Community pharmacists’ knowledge, attitude, and practice of Irritable Bowel Syndrome (IBS): the impact of training courses

Figures & data

Table 1 Demographic characteristics of participants (N=51)

Characteristics	Categories	Number (%)
Gender	Male	30 (58.8)
	Female	21 (41.2)
Age (years)	26–35	18 (35.29)
	36–45	15 (29.41)
	45–55	13 (25.4)
	56–65	3 (5.88)
	>65	2 (3.92)
Experience in pharmacy practice (years)	<5	8 (15.67)
	5–10	11 (21.56)
	10–15	13 (25.44)
	>15	19 (37.25)
Position in the pharmacy	Temporary pharmacist	0 (0.0)
	Technical responsible	15 (29.41)
	Owner	36 (70.58)
Prior training regarding IBS	Teaching classes during university Less than 5 hours of special training after graduation More than 5 hours of special training after graduation	38 (74.59) 10 (19.61) 3 (5.90)
Self-assessment of knowledge, attitude, and practice level about IBS	I need training courses in this area I do not need any training courses in this area	48 (94.11) 3 (5.90)

Abbreviation: IBS, Irritable Bowel Syndrome.

Table 2 Comparison of knowledge, attitude, and practice levels in the pre, post, and follow-up tests

Evaluation	Comparison between scores	Mean percent of correct answer		P-value
		Mean	±SD
Knowledge scores	Pre-test	58.22	5.42	<0.01
	Post-test	70.61	4.66
	Post-test	70.61	4.66	0.01
	Follow-up test	65.51	3.28
	Pre-test	58.22	5.42	0.12
	Follow-up test	65.51	3.28
Attitude scores	Pre-test	50.14	1.72	0.003
	Post-tet	72.57	1.14
	Post-test	72.57	1.14	0.002
	Follow-up test	63	1.21
	Pre-test	50.14	1.72	0.003
	Follow-up test	63	1.21
Practice scores	Pre-test	44.16	1.21	0.000
	Post-test	59.01	1.05
	Post-test	59.01	1.05	0.040
	Follow-up test	64.47	4.49
	Pre-test	44.16	1.21	0.020
	Follow-up test	64.47	4.49
	Follow-up test	60.83	1.11

Table 3 Relationship between participants’ demographic data and KAP components (N=51)

Variable		Correct answers in knowledge		Correct answers in attitude		Correct answers in practice		Correct answers in total
		Mean±SD	P-value	Mean±SD	P-value	Mean±SD	P-value	Mean±SD	P-value
Age	26–35	66.83±5.17	0.04	57.85±0.94	0.11	45.33±1.00	0.322	62.50±4.91	<0.01
	36–45	65.80±6.76		59.00±0.95		41.00±0.89		61.36±8.69
	46–55	55.06±4.72		42.85±1.07		46.50±0.92		51.90±5.20
	56–65	46.22±4.50		57.14±1.50		33.33±1.00		46.20±3.21
	>65	19.35±1.41		21.42±2.12		16.66±1.40		19.31±2.12
Experience in pharmacy practice (years)	<5	65.70±5.60	0.42	62.42±1.06	0.28	41.66±1.30	0.91	61.93±4.71	0.57
	5–10	61.47±4.35		50.57±1.03		45.33±1.34		57.48±4.39
	10–15	63.51±5.45		56±2.36		46±1.16		59.95±6.44
	>15	55.32±7.71		48±1.7		38.5±1.15		51.90±9.59
Position in the pharmacy	Technical responsible	64.51±5.41	0.28	52.28±1.71	0.91	40±1.45	0.57	59.68±5.50	0.42
	Owner	58.48±6.46		53.14±1.71		43.50±1.10		55.61±7.93
Gender	Male	54.70±5.12	0.013	50.85±1.88	0.49	42.66±1.22	0.90	52.50±6.70	<0.25
	Female	68.64±6.78		55.71±1.41		42.00±1.20		62.97±7.39
Prior training regarding the IBS	Teaching classes during university	56.93±5.29	0.1	48.85±1.65	0.20	42.50±1.10	0.07	49.42±2.68	0.12
	<5 hours of special training after graduation	70±8.80		60±1.31		35.00±1.44		55.26±3.85
	>5 hours of special training after graduation	73.38±1.06		85.71±1.41		66.66±0.00		72.25±2.47
Self-assessment of knowledge, attitude, and practice level about IBS	I need training courses in this area	60.06±6.33	0.58	50.85±1.63	0.014	41.16±1.20	0.09	56.04±7.33	0.19
	I do not need any training courses in this area	66.64±3.21		85.71±1.00		61.00±0.57		68.93±4.72

Abbreviations: KAP, Knowledge, Attitude and Practice; IBS, Irritable Bowel Syndrome.

Table

1. IBS is a serious condition that could decrease the quality-of-life	True	False
2. IBS could shorten the life of the subjects	True	False
3. Colon cancer is more prevalent than IBS	True	False
4. Dietary factors, food allergies, and food intolerances are highly associated with IBS	True	False
5. Genetic predisposition and a preceding viral or bacterial illness are major risk factors for IBS	True	False
6. Psychological and emotional illnesses are common disorders associated with IBS	True	False
7. The common symptoms of IBS include diarrhea, constipation, abdominal pain, and bloating	True	False
8. Dietary changes could improve IBS symptoms	True	False
9. Prescription medications could improve IBS symptoms	True	False
10. Alternative medications could improve the IBS status	True	False
11. The diagnosis of IBS is based on recognition of the symptoms	True	False
12. Differential diagnosis could enhance the early recognition of IBS	True	False
13. Prevalence of IBS is higher than colorectal cancer	Agree	Disagree	No Idea
14. Prevalence of IBS is higher than hypertension.	Agree	Disagree	No Idea
15. IBS only occurs in women	Agree	Disagree	No Idea
16. IBS is a disease that will increase mortality	Agree	Disagree	No Idea
17. IBS can effect the incidence of inflammatory bowel disease	Agree	Disagree	No Idea
18. IBS is one of the main risk factors for colorectal cancer	Agree	Disagree	No Idea
19. Nowadays IBS has become one of the most involved health problems in our country	Agree	Disagree	No Idea
20. The symptoms of IBS will never disappear, but will progress	Agree	Disagree	No Idea
21. In your opinion, which factors that are mentioned below may have an effect on the incidence of IBS? a. Genetic factors b. Environmental factors c. Diet d. Psychological problems
22. In patients with IBS, which of the following signs and symptoms are more common? a. Abdominal pain with constipation b. Abdominal pain with diarrhea c. Abdominal pain with constipation and diarrhea d. None
23. Which of the following complaints are more common in IBS? a. Anemia b. heart burn c. flatulence d. fever
24. Which of the following are relevant to IBS? a. Presence of fresh blood in stool b. Presence of mucus in stool c. Presence of dark blood in stool d. Oily diarrhea
25. Which of the following choices play a major role in the diagnosis of IBS? a. Blood test b. colonoscopy c. abdominal sonography d. CT scan
26. Which of the following options are the alarming signs of IBS? a. Weight loss b. anemia c. female gender d. family history of colorectal cancer
27. Which of the following phrases related to IBS are correct? a. IBS is related to the weight loss b. IBS has no poor prognosis c. Patients feel abdominal pain while sleeping d. IBS is related to bleeding of the intestine
28. In your opinion which of the following options can improve the signs of IBS? a. Change in diet b. OTC medications c. Medications that are prescribed by physicians d. Probiotic products e. Social support and psychological consultants f. Surgery
29. Which of the following medications are used in IBS? a. Bulk forming laxatives b. Anti-spasm medications c. Anti-diarrhea medications d. Anti-depressant e. Anti-flatulence f. Serotonin receptor agonist and antagonist chloride channel activator
30. A 31 years old woman enters your pharmacy with complaints of diarrhea, abdominal pain, and bloating and has suffered from these symptoms since 4 months ago. She said symptoms have progressed during the past months But abdominal pain improves a little after each defecation. Also this lady is now suffering from non-bleeding diarrhea. Which of the following phrases are more suitable for this patient? a. This woman has IBS, therefore refer her to specialist. b. This patient does not have IBS, therefore provide her loperamide c. This patient has IBS, therefore give her loperamide d. The information provided is not enough, so more questions need to be asked
31. A 30 years old woman with a 3-year history of IBS complications refers to your pharmacy with the chief complaint of severe abdominal pain, fever, and diarrhea. What is your suggestion for this patient? a. Use of acetaminophen with dicyclomine b. Use of acetaminophen with loperamide c. Use of acetaminophen with clidinium-C d. Refer the patient to GI specialist
32. A 36 years old man occasionally gets abdominal pain and constipation while having stress. In your opinion which of the following medications prescribed by a physician is more suitable?
a. Amitriptyline 10 mg every night b. Citalopram 20 mg every night c. Alprazolam 0.5 mg every night d. Clidinium-C TID before a meal
33. Which of the following choices are not suitable for the symptoms of abdominal pain and bloating in IBS patients? a. Hyoscine b. Clidinium-C c. Omeprazole d. Dicyclomine
34. Which of the following medications are prescribed for IBS? a. Famotidine b. Psyllium c. Sulfasalazine d. NSAIDs
35. A patient with a prescription containing prednisolone, Asacol, and loperamide enters your pharmacy. Which of the following diagnosis is the most probable according to this prescription? a. IBS b. IBD c. Peptic ulcer d. Indigestion
36. Which of the following antibiotics can be used in IBS? a. Ciprofloxacin b. Azithromycin c. Clindamycin d. Metronidazole
37. Which of the following herbal medications are selective for IBS? a. Garlic b. Clopermin c. Anethom d. Sena