Oral bisphosphonates are the first choice of therapy to reduce the risk of osteoporotic fractures. These medications have generally poor oral bioavailability, which may further be reduced by concomitant intake of certain foods and drugs; therefore, it is vital to follow specific instructions. The aim with this study was to assess general adherence to oral bisphosphonates and adherence to specific administration instructions among people admitted to two wards at Umeå University hospital in Sweden. This interview study focuses on elderly patients living at home and prescribed oral bisphosphonates. Invited were 27 patients admitted to an orthopaedic ward and a geriatric ward during the period 28 March 2017 and 5 December 2017. In total, 21 patients were interviewed regarding their adherence to oral bisphosphonates. Out of 21 patients, 13 (62%) were considered non-adherent. The most common reason was calcium intake less than 2 h after oral administration of bisphosphonate (54%). The number of regularly prescribed drugs was significantly higher among patients rated non-adherent to bisphosphonates compared to those rated adherent (p = 0.004). Adherence to bisphosphonates administration instruction among elderly people living at home was limited. More research is needed to confirm these results and to investigate the reasons for non-adherence and how adherence to bisphosphonates can be improved.
The objectives of this study were to explore pharmacy students’ perceptions and experiences of three-dimensional virtual worlds (3DVWs) as an instructional tool for clinical pharmacy teaching. Semi-structured interviews were carried out with Master of Science in Pharmacy students who had participated in communicative exercises in a 3DVW. Interviews were digitally recorded, transcribed and analyzed using thematic analysis. More than half of the students were positive to using 3DVWs for educational purposes and see the advantages of having a setting where communication can be practiced in an authentic but ‘safe’ environment available online. However, many students also reported technical difficulties in using the 3DVW which impacted negatively on the learning experience. Perceived ease of use and usefulness of 3DVWs appears to play an important role for students. The students’ level of engagement relates to not only their computer skills, but also to the value they place on 3DVWs as an instructional tool.
Distance education is becoming more and more common, and today distance education is well established within academic settings. The aim was to investigate first-year pharmacy students' expectations and perceptions of web-based pharmacy programs and of their future profession. Furthermore, student characteristics were compared over time. A questionnaire was distributed to all first-year students admitted to the pharmacy programs at Umea University in 2017. The students were asked questions about their background, motives for choosing pharmacy education, and their expectations and perceptions of their education and profession. Factors of most importance when choosing the education were: the education is interesting, leads to an interesting job, and is web-based. The students' expectations of the education were high, and they want to learn as much as possible and be well prepared for their future profession. Regarding the students' perception of their future profession, three themes were identified: to help other people, professional development, and employment related issues. Student characteristics have changed over the years, suggesting that the web-based pharmacy education and the flexibility it entails attracts other groups of students today compared with when the programs started.
In response to the shortage of pharmacists in Northern Sweden, a web-based Bachelor of Science in Pharmacy program was established at Umeå University in 2003. In 2009, the Swedish pharmacy market was re-regulated from a state monopoly to an open market, but it is unknown what impact this has had on education satisfaction. The objectives of this study were to examine the level of satisfaction among graduates from a web-based pharmacy program and to describe what subjects and skills students would have liked more or less of in their education. A secondary objective was to compare the level of satisfaction before and after the Swedish pharmacy market was re-regulated. A cross-sectional survey was conducted in 2015 with all alumni who had graduated from the pharmacy program between 2006 and 2014 (n = 511), and responses to questions about graduates' satisfaction with the program were analyzed (n = 200). Most graduates (88%) agreed or strongly agreed that the knowledge and skills acquired during their education were useful in their current job. The graduates stated that they would have wanted more applied pharmacy practice and self-care counselling, and fewer social pharmacy and histology courses. Further, 82% stated that they would start the same degree program if they were to choose again today, and 92% agreed or strongly agreed that they would recommend the program to a prospective student. Graduates were more likely to recommend the program after the re-regulation (p = 0.007). In conclusion, pharmacy graduates were very satisfied with their education, and no negative effects of the re-regulation could be observed on program satisfaction.
Age-associated physiological changes and extensive drug treatment including use of potentially inappropriate medications (PIMs) pose a significant risk of drug-drug interactions and adverse drug events among elderly people with dementia. This study aimed at analysing the effects of clinical pharmacists' interventions on use of PIMs, risk of emergency department visits, and time to institutionalization. Furthermore, a descriptive analysis was conducted of circumstances associated with drug-related readmissions. This is a secondary analysis of data from a randomized controlled intervention study conducted in two hospitals in Northern Sweden. The study included patients (n = 460) 65 years or older with dementia or cognitive impairment. The intervention consisted of comprehensive medication reviews conducted by clinical pharmacists as part of a healthcare team. There was a larger decrease in PIMs in the intervention group compared with the control group (p= 0.011). No significant difference was found in time to first all-cause emergency department visits (HR = 0.994, 95% CI = 0.755-1.307 p = 0.963, simple Cox regression) or time to institutionalization (HR = 0.761, 95% CI = 0.409-1.416 p = 0.389, simple Cox regression) within 180 days. Common reasons for drug-related readmissions were negative effects of sedatives, opioids, antidepressants, and anticholinergic agents, resulting in confusion, falling, and sedation. Drug-related readmissions were associated with living at home, heart failure, and diabetes. Pharmacist-provided interventions were able to reduce PIMs among elderly people with dementia and cognitive impairment.
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.
Understanding the role of pharmacists' job satisfaction is important because a lack of job satisfaction might have negative impacts on patient care and safety. The aim of this cross-sectional study was to explore and compare job satisfaction among pharmacists graduating from the pharmacy programs at Umea University, Sweden. Data concerning job satisfaction and associated factors were collected using an alumni survey conducted among pharmacists graduating between 2015 and 2018. Ethical committee approval is not required for this type of study in Sweden. A majority (92.6%) of the pharmacy graduates were female. A majority of the graduates (91.4%) were satisfied with their job most of the time or all of the time, which was similar to a previous investigation among pharmacists graduating between 2006 and 2014. High access to continuous professional development (CPD) was associated with higher job satisfaction (odds ratio (OR): 18.717 (95% confidence interval (CI): 1.685-207.871)). In total, 65.6% considered access to CPD to be high (i.e., satisfactory to very good). Variables like gender, age, employee category, workplace, years since graduation, and income did not affect job satisfaction. Knowledge regarding job satisfaction will enable employers to respond to employees' needs, decrease turnover, and improve the work environment.
Non-adherence is important to address because it might affect the effectiveness of therapy and lead to adverse effects. The objectives of this interview study were to investigate old peoples' general adherence to drugs and their awareness of and adherence to changes in drug therapy after their hospital stay. Following ethical approval, 42 patients admitted to the medical ward were invited to participate in this study. Of these, 36 persons, with a mean age of 82.5 years, who were discharged to their home, were interviewed by telephone using the Medical Adherence Report Scale (MARS) to assess their general adherence to prescribed drugs. Questions regarding awareness and adherence to drug changes during their hospital stay were asked. Different factors related to adherence and non-adherence were investigated using the Pearson chi-square test and the independent sample t-test. The average MARS score was 23.9 +/- 1.4, with 31 persons (86%) assessed as adherent to their drug therapy and 5 persons (14%) as non-adherent. Of the 36 people, 30 had at least one change in their drug therapy during their hospital stay, and 23 (77%) of these people were aware of all changes and 23 (77%) were adherent to all of the changes. No significant differences between adherence and age, gender, living situation, or number of drugs were found. This small study found that some older people who were discharged from hospital were generally non-adherent, and some were not aware of or adherent to changes made in the drug therapy during their hospital stay. This is an important problem to address with further interventions.