• Potential Research Projects

Research projects for Higher Degree by Research (HDR) students are available within the following School of Pharmacy research areas and research centre. 

Please email our academic staff to discuss potential HDR projects and ask if they are available as an advisor for your proposed HDR program.

Clinical Pharmacy and Pharmacometrics

Title: Implementing Pharmacogenomics into Community Pharmacy Practice to Personalise the Treatment of Depression Contact:  Associate Professor Chris Freeman

Title:  Developing pharmacokinetic models for immunosuppressants in solid organ transplant patients Contact:   Dr Christine Staatz

Title:  Improving the use of immunosuppressant agents in solid organ transplant patients Contact:   Dr Christine Staatz

Title:  Adherence and its relationship to patient beliefs towards their medicines Contact:   Associate Professor Neil Cottrell

Title: Pharmacokinetics of nicotine absorption from vaping devices Contact:   Associate Professor Kathryn Steadman

Medication Use, Safety and Health Services Research

Title:  The ethics of pharmacogenomic testing in community pharmacy Contact:  Doctor Adam La Caze

Title: Pharmacy ethics and the opioid crisis Contact:  Doctor Adam La Caze

Title:  Improving the use of immunosuppressant agents in solid organ transplant patients Contact:   Dr Christine Staatz

Title:  Establishing pharmacokinetic and pharmacodynamic models for antibiotics used in special paediatric populations Contact:   Dr Christine Staatz

Title:  Queensland Family Cohort (QFC) : Characterising medication usage within the perinatal-postnatal family environment Contact:   Dr Meng-Wong Taing

Title:  Pharmacy and oral healthcare Contact:   Dr Meng-Wong Taing

Pharmacoepidemiology, Pharmacovigilance and Pharmacoeconomics

No projects currently available.

Biotherapeutic Delivery and Diagnostic Solutions

Title: Computer-aided design, synthesis and evaluation of targeted drug delivery systems Contact:   Dr Ben Ross

Title:  Engineering peptides and proteins as therapeutics Contact:   Dr Peter Moyle

Title:  Improving the delivery characteristics of protein / peptide drugs Contact:   Dr Peter Moyle

Title:  Deciphering the roles of post-translational modifications Contact:   Dr Peter Moyle

Title:  Recombinant, semisynthetic and synthetic vaccines Contact:   Dr Peter Moyle

Title:  Targeted delivery systems for RNAi and DNA delivery Contact:   Dr Peter Moyle

Title:  Enhancing the activity of antimicrobial agents Contact:   Dr Peter Moyle

Title:  Engineering nanostructures and nanomedicines using supercritical fluid technology Contact:   Dr James Falconer

Title:  Improving delivery of challenging to formulate bioactives using advanced delivery systems Contact:   Dr James Falconer

Title:  Discovery of new drugs from indigenous Australian plants using supercritical fluids Contact:   Dr James Falconer

Title:  Design, construction, and development of supercritical fluid technology Contact:   Dr James Falconer

Title:  Characterisation of high pressure spray behaviour and bioactive Contact:   Dr James Falconer

Title:  Delivery of therapeutics to the posterior eye Contact:   Dr Harendra Parekh

Title:  Gene delivery in obesity & diabetes Contact:   Dr Harendra Parekh ,  Dr Ganesh Kokil

Title:  Development of bioresponsive drug/gene carrier systems Contact:   Dr Harendra Parekh , Dr Karnaker Tupally

Title:  Development of ultrasound-responsive formulations for diagnostic and therapeutic application Contact:   Dr Harendra Parekh , Assoc Prof Peter Cabot

Title:  Formulation of delivery systems for cannabinoid-based therapeutics  Contact:   Dr Harendra Parekh , Dr Juliana M Torres

Title: In silico led design, synthesis and evaluation of peptide/small molecule therapeutics Contact: Dr Harendra Parekh , Dr Ajit Kandale , Dr Rink-Jan Lohman ,  Assoc Prof Peter Cabot

Title:  Bioresponsive porous silicon-polymer composite nano- and micro-particles for oral protein delivery Contact:   Dr Amirali Popat

Title:  Mesoproous silica nanoparticles synthesis and application in drug delivery, diagnosis and therapeutic protein delivery Contact:   Dr Amirali Popat

Title:  Inorganic nanoparticles for targeting bacterial biofilms Contact:   Dr Amirali Popat

Pharmaceutical Biology

Title:  Calcium homeostasis in cancer: identification and characterisation of novel drug targets  Contact:  Professor Greg Monteith  and  Professor Sarah Roberts-Thomson

Title:  Identification and characterization of novel ion and drug transporters and the design of novel high throughput screening assays for new pharmaceuticals Contact:   Professor Greg Monteith

Title:  Physiological regulation and the role of calcium transporters   Contact:   Professor Greg Monteith

Title:  Morphine and metastasis Contact:   Associate Professor Marie-Odile Parat

Title:  Role of caveolar proteins in glioblastoma Contact:   Associate Professor Marie-Odile Parat

Title:  Effect of perioperative pharmacotherapy of cancer patients on tumour Biology  Contact:   Associate Professor Marie-Odile Parat ,  Dr Ben Ross  and  Professor Nick Shaw

Biomedicinal Discovery and Development

Title:  Design, synthesis and evaluation of novel molecules for the treatment of Alzheimer's disease Contact:   Dr Ben Ross

Title:  Computer-aided design, synthesis and evaluation of new drugs for cancer, pain and neurodegenerative diseases Contact:   Dr Ben Ross

Title:  Identification and evaluation of chemotherapeutic molecules in traditional plant-derived remedies used by the Aboriginal peoples Contact:   Professor Nick Shaw , Associate Professor Marie-Odile Parat and Professor Melissa Fitzgerald

Pharmacy Education Research Centre

No current projects available.

Alan Grant-Taylor Memorial Scholarship: Community Pharmacy Practice

Find out more about the Alan Grant-Taylor Memorial Scholarship

UQ Summer and Winter Research Programs

Coordinated by the UQ Student Employability Centre, these programs provide an opportunity for scholars to work with a researcher in a formal research environment in their area of interest.

By participating in a program students will gain valuable academic and professional opportunities, develop analytical, critical thinking, and communication skills, and have an opportunity to cultivate links with industry and academic contacts. 

It is also a chance to ‘test drive’ research before embarking on further research studies or higher degree research projects. Participation is open to undergraduate students and Masters by coursework students.

All students participating in the summer and winter programs will receive a scholarship. General information on the program, including how to apply, is available from the UQ Student Employability Centre’s program website .

Available Programs

Exploring stakeholder perspectives on definition of psychotropic medications for aged care regulation: a qualitative study, supervisors.

Dr Shakti Shrestha and Dr Adam La Caze

The safety concerns and limited benefit of psychotropic medications in Australian aged care setting led to major change in regulatory requirements. For this purpose, any drug capable of affecting the mind, emotions, and behaviour is considered as psychotropic medication. A wide range of medications fall under this definition, which can have aged care practice implications. It is not clear how aged care stakeholders perceive this definition and the approach(es) they take to meet the regulatory requirements within the scope of this definition. 

To examine aged care stakeholders’ perspective towards definition of psychotropic medication and their approach to meet the associated regulatory requirements.

Qualitative data from semi-structure interview that was collected from key stakeholders of aged care provider organisations as a part of a larger project will be used for this study. The data will be thematically analysed using a Qualitative Data Analysis Software until saturation will be achieved. This will result in themes around the aim of this project.

Implication

The outcome of this project will provide evidence on the effect of the current definition of psychotropic medication in aged care practice to the concerned regulatory bodies for the first time. Whether necessary appropriate guidance could be derived from the recommendations of this project.

Nanomedicine for overcoming biological barriers

A/Prof Amirali Popat

Advanced porous materials and permeation enhancers (PEs) strategies could be a key approach to improve transport of poorly absorbed active pharmaceutical ingredients across the intestinal epithelium.

Working on this project, you’ll explore permeation enhancers effect of porous nanoparticles to improve oral bioavailability of poorly soluble/permeable drugs and test its ability across many biological barriers (Brain, Gut, Lungs etc). A/Prof. Amirali Popat laboratory work experience will train you in preparation and characterization methods (FTIR, TGA/DSC, SEM, TEM and XRD, etc.) relevant to porous nanomaterials and their in-vitro intestinal permeability studies.

  • Higher Degrees by Research
  • Centre for Optimising Pharmacy Practice-based Excellence in Research
  • Optimising Medicine Information Handover After Discharge (OPTMED-D)
  • Safe and Effective Medication Collaborative
  • Seminar Series

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  • Can Pharm J (Ott)
  • v.149(4); 2016 Jul

Pharmacy Practice Research Abstracts

Table of contents.

This year, the Canadian Pharmacists Association (CPhA) and the Alberta Pharmacists’ Association (RxA) partnered to deliver four days of exciting educational sessions, exceptional keynote speakers, social events and networking opportunities at the annual Canadian Pharmacists Conference.

The Canadian Pharmacists Conference is an excellent opportunity for pharmacists from across Canada to network with colleagues and to share new and exciting ideas, research and innovation. Our oral and poster pharmacy practice research presentations provide an opportunity for members of the pharmacy community to engage in sessions that promote evidence-based practice and decision-making.

To help promote and disseminate pharmacy practice research, CPhA publishes the abstracts of the research presented at the conference in this special supplement of the Canadian Pharmacists Journal .

PHARMACY PRACTICE AND CARDIOVASCULAR HEALTH

S1 ECG screening in community pharmacy: An innovative pilot program to improve detection of cardiac arrhythmias in high-risk patients

S2 Impact of the Community Pharmacists Assisting Total Cardiovascular Health (CPATCH) strategy for improving medication adherence from community pharmacies – A cluster-randomized trial

S3 The Alberta Vascular Risk Reduction Community Pharmacy Project: RxEACH

SUCCESSFUL PHARMACISTS: POINT OF CARE AND MORE

S4 Implementation of a standardized HbA1c clinic worksheet to improve detection of drug therapy problems: Results from a multi-pharmacy pilot program

S5 Community pharmacist bone density point-of-care screening with osteoporosis and fracture risk estimation

S6 Defining characteristics of successful pharmacists

THE ELDERLY IN PHARMACY

S7 Development and implementation of a pharmacist intervention for frail elderly patients in an interdisciplinary primary care team: A qualitative analysis

S8 Identifying drug-related problems in retirement home residents following community pharmacist administered flu vaccinations

S9 Deprescribing guidelines for the elderly: Overview of findings from a 3-year program of research

MEDICATION ASSESSMENT AND MODELS OF CARE

S10 Community pharmacist standardized home medication consultation program by referral: Structured approach to identifying drug-related problems in the home-bound population

S11 The Medication Assessment Centre: A novel student training and patient care program

S12 Collaborative care model involving eHealth to improve treatment adherence and health outcomes of patients with gout

HOT TOPICS IN PHARMACY PRACTICE RESEARCH

S13 Effectiveness of community-based pharmacist interventions in chronic non-cancer pain: A systematic review

S14 The consideration of sex/gender and vulnerable populations in pharmacy practice research

POSTER ABSTRACTS

S15 Introducing a unit-based clinical pharmacist: A pilot study

S16 Patient-centered renovations

S17 Medication reconciliation practices on discharge into primary care homes in Prince George, British Columbia

S18 Stakeholder perspectives on economic analyses of billable pharmacy services in Ontario

S19 Opportunity and cost: Self-monitoring of blood glucose in Manitoba, 2000-2013

S20 Ibuprofen provides superior antipyretic efficacy vs. acetaminophen in childhood fever: Pooled analysis of 2 randomized trials

S21 Development of a hormonal contraception decision support tool for pharmacists

S22 The pharmacy services framework: Communicating the shift to clinical pharmacy services in Alberta

S23 Provider and patient perspectives regarding a community pharmacist-based case finding and intervention program — Alberta Vascular Risk Reduction Community Pharmacy project: RxEACH

S24 An audit of 8 centres’ use of anticoagulant therapies when discharging patients from hospital with acute venous thromboembolism

S25 An audit of 8 centres’ use of anticoagulant therapies when discharging patients from the emergency department

S26 Enhancing depression outcomes with better use of antidepressants: Evaluation of a pharmacy benefit manager–sponsored depression disease state management program

S27 Pharmacist intervention for a frail elderly population in primary care

S28 Impact of pharmacist assessment on classes of high-risk medications in a geriatric outpatient clinic

S29 Description of medication management problems and supports used in community-dwelling seniors

S30 Effectiveness of the peer-to-peer mentoring model for transitioning from classroom to professional practice

S31 Community pharmacy reports of potential QTc-prolonging drug interactions involving fluoroquinolones or macrolides: A multi-incident analysis

S32 Medication incidents involving insulin: A multi-incident analysis

S33 Potentially inappropriate medication use in older adults: A multi-incident analysis

S34 Patient counseling: An overarching method to mitigate medication errors and ensure continuity of care

S35 Older people’s attitudes towards deprescribing: A community study in Quebec

S36 The effect of health media reporting on self-medication use

S37 Documentation of functional medication management in older adults within an acute care hospital

S38 Global citizenship framework — Application to pharmacy student experience

S39 How does pharmacist prescribing fit with family physicians’ practice in Alberta? Developing a knowledge translation strategy

S40 Medication incidents involving smoking cessation therapies

S41 Medication incidents involving immunosuppressive agents

S42 Medication incidents that could have been prevented at the prescribing stage

S43 Direct oral anticoagulant medication incidents

S44 Drug allergy incidents in community pharmacies

S45 Medication incidents associated with hospital discharge

S46 Successful pharmacists: A qualitative study to understand pharmacists’ definitions of successful pharmacy practices

ECG screening in community pharmacy: An innovative pilot program to improve detection of cardiac arrhythmias in high-risk patients

John Papastergiou, BScPhm; Larissa Boychuk, BSc, PharmD candidate

Objectives:

Undiagnosed arrhythmias such as atrial fibrillation and torsades de pointes can have serious health consequences. Atrial fibrillation causes 1/3 of strokes and 1.4% of these patients are undiagnosed. Over 150 medications are known to prolong QT intervals. The purpose of this study is to assess point-of-care ECG screening in identifying undiagnosed abnormalities in high-risk patients in a community pharmacy setting.

High-risk patients were invited to participate in ECG screening at two community pharmacies in Toronto, Ontario. Patients met eligibility requirements if they were at risk of QT prolongation or atrial fibrillation secondary to medication therapy or a CHADS2 score of >2, respectively. Using the HeartCheckPenTM handheld device, a 30 second lead II screening test was performed. Data was uploaded to an ECG reading service where results were interpreted by a qualified professional. Results were forwarded to the pharmacy for follow-up. Pharmacists referred all patients with abnormal readings to their primary care physician for further investigation.

Thirty-five patients participated in the program. Eleven were identified at risk for atrial fibrillation and 18 for QT prolongation — 5 patients met both criteria. Screening identified 10 (28.6%) patients with one or more abnormal rhythms. These included premature atrial contraction (n=3), wide QRS (n=4), sinus arrhythmia (n=1), sinus tachycardia (n=3) and QT prolongation (n=1). Pharmacists referred all patients and, in the case of QT prolongation, intervened to alter therapy.

Conclusions:

Our experience demonstrates that point-of-care ECG testing can be successfully integrated into pharmacy workflow. The results illustrate the prevalence of abnormal rhythms in high-risk patients. They highlight a significant opportunity for pharmacists to use point-of-care screening as a tool to detect abnormal rhythms, intervene when warranted, and improve medication safety.

Impact of the Community Pharmacists Assisting Total Cardiovascular Health (CPATCH) strategy for improving medication adherence from community pharmacies – A cluster-randomized trial

David Blackburn, PharmD; Charity Evans, PhD; Jeff Taylor, PhD; Kerry Mansell, PharmD; Derek Jorgenson, PharmD; Yvonne Shevchuk, PharmD; Alfred Rémillard, PharmD; Dean Eurich, PhD; Bill Semchuk, PharmD; Anne Champagne, BSP

The highest risk for non-adherence occurs during the first year after starting a new chronic medication. Community pharmacists are well positioned to identify problems and provide support during this critical time.

Thirty community pharmacies in Saskatchewan, Canada, were randomized to deliver a brief adherence intervention or usual care to new users of HMG-CoA reductase inhibitors (statins). The intervention consisted of screening for new statin users, assessment for adherence barriers, and individualized follow-up when appropriate. The primary endpoint was mean statin adherence measured by the proportion of days covered (PDC). During follow-up, intervention pharmacies performed monthly assessments to estimate compliance with the study protocol.

A total of 1,906 new statin users were followed for six to twelve months following their first statin dispensation. No significant differences between intervention and control pharmacies were observed for mean adherence (72% (SD 33) vs 71% (SD 33); p=0.64), median adherence (89% versus 88%; p=0.84), or the percentage of subjects achieving optimal adherence (i.e., PDC ≥80%: 57.3% (520/907) versus 55.8% (558/999); p=0.51). However, several intervention stores reported poor compliance to the study protocol. In post-hoc analyses, mean adherence among pharmacies reporting good compliance with the study protocol was substantially higher than stores with poor compliance (76% versus 66%; p<0.01), and the percentage of patients achieving optimal adherence was 63% vs 52% (p<0.01) respectively.

The CPATCH strategy was not effective for improving statin adherence compared to usual care in community pharmacies. However, post-hoc analyses suggested that successful implementation might be the key to achieving important benefits.

The Alberta Vascular Risk Reduction Community Pharmacy Project: RxEACH

Yazid Al-Hamarneh, BS(Pharm), PhD; Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc; Charlotte A. Jones, MD, PhD; Brenda R. Hemmelgarn MD, PhD

Despite the risk associated with hypertension, diabetes, dyslipidemia, and smoking, these cardiovascular disease (CVD) risk factors remain poorly identified and controlled. To evaluate the effect of a community pharmacy-based case finding and intervention program on estimated cardiovascular risk.

Design: Randomized controlled trial. Setting: 56 community pharmacies across Alberta. Population: Adults at high risk for CVD events, including those with diabetes, chronic kidney disease, vascular disease and/or Framingham score > 20% who have at least one uncontrolled risk factor (hypertension, LDL-cholesterol (LDL-c), HbA1c, or current smoking). Randomization: Participants were randomized (1:1 basis) into advanced or usual care groups. Advanced care: Pharmacists provided participants with: Physical and laboratory assessments; Individualized CVD risk assessment and education; Pharmacists prescribed where appropriate to achieve treatment targets; Regular monthly follow-ups for 3 months. Usual care: Usual pharmacist care with no specific intervention for 3 months. Primary outcome: The difference in change in estimated CVD risk between advanced and usual care groups, calculated using a relevant risk calculator based on participants’ co- morbidities (Framingham, International, or UKPDS).

We enrolled 723 patients. Median age was 62 years (interquartile range 54-69), 57% were male and 27% were smokers. After adjusting for baseline values, the difference in change in CVD risk was 21% (p<0.001): a change of 0.2 mmol/L in LDL-c (p<0.001), 9.4 mmHg in systolic blood pressure (p<0.001), 0.92% in HbA1c (p<0.001), and 20.2% in smoking cessation (p=0.002) between advanced and usual care groupsaccess (96% and 91%).

This is the first large randomized trial of CVD risk reduction in community pharmacy settings. Patients in the advanced care group were 21% less likely to have a heart attack, stroke, or peripheral artery disease when compared to those in the usual care group. RxEACH provides evidence for the benefit of pharmacist care on both global CVD risk and individual risk factors

Implementation of a standardized HbA1c clinic worksheet to improve detection of drug therapy problems: Results from a multi-pharmacy pilot program

John Papastergiou, BScPhm; Bryan Gray, BScPharm, RPh, CDE

Point-of-care HbA1c screening devices are a valuable tool that community pharmacists can use to monitor patients with diabetes and improve their overall management. Here, we report data from a multi-pharmacy pilot program where a standardized worksheet was used by pharmacists offering HbA1c clinics in order to standardize the structure of the patient interviews and improve detection of drug therapy problems.

Thirteen community pharmacies from across Ontario interested in offering HbA1c screening as part of their professional programmes participated in the pilot program. Pharmacists received training on the use of the standardized worksheet and were provided with all the tools required to hold a clinic. HbA1c analysis was performed using the Roxon A1c Now®. Data collection took place over a period of 4 months beginning August 2015.

Eighty-eight patient attended the clinics. The mean HbA1c of the population was 7.76. Overall, 36% of patients had optimal glycaemic control (A1c <7.0%), 45% were hyperglycaemic (A1c >7 and <9%) and 19% of patients had marked hyperglycaemia (A1c >9.0). A total of 204 interventions were performed by pharmacists. An average of 2.32 interventions were performed per patient, and we observed a trend towards increased numbers of interventions in patients with poorer glycemic control. Interestingly, 23% and 15% of patients met the CDA guideline requirements for therapy with a statin and an ACE/ARB, respectively, but were identified by pharmacists as not receiving the appropriate therapy.

These results illustrate the prevalence of suboptimal glycaemic control among patients with diabetes in the community. They highlight a significant opportunity for pharmacists to use point-of-care screening in combination with a standardized worksheet to more readily detect drug therapy problems and intervene to improve disease management when warranted.

Community pharmacist bone density point-of-care screening with osteoporosis and fracture risk estimation

Bryan Gray, BScPharm, RPh, CDE

Point-of-care bone density screening is a valuable tool that community pharmacists can use to identify and educate patients at risk for osteoporosis and fractures. Here, we report data from screening 66 patients (12 male) at structured bone density clinics held at a community pharmacy in Thunder Bay, ON.

Bone density analysis was performed using the Omnisense 8000. Fracture risk factors and the point of care T-scores were interpreted with both the Canadian CAROC estimator and the WHO FRAX risk estimator to provide a 10-year fracture risk assessment. Recruitment involved in-pharmacy promotion to all patients. Data collection took place over a period of 3 months.

Testing successfully identified patients potentially at risk for osteoporosis and fracture. The CAROC found 5, 7, and 54 patients at high, moderate, low risk, respectively, for developing fracture over a 10-year period. The WHO FRAX calculator found a similar distribution with ten patients receiving a major fracture risk estimate 10% or greater, and five patients with a hip fracture risk estimate 5% or greater. The average patient age was 61, and the average BMI was overweight at 29. A total of 273 recommendations were provided by the pharmacist — average 4.13 per patient.

These results illustrate the prevalence of potentially undiagnosed osteoporosis for patients in the community. Our intervention data suggests that a structured bone density consultation by a community pharmacist can identify patients at risk for fractures. Patients at low risk were given evidence based and practical recommendations to maintain their bone health and reduce the risk of developing osteoporosis. Continued expansion in scope of pharmacy practice may contribute to increased osteoporosis identification and reduction in fracture risk.

Defining characteristics of successful pharmacists

Jay Mutch, BScPharm (student); Lydia Cheung, BScPharm (student); Theresa Charrois, BScPharm, ACPR, MSc; Jill Hall, BScPharm, ACPR, PharmD; Meagen Rosenthal, PhD; Ken Cor, PhD

Our primary objective was to identify the self-described characteristics of pharmacists that contribute to their success. Our working definition of success in pharmacy is based on the premise that successful pharmacists practice to the full extent of their knowledge and skills. The definition was derived from a literature review as well as the Blueprint for Pharmacy.

Semi-structured individual interviews were conducted with selected pharmacists. The interview tool was developed using previous research on success in health care professions and was modified based on trial interviews with faculty and practitioners. Potential candidates were nominated by prominent pharmacists in the field, using our definition of success. Lists from the nominators were compared and 10 pharmacists who appeared on more than one list were invited to participate.

A total of 8 out of 10 interviews have been analyzed to date. All 8 pharmacists had additional prescribing authorization (APA), with 4 of those pharmacists being early adopters (receiving APA prior to remuneration model implementation). In terms of factors contributing to success, participants noted strong communication skills and developing relationships as important. When asked what success meant to them, participants believed that self-development played a large role. Participants also felt a focus on emotional intelligence would help ensure the success of pharmacist practice in the future.

A clearly delineated definition of success was developed and used to frame interviews with practitioners viewed as successful by their peers. Communication skills were the most prominent factor that contributed to success. This data will help individual pharmacists become aware of what characteristics they may want to foster in themselves in order to have success in practice.

Development and implementation of a pharmacist intervention for frail elderly patients in an interdisciplinary primary care team: A qualitative analysis

Tejal Patel, PharmD; Lindsay Donaldson, BA; Linda Lee, MD; Jillian Bauer, BScPharm; Cathy Schill, BScPharm

There is a paucity of published literature describing activities involved in the implementation of an intervention in an interdisciplinary primary care environment. The objective of this research is to describe the development and implementation of the pharmacist intervention (PI) for frail elderly patients in an interdisciplinary primary care team.

This study is a deductive qualitative analysis of emails and meeting minutes pertaining to the PI for frail patients. Classical content analysis was conducted to quantify previously established codes and themes pertaining to: 1. Goal of the PI (e.g. codes: literature review, objectives of PI, etc); 2. Delivery of the PI (e.g. codes: care provision, follow-up, tracking outcomes, etc); 3. Work Environment (e.g. codes: roles and responsibilities, availability of staff, workflow processes, etc) and 4. Sustainability of PI (e.g. codes: scheduling, etc).

Of the 2,830 email items and minutes of 4 meetings between pharmacists, physicians, nurses, receptionists and administrators that were reviewed, 172 emails and 4 meeting minutes were eligible for classical content analysis. Of the resulting 718 coded items, 40% were related to Work Environment, 36% to the Delivery of the PI, 12%, each, to the Goal and Sustainability of the PI. The number of items coded for Goal of PI decreased from a high of 50 items in the period of 6 months pre-initiation to 2 items at the end of 24 months post initiation of PI. The number of items pertaining to the codes, “tracking” and “follow-up” of patients increased from 4 and 0 at 6 months pre-initiation to 19 and 39 at 24 months post-initiation of PI, respectively.

The impact and importance of the different aspects, such as the goal, delivery of the program, working environment and relationships changed with time. This analysis may be used to improve planning of other interventions in primary care in the future.

Identifying drug-related problems in retirement home residents following community pharmacist administered flu vaccinations

Community pharmacist administered flu vaccinations serve as an opportunity to screen patient’s medication profiles for drug-related problems. Here, we report data from medication consultations of 58 patients (16 male) from three retirement homes in Thunder Bay, ON.

Consenting retirement home residents were scheduled for a flu vaccination and a subsequent medication consultation. Following intramuscular vaccine administration, resident’s medication regimens and health status were screened for potential drug-related problems. Following consultation, the community pharmacist communicated potential drug-related problems to the resident’s primary care provider. Data collection took place over a period of 1 month.

Following vaccination, standardized medication consultations identified a total of 579 potential drug-related problems — an average of 9.98 interventions per patient. Very few of the patients were aware of their overall vaccination status (291 recommendations). Many patients were receiving inappropriate cardiovascular disease medications (over treating hypertension or lipids (76 recommendations). Consolidation of the medication regimen was very well received by residents (46 recommendations). The average patient age was 87 years old, with 9.5 medications per patient (average), with an average number of dosing intervals of 3.6 per day. Recommendations to improve adherence could reduce dosing intervals to 1.9 per day. Patients were appreciative to have their medication regimen and health status reviewed by the pharmacist instead of waiting independently for the 15 minutes post vaccination time period to pass.

In addition to the benefits provided by vaccination, subsequent medication consultations successfully identified potential drug-related problems.This data suggests that retirement home residents may be at risk for drug-related problems which may be mitigated by pharmacist intervention.

Deprescribing guidelines for the elderly: Overview of findings from a 3-year program of research

Barbara Farrell, BScPhm, PharmD, FCSHP; Lalitha Raman-Wilms, BScPhm, PharmD, FCSHP; James Conklin, PhD; Lisa McCarthy, BScPhm, PharmD, MSc; Kevin Pottie; MD MCISc; Carlos Rojas-Fernandez, BSc(Pharm), PharmD; Lise Bjerre, MD, PhD, MCFP; Hannah Irving, MA

Class-specific deprescribing guidelines are a potential solution to address the problem of polypharmacy. Optimal approaches to developing and implementing such guidelines with practitioners have yet to be identified. The purpose of the study was to understand factors associated with successful deprescribing guideline development, implementation and uptake and whether self-efficacy for deprescribing was affected.

Deprescribing guidelines were developed using AGREE-II (Appraisal of Guidelines for Research and Evaluation), and GRADE (Grading of Recommendations Assessment, Development, and Evaluation) to rate certainty of evidence and strength of recommendations. Developmental evaluation was performed using ethnographic methods: observations and interviews with guideline development and site implementation teams, and facilitated feedback sessions to discuss and agree on process improvements. Self-efficacy surveys were completed. Setting and participants included guideline development team members; members of three Family Health Teams and three Long-Term Care sites in Ottawa, Canada; and study team members.

Three evidence-based deprescribing guidelines were developed (proton pump inhibitors, benzodiazepine receptor agonists and antipsychotics). Process components and resulting decision-aid algorithms will be presented. Factors that facilitate successful development include team members’ expertise in content/ methods, access to additional expertise/resources through professional networks, and staff support. Development processes were modified for the 2nd and 3rd guidelines to ensure clarity in scope and responsibilities. Site implementation experience suggests practitioners are more interested in how to implement deprescribing approaches versus existing evidence to support stopping medications, that practice site priorities and processes shape ability to incorporate recommendations and that aligning guidelines with existing processes is critical to implementation success. Self-efficacy increased among 9 consistent respondents across all guidelines. Examples of how site experiences influence development of deprescribing guidelines will be provided.

Optimizing a deprescribing guideline development and implementation process aims to facilitate clinicians’ ability to address polypharmacy. Developmental evaluation contributes to the improvement of processes used to develop and implement such guidelines.

Community pharmacist standardized home medication consultation program by referral: Structured approach to identifying drug-related problems in the home-bound population

Bryan Gray, BScPharm, RPh, CDE; Laura Bron, BScPharm, RPh, CDE

Perform home medication consultation to identify drug-related problems and communicate concerns to the primary prescriber. Secondary objectives: Identify trends across the different intervention categories, identify drug-related problem trends by disease states and project the anticipated cost savings from avoided hospital admissions.

A referring agency in Thunder Bay, ON, sent requests for Home Medication Consultations for 33 patients (11 male) over a 3 month period. Pharmacists screened the patient’s medication regimen and health status for potential drug-related problems. Following consultation, the community pharmacist communicated potential drug-related problems to the resident’s primary care provider.

A total of 223 interventions (average of 6.76 per patient) were provided to 23 different prescribers. Average age was 76 years. Twelve were immediately accepted, 8 were immediately declined, and the remaining 203 would be discussed at the patient’s next visit Secondary outcome: Pharmaceutical Opinion Classification Trends — The majority of recommendations were related to: requiring additional drug therapy, adherence, and sub-optimal response to current therapy. Secondary outcome: Disease State DRP Trends — Based upon disease state and medical conditions, immunization/vaccination status was the most common DRP, followed by adherence (opportunity to reduce dosing frequency, merge drugs to combination therapy, and adherence packaging), and mental health (8 DRPs related to sleep/insomnia, 14 DRPs related to depression/mood/anxiety, and 2 DRPs related to smoking). Secondary outcome: Projected Case Cost Forecasted Savings — This totals $12,062.19 cost savings for avoided hospital admissions with 2 avoided hospital admissions.

A standardized and structured approach to performing home medication consultations successfully identified potential drug-related problems.

The Medication Assessment Centre: A novel student training and patient care program

Derek Jorgenson, BSP, PharmD, FCSHP; Eric Landry, BSP, ACPR; Katherine Lysak, BSP, MSc candidate

The Medication Assessment Centre (MAC) was launched in 2011 by the College of Pharmacy and Nutrition (University of Saskatchewan), with the dual purposes of: (1) providing access to pharmacist-led comprehensive medication assessments for highly complex patients who cannot access the service elsewhere; and, (2) creating a novel faculty supervised experiential training program for pharmacy students, located on campus. The objective of this project was perform an evaluation of this program from the perspective of patients and physicians.

A retrospective chart review was performed on all patients who attended at least one MAC appointment between March 2014 and July 2015 to measure: number/ description of patients; referral sources; and numbers/severity of drug therapy problems (DTPs). An experience/satisfaction survey was mailed to patients and their physicians who utilized MAC between April and October 2015.

A total of 173 patients were included in the chart review. Patients were referred from both health professionals (65.9%) and self-referrals (34.1%). Patient mean age was 64.8, with a mean of 6.5 diagnoses and 13.8 different chronic medications each. Pharmacists identified 6.2 DTPs per patient (31.1% moderate severity using Schneider criteria). Surveys were mailed to 121 patients and 81 physicians (response rates 66.9% and 43.2%, respectively). Almost 95% of both groups described their experience as very satisfied/satisfied and reported that they would refer MAC to their friends/family/colleagues; 59.2% of patients and 88.6% of physicians felt MAC improved patient outcomes; 98.8% of patients felt they were treated with dignity/ respect and that the pharmacist listened to their concerns; and 97.5% of patients felt they were involved in decisions about their health.

MAC is meeting its objective of providing access to medication assessments for highly complex patients. Physician and patient experience has been very positive and highly supportive of the program.

Collaborative care model involving eHealth to improve treatment adherence and health outcomes of patients with gout

Nicole Tsao, BSc, BScPharm, MScPharm; Kam Shojania, MD; Alison Kydd, MD, PhD; Jessica Galo, BSc; Alyssa Howren, BSc; Carlo Marra, BScPharm, PharmD, PhD; Mary De Vera, PhD

The prevalence of gout is increasing and despite availability of efficacious therapies, sub-optimal clinical outcomes persist due largely to medication non adherence. Pharmacists may have a role in supporting patients to improve their gout management. The objective of this study is to pilot the feasibility of an interdisciplinary care model involving rheumatology, pharmacy, and dietetics using shared electronic medical records (EMRs) to provide gout care.

This is a proof-of-concept study that employs a pharmacist-driven protocol whereby they are responsible for providing medication management, adherence counselling, interpretation of lab tests, and corresponding titration of urate-lowering therapies. Eligible patients are adults age ≥19 who have been diagnosed with gout by a rheumatologist for ≥1 year, ≥1 flare in the past year, and serum uric acid (SUA) >360 µmol/L within past 2 months. Remotely located health team members use shared EMRs to exchange patient information and communicate on care plans. Study outcomes include the impact of the care model on patients’: SUA levels (target <360 µmol/L); medication adherence (Compliance Questionnaire for Rheumatology 5-items); functional status (HAQ); and quality of life (EQ-5D); assessed at 0, 3, 6, and 12 months. Target enrollment is 50 patients.

Preliminary results on 21 patients enrolled from 3 rheumatology clinics since Feb. 2015 include 85% males, mean age 56 years (SD 15). All patients were prescribed allopurinol. At 6 months, adherence rate was 50%, and average SUA was 350 µmol/L versus 445 µmol/L at baseline. To date, pharmacy has provided 71 consultations and dietetics 12 consults. Anecdotal pharmacist interventions also included drug dose increases, discontinuation of unnecessary medications, and prescription continuations.

A virtual interdisciplinary clinic for gout management with expanded pharmacists’ role appears feasible with preliminary data showing improvement in SUA.

Effectiveness of community-based pharmacist interventions in chronic non-cancer pain: A systematic review

Feng Chang, BScPhm, PharmD; Mo Chen, BSc, MSc candidate; Tejal Patel, BScPhm, PharmD

Chronic pain is a common condition that has significant impact on patients’ physical and psychological well-being. Pharmacists have a key role in providing patient-centred care to optimize drug therapy used in the management of chronic pain. To evaluate the effectiveness of interventions by pharmacists providing care in community settings for ambulatory patients with chronic non-cancer pain.

Six electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, COCHRANE, PsychInfo, EMBASE and International Pharmaceutical Abstract) were searched for randomized controlled trials (RCT) and non-randomized studies (NRS) published in the English language involving pharmacists providing direct care in the management of chronic non-cancer pain. Team based approaches were included if a pharmacist was involved. Manual bibliography searches with retrieved articles were conducted. Risk of bias was assessed for all included studies.

The search strategy identified 17 full-text articles from 14 studies. Six of the studies were based on pharmacist-only interventions and the other 8 involved pharmacists working as part of an interprofessional team. The most frequently used pharmacist intervention was consultation involving medication review, recommendations, follow-up, and patient education. There was variation across pain measures and other self-reported measures in the included studies, but most studies showed positive results. Pharmacist interventions significantly decreased pain scores, improved quality of life and patient satisfaction, and reduced medication-related side effects and cost. Pain intensity reduction achieved ranged 8%-21%.

Pharmacist interventions were positive in several domains studied. However, the clinical significance remains debatable due to heterogeneity in relation to intervention, outcome measures, clinical setting, sample size, and study duration.

The consideration of sex/gender and vulnerable populations in pharmacy practice research

Nancy Waite, PharmD; Martin Cooke, PhD; Katie Cook, MA; Emily Milne, PhD; Feng Chang, PhD; Lisa McCarthy, PharmD; Beth Sproule, PharmD

Funders often now require that sex and gender are main considerations in research programs, but provide little guidance about how this can be accomplished. The Ontario Pharmacy Research Collaboration (OPEN), a multi-institutional and multidisciplinary research program, adopted a sex/gender and vulnerable population (GVP) model within the collaboration to promote incorporation of sex, gender and other dimensions of vulnerability across OPEN’s research projects. This presentation (1) addresses why the consideration of GVPs matter to pharmacy practice and (2) describes the GVP model’s mandate, activities and experiences.

This mixed method study incorporates: (1) literature search of published work on this topic; (2) critical reflection of co-leads of the GVP team with regards to the creation and implementation of the model; and (3) surveys (n=37) and interviews (n=23) conducted with OPEN members about their knowledge of GVP issues and engagement with GVP services.

The consideration of sex/gender and vulnerable populations within pharmacy practice research is necessary, but lacking. Within OPEN, a GVP team was established to support research projects in their incorporation of sex/gender and various dimensions of vulnerability into research design, analysis and interpretation. According to OPEN members, knowledge pertaining to GVP issues in research increased through OPEN involvement. The GVP model “surfaced” domains traditionally neglected in the field but important to ensuring quality pharmacist practice. OPEN members have been receptive and engaged with the GVP model and mandate. However, more work needs to be done in order to fully translate this awareness into research practices.

There is a need for increased awareness and consideration of sex/gender and vulnerable populations in pharmacy practice research. The experience of OPEN suggests that a cross-project structure can help integrate these considerations into a large and complex research project. We encourage practitioners to consider GVP focused initiatives, tools, and models within their work.

Introducing a unit-based clinical pharmacist: A pilot study

Vinita Arora, RPh, BScPhm, ACPR, MEd, PharmD; Heather Parker, RPh, BScPhm; Alexandra Hernandez, PhD; Karyn Li, BSc candidate; Mehrdad Alizadeh, RPh, PharmD

A pharmacist was stationed on a forensic mental health unit to more fully participate in the interprofessional team. Since clinical pharmacy services were previously centralized, we evaluated the impact of this change on staff and patients of a forensic wing.

We administered anonymous surveys at three time periods, post 1, post 2, and post 3, at 1, 5, and 12 months, respectively (72 beds; nstaff 25, 27, 28; npatients 21, 21, 18) to examine themes of accessibility, education, and medication therapy management (MTM). Non-parametric chi-square analyses were used to examine differences in overall satisfaction (Strongly Agree and Agree responses combined) scores over the time periods. We also compared percentages of satisfaction in these themes and qualitative changes over time.

The average change in staff satisfaction from post 1 to post 3 was 8% for the Accessibility theme, 9.5% for the Education theme (2 to 17%) and 11% for the MTM theme (1 to 30%), with the increase in MTM satisfaction approaching significance (x2=5.911, p=0.052). The average change in patient satisfaction from post 1 to post 3 for questions in the Education theme was -12.5% (-5 to -24%) and -28% for questions in the Accessibility theme, however the decreases were not statistically significant. Qualitatively, there were positive changes stated by staff in all themes, most notably, accessibility; while patients expressed desire for increased services in all themes.

Being situated on a forensic mental health unit enhances involvement of the clinical pharmacist in the interprofessional team. Accessibility may be a precursor to provision of increased MTM and education. Limitations surrounding patient satisfaction need further consideration.

Patient-centered renovations

Joan Cochrane, BSP

My object was to renovate my pharmacy to make it easy for my pharmacists to provide better patient care.

We have designed our pharmacy so that the pharmacist is the first point of contact for the patient. The pharmacist is situated in a semi-private area at the front of the store. Our design has 2 of these “pharmacist interaction stations” to decrease wait time. The patient comes to the pharmacy, gives their prescription, refill or new, to the pharmacist and sits down across from the pharmacist. The pharmacist station has a computer with Internet access, a phone, a scanner and a computerized blood pressure monitoring system. This allows the pharmacist to handle the prescription in a single efficient interaction with the patient. If there are no problems to solve, the pharmacist can fill the prescription, the label prints at the island in the main dispensary area, if in the robot, it is automatically counted, if not, the technician assembles the medication and then brings it over to the pharmacist, who can hand it out. The pharmacist has been talking to the patient about the prescription and giving the appropriate information. Then the prescription is handed to the patient who is directed to the cash station. If there are problems, drug interactions, 3rd party coverage issues, etc., they can be taken care of right away.

Our staff and patients are very happy with the layout. We are doing more prescriptions every month and yet have found that we have more time than we used to. Our patients feel that when it is their turn with the pharmacist they have their undivided attention. They like that both they and the pharmacist are sitting down.

It is much easier to provide meaningful patient care if you have a pharmacy that is designed primarily with this function in mind. This new design with pharmacist stations and a work island for the techs replacing the long counter has proven to be very effective.

Medication reconciliation practices on discharge into primary care homes in Prince George, British Columbia

Robert Pammett, BSc, BSP, MSc

Medication reconciliation is an integral part of safe medication practices, and should occur at all stages of hospital transition, including discharge to the primary care home (PCH). Ensuring that the PCH has an up to date list of patient medications after discharge can help avoid medication misadventures. The objectives of this study were: (1) to determine the proportion of patients who had a discharge medication list communicated to the primary care home which contained discrepancies from the hospital medication list, and (2) to categorize discrepancies as prescription medication, non-prescription medication, or medication dose.

Two PCHs were recruited to participate in the retrospective chart review. Records of 50 patients who received a hospital discharge from June 1 2014 to May 31 2015 were identified at each PCH. The list of hospital medications at discharge was compared to the medication list that was communicated to the PCH at discharge. Discrepancies between these lists were identified and categorized, as was the medium in which the medication list was communicated to the PCH.

Seventy-eight cases were included in the final data analysis. Mean age of patients was 46.7 years, 59% being female. The mean number of medications taken was 6.3 per case. Four cases had no medication use. All discharge medication information was communicated via a dictated discharge summary. The total number of discrepancies identified was 280, a mean of 3.6 per case. The majority of discrepancies were prescription medication omissions or errors (69%). The remaining discrepancies were non-prescription medication omissions or errors (18%) and medication dose discrepancies (13%).

A large number of discrepancies were present between the hospital chart and the discharge summary that was sent to the PCH. Improving communication of the medication list at discharge should be encouraged to reduce potential medication errors.

Stakeholder perspectives on economic analyses of billable pharmacy services in Ontario

Sherilyn Houle, BSP, PhD; Jilan Yang, MD, MSc, PhD

A number of pharmacy services in Ontario are government-funded; however, little is known about the costs and benefits of these services. This study solicited stakeholder perspectives on the most valuable economic analysis designs, the priority services, and concerns related to the conduct of the research or dissemination of results.

Semi-structured telephone interviews were conducted with 16 stakeholders from government, academia, pharmacy industry/associations/regulators, and insurers in March and April 2015. Interviews were audiotaped, transcribed verbatim, and coded both manually and using NVivo. Data analysis employed the constant comparison approach to identify emerging themes and patterns.

There was consensus among stakeholders that high-quality economic evaluations of pharmacy services are needed. While evaluation of MedsCheck reviews was considered highest priority, influenza vaccination was widely identified as a suitable starting point given data availability and clear patient outcome measurement. A broad perspective including those of government/payers, the pharmacy profession, and patients is encouraged, with patient outcomes identified as more valuable than financial outcomes. However, accurate and complete patient outcome data collection was identified as a key challenge. Stakeholders reported a desire to be actively involved in economic evaluations and knowledge dissemination.

Researchers considering economic evaluations of pharmacy services are encouraged by stakeholders to incorporate broad perspectives beyond solely the interests of the profession. While patient health outcomes are valued above financial outcomes, care should be taken to ensure this outcome data is accurate and complete to minimize the impact of assumptions on the validity of the results. Stakeholder engagement at all stages of the research can help ensure the relevance and uptake of economic analyses conducted.

Opportunity and cost: Self-monitoring of blood glucose in Manitoba, 2000-2013

Olena Serwylo, BSc(Pharm), PharmD candidate; Kevin Friesen, BSc(Pharm), MSc candidate; Jamie Falk, BSc(Pharm), PharmD; Shawn Bugden, BSc(Pharm), MSc, PharmD

Given the limited evidence of benefit of frequent self-monitoring of blood glucose (SMBG) by non-insulin using patients with diabetes, new guidelines and test strip limit policies have been suggested and implemented in various Canadian jurisdictions. The objective of this study was to assess the overall utilization and cost associated with blood glucose test strips (BGTS) and lancets for SMBG in Manitoba from 2000 to 2013 and to assess potential implications of such a policy.

A cohort of all patients with diabetes in Manitoba from 2000-2013 was established. Test strip and lancet utilization and cost were assessed for the overall cohort and for subgroups based on the type of diabetes treatment. The potential opportunity for a more selective practice of SMBG was assessed.

In the year 2000, 8 million BGTS were dispensed in Manitoba, and this increased by 270% to 21.7 million by 2013. Insulin users accounted for the majority of test strip use. However, it was estimated that test strip use could be reduced by 16 million test strips over 5 years by taking a guideline based approach to monitoring, with 95% of the potential reduction occurring in groups not using insulin. Over the next 5 years, a guideline based approach is projected to save $12.35 million, including $7.3 million in government spending.

Some provinces have placed therapy-linked limits on BGTS use. Whether or not a test strip limit policy is in place there is an important opportunity for pharmacists to help guide patients with diabetes to determine optimal frequency of SMBG. Expenditures above guideline recommendations represent an opportunity cost, money which could be redirected to programs and more useful interventions for the growing population of patients with diabetes in Manitoba.

Ibuprofen provides superior antipyretic efficacy vs. acetaminophen in childhood fever: Pooled analysis of 2 randomized trials

David Kellstein, PhD; Shyamalie Jayawardena, PhD

Compare antipyretic efficacy and safety of ibuprofen (IBU) vs acetaminophen (APAP) in children with fever from a pooled analysis of 2 studies.

Two IRB-approved, randomized, double-blind studies enrolled children 0.5 - 11 y, 13 - 95 lb with fever (101.5 - 104.9°F, rectally, ages 0.5 - 3 y; 101.0 - 103.9°F, orally, ages 4 - 11 y) for ≥2-h duration to single-dose IBU suspension (Children’s Advil® Suspension 7.5 mg/kg) or APAP suspension (Children’s Tylenol® Suspension 10 – 15 mg/kg) based on labelled dose/age. Temperatures (temperature; average of 2 readings) were assessed at baseline (predose) and after single dose of study medication at 15, 30 and 45 min and hourly from 1 - 8 h thereafter. Primary efficacy: time-weighted sum of temp difference from baseline over 8 h evaluated via analysis of variance. Secondary efficacy endpoints included time to onset and duration of temp control (temp: <100°F orally or <101°F rectally) via Cox proportional hazards; percentage with temperature control (Cochran-Mantel-Haenszel); safety was monitored throughout.

In total, 319 children (144 male, 175 female; 94% white; mean age 4.6 y; mean weight 42 lb) were evaluable for efficacy; 333 comprised the safety set. On primary efficacy, IBU 7.5 mg/kg was significantly better in terms of time-weighted sum of temperature differences vs APAP 10 – 15 mg/kg: mean (SD) -11.1 (8.5) vs -7.6 (8.0); p<0.001. Onset of temperature control occurred significantly earlier (median: 94.5 vs 111.6 min; p<0.001), lasted significantly longer (median: 191.3 vs 122.7 min; p=0.042) and occurred in a significantly higher percentage of children (89.6 vs 66.7%; p<0.001) with IBU suspension vs APAP suspension. Fifteen AEs occurred in each group; none severe. Most common AE was vomiting (4.6%: IBU; 6.3%: APAP; p>0.05).

IBU paediatric suspension (7.5mg/kg) is superior to APAP suspension (10 - 15mg/ kg) in treating paediatric fever, with better temperature reduction that was faster and of longer duration compared with APAP. Both products were well tolerated.

Development of a hormonal contraception decision support tool for pharmacists

Nese Yuksel, BScPharm, PharmD, FCSHP, NCMP; Humirah Sultani; Tasneem Siyam, BScPharm, MSc

Hormonal contraception continues to be a popular and effective method of contraception among women. With the expanded scope of practice in Alberta, pharmacists are perfectly positioned to manage the hormonal contraceptive needs of women, including initiating and adjusting hormonal contraceptives. The objective of this project is to develop a decision support tool to help pharmacists manage hormonal contraceptives in the community.

Development of the decision support tool involved a panel of local pharmacists with expertise in women’s health. Content of the tool was informed by current contraception guidelines, published literature and research team experience. The developed prototype was then reviewed by experts in the field including a pharmacist and nurse specialized in contraception, an obstetrician-gynecologist and a family physician with interest in women’s health. The modified prototype was alpha tested in a small cohort of community pharmacists (n=10) for acceptability and usability.

The tool includes 4 sections: (1) Patient Assessment — includes screening for indications, contraindications and risk factors, (2) Initiating Hormonal Contraceptives — includes guidance in choosing among different products, (3) Patient Education — provides an educational overview for shared decision making, and (4) Managing Ongoing Therapy — includes monitoring recommendations, approaches to dealing with side effects and adjusting therapy. An appendix with available Canadian Hormonal Contraceptives is also provided.

An evidence based clinical decision support tool may be a useful tool for pharmacists managing hormonal contraception in the community. Future plans are to evaluate the feasibility and applicability of the tool in the community setting.

The pharmacy services framework: Communicating the shift to clinical pharmacy services in Alberta

Theresa J. Schindel, BSP, MCE; Christine A. Hughes, BScPharm, PharmD; René Breault, BScPharm, PharmD; Deborah Hicks, MA, MLIS

To gain insight into communication of the Compensation Plan for Pharmacy Services, known as the Pharmacy Services Framework (PSF), by interpreting information described in news media articles, policies, government reports, and communications about the PSF.

Publicly available documents published 2012 - 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists’ Association, and the Blueprint for Pharmacy. Searches using the Canadian Newsstand database and Google identified additional documents. Search terms included “Pharmacy Services Framework,” “Compensation Plan for Pharmacy Services,” pharm*, compensat*, reimburse*, and Alberta. One research team member completed initial analysis of documents using a grounded theory approach and the entire team reviewed emerging thematic categories. During the analysis, attention was paid to how the PSF was presented to pharmacists and other audiences.

Preliminary analysis of documents written for practicing pharmacists consisting of government policies, newsletters, and other communications identified four main themes: reimbursing patient care services, legitimizing pharmacists’ professionalism, shifting focus to patient care role, and collaborating with health care team members. The PSF was framed as payment for professional services and as offering external validation and legitimization for pharmacists’ changing professional service roles. Further analysis of news media and communications directed to other audiences is underway.

Preliminary findings provide insight into how the PSF was communicated to pharmacists and other audiences. Researchers need to consider political and societal contexts that influence provision and reimbursement of clinical services. The results of this study will provide a foundation for future research on how clinical services reimbursed by the PSF are implemented.

Provider and patient perspectives regarding a community pharmacist-based case finding and intervention program — Alberta Vascular Risk Reduction Community Pharmacy project: RxEACH

Maoliosa Donald, BSc, MSc; Kathryn King-Shier, PhD; Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc; Yazid Al Hamarneh, PhD; Charlotte Jones, MD; Braden Manns, MSc, MD; Marcello Tonelli, SM, MD; Brenda Hemmelgarn, PhD, MD

To gain firsthand knowledge of pharmacists’ and patients’ experiences with pharmacist-based management of adults at risk for cardiovascular events.

Design: Qualitative descriptive — one on one telephone interviews. Setting: Community — Alberta. Population: Community pharmacists and patients. Data analysis: Multi-step process using conventional qualitative content analysis.

We completed 35 telephone interviews — 21 pharmacists and 14 patients, where we had 14 dyads (pharmacist and patient relationship). The majority of pharmacists were female (57%) between the ages of 36-45, and worked in an urban setting (57%) with 10 or less years of practice. Pharmacists reported a variety of factors that affected their ability to manage patients’ cardiovascular risk. These included features of their workplace (i.e., work autonomy, resources and physical space); their personal outlook and perspective (i.e., expanded professional role and professional development); collaborative physician/pharmacist relationship; and patient uptake. Common themes identified by patients included their trust of the pharmacist, ease of access to pharmacist services and presumed health care cost.

Understanding the provider and patient perspectives are key to maximizing the impact and sustainability of a pharmacy-based program to manage patients at high cardiovascular risk. Generally, patients were pleased with the clinical services provided by the pharmacist and pharmacists embraced the expanded clinical role.

An audit of 8 centres’ use of anticoagulant therapies when discharging patients from hospital with acute venous thromboembolism

Tammy Bungard, BSP, PharmD; Bruce Ritchie, MD; Cindy Jones, BScPharm; Jennifer Bolt, BScPharm, ACPR, PharmD; William Semchuk, MSc, PharmD, FCSHP

To report anticoagulant (AC) therapies patients receive for acute venous thromboembolism (VTE) upon hospital discharge.

This retrospective chart review from April 2014 to March 2015 included 4 urban Edmonton hospitals, 2 urban Regina hospitals and 3 rural Alberta hospitals. Patients > 18 years of age who were discharged with a diagnosis of VTE (DVT or PE) that lacked another indication for anticoagulant therapy and had an anticipated lifespan > 3 months were included. We primarily sought to assess the anticoagulant regimen prescribed for patients at hospital discharge and with whom follow-up care was to occur. Moreover, we sought to compare differences among the urban and rural centres.

After screening 1,047 patients, 692 (66.1%) were included. The majority of patients discharged from hospital had a PE (Edmonton 84.4%, Regina 81.2%, rural Alberta 63.3%). Novel oral anticoagulants (NOACS) were the most common discharge therapy in rural Alberta (50.0%), followed by warfarin (+/- a parenteral AC) (30.0%). In rural Alberta follow-up most commonly occurred with the GP (66.7%). In Regina, the most common therapy at discharge was warfarin (+/- a parenteral AC (59.0%) followed by a NOAC (23.9%), and a parenteral AC alone (16.2%). In Regina, the majority of follow-up was with the GP (52.1%) or specialist (52.1%). In Edmonton, 40.5% were discharged on warfarin (+/- a parenteral AC), 29.2% a parenteral agent alone, and 28.4% on a NOAC. Follow-up most commonly was with the general practitioner [GP] (29.9%) or VTE clinic (29.1%) in Edmonton.

The majority discharged after VTE-related hospitalizations have PEs, and NOACs are used more commonly in rural Alberta (50%) compared to urban centres (~25%). Depending on the centre, follow-up is either done via the family doctor or through specialists / VTE clinic.

An audit of 8 centres’ use of anticoagulant therapies when discharging patients from the emergency department

To report anticoagulant (AC) therapies patients receive for acute venous thromboembolism (VTE) upon discharge from the emergency department (ED).

This retrospective chart review included patients discharged from the ED with a diagnosis of VTE (DVT or PE) between April 2014 and March 2015. Two urban Edmonton hospitals having VTE clinics (Edm-VTE), 2 without VTE clinics (Edm), 2 urban Regina hospitals and 3 rural Alberta hospitals were included. We primarily sought to assess the AC regimen at ED discharge to the community and with whom follow-up care was to occur. Moreover, we compared differences among the urban and rural centres.

After screening 1,734 patients, 418 (24.1%) were included. The majority were discharged with DVT as compared to PE/PE plus DVT (Edm-VTE 54.5%, Edm 59.0%, Regina 91.7%, rural Alberta 80.0%). For Edm-VTE, discharge therapy with a parenteral AC alone (60.1%) or novel oral anticoagulant (NOAC) (20.0%) with follow up in the VTE clinic (80.6%) was most common. The majority for Edm were prescribed a parenteral AC (41.0%) or NOAC (40.3%) with either general practitioner [GP] (28.1%) or VTE clinic (33.8%) follow-up. In Regina, the majority (75.0%) were discharged on a parenteral AC with warfarin, with 11.9% each on a parenteral AC or NOAC, with GP follow-up (56.0%). Rural Alberta sites most commonly used NOACs (43.3%) or a parenteral AC with warfarin (26.7%), with GP follow up (53.3%).

Urban Alberta sites discharge more patients with PE (43.4%) from ED compared with Regina or rural Alberta sites. Traditional therapy with a parenteral AC (+/- warfarin) is still most commonly used at discharge, with anywhere from 12-43%receiving a NOAC across the sites assessed. NOAC use was most common (~40%) in rural Alberta and at the Edmonton site not having a VTE clinic. Variation in practice is evident.

Enhancing depression outcomes with better use of antidepressants: Evaluation of a pharmacy benefit manager– sponsored depression disease state management program

Katherine Giannoulis, BScPharm, CGP; Leanne McFarlane, BScPharm; Heather Creighton, BScPharm; Moira Reiley, BScPharm, CGP

Non-adherence to antidepressants is associated with poor health outcomes and is common in people with depression. Studies using medication possession ratio (MPR) or proportion of days covered (PDC) to calculate adherence found 34-56% of patients were adherent to therapy. Persistence to antidepressants at 1, 3 and 6 months is estimated to be 70-75%, 56-60% and 40-43% respectively. To improve adherence and patient depression outcomes MHCSI developed and funded a two-year pharmacist Depression Disease State Management (DSM) pilot program for plan members.

Pharmacists within MHCSI’s Preferred Provider Network were encouraged to have multiple consultations with each patient in-program over a one-two year period. Pharmacists received equal compensation for each consultation. Adherence was calculated at program completion based on drug claims data using the PDC method. Patients were considered adherent if the PDC was >80%. Persistence was calculated for patients new to antidepressant therapy. Pharmacists completed a Patient Outcome Survey for each patient.

There were 59 patients in the Depression DSM program. Patients had an average of three consults. The percentage of patients considered adherent to antidepressant therapy was 70%. The average proportion of days covered for participants was 81%. Persistence to 1, 3 and 6 months was 100%, 89% and 61%. Patient Outcome Surveys were completed for 57 of the 59 patients with 81% of respondents reporting that the patient had a better understanding of condition/treatment, 65% of the patients reported “feeling better” and 54% reported productivity gains.

This suggests a pharmacist longitudinal follow-up model may improve adherence to antidepressant medication with the goal of improving patient health outcomes.

Pharmacist intervention for a frail elderly population in primary care

Tejal Patel, PharmD; Jillian Bauer, BScPharm; Linda Lee, MD; Cathy Schill, BScPharm

In 2013, the Centre for Family Medicine Family Health Team initiated a new program called the “Case-Finding for Complex Chronic Conditions in seniors 75+ (C5-75)” to systematically screen for frailty among all persons aged 75 years and older to address medical conditions appropriately and to avert crises. As a component of this program, a pharmacist intervention was developed to address medication-related problems (MRPs). The objectives of this study are to describe the medication use in the population referred and activities performed by pharmacists in this program.

This was a retrospective medical records review of frail elderly patients seen by pharmacists in the C5-75 program from April 2013 to August 2015. Data pertaining to patient demographics, medical conditions, and medication history as well as activities performed and recommendations made by pharmacists were abstracted.

Of 142 patients (54 males and 88 females, mean age 85 years [range: 75-98]) identified as frail, 54 patients accepted the offer of a medication review with a pharmacist in the C5-75 program. At initial visit with the pharmacist, the means for number of total medications was 11.60 (range: 5-23), for prescribed medications, 7.67 (range: 3-20), and for over-the-counter medications, 3.93 (0-15). Polypharmacy and high-risk medication use was highly prevalent (83% and 93%, respectively). A total of 218 MRPs were identified among the 41 patients with at least one follow-up visit with the pharmacist. Pharmacists made a total of 222 recommendations. Of the 138 that were measurable, physicians had accepted 70% and 50% were implemented at most recent follow-up.

Polypharmacy, high-risk medication use and MRPs are highly prevalent in the frail elderly in primary care. Pharmacists were able to address these problems with recommendations, many of which were accepted and implemented.

Impact of pharmacist assessment on classes of high-risk medications in a geriatric outpatient clinic

Sharon Ong, BPharm, PharmD; Alexandra Marin, MD, CCFP, Dip. COR; Imran Hassan, MSc; Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC; Cheryl Sadowski, BSc(Pharm), PharmD, FCSHP

Seniors often take multiple medications because of a high burden of chronic diseases. This complex population is vulnerable to medication-related problems. Pharmacists can improve suboptimal prescribing in older adults, however, the evidence base for this is weak. Our objective was to determine if pharmacist assessment is effective in reducing classes of high-risk medications in seniors at a geriatric clinic.

We reviewed the medical charts of 245 patients aged 65 and over who were referred to our outpatient geriatric clinic and assessed using comprehensive geriatric assessment (CGA). The CGA team consisted of a geriatrician, medical trainee (student, resident or fellow), pharmacist (available part-time), and nurse. Since the pharmacist was only in the clinic on certain days, we conducted a non-randomized comparison of medication use in those seen by a pharmacist versus those who were not. Number of medications was compared using t-test and exact McNemar’s test was performed to assess medication changes.

The mean number of medications of patients assessed by pharmacist (n=99) vs not assessed by pharmacist (n=89) was 10.5 (SD 5.5) vs 9.4 (SD 4.7) with a mean difference of 1.07 (95% CI, -0.41 to 2.55), p=0.157. The proportions of patients taking acetylcholinesterase inhibitor in both pharmacist and non-pharmacist groups increased, respectively, from 20% to 37%, p<0.001 and 14% to 28%, p=0.001. Other classes of medication with statistical significant changes were exclusively in the pharmacist group, such as selective serotonin reuptake inhibitor from 20% to 27%, p=0.007; over-the-counter analgesic e.g. acetaminophen from 30% to 41%, p=0.002; non-steroidal anti-inflammatory drug from 22% to 16%, p=0.013; and antihistamine or other anticholinergic (not for overactive bladder) from 7% to 2%, p=0.016.

Pharmacist assessment as part of an interprofessional geriatric clinic team led to an improvement in medication use.

Description of medication management problems and supports used in community-dwelling seniors

Objective(s).

Seniors commonly have problems managing their medications due to extensive medication use, medication regimen complexity, and functional or cognitive limitations. With an aging population, it is important to identify these problems so that resources can be directed to meet their health care needs. The purpose of our study was to describe the medication management problems of seniors living in the community.

A retrospective chart review of patients aged 65 years and over who were referred to our geriatric clinic and assessed using comprehensive geriatric assessment (CGA). The CGA team consisted of a geriatrician, medical trainee (student, resident or fellow), pharmacist and nurse. Data were analyzed descriptively and McNemar’s test was used for changes in calendar packaging.

The mean age was 80.6 (SD 7.2) years, 41% lived alone and 46% lived with spouse/ partner. On admission, the mean number of medications (n=236) per patient was 9.8 (SD 4.8), and 46% had medications administered via a non-oral route. Medication-related problems were non-adherence (43%), difficulty managing medication (40%) and dependence with medication use (49%). The dependent patients obtained assistance from spouse or partner (37%), family member/living separately (25%), family member/living with (18%), formal home care cueing/ administration (11%) or monitoring (8%), and caregiver (9%). Calendar packaging from 55% to 70%, p<0.001, and community care services from 27% to 42%, following assessment.

Conclusion(s)

About half the seniors seen at the geriatric outpatient clinic had complex medication regimens, were non-adherent, had difficulty managing medications and were dependent with medication use. There appeared to be a high dependency on their spouse and family members in medication management. As such, assessing seniors for medication management and inquiring about supports for medication assistance are important roles for pharmacists in a geriatric practice.

Effectiveness of the peer-to-peer mentoring model for transitioning from classroom to professional practice

Thomas Huang, PharmD (student); Annie Lee, MSc(T), ACPR; Certina Ho, RPh, BScPhm, MISt, MEd; Edric Paw Cho Sing, PharmD; Michael Vinh, PharmD

To better prepare pharmacy students for practice by implementing a peer-to-peer mentoring model of student-led pharmacotherapy sessions (SLPS) in the PharmD program. The learning impact and the utility of the model for student preparedness for Advanced Pharmacy Practice Experiences and the licensing exam were examined.

Fourth-year students delivered SLPS on Cardiology, Infectious Diseases, and Patient Self-Care online and live to both third- and fourth-year students. Retrospective self-assessment surveys were administered after each SLPS. Five knowledge domains (etiology, clinical presentation, pharmacotherapy, monitoring/follow-up, and overall knowledge) were assessed. A paired t-test was utilized to evaluate the survey data. Thematic analysis was applied to the qualitative comments on the survey.

Eighty-one students (59% third-years; 41% fourth-years) responded to the survey. Prior to the SLPS, 46.8% of students rated their knowledge “Average” (3 of 5), while 33.1% rated their knowledge “Above Average” (4 of 5) in all knowledge domains. After the SLPS, 53.6% of students rated their knowledge to be “Above Average” (4 of 5), while 27.5% rated their knowledge “Excellent” (5 of 5) in all knowledge domains. Statistically significant increase (p<0.001) was shown in all five knowledge domains post-SLPS for both third- and fourth-year students. Students stated that cases, drug charts and therapeutic overview were the most useful. Suggestions for improvement included increased interactions, counselling points, and providing practice examples.

The peer-to-peer mentoring model was an effective model for student learning. Students perceived a therapeutic knowledge increase after attending the SLPS. Student presenters developed public speaking skills and built confidence while consolidating knowledge. This model has proven to be effective in developing skills and knowledge for students transitioning into professional practice.

Community pharmacy reports of potential QTc-prolonging drug interactions involving fluoroquinolones or macrolides: A multi-incident analysis

Roshan Tahavori, RPh, BScPhm, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Significantly prolonged QTc may lead to torsades de pointes (TdP) in at-risk patients. Fluoroquinolones (FQs) and macrolides have the potential to prolong the QTc, and given their widespread use, are implicated in relatively high number of significant QTc-prolongation events. The purpose of this project was to analyze incidents of potential QTc-prolonging drug interactions involving FQs and macrolides, in order to fill in patient-safety gaps.

We searched the Community Pharmacy Incident Reporting program for QTc-related incidents involving FQs and macrolides between April 2010 and January 2015. Using a qualitative, multi-incident analysis approach, we analyzed 56 incidents, identified themes, potential contributing factors, and provided recommendations.

Most incidents were pharmacy-intercepted drug interactions (i.e., near misses) involving moxifloxacin, ciprofloxacin, clarithromycin, and azithromycin. Commonly reported classes of interacting drugs were antidepressants, antiarrhythmics, and antipsychotics. The following themes and possible contributing factors were captured: 1) Prescriber-triggered potential for QTc-prolongation due to absence of drug-interaction assessment, 2) Potentially inappropriate pharmacist-intervention due to absence of patient risk-assessment, and 3) Patient-potentiated risk for harm due to polydoctoring and polypharmacy practices while failing to disclose complete medication lists to the providers.

Prescribers should seek patients’ complete medication list and medical history, and make TdP risk-assessment when prescribing drugs with QTc-liability. Pharmacists should assess patients’ risk factors for QTc-prolongation before intervening on drug-interactions. We developed a QTc-Prolongation Risk Factors Checklist to facilitate these assessments. Patients should regularly be provided with a comprehensive medication list and educated on safe medication use by pharmacists.

Medication incidents involving insulin: A multi-incident analysis

Carolyn Kasprzak, RPh, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Insulin is a life-saving pharmacological therapy for many diabetic patients. However, insulin has been identified as a high alert medication as it has the potential to cause detrimental patient harm when used in error; particularly, an excessive dose can lead to life-threatening hypoglycemia. The objective of this multi-incident analysis was to examine insulin-related medication incidents and determine potential system-based improvements that may be customized in pharmacy practice to enhance medication safety.

Reports of medication incidents involving insulin were extracted from a national incident reporting database between January and December 2014. After a review of 226 incidents, 81 were included in this qualitative, multi-incident analysis. The incidents were then analyzed and categorized into main themes and subthemes.

The four main themes identified were: (1) product selection (related to unique insulin properties), with prescribing, order entry and dispensing as subthemes; (2) therapeutic regimen change; (3) dosage calculations; and (4) storage requirements. Potential solutions for prevention of insulin-related incidents included the use of standardized pre-printed order forms, integrating warning flags into pharmacy software, incorporation of independent double checks throughout the entire pharmacy workflow, and conducting comprehensive diabetes-focused medication reviews with patients.

Medication incidents involving insulin in pharmacy practice are common and have the potential to cause serious patient harm. Findings from this analysis are intended to educate health care professionals on the vulnerabilities in the medication-use process that may contribute to insulin-specific medication incidents and offer recommendations to prevent such events from recurring.

Potentially inappropriate medication use in older adults: A multi-incident analysis

Kelly Ng, BSc, PharmD candidate; Certina Ho, RPh, BScPhm, MISt, MEd; Roger Cheng, RPh, BScPhm, PharmD

Potentially inappropriate medication use in older adults can lead to preventable adverse events, which may account for a significant portion of emergency room visits and hospitalization. This multi-incident analysis identifies points of intervention in the community setting in order to prevent medication incidents that may compromise patient safety.

A qualitative, multi-incident analysis was conducted on medication incidents reported to the Community Pharmacy Incident Reporting (CPhIR) program. Reports of medication incidents involving drug therapy problems, contraindications, and duplications in patients over 65 years of age were extracted between 2010 and 2015. In total, 184 incidents met the inclusion criteria of this multi-incident analysis.

Two main themes were identified: (1) patient-specific factors and (2) drug interactions. Patient specific factors include incidents where the medication was not best suited for the patient due to their intolerances or allergies, medical conditions, and inappropriate dosing/prescribing for older adults over 65 years old. Medication incidents involving drug interactions include antibiotic and chronic medication interactions, interactions between different therapeutic classes, and drug duplications of the same therapeutic class. Comprehensive medication reviews (such as MedsChecks in Ontario) help to ensure patients are safely and appropriately using medication therapies and reduce potential adverse drug events when transitioning between points of care.

Although the use of multiple medications may be appropriate in older adults, the complexity of these medication regimens increases the risk of errors and adverse effects. Implementing system-based strategies in the pharmacy workflow can help pharmacists improve patient safety and mitigate the risks of potentially inappropriate medication use in older adults.

Patient counseling: An overarching method to mitigate medication errors and ensure continuity of care

Tracy He, PharmD candidate; Certina Ho, RPh, BScPhm, MISt, MEd

To explore the methods and behavioural tools in which community pharmacists utilize patient counselling to prevent medication incidents. The findings of this qualitative, multi-incident analysis will substantiate the strongholds in which pharmacists mitigate errors and the role of patient education in encouraging health literacy and continuity of care.

A multi-incident analysis was performed on medication incidents reported to the Community Pharmacy Incident Reporting Program (CPhIR) developed by the Institute for Safe Medication Practices Canada. The keywords in the incident description included patient-counselling terminology, such as “identified,” “counsel,” “explain,” and “teach.” The incidents included in this analysis spanned from September 2014 to August 2015. They were then stratified thematically based on their modes of identification.

Of the 115 incidents that met the inclusion criteria, two emergent themes were identified: pharmacist-led and patient-led identification of medication incidents. The themes gave rise to further subthemes respectively, focussing on prescription reconciliation, therapy evaluation and clarification, storage education, patient identifier verification, and product demonstration. Reinforcement of safe medication use at the stage of patient counselling can also gear pharmacists towards patient-focused care and effective medication therapy management.

Community pharmacy practitioners can effectively identify near misses and medication incidents at the stage of patient counselling. Having a dialogue with patients at the point of care will not solely be helpful for the mitigation of errors, but also serve as a quality assurance of continuity of care.

Older people’s attitudes towards deprescribing: A community study in Quebec

Caroline Sirois, BPharm, PhD; Nicole Ouellet, PhD; Marie-Eve Gagnon, BInf; Joanie Renaud; Lyndia Huard

Polypharmacy is very common among older individuals and has been associated with adverse outcomes. Reducing the number of medications (deprescribing) might be a valuable option to reduce the risks. However, little is known about older individuals’ attitudes towards deprescribing.

We ran a pilot study to evaluate the feasibility of using a self-administered questionnaire among community-dwelling older individuals to address their perceptions towards deprescribing. We used a French version of the Australian Patient’s Attitudes Towards Deprescribing Questionnaire. The questionnaires were distributed in ten community pharmacies and two community centers in the province of Quebec. The participants (n=129) completed the questionnaire containing 10 Likert type questions about polypharmacy/deprescribing and 5 multiple-choice questions. We used descriptive statistics to summarize the participants’ characteristics. We performed chi-square tests to compare the proportions of agreement, and evaluated correlations with Spearman’s Rho (alpha=0.05).

The participants were mostly women (63%) with a median age of 76 years (IQR:7180). The median number of daily medication was 6 (IQR: 3-8). Half of the participants considered they were taking a lot of medications, but 80% judged these medications were necessary and felt comfortable with the number they were taking. More than 80% would agree to take more medications for their health condition if required. Nonetheless, 50% of the participants mentioned they would like to reduce the number of medications they were taking. If their doctor said it would be possible, 71% would be willing to reduce the number of medications used. Those who thought they were taking a lot of medications were more willing to have their number reduced (p<0.001).

The results show that older individuals in the community are eager to undertake deprescribing, conditional on their doctor’s approval.

The effect of health media reporting on self-medication use

I fan Kuo, BSc (Pharm), ACPR, MSc, PharmD; Amanda Church, BSc (Pharm) candidate; Christopher Louizos, BSc (Pharm), PharmD; Brenna Shearer, PhD

The news media serves the crucial role of conveying complex scientific findings and health issues to the general public. The main objectives of this study are (1) to describe the public’s perception of health-related content in the news media and their dependence on the media in decision-making surrounding self-medication use, and (2) to examine potential factors, both individual and media-related, that influence self-medication behaviour.

Twenty-Nine adult volunteers participated in five focus group interviews that were conducted at the College of Pharmacy, University of Manitoba in Winnipeg. Each 90 minute interview was moderated by a study coordinator, audio-recorded, and transcribed. Two study team members independently analyzed the transcripts.

The general public expressed varying degrees of uncertainty towards the reliability of health reporting in news media. Most felt overwhelmed and frustrated by the excess sources of information, and the often mixed and transient messages in health news reports. A trusting relationship with a pharmacist or physician was identified as the most important factor in self-medication decision, but not all individuals had access to health care providers, due to a variety of reasons. Other influences on over-the-counter product use include education background, previous experience, upbringing, credentials of the sources, and the individual’s social circle.

Decision-making surrounding the use of over-the-counter products is a complex process, often implicitly influenced by health news reporting in the media. Trusting interaction with health care providers, especially pharmacists is an important component in choosing non-prescription product use, but one that is not always readily accessible. Pharmacists are yet to maximize the opportunity in filling this health care gap.

Documentation of functional medication management in older adults within an acute care hospital

Monika Bolina, BScPharm, ACPR; Allyson Jones, PhD; Sheri Koshman, BScPharm, PharmD, ACPR; Erin Heintz, BScPharm, ACPR; Ronald Lehmann, BScPharm, ACPR; Cheryl Sadowski, BSc(Pharm), PharmD, FCSHP

To describe the documentation of functional medication management (FMM) in adults, age 65 years and older, on medicine wards, during their hospital stay. The secondary objective was to describe the characteristics of the health care providers (HCP) documenting on FMM.

This study was a retrospective chart review of a random selection of 140 patients admitted at the University of Alberta Hospital from January 2013 to October 2014. FMM was defined as the process of taking medications (including ordering, picking up, organizing, preparing, monitoring, and administering medications). This ability requires assessing factors such as physical function (including vision, dexterity, and swallowing ability) related to medications and cognitive function.

A total of 140 patient charts were reviewed. The average age was 78.9 (SD 8.4) years, 68 (48%) male, and mean 8 (SD 3.1) scheduled oral medications taken. Commonly documented components of FMM included administration of medications (52%), organizing of medication (33%), assessments of physical function including vision (25%), swallowing ability of medications (18%), and cognitive function (21%). Documention of these activities was most frequently done by physicians (39%), occupational therapists (34%), and pharmacists (17%).

Clinicians occasionally document FMM. Given the complexity of medication regimens and the functional demands of handling these, there is a need to incorporate these assessments when evaluating patients.

Global citizenship framework — Application to pharmacy student experience

Cheryl Sadowski, BSc(Pharm), PharmD, FCSHP; Lynette Shultz, PhD, Marlene Gukert, BScPharm, ACPR; Cheryl Cox, BSP, MBA

The role of pharmacists as citizens is important in terms of community engagement, public health, and advocacy. Student exposure to global citizenship is important in order to develop a view of citizenship in their future role as pharmacists. The purpose of our research was to apply a framework for global citizenship to student experiences in an international course taught in Italy.

This was an exploratory qualitative study. Students at the University of Alberta enrolled in Pharm 453 (Intercultural Exploration of Pharmacy & Health) between 2011 and 2013 were invited to participate after completing the course. Students who consented individually participated in a semi-structured interview regarding their experience. We applied a published framework and the data was transcribed and analyzed by content analysis methods.

The framework included 4 main components, with examples of application in practice. The components were politics/ideology, social/collective, self/ subjectivity, and praxis/engagement. Examples of each component include: (1) politics — awareness of food insecurity, injustices; (2) social — appreciation of interconnectedness, inclusion of those with different values; (3) self — being aware of one’s own perspectives, concern for social justice; (4) praxis — ethical action and active participation in society.

Applying a framework in describing student experiences with global citizenship through an international course was valuable, and demonstrated that students can be engaged with important citizenship issues.

How does pharmacist prescribing fit with family physicians’ practice in Alberta? Developing a knowledge translation strategy

Chowdhury Faruquee, BPharm, MPharm, MBA; Amandeep Khera, MD, CCFP, MPH; Lisa Guirguis, BSc Pharm, PhD

Alberta family physicians are seeing patients with an increasing number of chronic diseases and complex medication regimens. Pharmacists are medication experts with prescribing authority who can help both physicians and patients to manage medications. However, literature and anecdotes suggest physicians have low level of understanding and speculative beliefs about pharmacist prescribing. Our objective is to develop a knowledge translation strategy to address family physicians’ gap in understanding of pharmacist prescribing.

Qualitative interviews were used to explore Alberta family physicians’ understanding and experience with pharmacist prescribing. We used purposeful sampling method with semi structured face to face or telephone interviews. We planned to interview 12 to 15 Alberta family physicians having experience of pharmacist prescribing in their practice as well as pharmacists who are working with these physicians. Gaps in physicians’ understanding were identified and will be used to develop infographics to communicate pharmacists’ roles in prescribing medications

To date we have interviewed 11 physicians and one pharmacist. Often, family physicians first learned of pharmacist prescribing after receiving notification that a patient received this service or from the pharmacists they work with on teams. Preliminary themes include interprofessional hierarchy, assorted acceptability, building trust, and shared goals. Gaps include knowledge about pharmacist expertise and pharmacist prescribing authority, and communication strategies to foster collaboration. We will create infographics as educational tools, addressing the gaps. We will develop a usability testing survey to test its usability and will refine the educational tools using feedback. We will disseminate our infographics to both physicians and pharmacists through Alberta PCN leads, professional associations, and encourage pharmacists to use it with individual physicians.

We confirmed that some Alberta family physicians have limited understanding of pharmacist prescribing, resulting in lack of trust. Future research should evaluate the effectiveness of this knowledge translation strategy in the Alberta context.

Medication incidents involving smoking cessation therapies

Phillip Yang, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Ontario pharmacists have been granted the authority to prescribe medications for smoking cessation in their expanded scope of practice. To help pharmacists minimize errors when prescribing for smoking cessation, medication incidents involving varenicline and bupropion must be examined. The objective of this project was to identify areas of vulnerability when prescribing and dispensing smoking cessation therapies.

A qualitative, multi-incident analysis was conducted using anonymous incident reports submitted to the Institute for Safe Medication Practices Canada Community Pharmacy Incident Reporting Program. Medication incidents involving varenicline and bupropion were included in the analysis.

A total of 360 incidents were analyzed. Our findings were divided into two main themes according to the medication therapies: (1) varenicline and (2) bupropion. The main themes were then further divided into subthemes, comprising prescription instructions, quantity of tablets, and drug formulation. Safety interventions include separation of instructions for starter pack and continuation packs, implementation of preprinted order forms and independent double checks in the pharmacy workflow, and verification of the medication with patients during patient counselling.

As more patients access smoking cessation therapies, there are more opportunities for pharmacist-patient interactions. With pharmacists’ expanded scope of practice, there is also a new potential for near misses and incidents involving prescribing errors in the pharmacy. Through shared learning of existing smoking cessation medication incidents from this project, pharmacists will be more prepared and aware of safe medication use when executing their expanded scopes.

Medication incidents involving immunosuppressive agents

Melody Truong, RPh, BScPhm, PharmD; Amanda Chen, RPh, BSc, BScPhm, ACPR, PharmD; Jim Kong, BSc, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Immunosuppressants are potent, immune-modulating medications that can cause significant harm to patients if used incorrectly. The objective of this multi-incident analysis is to assess the challenges of managing immunosuppressive therapy in the community setting and identifying system-based vulnerabilities.

Oral immunosuppressive agents of interest, such as azathioprine and cyclosporine, were retrieved from the American Hospital Formulary Service classification system. Intravenous agents were excluded due to a lack of presence in the community setting. Relevant medication incidents were gathered from ISMP Canada’s Community Pharmacy Incident Reporting (CPhIR) Program between January 2010 and May 2015. From an initial collection of 61 cases, a total of 47 medication incidents met inclusion criteria and were analyzed and reviewed by two analysts independently.

Quantitative analysis found that of the initial 61 medication incidents, 59% (36) were near-misses, 18% (11) resulted in no harm, and 3% (2) resulted in mild harm to the patient. The remaining 20% (12) were excluded due to insufficient narrative information provided by the reporter. Qualitative analysis uncovered three major themes that ran prevalent throughout all 47 incidents: (1) indication, (2) effectiveness, and (3) safety. Indication referred to incidents where an incorrect drug was being prescribed or dispensed due to look-alike/sound-alike names and/ or formulation oversight. Effectiveness primarily focused on medication errors arising from sub-therapeutic dosing that resulted in therapy failure, while safety referred to incidents that resulted in toxicity due to either supra-therapeutic dosing or drug interactions. System-based vulnerabilities included factors such as confirmation bias, practitioner’s knowledge gap, and lack of independent double checks in pharmacy workflow.

Immunosuppressive agents are commonly used by all patient populations within the community. Analysis of medication incidents provides an opportunity for health care practitioners to learn from errors and advance safe medication practices for quality patient care.

Medication incidents that could have been prevented at the prescribing stage

Kacy Park, BSc, PharmD candidate; Jim Kong, BSc, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

As the initial step in the medication-use process, prescribing errors can lead to a cascade effect that ultimately places the patient at risk for harm. The goal of this multi-incident analysis was to identify and prevent the occurrence of these systematic errors to mitigate patient harm.

Data were gathered from the Community Pharmacy Incident Reporting (CPhIR) Program between January 2010 and April 2015. Search criteria excluded incidents that did not occur during the “Prescribing” stage and/or resulted in “No Error.” A total of 111 incidents met the initial search criteria with 50 incidents being excluded due to insufficient narrative descriptions. The remaining 61 incidents were then analyzed.

Of the 61 medication incidents analyzed, quantitative analysis showed that 84% (51) resulted in mild harm and 16% (10) resulted in moderate harm. No incidents resulted in patient death. Qualitatively, two main themes were extrapolated from these incidents: (1) Therapeutic Plan Error and (2) Therapeutic Plan Execution Error. Therapeutic Plan Error consisted of incidents that occurred due to incorrect dose, medication discrepancy, drug allergies or drug-drug interactions. Underlying contributing factors included a lack of reliable Computerized Decision Support Systems to help capture potential drug therapy problems, and limited communication networks between health care professionals within the patient’s circle of care. Therapeutic Plan Execution Error included incidents that occurred due to incomplete prescriptions, illegible writing, or wrong patients. Potential contributing factors included a lack of system-based or forcing functions to support prescribers when prescribing and documenting medication therapies.

The prescribing stage represents a key step in the patient’s encounter with the medication-use process. Both physicians and pharmacists can improve patient safety by developing system-based strategies to prevent medication incidents at this crucial stage of patient care.

Direct oral anticoagulant medication incidents

Nusrat Amin, PharmD; Jim Kong, BSc, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Direct oral anticoagulation utilizing apixaban, dabigatran and rivaroxaban has become highly prevalent due to their ease of use and convenient monitoring parameters. Though their unique pharmacologic properties make them a popular choice among health care professionals, increasing use has also led to an increase in medication incidents involving these medications. This multi-incident analysis serves to explore themes that contribute to incidents involving direct oral anticoagulation medications in the community setting.

Incidents were extracted from the Community Pharmacy Incident Reporting (CPhIR) Program between January 2010 and April 2015. A total of 145 incidents met the initial search criteria with 36 being excluded due to insufficient narrative descriptions. The remaining 109 incidents were then analyzed.

Qualitative, multi-incident analysis found a total of five major themes underlying all medication incidents involving direct oral anticoagulants. These included look-alike/ sound-alike medications, drug-drug interactions, transition of care, intricacies of anticoagulant dosing/frequency, and pharmacy operation. Although the primary focus of the analysis was on medication incidents in the community, transition of care presented a unique challenge as it referred to medication incidents that occurred when patients were transitioning from a different health care setting into the community setting. Numerous contributing factors such as confirmation bias, a lack of reliable Computerized Decision Support Systems, and knowledge deficit of health care practitioners all played a role in facilitating these medication incidents.

The expanding role of direct oral anticoagulants in conventional chronic drug therapy requires increased vigilance from health care professionals. In the community setting, long-term use of direct oral anticoagulants can place the patient at risk of harm if not managed and monitored appropriately. By developing safe medication practices, pharmacists can help educate patients and prevent anticoagulant medication incidents.

Drug allergy incidents in community pharmacies

Leo Kim, RPh, PharmD; Jim Kong, BSc, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Drug-induced allergic reactions are frequent, unpredictable events of medication usage in the community setting. The lack of homogeneity in their presentation and severity can range from mild, localized discomfort to systemic, life-threatening anaphylaxis, which presents a challenge for community pharmacists to manage. The objective of this multi-incident analysis was to identify common themes underlying drug allergy medication incidents, involving patients with documented allergies, and offer recommendations to help prevent future incidents in the community setting.

Incidents were extracted from the Community Pharmacy Incident Reporting (CPhIR) Program utilizing the inclusion criteria of “Drug Therapy Problem Documented allergy” for the type of medication incident, and generalized signs and symptoms of anaphylaxis as key words in the narrative description. A total of 273 medication incidents were captured and reviewed in this multi-incident analysis.

The three major themes identified were: (1) missing documentation, (2) computer detection incapacity, and (3) alert bypass. Missing documentation involved medication incidents that stemmed from both prescriber and pharmacy-related databases, while computer detection incapacity and alert bypass incidents only involved pharmacy-related dispensing systems. Recommendations primarily focused on the proper usage/maintenance of computer databases and communication strategies with patients. System-based strategies such as various enhancements to existing pharmacy databases, along with other continuous quality improvement programs, provide further solutions to prevent patient harm.

Drug-induced allergies can be easily screened and documented given the right tools and appropriate resources. Although unpredictable in nature, the presence of an existing drug allergy should prompt health care professionals to be mindful and cautious when prescribing and/or dispensing medications.

Medication incidents associated with hospital discharge

John Cao, PharmD; Kelly Ng, BSc, PharmD candidate; Jim Kong, BSc, PharmD; Certina Ho, RPh, BScPhm, MISt, MEd

Hospital discharge is a form of transitional patient care that involves multistep processes with multiple health care professionals at different levels of care. Due to its innate complexity, this process places patients at high risk for medication errors and potential subsequent hospital readmissions. This project examines common themes that are prevalent in medication incidents associated with hospital discharge, and provides insight into system-based recommendations for advancing safe medication practices.

Incidents were extracted from ISMP Canada’s Community Pharmacy Incident Reporting (CPhIR) Program between April 2010 and December 2014. A total of 83 incidents met the inclusion criteria. These incidents were analyzed and reviewed by two analysts independently.

A qualitative, multi-incident analysis revealed three main themes underlying these medication incidents: (1) error on the discharge prescription, (2) communication issues, and (3) community integration. Error on the discharge prescription involved preparation errors in the hospital such as inappropriate medications being ordered, inadvertent omission of medications, dosing errors, and wrong patient name on discharge prescriptions. Communication issues referred to miscommunication incidents between the hospital and community that involved illegible writing/ print on faxed and written discharge prescriptions, as well as complex medication orders. Finally, community integration explored the lack of continuity between hospital and community care that facilitated medication errors. This included issues such as duplication in medication therapy, different preparations used in the hospital compared to community, and interruptions/additions to multi-medication compliance aids. Medication reconciliation is an effective strategy that can empower community pharmacists to mitigate patient harm and enhance transitional care during hospital discharge.

Patients discharged from hospitals will continue to experience harm from medication incidents if system-based vulnerabilities are not addressed properly. The results of this multi-incident analysis, along with further investigations, will help develop or improve seamless and comprehensive transitional care practices.

Successful pharmacists: A qualitative study to understand pharmacists’ definitions of successful pharmacy practices

Meagen Rosenthal, PhD; Joseph A Dikun, PharmD; Ashley S Crumby, PharmD AAHIVP; Jill Hall, BScPharm, ACPR, PharmD; Theresa L. Charrois; BScPharm, ACPR, MSc

Efforts to improve uptake of advanced pharmacy practice services by various pharmacy professional organizations have included the development of definitions of pharmacists’ role in patient care, meant to transmit what is a successful pharmacy practice. However, there is little evidence of how these messages are reaching practicing pharmacists. The objective of this study is to understand success in pharmacy practice from the perspective of pharmacy practitioners in various settings.

In-depth semi-structured interviews were undertaken. Pharmacist participants were identified through reviews of national professional organization awardee lists and contact with state professional organizations in Mississippi, USA. The interview guide was developed from a scoping review by the authors. Interviews continued until saturation had been achieved. Qualitative content analysis was completed on all transcribed interviews.

A total of 14 interviews were conducted. There was an even split between participants practicing in community and hospital/ambulatory care settings. Two major themes emerged in the analysis. First, success was the development of meaningful relationships with patients, which led to the perceived improved uptake by patients of pharmacists’ recommendations. Second, success was achieving job satisfaction. Job satisfaction was often described as knowing they were making a difference in lives of patients. Participants also identified factors contributing to success, which included communication skills, self-confidence, and a supportive work environment.

The number, or kind, of advanced pharmacy services being provided to patients was not part of the definition of practice success offered. This implies a gap between the objectives of pharmacy professional organizations and practicing pharmacists. This study provides insight into the definition of success by practitioners, and direction for how professional organizations can improve communications with practitioners.

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Pharmacy Research Topics

Pharmacy Research Topics

Research Topic Ideas for Biology

Pharmacy research ideas encompasses a variety of topics dealing with drugs and pharmaceuticals. Some broad areas of pharmaceutical research relate to drug delivery, pharmaceutical cell biology, medicinal chemistry and medicine management. Faculty and graduate students at pharmaceutical colleges typically engage in such research, and some go on to develop new drugs and delivery methods.

TL;DR (Too Long; Didn't Read)

For students pursing doctorate degrees, pharmacy research offers many topics for a thesis, such as developing new drugs for cancer treatments, drug delivery methods, pharmaceutical cell biology and medicine management. Other topic ideas include plants as a source of medicinal products, interaction of drugs with RNA, synthetic medicines and many more.

Cancer Drug Studies

Cancer drug studies represent one type of pharmacological research topic. For instance, researchers study the role of steroid drugs in the growth of breast cancer. Other topics include the development of new cancer therapies and using targeted approaches for drug delivery to treat cancer. These types of studies aim to help patients deal with cancer and better handle the effects of cancer.

Drug Delivery

Another major topic for pharmacy research relates to drug delivery. One such research study at looks at the design and evaluation of drug delivery systems, emphasizing some methods of delivery such as liposomes and liquid crystals. Another research project studies the immediate environment of the lung, particularly how a person reacts to inflammatory stress and the use of drug treatments. Investigators use human lung epithelial cell culture for the study, studying humans as well as animals.

Pharmaceutical Cell Biology

Research in the area of pharmaceutical cell biology aims to understand basic cell biology and relate the findings to diseases in humans. Some such research projects in this area have dealt with topics such as inflammation processes in human disease, mechanisms for cell-to-cell communications and mechanisms of carcinogenesis. This sort of research is likely to involve close work with biologists who have similar research interests in these sorts of topics.

Medicine Management

Medicines management research looks into the cost effectiveness of new interventions that aim to improve the health of patients. Some of this research focuses on older people and on mental illness along with medicine management. These topics deal with the evaluation of pharmacist-led services, interventions that improve the adherence of medications, consultation skills, medication review services and interventions for reducing the problems that come about as a result of dysphagia.

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Research Article

Effectiveness of blended learning in pharmacy education: An experimental study using clinical research modules

Roles Conceptualization, Data curation, Formal analysis, Methodology, Project administration, Validation, Writing – original draft

Affiliation Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, Manipal Academy of Higher Education, Manipal, Karnataka, India

Roles Investigation, Supervision, Validation, Writing – review & editing

Roles Formal analysis, Investigation, Writing – review & editing

Roles Data curation, Project administration

Roles Writing – review & editing

Affiliations Department of Pharmacy Practice, National College of Pharmacy, Kozhikode, Kerala, India, NGSM institute of Pharmaceutical Sciences, NITTE University, Manglore, Karnataka, India

Roles Formal analysis, Writing – review & editing

Affiliation Statistician, Bangalore, India

Roles Data curation, Investigation

Roles Conceptualization, Investigation, Project administration, Resources, Software, Supervision

* E-mail: [email protected]

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  • Athira Balakrishnan, 
  • Sreedharan Nair, 
  • Vijayanarayana Kunhikatta, 
  • Muhammed Rashid, 
  • M. K. Unnikrishnan, 
  • P. S. Jagannatha, 
  • Viji P. Chandran, 
  • Kanav Khera, 
  • Girish Thunga

PLOS

  • Published: September 1, 2021
  • https://doi.org/10.1371/journal.pone.0256814
  • Peer Review
  • Reader Comments

Table 1

Background &objectives

Though there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students’ scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary aim was to evaluate the effectiveness of blended learning on knowledge score using clinical research modules. Secondary objective was designed to compare the use of self-regulated learning strategies between blended learning, web-based e-learning and didactic teaching.

Materials and methods

A prospective cluster randomized trial was conducted with didactic teaching as control and web-based e-learning and blended learning as interventions. The target population was final year Pharm D students. Outcome was assessed using a validated knowledge questionnaire, a motivated strategies for learning questionnaire and a feedback form. All statistical analyses were carried out using Statistical Package for Social Science (SPSS) Version 20.

A total of 241 students from 12 colleges completed the study. Mean knowledge score of students in blended learning group was higher than those in the didactic teaching and web- based e- learning program (64.26±18.19 Vs 56.65±8.73 Vs 52.11±22.06,p<0.001).Frequency of use of learning strategies namely rehearsal, elaboration, organization and critical thinking was statistically significantly higher in the blended learning group compared to those of didactic and web-based e-learning group (p<0.05) But there were no statistically significant difference of motivational orientations between didactic and blended learning group except strategies of extrinsic goal orientation and self-efficacy. Students preferred blended learning (86.5%) over didactic and web-based e-learning.

Blended learning approach is an effective way to teach clinical research module. Students of blended learning group employed all motivational and learning strategies more often than students of the didactic and web- based e-learning groups except strategies of intrinsic goal orientation, task value, control of learning belief and help seeking.

Citation: Balakrishnan A, Nair S, Kunhikatta V, Rashid M, Unnikrishnan MK, Jagannatha PS, et al. (2021) Effectiveness of blended learning in pharmacy education: An experimental study using clinical research modules. PLoS ONE 16(9): e0256814. https://doi.org/10.1371/journal.pone.0256814

Editor: Ritesh G. Menezes, Imam Abdulrahman Bin Faisal University, SAUDI ARABIA

Received: March 19, 2021; Accepted: August 17, 2021; Published: September 1, 2021

Copyright: © 2021 Balakrishnan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Introduction

Blended learning (BL) or the integration of face-to-face and online instruction is widely adopted across the globe for tertiary education with the increasing use of information technology and electronic learning [ 1 ]. There is considerable growth in research analyzing the effectiveness of BL and understanding students’ preference and satisfaction towards BL in pharmacy education [ 2 – 6 ]. Some studies have concluded that BL is as effective as traditional teaching [ 2 , 3 ] while a few have reported that BL is more effective than conventional teaching [ 4 – 6 ]. However, most of these studies originate from US, and have employed previous year students’ scores as control. Moreover, only few studies come from developing countries. Currently lacking is, prospective controlled trials to analyze the effectiveness of BL in pharmacy education. A systematic review and meta-analysis on this topic is published by same authors [ 7 ]. Accordingly, we designed our study to evaluate the effectiveness of BL in final year Pharm D (Doctor of Pharmacy) students employing a 9 hour learning module entitled “Fundamentals of clinical research”. “Clinical research” was chosen because India is the preferred destination for multinational companies for clinical trials which raises the demand for skilled qualified personnel. Academia is unable to keep pace with industry because of quick regulatory reforms and technology upgrades thereby making timely syllabus revisions difficult. Training in these areas will help graduates gain more updated knowledge [ 8 , 9 ].

Self-regulated learning (SRL) involves cognitive, metacognitive, motivational, emotional, and behavioural aspects of learning and is currently a subject of extensive research and discussion in educational psychology. Student learning strategies are dynamic and developed to achieve learning objectives in a limited time span [ 10 ]. However, there is a little or no study comparing SRL strategies between BL and conventional methods [ 11 ]. In this study we have used Pintrich’ motivated strategies for learning questionnaire (MSLQ) [ 12 , 13 ] comprised of 15 variables and measures cognitive, metacognitive, motivational, and emotional aspects of learning procedures (Details of MSLQ is provided in S1 File ). MSLQ successfully measures motivation and learning strategies in higher education, irrespective of discipline. Accordingly, we designed our secondary objective to compare the use of motivation and learning strategies between BL, web-based e-learning (WEL) and didactic teaching (DT). Blended learning refers to combination of online and face-to face, whereas web-based e-learning refers to all education that takes place online, while didactic teaching refers to all learning experiences that take place face-to-face in the classroom [ 14 – 17 ].

Design and implementation of web-based e-learning platform

Description of the learning module..

This learning module was intended to teach site-based clinical trial activities to final year Pharm D students. The learning module comprised of five chapters, which included how to start a clinical trial, randomization, informed consent procedure, electronic case report forms, and adverse drug reaction reporting. Each chapter described the theory with the aid of case studies. Details of each chapter are outlined in Table 1 . Experts from relevant areas verified contents in each chapter.

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https://doi.org/10.1371/journal.pone.0256814.t001

Trial design

A prospective cluster randomized trial, having three arms with DT as control and WEL and BL as interventions 1 & 2 respectively, was conducted between October 2019 to February 2020.

Ethical consideration

Ethical approval for the study was obtained from Institutional Ethics Committee of Kasturba Hospital Manipal (25/2018), Karnataka, India. This study was registered under clinical trial registry of India (CTRI/2019/11/022021).

Inclusion criteria for colleges and participants

Colleges affiliated with All India Council for Technical Education (AICTE)/Pharmacy Council of India (PCI) were included. The target population was final year Pharm D students. Students who were interested in participating in the research study were included.

Recruitment of colleges and participants

Principal investigator approached institutional head through email providing a summary of the study, including randomization, along with an assurance of participant and institutional confidentiality. Details of study was summarized in each email and had informed that colleges would be allocated to control/interventions based on randomization. Consent was obtained from institutional heads for colleges’ participation.

Once consent obtained from institutional heads, investigators visited respective colleges and explained the study to participants. Participant information sheet(PIS) was provided to participants and all interested candidates willfully signed written informed consent form.

Sample size calculation

Sample size was calculated based on the primary outcome, total knowledge score. Effect size was calculated based on a pilot study, involving 22 students from Manipal College of Pharmaceutical Sciences, Manipal ( S2 Appendix for pilot study details). Difference between the largest and smallest means divided by the square root of the mean square error, was used to compute the effect size [ 18 ]. A similar effect size was obtained by our meta-analysis of effectiveness of blended learning in pharmacy education [ 7 ]. Effect size (σ) of 0.6, at 5% level of significance, 80% power and design effect (d) of 2, the required sample size was 90 in each method of learning strategies. The required number of colleges in each geographical area was 3, assuming approx. 30 students in each class to each method of learning strategies. Students who participated in pilot study were excluded from the main study.

Randomization

Colleges that granted permission to conduct the study were grouped based on the geographical areas (GA) namely, Southern Karnataka (GA1), South East Karnataka (GA2), and Kerala (GA3) First, these geographical areas were randomly allocated to three methods of learning strategies and within each geographical area, 4 colleges were selected. There was no random selection of institutions in GA1 as there was only 4 institutions agreed to participate. Eight institutions out of ten agreed to participate were chosen at random in GA2 and GA3 (To reduce the contamination bias, we chose geographical areas as clusters. If students from surrounding colleges enrolled for different arms, there is a chance that they will share their login id & password).

Study procedure

DT, WEL and BL had the same course contents. All face- to- face sessions in DT & BL were conducted in respective colleges by same experts. Chapters were presented in the format of Microsoft PowerPoint with synchronous voice over slides in website. Script of voice was also attached in platform. Same PowerPoint slides were used to take classes in DT. Website contained 5 chapters, each lasting one hour as well as 4 hours of additional case studies and simulated forms, totaling 9 hours. Each chapter contained theoretical explanation, followed by reinforcing the concept with one or two case studies. Additional case studies and simulated forms were attached to the platform, which was available only to students of WEL. There was a case scenario, based on which students were asked to fill the simulated forms to provide realistic experiences. Simulated form included feasibility questionnaire, ADR reporting form, electronic case report form, and informed consent form. Students of BL were unable to access additional case studies and simulated forms on the website which was taught by face-to-face instruction. Students were required to sign up for first time and log in to the web page to access the learning materials. Students were enrolled for a study period of 8 weeks (details of each learning strategy is depicted in S3 Appendix ).

Web-based e-learning platform for Fundamentals of clinical research

CLINIC E-LEARNING ( http://clinilearn.in/my/ ): A new learning management system, CLINILC E-LEARNING, was developed to implement training program for students. This platform was developed using Moodle platform Version 3.2. PHP 7.0x was used to code the contents. CLINIC E-LEARNING contained five chapters as described above, and each chapter had pre-and post-test, case study questions, case study for references, important links and files, simulated forms, assignments and feedback forms. Only eligible participants were permitted to access the learning management system through login id and password. (See S4 Appendix for details of Website).

Experimental and control group

Dt-(control)..

Students attended the 9 hour face-to-face lecture delivered by experts with the aid of PowerPoint slides (Same slides of website). Face-to face session was conducted via workshops in each selected college.

WEL-(Experimental group 1).

WEL group were provided with URL and were asked to sign up with the option to access the website anytime, anywhere. They could clarify doubts by posting their queries to experts in the learner management system. Students were told to complete 9 hour learning module (5 chapters within 6 weeks and remaining two weeks for case study analysis and practicing simulated forms) within 2 months.

BL-(Experimental group 2).

BL students were provided with 5-hour e-learning and 4 hour face-to-face instruction, totaling 9hours. Students of BL studied the same audiovisual slides (in the same website) during the same period. Followed by, 4 hour discussion by experts (face-to-face instruction provided by the DT team) on additional case studies and important forms used in clinical trials.

Outcome assessment

We employed the same tests to assess outcomes in all three groups. Outcomes were measured immediately after the completion of the learning module. Outcome assessment consisted of 3 parts (see S5 Appendix for questionnaires). All questionnaires were validated by 5 experts for content validity.

  • Evaluation of knowledge gain: Pre-test and post-test, consisted of same multiple choice questions (50 questions, ten questions from each chapter; 1 mark for each correct answer). Evaluation of conceptual understanding: Case study questions (had 17 items 2 marks for each correct answer).
  • Evaluation of usage of SRL: Motivated strategies for learning questionnaire (MSLQ) by Pintrich et al, comprised of 81 questions. Scoring of MSLQ questionnaire is provided in appendix A.
  • Evaluation of student’s experience and satisfaction: Feedback collected in two sessions with 12 questions.

Statistical analysis

All statistical analyses were carried out using Statistical Package for Social Science (SPSS) Version 20. Continuous variables were reported in terms of mean and standard deviation whereas categorical variables were expressed as percentages. Shapiro Wilks test was performed to ensure the normal distribution of variables. One way Anova or Kruskal Wallis test was conducted to find significant differences in test scores between the groups. Pairwise comparison performed by Dunn’s post hoc test, and Games Howell test. Relationships between variables were examined by multiple linear regressions. Spearman correlation was conducted to find out the correlation between variables. Mann Whitney U test performed to analyze difference in opinions of students of WEL and BL groups.

A total of 317 students enrolled from 12 colleges, of them 241 students completed the learning module on Fundamentals of clinical research. Only students who finished both pre-test and post-test were included for the analysis.

Comparison of knowledge score

Pretest scores were compared by one way ANOVA and found that there was no significant difference between groups, p>0.05. As shown in Table 2 , mean difference between post-test and pre-test, case studies score, and total score in BL was higher than DT and WEL. There was statistically significant difference in mean difference score (Post to pretest) in knowledge (p<0.001), post-case study score (p = 0.034), and total score (p<0.001) between learning strategies. BL showed statistically significant highest total score than didactic teaching (p<0.001) and web-based e-learning program (p<0.001) by Dunn’s post hoc test. Results are presented in Table 2 .

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https://doi.org/10.1371/journal.pone.0256814.t002

Multiple linear regression model showed an R 2 value of 0.41, which means independent variable (pretest, gender and learning strategies keeping BL as reference category) can explain 41% of the variability of dependent variable (total score). The coefficient on Intervention (β3 = -5.32) means that, holding all other variables constant, the score on the final test of a student who was taught via the DT is expected to decrease 5.32 points compared to a student who received the BL intervention. Similarly, total score of WEL group students are expected to decrease -12.03 compared to BL group. The findings are depicted in Table 3 .

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https://doi.org/10.1371/journal.pone.0256814.t003

Comparison of MSLQ scores

It was found that usage of SRL strategies were higher in BL group than DT and WEL except intrinsic goal orientation, task value, control of learning belief and help seeking. There was no statistically significant difference in test anxiety, time management and effort regulation between groups (p>0.05). SRL strategies are composed of 15 variables and were analyzed by Kruskal Wallis test and presented in Table 4 .

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https://doi.org/10.1371/journal.pone.0256814.t004

Further pairwise comparison between the groups showed that there was no statistically significant difference in usage of intrinsic goal orientation, task value and control of learning belief between DT and BL (p>0.05). Pairwise comparison of usage of rehearsal, elaboration, organization, and critical thinking indicated there was no statistically significant difference between the DT and WEL. Peer learning showed no significant difference between DT and BL, whereas significant difference exist between the DT and WEL in help seeking.

To determine the relationship between motivational and learning strategy use and final score, Spearman correlation was performed separately for DT, WEL and BL groups. Result showed final score had significant weak positive correlation with extrinsic goal orientation (r = 0.213), control of learning belief (r = 0.280) and rehearsal(r = 226) for students of BL. We did not find any significant correlation between final score and MSLQ strategies in DT and WEL.

Comparison of students’ opinion about contents of web-based e- learning platform

It was found that there was no statistically significant difference(p>0.05) in opinions regarding design of module, clarity of explanation, comprehensive coverage of subject matter, and relevancy of hyperlinks between the WEL and BL groups who used the website for learning. Students of BL were asked their preference for learning strategies and found that 86.5%of students prefer BL, 2.7% and 9.5% preferred DT and WEL, respectively. Students responded that they were satisfied with the clinical research modules and accomplished various learning activities. Mann-Whitney test showed no significant difference between students’ opinion (p>0.05).

A total of 92.2% students enrolled for didactic teaching responded that they were satisfied with workshops. More than three quarters of DT students agreed that they were satisfied with clarity of explanation and discussion of module lesson, comprehensive coverage of subject matter, consistency of content with subject objectives and syllabus Results are presented in Table 5 .

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https://doi.org/10.1371/journal.pone.0256814.t005

Published literature suggests that BL generates better performance in pharmacy education, but most of such studies used previous year students’ score as control [ 19 , 20 ]. To the best of our knowledge, this report will be the first attempt to evaluate the effectiveness of BL in clinical research modules in pharmacy education. Despite the fact that the term "blended learning" is commonly used, there are some uncertainty about what it means. These approaches are still little understood in higher education, and their descriptions in the literature are inconsistent. In higher education, the term “hybrid” is often used synonymously with “blended” learning, “flipped,” “online,” or “technology-enhanced” learning [ 15 ]. A recent article by Kendra Gagnon distinguish blended and hybrid learning based on face-to- face time [ 16 ]. Blended learning does not replace face-to-face time but hybrid learning does. To be more specific, hybrid learning reduces seat time in class. As a result, our model will be better suited to hybrid learning. However, we used the term blended learning because literatures describe hybrid learning is a type of blended learning, and a precise definition remains an ongoing conversation [ 14 , 15 ]. In comparison to blended learning, the term hybrid learning might have been more extensively used in practice than research as there are less highly cited articles on hybrid learning. According to Stefan Hrastinski it is important that researchers and practitioners carefully describe what blended learning means to them. He also proposes, researchers should carefully consider while using a more precise, descriptive term as a supplement or replacement for blended learning [ 15 ]. So we believe we have adequately addressed this issue.

Though Clinical trials appear to be concentrated in developed nations, highest percentage increase in registered human clinical research, particularly phase 3 trials are increasing in developing countries [ 21 ]. So training in these areas have the potential to enhance students’ basic understanding of how the industry works. We have shown that BL is more effective than DT and WEL in teaching clinical research modules, which is in agreement with previous reports in similar settings [ 22 , 23 ]. Ample data have shown that case studies are a gratifying and motivational educational tool that extends declarative and procedural knowledge/expertise [ 24 ]. We incorporated case studies in all three learning strategies. Both DT and BL used case study discussions as an active learning strategy in the classroom and enhanced student tutor interaction. Though case studies were incorporated on website and students could post their queries in learning management system itself, there were no provision of face–to-face tutor to student interaction for students who participated in WEL. Students who experienced face-to- face discussion (DT & BL) demonstrated better performance than WEL group, underlining the importance of face-to-face interaction in improving the final score.

In blended learning model class time was effectively used for active learning strategies as students had already viewed recorded videos. This allowed more meaningful face-to face interaction, application of course content and also provided an equal educational value as didactic teaching. BL students spent less time in class compared to DT, which echoes the result of a similar study by the US Department of Education on Distance Education as well as another study by Philips JA [ 25 , 26 ].

BL employed motivational and learning strategies more frequently than DT, except in strategies of intrinsic goal orientation, task value, control of learning belief and help seeking. WEL students scored less in all scales of motivational and learning strategies compared to BL. However, DT students employed all motivational and learning strategies more often than WEL students, except in extrinsic goal orientation, self-efficacy and test anxiety. Interestingly, there is no significant difference between DT and BL in the use of motivational strategies, except in extrinsic goal orientation and self-efficacy; suggesting that face-to—face interaction with tutor considerably influences the use of motivational strategies. This result is in accordance with a study by Kassab et al [ 27 ]. DT scored highest for intrinsic goal orientation but least for extrinsic goal orientation, possibly because DT students were personally motivated by the tutor.

BL showed statistically significant highest score in all scales of cognitive strategies (rehearsal, elaboration, organization, and critical thinking) than DT and WEL. Possible reason could be, in BL, students are getting more meaningful interaction with tutors as they are familiar with the content before class. This finding is mostly in accord with a study by Ruchan Uz [ 28 ] who reported use of blended instruction is more effective than traditional instruction in terms of developing learning strategies. However our results are in contrast to those of Broadbent [ 11 ] who reported that online learning students reported more frequent usage of learning strategies than BL.

Another key finding of this study was that no significant difference was found in metacognitive self-regulation score between DT and BL. So we assume that face-to-face interaction with tutors can demonstrate what to learn, when to learn and how to learn which in turn affect on metacognitive approaches such as planning, monitoring, and regulating.

As expected peer learning and help seeking score was less in WEL group. Help seeking was highest in DT. Understandably, online students felt more isolated when deprived of a sense of community. This is in line with previous studies [ 11 , 29 ].

We have shown that only extrinsic goal orientation, control of learning belief and rehearsal strategies had a weak positive correlation with final score of clinical research examination in BL. On the other hand, SRL did not correlate with final score in DT and WEL.

To the best of our knowledge, there was only one study by Broadbent et al [ 11 ] who compared the use of SRL between online and blended environment in higher education. Our result contradicts Broadbent, possibly because, we employed the same learning module for all evaluation unlike much more broad based subject range by Broadbent et al. Moreover, online students had an opportunity for one-to-one interaction with peers and instructors in Broadbent’s study. Since student’s attitude towards course content also determine SRL, Broadbent’s results may not apply to our situation.

In addition, the blended-learning approach used in this course was generally well received by the students. These findings align with other studies that report positive student perceptions of BL in pharmacy education [ 30 , 31 ].

There are some inherent limitations to this study. Firstly, as this study was focused on a single topic, our findings may not be extrapolated to other topics of pharmacy or any other healthcare disciplines. Second, this study accessed short term retention of material. Third, we did not assess how many times students logged in to the website and how long they spent to viewing the materials. As stated by previous reported study [ 26 ] we could overcome this by stating that students logging in does not necessarily mean they were actively studying the content. The time obtained may have provided time that the students may not have been physically seated in front of the screen watching the e-lectures because the lecture window would remain active as long as they were signed on to the web-based e-learning portal. Fourth, due to the anonymous nature of feedback form, we were not able to link students’ satisfaction level and academic achievement.

Conclusion and future research lines

Blended learning approach, with online and face-to-face instruction is an effective way to teach clinical research module. Results showed students of blended learning group employed all motivational and learning strategies more often than students of didactic and web- based e-learning groups except strategies of intrinsic goal orientation, task value, control of learning belief and help seeking. Also Students prefer blended learning program than didactic and pure online courses.

Blended learning will be the future of the education sector, since online learning cannot replace physical experience at universities. Given the rapid growth of online studies in last decades, and in the wake of COVID 19, it is paramount to evaluate the effectiveness of computer mediated instruction and to understand how students utilise SRL strategies to achieve academic success. There is an urgent need of fine grained studies with solid experimental design to evaluate the use of SRL between various pedagogies. More insights are needed to correlate the use of SRL and academic achievement. Most BL studies, including current research have assessed short-term retention of knowledge, so future research should address long-term retention of knowledge.

Supporting information

S1 appendix. motivated strategies for learning questionnaire (mslq)..

https://doi.org/10.1371/journal.pone.0256814.s001

S2 Appendix. Pilot study details.

https://doi.org/10.1371/journal.pone.0256814.s002

S3 Appendix. Various strategies used for different teaching learning method.

https://doi.org/10.1371/journal.pone.0256814.s003

S4 Appendix. Web-based e-learning program.

https://doi.org/10.1371/journal.pone.0256814.s004

S5 Appendix. Questionnaires.

https://doi.org/10.1371/journal.pone.0256814.s005

S1 File. Students demographics, knowledge score & MSLQ score.

https://doi.org/10.1371/journal.pone.0256814.s006

S2 File. Feedback file.

https://doi.org/10.1371/journal.pone.0256814.s007

Acknowledgments

Authors also would like to acknowledge Department of Pharmacy Practice, Manipal College of Pharmaceutical Sciences, and Manipal Academy of Higher Education for all the support and facilities for the best possible completion of this study. We also would like to acknowledge Muscle Infotech. Bangalore for the website development.

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College of Pharmacy

List of Researches

Formulation of Anti-Hypertensive Standardized Herbal Extracts for Pre-Clinical and Clinical Development (2016, On-going study of Toralba, Bulatao, & Larcia)

Formulation of Standardized Herbal Alpha-Glucosidase Inhibiting Extracts for Pre-Clinical and Clinical Development (2016, On-going study of Balotro, Yu, & Quibin)

Formulation of Xanthine Oxidase Inhibition Activity of the Formulated Tablet from the Ethanolic Extracts of Selected Medicinal Plants for Gout (2016, On-going study of Palacpac & Ladignon)

Modification of a Pharmaceutical Analytical Chemistry Laboratory Course Design to Improve Student Performance (2016, Toralba, Larcia, & Orejola)

Effect of the Expanded Senior Citizens Act of 2010 (Republic Act of 9994) on Drug Accessibility among Elderly (2016, Salenga, Loquias, Sarol)

Determination of the Angiogenic Effect of Ficus pseudopalma Blanco (Niyog-niyogan) Leaf Fractions on the Chorioallantoic Membrane of 10-Day Old Anna luzonica (Duck) Eggs (2015, Santiago, et al.)

Fractionation of the Antibacterial Components of Citrus aurantifolia Swingle (Fam. Rutaceae) Fruit Extracts (2015, Padilla, Avestruz, Gutierrez, & Toralba)

Academic Entrepreneurial Intention of Researchers of the University of the Philippines Manila – National Institutes of Health (2014, Balotro & Nevado)

Conceptual Design of Community-Based Herbal Manufacturing and Testing Laboratory in a Primary Health Care Setting (2014, Casauay)

Extraction and Purification of Pectin from the Fruit Peel Wastes of Selected Philippine Fruits (2014, Loquias)

Formulation of Standardized Plant Extracts as Supplements for Diabetes Mellitus (2014, Toralba, Orejola, & Ladignon)

In Vitro Pediculicidal Efficacy and Acute Dermal Irritation Tests of Coconut Oil Lotion and Cream Shampoo from Makabuhay Extract (2014, Balotro, Sagun, Balita, & Salud-Gnilo)

Junior Faculty Mentoring Relationships and Its Effectiveness in the College of Pharmacy in Metro Manila (2014, Gutierrez)

Evaluation of Community Pharmacy Internship Programme in the Philippines (2013, Carrido, Lorenzo, Macaldo, & Loquias)

Screening for the Anti-Angiogenic Activity of Selected Philippine Medicinal Plants using Chorioallantoic Membrane Assay (2013, Camposano, Dela Torre, Laxamana, Larcia, Loquias)

Peel Wastes of Ananas comosus , Sandoricum koetjape , Citrus nobilis as Lead and Cadmium Biosorbent in Manila Tap Water (2013)

Lead, Cadmium and Chromium in Selected Local Cigarettes Available in the Philippines (2013)

Comparison of Lead Absorption Ability of Bougainvillea ( Bougainvillea spectabilis L.) Leaves in Two Cities in Metro Manila, Philippines (2013)

The Roles of Pharmacists in Relation to Medical Doctors, Nurses, and BHWs in Preventing Dengue (2013)

Heavy Metal Concentrations in Canned Fruits of Litchi chinensis , Prunus persica , and Ananas comosus Marketed in the Philippines (2013)

Assessment and Filling of Gaps of the Anti-Dengue Program in the Philippines (2013)

Chemical Analysis and Culture Characterization of Water Kefir (2013)

Comparative Stability Study of Innovator and Generic Cefuroxime Sodium Powder for Injection Using High Performance Liquid Chromatography (2013)

Thin Layer Chromatography Methods in the Characterization and Stability Analyses of the Aqueous and Dichloromethane Extracts of Lagerstroemia speciosa L. (Fam. Lythraceae) Leaves (2013)

Identification and Segregation of Chemical Wastes of Unknown Composition Generated and Implementation of Proper Chemical Waste Disposal by the College of Pharmacy University of the Philippines Manila (2011)

A Simple and Direct Titrimetric Assay of Acetaminophen in Tablets Using Cerium (IV) Sulfate (2010)

Comparative TLC Analysis of the Constituents of Four Commercially-Available Blumea balsamifera Preparations (2009)

Comparison of the Spectrophotometric and Titrimetric Methods for the Quantitative Analysis of Sulfa Drugs using Diazotization and Coupling Reactions with Phenol (2009)

Bioactive Metabolites from Sponge-derived Fungi (2007)

Research Scholar

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150 Experiment Research Topics

Welcome to our intriguing collection of experimental research topics! Experiments are the cornerstone of empirical research, allowing researchers to test hypotheses, draw conclusions, and expand knowledge across various disciplines. With our experimental research questions ideas, you can uncover the diverse realms of experimental studies, from the natural sciences to social sciences and beyond. Let’s study the world of scientific inquiry and empirical investigations!

🧪 10 Best Experimental Research Questions Ideas

🏆 best experimental research topics, 👍 catchy experimental research questions ideas, 🎓 interesting experimental research topics, 💡 simple experimental essay titles, ❓ more experimental research questions ideas.

  • The Impact of Sleep Deprivation on Cognitive Performance.
  • The Effects of Music on Concentration and Productivity.
  • The Relationship Between Exercise and Mood.
  • The Influence of Social Media Usage on Mental Health.
  • The Use of Virtual Reality in Pain Management.
  • Examining the Efficacy of Various Teaching Methods.
  • The Effects of Color on Emotional Responses.
  • The impact of Meditation on Stress Reduction.
  • The Role of Nutrition and Diet in Athletic Performance.
  • The Impact of Environmental Factors on Plant Growth.
  • Water Quality and Contamination Experiment Report This paper seeks to provide a detailed report on what should be done to ensure quality water for human consumption.
  • Physical Health Indicator: Pulse Rate Experiment An examination of a person’s pulse can provide insight into their health, especially when measuring the before and after the pulse of an individual engaged in exercise.
  • Static and Kinetic Friction: A Lab Experiment Static friction is the force that opposes the motion of two surfaces or bodies that are in physical contact when the surfaces/bodies are at rest.
  • John Watson and the “Little Albert” Experiment John Watson is considered to be the founder of behaviorism, a psychological theory that focuses on visible behavior while diminishing the notion of consciousness.
  • “Stanford Prison Experiment Ethics” by Philip Zimbardo The primary purpose of Zimbardo’s work was to explore how quickly individuals would identify with corrections officers and prisoner roles during the prison simulation.
  • Human Transport Systems: The Pulse Rate Experiment The report provides an analysis of the pulse rate experiment aimed at determining the pulse rates before and after a five-minute exercise conducted by the researcher.
  • Experiment: Flame Test and Chemical Fingerprinting Flame test and chemical fingerprinting are analytical procedures that are used to identify metals or metalloid compounds.
  • Archimedes’ Principle Experiment: Determining Gravity of Objects This paper describes an experiment that aims in determining the specific gravity of different metallic objects, a liquid, and wood.
  • Unethical Research Experiments Violation of ethical principles can be traced in two analyzed cases; only in Landis’s experiment harm and killing were real in relation to animals.
  • Hawthorne Experiments – Elton Mayo With Roethlisberger and Dickson The Hawthorne theories have brought about a positive change in the behavior and attitude of the managers as well as the workers.
  • Scientific Report Draft on Osmosis Egg Experiment Understanding how an egg reacts when placed in solutions of different concentrations enables one to understand the role of osmosis in the human body.
  • Fiji Water Quality: Biology Lab Experiment Since Fiji water is among the popular brands in the US, it is essential to evaluate whether it is clean, that is, safe for human consumption.
  • Ideal Gas Expansion Law: Experiment The purpose of the experiment was to understand the differences between different types of ideal gas expansions, paying attention to the amount of work done.
  • Why People Obey Authority: Milgram Experiment and Real-World Situation Human beings would obey authority depending on the overall rewards, potential personal gains, and the consequences of failing to do so.
  • Helicopter Experiment Assessment This report of a paper helicopter experiment involved designating a paper helicopter in varied designs and then dropping it severally while recording the flight time.
  • The Milgram Experiment: Ethical Issues The Milgram experiment is a controversial study on the subject of obedience to authority figures. The participants were asked to deliver electric shocks to other people.
  • Kant’s Ethical Philosophy and Milgram’s Experiments The problem for Kant’s ethical philosophy is whether moral principles are applicable to nonhumans, such as Galacticans.
  • Inductor-Capacitor-Resistor Circuit Experiment The article presents the experiment that will demonstrate the relationship between an inductor, voltmeter, and resistor in an inductor-capacitor-resistor (LCR) circuit.
  • Metal and Non-metal Redox Reactions Experiment The following experiment aimed to investigate Redox reaction and hence determine which elements were reactive; metal v. metal redox reactions, and non-metal v. non-metal reactions.
  • Bolted & Welded Connections and Tension Experiment Exploring and comparing the expected and actual failure modes of both bottled and welded connections in tension are the primary purposes of the paper.
  • Chemical Experiment on Enzyme Amylase This paper presents an experiment that was conducted to determine the activity of amylase on starch at various pH levels.
  • Gender Stereotyping Experiment: The Level of Gender Stereotyping in Society The present study measures the effects of stereotyping women. It examines the first impression formed by subjects based on the information about a fictitious man or a woman.
  • Putnam’s “Twin Earth” Thought-Experiment Throughout the history of analytic philosophy, the problem of meaning has been and remains one of its central themes.
  • Extraneous Variables in Experiments There are some variables in experiments besides the independent variables that usually cause a variation or a change to the dependent variables.
  • Air Pressure Experiment Methods and Results The plastic mesh fabric was placed over the mouth of the Mason jar, and the metal screw band of the latter was fastened firmly over the plastic mesh sheet.
  • Metrology Experiment with Measurement Tools The experiment concerned testing the efficacy of the measurement tools such as the Vernier caliper, a depth gauge, a micrometer, and a gauge in an uncertainty analysis.
  • Virtue Ethics in Stanford and Milgram’s Experiments This paper investigates the notion of virtue ethics, discussing two major studies, the Stanford prison experiment, and Milgram’s obedience studies.
  • Lab Experiment on Photovoltaics The experiment was done specifically to ascertain how various connected units could be coordinated to give a more reliable and controllable functioning.
  • A Personal Behavior Modification Experiment Using Operant Conditioning This research paper points out the positive outcomes of swearing: it can relieve stress and help one cope with emotional work.
  • Ideal Experiment Design: Independent and Dependent Variables This work describes the ideal experiment, that is designed to verify the causal relationship between independent and dependent variables.
  • Milgram Experiment: The Question of Ethics This essay will discuss the Milgram experiment and also argue that it was ethical as medical research standards were met, and no undue harm to the participants was caused.
  • Chemistry of Cooking. Saffron Rice Experiment This research project outlines an experiment that aims to determine the temperature at which Saffron rice turns yellow.
  • Scientific Experiments on Animals from Ethical Perspectives This paper discusses using animals in scientific experiments from the consequentialist, Kantian deontological and Donna Yarri’s Christian character-based perspectives.
  • Experiment on Effect of Energy Drinks on Athletic Performance Experimental research is a study that a researcher sets up to evaluate a given situation, such as a drug or treatment intervention.
  • Anaerobic Threshold: An Experiment Anaerobic Threshold refers to the minimum level below which no increase in blood lactose can occur. At levels above AT, supplementing aerobic production needs aerobic energy.
  • Ethics: Experiments on Animals Industrial and biomedical research is often painful and most of the test ends up killing the animals. Experiments such as these often incur the wrath of the animal rights movement.
  • Studying Organisations: The Hawthorne Experiments The Hawthorn experiments marked a new direction in research of motivation and productivity. More than half a century has passed, and productivity remains a concern of management.
  • Social Experiment: Informal Norms of Gender Issues The social experiment presents a contradiction between the socially-accepted norms and the understanding of equality between men and women.
  • The Stanford Prison Experiment The Stanford prison experiment is an example of how outside social situations influence changes in thought and behavior among humans.
  • Situation, Institutional Norms, and Roles: The Stanford Experiment of Zimbardo Philip Zimbardo’s Stanford Experiment brought him critical acclaim. At the same time, it accorded him a certain level of notoriety; because of the methodologies he utilized to conduct the experiment.
  • Miles Davis and Steve Reich: Geniuses of Experiments and Creativity Although Miles Davis’ and Steve Reich’s music belongs to different genres, they are connected in their constant search for a new sound by experimenting and improvising.
  • “Tuskegee Syphilis Experiment – The Deadly Deception”: Unethical Scientific Experiment “Tuskegee Syphilis Experiment – The Deadly Deception” reviews an unethical scientific experiment on humans that was conducted by White physicians on African-Americans.
  • An Enzyme Linked Immunosorbent Assay Experiment In our society presently, immunoassay techniques used in data analyses have assumed a place of high significance, particularly as it applies to pure/applied research.
  • Socioeconomic Status and Sentencing Severity Experiment There are two types of validity threats: external and internal. External validity refers to the degree to which the study can be applied to situations outside the research context.
  • Psychology: Zimbardo Prison Experiment Despite all the horrors that contradict ethics, Zimbardo’s research contributed to the formation of social psychology. It was unethical to conduct this experiment.
  • Conducting a Titration Experiment Titration studies are conducted to quantify the amount of an unidentified element in the sample using a methodological approach.
  • Post-Covid Adaptation Laboratory Experiment The goal of the laboratory experiment that this paper will outline is to test the hypothesis about the needs of senior citizens in the post-pandemic era.
  • Psychology: Milgram Obedience Experiment Milgram’s experiment may be the last psychological experiment that has had a significant impact on psychology and public opinion.
  • Predicting the Replicability of Social Science Lab Experiments The quality of work is the most significant factor for any academic organization. A research process for any scientific project requires careful evaluation of information sources.
  • Moral Dilemma and Thought Experiments The aim of this essay is to set up a thought experiment in which a moral dilemma must be resolved. A person is invited to make a choice as a result of which people should suffer.
  • Experiments in High-Frequency Trading High-frequency trading (HFT) is becoming increasingly popular with private businesses and traders. HFT allows traders to make transactions within fractions of seconds.
  • The Ethical Issues in 1940’s U.S. Experiments With Syphilis in Guatemala The Guatemala tests have been viewed as a dark side of the U.S. clinical examination: in the 1940s, they purposely uncovered over 5,000 individuals with syphilis and gonorrhea.
  • Isopods and Their Use in Experiments Isopod is a large family belonging to the crayfish order. The fact that isopods are good to use in various experiments is related to their habitat.
  • Sociological Experiment: The Salience of Social Norms Based on the sociological experiment described in the paper, the author demonstrated the salience of social norms that exist in our culture.
  • Thought Experiment: The Morality of Human Actions A thought experiment aimed at assessing the morality of human actions motivated by divine punishment or reward raises the question of morality and religion correlation.
  • Ethical Implications of the Early Studies in Psychology: Milgram’s Experiment Milgram’s experiment on obedience content and results are valuable for understanding the ethical issues that may occur in social and behavioral research.
  • Blue-Eyed vs. Brown-Eyed Experiment Elliot exposed the learners to discrimination, in which blue-eyed children were initially preferred and given more privileges in the classroom than brown-eyed students.
  • Experiment: Science Meets Real Life The experiment involves the sequential study of the dog’s behavior and its reaction to a change in some factors, such as food and bowl.
  • P. Zimbardo’s Stanford Experiment A psychological experiment is an event conducted to acquire new scientific knowledge about psychology through the researcher’s deliberate intervention in the life of the examinee.
  • Should Animals Be Used for Scientific Experiments? Unfortunately, at the moment, the use of animals in science and medicine cannot be excluded entirely. However, it is possible to conduct experiments using mathematical models.
  • Smoking: An Idea for a Statistical Experiment The hypothesis is that people who smoke cigarettes daily tend to earn more than others: this is a personal observation that requires careful experimental testing.
  • The Stanford Jail Experiment Critiques One of the most important critiques leveled at the Stanford Jail Experiment is the length of time it took Zimbardo to call a halt to the experiment.
  • Super Size Me and Jogn Cisna Experiments In comparison to Super Size Me, the experiment of John Cisna immediately stands out with a positive attitude towards fast food.
  • Health and Medicine: Experiments and Discussions In the first experiment, researchers tested the subjectivity of polygraph examiners’ assessments. The specialist was given a specific name before the test began to do it.
  • Stanford Prison Experiment: Behind the Mask Stanford Prison Experiment organized by Stanford researcher Philip Zimbardo led to a strong public response and still discussed today.
  • An Experiment in DNA Cloning and Sequencing The aim of this experiment is to clone a fragment of DNA that includes the Green Fluorescent Protein (GFP) gene into the vector pTTQ18, which is an expression vector.
  • Lab Experiment on Animals’ Taste or Smell Senses The hypothesis of the study is that taste perception and detection of different sugars by insects were similar to that of humans.
  • Comparative Effectiveness of Various Surfactants: Experiment Surfactants refer to chemical substances that lessen the surface tension in water. This experiment aimed at establishing the comparative effectiveness of various surfactants.
  • A Hypothesis and an Experiment: A Case Study On the control experiment, there would be a seed grown at normal aeration, and wind conditions. All should have a viable bean seed planted centrally on watered soil preferably.
  • An Experiment on Data Mining Extend This experiment aims to utilize knowledge and principles of data mining in depicting the investigation of emergent data in biology- particularly on the development of ELISAs.
  • Mind Control: Ethics of the Experiment The topics of mind control and free will has always been seen as a morally grey area in terms of its research potential.
  • Jane Elliott’s Experiment on Discrimination The teacher Jane Elliott from Iowa decided to conduct an experiment demonstrating to her students what discrimination is and what it feels like.
  • The Tuskegee Syphilis Experiment When the Tuskegee Syphilis Experiment was begun, over 75 years ago, no such principles were officially in place.
  • The Power of Conformity: Asch’s Experiments The article examines a series of experiments by Asch that helped him identify the factors influencing social conformity.
  • The Critical Characteristics of an Experiment The main aim of this assignment is to evaluate the thought control experiment by famous psychologist Ellen Langer and determine whether it is a qualitative experiment.
  • Ethical Analysis of the Tuskegee Syphilis Experiments The Tuskegee Syphilis Study failed to take into account several critical ethical considerations. This essay examines some of the ethical problems linked to the investigation.
  • The Use of Animals in Psychological Experiments The method of experimentation is of great significance for multiple fields of psychology, especially for the behaviorist branch.
  • Boston’s Experiment: Harvard Business Review’s Lessons In Harvard Business Review’s Lessons from Boston’s Experiment with The One Fund, Mitchell discusses his experience with fund distribution to the victims of the Boston bombing.
  • The Stanford Prison Experiment Review The video presents an experiment held in 1971. In general, a viewer can observe that people are subjected to behavior and opinion change when affected by others.
  • The Way to Come To Terms With Yourself: Social Distancing Experiment In this work, the author describes the course and results of an experiment on social distance: refusal to use gadgets, any communication, and going out.
  • Experiment: Bacteria vs Antibiotics The experiment aimed was to test the reaction of bacteria towards some antibiotics and determine the effectiveness of those antibiotics in treating some diseases.
  • Impact of the Stanford Prison Experiment Have on Psychology This essay will begin with a brief description of Zimbardo’s Stanford Prison Experiment then it will move to explore two main issues that arose from the said experiment.
  • Medical Pharmacology: The Langendorff Experiment The Langendorff experiment aimed at using an ex vivo isolated rat heart preparation to demonstrate the pharmacological effects of two unknown drugs.
  • Worldview Changes After the Blindness Experiment Our senses are the central source of information about the world and events that happen around us. So, the loss of one of these is a significant challenge for a person.
  • Evaluation of the Stanford Prison Experiment’ Role The Stanford Prison Experiment is a study that was conducted on August 20, 1971 by a group of researchers headed by the psychology professor Philip Zimbardo.
  • Social Experiment: Wrong Outfit in a Wedding Event The attendees of the wedding event displayed disappointment, discomfort, and open resentment towards the dressing style.
  • Heat Transfer Rates in a Hot Jet: Experiment The experiment is aimed at determining the heat transfer rates in a hot jet. The reasons for the hot jet to have different heat rates in different areas will be determined.
  • Acoustics Experiment in Brunel’s Thames Tunnel In this project, tunnels that exist below London streets for a variety of communications, civil defense, and military purposes will be used as the objects of the experiment.
  • Inattentive Blindness in Psychological Experiment The features of the human consciousness not to notice quite obvious changes are natural and innate. Such blindness can be caused by several factors.
  • Pasture Experiment: Fertiliser Treatments Response This work is an experiment that defines the role of fertilizers in pasture production and to establish the appropriate use of pasture sampling to assess pasture mass.
  • An Observable Experiment: Control Over the Variables An observable experiment is defined as the experiment in which the independent variables cannot possibly be controlled by the person or person setting the test.
  • Tuskegee Syphilis Experiment: Ethical Controversy Tuskegee case set the background for the reconsideration of healthcare ethics, which means that the ethical value of the given case deserves reconsideration.
  • Psychological Studies and Experiments: Code of Conduct The following paper is based on past psychological studies i.e. Stanly Milgram’s ‘Obedience Experiment’, Philip Zimbardo’s ‘Stanford Prison Experiment, and Jane Elliott’s ‘Class Divided’.
  • Using Animals in Medical Experiments This paper explores how the principles of the character-based ethical approach can be applied to the discussion of using animals in the medical research and experiments.
  • The Stanford Experiment by Philip Zimbardo Philip Zimbardo’s Stanford Experiment shows that situational power and norms dictate the behavior of the individual more than the core beliefs that made up his personal identity.
  • Osmosis Experiment With Parsnip Through Differing Concentration of Sucrose
  • Identifying the Benefits of Home Ownership: A Swedish Experiment
  • Experiment for Cancer Risk Factors
  • Hydrochloric Acid Into Tubes of Water and Sodium Thiosulphate Experiment
  • General Information about Monkey Drug Trials Experiment
  • Reaction Rates Experiment Hydrochloric Acid
  • Hydrochloric Acid and Marble Chips Experiment
  • Physical Disability and Labor Market Discrimination: Evidence From a Field Experiment
  • Canadian Advanced Nanosatellite Experiment Biology
  • Dr. Heidegger’s Experiment: Reality or Illusion
  • Experiment and Multi-Grid Modeling of Evacuation From a Classroom
  • High-Performance Liquid Chromatography Experiment
  • Social Capital and Contributions in a Public-Goods Experiment
  • Illusory Gains From Chile’s Targeted School Voucher Experiment
  • Short Selling and Earnings Management: A Controlled Experiment
  • Theft and Rural Poverty: Results of a Natural Experiment
  • Lab Experiment: The Effectiveness of Different Antibiotics on Bacteria
  • Brucellosis and Its Treatment: Experiment With Doxycycline
  • The Link Between Stanford Prison Experiment and Milgram Study
  • Four Fundamental Results From the Mice Experiment
  • Can Nonrandomized Experiments Yield Accurate Answers?
  • What Kind of Experiments Are Done on Animals?
  • Is It Good to Use Animals for Experiments?
  • What Are the Types of Experiments?
  • Is There Any Healthy Way to Experiment With Drugs?
  • What Are the Top Experiments of All Time?
  • Are Breaching Experiments Ethical?
  • What Does It Mean to Experiment With a Drug?
  • Why Do We Use Factorial Experiments?
  • How Does Temperature Affect the Rate of Reaction Experiment?
  • What Are the Easiest Experiments to Do?
  • How Can Rushing Harm the Data and the Experiment Overall?
  • What Are the Steps to a Science Experiment?
  • How Do Errors Affect the Experiment?
  • What Is the Purpose of the Wax Experiment and What Conclusion Does Descartes Reach on Its Basis?
  • Can an Experiment Be Invalid but Reliable?
  • What Is the Most Influential Experiment in Psychology?
  • Why Are Fruit Flies Used for Experiments?
  • How Can You Improve the Accuracy of an Experiment?
  • What Was Galileo’s Famous Cannonball Drop Experiment?
  • What Can Knowledge Be Gained From Conducting a Breaching Experiment?
  • How Do You Identify the Independent and Dependent Variables in an Experiment?
  • What Was Griffith’s Experiment and Why Was It Important?
  • What Is the Difference Between Contingent Valuation and Choice Experiment?
  • What Is the Choice Experiment Valuation Method?
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These essay examples and topics on Experiment were carefully selected by the StudyCorgi editorial team. They meet our highest standards in terms of grammar, punctuation, style, and fact accuracy. Please ensure you properly reference the materials if you’re using them to write your assignment.

The essay topic collection was published on December 21, 2021 . Last updated on December 31, 2023 .

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    Research Research projects for Higher Degree by Research (HDR) students are available within the following School of Pharmacy research areas and research centre. Please email our academic staff to discuss potential HDR projects and ask if they are available as an advisor for your proposed HDR program. Clinical Pharmacy and Pharmacometrics

  6. Hot Topics in Pharmaceutical Research

    Highly Cited Articles in Molecular Pharmaceutics: Hot Topics in Pharmaceutical Research Lynne S. Taylor * Mol. Pharmaceutics 2023, 20, 7, 3251-3251 Publication Date (Web): July 3, 2023 Full Text PDF Covid and RNA delivery COVID-19 Transmission, Current Treatment, and Future Therapeutic Strategies Vrishali S. Salian , Jessica A. Wright ,

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    HOT TOPICS IN PHARMACY PRACTICE RESEARCH. S13 Effectiveness of community-based pharmacist interventions in chronic non-cancer pain: A systematic review. S14 The consideration of sex/gender and vulnerable populations in pharmacy practice research. POSTER ABSTRACTS. S15 Introducing a unit-based clinical pharmacist: A pilot study

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    Ensuring rigour and trustworthiness of qualitative research in clinical pharmacy.. PubMed. Hadi, Muhammad Abdul; José Closs, S. 2016-06-01. The use of qualitative research methodology is well established for data generation within healthcare research generally and clinical pharmacy research specifically. In the past, qualitative research methodology has been criticized for lacking rigour ...

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    There is an urgent need for research into the mechanisms underlying cognition and for the development of strategies that predict the drug responses of individual patients. Drug Effects on Cognition Description of Drug Effects on Cognition Graphic showing drug effects on cognition in three main sections that connect together. The first section is Cognitive Assessment of Drug Effect, which ...

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    Pharmacists are expected to participate in the conduction of research to advance the profession and health care broadly. Additional opportunities for pharmacist research engagement have emerged with the increased integration of clinically trained pharmacists into interprofessional care teams. Research conducted over the past four decades has demonstrated an increasing trend of pharmacist ...

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    Keywords: Education, Training, Learning, Best Practises, Prescribing, Clinical Pharmacology, Experimental Pharmacology, Drug Discovery, Bench-to-bedside, Drug Development, Early-Career.. Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements.

  18. Effectiveness of blended learning in pharmacy education: An ...

    Background &objectives Though there are studies to evaluate the effectiveness of blended learning in pharmacy education, most of them originate from USA and have used previous year students' scores as control. Also there is less research in comparing use of self -regulated learning strategies between blended and other learning strategies. Primary aim was to evaluate the effectiveness of ...

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