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Wallman, A., Svärdsudd, K., Bobits, K. & Wallman, T. (2024). Antibiotic prescribing by digital health care providers as compared to traditional primary health care providers: cohort study using register data. Journal of Medical Internet Research, 26, Article ID e55228.
Open this publication in new window or tab >>Antibiotic prescribing by digital health care providers as compared to traditional primary health care providers: cohort study using register data
2024 (English)In: Journal of Medical Internet Research, E-ISSN 1438-8871, Vol. 26, article id e55228Article in journal (Refereed) Published
Abstract [en]

Background: "Direct-to-consumer (DTC) telemedicine" is increasing worldwide and changing the map of primary health care (PHC). Virtual care has increased in the last decade and with the ongoing COVID-19 pandemic, patients' use of online care has increased even further. In Sweden, online consultations are a part of government-supported health care today, and there are several digital care providers on the Swedish market, which makes it possible to get in touch with a doctor within a few minutes. The fast expansion of this market has raised questions about the quality of primary care provided only in an online setting without any physical appointments. Antibiotic prescribing is a common treatment in PHC.

Objective: This study aimed to compare antibiotic prescribing between digital PHC providers (internet-PHC) and traditional physical PHC providers (physical-PHC) and to determine whether prescriptions for specific diagnoses differed between internet-PHC and physical-PHC appointments, adjusted for the effects of attained age at the time of appointment, gender, and time relative to the COVID-19 pandemic.

Methods: Antibiotic prescribing data based on Anatomical Therapeutic Chemical (ATC) codes were obtained for Region Sörmland residents from January 2020 until March 2021 from the Regional Administrative Office. In total, 160,238 appointments for 68,332 Sörmland residents were included (124,398 physical-PHC and 35,840 internet-PHC appointments). Prescriptions issued by internet-PHC or physical-PHC physicians were considered. Information on the appointment date, staff category serving the patient, ICD-10 (International Statistical Classification of Diseases, Tenth Revision) diagnosis codes, ATC codes of prescribed medicines, and patient-attained age and gender were used.

Results: A total of 160,238 health care appointments were registered, of which 18,433 led to an infection diagnosis. There were large differences in gender and attained age distributions among physical-PHC and internet-PHC appointments. Physical-PHC appointments peaked among patients aged 60-80 years while internet-PHC appointments peaked at 20-30 years of age for both genders. Antibiotics with the ATC codes J01A-J01X were prescribed in 9.3% (11,609/124,398) of physical-PHC appointments as compared with 6.1% (2201/35,840) of internet-PHC appointments. In addition, 61.3% (6412/10,454) of physical-PHC infection appointments resulted in antibiotic prescriptions, as compared with only 25.8% (2057/7979) of internet-PHC appointments. Analyses of the prescribed antibiotics showed that internet-PHC followed regional recommendations for all diagnoses. Physical-PHC also followed the recommendations but used a wider spectrum of antibiotics. The odds ratio of receiving an antibiotic prescription (after adjustments for attained age at the time of appointment, patient gender, and whether the prescription was issued before or during the COVID-19 pandemic) during an internet-PHC appointment was 0.23-0.39 as compared with a physical-PHC appointment.

Conclusions: Internet-PHC appointments resulted in a significantly lower number of antibiotics prescriptions than physical-PHC appointments, adjusted for the large differences in the characteristics of patients who consult internet-PHC and physical-PHC. Internet-PHC prescribers showed appropriate prescribing according to guidelines.

Place, publisher, year, edition, pages
JMIR Publications, 2024
Keywords
Sweden, Swedish, antibiotic, antibiotics, compare, comparison, digital, digital care, eHealth, ePrescribing, ePrescription, ePrescriptions, health care, infectious disease, internet-primary health care, mobile phone, online consultation, online setting, patient record, patient records, physical-primary health care, prescribing, prescription, prescriptions, primary care, quality of care, telehealth, telehealth prescribing, telemedicine, traditional, virtual care
National Category
Social and Clinical Pharmacy Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:umu:diva-227462 (URN)10.2196/55228 (DOI)38924783 (PubMedID)2-s2.0-85197169605 (Scopus ID)
Funder
Uppsala UniversityUmeå University
Available from: 2024-06-27 Created: 2024-06-27 Last updated: 2024-07-08Bibliographically approved
Gustafsson, M., Wallman, A. & Mattsson, S. (2021). Education Satisfaction among Pharmacy Graduates in Sweden. Pharmacy, 9(1), Article ID 44.
Open this publication in new window or tab >>Education Satisfaction among Pharmacy Graduates in Sweden
2021 (English)In: Pharmacy, E-ISSN 2226-4787, Vol. 9, no 1, article id 44Article in journal (Refereed) Published
Abstract [en]

Education satisfaction is considered important for development of a professional identity and to increase learning. The aim was to investigate and compare education satisfaction over time among pharmacists who have graduated from the pharmacy programs at Umea University, Sweden. Data concerning education satisfaction were collected using an alumni survey of pharmacists who graduated between 2015 and 2018. This was compared with pharmacists graduating between 2006 and 2014. The majority of the pharmacy graduates were very satisfied with their education (96%) and thought that the programs gave them a clear professional identity (92%). No differences in education satisfaction between graduation years 2015 and 2018 and 2006 and 2014 were found. A majority of the graduates considered that the knowledge and skills acquired during their education were useful in their present job (83%). Of the graduates who thought that the studies gave them a clear professional identity, a higher proportion were satisfied with their job (p < 0.001) and thought that their work duties reflected their studies (p = 0.005). Exploring education satisfaction may help educators to further develop the education and to better prepare the students for their professional working life.

Place, publisher, year, edition, pages
MDPI, 2021
Keywords
pharmacy education, professional identity, education satisfaction, pharmacists
National Category
Nursing Pedagogy
Identifiers
urn:nbn:se:umu:diva-187352 (URN)10.3390/pharmacy9010044 (DOI)000633157200001 ()33670619 (PubMedID)
Available from: 2021-09-09 Created: 2021-09-09 Last updated: 2023-10-03Bibliographically approved
Wallman, A., Gustafsson, M., Helgesson, E., Nilsson Lindgren, Å. & Mattsson, S. (2019). Implementing reflective professional development portfolios in pharmacy education. Research in Social and Administrative Pharmacy, 15(12), E50-E50
Open this publication in new window or tab >>Implementing reflective professional development portfolios in pharmacy education
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2019 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 15, no 12, p. E50-E50Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: This study aims to present an implementation of reflective professional development portfolios in pharmacy programs. The overall aim with the project is to stimulate pharmacy students’ professional development. Reflection can be a way to deal with new knowledge and increase professional confidence and competence. Since the process of learning professional values, attitudes and behaviours starts early, an emphasis on students’ development is crucial.

Methods: New written reflective assignments have been introduced in about 10 different courses in the pharmacy programs at Umeå University, Sweden. Students’ level of reflection was measured (on a 6-degree level of reflection scale) to establish students’ level without any further introduction to reflective thinking and learning in the current curricula.

Results: Preliminary results show low reflection in the first introduction course in the program (mean 3.08, 22% reflective, n¼49) and the level has only slightly increased at the 6th semester (mean 3,48, 48,8% reflective, n¼66) and on the 10th semester (mean 3,5, 50% reflective, n¼46). Interrater reliability was calculated by Cohens kappa k¼0,37-0,63. Results from more courses, feasibility, and interrater reliability are going to be evaluated and calculated this spring and presented at the conference.

Conclusions: Umeå University are introducing “Reflective professional development portfolios (RPDP)” as a learning activity integrated in all theoretical courses as writing assignments combined with mentor discussions (4 occasions) and summative portfolios (2 assignments) in the pharmacy curricula. Assessments and feedback on reflective writing of portfolios are planned to occur on several occasions and different levels including level of reflection, discussions on professionalism, and content. This baseline measurement can be used to assess the suggested curricula developments.

Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:umu:diva-166807 (URN)10.1016/j.sapharm.2019.09.006 (DOI)000500574500054 ()
Available from: 2020-01-03 Created: 2020-01-03 Last updated: 2020-01-03Bibliographically approved
Wallman, A., Gustafsson, M., Helgesson, E., Nilsson-Lindgren, Å. & Mattsson, S. (2019). Implementing reflective professional development portfolios in pharmacy education. In: Universitetspedagogiska konferensen 2019: helhetssyn på undervisning - kropp, känsla och kognition i akademin. Paper presented at Universitetspedagogiska konferensen 2019, Umeå, 10-11 oktober, 2019. (pp. 7-7). Umeå: Universitetspedagogik och lärandestöd (UPL), Umeå universitet
Open this publication in new window or tab >>Implementing reflective professional development portfolios in pharmacy education
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2019 (English)In: Universitetspedagogiska konferensen 2019: helhetssyn på undervisning - kropp, känsla och kognition i akademin, Umeå: Universitetspedagogik och lärandestöd (UPL), Umeå universitet , 2019, p. 7-7Conference paper, Poster (with or without abstract) (Other academic)
Place, publisher, year, edition, pages
Umeå: Universitetspedagogik och lärandestöd (UPL), Umeå universitet, 2019
Series
Skriftserie från Universitetspedagogik och lärandestöd (UPL) ; 2019:1
National Category
Educational Sciences
Identifiers
urn:nbn:se:umu:diva-194787 (URN)
Conference
Universitetspedagogiska konferensen 2019, Umeå, 10-11 oktober, 2019.
Available from: 2022-05-17 Created: 2022-05-17 Last updated: 2022-05-23Bibliographically approved
Nørgaard, L. S., Wallman, A., Bjørnsdottir, I., Halvorsen, K. H., Blöndal, A. B., Hedegaard, U. & Høien Bergene, E. (2019). Pharmacy internship in the nordic countries - status and future. Research in Social and Administrative Pharmacy, 15(12), E54-E54
Open this publication in new window or tab >>Pharmacy internship in the nordic countries - status and future
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2019 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 15, no 12, p. E54-E54Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

This educational workshop is a reoccurring opportunity to address best practices, content, assessment methods and research projects from pharmacy internship courses in the Nordic countries, providing a collaboration platform for development. The content components will be described and discussed in terms of development, stimulation and assessment in the different settings. The objective of the workshop is to share experiences from the pharmacy internships and related courses in the Nordic countries. We also want to investigate the opportunity to develop a platform for multicenter pharmacy practice research within the Nordic countries, aiming to improve the internship in each country. A short presentation from the Nordic countries on internship experiences will be the foundation for the discussion between the workshop participants. A possible joint project about supervisors’ skills and competences will be discussed. Prior to the workshop participants are therefore kindly asked to consider how to answer (some of the questions below:

1. Have you introduced any new methods for stimulating learning activities and assessment methods at the pharmacy internship course in your country?

2. What are the three most successful aspects/components of the pharmacy internship run by your university e and what is the most problematic aspect/component)

3. How is the pharmacy internship evaluated in your university (and why so?) e do you have ideas for changing the evaluation? What other courses (elective/obligatory) are run in your university which builds upon the pharmacy internship (might be clinical pharmacy courses, PhD-courses etc) e and which courses do you plan to run?

4. What are the skills, experiences and competencies of the supervisors today e and what are the competencies needed in the future? Our discussions on this issue will take the starting point from a pre-developed questionnaire that the workshop leaders plan to distribute in all the Nordic countries. The learning outcomes for the workshop are the following:

  • The participants will learn about pharmacy internships and related courses in the Nordic countries in terms of current and planned learning outcomes and formal and summative evaluation.
  • The participants will discuss and potentially develop a platform for a multicenter pharmacy practice research studies within the Nordic countries (on supervisor skills and training)
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:umu:diva-166818 (URN)10.1016/j.sapharm.2019.09.006 (DOI)000500574500067 ()
Available from: 2020-01-03 Created: 2020-01-03 Last updated: 2020-01-03Bibliographically approved
Svensberg, K., Kälvemark Sporrong, S., Lupattelli, A., Olsson, E., Wallman, A. & Björnsdottir, I. (2018). Nordic Pharmacy Students' Opinions of their Patient Communication Skills Training. American Journal of Pharmaceutical Education, 82(2), 152-165, Article ID 6208.
Open this publication in new window or tab >>Nordic Pharmacy Students' Opinions of their Patient Communication Skills Training
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2018 (English)In: American Journal of Pharmaceutical Education, ISSN 0002-9459, E-ISSN 1553-6467, Vol. 82, no 2, p. 152-165, article id 6208Article in journal (Refereed) Published
Abstract [en]

Objective. To describe Nordic pharmacy students' opinions of their patient communication skills training (PCST), and the association between course leaders' reports of PCST qualities and students' perceptions of their training. Secondary objective was to determine what factors influence these associations. Methods. A cross-sectional questionnaire-based study was performed. The various curricula were categorized into three types (basic, intermediate and innovative training) and students were divided into three groups according to the type of training they had received. Multivariable logistic regression models were fitted with different opinions as outcomes and three types of training as exposure, using generalized estimation equations. Results. There were 370 students who responded (response rate: 77%). Students within the innovative group were significantly more likely to agree that they had received sufficient training, and to agree with the assertion that the pharmacy school had contributed to their level of skills compared to students in the basic group. Conclusion. There appears to be an association between larger and varied programs of training in patient communication skills and positive attitudes toward this training on the part of the students, with students reporting that they received sufficient training, which likely enhanced their skills.

Place, publisher, year, edition, pages
American Association of Colleges of Pharmacy (AACP), 2018
Keywords
patient communication skills training, pharmacy students, Nordic countries
National Category
Pharmacology and Toxicology Pharmaceutical Sciences Educational Sciences
Identifiers
urn:nbn:se:umu:diva-146819 (URN)10.5688/ajpe6208 (DOI)000428738400011 ()29606708 (PubMedID)2-s2.0-85044319188 (Scopus ID)
Available from: 2018-04-24 Created: 2018-04-24 Last updated: 2024-07-02Bibliographically approved
Gustafsson, M., Mattsson, S., Wallman, A. & Gallego, G. (2018). Pharmacists' satisfaction with their work: Analysis of an alumni survey. Research in Social and Administrative Pharmacy, 14(7), 700-704
Open this publication in new window or tab >>Pharmacists' satisfaction with their work: Analysis of an alumni survey
2018 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 14, no 7, p. 700-704Article in journal (Refereed) Published
Abstract [en]

Background: The level of job satisfaction among practicing pharmacists is important because it has been found to affect job performance and employee turnover. The Swedish pharmacy market has undergone major changes in recent years, and little is known about pharmacists' job satisfaction.

Objectives: The objective of this study was to investigate the level of job satisfaction and associated factors among graduates from the web-based pharmacy programs at Umea University.

Methods: Job satisfaction of pharmacists was measured as part of an alumni survey conducted with those who graduated from the pharmacy programmes between 2006 and 2014. Data analysis included descriptive statistics, and logistic regression was used to explore factors affecting job satisfaction.

Results: The total number of graduates who completed the survey was 222 (response rate 43%.) The majority of respondents were female (95%), and most were employed at a community pharmacy (85%). The mean age was 39.7 years. The majority of graduates (91%) were satisfied with their job "most of the time" or "all of the time", and 87% of the respondents would "definitely" or "maybe" choose the same career again. The multivariate analysis showed that increasing years in the current position (OR: 0.672 (0.519-0.871)) was associated with lower job satisfaction. Older age (OR: 1.123 (1.022-1.234)), the perception that the knowledge and skills acquired during university education is useful in the current job (OR: 4.643 (1.255-17.182)) and access to continuing professional development (OR: 9.472 (1.965 -45.662)) were associated with higher job satisfaction.

Conclusion: Most graduates from the web-based pharmacy programmes were satisfied with their current job. Access to continuing professional development seems to be important for the level of job satisfaction among pharmacists.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Job satisfaction, Pharmacy education, Continuing professional development
National Category
Social and Clinical Pharmacy
Identifiers
urn:nbn:se:umu:diva-150749 (URN)10.1016/j.sapharm.2017.08.006 (DOI)000436607800011 ()28870444 (PubMedID)2-s2.0-85028652433 (Scopus ID)
Available from: 2018-08-16 Created: 2018-08-16 Last updated: 2018-08-16Bibliographically approved
Svensberg, K., Björnsdottir, I., Wallman, A. & Kälvemark Sporrong, S. (2017). Nordic Pharmacy Schools' Experience in Communication Skills Training. American Journal of Pharmaceutical Education, 81(9), Article ID 6005.
Open this publication in new window or tab >>Nordic Pharmacy Schools' Experience in Communication Skills Training
2017 (English)In: American Journal of Pharmaceutical Education, ISSN 0002-9459, E-ISSN 1553-6467, Vol. 81, no 9, article id 6005Article in journal (Refereed) Published
Abstract [en]

Objective. To assess communication skills training at Nordic pharmacy schools and explore ways for improvement. Methods. E-mail questionnaires were developed and distributed with the aim to explore current practice and course leaders' opinions regarding teaching of patient communication skills at all the 11 master level Nordic (Denmark, Finland, Iceland, Norway and Sweden) pharmacy schools. The questionnaires contained both closed-and open-ended questions. Results. There was a variation of patient communication skills training among schools. In general, communication skills training was included in one to five courses (mode 1); varied in quantity (6-92 hours); had low use of experiential training methods; and had challenges regarding assessments and acquiring sufficient resources. However, some schools had more focus on such training. Conclusion. The results show room for improvement in patient communication skills training in most Nordic pharmacy schools and give insights into how to enhance communication skill building in pharmacy curricula. Suggestions for improving the training include: early training start, evidence-based frameworks, experiential training, and scaffolding.

Place, publisher, year, edition, pages
American Association of Colleges of Pharmacy, 2017
Keywords
patient communication skills training, pharmacy students, Nordic countries
National Category
Pedagogy Pharmacology and Toxicology
Identifiers
urn:nbn:se:umu:diva-143678 (URN)10.5688/ajpe6005 (DOI)000418323800005 ()2-s2.0-85038417945 (Scopus ID)
Available from: 2018-01-05 Created: 2018-01-05 Last updated: 2024-07-02Bibliographically approved
Wallman, A., Vaudan, C. & Sporrong, S. K. (2013). Communications training in pharmacy education, 1995-2010. American Journal of Pharmaceutical Education, 77(2), 36
Open this publication in new window or tab >>Communications training in pharmacy education, 1995-2010
2013 (English)In: American Journal of Pharmaceutical Education, ISSN 0002-9459, E-ISSN 1553-6467, Vol. 77, no 2, p. 36-Article in journal (Refereed) Published
Abstract [en]

The role of the pharmacist as a "communicator" of information and advice between patients, other healthcare practitioners, and the community is recognized as a vital component of the responsibilities of a practicing pharmacist. Pharmacy education is changing to reflect this, although the difficulty is in designing a curriculum that is capable of equipping students with the necessary knowledge and skills, using activities that are effective in promoting communication competency. The objective of this review was to identify published, peer-reviewed articles concerning communication training in pharmacy education programs, and describe which communication skills the structured learning activities aimed to improve and how these learning activities were assessed. A systematic literature search was conducted and the articles found were analyzed and divided into categories based on specific communication skills taught and type of learning activity used. Oral interpersonal communication skills targeted at patients were the most common skill-type described, followed by clinical writing skills. Common teaching methods included simulated and standardized patient interactions and pharmacy practice experience courses. Most educational interventions were assessed by subjective measures. Many interventions were described as fragments, in isolation of other learning activities that took place in a course, which impedes complete analysis of study results. To succeed in communication training, integration between different learning activities and progression within pharmacy educations are important.

Keywords
communication, educational methods, learning outcomes, pharmacy education
National Category
Chemical Sciences
Identifiers
urn:nbn:se:umu:diva-67683 (URN)10.5688/ajpe77236 (DOI)000316182600016 ()23519011 (PubMedID)2-s2.0-84875161941 (Scopus ID)
Available from: 2013-03-27 Created: 2013-03-27 Last updated: 2023-03-24Bibliographically approved
Kettis, Å., Ring, L., Gustavsson, M. & Wallman, A. (2013). Placements: an underused vehicle for quality enhancement in higher education?. Quality in Higher Education, 19(1), 28-40
Open this publication in new window or tab >>Placements: an underused vehicle for quality enhancement in higher education?
2013 (English)In: Quality in Higher Education, ISSN 1353-8322, E-ISSN 1470-1081, Vol. 19, no 1, p. 28-40Article in journal (Refereed) Published
Abstract [en]

Placements have the potential to contribute more effectively to the quality of higher education. The aim of this article is to discuss how placements can be made more worthwhile for individual students, while also contributing to the overall quality of teaching and learning at HEIs as well as to the development of workplace cultures that are conducive to learning. Work experience opportunities help students to build substantive relationships and apply what they are learning. Students’ overall view of their learning experience becomes more positive, their identification with their intended profession strengthens and academic performance improves, as do graduate employment rates. Introducing placements in the curriculum does not, however, guarantee these positive effects. Learning is likely to be greater if the experience is ‘intentional and recognised’ and tightly knit into the curriculum. Using evidence from research on workplace learning is one way to improve the quality of placements, as exemplified by a scholarly approach to the development of placements for pharmacy students at Uppsala University. HEIs’ interaction with employers through placements enriches both parties. Academics gain insights into practice which may inspire teaching on campus, e.g. by generating real life examples that trigger students’ motivation and by informing curriculum design. Practitioners supervising students on placements are often excellent educational development partners. Placements may also contribute to organisational development. Developing a reflective, deliberate approach to learning in the workplace may be as useful for the employees as for the students. Also, students may carry out projects of value to the employer, while also keeping the university informed of current practice. An increased engagement in students' work experience opportunities may improve the student experience, and contribute to bridging the academy-practice divide in a way that is as much about influencing the rest of society as being influenced by it.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2013
Keywords
placements, workplace learning, employability, quality enhancement, higher education, work experience
National Category
Chemical Sciences
Identifiers
urn:nbn:se:umu:diva-67685 (URN)10.1080/13538322.2013.772697 (DOI)2-s2.0-84875827183 (Scopus ID)
Available from: 2013-03-27 Created: 2013-03-27 Last updated: 2023-03-24Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0873-2519

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