The Universities of Greenwich and Kent at Medway

Kings Hill, United Kingdom

The Universities of Greenwich and Kent at Medway

Kings Hill, United Kingdom
SEARCH FILTERS
Time filter
Source Type

Jarernsiripornkul N.,Khon Kaen University | Chaipichit N.,Khon Kaen University | Chumworathayi P.,Khon Kaen University | Krska J.,The Universities of Greenwich and Kent at Medway
Pharmacy Practice | Year: 2015

Background: Drug allergy a serious adverse drug reaction commonly concerned in healthcare practice. Inadequate documentation and communication between health providers, and limited health literacy and knowledge in patients could contribute to the re-occurrence of allergic reactions. Objective: To evaluate the effectiveness of initiatives aiming to improve patients’ knowledge, understanding and behavior in preventing recurrent drug allergy. Methods: A before-and-after study was conducted at an 800-bed university teaching hospital, involving patients with a history of drug allergy. Questionnaires, completed at baseline and one month after receiving information were used to compare knowledge and understanding of drug allergy and behaviors in relation to drug allergy cards. Patients in Group 1 received a brochure only, but patients in Group 2 also received a pharmacist counseling intervention in addition to the brochure. Outcomes were evaluated within intervention group and between intervention groups. Results: The study included 299 (30.4%) and 100 patients (100.0%) in Groups 1 and 2 respectively who completed the baseline questionnaire, of whom 179 (59.8%) and 96 (96.0%) completed the follow-up questionnaire. At baseline, higher educational levels and possession of a drug allergy card were significantly associated with better knowledge about drug allergy. After intervention, Group 2 had significantly greater increases in mean overall knowledge scores than Group 1 (p<0.01) and also greater increases in the proportions self-reporting carrying and presenting drug allergy cards (p<0.05 and p<0.01). Conclusions: Pharmacist counseling plus brochure may be more effective than brochure alone in promoting patients’ knowledge of drug allergy and drug allergy card importance. © 2015, Grupo de Investigacion en Atencion Farmaceutica. All rights reserved.


Saramunee K.,Liverpool John Moores University | Saramunee K.,Mahasarakham University | Mackridge A.,Liverpool John Moores University | Richards J.,Liverpool John Moores University | And 2 more authors.
Journal of Pharmaceutical Health Services Research | Year: 2016

Objective: To evaluate methodological outcomes and cost-effectiveness of seven survey modes, using a study of general public views towards pharmacy public health services. Methods: A cross-sectional, paper-based survey was conducted in North West England among people aged ≥18 years, using two approaches. Three interviewer-assisted modes were street, door-to-door and telephone. Four self-completion modes were single- and double-mailing to residential addresses, surveys sent to public/private business by post (postal-business) and questionnaires dropped-off at venues (drop-off). The study compared response rates, demographics and two domains ((a) actual use of and (b) willingness to use pharmacy public health services) between modes. Incremental cost-effectiveness ratios of different modes were assessed against the single-mailing. Key findings: Response rate varied between 5.1% (postal-business) and 34.5% (street). Respondent age, education, employment, socioeconomic and deprivation status varied between different modes. Results for domain (a) were similar for all modes. Interviewer-assisted modes resulted in more positive views on willingness to use advisory services (P < 0.05). The drop-off mode saved £45.92 (US$72.55) per 1% increase in response rate compared to single-mailing, while interviewer-assisted and double-mailing were more costly. At higher response rates, cost-savings by the drop-off mode diminished, but for other survey modes, additional costs decreased. Conclusion: Drop-off mode is cost-effective compared to the standard single-mailing, but selection bias is possible. Street surveys are also an efficient method, but may carry a higher risk of obsequiousness bias. Mixed-modes surveys may reach wider sectors of the population. The similarity in use of services suggests all survey modes reach members of the public relevant to pharmacy researchers. JPHSR © 2016 Royal Pharmaceutical Society.


Saramunee K.,Liverpool John Moores University | Saramunee K.,Mahasarakham University | Krska J.,The Universities of Greenwich and Kent at Medway | Mackridge A.,Liverpool John Moores University | And 3 more authors.
Public Health | Year: 2015

Objectives: To explore the experience of and willingness to use seven pharmacy public health services related to cardiovascular risk among the general public in England. Study design: Mixed-methods study. Methods: A mixed-methods study, involving a cross-sectional survey using multiple distribution methods followed by a focus group discussion (FGD) with a sample of survey respondents. Results: From 3596 approachable individuals, 908 questionnaires were completed (response rate 25.3%). Few respondents (2.1-12.7%) had experienced any of the seven pharmacy public health services. About 40% stated they would be willing to use health check services, fewer (9.3-26.3%) were willing to use advisory services. More females, frequent pharmacy users and those in good health were willing to use services in general (P < 0.05). Smokers, overweight individuals and those with alcohol-related problems were most willing to use specific advisory services supporting their problems (P < 0.05). FGD identified barriers to service use; for example, frequent staff changes, seeing pharmacist as medicines suppliers and concerns about competence for these services. Conclusion: The general public are receptive to pharmacy public health services. Pharmacists must consider barriers if uptake of services is to increase. © 2015 The Royal Society for Public Health.


PubMed | University of Liverpool, Liverpool John Moores University, Mahasarakham University, Chiang Mai University and 2 more.
Type: Journal Article | Journal: Public health | Year: 2015

To explore the experience of and willingness to use seven pharmacy public health services related to cardiovascular risk among the general public in England.Mixed-methods study.A mixed-methods study, involving a cross-sectional survey using multiple distribution methods followed by a focus group discussion (FGD) with a sample of survey respondents.From 3596 approachable individuals, 908 questionnaires were completed (response rate 25.3%). Few respondents (2.1-12.7%) had experienced any of the seven pharmacy public health services. About 40% stated they would be willing to use health check services, fewer (9.3-26.3%) were willing to use advisory services. More females, frequent pharmacy users and those in good health were willing to use services in general (P < 0.05). Smokers, overweight individuals and those with alcohol-related problems were most willing to use specific advisory services supporting their problems (P < 0.05). FGD identified barriers to service use; for example, frequent staff changes, seeing pharmacist as medicines suppliers and concerns about competence for these services.The general public are receptive to pharmacy public health services. Pharmacists must consider barriers if uptake of services is to increase.


Jarernsiripornkul N.,Khon Kaen University | Chaipichit N.,Khon Kaen University | Pratipanawatr T.,Khon Kaen University | Uchaipichat V.,Khon Kaen University | Krska J.,The Universities of Greenwich and Kent at Medway
Pharmacoepidemiology and Drug Safety | Year: 2016

Purpose: To develop and conduct preliminary testing of a causality assessment tool for patients, for potential use in encouraging both discussions with clinicians about suspected adverse drug reactions (ADRs) and reporting to authorities. Methods: Ten causality statements, developed from qualitative studies involving patients, with a scoring system allowing categorization, were embedded in a questionnaire which also included a symptom checklist and additional details about one suspected ADR and medicine, selected for causality assessment. Patients with experiences of suspected ADRs were involved in cognitive interviews (15), piloting (20) and psychometric testing (120). Test-retest reliability, construct validity and criterion-related validity were evaluated, through repeated causality assessment, comparison with a visual analogue scale assessing certainty of causality and comparison with causality assessment using World Health Organization-Uppsala Monitoring Centre (WHO-UMC) criteria, respectively. The study involved outpatients at a university hospital in northeast Thailand. Results: Ninety-eight patients completed causality assessment twice: both causality scores (Spearman rs=0.715; p<0.001) and causality classification [percentage of positive agreement (PPA)=68.4; κ=0.419; p<0.001] showed satisfactory reliability. Causality scores were positively correlated with certainty of causality (Spearman rs=0.556; p<0.01). There was moderate agreement against WHO-UMC criteria [PPA=70.4; κ=0.440; p<0.001]. Of the 91 completing an evaluation, 88% agreed that the tool should be used routinely, 78% agreed that it gave them useful results and 80% agreed that it was easy to use. Conclusions: This novel instrument has satisfactory psychometric properties and was acceptable to Thai patients, but it requires further testing. It has potential for use in supporting patients with suspected ADRs to discuss these with health professionals, and perhaps to report directly. © 2016 John Wiley & Sons, Ltd.


Chaipichit N.,Khon Kaen University | Krska J.,The Universities of Greenwich and Kent at Medway | Pratipanawatr T.,Khon Kaen University | Jarernsiripornkul N.,Khon Kaen University
International Journal of Clinical Pharmacy | Year: 2015

Background Although statins have great benefit on the prevention of cardiovascular diseases with limited adverse effects (AEs), little is known about patients’ contribution of AE reports in clinical practice. Objectives To explore patients’ experiences of statin AEs and related laboratory monitoring in clinical practice. Setting Outpatient clinics of two University hospitals in northeast Thailand. Methods Generic symptom checklist questionnaires for self-reporting AEs were distributed to patients prescribed simvastatin, atorvastatin, or rosuvastatin at outpatient clinics. Clinical information was obtained from medical records. Reported symptoms were assessed for causality considering previously known statin AEs, concomitant diseases and drugs. Main outcome measure Potential statin AEs reported by patients and monitoring of laboratory parameters related to musculoskeletal and liver disorders. Results Of the total 718 valid responses, 76.0 % of patients reported at least one symptom, most of which (69.0 %) were probable/possible statin AEs. Musculoskeletal and liver-related symptoms were reported by 283 (39.4 %) and 134 patients (18.7 %), respectively. Probable/possible AEs were categorized in 56.7 % of their musculoskeletal and gastrointestinal symptoms. Majority of patients had at least one laboratory test on initiation of (64.8 %) and during statin treatment (61.8 %). Patients taking atorvastatin or rosuvastatin, and patients with history of chronic renal diseases were more likely to have creatine kinase (CK) monitored on initiation of and during statin treatment. Additionally, taking drugs which could potentially increase muscle injury (OR 1.929, P < 0.01) and self-reporting of musculoskeletal symptoms (OR 1.805, P < 0.01) were associated with CK monitoring during statin treatment. Reporters of musculoskeletal symptoms also had significantly higher mean CK level than those not reporting any musculoskeletal symptoms (207.35 ± 155.40 vs. 143.95 ± 83.07 U/L, respectively; P = 0.037). Patient reporting of liver AEs was not related to alanine aminotransferase (ALT) level and monitoring, however, prior history of liver disorders was significantly associated with monitoring of ALT on initiation of and during statin treatment (OR 5.745 and OR 23.063, respectively; P < 0.01). Conclusion Many patients experienced at least one possible adverse effects on a statin. The findings suggest that laboratory monitoring is relatively selective in relation to risks and patient-reported adverse symptoms. © 2015, Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie.


PubMed | The Universities of Greenwich and Kent at Medway and Khon Kaen University
Type: Journal Article | Journal: Pharmacoepidemiology and drug safety | Year: 2016

To develop and conduct preliminary testing of a causality assessment tool for patients, for potential use in encouraging both discussions with clinicians about suspected adverse drug reactions (ADRs) and reporting to authorities.Ten causality statements, developed from qualitative studies involving patients, with a scoring system allowing categorization, were embedded in a questionnaire which also included a symptom checklist and additional details about one suspected ADR and medicine, selected for causality assessment. Patients with experiences of suspected ADRs were involved in cognitive interviews (15), piloting (20) and psychometric testing (120). Test-retest reliability, construct validity and criterion-related validity were evaluated, through repeated causality assessment, comparison with a visual analogue scale assessing certainty of causality and comparison with causality assessment using World Health Organization-Uppsala Monitoring Centre (WHO-UMC) criteria, respectively. The study involved outpatients at a university hospital in northeast Thailand.Ninety-eight patients completed causality assessment twice: both causality scores (Spearman rs =0.715; p<0.001) and causality classification [percentage of positive agreement (PPA)=68.4; =0.419; p<0.001] showed satisfactory reliability. Causality scores were positively correlated with certainty of causality (Spearman rs =0.556; p<0.01). There was moderate agreement against WHO-UMC criteria [PPA=70.4; =0.440; p<0.001]. Of the 91 completing an evaluation, 88% agreed that the tool should be used routinely, 78% agreed that it gave them useful results and 80% agreed that it was easy to use.This novel instrument has satisfactory psychometric properties and was acceptable to Thai patients, but it requires further testing. It has potential for use in supporting patients with suspected ADRs to discuss these with health professionals, and perhaps to report directly.


PubMed | University of Liverpool, The Universities of Greenwich and Kent at Medway and Liverpool John Moores University
Type: Journal Article | Journal: JRSM open | Year: 2016

It is recommended that patients are seen within 4h of arrival in Acute Medical Units in English hospitals. This study explored the frequency and nature of interruptions and delays potentially affecting the duration of the Acute Medical Unit admission process and the quality of care provided.The admission process was directly observed for patients admitted to the Acute Medical Unit over four one-week periods, November 2009 to April 2011.UK teaching hospital Acute Medical Unit.Hospital staff n=36.Patient waiting times, duration of clerking, number of interruptions and/or delays.Thirty-five doctors and one nurse practitioner were observed admitting 71 medical patients, 48/71 (68%) patients were clerked within 4h of arrival. A delay and/or interruption affected 49/71 (69%) patients. Sixty-six interruptions were observed in 36/71 (51%) of admissions, of these 19/36 (53%) were interrupted more than once. The grade of doctor had no bearing on the frequency of interruption; however, clerking took significantly longer when interrupted; overall doctors grade ST1 and above were quicker at clerking than foundation doctors. Delays affected 31/71 (44%) of admissions, 14/31 (45%) involved X-rays or ECGs; other causes of delays included problems with equipment and computers.Interruptions and delays regularly occurred during the admission process in the study hospital which impacts adversely on patient experience and compliance with the recommended 4-h timeframe, further work is required to assess the impact on patient safety. Data obtained from this observational study were used to guide operational changes to improve the process.

Loading The Universities of Greenwich and Kent at Medway collaborators
Loading The Universities of Greenwich and Kent at Medway collaborators