|Year : 2017 | Volume
| Issue : 4 | Page : 204-209
Pharmacy student's practice surrounding health issues of their family: A cross-sectional survey
D Raja, KV Sruthy, Ponnusankar Sivasankaran
Department ofPharmacy Practice, JSS College of Pharmacy, Udhagamandalam (Ooty), Tamilnadu, JSS University, Mysuru, Karnataka, India
|Date of Web Publication||12-Dec-2017|
Dr. Ponnusankar Sivasankaran
Department of Pharmacy Practice, JSS College of Pharmacy, PB No: 20, Rocklands, Udhagamandalam (Ooty), Tamilnadu, JSS University, Mysuru, Karnataka
Source of Support: None, Conflict of Interest: None
INTRODUCTION: Globally, pharmacists play an important role in health-care system. The academic knowledge and the clinical skills that pharmacy student undertakes can be used to improve patient care and the medication use, especially in chronic conditions.
OBJECTIVES: The objective of this study is to find out the extent of pharmacy students' involvement in addressing the medical related issues in their own family.
METHODS: Students' extent and involvement in Addressing their Family member Medical Condition Questionnaire (SAFMCQ) was developed and validated. Pretest, pilot-tests and test-retest were performed with samples of 34, 108 and 34 respectively. SAFMCQ was used to collect responses from selected students of pharmacy colleges in South India.
RESULTS AND DISCUSSIONS: From the study, we found that M.Pharm Pharmacy Practice students are involved more in attending family member health issues. We observed mixed responses from the PharmD and poor practice among B.Pharm students.
CONCLUSION: In general, staying away from family members and not being familiar with their health status are the reasons for pharmacy students' inadequate practice in addressing the health issues of their family members. We conclude that pharmacy students in India can improve their interest and practice surrounding the health of the family members.
Keywords: Family member, medical issue, pharmacy students' involvement, questionnaire, Students' extent and involvement in Addressing their Family member Medical Condition Questionnaire
|How to cite this article:|
Raja D, Sruthy K V, Sivasankaran P. Pharmacy student's practice surrounding health issues of their family: A cross-sectional survey. Int J Health Allied Sci 2017;6:204-9
|How to cite this URL:|
Raja D, Sruthy K V, Sivasankaran P. Pharmacy student's practice surrounding health issues of their family: A cross-sectional survey. Int J Health Allied Sci [serial online] 2017 [cited 2023 Mar 28];6:204-9. Available from: https://www.ijhas.in/text.asp?2017/6/4/204/220524
| Introduction|| |
Globally, pharmacists play an important role in health-care system. The pharmacist responsibilities include a wide range of patient care activities such as dispensing medicines to patients and consumers, advice on over the counter medications and the counseling on the prescriptions. It also extend to provide information on medications, its storage, disposal of drugs, reviewing medications, and interaction with physicians.
A pharmacist role is not limited to public alone. However, it can include addressing their family members' medical issues by monitoring of their medications, self-care practice, and medication-related problems and having a track of test results. Among adverse drug reaction-related hospitalization, 88% in elderly and 24% of nonelderly are preventable. At home, medication-related drug interactions are an important issue. Further, among patients with chronic conditions, only 33%–50% of patients adhere completely to prescribed drug therapy.
Although a pharmacy student is not a professional, the academic knowledge and the clinical skills that one undertakes can be used to improve patient care and the medication use, especially in chronic conditions. They can be involved in monitoring laboratory parameters, interacting with physician, assessing medication effectiveness, minimizing adverse effects, reducing the cost of drug therapy, helping in increasing adherence to the drug regimen, and counseling about the storage and disposal of medications. By doing so, the students can make differences in the health care of their family members. Since this pattern of addressing family-related medical issues is not known, the objective of this study is to find out the extent of pharmacy students involvement in addressing the medical-related issues in their own family.
The objectives of this study are to find out the extent and involvement of pharmacy students in addressing the health issues of their family members.
| Methods|| |
Pharmacy students' extent and involvement in Addressing their Family member's Medical Condition Questionnaire (SAFMCQ) was developed and validated.,,,, SAFMCQ was circulated through Google forms to collect the required information. The generation of the item in the questionnaire was done. Pretest, pilot-tests, and test-retest were performed with samples of 34, 108, and 34, respectively.
Factor analysis and Cronbach's alpha were used to establish validity and reliability of the questionnaire. Readability of the questionnaire item was measured by the following online test tools.
- Flesch–Kincaid readability tests designed to indicate how difficult a reading passage in English is to understand
- The Gunning fog index measures the readability of English writing
- The Coleman–Liau index designed to gauge the understandability of a text
- The Simple Measure of Gobbledygook (SMOG) is a measure that estimate the years of education needed to understand
- The automated readability index designed to gauge the understandability of a text.
Finally, the average grade level of these tests was taken into account. These tests were done using free online readability calculator available from https://readability-score.com/.
The validated SAFMCQ was circulated through E-mail and social media sharing (includes WhatsApp and Facebook) to selected students of pharmacy college belonging to South India. The nonresponders were given a gentle reminder. The responses were collected. SPSS version 22 (IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.) was used for statistical analysis.
| Results and Discussion|| |
The scheme of questionnaire development is shown in [Table 1]. The results of readability tests are shown in [Table 2].
The validity of the SAFMCQ is given by content validity and factor analysis. A principal axis factor analysis was conducted on the 12 items with oblique rotation. The Kaiser-Meyer-Olkin (KMO) measure verified the sampling adequacy for the analysis, KMO = 0.653 (need to be > 0.5). An initial analysis was run to obtain eigen values for each factor in the data. 3 factors had eigenvalues over Kaiser's criterion of 1 and in combination explained 0.707 of the variance. The scree plot was ambiguous and showed inflexions that would justify retaining 2 or 3 factors. We retained 2 factors; interest and practice because of the convergence of scree plot and Kaiser criterion on this value. The reliability of the SAFMCQ was established by Cronbach's value 0.805.
In general, family members expect health-care professionals help in matters of health information.,,, We tried to study the role of pharmacy students in addressing the health issues of their family members. SAFMCQ was surveyed among pharmacy students of more than 16 colleges.
A total of 300 pharmacy students received the questionnaire, of which 252 students provided the response. SAFMCQ was framed with check codes that allow for certain questions to occur depending on what answer a respondent had given. For example, 48 of them had given the answer “Nil” to the question “How many of your family members suffer from any of these following diseases? (Diabetes mellitus, hypertension, asthma, renal failure, cardiac diseases, infectious diseases).” They were diverted to item no: 11 and 12 directly, disabling the other questions. It was found that 90.69% pharmacy students had shown interest on checking laboratory reports, 90.69% reviewing medications, 81.86% provide counseling regarding disease, 84.8% provide counseling regarding medications, 79.36% providing information on storage of drugs, and 63.89% providing information on disposal of drugs. By providing health information, pharmacy students not only improve patient care but can improve their medical expertise and the confidence level. From the study, the mean (standard deviation [SD]) age of the responders was found to be 21.33 (2.011). The gender-wise and course-wise responses were shown in [Figure 1] and [Figure 2]. Female students (79.44%) and PharmD students (51.4%) highly responded to this survey. The responses for SAFMCQ are shown in [Figure 3] and [Figure 4].
89% of PharmD, 90% of B. Pharm, 100% of M. Pharm (Pharmacy Practice), 100% of M. Pharm (Others) said “Yes” to the question, “Do you review their medications.” 85% of PharmD, 90% of B. Pharm, 100% of M. Pharm (Pharmacy Practice), and 95% of M. Pharm (Others) would ensure that their family members adhere to their medication. Similarly, 89% of PharmD, 92% of B. Pharm, 100% of M. Pharm (Pharmacy Practice), 95% of M. Pharm (Others) check their family members' laboratory reports.
Among the pharmacy students, 50% of M. Pharm Pharmacy Practice Strongly agreed, followed by 44% of B. Pharm, 42% of M. Pharm (Other specialization), and 24% of PharmD for the item “I ensure my family members undergo regular follow-up.” 56% of PharmD students have agreed, followed by 50% of M. Pharm Pharmacy Practice, 42% of B. Pharm and 32% of M. Pharm (Other specialization).
For the question, “I provide counseling regarding disease,” 50% of M. Pharm Pharmacy Practice strongly agreed, followed by 32% of M. Pharm (Others), 26% of B. Pharm, and 19% of PharmD. 65% of PharmD students have agreed, followed by 53% of M. Pharm (Others), 52% of B. Pharm, and 25% of M. Pharm Pharmacy Practice.
58% of M. Pharm (Others) have strongly agreed, followed by 50% M. Pharm Pharmacy Practice, 32% of B. Pharm, and 15% of PharmD for the item “I provide counseling regarding medications.” Similarly, 67% of PharmD students have agreed, followed by 52% of B. Pharm, 50% of M. Pharm Pharmacy Practice, and 37% of M. Pharm (Others).
50% of M. Pharm Pharmacy Practice, 30% of B. Pharm, 26% of M. Pharm other specialization, and 7% of PharmD students have strongly agreed, 61% of PharmD students have given response agree, followed by 41% of B. Pharm, 37% M. Pharm (Others), and 25% of M. Pharm Pharmacy Practice for the item “provide information on current medications, past medical history, past medication history, family history, allergies (whichever applicable) at each visit.”
For the item, “I interact with physician about the current status of the affected family member during each visit” 5% of PharmD students have strongly disagreed followed by 3% of B. Pharm students. 20% of PharmD students disagreed followed by 16% of M. Pharm (Others) and 12% of B. Pharm students. Furthermore, 50% of M. Pharm Pharmacy Practice responded neutral followed by 28% of PharmD, 27% of B. Pharm, and 21% of M. Pharm (Others) students.
39% of B. Pharm strongly agreed, followed by 29% M. Pharm (Others), 20% of M. Pharm Pharmacy Practice, and 15% of PharmD for the item “I provide information on safe and appropriate storage of drugs.” 60% of M. Pharm Pharmacy Practice has given the response agreed, followed by 56% of PharmD, 54% of M. Pharm (Others), and 50% of B. Pharm.
For the item “I provide counseling about the disposal of drugs,” 20% of M. Pharm Pharmacy Practice students strongly disagreed followed by 6% of PharmD students, 4% of M. Pharm (Others) and 3% B. Pharm. 20% of M. Pharm Pharmacy Practice students followed by 13% of M. Pharm (Others), 11% of PharmD, and 7% of B. Pharm disagreed. In addition, 29% of PharmD responded neutral followed by 15% of B. Pharm students and 8% of M. Pharm (Others). In overview 14.14% of B. Pharm, 9.14% of PharmD, 6% of M. Pharm (Others), and 5.71% of M. Pharm (Pharmacy Practice) gave both disagree and strongly disagree responses to above said items of the questionnaire. From the study, we found that M. Pharm Pharmacy Practice students are involved more in attending family member health issues. The reason for this trend could be they are already pharmacy graduates, and the present exposure to clinical curriculum enables them to intervene in health care. However, among PharmD that is again clinical oriented, we got mixed responses from the students. As these responses were taken from all classes of PharmD, the results we obtained shown lesser intervention in addressing the family members' health issues. Further class-wise analysis required in future study to identify the degree of intervention by Interns. B. Pharm students showed poor response compared to other pharmacy students.
Reasons for less contribution from students' side may be lack of confidence, family members perception of them as not a medical expert, etc. In addition, 78.97% of students reside in hostel for a mean (SD) 3.28 years (1.56). Staying away from home likely prevent students from giving direct attention on their family members' medical issues.
Reports are limiting the involvement of doctors in treating their own family members because of many reasons including legal concerns.,,, However, no such regulations can prevent pharmacy students to do so because they are not directly involved in treating patients. Instead, they are only helping them with their knowledge to achieve better outcomes. In fact, the family members trust in their ward make them involved in their health care even if they are not an expert medical professional. Some instances patients may fail to get or forget medical information from the health care providers when pharmacy students could advice these matters and ensure their adherence to therapy can benefit such patient in their family. By regularly attending to health status of family the progress of many diseases can be controlled. Seeing the interaction of their wards with own physicians the confidence and comfort of the family member would improve much higher. A report from plastic surgeons point out that 99.5% of patients were satisfied with their outcomes when they (Plastic Surgeon) performed anesthetic surgery on their family members. One write up suggests that outcomes due to referral can make a difference when intervened with general physicians of their family members. One of the biggest concern in today's world is the health issue and people may feel desirable if a health-care provider is already available at home and care for them., In contrast, there are reports that family members feel uncomfortable in disclosing personal information.,, However, pharmacy students should not be over concerned and unrealistic because of the fear and anxiety when patient is their close relation. It is important just because of their dissatisfaction that they should not be an obstruction to their family members convenience to approach their choice of physician., In addition, they should stop advising when they feel uncomfortable and do not indulge in areas which is out of their expertise even though family members compel them.,, Pharmacy students require some basic qualities, like expertise in medicine, counseling skill to provide advices not only to their family members but also to any patient. The knowledge and practice acquired can help them when they become a clinical pharmacist in the near future as society hold a lot of expectations and standards for the pharmacists.
| Conclusion|| |
The SAFMCQ questionnaire seems readable, reliable and construct valid. The Cronbach's alpha value of 0.805 indicated the reliability of the SAFMCQ questionnaire. As an emerging pharmacist, the students are expected to do their roles and responsibilities such as involvement in addressing their family members' medical related issues. In each category of pharmacy students, the responses varied. M. Pharm Pharmacy Practice students showed better interest and practice in addressing the family members' medical issues. In general, staying away from family members and not being familiar with the health issues of their family members are the reasons for pharmacy student inadequate practice in addressing the health issues of their family members. We conclude that Pharmacy students in India can increase their interest and practice in their family members' health issues.
The authors would like to thank the student participants for their valuable time in completing the survey.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Bell J, Dziekan G, Pollack C, Mahachai V. Self-care in the twenty first century: A Vital role for the pharmacist. Adv Ther 2016;33:1691-703.
Beijer HJ, de Blaey CJ. Hospitalisations caused by adverse drug reactions (ADR): A meta-analysis of observational studies. Pharm World Sci 2002;24:46-54.
Smith M, Bates DW, Bodenheimer T, Cleary PD. Why pharmacists belong in the medical home. Health Aff (Millwood) 2010;29:906-13.
Hsu Y, Serpell JA. Development and validation of a questionnaire for measuring behavior and temperament traits in pet dogs. J Am Vet Med Assoc 2003;223:1293-300.
Jenkinson C, Coulter A, Bruster S. The picker patient experience questionnaire: Development and validation using data from in-patient surveys in five countries. Int J Qual Health Care 2002;14:353-8.
Noorbala AA, Bagheri Yazdi SA, Yasamy MT, Mohammad K. Mental health survey of the adult population in Iran. Br J Psychiatry 2004;184:70-3.
Shaw MJ, Talley NJ, Beebe TJ, Rockwood T, Carlsson R, Adlis S, et al.
Initial validation of a diagnostic questionnaire for gastroesophageal reflux disease. Am J Gastroenterol 2001;96:52-7.
Westaway MD, Stratford PW, Binkley JM. The patient-specific functional scale: Validation of its use in persons with neck dysfunction. J Orthop Sports Phys Ther 1998;27:331-8.
La Puma J, Stocking CB, La Voie D, Darling CA. When physicians treat members of their own families. Practices in a community hospital. N Engl J Med 1991;325:1290-4.
Eastwood GL. When relatives and friends ask physicians for medical advice: Ethical, legal, and practical considerations. J Gen Intern Med 2009;24:1333-5.
Reagan B, Reagan P, Sinclair A. 'Common sense and a thick hide'. Physicians providing care to their own family members. Arch Fam Med 1994;3:599-604.
Jackson D, Estanislau J, Kim WJ, Le V, Nguyen T. Do PAs Intervene in their Family's Health Matters in the Same Ways as Physicians? Poster Session Presented at. San Antonica TX: American Academy of Physicians Assistant; 14-18 May, 2016.
McSherry J. Long-distance meddling: Do MDs really know what's best for their children? CMAJ 1988;139:420-2.
Bishop L. Treating yourself and members of your family. Medical Insurance Group Australia Bulletin; February, 2006. p. 1.
Gold KJ, Goldman EB, Kamil LH, Walton S, Burdette TG, Moseley KL, et al.
No appointment necessary? Ethical challenges in treating friends and family. N Engl J Med 2014;371:1254-8.
Krall EJ. Doctors who doctor self, family, and colleagues. WMJ 2008;107:279-84.
Christman KD. AMA attacks physicians caring for their families. J Am Phys Surg 2011;16:85-7.
Slavin SA, Slavin SA, Goldwyn RM. A family operation: Plastic surgeons who perform aesthetic surgery on spouses or other family members. Plast Reconstr Surg 2010;125:1018-23.
Personal views. Daughter and doctor: two conflicting roles BMJ 2002;324:1530.
Kerrigan J, Rovelstad S, Kodner IJ, La Puma J, Keune JD. All in the family: How close is too close? The ethics of treating loved ones. Surgery 2011;149:433-7.
Kling S. Is it ethical to treat one's family and friends? Curr Allergy Clin Immunol 2015;28:118-20.
Schneck SA. “Doctoring” doctors and their families. JAMA 1998;280:2039-42.
Klein MC. Too close for comfort? A family physician questions whether medical professionals should be excluded from their loved ones' care. CMAJ 1997;156:53-5.
Chen FM, Feudtner C, Rhodes LA, Green LA. Role conflicts of physicians and their family members: Rules but no rulebook. West J Med 2001;175:236-9.
Dhakal AK. Nepalese context: Should physician treat themselves and their family members? J Kathmandu Med Coll 2014;3:174-6.
Korenman SG, Bramstedt KA. Your spouse/partner gets a skin infection and needs antibiotics: Is it ethical for you to prescribe for them? Yes: It is ethical to treat short-term, minor problems. West J Med 2000;173:364.
Rubin MH. Is there a doctor in the house? J Med Ethics 2007;33:158-9.
[Figure 1], [Figure 2], [Figure 3], [Figure 4]
[Table 1], [Table 2]