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      Undergraduate pharmacy students’ attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal

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          Abstract

          Background: Pharmaceutical care (PC) has a significant impact on optimizing pharmacotherapy and improving patients’ quality of life. We aimed to determine the attitudes and perceived barriers of final year pharmacy undergraduates towards provision of PC services in Nepal.

          Methods: A cross-sectional study was conducted among 232 students using a 13-item-standard PC attitude survey (PCAS) questionnaire and 12-itemed PC barrier questionnaires. Mann–Whitney U test and Kruskal–Wallis tests were used to measure the median difference between groups, at alpha=0.05, and Spearman’s rho test was used to measure the strength of the correlation.

          Results: Majority of students were self-motivated in undertaking the current pharmacy education (178, 76.7%) and had no previous incomplete grades that could delay their graduation (177, 76.3%). Over 80% of students had a positive attitude toward all items of PCAS (agreed and strongly agreed) except for two items. Whereas, 61 (26.3%) disagreed and strongly disagreed that providing PC takes too much time and effort. The major barriers perceived were inadequate PC training (176, 75.9%), inadequate drug information resources in the pharmacy (170, 73.3%), and lack of access to patient medical records in the pharmacy (165, 71.1%). A significant relationship was noticed between positive attitude towards PC and three factors; source of motivation, current employment in pharmacy job, and incomplete grades delaying graduation. Age factor was significant but negatively correlated with the scores of positive attitudes namely “I would like to perform PC as a pharmacist practitioner”, “Providing PC is professionally rewarding” and “I feel that the PC is the right direction for the provision to be headed”.

          Conclusion: Nepalese undergraduate pharmacy students had positive attitudes toward PC. Exercising proper pharmacy practice regulations and educational efforts to overcome the perceived barriers may lead to better delivery of PC.

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          Most cited references39

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          Sample size for pre-tests of questionnaires.

          To provide guidance regarding the desirable size of pre-tests of psychometric questionnaires, when the purpose of the pre-test is to detect misunderstandings, ambiguities, or other difficulties participants may encounter with instrument items (called «problems»).
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            Pharmaceutical care: the PCNE definition 2013.

            Twenty-three years after Hepler and Strand published their well-known definition of Pharmaceutical Care (PhC), confusion remains about what the term includes and how to differentiate it from other terms. The board of the Pharmaceutical Care Network Europe (PCNE) felt the need to redefine PhC and to answer the question: "What is Pharmaceutical Care in 2013". The aims of this paper were to review existing definitions of PhC and to describe the process of developing a redefined definition. A literature search was conducted in the MEDLINE database (1964-January 2013). Keywords included "Pharmaceutical Care", "Medication (Therapy) Management", "Medicine Management", and "Pharmacist Care" in the title or abstract together with the term "defin*". To ease comparison between definitions, we developed a standardised syntax to paraphrase the definitions. During a dedicated meeting, a moderated discussion about the definition of PhC was organised. The initial literature search produced 186 hits, with eight unique PhC definitions. Hand searching identified a further 11 unique definitions. These 19 definitions were paraphrased using the standardised syntax (provider, recipient, subject, outcome, activities). Fourteen members of PCNE and 10 additional experts attended the moderated discussion. Working groups of increasing size developed intermediate definitions, which had similarities and differences to those retrieved in the literature search. At the end of the session, participants reached a consensus on a "PCNE definition of Pharmaceutical Care" reading: "Pharmaceutical Care is the pharmacist's contribution to the care of individuals in order to optimize medicines use and improve health outcomes". It was possible to paraphrase definitions of PhC using a standardised syntax focusing on the provider, recipient, subject, outcomes, and activities included in PhC practice. During a one-day workshop, experts in PhC research agreed on a definition, intended to be applicable for the present time, representative for various work settings, and valid for countries inside and outside of Europe.
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              The changing face of pharmacy practice and the need for a new model of pharmacy education.

              Pharmacy profession has evolved from its conventional and traditional drug focused basis to an advanced patient focused basis over the years. In the past century the pharmacists were more involved in compounding and manufacturing of medicines, but this role has significantly reduced over time. This advancement in the role of pharmacist calls for them to be the part of the broader health care team working for providing better health care for the patients, thus contributing in achieving the global millennium development goals. To match up, the role of today's pharmacists needs to be expanded to include pharmaceutical care concepts, making the pharmacist a health care professional rather than a drug seller in a commercial enterprise. Therefore, pharmacy schools should prepare a program that has competence with the changing role of the pharmacist. The education should provide ability for critical thinking, improve problem-solving skills and decision making during pharmacotherapy. The student should be trained to create, transmit, and apply new knowledge based on cutting-edge research in the pharmaceutical, social, and clinical sciences; collaborate with other health professionals and learn to enhance the quality of life through improved health for the people of local society and as well as the global community.
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                Author and article information

                Journal
                Integr Pharm Res Pract
                Integr Pharm Res Pract
                IPRP
                iprp
                Integrated Pharmacy Research & Practice
                Dove
                2230-5254
                05 June 2019
                2019
                : 8
                : 47-59
                Affiliations
                [1 ] Department of Pharmacy and Pharmacology, Chitwan Medical College , Bharatpur-10, Chitwan, Nepal
                [2 ]School of Nursing and Health Sciences, Flinders University , Adelaide, Australia
                [3 ]School of Pharmacy, University of Queensland , Brisbane, QLD, Australia
                [4 ]Department of Pharmacy, Valley College of Technical Sciences , Kathmandu, Nepal
                [5 ]Department of Pharmacy, College of Medical and Allied Sciences, Purbanchal University , Gothgaun, Morang, Nepal
                [6 ]Department of Pharmacy, Novel Academy , Pokhara-8, Nepal
                [7 ]College of Pharmacy, Gulf Medical University , Ajman, UAE
                [8 ]CiST College , Kathmandu, Nepal
                Author notes
                Correspondence: Sanjay Raj BaralDepartment of Pharmacy and Pharmacology, Chitwan Medical College , P.O. Box. 42, Bharatpur-10, Chitwan, NepalTel +977 986 031 1096Email sanjaylks01@ 123456gmail.com
                [*]

                These authors contributed equally to this work

                Article
                203240
                10.2147/IPRP.S203240
                6556473
                31240200
                d14110e2-ceea-4d0e-b422-749b383e1378
                © 2019 Baral et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 28 January 2019
                : 26 April 2019
                Page count
                Tables: 6, References: 53, Pages: 13
                Categories
                Original Research

                pharmacy practice internship,pharmaceutical care,undergraduate pharmacy student,nepal

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