Inhaled medications are critical in the pharmaceutical management of respiratory conditions, however, the majority of patients demonstrate at least one critical error when using an inhaler. Since community pharmacists can be instrumental in addressing this care gap, we aimed to determine the rate and type of critical inhaler errors in community pharmacy settings, elucidate the factors contributing to inhaler technique errors, and identify instances when community pharmacists check proper inhaler use. Fourth year pharmacy students on community practice placement (n = 53) identified 200 patients where at least one error was observed in 78% of participants when demonstrating inhaler technique. Prevalent errors of the users were associated with metered dose inhaler (MDI) (55.6%), Ellipta® (88.3%), and Discus® (86.7%) devices. Overall, the mean number of errors was 1.09. Possession of more than one inhaler, use of rescue inhaler, and poor control of asthma were found to be significant predictors of having at least one critical error. In all participating pharmacies, inhaler technique is mainly checked on patient request (93.0%) and for all new inhalers (79.0%).
Pharmacy education is focused on preparing students for practice as health professionals. Curriculum for this professional programme includes pharmaceutical, social and health sciences. For pharmacy students to appreciate their role as citizens, exposure to citizenship teaching must be integrated into the curriculum, but this has not been studied within pharmacy. The purpose of our research was to describe the impact of an international pharmacy elective course that placed University of Alberta pharmacy students in Italy for a three-week period. Activities within the course were designed to expose the students to social justice, health policy, citizenship and their role in addressing health issues. Student interviews and course materials were analysed for emerging themes. The analysis identified themes relating to an developing awareness of citizenship and the personal and professional roles the students could play; appreciating broader health issues in the world, and the realization that medications are not always the primary approach for health; the importance of policy and advocacy for the right to food and health; and the integration of professionalism, advocacy, justice and citizenship in addressing health. Student learning regarding citizenship was supported through course activities and the context of the cross-cultural setting. The learnings about citizenship started at a basic level, identifying a significant curriculum gap in pharmacy education. Further collaboration between Pharmacy and Education, and international course experiences can assist in enhancing the citizenship teaching and learning of future health professionals. 158
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