Experience and attitudes of pharmacists towards challenges and adaptive measures to new norm in ward pharmacy practice during the COVID-19 pandemic

Ng et al. Journal of Pharmaceutical Policy and Practice https://doi.org/10.1186/s40545-023-00579-4 (2023) 16:85 Journal of Pharmaceutical Policy and Practice Open Access SHORT REPORT Experience and attitudes of pharmacists towards challenges and adaptive measures to new norm in ward pharmacy practice during the COVID‑19 pandemic Chew Beng Ng1, You Leng Tan1, Ros Sakinah Kamaludin2, Chang Chee Tao3,4* , Chii‑Chii Chew3, Wai Keng Foong5, Siew Huang Lee6, Normi Hamdan7 and Su Yin Ong8 Abstract Background COVID-19 pandemic has created challenges to the ward pharmacy practice. Challenges arose due to new norms in the ward pharmacy practice. Adaptive measures to overcome these challenges were important to sustain the quality of pharmaceutical care. This study aimed to identify the perceived challenges and attitudes towards adaptive measures in the ward pharmacy practice during the COVID-19 pandemic and determined their association with pharmacists’ characteristics. Method This cross-sectional study was conducted in 14 Perak state hospitals and 12 primary health clinics through an online survey. All ward pharmacists and trainee pharmacists with at least 1 month of ward pharmacy experience and working in government-funded health facilities were included. The validated survey tool con‑ sisted of demographic characteristics, pharmacists’ experience towards challenges (22 items), and their attitude towards adaptive measures (9 items). Each item was measured based on a 5-point Likert scale. One-way ANOVA and logistic regression were employed to determine the association of pharmacists’ characteristics against their expe‑ rience and attitude. Results Out of 175 respondents, 144 (81.8%) were female, and 84 (47.7%) were Chinese. Most pharmacists served in the medical ward (124, 70.5%). Commonly reported perceived challenges were difficulties in counselling medica‑ tion devices (3.63 ± 1.06), difficulties in clerking medication history from family members (3.63 ± 0.99), contacting fam‑ ily members (3.46 ± 0.90), patient’s digital illiteracy in virtual counselling (3.43 ± 1.11) and completeness of the elec‑ tronic records (3.36 ± 0.99). For attitude towards adaptive measures, improving internet connection (4.62 ± 0.58), ensuring availability of multilingual counselling videos (4.45 ± 0.64), and provision of internet-enabled mobile devices (4.39 ± 0.76) were the most agreeable by the pharmacists. Male (AOR: 2.63, CI 1.12–6.16, p = 0.026) and master’s degree holders (AOR: 2.79, CI 0.95–8.25, p = 0.063) had greater odds of high perceived challenging experience scores. Master’s degree holders (AOR: 8.56, CI 1.741–42.069, p = 0.008) were also more likely to have a positive attitude score towards adaptive measures. Conclusion Pharmacists faced multiple challenges in the ward pharmacy practice during the COVID-19 pandemic, especially in medication history assessment and patient counselling. Pharmacists, especially those with higher levels *Correspondence: Chang Chee Tao Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Ng et al. Journal of Pharmaceutical Policy and Practice (2023) 16:85 Page 2 of 11 of education and longer tenure, exhibited a higher level of agreement towards the adaptive measures. The positive attitudes of pharmacists towards various adaptive measures, such as improvement of internet infrastructure and digi‑ tal health literacy among patients and family members, warrant immediate action plans from health authorities. Keywords Challenges, Adaptive measure, Ward pharmacist, New norm, COVID-19 pandemic Introduction The declaration of the COVID-19 pandemic, a global health emergency, on March 11, 2020, by the World Health Organization (WHO), had a tremendous impact on healthcare services, including pharmacy [1]. Globally, the COVID-19 pandemic had changed work practices for pharmacists, with many working overtime, experiencing an increased workload, and working with reduced staffing [2]. In Malaysia, pharmacy activities such as medication dispensing to out-patients and pharmacist-led medication therapy adherence clinics, which involved medication knowledge assessment, adherence evaluation, medication-related problem assessment, and therapeutic recommendations, were impacted by the government’s quarantine policy and movement control order, leading to disruptions in appointment scheduling [3]. Extended pharmacy services such as drive-through pharmacies and drug supply via postal delivery were intensified in out-patient pharmacies to ensure continuity of medication supply and pharmaceutical care to patients [3, 4]. Temporary deployment of some ward pharmacists to the out-patient pharmacies to help with value-added service might also cause a shortage of pharmacists in the ward, affecting the ward pharmacy services [5]. Ward pharmacy services were hampered due to significant disruption in pharmaceutical care delivery in the ward [5–7], partly caused by tightened infection control practices. The routine local ward pharmacy activities usually include medication history taking & reconciliation, case clerking, pharmacotherapy rounds with physicians, medication reviewing, medication counselling, and discharge planning for warded patients [8]. During the COVID-19 outbreak, visitor restriction policy, frequent changes of the medical wards into COVID-19 isolation wards and vice versa, and quarantine policies posed different challenges to ward pharmacy services. The usual ward pharmacy routine was changed to adapt to the “new norm”, i.e. to avoid 3Cs (crowded places, confined spaces, and close conversation) and to practice 3Ws (wash, wear and warn) [3, 10]. Pharmacists were split into teams to work on an alternate scheduling system to allow physical distancing and less crowding in the workplace [5, 9]. To limit contact with COVID-19 patients and to prevent unnecessary use of Personal Protective (...truncated)