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Implementing a Chatbot on Facebook to Reach and Collect Data from Thousands of Healthcare Providers: PharmindBot as a Case

Alkoudmani RM, Ooi GS, Tan ML

J Am Pharm Assoc (2003), 2023 Jun 14.
PMID: 37327997 DOI: 10.1016/j.japh.2023.06.007

BACKGROUND: The world is moving fast towards digital transformation as we live in the artificial intelligence (AI) era. The COVID-19 pandemic accelerates this movement. Chatbots were used successfully to help researchers collect data for research purposes.
OBJECTIVE: To implement a chatbot on the Facebook® platform to establish connections with healthcare professionals who had subscribed to the chatbot, provide medical and pharmaceutical educational content, and collect data for online pharmacy research projects. Facebook® was chosen because it has billions of daily active users which offers a massive potential audience for research projects.
PRACTICE DESCRIPTION: The chatbot was successfully implemented on the Facebook® platform following three consecutive steps. Firstly, the ChatPion script was installed on the Pharmind website to establish the chatbot system. Secondly, the PharmindBot application was developed on Facebook®. Finally, the PharmindBot app was integrated with the chatbot system.
PRACTICE INNOVATION: The chatbot responds automatically to public comments and sends subscribers private responses using artificial intelligence. The chatbot collected quantitative and qualitative data with minimal costs.
EVALUATION METHODS: The chatbot's auto-reply function was tested using a post published on a specific page on Facebook®. Testers were asked to leave pre-defined keywords to test its functionality. The chatbot's ability to collect and save data was tested by asking testers to fill out an online survey within Facebook Messenger® for quantitative data and answer pre-defined questions for qualitative data.
RESULTS: The chatbot was tested on 1000 subscribers who interacted with it. Almost all testers (n = 990, 99%) obtained a successful private reply from the chatbot after sending a pre-defined keyword. Also, the chatbot replied privately to almost all public comments (n = 985, 98.5%) which helped to increase the organic reach and to establish a connection with the chatbot subscribers. No missing data was found when the chatbot was used to collect quantitative and qualitative data.
CONCLUSIONS: The chatbot reached thousands of healthcare professionals and provided them with automated responses. At a low cost, the chatbot was able to gather both qualitative and quantitative data without relying on Facebook® ads to reach the intended audience. The data collection was efficient and effective. Using chatbots by pharmacy and medical researchers will help do more feasible online studies using AI to advance healthcare research.
Airport based pharmacies; products, services and challenges essential for patients in a global travel landscape

Jairoun AA, Al-Hemyari SS, Shahwan M, Zyoud SH, Abu-Gharbieh E, Jairoun M, et al.

J Am Pharm Assoc (2003), 2023 Jun 22.
PMID: 37354940 DOI: 10.1016/j.japh.2023.06.013

The role of airport pharmacies has grown in recent years to provide a range of services to travelers including OTC and prescription medicines as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics as seen with the recent COVID-19 pandemic. In addition, offering vaccinations where appropriate. However, this is not universal and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward including greater research into their activities to enhance their role and address challenges. These include issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services benefiting airport staff and travelers in the future.
Clinical and Economic Implications of Increasing Access to Herpes Zoster Vaccination Rate in Community Pharmacies

Watanabe AH, Veettil SK, Le LM, Bald E, Tak C, Chaiyakunapruk N

J Am Pharm Assoc (2003), 2023 May 17.
PMID: 37207710 DOI: 10.1016/j.japh.2023.05.012

BACKGROUND: Community pharmacist plays an important role in providing vaccination to the general public in the United States. No economic models have been used to assess the impact of these services on public health and economic benefits.
OBJECTIVE: To estimate the clinical and economic implications of community pharmacy-based herpes zoster (HZ) vaccination services with a hypothetical scenario of non-pharmacy-based vaccination in the State of Utah.
METHODS: A hybrid model of decision tree and Markov models was used to estimate lifetime cost and health outcomes. This open-cohort model was populated based on Utah population statistics and included a population of 50 years and above who were eligible for HZ vaccination between the years 2010 and 2020. Data were derived from the United States Bureau of Labor Statistics, the Utah Immunization Coverage Report, the CDC Behavioral Risk Factor Surveillance System, the CDC National Health Interview Survey, and existing literature. The analysis was performed from a societal perspective. A lifetime time horizon was used. The primary outcomes were the number of vaccination cases increased, and the number of shingles and postherpetic neuralgia (PHN) cases averted. Total costs and quality-adjusted life-years (QALYs) were also estimated.
RESULTS: Based on a cohort of 853,550 people eligible for HZ vaccination in Utah, an additional 11,576 individuals were vaccinated in the community pharmacy-based scenario compared to the non-pharmacy-based vaccination, resulting in 706 averted cases of shingles and 143 averted cases of PHN. Community pharmacy-based HZ vaccination was less costly (-$131,894) and gained more QALYs (52.2) compared to the non-pharmacy-based vaccination. A series of sensitivity analyses showed that the findings were robust.
CONCLUSIONS: Community pharmacy-based herpes zoster vaccination was less costly and gained more QALYs and was associated with improved other clinical outcomes in the State of Utah. This study might be used as a model for future evaluations of other community pharmacy-based vaccination programs in the United States.
Evaluation of Community Pharmacists' Perceptions and Willingness to Integrate ChatGPT into their Pharmacy Practice: A Study from Jordan

Abu-Farha R, Fino L, Al-Ashwal FY, Zawiah M, Gharaibeh L, Harahsheh MM, et al.

J Am Pharm Assoc (2003), 2023 Aug 28.
PMID: 37648157 DOI: 10.1016/j.japh.2023.08.020

OBJECTIVES: The aim of this study is to examine the extent of community pharmacists' awareness of ChatGPT, their willingness to embark on this new development of AI development, and barriers that face the incorporation of this non-conventional source of information into pharmacy practice METHODS: A cross-sectional study was conducted among community pharmacists in Jordanian cities between April 26, 2023, and May 10, 2023. Convenience and snowball sampling techniques were utilized to select study participants due to resource and time constraints. The questionnaire was distributed by research assistants through popular social media platforms. Logistic regression analysis was employed to assess predictors affecting their willingness to use this service in the future.
RESULTS: A total of 221 community pharmacists participated in the current study (response rate was not calculated since opt in recruitment strategies were used). Remarkably, nearly half of the pharmacists (n= 107, 48.4%) indicated a willingness to incorporate the ChatGPT into their pharmacy practice. Nearly half of the pharmacists (n=105, 47.5%) demonstrated a high perceived benefit score for ChatGPT, while around 37% of pharmacists (n= 81) expressed a high concern score about ChatGPT. More than 70% of pharmacists believed that ChatGPT lacked the ability to utilize human judgment and make complicated ethical judgements in its responses (n= 168). Finally, logistics regression analysis showed that pharmacists who had previous experience in using ChatGPT were more willing to integrate ChatGPT in their pharmacy practice than those with no previous experience in using ChatGPT (OR= 2.312, p= 0.035).
CONCLUSION: While pharmacists show a willingness to incorporate ChatGPT into their practice, especially those with prior experience, there are significant concerns. These mainly revolve around the tool's ability to make human-like judgments and ethical decisions. These findings are crucial for the future development and integration of AI tools in pharmacy practice.
Prevalence of sodium-glucose transporter 2 inhibitor-associated diabetic ketoacidosis in real-world data: A systematic review and meta-analysis

Al-Hindi B, Mohammed MA, Mangantig E, Martini ND

J Am Pharm Assoc (2003), 2023 Oct 14.
PMID: 37844733 DOI: 10.1016/j.japh.2023.10.010

BACKGROUND: The U.S. Food and Drug Administration revised the labels of sodium-glucose transporter 2 (SGLT2) inhibitors in December 2015 to inform users regarding the risk of diabetic ketoacidosis (DKA). As more drugs of this class are approved and their indications are expanded, this serious adverse effect has been increasingly reported.
OBJECTIVE: This review evaluated observational studies to inform the prevalence of SGLT2-inhibitor-associated DKA compared with other antihyperglycemic agents.
METHODS: A systematic review was conducted in PubMed and EMBASE until 19 July 2022 (PROSPERO: CRD42022385425). We included published retrospective cohort active comparator/new user (ACNU) and prevalent new user studies assessing SGLT2-inhibitor-associated DKA prevalence in adult patients with type 2 diabetes mellitus (T2DM) against active comparators. We excluded studies which lacked 1:1 propensity score matching. The JBI Checklist for Cohort Studies guided the risk-of-bias assessments. Meta-analysis was conducted based on the inverse variance method in R software.
RESULTS: Sixteen studies with a sample of 2,956,100 non-unique patients met the inclusion criteria. Most studies were conducted in North America (n = 9) and adopted the ACNU design (n = 15). Meta-analysis of 14 studies identified 33% higher DKA risk associated with SGLT2 inhibitors (HR = 1.33, 95% CI: 1.14-1.55, p < 0.01). Meta-regression analysis identified the study location (p = 0.02), analysis principle (p < 0.001), exclusion of chronic comorbidities (p = 0.007), and canagliflozin (p = 0.04) as significant moderator variables.
CONCLUSIONS: Despite limitations related to heterogeneity, generalisability, and misclassification, the results of this study show that SGLT2 inhibitors increase the prevalence of DKA among adult T2DM patients in the real world. The findings supplement evidence from randomised controlled trials and call for continued vigilance.