PHARMACY STUDENT PRACTICAL FORMATION TO PHARMACEUTICAL HEALTHCARE IN HOSPITAL CARE UNIT
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European Statement
Education and Research
Author(s)
Elisa Vitale, Quentin Perrier, Arnaud Tanty, Claire Chapuis, Armance Grevy, Agathe Landoas, Dorothée Lombardo, Prudence Gibert, Lénaik Doyen, Benoit Allenet, Pierrick Bedouch, Sébastien Chanoine
Why was it done?
In France, during their 5th year of study, pharmacy students complete a six-month full-time equivalent internship in a hospital setting. At our hospital, most students spend six months in a care unit to perform pharmaceutical care and promote quality use of medicines. These missions are carried out in collaboration with all healthcare professionals, either under the direct supervision of a pharmacy resident, senior pharmacist, or independently. While tasks assigned to pharmacy students in the care unit with direct pharmaceutical supervision were well known, other students reported difficulties in understanding what was expected of them, as well as a lack of confidence when integrating an established interprofessional team.
What was done?
The aim was to create and evaluate a specific training session for all pharmacy students joining a care unit for the first time.
How was it done?
Four hospital pharmacists collaborated to define the learning objectives and select the appropriate teaching tools. A pre- and post-training self-assessment questionnaire consisting of seven questions was created to evaluate students’ self-efficacy regarding the learning objectives and their satisfaction with the training.
What has been achieved?
A four-hour training session, divided into five sequences, was created. The objectives were: 1) Highlighting the challenges of joining an interprofessional team, 2) identifying the tasks and learning opportunities for pharmacy students, 3) simulating a medication reconciliation, 4) managing pharmaceutical issues through problem-solving exercises.
Regarding the evaluation, students reported that they: a) were more enthusiastic about the idea of working in a care unit after the training course (85% vs. 74%, p=0.001); b) had a clear understanding of their mission (84% vs. 53%, p<0.001); c) felt more confident in performing a medication reconciliation (93% vs. 35%, p<0.001); d) were more aware of the pharmaceutical resources available to them (95% vs. 27%, p<0.001); e) had a better understanding of how hospital pharmacy is organized (58% vs. 19%, p<0.001). Additionally, 99% found the training useful, and 94% felt that the training methods aligned with the training objectives.
What next?
Assess the long-term impact of the training and its effectiveness in ensuring that pharmacy students perform pharmaceutical care successfully and confidently
APPLICATION OF ARTIFICIAL INTELLIGENCE FOR THE COMPARISON OF NEW DRUGS AND MEDICAL DEVICES
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European Statement
Education and Research
Author(s)
Damuzzo V (1), Rivano M (2), Cancanelli L (3), Brunoro R (4), Gasperoni L (5), Ossato A (6), Colicchio A (7), Del Bono L (8), Di Spazio L (9), Celentano Fasano CN (10), Chiumente M (11), Mengato D (12), Messori A (13)
1) UOC Farmacia, AULSS2, P.O. di Vittorio Veneto
2) Hospital Pharmacy, Azienda Ospedaliero Universitaria, Cagliari
3) UOC Farmacia, AULSS2 Marca Trevigiana, P.O. di Castelfranco
4) School of Specialisation in Hospital Pharmacy, University of Milan, Milan
5) Oncological Pharmacy, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) ‘Dino Amadori, Meldola;
6) School of Specialisation in Hospital Pharmacy, University of Padua, Padua
7) Hospital Pharmacy, Azienda Unica Sanitaria Locale di Bologna (AUSL), Bologna
8) Azienda Ospedaliera Universitaria Pisana, Pisa
9) Hospital Pharmacy, Santa Chiara Hospital, Trento, Azienda Provinciale per i Servizi Sanitari (APSS);
10) Hospital Pharmacy, Azienda Ulss 3 Serenissima, Mirano,
11) Italian Society of Clinical Pharmacy and Therapeutics (SIFaCT), Milan
12) Hospial Pharmacy Unit – Azienda Ospedale-Università Padova
13) HTA Unit, Tuscany Region, Florence
Why was it done?
The clinical selection of available treatments and medical devices (MDs) is often hindered by the absence of direct efficacy comparisons between emerging therapies. This AI-tool aimed to address this challenge by employing advanced analytical techniques to facilitate informed decision-making in clinical settings.
What was done?
In 2016, the Italian Society for Clinical Pharmacy and Therapeutics (SIFaCT) launched the AVVICINARE project with the goal of training young hospital pharmacists to develop innovation in research based on non-original, already published data. We recently approached the field of indirect comparisons, applying the artificial intelligence (AI) technique ‘IPDfromKM’ to extract individual patient data (IPD) from Kaplan-Meier (KM) survival curves, enabling the indirect comparison of emerging pharmacological treatments and MDs
How was it done?
Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.
What has been achieved?
Drugs and technologies with similar therapeutic roles and efficacy assessed by time-dependent endpoints (Overall Survival, Progression-Free Survival) were identified. KM curves from relevant clinical trials were digitized, and the IPDfromKM application was used to reconstruct the IPD. Data from different studies on the same treatments were pooled to enhance sample size, and standard statistical techniques (Cox regression, inter-treatment comparison) were employed, considering long-surviving patients (restricted mean survival time [RMST]). A heterogeneity analysis ensured comparability of patient cohorts.
What next?
Given the increasing value of indirect comparisons in both clinical and pharmacoeconomic contexts, ongoing efforts will focus on refining the analytical techniques and expanding training programs for hospital pharmacists. Future work will also explore additional therapeutic areas to broaden the impact of evidence-based medicine and enhance the role of hospital pharmacists in clinical decision-making.
HOW CAN A SOCIAL MEDIA GRAPHIC PROJECT BECOME EDUCATIONAL? AN ITALIAN EXPERIENCE
Pdf
European Statement
Education and Research
Author(s)
Lamesta Chiara
Del Pizzo Mariagiovanna
Della Costanza Chiara
Why was it done?
“SIFOgram” is an information graphic project created by the Young Area of the Italian Society of Hospital
Pharmacy (SIFO) to promote scientific divulgation not only directed to students and pharmacists but also to
a broader audience.
What was done?
We inspected the development and popularity of this educational project. SIFOgram aims to create a smart and direct interaction that impact on patient perceptions, adherence, and responsibilities of hospital pharmacists in mitigating potential risks.
How was it done?
A graphic program was used for the creation of content published on official network pages. The references
for the subjects covered include certified bibliographies for scientific topics and digital graphics for
illustrations. The tool is applied to main topics related to contemporary health professions education
curricula, which include integrated educational designs, approvals of new drugs and supplementary
applications, new target therapies, drug dosing, and events organized by our society.
What has been achieved?
Since 1st March 2023 to 30th September 2024, we gathered +91% accounts with 12.000 reactions. Most of these interactions are for uploading of stories (67,2%) and post (28, 1%) and reels (4,5%). Of this total 3% -located across the different regions of Italy-was from general community; 2% from other European countries and outside Europe, including Africa. The age group that interacted were 25-34 ( 52,5%), -35-44 years old ( 27,4%) , 45-54 years old (9%), 55-64 years old (5%), +65 years old (2,3%). Most liked contents were : antimicrobial stewardship (average 900 views), international and national guidelines (average 650 views), management oxygen (1738 views) , conferences (average 1700 views) where healthcare professionals present their practices as leaders in their respective specialties. We invited our followers, via email, to complete a qualitative questionnaire made up of close-ended questions. 6 broad themes (each containing sub-themes) were identified: Content/clarity, Design/Layout, Audience, Graphics/Images, Interaction on social platforms (live box, chat) and References. The feedback received indicated a positive agreement.
What next?
Through this infographic project, we can gain a deeper successful use of social media in healthcare for public health awareness and improvement communication in the present and in the future.
AN INTERPROFESSIONAL TRAINING WARD AND ITS BENEFIT FOR PHARMACY STUDENTS
Pdf
European Statement
Education and Research
Author(s)
Dückelmann Christina C., Landwehr Frauke
Why was it done?
According to the World Health Organization, interprofessional education and collaborative practice are leading to improved health outcomes. Interprofessional education occurs when students from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes.
What was done?
A cohort of two medical and two pharmacy students as well as four nursing trainees were selected to take over ward mangement and patient care for up to four real patients in a real hospital setting during a five weeks´ period. They were supervised by experienced professionals who “sit on their hands and look out of the window” only interfering when patients are endangered or situations are getting risky for patients.
How was it done?
To find out what the benefit was for pharmacy students, all six of them that where included in this year´s interprofessional wards on a cardiology and a neurology department, were interviewed using guided, problem-centred interviews. Their experiences were qualitatively explored and evaluated with regard to structure, supervsion, feedback and interprofessionality of this training.
What has been achieved?
Pharmacy students reported that the current structure, supervision and feedback enabled them to learn clinical pharmacy in a very profound way. On the other hand, it made other health care professionals aware of how they could benefit from clinical pharmacists and what the role of clinical pharmacists really is. The experience of being responsible for patients together with medical students and nursing trainees in this interprofessional setting was extremely helpful for their learning success and made them realize which influence on patients´ outcome working together in a team like that could have.
What next?
The Interprofessional Training Ward will be continued and rolled out on further departments of the hospital. In 2025, the surgery department will be part of the project. There, clinical pharmacists are badly needed. This qualitative research revealed the potential for further optimization of this programme in order to meet the learning objectives and expectations of the students even better. This will be aimed for in the next interprofessional training wards.
Hospital pharmacists’ professional empowerment through skills integration: experience of international cooperation between Italy and Tanzania
Pdf
European Statement
Education and Research
Author(s)
Agnese Bosio, Chiara Carcieri, Sixberth Bugeraha, Silvia Scalpello, Giovanna Fazzina, Maria Carmen Azzolina, Gianluca Miglio, Annalisa Gasco
Why was it done?
Drug dispensing and patient monitoring are institutional activities of hospital pharmacists worldwide. Nevertheless, the enhancement of managerial capabilities, hard and soft skills is crucial to tackle the critical challenge arising from geographical, epidemiological, demographic, cultural and legislative differences between different countries.
What was done?
An initiative for cooperation and interaction between hospital pharmacists from different income countries has been developed.
How was it done?
The initiative was led by a pharmacist from an Italian hospital who was hosted by a hospital in southern Tanzania and spent a month collaborating with local hospital pharmacists, in order to streamline integrated workflows and optimise clinical care outcomes and professional training.
What has been achieved?
A Strengths Weaknesses Opportunities Threats (SWOT) matrix was developed to assess the impact on three main areas: drug management, clinical pharmacy and pharmaceutical care.
Strengths: attitude for workflow standardisation, multidisciplinary and multicultural teamwork, sharing of expertise and best practice, speed up of limiting processes in order to develop activities in support of patients and clinicians, time and effectiveness in qualified staff training.
Weaknesses: complexity of procedures for drug import, hospital staff shortage (both pharmacists and physicians), absence of primary care and hospital-territory continuity of care network, clinical severity of patients admitted to hospital, imbalance between clinical pharmacy/pharmaceutical care in favour of drug management.
Opportunities: professional growth due to new healthcare challenges facing, soft skills improvement (problem solving, versatility, working under stress, teamwork, integration, overcoming prejudices), hard skills enhancement (logistics, international legislation, scientific English), budget optimisation for new investments (equipment/staff), improvement of patient safety and overall level of care.
Threats: language/cultural barriers, variable learning curve and resistance to change, barriers in social/professional relationships, individual variability in adaptation period, different patient perceptions of health and medical care.
What next?
Professional integration of hospital pharmacists from different educational and cultural backgrounds could enhance their ability to address different clinical, environmental and socio-economic issues, with the following outcomes: strengthening the professional pathway; optimising outcomes with consequent cost savings; improving the quality of healthcare for patients.
On-line education for pharmacists about one pill killers
Pdf
European Statement
Education and Research
Author(s)
RAQUEL AGUILAR SALMERÓN, LÍDIA MARTÍNEZ SÁNCHEZ, ANNA MARIA JAMBRINA ALBIACH, NEUS RAMS PLA, MANEL RABANAL TORNERO, MARIA ÀNGELS GISPERT AMETLLER, MILAGROS GARCÍA PELÁEZ, NÚRIA PI SALA, SANTIAGO NOGUÉ XARAU
Why was it done?
HTDs in infants are defined as those that might cause severe or lethal poisoning in children. Some HTDs are considered “one pill killers”: those in which the ingestion of one unit, a single tablet or tablespoon, in an infant with a body weight of 10 kg, could be fatal. In Spain, there are 29 active ingredients (from seven therapeutic groups) considered “one pill killers”. Counseling and information are crucial activities developed by pharmacists that could help to avoid fatal intoxications.
What was done?
A virtual and interactive course for pharmacists was designed to improve knowledge about highly toxic drugs (HTDs) in infants and potentially fatal intoxications. The education platform integrates microlearning and gamification methodologies, and the course could be followed via web or smartphone.
How was it done?
A group of experts, including toxicologist paediatricians and clinical pharmacists, carried out a literature review and determined the toxic dose for HTDs. They also determined the number of units (considering the most concentrated presentation) needed to achieve the potentially fatal dose in a 10 kg infant. A virtual microlearning platform (Snackson®) was chosen, and specific training content was designed. It will be offered to community pharmacists by our Catalan Ministry of Health.
What has been achieved?
This project has enhanced the collaboration between the group of experts and the Catalan Ministry of Health. An agreement has been signed, and, in this frame, the educational activity has been offered (Autumn 2023) to 250 community pharmacists.
A list of HTDs has been published (DOI: 10.1016/j.anpede.2020.02.007).
A video was recorded, addressed to the general population to inform them about the existence of HTDs. This video is a divulgation tool with recommendations to prevent drug poisoning and is periodically broadcast in the waiting rooms of health centers.
(https://www.youtube.com/watch?v=uSHDRte7Nr8&t=14s).
What next?
The next objective will be to evaluate the impact of the training activity on community pharmacists and the usability of the virtual microlearning platform. Future plans also include the expansion of this education tool to other regions in Spain, and to explore the application of microlearning methodology to other areas of knowledge.
«At the pharmacy, it is not just the cross that is green » Design and distribution of an awareness video on sustainable development related to the hospital pharmacy sector
Pdf
European Statement
Education and Research
Author(s)
Pascaline Hubot, Anais Lumen , Marion Lefebvre, Audrey Christiaens , Claudia Tavernier , Olivia Dalleur
Why was it done?
With the healthcare sector’s climate footprint accounting for 4.4% (2019) of global greenhouse gas emissions, sustainable development in healthcare is one of today’s challenges. It is important and urgent to highlight the simple actions that can be implemented to reduce these emissions and to promote them. The objectives were: (1) To identify eco-friendly practices related to the pharmacist’s work. (2) To design an animated video and (3) To raise awareness among pharmacy staff about sustainable development.
What was done?
Students in their final year of a complementary master’s degree in hospital pharmacy at the Université Catholique de Louvain (Belgium) decided to take on the challenge of producing an animated video on eco-actions specific to the profession of hospital pharmacist.
How was it done?
Firstly, a literature review (PubMed, Google Scholar) on sustainable development in healthcare followed by a focus group was carried out to identify and select ten eco-actions most relevant to the hospital pharmacist’s job. We provide at least one example for each sector of the pharmacy. Secondly, a brainstorming session was held to select the most appropriate communication tool.
What has been achieved?
An 8-minute animated video was produced using Powtoon software (January 2023 version). This video is available free of charge on Youtube (https://www.youtube.com/watch?v=5eKQVcVlP00). A poster was created for display in all hospital pharmacies in French-speaking Belgium to inform as many staff members as possible about best practices in sustainable development. A QR code was added to the poster to enable a direct access to the video. The project was presented by webinar for French-speaking Belgian hospital pharmacists in April 2023. This video is now included in the programme of a complementary Master’s degree in hospital pharmacy at the Université Catholique de Louvain.
What next?
In the face of climate challenges, raising awareness of sustainable development issues remains the watchword This educational video is a first step in initiating actions to make pharmacy more sustainable. It will be presented at the next annual meeting of French-speaking Belgian hospital pharmacists in 2024 and we hope that pharmacists will implement these concrete eco-friendly practices within their institutions.
« S’cape Pharm: Can you keep your cool? » Design and implementation of an educational escape game in Chirec’s distribution departments
Pdf
European Statement
Education and Research
Author(s)
Pascaline Hubot , Elise Francq, Guy Stichelbaut
Why was it done?
Hospital pharmacy is a constantly evolving field that requires ongoing training. New teaching strategies based on the gamification of educational objectives have been making headlines for several years. These include EG.
What was done?
An educational escape game (EG) has been designed and implemented for hospital pharmacists and pharmaceutical-technical assistants (Apth) working in one of Chirec’s distribution departments (Belgium). The objectives were : to provide continuing education and to improve various cross-disciplinary skills such as communication, team cohesion and critical thinking.
How was it done?
After considering the various constraints (dedicated time per session, number of players, etc.), a non-linear scenario was constructed. Distribution-specific themes were chosen for the creation of 12 enigmas, some in paper format and others in virtual format using Genially platform (November 2022 version). To ensure that the training sessions ran smoothly, hint envelopes containing the updated procedures were provided. Finally, the EG was pilot tested to get an idea of the game’s timing, to identify and correct any practical problems, and to adapt certain enigmas deemed too complex if necessary.
What has been achieved?
Nine sessions were held between December 2022 and September 2023. Each session included : briefing (5’), EG session (45’), debriefing (10’) and the distribution of an anonymous satisfaction survey at the end of the session (2’). Pharmacists (n = 24) and Apth (n = 15) respectively agreed (37.5% (n = 9) ; 66.7% (n = 10)) and strongly agreed (54.2 % (n = 13) ; 20% (n = 3)) that the EG improved their knowledge, and all participants found the EG to be a good teaching tool. Feedback was also very positive on cross-functional skills such as communication, team cohesion and critical thinking.
What next?
Futures sessions will be planned for newcomers to the pharmacy. Given the popularity of this educational tool and the suggestions for new topics, a new EG theme will certainly be on the agenda for 2024 pharmacy continuing education.
Creation of a pedagogical tool to optimise the validation of chemotherapies related to rhabdomyosarcoma
Pdf
European Statement
Education and Research
Author(s)
Franco Perna, Maria Elisabetta Uda, Maxime Annereau, Hail Aboudagga , André Rieutord, My Lan Vo
Why was it done?
The process of pharmaceutical validation of chemotherapy involves several steps, and the hospital pharmacist must rely on multiple therapy protocols. In addition, pharmacists who have just finished university do not have the appropriate training for pharmaceutical validation. Thus, we decided to develop a tool to support the validation of chemotherapy, in which pharmacists can learn therapy protocols.
What was done?
The hospital pharmacy has developed a pedagogical tool to support pharmaceutical validation in the context of rhabdomyosarcoma (RMS).
How was it done?
We initially carried out a systematic review, following the PRISMA 2020 Statement, to find if there were any educational methods or tools exist to facilitate pharmaceutical validation in paediatric oncology.
Then, we contacted several pharmacists, currently employed in French hospitals and abroad, to understand how they train new pharmacists and resident students about chemotherapies validation. After this first stage, we focused our research on the content of our future educational tool. We created an easy-to-fill questionnaire to obtain information and meet from clinical pharmacists inside our department to understand which information was needed for the tool and what could be the most suitable format for them.
What has been achieved?
Regarding the systematic review, only two studies were identified, in which tools for pharmacists were developed, but none of these concerned the pharmaceutical validation of paediatric chemotherapy. The hospital centres contacted did not develop pedagogical tools, but some of them support the training with standard operating procedures (SOPs).
The questionnaire, in which 15 pharmacists (27% students) were interviewed, revealed that most preferred a tool in pdf (48%) and paper format (22%), containing information on pathophysiology (48%) and epidemiology (22%) of rhabdomyosarcoma, on chemotherapy protocols (32%) and dosage regimens (19%). For this reason, a pedagogical tool has been developed in pdf format and in the form of a paper booklet with the required information.
What next?
This tool could be the first presented regarding the validation of paediatric chemotherapy.
The future prospect would be to develop other tools to support pharmaceutical validation so that we can invest more and more and provide more and more quality training to new hospital pharmacists.
Use of an integrated research management system on a clinical trials unit of a Portuguese hospital
European Statement
Education and Research
Why was it done?
The evaluation of the use of the software was based on a retrospective analysis of all clinical trials introduced since 2020 and the interpretation of the results of a survey (carried out from July to August 2023) aimed at Clinical Research Associates (CRAs)
What was done?
Evaluation of the use of an Integrated Research Management System based on a retrospective analysis of all clinical trials introduced into the software since 2020.
How was it done?
The evaluation of the use of the software was based on a retrospective analysis of all clinical trials introduced since 2020 and the interpretation of the results of a survey (carried out from July to August 2023) aimed at Clinical Research Associates (CRAs)
What has been achieved?
With the introduction of an integrated management system as a registration platform of investigational product receipt, dispensing and return, were introduced into the software 204 clinical trials.
Since its implementation in 2020, the integrated system has been authorised by the sponsor as a registration platform in 55 clinical trials, corresponding to 79% of clinical trials initiated since that date.
The clinical trials Unit grants remote access to the clinical trials information to CRAs through the filling out of a declaration. Since the adoption of this system, remote access to the platform has been granted to 35 CRAs.
According to the survey distributed between July and August:
-85.7% of CRAs use the system in their monitoring work.
-The use of System has been exclusively approved to replace paper records in 88.9% of active clinical trials (with the exception of receipt confirmation via IWRS – Interactive Web Response System).
-All the CRAs who answered the questionnaire consider remote access to clinical trial data to be an advantage.
– 77.8% believe that by using the platform the time spent on presential visits has been reduced.
What next?
The use of this type of system is essential to ensure the efficiency of the tasks carried out by research teams. The approval of system by the sponsor allowed a significant reduction of paper records and the CRA’s remote access to the platform has allowed the early detection of errors, as well as a substantial reduction on time spent on presential visits. The CRA’s remote access to the movements associated with the experimental product like temperature records, calibration certificates, CVs (Curriculum Vitae) and GCP’s (Good Clinical Practices). Although use of the platform has been increasing, some sponsors still do not authorise the exclusive use of the system. It is therefore essential to share the platform’s added value in order to change the traditional ways of management of clinical trials information.