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The purpose of this paper is to compare the pharmacy services provided to people taking psychotropic and cardiovascular medications and examine the association between pharmacists’ attitudes towards mental illness and provision of pharmacy services. The paper also considers pharmacists’ opinions of the pharmaceutical care needs of people with mental illness including their physical health.

A survey instrument was sent by facsimile to a random sample of community pharmacists in England and Wales.

Community pharmacists had generally positive attitudes towards mental illness but provided significantly fewer pharmacy services (and were less comfortable providing them) to patients taking psychotropic medications than to patients taking cardiovascular medications. Awareness of the higher prevalence of physical health conditions among people with severe mental illness was not high. Provision of pharmacy services was associated with pharmacists’ attitudes towards mental illness and comfort providing pharmaceutical care. Other factors that may contribute to these disparities in service provision are discussed.

The study findings indicate the need for enhanced mental health education for pharmacy students to improve attitudes, knowledge and confidence in mental health and the inclusion of mental health in pharmacy advanced services.

Few studies have examined the relationship between attitudes towards mental illness and provision of pharmacy services. This was the first study to examine the attitudes of British community pharmacists towards mental illness.

The purpose of this paper is to examine the mental health literacy (MHL) of British community pharmacists.

A survey instrument was sent by facsimile to a random sample of community pharmacists in England, Scotland and Wales. The survey instrument contained items concerning recognition of the symptoms of depression, bipolar disorder or schizophrenia, the helpfulness of a range of interventions, mental health stigma and the degree of comfort providing pharmaceutical care to people with mental health problems.

Among community pharmacists (n=329) symptom recognition was high for depression but lower for bipolar disorder and schizophrenia. Pharmacists showed a preference for evidence-based interventions and support for psychological therapies and physical activity for all three mental health problems. Pharmacists expressed less comfort providing pharmacy services to people with bipolar disorder, schizophrenia and depression than cardiovascular disease. Mental health stigma was higher for schizophrenia and bipolar disorder than depression, with many pharmacists holding misperceptions about schizophrenia and bipolar disorder.

The study findings indicate the need for enhanced mental health content in the undergraduate pharmacy curriculum which should challenge misperceptions of mental illness.

This is the first study to investigate the MHL of British community pharmacists.

The purpose of this paper is to identify primary health concerns prompting older and younger prisoners in Switzerland to consult a nurse or a general practitioner (GP) within the prison healthcare setting, and explores if these reasons for visits differ by age group (49 years and younger vs 50 years and older). The authors used 50 years and older as the benchmark for older prisoners in light of literature indicating accelerated aging among prisoners.

Retrospective information from medical records of 406 prisoners were collected for a period of six months. This study analyzed the reasons for which prisoners visited the nurses and GPs available to them through the prison healthcare service. These reasons were coded using the International Classification of Primary Care-version 2. Data were analyzed descriptively and four generalized linear models were built to examine whether there was an age group difference in reasons for visiting nurses and GPs.

The health reasons for visiting nurses and GPs by 380 male prisoners from 13 Swiss prisons are presented. In the six month period, a total of 3,309 reasons for visiting nurses and 1,648 reasons for visiting GPs were recorded. Prisoner participants’ most common reasons for both visits were for general and unspecified complaints and musculoskeletal problems. Older prisoners sought significantly more consultations for cardiovascular and endocrine problems than younger prisoners.

Nurses play an important role in addressing healthcare demands of prisoners and coordinating care in Swiss prisons. In light of age-related healthcare demands, continuing education and training of both nurses and GPs to adequately and efficiently address the needs of this prisoner group is critical. Allowing prisoners to carry out some care activities for minor self-manageable complaints will reduce the demand for healthcare.

This study presents unique data on healthcare concerns for which prisoners visit prison nurses and GPs. It highlights the varied needs of older prisoners as well as how these needs are addressed based on the availability of the primary healthcare provider within the prison.

Patient safety is gaining prominence in health professional curricula. Patient safety must be complemented by teaching and skill development in practice settings. The purpose of this paper is to explore how experienced pharmacists identify, prioritize and communicate adverse drug effects to patients.

A focus group discussion was conducted with cardiology pharmacy specialists working in a Doha hospital, Qatar. The topic guide sought to explore participants’ views, experiences and approaches to educating patients regarding specific cardiovascular therapy safety and tolerability. Discussions were audio-recorded and transcribed verbatim. Data were coded and organized around identified themes and sub-themes. Working theories were developed by the three authors based on relevant topic characteristics associated with the means in which pharmacists prioritize and choose adverse effect information to communicate to patients.

Nine pharmacists participated in the discussion. The specific adverse effects prioritized were consistent with the reported highest prevalence. Concepts and connections to three main themes described how pharmacists further tailored patient counseling: potential adverse effects and their perceived importance; patient encounter; and cultural factors. Pharmacists relied on initial patient dialogue to judge an individual’s needs and capabilities to digest safety information, and drew heavily upon experience with other counseling encounters to further prioritize this information, processes dependent upon development and accessing exemplar cases.

The findings underscore practical experience as a critical instructional element of undergraduate health professional patient safety curricula and for developing associated clinical reasoning.

The world’s aging population has led to a greater use of prescription and non-prescription medication by the elderly. Besides, older drinkers consume alcohol often regardless of the medication they consume. The purpose of this paper is to examine the intake of medication and alcohol simultaneously in a group of elderly in the community of Madrid, and the possible differences in consumption between men and women.

An observational cross-sectional study of 342 elderly in Madrid, aged 65–96 years was conducted, including the collection of anthropometric data (weight, height, waist circumference, BMI), information about the quantity of daily alcohol intake and medication taken from each subject.

A high percentage of the sample used medication, especially women. A smaller percentage of the sample consumed alcohol, being more frequent among men and decreasing with age. In addition, almost half of the sample (46.4 percent) combined medication intake with alcohol, especially men. High alcohol consumption was observed simultaneously in those subjects taking medication; in addition to the non-perception of the real risk to health. Statistically significant sex differences were observed, since men drank more, including when taking medication; although women may be more vulnerable to harm derived from alcohol.

This study contributed to estimate the risk to the public health of old people, and the integrity of their health, by observing the consumption of both medication and alcohol, given that medication taken in conjunction with alcohol can cause adverse side effects.

This study aims to explore current attitudes among doctors working in psychiatry, with regard to their perceived role and their confidence in managing their patients’ physical health problems.

A 20-item electronic questionnaire was distributed to doctors working in psychiatry within two large UK mental health trusts in 2018. Quantitative analysis was conducted, alongside qualitative analysis of free-text comments made by participants.

Many participants perceived their physical examination skills to have deteriorated since working in psychiatry (78 per cent). Participants were questioned on which professional group should hold responsibility for managing the physical health of patients under psychiatric services. A minority felt it should be psychiatrist-led (5 per cent), followed by general practitioner (GP)-led (42 per cent) and then shared responsibility (47 per cent). The majority felt there should be more focused training on physical health in the Core (72 per cent) and Advanced (63 per cent) psychiatry training. Key themes from a framework analysis of qualitative data included potential barriers to shared care, psychiatrists’ concerns regarding their experience and confidence in managing physical health, reasons in favour of shared responsibility, ideas for training and suggestions for improving the current situation.

Psychiatric patients may engage less well with health services, yet psychiatric medication often impacts significantly on physical health. In this context, there is often a blurring of role boundaries between a psychiatrist and a GP, and there is considerable variation between individual teams. There is a consistent call for more physical health training opportunities for psychiatrists and for mental health services to more proactively promote the physical health of their patients.

Increased outsourcing and importation of drugs from different parts of the world to the Latin America and the Caribbean (LAC) region result in the proliferation of substandard and fake medicines, posing a threat to public health. The presence of substandard and fake medications in LAC regions is a source of public health concern and causes an economic burden to the governments in these regions. Whereas testing and detecting medication quality can easily be achieved in developed countries, the situation is different in developing countries such as LAC. This paper aims to examine the public health challenges faced by LAC regarding substandard, fake and counterfeit medicines and how the region can tackle these challenges.

Databases such as Scopus, PubMed, ScienceDirect, Embase, HINARI, EBSCOhost, Google Scholar, unpublished data, conference abstracts and papers from World Health Organization, Pan-American Health Organization and electronic newspapers were searched concerning medicine quality and in LAC.

Drug treatment improves the quality of life while decreasing morbidity and mortality among diseased populations. Absence of or inadequate testing laboratories, old and ineffective legislature, lack of enforcement or willpower and lack of effective surveillance are challenges in LAC for the proliferation of substandard and falsified medicines (SFMs).

The most significant limitation of this study was the need for the reviewers to have used articles written in other languages besides English. The LAC region has a large population in non-English-speaking countries, and many articles are written using local languages. Hence, excluding those articles is a limitation worthy of note in this review. The articles accessed needed to provide adequate information on SFM markets and illegal pharmacies or hospitals but did not. Future reviews may focus on providing illegal substandard and falsified medicines markets in the region and how they can be minimized or eliminated.

This review highlights the challenges faced by LAC countries regarding substandard, fake and counterfeit medicines. The sources, prevalence and consequences of substandard and falsified drugs were identified to suggest the measures needed to curb the infiltration of low-quality medicines in LAC.

Attention disorders in people with intellectual disabilities (ID) is common. Current drug treatments are based on the literature in people without ID. The purpose of this paper is to present a review of the drug treatment of Attention Deficit Hyperactivity Disorder (ADHD) in people with ID in the German and English languages literature with the aim of exploring the current evidence base.

The paper provides a general review of the evidence base on drug treatment of ADHD in people with ID from the German and English language literature.

Studies and practice guidance on ADHD in both languages are similar with more information published in English. Much of the evidence on drug therapy to treat ADHD in people with ID is based on studies in children. The literature on ADHD in children without ID is helpful but not specific to all people with ID who have ADHD. The response rates to medication to treat ADHD in people with ID are lower than in people without ID. The occurrence of side effects from medication is more common in people with ID. Co-morbid disorders are often present in people with ADHD that could affect study findings.

Medication used to treat ADHD is effective when treating ADHD in people with ID. Prescribers should be aware of guidelines on medication and their potential drug interactions and side effects. Newer drugs could offer more effective treatments because of fewer adverse effects than current medications.

The general review offers an insight in to the literature in German and English on ADHD in ID comparing what is published in both languages.

While cardiovascular disease (CVD) is the leading cause of death globally, over 80% of the cases could be prevented through early lifestyle changes. From the perspective of quality management in healthcare, this may offer an effective prevention window if modifiable CVD risk factors are identified and treated in adolescence. The purpose of this research is to examine the negative emotions in adolescents and determine if it independently increases CVD risk later in life.

Longitudinal data from 12,350 participants of the Add Health study, which conducted a multi-wave survey for 14 years from adolescence (Wave 1) through adulthood (Wave 4), were used to test the research hypothesis. Four items (perception of life, self-reported depression, perceived loneliness and fearfulness) reflective of adolescent negative emotion were identified from the Wave 1 questionnaire, and factor analysis was conducted to confirm the hypothesized structure. The outcome variable, 30-year adulthood CVD risk category (high or low risk), was estimated using biomarkers, biological data and other factors collected during the 14-year follow-up in Wave 4. A logistic regression analysis was employed to assess the impact of adolescent negative emotions on adulthood CVD risk after adjusting for common risk factors such as sociodemographic characteristics, socioeconomic status and medical conditions in adolescence.

The results indicated adolescent negative emotion to be significantly associated with CVD risk category (p-value < 0.0001), even after controlling for common risk factors. A unit increase in the level of adolescent negative emotion increased the chance of being in the high CVD risk group in adulthood by 8% (odds ratio = 1.08 ± 0.03).

Healthcare providers and organizations could capitalize on the research findings by screening for negative emotions early in life through individual and societal interventions. The findings also provide an opportunity for implementing quality improvement initiatives to deliver robust preventive care, which, in turn, could improve the overall population health, reduce healthcare costs and improve care quality.

Although previous studies showed a strong link between adolescent physiological factors (e.g. obesity) and adulthood cardiovascular disease (CVD), the association between adolescent outlook/attitude (negative emotion) and CVD risk has not been examined.

Stroke patients with low and very low functional movement are not usually considered suitable for rehabilitation. Without therapy the more-affected side will not improve and may lose any residual function. Poor movement ability reduces independence and limits the social engagement of such patients. The purpose of this paper was to investigate whether Wii-based Movement Therapy was suitable and beneficial for stroke patients with low and very low movement ability.

In total, 13 patients aged 22-77 years and three months to 21 years post-stroke completed the standardised 14-day protocol of Wii-based Movement Therapy. Therapy is a structured and targeted programme, tailored to the individual needs and deficits of each patient. Functional ability was assessed using a suite of tools. Increased use of the more-affected hand and arm in everyday life was assessed using the Quality of Movement subscale of the Motor Activity Log.

Functional movement of the more-affected hand and arm improved by 40 per cent on the Fugl-Meyer Assessment. Hand-use in everyday tasks more than doubled and improvements were also seen in lower-limb function, balance, and cardiovascular function. Qualitative improvements in psychological status were also noted.

The paper demonstrates that stroke patients with low and very low movement ability post-stroke can benefit from upper-limb rehabilitation. Wii-based Movement Therapy is a viable and effective option with high patient compliance.

The patients in this study became less disabled. Improving movement ability of stroke survivors will not only increase their independence in activities of daily living but will also reduce the burden of care on patients, their families and the community.