A Multi-Institutional Study of Yemeni Final Year Undergraduate Pharmacy Students’ Understanding, Attitudes, and Perceived Barriers Toward Provision of Pharmaceutical Care: A Cross-Sectional Study

Abstract

Introduction Pharmaceutical care (PC) is the philosophy of the pharmacist’s practice to achieve a better health-related outcome by designing, implementing and monitoring the therapeutic plans. It is in its infancy in Yemen. Hence, the study objectives were to examine the barriers to PC provision as perceived by Yemen pharmacy students and to assess their level of understanding of PC and their attitudes toward PC. Methodology A cross-sectional study was conducted among ten pharmacy colleges in Yemen, offering undergraduate pharmacy programs. A stratified sample of 518 students from the included universities were surveyed using a well-structured, validated and self-administered questionnaire. Chi-square, Mann–Whitney U, and Kruskal–Wallis tests were conducted at an alpha level of 0.05. Results Four hundred and seventy-five (475) participants were included (92.9% response rate). More than 17% (n=84) of participants were involved in Pharm.D program, and nearly 29.9% (n=142) preferred pharmaceutical marketing as a career after graduation. About 65% of participants recognized the purpose of PC, and pharmacists’ role within PC. However, only 43.8% (n=208) knew the difference between clinical pharmacy and PC. About 82% of respondents showed very good attitudes toward PC. Pharm.D students showed higher attitudes’ total scores, median (IQR): 4.3 (4.1–4.4), 4.2 (4–4.2) and 4 (3.9–4.2) for Pharm.D, bachelor of pharmacy and bachelor of clinical pharmacy respectively, ( p -value = 0.032). Moreover, students who currently employed in pharmacy-related job during their study were also associated with high attitudes scores compared to unemployed students, median (IQR): 4.2 (4–4.4) and 4(3.9–4.1) respectively ( p -value = 0.023). “Lack of access to the patient medical record in the pharmacy” and “inadequate (hospital and community pharmacy) internship period” were the top reported barriers with 81.5% (n=387) agreement. Conclusion Although PC is in its infancy in Yemen, pharmacy students showed positive attitudes toward practicing PC. Educational institutions should exert efforts for curricular revision to improve understanding, and overcome the reported barriers in the future.

Insights into participation in ward rounds in hospitals: A survey of clinical pharmacists' perceptions

“…The first commonly adopted program is five years of Bachelor of Science in Clinical Pharmacy (BClinPharm), and the internship period varies among universities, with almost 6–3 months of clinical internship in hospitals such as Hodeidah University, which is considered the leader in the field, adopting a 6-month internship. The second program is a Doctor of Pharmacy (PharmD) six-year program with a 12-month internship ( Hatem et al, 2023b ). Our data results show that most respondents have been involved in an internship duration of 6 months or less.…”

“…We believe that there are two possible justifications for this low number. First, according to Hatem et al ( Hatem et al, 2023b ), most Yemeni universities have not yet established their educational hospitals. More than three colleges may use one or two hospitals as training locations, and this overload may affect the quality of supervision, which is also affected by the low number of clinical pharmacy preceptors in the country.…”

“…( Hatem et al, 2023a ) and bachelor’s degree clinical pharmacy programs to promote the spread of clinical pharmacy services in the vast majority of healthcare facilities. Clinical pharmacy and medication management have drawn more attention in Yemen during the past ten years ( Hatem et al, 2023b ). According to a previous study conducted in Yemen, clinical pharmacists participated in ward-based pharmacy services (such as medication history and therapeutic drug monitoring), and approximately 62% of these interventions were considered accepted by physicians ( Kubas et al, 2020 ).…”

Lebanese pharmacists’ knowledge of generic drugs and factors affecting their use and selection following the pandemic and the economic crisis: A pilot cross-sectional study

“…In Lebanon, the coronavirus disease of the 2019 pandemic has imposed new challenges on the provision of pharmaceutical care, 16 in addition to the delay of unurgent chronic disease follow-up, 17 putting community pharmacists as frontline health professionals for patients. Moreover, the economic crisis has led to a decrease in the accessibility and availability of some drugs in addition to the increase in healthcare costs and depletion of pharmaceutical stocks, creating an opportunity for generic drug promotion.…”

A comprehensive review addressing the factors influencing generic drug substitution

“…7 Most recently, the coronavirus disease pandemic and the corresponding economic impact induced a lack of access to essential drugs, which encouraged the costeffective prescription of substitutes. 8 Many policies were developed and implemented to encourage doctors to prescribe generics, 9,10 increase their acceptance among patients, 11 and promote their substitution by pharmacists when possible. 9 Specific requirements and regulations for interchangeability exist and differ between countries.…”