Background: Reports on using virtual patients to assess counselling skills is scarce. Aim: This paper describes the feasibility and acceptability of assessing patient counselling skills of pharmacy students using a virtual patient simulator. Description: In this innovative method, a high quality simulator ‘Virtual Patient Learning’ (VPL) was developed at Gulf Medical University (GMU) and was used to assess the counselling skills of 15 pharmacy graduate students. Counselling skills were measured using a four-domain scoring rubric of 1 to 5 marks followed by instant feedback for improvements. Student and faculty satisfaction scores were collected based on the feasibility and acceptability of the assessment method. Evaluation: The average counselling skills score for all students was 68.4 (85.5%) out of 80 (range 54-76), with a standard deviation of 5.8. The overall student agreement on the feasibility and acceptability of the assessment method was 92.8%; it was 100% agreement for faculty. Conclusion: The use of a high quality VPL simulator in assessing counselling skills was deemed feasible and acceptable for students and faculty. The assessment was repeated among 30 Doctor of Pharmacy (Pharm.D.) graduates with similar outcomes. The virtual counselling method will be used in the programme exit exams, as well as in students entering their experiential year. Further studies are required to assess its validity and reliability with more students.
Non-steroidal anti-inflammatory drugs (NSAIDs) were differentiated from steroidal anti-inflammatory medicines to help clinicians who needed to use anti-inflammatory agents that were safer than steroids. With market entry of rofecoxib in 1999, NSAIDs were then further classified into traditional NSAIDs and cyclooxygenase (COX)-2 inhibitors (coxibs), the latter posing potentially fewer gastrointestinal risks. In 2005, rofecoxib was withdrawn from the market because of concerns about the risk of heart attack and stroke with long-term use, and clinical practice began focusing more on the cardiovascular versus gastrointestinal safety of coxibs. Since then, many coxibs have remained unapproved by the US FDA or have been removed from the market. This article explains how coxibs refocused attention on the cardiovascular safety of NSAIDs and the general implications of that. COX-2 activity/specificity is one factor associated with increased cardiovascular risks; however, these risks cannot be attributed to coxibs alone. The traditional NSAIDs (i.e., meloxicam, etodolac, and nabumetone) have significant COX-2 specificity, but naproxen and ibuprofen have less specificity. All NSAIDs, whether traditional or a coxib, pose some cardiovascular risks. It is possible that clinicians continue to focus more on decreasing the immediate gastric risks than preventing the later cardiovascular risks. The cardiovascular risks posed by NSAIDs should not be disregarded for the sake of achieving gastrointestinal benefits. Current recommendations suggest NSAIDs should be considered a single class of non-aspirin NSAIDs. Preferred NSAIDs are ibuprofen and naproxen. Coxibs are preferred in patients with low cardiovascular risk and high gastrointestinal risk who are intolerant to anti-dyspepsia therapy.
Objective: Although pharmacoeconomics was recognized as a sub-discipline of health economics for over 25 years, its diffusion into pharmacy education has been gradual. The purpose of this review was to describe the global trend of inclusion of pharmacoeconomics course in the undergraduate pharmacy education. Methods: Published literatures were searched and information on the inclusion of pharmacoeconomics course in the undergraduate pharmacy curriculum was collected and collated. Pub Med, Google Scholar, and Google databases were used for the search in October and December 2015. Both compulsory and elective pharmaco economic courses in the undergraduate pharmacy curriculum (BS, B. Pharm, Pharm.D) were considered. We have organized and summarized the information by countries and time period. Trends: Out of 13 surveys reviewed, 4 surveys from the US have provided the key baseline for documenting trends in inclusion of pharmacoeconomics course in the pharmacy curriculum. As per a 2011 survey, pharmacoeconomics course was included in almost all colleges/schools of pharmacy in the US. Other than surveys from the US, 6 were conducted or published in the last 3 years. Many of the surveys identified that the contents in pharmaco economic course vary to different extent. Information from many countries was not available, especially in Africa and Asia. Conclusion: The pharmacoeconomics course was very much part of the undergraduate pharmacy programs in the US. Even though the diffusion of pharmacoeconomics course to the rest of the world was slow; it has picked up the pace in this decade. Standardization of pharmacoeconomics education shall be necessary. Further surveys from countries other than the US are required to comprehend the implications of the trend.
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