Shweta Shah

The potential risks of over-the-counter (OTC) medications are often aggravated in vulnerable populations, such as older adults. The elevated patterns of older-adult OTC medication use do not necessarily translate into a greater understanding of these medications or their safety implications. The objective of this study was to assess how older adults’ knowledge, beliefs, and attitudes inform their decision-making regarding OTC use. Situational interviews were conducted in three community pharmacies with 87 older-adult participants to capture how they intended to use an OTC medication. The interviews were transcribed and qualitatively analyzed, generating seven key themes: (1) medication use concerns; (2) following label instructions; (3) wait time until medication effect; (4) responses to medication not working; (5) decision to stop medication; (6) sources of information; and (7) safety implications. This study shows substantial variations in older-adult OTC medication use while providing insight on factors that influence older adults’ appropriate OTC medication use and, in some cases, the potential for harmful effects.

An online program for pharmacy preceptors to improve their clinical teaching using continuing professional development (CPD) was launched in 2017. While 491 preceptors participated in the CPD program, only 35% of potential participants completed this voluntary program. A secondary data analysis was undertaken to determine the characteristics of preceptors who completed the program and identify ways to target program advertising for those who did not complete it. Residency-trained preceptors were more likely to complete the CPD program compared with those without residency training (45% and 37%, respectively; p = 0.011). This may be due to the inclusion of CPD in residency accreditation standards. To improve completion of the CPD program by preceptors without residencies, a brief introduction to CPD, a statement of benefits, and use of a personalized plan should be included in advertisements. Preceptors teaching more experiential students were more likely to complete the CPD program (p < 0.001 for introductory and advanced experiences). To encourage preceptors with less students to participate, the CPD program should be advertised year-round to allow preceptors to complete the training when it is most relevant to their precepting schedule. Future directions include the monitoring of changes in CPD program participation rates following changes in advertisements and exploring other motivations for program completion such as collaborations with employers.

This study aimed to describe the impact of 13 different health information technologies (HITs) on patient safety across pharmacy practice settings from the viewpoint of the working pharmacist. A cross-sectional mixed methods survey of all licensed practicing pharmacists in 2008 in Nebraska (n = 2195) was developed, pilot-tested and IRB approved. One-fourth responded (24.4%). A database of pharmacists’ responses to closed-ended quantitative questions and in vivo qualitative responses to open-ended questions was built. Qualitative data was coded and thematically analyzed, transformed to quantitative data and descriptive and relational statistics performed. One-third were involved in an error of any kind in the six months preceding the survey, and half observed an error or “near miss”. Most errors or near misses were attributed to workload. When asked specifically about the 13 HITs, these participants reported 3252 observations about the types of errors that were associated with each. These were reports about either error types reduced or eliminated by integration of HIT (n = 1908) or occurring in association with a specific technology’s use (n = 1344). Integration of HIT into pharmacy practice also introduced new error types such as excessive alert programming in the pharmacy computer systems clinical information support causing pharmacists to experience alert fatigue and ignore warnings or bar code scanners mismatching NDC codes of products resulting in wrong drug product identification. Continued vigilance is essential to identifying patient safety issues and implementing safety strategies specific to each HIT.