Introduction There have been limited studies on the views of persons with MS (PwMS) around the systematic use of Patient Reported Outcome Measures (PROMs). The objective of this study was to explore the perspectives of PwMS on the integration of PROMs into clinical practice as part of a randomized trial. Methods We conducted a qualitative substudy of our previous randomized controlled trial (RCT)(Clinicaltrials.gov NCT0497954), which was conducted from November 2021 to April 2024 and evaluated the effect of the systematic use of PROMs on depression and anxiety in PwMS. In this sub-study that ran from May 6, 2025 to August 31, 2025, we used purposive sampling of the participants from our RCT and conducted virtual semi-structured interviews. Thematic analysis of the interview transcripts was performed by two researchers independently using an inductive approach to create codes, categories, and abstract themes. Results 33 PwMS participated in semi-structured interviews that ranged from 10 to 40 minutes. Three main themes emerged to describe the perspectives of PwMS on the use of PROMs within their treatment: (i) Patient empowerment; (ii) Reassurance that their provider had reviewed their results; (iii) Individualized PROMs. Additionally, PwMS described challenges to incorporating PROMs, the perceived impact of PROMs on their care, and facilitating factors of PROMs. Discussion PROMs within this clinical setting were accepted by patients and created opportunities for patient empowerment. Some improvements to the use of PROMs were suggested, such as the addition of open-ended questions, making sure the physicians are ready to review the PROMs, and individualizing the PROMs to better serve the patient’s needs.

Background:Professional identities shape who pharmacists are, what they do, and what they stand for as professionals. Novel research methodologies have potential to illuminate pharmacists' professional identity and roles in new and innovative ways. This study aimed to explore international pharmacists' identity through reflection on their professional roles. Methods:Q Methodology, which uses quantitative techniques to systematically study subjectivity, was used to allow for an in-depth analysis of professional identity. The participants were self-identified pharmacists working in patient-facing roles who attended the International Pharmaceutical Federation (FIP) Congress in Brisbane, Australia, from September 24-28, 2023. They completed Q methodology online activities to sort the Q-Set within a fixed quasi-normal distribution grid. Results:Twenty participants completed the Q-Sort activity. Participants came from 10 countries (five of the six World Health Organization regions), two thirds identified as women and approximately one third practiced in hospital and community pharmacy settings, respectively. Three factor arrays are described, which explain 52 % of the variance; Factor 1: Pharmacists as autonomous healthcare providers AND clinical team members; Factor 2: Pharmacists as healthcare providers for individual patients; and Factor 3: Pharmacists as managers first, then healthcare providers. Conclusion:This study offers a new perspective, revealing how various roles may converge to form a pharmacist's professional role identity: for example, autonomous healthcare providers AND clinical team members AND patient-focused practitioners AND leaders mindful of management responsibilities. Viewing the Q Methodology with a systems thinking lens illuminates pharmacists' professional identities as neither a mere sum of the roles and services they provide, nor represented by a singular aspect of their professional work. Recognizing the complexity of the pharmacists' identities as individuals helps to break free from the cognitive dissonance that has plagued the profession suggesting that professional identity is represented by singular or often competing roles as the scope of pharmacy practice evolves.

Purpose: As the scope of practice continues to evolve for pharmacists, professional abstinence is being observed by students in workplaces and practicums. Professional abstinence is defined as “consciously choosing not to provide the full scope of patient care activities”. Exposure of students to professional abstinence may cause cognitive dissonance, as they are challenged by practices that do not match what they are taught in school. This study explores pharmacy student perspectives on professional abstinence in community practice settings and their thoughts on how it could be addressed. Methods: Pharmacy students enrolled at an accredited Canadian pharmacy school with previous experience at a community practice site were invited to participate via email and social media. Data were collected between March and November 2021 through virtual individual interviews using a semistructured guide and the Zoom platform. Recordings were transcribed verbatim, and data were analyzed using cognitive dissonance theory to guide the inductive coding and interpretation of results. Results: Twenty students representing 6 pharmacy schools were recruited. Themes identified regarding students’ experiences with professional abstinence were “introspection and reflection” and “the system”, with the subthemes of emotion, excuses, professional identity and infrastructure, and inertia/disengagement, respectively. Regarding how to address professional abstinence, the themes “self as professional” and “empowering professionals” emerged. Self as professional included the subthemes of continuous learning, role modelling/mentorship, and internal drive/initiative, while empowering professionals included improved logistics, self-care, and advocacy. Conclusion: Students’ experiences with professional abstinence led to mixed feelings and influences on their professional identity. Pharmacy schools should be made aware of the phenomenon of professional abstinence and its effect on students, as they can potentially help manage learners’ cognitive dissonance and best prepare them for their future full-scope practices.

BACKGROUND:The effect of systematic capture of patient-reported outcome measures (PROMs) on depression and anxiety levels in persons with multiple sclerosis (PwMS) is not known. We evaluated the effects of PROMs on depression and anxiety levels in PwMS in a randomized controlled trial. METHODS:PwMS were randomized on a 1:1 basis to intervention or control arms. The intervention group completed PROMs at baseline, 6 months, and 12 months. The control group completed PROMs at baseline and 12 months. OBJECTIVES:Outcomes were the difference in change in PROM scores at 12 months, primarily the Hospital Anxiety and Depression Scale (HADS). RESULTS:237 PwMS (mean age 48.3 years; 78.9 % of female sex) were randomized at baseline, with 153 (79 in the intervention arm and 74 in the control arm) completing at least 1 PROM at 12-month follow-up. Improvements in the total HADS score (-1.39, 95 % CI -2.55 to -0.22, p = 0.02) and HADS anxiety sub-score (-1.03, 95 % CI -1.72 to -0.34, p < 0.01) were observed in the intervention group compared to the control group. No differences in other PROMs were detected between the groups. CONCLUSIONS:Use of PROMs can reduce anxiety levels in PwMS. TRIAL REGISTRATION:ClinicalTrials.gov: NCT0497954 (https://www. CLINICALTRIALS:gov/study/NCT04979546).

Between January 29 and February 11, 2019, the Townsville region in Australia experienced a major flooding event. This study explored impacts on affected community pharmacies. Semi-structured phone interviews were conducted with six pharmacists who worked in affected Townsville community pharmacies during this flood. De-identified transcript data were analyzed using reflexive thematic analysis. The thematic analysis yielded six themes - "financial impact on pharmacy owners," "engagement with Local Disaster Coordination Center (LDCC) important," "workload pressures," "preparedness," "medication supply impacts," and "communication and collaboration." Financial impacts to owners included loss of property (two pharmacies were completely flooded), purchase or hire costs of generators when power was lost, and loss of revenue from complete or early closure of pharmacies and when patients could not pay or did not have a prescription and did not return to the pharmacy after the event. Engagement with the LDCC assisted pharmacy responsiveness. Medication supply issues were experienced by patients whose houses had flooded, or who had left their prescriptions with pharmacies that had flooded. Opioid Replacement Therapy (ORT) program patients were also impacted due to communication difficulties between them, their clinics, and their pharmacies. Increased customer numbers by those whose regular pharmacy was closed, reduced staff numbers, and austere working conditions increased workload pressures. Pharmacists collaborated to consolidate resources with those whose pharmacy had closed, working in pharmacies that were open. This research highlights a critical need for improved flood preparedness among Townsville pharmacists. Regardless, they collaborated to ensure there were minimal critical medication delays.

Chronic pain is often a primary symptom for rheumatologic conditions. With the legalization of cannabis in Canada and many other jurisdictions, the use of cannabis is increasing. A risk assessment tool can guide clinicians and patients on the potential risk associated with cannabis use for alleviating the symptoms of rheumatologic conditions. The aim of this Delphi study is to identify key elements for the development of a risk assessment tool for the safe use of cannabis for people with rheumatologic disease. International experts representing different healthcare professions in rheumatology were invited through targeted recruitment. The research team developed statements for the Delphi consensus based on literature review and focus groups. The number of rounds was dependent on when consensus was reached. The level of agreement was set at 75

OBJECTIVES:Our aim in this work was to 1) explore barriers and enablers to patient and health-care provider (HCP) behaviours related to sick-day medication guidance (SDMG), 2) identify theory-informed strategies to advise SDMG intervention design, and 3) obtain perspectives on an eHealth tool for this purpose.METHODS:A qualitative descriptive study using qualitative conventional content analysis was undertaken. Interviews and focus groups were held with patients and HCPs from January 2021 to April 2022. Data were analyzed using the Behaviour Change Wheel and Theoretical Domains Framework to inform intervention design.RESULTS:Forty-eight people (20 patients, 13 pharmacists, 12 family physicians, and 3 nurse practitioners) participated in this study. Three interventions were designed to address the identified barriers and enablers: 1) prescriptions provided by a community-based care provider, 2) pharmacists adding a label to at-risk medications, and 3) built-in prompts for prescribing and dispensing software. Most participants accepted the concept of an eHealth tool and identified pharmacists as the ideal point-of-care provider. Challenges for an eHealth tool were raised, including credibility, privacy of data, medical liability, clinician remuneration and workload impact, and equitable access to use of the tool.CONCLUSIONS:Patients and HCPs endorsed non-technology and eHealth innovations as strategies to aid in the delivery of SDMG. These findings can guide the design of future theory-informed SDMG interventions.

Journal Article Corrected proof The need for an emergency planning and preparedness strategic plan for pharmacy leadership Get access Kaitlyn E Watson, BPharm (Hons), PhD, GradCertAppPharmPrac, FHEA, Kaitlyn E Watson, BPharm (Hons), PhD, GradCertAppPharmPrac, FHEA Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, CanadaDisaster Pharmacy Solutions Address correspondence to Dr. Watson (Kewatson@ualberta.ca). Search for other works by this author on: Oxford Academic Google Scholar Jason Chou, PharmD, MS, Jason Chou, PharmD, MS Ochsner Health, New Orleans, LA, USA Search for other works by this author on: Oxford Academic Google Scholar Deborah Simonson, BS, PharmD, CPEL Deborah Simonson, BS, PharmD, CPEL Ochsner Health, New Orleans, LA, USA Search for other works by this author on: Oxford Academic Google Scholar American Journal of Health-System Pharmacy, zxae044, https://doi.org/10.1093/ajhp/zxae044 Published: 19 February 2024 Article history Published: 19 February 2024 Corrected and typeset: 05 March 2024

Importance: We designed an online educational program for primary care health care providers, the Hypertension Canada Professional Certification Program (HC-PCP), based upon its 2020 guidelines. Objective: The objective was to determine the effect of the HC-PCP, taken by pharmacists, on systolic blood pressure (BP) in patients with poorly controlled hypertension. Design: Stepped wedge cluster randomized trial (unit of randomization was the pharmacy). Participants: Patients with poorly controlled hypertension (BP >140/90 mmHg or >130/80 mmHg [diabetes]) in community pharmacies in Alberta, Canada, were recruited by their pharmacist. Intervention: Pharmacists completed the HC-PCP program, then provided care to their patients with poorly controlled hypertension according to what they learned in the course. Control: Pharmacists were given a copy of the Hypertension Canada guidelines and provided their usual care to their patients prior to undertaking the HC-PCP later. Main outcome and measure: The primary outcome was a difference in change in systolic BP at 3 months between groups, while the secondary outcome was patient satisfaction with using the Consultation Satisfaction Questionnaire. Results: We enrolled 890 patients from 59 pharmacies (including 104 pharmacists). Using a linear mixed-effect model with BP reduction as the dependent variable and independent variables of treatment allocation, baseline BP, site effect and patient effect, the intervention was associated with a 4.76 mmHg (95% confidence interval, 2.02-7.50, p < 0.0001) systolic BP reduction at 3 months. Patient satisfaction with using the Consultation Satisfaction Questionnaire was high at 75.9 (/90). Conclusion and relevance: Most educational programs are not evaluated at the patient care level. The HC-PCP taken by pharmacists resulted in a 4.76 mmHg systolic BP reduction in their patients over 3 months. This would have major implications for public health, reducing heart disease, stroke and kidney failure.

Background: Human papillomavirus (HPV) immunization can prevent cancers, but uptake has been incomplete (and worse with the COVID-19 pandemic). Dental clinicians already screen for oral cancers, many of which are caused by HPV, and could identify vaccination candidates, but this requires a case-finding strategy. Objective: The purpose of this study was (1) to develop and test a case-finding approach to identify patients who were candidates for HPV vaccinations, (2) to test an HPV vaccination intervention by dental professionals on vaccination uptake. Methods: Design: Prospective, non-randomized feasibility case finding study with a 4-week enrollment period and a 6 week follow up period in general dental offices. Setting: Two general and non-commercial dentistry offices in Edmonton, Alberta Canada. Subjects: Consecutive scheduled (non-emergent) patients who met the Health Canada criteria for HPV vaccination: immunocompetent males and females aged 9-45 years and those who are immunocompromised. Consent for the discussion was obtained from each subject or parent. Intervention: Scheduled dental patients meeting the inclusion criteria were flagged by a research assistant who reviewed the appointment schedule each week for 4 weeks. For these subjects, dental clinicians (dentists and dental hygienists) used our Dental Dialogue Tool to discuss HPV vaccination and answer questions. Participating patients who consented to receive the HPV vaccine were given a prescription by the attending dentist and were directed to follow-up with a local pharmacy to have the vaccine administered. Each participant that was provided with an HPV prescription was contacted after 6 weeks to identify if they received the first dose of vaccine. Outcomes: Yield of our case-finding strategy and receipt of a patient's first HPV vaccine dose during 6 weeks post vaccine prescription. Results: Our case-finding strategy assessed 656 scheduled patients over 4 weeks. From this screening,179 (a casefinding yield of 20.4 %), were candidates for HPV vaccine discussion. Forty-three of these 179 patients (24 %) were already vaccinated.. Two patients (1.1 %) did not consent to be spoken with and 134 (74.8 %) consented to the HPV vaccine discussion.. Forty-eight of 134 patients (35.8 %) of patients accepted a prescription from the dentist after speaking with the dental clinician. Ultimately, 8/48 (16 %) (patients received their first dose of the HPV vaccine by the 6 week of follow-up call. However, this is only 4.5 % (8/177) of those patients who did consent for the discussion of HPV cancers and vaccination from their dentist. Conclusion: We demonstrated that case-finding for HPV vaccine candidates in general dental offices was feasible, with a reasonable yield. While the dental dialogue tool was described as a great resource to explain the facts and answer questions, very few patients were vaccinated after 6 weeks of follow-up. Further work is necessary to sharpen the intervention, perhaps including follow-up discussions with the dental clinicians.

Background: The importance of pharmacists' involvement in disasters is becoming increasingly recognised in the literature. The aim of this project was to determine the effectiveness of a disaster workshop in improving pharmacy staff’s perceived capabilities to prevent, prepare for, respond to, and recover from disasters. Methods: A disaster workshop was provided at a pharmacy conference. The workshop incorporated an evolving emergency scenario in which participants worked through activities pertaining to the prevention, preparedness, response, and recovery cycles. The attendees were invited to complete a previously validated pre-post survey assessing their perceptions of their skills and capabilities in the components of disaster management. Results: The pre-post survey was completed by 31 attendees. After the workshop, participants' perceptions of their ability to prevent, respond to, and recover from a disaster significantly improved (p=0.004, 0.013, and 0.013, respectively). Conclusion: This study demonstrated that a conference disaster workshop can improve the understanding and perceived disaster capabilities of health-system pharmacy personnel.

Introduction: Pharmacists have been recognized as essential healthcare professionals during the COVID-19 pandemic. However, evidence of the challenges that were faced by the profession and the way pharmacists adapted their roles throughout the pandemic are largely unknown. This study aimed to describe the impact of COVID-19 on pharmacy practice around the world. Method: A cross-sectional online questionnaire with pharmacists who provided direct patient care during the pandemic. Pharmacists were recruited through social media with assistance from national/international pharmacy organizations. The questionnaire was divided into three sections; 1) demographics, 2) pharmacists’ roles/services during the pandemic, and 3) practice challenges. The questionnaire was adapted from the established, piloted, and published INSPIRE Canadian Survey. The data were analyzed using SPSS 28. Descriptive statistics were used to report frequencies and percentages. Results: A total of 505 pharmacists practicing in 25 countries consented and completed the questionnaire. Only 26.4% (132/500) of participants were engaged with local disaster and public health agencies during the pandemic to coordinate pandemic response. The most common role that pharmacists undertook was responding to drug information requests (89.4%, 448/501), followed by allaying patients' fears/anxieties about COVID-19 (82.7%, 413/499), educating the public on reducing the spread of COVID-19 (81.3%, 409/503), and addressing misinformation on COVID-19 treatments/vaccinations (79.1%, 397/502). The most common services provided by pharmacists were performing medication reviews (78.5%, 391/498) and managing and/or monitoring patients’ chronic diseases (72.3%, 362/501). Almost half of the participants reported administering COVID-19 vaccines (44.9%, 225/501). The most common challenge that pharmacists encountered was increased stress level (82.2%, 415/505), followed by medication shortages (72.3%, 360/505). Conclusion: Despite the unprecedented nature of the COVID-19 pandemic and the various challenges associated with it, pharmacists around the world adapted their roles and services to continue to meet the needs of their patients and be their safe-haven for ongoing care.

Abstract Background Multiple sclerosis (MS) is a chronic disease affecting multiple functional aspects of patients’ lives. Depression and anxiety are common amongst persons with MS (PwMS). There has been an interest in utilizing patient-reported outcome measures (PROMs) to capture and systematically assess patient’s perceptions of their MS experience in addition to other clinical measures, but PROMs are not usually collected in routine clinical practice. Therefore, this study aims to systematically incorporate periodic electronically administered PROMs into the care of PwMS to evaluate its effects on depression and anxiety. Methods A randomized controlled trial will be conducted with patients allocated 1:1 to either intervention or conservative treatment groups. Patients in the intervention group will complete PROMs at the start of the study and then every 6 months for 1 year, in addition to having their MS healthcare provider prompted to view their scores. The conservative treatment group will complete PROMs at the start of the study and again after 12 months, and their neurologist will not be able to view their scores. For both groups, pre-determined critical PROM scores will trigger an alert to the patient’s MS provider. The difference in change in Hospital Anxiety and Depression Scale score between the intervention and conservative treatment groups at 12 months will be the primary outcome, along with difference in Consultation Satisfaction Questionnaire and CollaboRATE scores at 12 months, and proportion and type of healthcare provider intervention/alerts initiated by different PROMs as secondary outcomes. Discussion This study will determine the feasibility of utilizing PROMs on an interval basis and its effects on the psychological well-being of PwMS. Findings of this study will provide evidence on use of PROMs in future MS clinical practice. Trial registration This trial is registered at the National Institutes of Health United States National Library of Medicine, ClinicalTrials.gov NCT04979546 . Registered on July 28, 2021.

Background:The COVID-19 pandemic presented a unique challenge for pharmacists as they navigated information scarcity on the frontlines while being identified as information experts. Alberta pharmacists looked to their professional organizations for direction regarding what their roles should be in a crisis. The objective of this study was to explore pharmacists' roles and services and how they were communicated by pharmacy organizations during the first year of the COVID-19 pandemic.Methods:The study used a conventional content analysis method to explore the online communication of relevant pharmacy organizations for Alberta pharmacists. Five organization websites (National Association of Pharmacy Regulatory Authorities, Canadian Pharmacists Association [CPhA], Canadian Society of Hospital Pharmacists [CSHP], Alberta College of Pharmacy [ACP] and the Alberta Pharmacists' Association [RxA]) were examined to identify and catalogue publicly accessible documents that communicated pharmacists' roles and services during the first year of the pandemic for Alberta pharmacists.Results:A total of 92 documents were collected from CPhA (60), CSHP (2), ACP (26) and RxA (4). While most documents communicated information about pharmacists' roles in public health, patient care and drug and personal protective equipment supply, more than one-third of the documents (32/92, 34.8%) required contextual information to interpret the communication. There was an observed shift in the communication after the first 6 months, becoming more direct in its messaging and context.Conclusion:These pharmacy organizations communicated information for pharmacists' roles and services to provide direction and guidance in the ever-changing context of the COVID-19 pandemic for Alberta pharmacists. Their communication became clearer and more direct as the pandemic progressed, requiring less inference to understand the intended message.

Abstract Introduction People with chronic medical conditions often take medications that improve long‐term outcomes but which can be harmful during acute illness. Guidelines recommend that healthcare providers offer instructions to temporarily stop these medications when patients are sick (i.e., sick days). We describe the experiences of patients managing sick days and of healthcare providers providing sick day guidance to their patients. Methods We undertook a qualitative descriptive study. We purposively sampled patients and healthcare providers from across Canada. Adult patients were eligible if they took at least two medications for diabetes, heart disease, high blood pressure and/or kidney disease. Healthcare providers were eligible if they were practising in a community setting with at least 1 year of experience. Data were collected using virtual focus groups and individual phone interviews conducted in English. Team members analyzed transcripts using conventional content analysis. Results We interviewed 48 participants (20 patients and 28 healthcare providers). Most patients were between 50 and 64 years of age and identified their health status as ‘good’. Most healthcare providers were between 45 and 54 years of age and the majority practised as pharmacists in urban areas. We identified three overarching themes that summarize the experiences of patients and healthcare providers, largely suggesting a broad spectrum in approaches to managing sick days: Individualized Communication, Tailored Sick Day Practices, and Variation in Knowledge of Sick Day Practices and Relevant Resources. Conclusion It is important to understand the perspectives of both patients and healthcare providers with respect to the management of sick days. This understanding can be used to improve care and outcomes for people living with chronic conditions during sick days. Patient or Public Contribution Two patient partners were involved from proposal development to the dissemination of our findings, including manuscript development. Both patient partners took part in team meetings and contributed to team decision‐making. Patient partners also participated in data analysis by reviewing codes and theme development. Furthermore, patients living with various chronic conditions and healthcare providers participated in focus groups and individual interviews.

The uptake of clinical practice guidelines into practice is poor for many chronic conditions, including hypertension. We designed a guidelines-based educational program for primary care clinicians, the Hypertension Canada Professional Certification Program (HC-PCP, www.hypertension.ca/professional-certification-program). It consists of four online modules, an online prospective patient registry, and expert evaluations of the blood pressure measurement technique and case management by the learner. We then evaluated its impact on patient level outcomes. Objective: The objective of RxPATH was to determine the effect of the HC-PCP for pharmacists on systolic blood pressure reduction in patients with poorly controlled hypertension. Design and Methods: Design: Stepped wedge cluster randomized trial (unit of randomization was the pharmacy). Setting: Community pharmacies in Alberta, Canada Population: Pharmacists with prescriptive authority volunteered to participate. We enrolled patients with poorly controlled hypertension (BP > 140/90mmHg or > 130/80mmHg in those with diabetes), identified by their pharmacist. Intervention: Pharmacists were enrolled in the HC-PCP. They then provided this care to their patients with poorly controlled hypertension. Control: Pharmacists were given a copy of the Hypertension Canada Guidelines and provided usual care to their patients prior to undertaking the HC-PCP. Outcomes: The primary outcome was difference in change in systolic blood pressure between intervention and control groups at 3 months. We also evaluated patient satisfaction using the Consultant Satisfaction Questionnaire (CSQ). Results: We enrolled 890 patients from 61 pharmacies (104 pharmacists). Mean age was 61.6 (SD 14.1) years, 46% were female, 35.5% had diabetes, and mean baseline BP was 152.4 (SD 13.8)/87.0 (SD 10.6)mmHg. Change in systolic BP was 9.9 (SD 16.5) for the intervention group, compared to 9.9 (SD 16.2) mmHg in the control group, p = 0.29. Patient satisfaction using the CSQ was high at 76 (of 90 maximum). Conclusions: Most educational programs do not get evaluated at the patient level. RxPATH demonstrated that the HC-PCP intervention did not result in a greater reduction in systolic BP compared to control. While both groups did have clinically meaningful reductions in BP, possible reasons for lack of a difference with the intervention include: COVID-19 staffing/workload issues in pharmacies, selection bias for pharmacists interested in hypertension/contamination of usual care group, and short follow-up duration. Feedback on the HC-PCP from pharmacists was positive, patient satisfaction was high, and we plan to make this program widely available to primary care providers.

Introduction: While the importance of pharmacists' involvement in disaster management is becoming increasingly recognized in the literature, there are few mechanisms by which pharmacists can prepare themselves for emergencies. This project aimed to determine the effectiveness of a disaster tabletop exercise (TTX) in preparing pharmacy staff for disasters. Method: A TTX was held at the American Society of Health-System Pharmacists Summer Meeting which was held in Phoenix, Arizona in June 2022. The workshop incorporated an evolving emergency scenario in which participants worked through activities pertaining to the mitigation, preparedness, response, and recovery cycle. The scenario involved a hypothetical storm and landside scenario across fictional towns in Arizona, US. Workshop attendees worked in small groups on one of two provided hospital profiles. The attendees were invited to complete a pre-post survey assessing their perceptions of disaster management including perceived preparedness. This survey was previously developed, piloted, and published. The paper surveys were collected at the end of the workshop and inputted into RedCap. Data were descriptively summarized using SPSS, and pre-post survey results were compared using appropriate statistical tests. Results: The workshop was attended by 40 pharmacy personnel and 31 completed the survey. All participants agreed that the exercise was well structured, realistic, allowed them to test their response plans and systems, and helped improve their understanding of their role and function in disaster response. After the workshop, participants' perceptions of their ability to prevent, respond, and recover from a disaster all significantly improved (p=0.004, 0.013, and 0.013 respectively). However, perceptions of their preparedness for a disaster did not significantly change (p=0.197). Conclusion: This study adds to the evidence of the effectiveness in training and preparing the pharmacy workforce. The TTX improved the understanding and perceived capabilities of pharmacy personnel in responding and recovering from emergencies.

BACKGROUND:Community pharmacists were the face of the health response to the unprecedented COVID-19 pandemic. Their pivotal role during the pandemic has been widely recognized, as they adapted to continue to provide a higher level of care to their patients.OBJECTIVE:The objective of this study was to gain a deeper understanding of frontline pharmacists' lived experiences of the COVID-19 pandemic and its impact on their roles.METHODS:Photovoice, a visual research method that uses participant-generated photographs to articulate their experiences, was used with semi-structured interviews to explore pharmacists' lived experiences. Frontline community pharmacists who provided direct patient care during the COVID-19 pandemic in Alberta, Canada were recruited. Participants were asked to provide 3-5 photos that reflected on how they see themselves as a pharmacist and/or represents what they do as a pharmacist. Data analysis incorporated content, thematic and visual analysis and was facilitated using NVivo software. A published conceptual framework model was used as the foundation of the analysis with care taken to include new concepts. Ethics approval was obtained from the University of Alberta health research ethics board.RESULTS:Interviews were conducted with 21 participants and they 71 photos. This study advanced the conceptual framework model presented in a scoping review, of what was made visible (pharmacists' information, public health, and medication management roles) and what was invisible but made visible by the pandemic (pharmacists' leadership roles). It was revealed through the reflective nature of this study the important leadership role pharmacists have in their communities.CONCLUSIONS:This study highlighted the work of community pharmacists responding to the COVID-19 pandemic through their information, public health, medication management, and leadership roles. Their experiences also made visible the cost their work had on them as they did more to adapt and continually respond as the pandemic evolved. Pharmacists recognized their role as leaders in their practice and communities.