional de Protec¸a˜o de Dados/CNPD) (Permit No. 2886/2013). Results: Situations explored during focus group sessions, were helpful to construct a questionnaire with 17 statements about attitudes and knowledge of pharmacists to microbial resistance and antibiotics misuse, followed in each case by a continuous visual analogue scale (VAS), and 4 statements identifying situations where pharmacists, recognized that sometimes antibiotics could be dispensed without medical prescription, a measure of propensity to dispense antibiotics without medical prescription. Questionnaire internal consistency and reliability was demonstrated. The rate of response during cross-sectional study was 64,8 %. Propensity to dispense antibiotics without prescription among respondents was 48,6 %. It was identified three major attitudes as influencing propensity to dispense antibiotics without medical prescription: complacency with patients, responsibility of others (patients and health-care systems) and fear/precaution. Attending this attitudes, educational outreach visits were made with: (1)interactive educational meeting by PowerPoint presentation (IEM); (2)printed educational materials (pharmacists reminders and a poster to display in pharmacy facilities); (3)selected articles referenced during IEM. A participation pharmacist in the educational interventions was around 55% within the cluster intervention group. Conclusions: Interventions were well accepted by pharmacists and, all of them demonstrated motivation to promote rational use of antibiotics of their patients. This work was supported by Foundation for Science & Technology (Fundac¸a˜o para a Cieˆncia e Tecnologia FCT) grants [PTDC/SAU-ESA/105530/2008] and [PestOE/EGE/UI4056/2014] from the Portuguese Ministry of Science & Education.
Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64
screening programs have the potential to increase the early detection of depression which may lead to early intervention, and potentially contribute to easing the enormous disease burden associated with depression. Depression Training for Pharmacists Significantly Improves Patients’ Concerns and Feelings about Side Effects Regarding Antidepressant Therapy S. Liekens1, T. Smits2, G. Laekeman1, V. Foulon1, 1KU Leuven, Department of Pharmaceutical & Pharmacological sciences, Leuven Belgium, 2KU Leuven, Institute for Media Studies, Leuven Begium The objective of the SIMCA study was to Study the Impact of structured Medication Counseling on patients starting a new treatment with Antidepressants. Methods: A controlled RCT was set up in the Surplus Pharmacy chain, with 53 pharmacists in the control group (delivered standard care) and 46 in the intervention group (trained to counsel patients with a new prescription for antidepressants with use of pharmacy software). Telephone survey interviews based on validated scales were used to collect data at the start of treatment, after 1 month, 3 months and 6 months of treatment. Patient data were compared between the intervention and control group at the different time points. Mann-Whitney U tests were used to compare the median scores of the different scales between intervention and control group. Results: Significantly more patients, who started treatment with antidepressants for mood disorders and visited an intervention pharmacy were satisfied with the information regarding treatment (p¼ 0.003) and side effects (p¼ 0.014), compared to patients with the same condition who visited control pharmacies. Both after one month and after three months of treatment, significantly fewer patients of the intervention pharmacies had concerns about the negative effects of antidepressants (p¼ 0.026 resp. p¼ 0.004) compared to patients of control pharmacies. After three months of treatment significantly more patients of the intervention pharmacies had positive feelings about side effects of antidepressants (p¼ 0.004) compared to patients of control pharmacies. Conclusion: Structured medication counseling for patients starting a new treatment with antidepressants had a positive impact on patients’ satisfaction with the information regarding treatment and side effects, concerns about the negative effects of antidepressants and feelings about side effects. Design of an Educational Intervention in Portuguese Community Pharmacists to Improve Antibiotics Use Fa´tima Roque1,2,3, Sara Soares2, Anto´nio TeixeiraRodrigues2, Luiza Breitenfeld1, Adolfo Figueiras4, M.T. Herdeiro2,5,6, 1Health Sciences Research Centre, University of Beira Interior (Centro de Investigac¸a˜o em Cieˆncias da Sau´de- CICS/UBI);, 2Centre for Cell Biology, University of Aveiro (Centro de Biologia Celular
- CBC/UA), 3Research Unit for Inland Development, Polytechnic Institute of Guarda (Unidade de Investigac¸a˜o para o Desenvolvimento do Interior - UDI/IPG), Portugal, 4Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiologı´a y Salud Pu´blica - CIBERESP), University of Santiago de Compostela, Spain, 5Centre for Health Technology & Information Systems Research (Centro de Investigac¸a˜o em Tecnologias e Sistemas de Informac¸a˜o em Sau´de CINTESIS/FMUP), Portugal;, 6Health Technology Research Centre (CITS/Cooperativa de Ensino Superior Polite´cnico e Universita´rio - CESPU), Portugal Improve antibiotics use by an educational intervention in community pharmacists towering their attitudes related to microbial resistances and antibiotic misuse. Methods: The study included four phases: (1) a focus group study with community pharmacists; (2) questionnaire design and reliability assessment; (3) a crosssectional study with 1197 pharmacists, and (4) design and implementation of educational intervention, a cluster-randomized controlled trial, with 4 cluster in control group and 4 cluster in intervention group. The study was approved by Portuguese Data Protection Authorities (Comissa˜o Nacional de Protec¸a˜o de Dados/CNPD) (Permit No. 2886/2013). Results: Situations explored during focus group sessions, were helpful to construct a questionnaire with 17 statements about attitudes and knowledge of pharmacists to microbial resistance and antibiotics misuse, followed in each case by a continuous visual analogue scale (VAS), and 4 statements identifying situations where pharmacists, recognized that sometimes antibiotics could be dispensed without medical prescription, a measure of propensity to dispense antibiotics without medical prescription. Questionnaire internal consistency and reliability was demonstrated. The rate of response during cross-sectional study was 64,8 %. Propensity to dispense antibiotics without prescription among respondents was 48,6 %. It was identified three major attitudes as influencing propensity to dispense antibiotics without medical prescription: complacency with patients, responsibility of others (patients and health-care systems) and fear/precaution. Attending this attitudes, educational outreach visits were made with: (1)interactive educational meeting by PowerPoint presentation (IEM); (2)printed educational materials (pharmacists reminders and a poster to display in pharmacy facilities); (3)selected articles referenced during IEM. A participation pharmacist in the educational interventions was around 55% within the cluster intervention group. Conclusions: Interventions were well accepted by pharmacists and, all of them demonstrated motivation to promote rational use of antibiotics of their patients. This work was supported by Foundation for Science & Technology (Fundac¸a˜o para a Cieˆncia e Tecnologia FCT) grants [PTDC/SAU-ESA/105530/2008] and [PestOE/EGE/UI4056/2014] from the Portuguese Ministry of Science & Education.