Pharmacy

8 pages, 215 KiB

Open AccessReview

Considering the Intercultural Development Inventory (IDI) to Assess Intercultural Competence at U.S. Pharmacy Schools

by Diana Tamer, Yifei Liu and Jennifer Santee

Pharmacy 2023, 11(1), 39; https://doi.org/10.3390/pharmacy11010039 - 19 Feb 2023

Viewed by 1715

Background: U.S. pharmacy schools need to engage in improving intercultural competence among administrators, faculty, staff, and students. The Intercultural Development Inventory (IDI) can be a possible tool to determine the level of intercultural competence. U.S. pharmacy schools need to examine the validity of [...] Read more.

Background: U.S. pharmacy schools need to engage in improving intercultural competence among administrators, faculty, staff, and students. The Intercultural Development Inventory (IDI) can be a possible tool to determine the level of intercultural competence. U.S. pharmacy schools need to examine the validity of the IDI within the context of health professional education prior to using this tool. Objectives: To describe the relationship between the IDI and its underlying theory, identify whether the validity of the IDI has been established within two specific contexts, and discuss the practical issues and implications of using the IDI. Methods: Medline, Embase, and selected health professional education journal websites were searched to identify fully published studies utilizing the IDI within health professional education. Eligibility of articles was determined with a standardized approach. Results: Ten studies were identified by full-text reviews, but none investigated the validity of the IDI. Conclusions: The IDI has been shown to be valid in certain contexts, but its validity has yet to be confirmed within health professional education. U.S. pharmacy schools need to examine practical issues and implications when deciding if the resources required to administer, analyze, and report IDI results are reasonable. Full article

(This article belongs to the Special Issue Pharmacy Reviews in 2022)

11 pages, 231 KiB

Open AccessArticle

Expansion of MyDispense: A Descriptive Report of Simulation Activities and Assessment in a Certified Pharmacy Technician Training Program

by Cassandra R. Doyno, Lisa M. Holle, Renee Puente, Sharee Parker, Lauren M. Caldas and Barbara Exum

Pharmacy 2023, 11(1), 38; https://doi.org/10.3390/pharmacy11010038 - 16 Feb 2023

Viewed by 1376

Abstract

Background: Yale New Haven Health (YNHH) implemented a pharmacy technician training program in 2016. The curriculum includes 14 weeks of combined didactic and simulation hours (280 h in total), followed by 360 h of experiential learning. MyDispense, an online pharmacy simulation, allows students [...] Read more.

Background: Yale New Haven Health (YNHH) implemented a pharmacy technician training program in 2016. The curriculum includes 14 weeks of combined didactic and simulation hours (280 h in total), followed by 360 h of experiential learning. MyDispense, an online pharmacy simulation, allows students to develop and practice their dispensing skills in a safe environment with minimal consequences for mistakes. We describe a novel innovation, expanding the functionality of MyDispense to the training of pharmacy technicians. Methods: Technician training coordinator, supervisor, faculty members with experience in MyDispense, and experiential pharmacy students created cases within the MyDispense software that were targeted towards pharmacy technician activities. Activities were aligned with current American Society of Health-System Pharmacists (ASHP)-Accreditation Council for Pharmacy Education (ACPE) Accreditation Standards for pharmacy technician education and training programs. Results: A total of 14 cases were developed to be utilized in student technician training, and account for approximately 14 h of simulation. Conclusions: MyDispense is an innovative software that could allow students to access and complete exercises, and to continue developing dispensing skills in a safe, remote environment. We identified similarities between activities performed by student pharmacists and student pharmacy technicians, expanding MyDispense to a new learner group to practice, develop and be assessed on dispensing skills within their scope, as part of a formal technician training program and in preparation for the Pharmacy Technician Certification Examination (PTCE). Full article

(This article belongs to the Special Issue Technology-Enhanced Pharmacy Teaching and Learning Strategies III)

19 pages, 754 KiB

Open AccessReview

Comprehensive Medication Management Services with a Holistic Point of View, a Scoping Review

by Evelyn I. Rojas, Niurka M. Dupotey and Hans De Loof

Pharmacy 2023, 11(1), 37; https://doi.org/10.3390/pharmacy11010037 - 16 Feb 2023

Cited by 2 | Viewed by 2333

Abstract

Implementing Comprehensive Medication Management (CMM) services uncovered the importance of the totality of the patient’s perspective in this process. The holistic approach takes into account the physical, mental and emotional well-being of individuals, as well as their socioeconomic circumstances. The aim of this [...] Read more.

Implementing Comprehensive Medication Management (CMM) services uncovered the importance of the totality of the patient’s perspective in this process. The holistic approach takes into account the physical, mental and emotional well-being of individuals, as well as their socioeconomic circumstances. The aim of this study was to characterize the scientific evidence associated with CMM services that included this holistic approach. A scoping review was conducted based on Arksey and O’Malley’s method. Searches were performed in Google Scholar for papers published between 2010 and 2020 in English, Spanish and Portuguese. Study design, health contexts, sample of patients, results obtained, barriers and facilitators, and the integration of a holistic approach were determined. Two hundred and eighteen papers were evaluated, most of which focused on the implementation of this service through prospective observational studies. A minority of studies reported on a holistic approach, a smaller number examined the effect of social determinants of health, the patient’s medication experiences and the pharmacotherapy outcomes from the patient’s perspective. Despite the progress achieved, most of the referents do not yet reflect a broader view of the patient’s life situation and its relationship to pharmacotherapy and the ways in which the pharmacist implements holistic elements to solve or prevent drug-related problems. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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9 pages, 369 KiB

Open AccessArticle

Assessing Learner Engagement and the Impact on Academic Performance within a Virtual Learning Environment

by Suzanne Galal, Deepti Vyas, Martha Ndung’u, Guangyu Wu and Mason Webber

Pharmacy 2023, 11(1), 36; https://doi.org/10.3390/pharmacy11010036 - 15 Feb 2023

Cited by 3 | Viewed by 1856

Abstract

Background: The objective of this pilot study was to examine student engagement with weekly self-paced learning materials in a virtual therapeutics course, and how sub-factors in the Motivated Strategies for Learning Questionnaire (MSLQ) may have influenced academic performance. Methods: Students within a diabetes [...] Read more.

Background: The objective of this pilot study was to examine student engagement with weekly self-paced learning materials in a virtual therapeutics course, and how sub-factors in the Motivated Strategies for Learning Questionnaire (MSLQ) may have influenced academic performance. Methods: Students within a diabetes module of a therapeutics course were provided with weekly asynchronous optional self-directed learning activities. Student submissions, on-time rates, self-reported weekly study time, and exam performance were collected. Students completed the MSLQ at the completion of the study. Data was evaluated using various correlation analyses to determine the predictive ability of the MSLQ and its 5 subscales. Results: In total, 173 students completed the study. Students’ self-efficacy score on the MSLQ subscale and case submission on-time rate have the strongest positive correlation with the exam score, while the test anxiety as reported on the MSLQ test anxiety subscale had the strongest negative correlation with the exam score. Conclusions: Study results proved the MSLQ to be an effective predictive tool in students’ self-regulation skills. Results can be used to develop intentional interventions aimed at improving self-regulation skills while providing opportunities to enhance student learning. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)

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15 pages, 1442 KiB

Open AccessArticle

Potential Drug-Related Problems in Pediatric Patients—Describing the Use of a Clinical Decision Support System at Pharmacies in Sweden

by Sazan Abass Abdulkadir, Björn Wettermark and Tora Hammar

Pharmacy 2023, 11(1), 35; https://doi.org/10.3390/pharmacy11010035 - 14 Feb 2023

Viewed by 1524

Abstract

The clinical support system Electronic Expert Support (EES) is available at all pharmacies in Sweden to examine electronic prescriptions when dispensing to prevent drug-related problems (DRPs). DRPs are common, and result in patient suffering and substantial costs for society. The aim of this [...] Read more.

The clinical support system Electronic Expert Support (EES) is available at all pharmacies in Sweden to examine electronic prescriptions when dispensing to prevent drug-related problems (DRPs). DRPs are common, and result in patient suffering and substantial costs for society. The aim of this research was to study the use of EES for the pediatric population (ages 0–12 years), by describing what types of alerts are generated for potential DRPs, how they are handled, and how the use of EES has changed over time. Data on the number and categories of EES analyses, alerts, and resolved alerts were provided by the Swedish eHealth Agency. The study shows that the use of EES has increased. The most common type of alert for a potential DRP among pediatric patients was regarding high doses in children (30.3% of all alerts generated). The most common type of alert for a potential DRP that was resolved among pediatrics was therapy duplication (4.6% of the alerts were resolved). The most common reason for closing an alert was dialogue with patient for verification of the treatment (66.3% of all closed alerts). Knowledge of which type of alerts are the most common may contribute to increased prescriber awareness of important potential DRPs. Full article

(This article belongs to the Special Issue Pediatric Drug Safety and Medication Use)

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11 pages, 1055 KiB

Open AccessReview

Practical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice

by Mohammed Aldhaeefi, Hisham A. Badreldin, Faisal Alsuwayyid, Tariq Alqahtani, Omar Alshaya, Majed S. Al Yami, Khalid Bin Saleh, Shmeylan A. Al Harbi and Abdulrahman I. Alshaya

Pharmacy 2023, 11(1), 34; https://doi.org/10.3390/pharmacy11010034 - 11 Feb 2023

Cited by 2 | Viewed by 14808

Abstract

In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the [...] Read more.

In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the primary concern among patients using antithrombotics. Direct oral anticoagulants (DOACs) include rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors (DTIs) include argatroban, bivalirudin, and dabigatran. DOACs are associated with lower rates of fatal, life-threatening, and significant bleeding risks compared to those of warfarin. The immediate reversal of these agents can be indicated in an emergency setting. Antithrombotic reversal recommendations are still in development. Vitamin K and prothrombin complex concentrate (PCCs) can be used for warfarin reversal. Andexanet alfa and idarucizumab are specific reversal agents for DOACs and DTIs, respectively. Protamine sulfate is the solely approved reversal agent for unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH). However, there are no specific reversal agents for antiplatelets. This article aims to provide a practical guide for clinicians regarding the reversal of anticoagulants and antiplatelets in clinical practice based on the most recent studies. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in USA)

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16 pages, 911 KiB

Open AccessReview

Revisiting the Therapeutic Effects of Essential Oils on the Oral Microbiome

by Casandra-Maria Radu, Carmen Corina Radu, Sergiu-Alin Bochiș, Emil Marian Arbănași, Alexandra Ioana Lucan, Viorela Romina Murvai and Dana Carmen Zaha

Pharmacy 2023, 11(1), 33; https://doi.org/10.3390/pharmacy11010033 - 10 Feb 2023

Cited by 2 | Viewed by 3560

Abstract

The extensive use of antibiotics has resulted in the development of drug-resistant bacteria, leading to a decline in the efficacy of traditional antibiotic treatments. Essential oils (EOs) are phytopharmaceuticals, or plant-derived compounds, that possess beneficial properties such as anti-inflammatory, antibacterial, antimicrobial, antiviral, bacteriostatic, [...] Read more.

The extensive use of antibiotics has resulted in the development of drug-resistant bacteria, leading to a decline in the efficacy of traditional antibiotic treatments. Essential oils (EOs) are phytopharmaceuticals, or plant-derived compounds, that possess beneficial properties such as anti-inflammatory, antibacterial, antimicrobial, antiviral, bacteriostatic, and bactericidal effects. In this review, we present scientific findings on the activity of EOs as an alternative therapy for common oral diseases. This narrative review provides a deeper understanding of the medicinal properties of EOs and their application in dentistry. It not only evaluates the effectiveness of these oils as antibacterial agents against common oral bacteria but also covers general information such as composition, methods of extraction, and potential toxicity. Further nonclinical and clinical studies must be conducted to determine their potential use and safety for treating oral diseases. Full article

(This article belongs to the Special Issue Pharmacy Reviews in 2022)

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9 pages, 243 KiB

Open AccessReview

Adaptive Expertise in Undergraduate Pharmacy Education

by Naomi Steenhof

Pharmacy 2023, 11(1), 32; https://doi.org/10.3390/pharmacy11010032 - 09 Feb 2023

Cited by 1 | Viewed by 1250

Abstract

Pharmacy educators are grappling with concerns around curriculum overload and core pharmacist competencies in a rapidly changing and increasingly complex healthcare landscape. Adaptive expertise provides a conceptual framework to guide educators as they design instructional activities that can support students on their journey [...] Read more.

Pharmacy educators are grappling with concerns around curriculum overload and core pharmacist competencies in a rapidly changing and increasingly complex healthcare landscape. Adaptive expertise provides a conceptual framework to guide educators as they design instructional activities that can support students on their journey towards becoming pharmacists who can perform procedural tasks efficiently, as well as creatively handle new and difficult-to-anticipate problems that arise regularly in pharmacy practice. This article explores undergraduate pharmacy education through a cognitive psychology lens and foregrounds three instructional design strategies which support the development of adaptive expertise: (1) cognitive integration, (2) productive failure, and (3) inventing with contrasting cases. These three evidence-based strategies cultivate long-term learning and provide a practical mechanism to combat curriculum overload and backwards-facing assessments. Pharmacy education can encourage the development of procedural and conceptual knowledge and position pharmacy students to excel as they move into more complicated and ambiguous roles in our healthcare system. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

15 pages, 394 KiB

Open AccessArticle

Evaluation of Scholarship Motivators and Barriers for Non-Tenure-Track Faculty in a Department of Pharmacy Practice

by Cecilia Farias-Ruiz, Theresa Byrd, Eric J. MacLaughlin and Ronald G. Hall 2nd 2nd

Pharmacy 2023, 11(1), 31; https://doi.org/10.3390/pharmacy11010031 - 08 Feb 2023

Cited by 2 | Viewed by 1471

Abstract

The Accreditation Council for Pharmacy Education (ACPE) Standards 2016 set explicit expectations for faculty scholarship. However, many non-tenure-track faculty have struggled with the scholarship portion of the academic tripart mission of clinical practice, teaching, and scholarship. Therefore, we sought to identify themes regarding [...] Read more.

The Accreditation Council for Pharmacy Education (ACPE) Standards 2016 set explicit expectations for faculty scholarship. However, many non-tenure-track faculty have struggled with the scholarship portion of the academic tripart mission of clinical practice, teaching, and scholarship. Therefore, we sought to identify themes regarding the barriers, motivators, and potential solutions associated with non-tenure-track faculty scholarship. Four focus group interviews were held via videoconference during July 2021, which consisted of non-tenure-track faculty within the TTUHSC Jerry H. Hodge School of Pharmacy. Each focus group answered a standard script of questions that were evaluated for face validity over a 30–60 min session. Twenty-two non-tenure-track faculty members (47% response) participated in one of the four focus group interviews. The four common barriers were insufficient time, lack of acknowledgment, obscurity of scholarship expectations, and a lack of resources and support. Scholarship’s lasting impact on academia, students, and clinical practice was the one common motivator identified by the groups. The barriers identified were not unique to our faculty, despite the unique four-city structure of our program. Actions have continued to be taken to help address the barriers and potential solutions identified by the focus groups. In summary, our results echo that non-tenure-track faculty need more time and training to help them feel like they can meet institutional scholarship requirements. Full article

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9 pages, 223 KiB

Open AccessArticle

Student Pharmacists’ Perspectives Regarding a Virtually Delivered Research Proposal Course in the Doctor of Pharmacy Curriculum

by David R. Axon

Pharmacy 2023, 11(1), 30; https://doi.org/10.3390/pharmacy11010030 - 05 Feb 2023

Viewed by 1263

Abstract

This study aimed to assess third-year student pharmacists’ perspectives regarding a virtually delivered research proposal course. A 23-item questionnaire was distributed to third-year student pharmacists enrolled in a research proposal course over three weeks in April 2021. The questionnaire contained 15 Likert-scale items, [...] Read more.

This study aimed to assess third-year student pharmacists’ perspectives regarding a virtually delivered research proposal course. A 23-item questionnaire was distributed to third-year student pharmacists enrolled in a research proposal course over three weeks in April 2021. The questionnaire contained 15 Likert-scale items, seven descriptive items, and a free-text item for additional comments about the course. Items were summarized using descriptive statistics. Fifty-four student pharmacists (response rate = 40.9%) participated in the survey. The student pharmacists surveyed generally had a positive perception of the virtually delivered research proposal course with median scores ≥ 4 (indicating agreement) for the majority (13/15) of survey items. Students did not agree that there was no difference in their motivation to succeed in the virtual course versus an in-person course and did not agree that they were more likely to pursue a career that involves undertaking a research project. This study found that student pharmacists generally had a positive perception of a virtually delivered research proposal course. These findings offer some support for the provision of an online, virtually delivered research proposal course for student pharmacists. Further research with a larger sample of students from multiple pharmacy schools is needed to improve the generalizability of the results. Full article

(This article belongs to the Collection New Insights into Pharmacy Teaching and Learning during COVID-19)

19 pages, 284 KiB

Open AccessCase Report

Risk Factors for Rivaroxaban-Related Bleeding Events—Possible Role of Pharmacogenetics: Case Series

by Livija Šimičević, Ana Marija Slišković, Majda Vrkić Kirhmajer, Lana Ganoci, Hrvoje Holik, Jozefina Palić, Jure Samardžić and Tamara Božina

Pharmacy 2023, 11(1), 29; https://doi.org/10.3390/pharmacy11010029 - 05 Feb 2023

Cited by 2 | Viewed by 2267

Abstract

Non-vitamin K antagonist oral anticoagulants’ interindividual trough concentration variability affects efficacy and safety, especially in bleeding events. Rivaroxaban is metabolised via CYP3A4/5-, CYP2J2-, and CYP-independent mechanisms and is a substrate of two transporter proteins: ABCB1 (MDR1, P-glycoprotein) and ABCG2 (BCRP; breast-cancer-resistance protein). The [...] Read more.

Non-vitamin K antagonist oral anticoagulants’ interindividual trough concentration variability affects efficacy and safety, especially in bleeding events. Rivaroxaban is metabolised via CYP3A4/5-, CYP2J2-, and CYP-independent mechanisms and is a substrate of two transporter proteins: ABCB1 (MDR1, P-glycoprotein) and ABCG2 (BCRP; breast-cancer-resistance protein). The polymorphisms of these genes may possibly affect the pharmacokinetics of rivaroxaban and, consequently, its safety profile. Rivaroxaban variability may be associated with age, liver and kidney function, concomitant illness and therapy, and pharmacogenetic predisposition. This case series is the first, to our knowledge, that presents multiple risk factors for rivaroxaban-related bleeding (RRB) including age, renal function, concomitant diseases, concomitant treatment, and pharmacogenetic data. It presents patients with RRB, along with their complete clinical and pharmacogenetic data, as well as an evaluation of possible risk factors for RRB. Thirteen patients were carriers of ABCB1, ABCG2, CYP2J2, and/or CYP3A4/5 gene polymorphisms. Possible drug–drug interactions with increased bleeding risk were identified in nine patients. Six patients had eGFR <60 mL/min/1.73 m². Our data suggest a possible role of multiple factors and their interactions in predicting RRB; however, they also indicate the need for further comprehensive multidisciplinary research to enable safer use of this product based on a personalised approach. Full article

(This article belongs to the Special Issue Pharmaceutical Care Services in Pharmacy Practice)

10 pages, 220 KiB

Open AccessArticle

Pharmacy Technician Efficacies and Workforce Planning: A Consensus Building Study on Expanded Pharmacy Technician Roles

by Wesley Sparkmon, Marie Barnard, Meagen Rosenthal, Shane Desselle, Jordan Marie Ballou and Erin Holmes

Pharmacy 2023, 11(1), 28; https://doi.org/10.3390/pharmacy11010028 - 03 Feb 2023

Cited by 3 | Viewed by 1533

Abstract

The expansion of pharmacy technician scope of practice in recent years, though remaining somewhat contentious, has afforded multiple opportunities for pharmacy technicians to provide additional assistance within the pharmacy. However, much of the research examining this growth has focused on specific tasks, which [...] Read more.

The expansion of pharmacy technician scope of practice in recent years, though remaining somewhat contentious, has afforded multiple opportunities for pharmacy technicians to provide additional assistance within the pharmacy. However, much of the research examining this growth has focused on specific tasks, which were determined by either the researchers themselves or the respective state boards of pharmacy. This study aimed to gain a better understanding of what expanded tasks pharmacists believe technicians should have an increased role in performing. A consensus-building research methodology was used to survey practicing pharmacists to determine which tasks those pharmacists believed technicians should take an increased role in performing. This study used modified Delphi techniques to build consensus among panels of both hospital and community pharmacists regarding 20 setting-specific technician tasks. Results of our study indicated that both hospital and community pharmacists believed technicians should have an increased involvement in performing tasks which are more related to the operations of the pharmacy rather than tasks which are more clinical in nature. This finding illustrates a belief among a segment of pharmacists that expanded roles for technicians should do more to alleviate the managerial and operational burden placed on pharmacists, potentially allowing pharmacists to take on increased clinical roles. Full article

(This article belongs to the Special Issue The 10th Anniversary of Pharmacy—Advances in Pharmacy Education and Practice)

10 pages, 1029 KiB

Open AccessArticle

Efficacy of Lanthanum Carbonate and Sevelamer Carbonate as Phosphate Binders in Chronic Kidney Disease—A Comparative Clinical Study

by Parminder Nain, Narendra Nayak, Mary C. Maj, Rohit Kumar Singh, Jaspreet Kaur, Yujin Jeong, Sabyasachi Maity, Reetuparna Nath, Robert H. Hilgers, Shreya Nauhria and Samal Nauhria

Pharmacy 2023, 11(1), 27; https://doi.org/10.3390/pharmacy11010027 - 02 Feb 2023

Viewed by 3345

Abstract

(1) Background: Hyperphosphatemia is correlated with an increased rate of mortality and morbidity due to cardiovascular diseases in chronic kidney disease (CKD) patients. It can be improved by restricting dietary intake of phosphate and oral phosphate binders, such as lanthanum carbonate and sevelamer [...] Read more.

(1) Background: Hyperphosphatemia is correlated with an increased rate of mortality and morbidity due to cardiovascular diseases in chronic kidney disease (CKD) patients. It can be improved by restricting dietary intake of phosphate and oral phosphate binders, such as lanthanum carbonate and sevelamer carbonate. (2) Objective: To evaluate the clinical efficacy of sevelamer carbonate in comparison to lanthanum carbonate as phosphate binders for the treatment of hyperphosphatemia in CKD patients. (3) Methods: A randomized control comparative clinical study was conducted for one year on 150 CKD patients associated with hyperphosphatemia, divided into two groups, i.e., Group 1 (n = 75) treated with sevelamer carbonate 800 mg thrice daily and Group 2 (n = 75) treated with lanthanum carbonate 500 mg thrice daily. The patients were assessed at the time of enrollment in the study, after three months and after six months from baseline for different parameters, i.e., complete blood count, liver function tests, renal function tests, electrolytes, and serum phosphate level. (4) Results: 150 CKD patients aged 51–60 participated in the study. The mean age of patients was 54 ± 4.6 years, and males (55.71%) were more common than females (44.29%). Hypertension was the common comorbidity in both groups with chronic kidney disease. After six months of treatment, the mean serum phosphate level was significantly decreased from 8.31 ± 0.09 mg/dL to 5.11 ± 0.18 (38%) in Group 1 and from 8.79 ± 0.28 mg/dl to 4.02 ± 0.12 (54%; p < 0.05) in Group 2, respectively. In both groups, no significant difference was found in other parameters such as parathyroid hormone, calcium, uric acid, LFT, RFT, CBC, etc. (5) Conclusion: Lanthanum carbonate is more efficacious in lowering serum phosphate concentrations and effectively managing hyperphosphatemia as compared to sevelamer carbonate. Full article

(This article belongs to the Special Issue Pharmacists’ Role in the Management of Kidney Disease)

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6 pages, 614 KiB

Open AccessCommunication

Antimicrobial Stewardship Practices in a Subset of Community Pharmacies across the United States

by Yuman Lee and Nicole Bradley

Pharmacy 2023, 11(1), 26; https://doi.org/10.3390/pharmacy11010026 - 02 Feb 2023

Cited by 1 | Viewed by 1781

Abstract

Background: Antimicrobial stewardship in the community is essential as most antibiotic prescribing occurs in the outpatient setting. Pharmacists are recognized as co-leaders for implementing efforts to improve antimicrobial use. Objectives: the purpose of this study is to evaluate current antimicrobial stewardship practices in [...] Read more.

Background: Antimicrobial stewardship in the community is essential as most antibiotic prescribing occurs in the outpatient setting. Pharmacists are recognized as co-leaders for implementing efforts to improve antimicrobial use. Objectives: the purpose of this study is to evaluate current antimicrobial stewardship practices in community pharmacies across the United States and identify perceptions and challenges faced by community pharmacists. Methods: a survey based on the Center of Disease Control and Prevention (CDC) Core Elements of Outpatient Antibiotic Stewardship was created and distributed. Results: Sixty-one community pharmacists participated in the survey. The majority of pharmacists practiced in chain pharmacies. Based on the responses, a minority of pharmacies met the requirements of the CDC core elements: commitment (27.9%), action (24.6%), tracking and reporting (14.8%), and education and expertise (23% for providing pharmacist resources and 9.8% for providing patient resources). Regarding perception, 67.9% felt antimicrobial stewardship is important in the community and would participate in antimicrobial stewardship activities if the opportunity was provided (88.5%). Challenges faced by community pharmacists include the lack of time, staff, training, and technology support; pushback from prescribers and patients; and the lack of leadership, financial incentives, funding, and legal requirements. Conclusions: many challenges exist in community pharmacies inhibiting the full potential of pharmacists in implementing antimicrobial stewardship. Full article

(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship 2.0)

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26 pages, 782 KiB

Open AccessReview

Pharmacists’ Experiences, Perceptions, and Attitudes towards Suicide and Suicide Prevention: A Scoping Review

by Lujain Kamal and Sabrina Anne Jacob

Pharmacy 2023, 11(1), 25; https://doi.org/10.3390/pharmacy11010025 - 30 Jan 2023

Cited by 1 | Viewed by 1749

Abstract

It is important to understand pharmacists’ experiences, stigmas, trainings, and attitudes to suicide, as they can affect the way pharmacists interact with at-risk individuals and influence outcomes. The aim of this scoping review is to explore pharmacists’ willingness, experiences, and attitudes towards suicide [...] Read more.

It is important to understand pharmacists’ experiences, stigmas, trainings, and attitudes to suicide, as they can affect the way pharmacists interact with at-risk individuals and influence outcomes. The aim of this scoping review is to explore pharmacists’ willingness, experiences, and attitudes towards suicide prevention, as well as to examine the impact of suicide prevention training programs. A systemic search was conducted using the following databases: PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews. Studies included were from database inception to 31 August 2022, in English, with full-text available. A total of 13 studies were included. Training was a key factor which had an impact on pharmacists’ attitudes, experiences, and preparedness to participate in suicide care, with studies revealing the lack of training and the call for more training by pharmacists. Another key factor was closeness to mental illness, which also impacted pharmacists’ attitudes and experiences with at-risk patients. More research is needed worldwide to understand the different barriers and facilitators to pharmacist involvement in suicide care. Targeted training programs should also be developed to not only increase knowledge and competence, but also to address stigma related to suicide. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)

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19 pages, 1078 KiB

Open AccessReview

Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review

by Begashaw Melaku Gebresillassie, Kelly Howells and Diane Ashiru-Oredope

Pharmacy 2023, 11(1), 24; https://doi.org/10.3390/pharmacy11010024 - 30 Jan 2023

Cited by 2 | Viewed by 2010

Abstract

Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa’s Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore [...] Read more.

Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa’s Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore and map the available evidence on pharmacy professional-delivered public health interventions in Africa’s LMICs. Six electronic databases (Medline, Embase, International Pharmaceutical Abstract, PsycInfo, Maternity and Infant Care, and Cochrane database), relevant grey literature sources, key journals focused on African health issues, and libraries of relevant organizations were searched between January 2010 and December 2020. Studies were included if they reported public health interventions delivered by pharmacy professionals (pharmacists or pharmacy technicians) or their teams. The quality of the individual studies was assessed using an adapted grading system. Thirty-nine studies were included in this review. Pharmacy professionals delivered a wide range of public health interventions, with the most common themes being noncommunicable diseases, infectious diseases, sexual and reproductive health, antimicrobial resistance, and other health conditions, e.g., dental health, unused drugs or waste, minor ailments. The majority of the studies were classified as low-quality evidence. They were predominantly feasibility and acceptability studies conducted in a narrow study area, in a small number of LMICs in Africa, resulting in little evidence of service effectiveness, issues of broad generalizability of the findings, and sustainability. The major constraints to service provision were identified as a lack of training, public recognition, and supporting policies. Pharmacy professionals and their teams across LMICs in Africa have attempted to expand their practice in public health. However, the pace of the expansion has been slow and lacks strong evidence for its generalizability and sustainability. Future research is needed to improve the quality of evidence, which will subsequently serve as a foundation for policy reform, allowing pharmacy professionals to make significant contributions to the public health initiatives in the region. Full article

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14 pages, 293 KiB

Open AccessArticle

Metabolic Syndrome in Adults Receiving Clozapine; The Need for Pharmacist Support

by Kathleen Hurley, Sinead O’Brien, Ciaran Halleran, Derina Byrne, Erin Foley, Jessica Cunningham, Fionnuala Hoctor and Laura J. Sahm

Pharmacy 2023, 11(1), 23; https://doi.org/10.3390/pharmacy11010023 - 24 Jan 2023

Cited by 1 | Viewed by 3352

Abstract

People who are diagnosed with treatment resistant schizophrenia (TRS) are likely to have clozapine as a therapeutic management option. There is a high prevalence of metabolic syndrome in patients receiving clozapine. To mitigate against this, monitoring of weight, waist circumference, lipid profile, glycated [...] Read more.

People who are diagnosed with treatment resistant schizophrenia (TRS) are likely to have clozapine as a therapeutic management option. There is a high prevalence of metabolic syndrome in patients receiving clozapine. To mitigate against this, monitoring of weight, waist circumference, lipid profile, glycated haemoglobin (HbA1c), fasting blood glucose (FBG) and blood pressure (BP) is recommended. The aims of this study were to examine the prevalence of metabolic syndrome and whether any variables were correlated with its development, and to highlight any opportunities for the pharmacist to offer support. This study was conducted in an urban hospital and its associated Clozapine Clinic in Cork, Ireland. A retrospective audit assessed the prevalence of metabolic syndrome using the International Diabetes Federation (IDF) criteria. Patients were eligible for inclusion if they were aged 18 years or more, registered with the Clozapine Clinic, and had the capacity to provide informed consent. All data were entered into Microsoft^® Excel ^® (Microsoft Corporation) and further statistical analysis was undertaken using R, t-tests, Fisher’s Exact Test and Mann–Whitney U tests as appropriate, and p ≤ 0.05 was considered statistically significant. Of 145 patients (32% female; mean age (SD) 45.3 (±11.7) years; 86.2% living independently/in family home), nearly two thirds (n = 86, 59.3%) were diagnosed with metabolic syndrome. The mean age of participants with metabolic syndrome was 44.4 years (SD = 10.8), similar to the 46.6 years (SD = 12.8) for those without. Variables that were identified to be statistically significantly associated with metabolic syndrome included waist circumference, weight, triglycerides, high density lipoprotein-cholesterol (HDL-C), BP, FBG and HbA1c. The high incidence of metabolic syndrome in this patient population highlights the need for continued physical health monitoring of these patients to ameliorate the risk of developing metabolic syndrome. Full article

(This article belongs to the Special Issue Addiction and Mental Health in Pharmacy)

17 pages, 1768 KiB

Open AccessArticle

Characterizing Pharmacist Perspectives on Utilizing a Personalized Family Medication Safety Plan for Opioid Education with Adolescents and Parents

by Olufunmilola Abraham, Joanne Peters and Kourtney A. Peterson

Pharmacy 2023, 11(1), 22; https://doi.org/10.3390/pharmacy11010022 - 24 Jan 2023

Cited by 3 | Viewed by 2598

Abstract

Background: Exposure to prescription opioids during adolescence is associated with an increased risk of future opioid misuse. The pervasive and growing impact of the opioid epidemic requires evidence-based, co-designed interventions targeted at adolescents. MedSMA℞T Families is an intervention tailored to educate adolescents and [...] Read more.

Background: Exposure to prescription opioids during adolescence is associated with an increased risk of future opioid misuse. The pervasive and growing impact of the opioid epidemic requires evidence-based, co-designed interventions targeted at adolescents. MedSMA℞T Families is an intervention tailored to educate adolescents and their families about opioid misuse prevention and consists of two parts: the MedSMA℞T: Adventures in PharmaCity videogame and the family medication safety plan (FMSP). Objective: This study sought to explore pharmacists’ perceptions of using the family medication safety plan to facilitate opioid education among parents and their adolescents. The purpose of this project was to also gather information for iterative adaptations to improve implementation and dissemination of the FMSP in pharmacy settings. Methods: Pharmacists were recruited from Pharmacy Practice Enhancement and Action Research Link (PearlRx) and the Pharmacy Society of Wisconsin (PSW). Twenty-one pharmacist interviews were conducted between September 2021 and March 2022. Consenting pharmacists reviewed the FMSP. Then, semi-structured interviews were conducted, recorded, and transcribed. Inductive thematic analyses were performed using NVivo software. Results: Four prevalent themes emerged: (1) the purpose of FMSP as a communication tool, (2) instructions to clarify how to use FMSP, (3) barriers to using FMSP, and (4) suggestions to improve FMSP format. Most pharmacists described the FMSP as a tool to encourage interactive opioid conversations between adolescents, families, and pharmacists. Pharmacists suggested creating multiple customizable formats and incorporating instructions on how to use the FMSP. Conclusions: Pharmacists noted that the FMSP was an interactive and engaging communication tool to tailor opioid consultations with adolescents and their families. Patients might use the FMSP as a visual cue to help think of what question(s) they should ask pharmacists. Pharmacists stated that the FMSP could facilitate tailored opioid safety communication and medication consultations. Insights will inform future medication misuse prevention interventions as well as adaptation. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)

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19 pages, 3627 KiB

Open AccessArticle

Pharmacists’ Satisfaction with Work and Working Conditions in New Zealand—An Updated Survey and a Comparison to Canada

by Sharon Jessie Lam, Larry D. Lynd and Carlo A. Marra

Pharmacy 2023, 11(1), 21; https://doi.org/10.3390/pharmacy11010021 - 23 Jan 2023

Cited by 2 | Viewed by 1999

Abstract

Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. Aim: To evaluate pharmacists’ perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and [...] Read more.

Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. Aim: To evaluate pharmacists’ perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and compare results with Canadian studies and historic NZ data. Methods: A cross-sectional online survey was distributed to registered pharmacists in NZ. The survey included demographics, work satisfaction, psychological distress, and perceptions of their working conditions (six statements with agreement rated on a 5-point Likert scale). Comparisons were made with surveys from Canada and NZ. Chi-square, t-tests, and non-parametric statistics were used to make comparisons. Results: The response rate was 24.7% (694/2815) with 73.1% practicing in a community pharmacy (45.8% independent, 27.3% chains). Pharmacists disagreed on having adequate time for breaks and tasks, while the majority contemplated leaving the profession and/or not repeating their careers again if given the choice. Working longer hours and processing more prescriptions per day were predictive factors for poorer job satisfaction. More NZ pharmacists perceived their work environment to be conducive to safe and effective primary care (57% vs. 47%, p < 0.001) and reported that they had enough staff (45% vs. 32%, p = 0.002) as compared to Canadian pharmacists. Pharmacists’ job satisfaction and psychological distress have not improved compared to the assessment 20 years prior. Conclusions: NZ pharmacists perceive working conditions to be sub-optimal yet had higher satisfaction than their Canadian counterparts. Work dissatisfaction and psychological distress are high and have not improved over the last two decades. Full article

(This article belongs to the Special Issue Community-Based Pharmacy Practice Quality Improvement and Research)

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5 pages, 253 KiB

Open AccessEditorial

Acknowledgment to the Reviewers of Pharmacy in 2022

by Pharmacy Editorial Office

Pharmacy 2023, 11(1), 20; https://doi.org/10.3390/pharmacy11010020 - 20 Jan 2023

Viewed by 1221

Abstract

High-quality academic publishing is built on rigorous peer review [...] Full article

10 pages, 945 KiB

Open AccessArticle

Quality of Life Assessment in Patients Using Benzodiazepines during the COVID-19 Pandemic in a Community Pharmacy Using EuroQol 5D-3L

by Daida Alberto Armas, Juan Ramón Santana Ayala, Yanira Román Castillo, Arturo Hardisson de la Torre and Carmen Rubio Armendáriz

Pharmacy 2023, 11(1), 19; https://doi.org/10.3390/pharmacy11010019 - 18 Jan 2023

Cited by 1 | Viewed by 1290

Abstract

Users of benzodiazepines (BZDs) should have their quality of life monitored to minimize the risks associated with long-term treatments. The aim of this study is to use the EuroQol 5D-3L to analyze the quality of life of 127 patients under treatment with BZDs [...] Read more.

Users of benzodiazepines (BZDs) should have their quality of life monitored to minimize the risks associated with long-term treatments. The aim of this study is to use the EuroQol 5D-3L to analyze the quality of life of 127 patients under treatment with BZDs during the COVID-19 pandemic. The results show that lorazepam comprises 25.49% of all dispensing requests, and that the mean duration of BZDs treatments is four years (range: 0.3–25). When rating their general health status, BZDs users reported 59.29 points out of 100. Thirty-two percent of patients reported mobility problems; 16.5% reported having a lot of pain or discomfort despite being treated with BZDs, and 16.54% used a BZD together with an opioid analgesic. The EuroQol 5D-3L dimension “anxiety/depression” showed that, despite the use of BZDs, 48.2% of the patients reported being moderately anxious or depressed and 13.4% described themselves as very anxious or depressed. Nevertheless, 37.8% of BZDs users were identified as potential candidates to follow a BZD deprescription plan. In conclusion, BZDs users showed a low quality of life during the COVID-19 pandemic. Older patients and females have been identified as groups of patients that could benefit from integrating the use of the EuroQol 5D-3L instrument into the protocols of the pharmaceutical care follow up. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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19 pages, 1306 KiB

Open AccessArticle

Exploring the Value of Real-Time Medication Adherence Monitoring: A Qualitative Study

by Sadaf Faisal, Jessica Ivo, Sarah Abu Fadaleh and Tejal Patel

Pharmacy 2023, 11(1), 18; https://doi.org/10.3390/pharmacy11010018 - 18 Jan 2023

Cited by 2 | Viewed by 2374

Abstract

Smart adherence products enable the monitoring of medication intake in real-time. However, the value of real-time medication intake monitoring to different stakeholders such as patients, their caregivers, clinicians, and insurers is not elucidated. The aim of this study was to explore the value [...] Read more.

Smart adherence products enable the monitoring of medication intake in real-time. However, the value of real-time medication intake monitoring to different stakeholders such as patients, their caregivers, clinicians, and insurers is not elucidated. The aim of this study was to explore the value different stakeholders place on the availability of smart adherence products and access to real-time medication intake data. A qualitative study design using semi-structured one-on-one virtual interviews was utilized. Schwartz’s theory of values provided the foundation for the interview questions, data were analyzed using Braun and Clark’s thematic analysis framework, and findings were mapped back to the constructs of Schwartz’s theory of values. A total of 31 interviews with patients, caregivers, healthcare providers, and representatives of private or public insurance providers were conducted. Three themes and ten subthemes were identified. Themes included perceptions of integrating smart medication adherence technologies and real-time monitoring, technology adoption factors and data management. Stakeholders place different values based on the motivators and goals that can drive product use for daily medication management. Stakeholders valued the availability of real-time medication taking data that allow clinicians to make timely data-driven recommendations to their patients that may improve medication management for patients and reduce the caregiver burden. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)

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16 pages, 923 KiB

Open AccessReview

Inequity of Access: Scoping the Barriers to Assisted Reproductive Technologies

by Amanda Mackay, Selina Taylor and Beverley Glass

Pharmacy 2023, 11(1), 17; https://doi.org/10.3390/pharmacy11010017 - 16 Jan 2023

Cited by 5 | Viewed by 3116

Abstract

Infertility impacts millions of people of reproductive age worldwide, with approximately 10–15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility [...] Read more.

Infertility impacts millions of people of reproductive age worldwide, with approximately 10–15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility and include procedures such as in vitro fertilisation. This scoping review aims to explore the barriers to accessing assisted reproductive technologies to highlight a potential role for the pharmacist in addressing these barriers. Five databases, including CINAHL, Emcare, Medline, Scopus, and Web of Science, were searched using keywords that resulted in 19 studies that explored barriers to initially accessing or continuing ART. Studies identified more than one barrier to accessing ART, with the most mentioned barrier being the geographic location of the patient, with others themed as psychological, financial, minority groups, educational level, and the age of the patient. Recommendations were made to address barriers to accessing ART, which included changes to government regulations to increase health education and promotion of infertility. Pharmacists’ accessibility, even in geographically remote locations, places them in an ideal position to address many of the challenges experienced by people accessing infertility treatment to improve outcomes for these people. Full article

(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)

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9 pages, 787 KiB

Open AccessArticle

Impact of Different Attitudes toward Face-to-Face and Online Classes on Learning Outcomes in Japan

by Mai Aoe, Seiji Esaki, Masahiro Ikejiri, Takuya Ito, Katsuhito Nagai, Yasutoshi Hatsuda, Yoshimi Hirokawa, Tomohisa Yasuhara, Takehiko Kenzaka and Toru Nishinaka

Pharmacy 2023, 11(1), 16; https://doi.org/10.3390/pharmacy11010016 - 13 Jan 2023

Cited by 1 | Viewed by 2012

Abstract

During the coronavirus disease 2019 (COVID-19) pandemic, online-based learning has become mainstream in many countries, and its learning outcomes have been evaluated. However, various studies have shown that online-based learning needs to be optimized in the future, and the number of reports for [...] Read more.

During the coronavirus disease 2019 (COVID-19) pandemic, online-based learning has become mainstream in many countries, and its learning outcomes have been evaluated. However, various studies have shown that online-based learning needs to be optimized in the future, and the number of reports for this purpose is currently not sufficient. The purpose in this study was to determine the relationship between academic performance and attitudes toward face-to-face and remote formats among Japanese pharmacy students enrolled in a course designed for knowledge acquisition. A combination of face-to-face and remote formats was used in a practice course for sixth-year pharmacy students, designed to improve academic performance through knowledge acquisition. To evaluate learning outcomes, we used a questionnaire that was administered to the course participants and the results of examinations conducted before and after the course. Online-oriented and face-to-face-oriented groups differed in their attitudes toward the ease of asking questions of faculty and communicating with the faculty members and classmates in each format. In a knowledge acquisition course for Japanese pharmacy students, the study revealed that the same academic outcomes were achieved, regardless of the students’ own perceptions of their aptitude for face-to-face or remote learning style. Full article

(This article belongs to the Collection New Insights into Pharmacy Teaching and Learning during COVID-19)

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16 pages, 1104 KiB

Open AccessSystematic Review

Guidance on the Conduct of Clinical Research within OECD Countries during the Early Stages of the COVID-19 Pandemic: A Systematic Review

by Renu Bhutkar, Jack C. Collins, Claire L. O’Reilly and Sarira El-Den

Pharmacy 2023, 11(1), 15; https://doi.org/10.3390/pharmacy11010015 - 12 Jan 2023

Cited by 1 | Viewed by 1522

Abstract

Background: In response to the COVID-19 pandemic, member countries of the Organisation for Economic Co-operation and Development (OECD) rapidly published guidance regarding the conduct of clinical research. A systematic review was conducted to explore the recommendations issued in relation to the commencement, continuation [...] Read more.

Background: In response to the COVID-19 pandemic, member countries of the Organisation for Economic Co-operation and Development (OECD) rapidly published guidance regarding the conduct of clinical research. A systematic review was conducted to explore the recommendations issued in relation to the commencement, continuation and termination of clinical research during the early phases of the pandemic. Methods: Searches consisting of the terms “COVID-19”, “clinical research”, and “guidance”, were conducted in PubMed, Embase, MEDLINE, Trip, Guidelines International Network, and Google in April–May 2021 (up to 4 May 2021). Data were extracted from guidance published from OECD member countries and mapped to inductively-developed categories. Results: 9419 references were systematically screened, resulting in the inclusion of 46 publications from 27 OECD countries. Thirty-three sources made recommendations regarding monitoring, risk-benefit assessments and information technology. There was limited specific recommendations made in relation to personal protective equipment (PPE) in the included guidance. Findings demonstrate that guidance differed by publication date demonstrating the rapidly evolving environment within which research was conducted. Importantly, many organisations opted to endorse existing guidance published by the United States’ Food and Drug Administration and the European Medicines Agency rather than develop their own recommendations. Conclusions: Given the rapidly evolving nature of the pandemic, particularly in the early stages, findings demonstrate the global response in relation to clinical research conduct, thereby providing important insights for future public health emergencies. Full article

(This article belongs to the Special Issue Pharmacy Reviews in 2022)

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17 pages, 318 KiB

Open AccessArticle

Development of a Positive Psychology Well-Being Intervention in a Community Pharmacy Setting

by Jennifer Louise Ward, Alison Sparkes, Marie Ricketts, Paul Hewlett, Amie-Louise Prior, Britt Hallingberg and Delyth Higman James

Pharmacy 2023, 11(1), 14; https://doi.org/10.3390/pharmacy11010014 - 11 Jan 2023

Cited by 1 | Viewed by 1693

Abstract

Background: Community pharmacies are well-placed to deliver well-being interventions; however, to date, nothing has been produced specifically for this setting. The aim of this study was to develop a positive psychology intervention suitable for a community pharmacy setting with the goal of [...] Read more.

Background: Community pharmacies are well-placed to deliver well-being interventions; however, to date, nothing has been produced specifically for this setting. The aim of this study was to develop a positive psychology intervention suitable for a community pharmacy setting with the goal of increasing the well-being of community members. Methods: Intervention development consisted of three steps: Step 1—identify the evidence-base and well-being model to underpin the basis of the intervention (Version 1); Step 2—model the intervention and gather user feedback to produce Version 2, and Step 3—revisit the evidence-base and refine the intervention to produce Version 3. Results: Findings from nine studies (seven RCTs, one cross-sectional, one N-1 design plus user feedback were applied to model a 6-week ‘Prescribing Happiness (P-Hap)’ intervention, underpinned by the PERMA model plus four other components from the positive psychology literature (Three Good Things, Utilising Your Signature Strengths in New Ways, Best Possible Selves and Character Strengths). A PERMA-based diary was designed to be completed 3 days a week as part of the intervention. Conclusions: This work is an important development which will direct the future implementation of interventions to support well-being in this novel setting. The next stage is to gain the perspectives of external stakeholders on the feasibility of delivering the P-Hap for its adoption into community pharmacy services in the future. Full article

26 pages, 2292 KiB

Open AccessArticle

Vancomycin Flight Simulator: A Team-Based Learning Exercise

by Nicholas W. Carris, Jaclyn D. Cole, Ann Snyder Franklin and Katlynd M. Sunjic

Pharmacy 2023, 11(1), 13; https://doi.org/10.3390/pharmacy11010013 - 11 Jan 2023

Viewed by 2242

Abstract

BACKGROUND: Team-based learning (TBL) encourages learners to think critically to solve problems they will face in practice. Pharmacokinetic dosing and monitoring are complex skills requiring the application of learned knowledge. The study sought to assess the impact of a TBL, vancomycin dosing activity [...] Read more.

BACKGROUND: Team-based learning (TBL) encourages learners to think critically to solve problems they will face in practice. Pharmacokinetic dosing and monitoring are complex skills requiring the application of learned knowledge. The study sought to assess the impact of a TBL, vancomycin dosing activity in a Pharmaceutical Skills IV course measured with exam question performance during the second professional year. METHODS: This retrospective, descriptive study relates a TBL activity, assigned to 85 students, which included an individual student pre-preparation quiz, assigned readings, in-class individual and team-based readiness assessments, small group application of a vancomycin patient case, and group discussion/feedback on clinical decisions with supportive reasoning. The class year before and class year of the TBL implementation were compared using the total percentage of points possible earned by the class years, by topic. To minimize potential confounding, the primary outcome was the change in topic performance by the rank difficulty (e.g., the largest possible benefit being the hardest topic becoming the easiest with no other variation in topic rank difficulty). RESULTS: In the year of implementation, the mean individual readiness assurance test (IRAT) performance was 5.5 ± 1.88 (10 points possible, 55%). The mean team readiness assurance test (TRAT) performance was 10 of 10 points possible (100%). The class exam item performance in the year before (n = 101) and year of (n = 84) TBL implementation showed a general decline in exam scores. However, the vancomycin topic difficultly went from fifth easiest, to second easiest, with less than 1% change in raw score. CONCLUSIONS: Implementation of a pharmacokinetic TBL activity appeared to moderately support the students’ vancomycin learning. Additional studies are warranted on APPE readiness and performance. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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10 pages, 265 KiB

Open AccessArticle

Patients’ Perception in Japan Regarding the Appropriate Use of Antimicrobial Drugs: A Questionnaire Survey

by Hikaru Matsui, Shinya Abe, Taku Obara, Tasuku Sato, Shouko Yoshimachi and Kazuhiko Nomura

Pharmacy 2023, 11(1), 12; https://doi.org/10.3390/pharmacy11010012 - 09 Jan 2023

Viewed by 1794

Abstract

This study sought to investigate the actual status of awareness regarding the appropriate use of antimicrobial drugs among patients of a wide age range who visit dispensing pharmacies in order to explore more effective intervention methods for improving awareness of the appropriate use [...] Read more.

This study sought to investigate the actual status of awareness regarding the appropriate use of antimicrobial drugs among patients of a wide age range who visit dispensing pharmacies in order to explore more effective intervention methods for improving awareness of the appropriate use of antimicrobial drugs for patients. A questionnaire survey was conducted with 1301 patients who visited different Tsuruha Holdings-operated pharmacies between 1 September 2018 and 31 October 2018. Using multiple regression analysis, we calculated scores based on the patients’ answers regarding their knowledge of antimicrobial drugs and antimicrobial resistance and examined factors related to these scores. Of the 1185 respondents who successfully completed the survey (mean age ± SD, 52.5 ± 18.2 years), 37.2% were 60 years old or older, 13.2% had never or were not sure whether they had taken antimicrobial drugs, and 73.2% did not understand the problem of antimicrobial resistance. Older age, the non-usage of drugs and self-reports of the “lack” of knowledge of antimicrobial resistance were identified as the group that needs education regarding the appropriate use of antimicrobial drugs. Intervention studies should be conducted to examine the efficacy of interventions based on these factors. Full article

(This article belongs to the Special Issue Pharmacist-Led Antimicrobial Stewardship 2.0)

8 pages, 534 KiB

Open AccessArticle

A Pilot Study Exploring the Impact of a Primary Medication Non-Adherence Intervention among Four Chronic Disease States in One Regional Division of a Large Community Pharmacy Chain

by Danya H. Wilson, Leanne J. Rein, Michele Fountain, Andrea Brookhart, Daniel Atchley and Kenneth C. Hohmeier

Pharmacy 2023, 11(1), 11; https://doi.org/10.3390/pharmacy11010011 - 06 Jan 2023

Cited by 3 | Viewed by 1822

Abstract

There is a 12.2% rate of primary medication non-adherence (PMN) among community pharmacy patients. The Pharmacy Quality Alliance (PQA) has developed a standardized definition of PMN to aid stakeholders in addressing PMN. However, little research had been conducted to date on how to [...] Read more.

There is a 12.2% rate of primary medication non-adherence (PMN) among community pharmacy patients. The Pharmacy Quality Alliance (PQA) has developed a standardized definition of PMN to aid stakeholders in addressing PMN. However, little research had been conducted to date on how to address PMN. The objective of the study was to determine the impact of an evidence-based adherence intervention program on PMN rates among four chronic disease states and to identify and characterize factors associated with PMN. Patients at risk of PMN were randomized into a control or intervention group. Those in the intervention group received a live call from a pharmacist to determine reason for and to discuss solutions to overcome PMN. Subjects included adult patients with newly prescribed medications used to treat diabetes, hypertension, hyperlipidemia, and/or chronic obstructive pulmonary disease (COPD). This study occurred in six pharmacies across one regional division of a national supermarket, community pharmacy chain. Prescriptions were considered newly initiated when the same drug, or its generic equivalent, had not been filled during the preceding 180 days. Prescriptions were considered at risk if they had not been obtained by day 7 of it being filled. Prescriptions were considered PMN if the patient had not obtained it, or an appropriate alternative, within 30 days after it was prescribed. During the 4-month intervention period, 203 prescriptions were included in the study with 94 in the intervention group and 109 in the control group. There was a 9% difference (p = 0.193) in PMN between the intervention group (44 patients, 47%) and the control group (61 patients, 56%). The therapeutic class most at risk of PMN was statins (34%). Cost (26%) and confusion/miscommunication (15%) were the most common reasons for PMN within the intervention group. Among the four chronic disease states studied, the intervention had the largest impact on hypertension. The PMN intervention did not significantly decrease PMN rates. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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12 pages, 285 KiB

Open AccessReview

Pharmacovigilance in High-Income Countries: Current Developments and a Review of Literature

by Muhammad Akhtar Abbas Khan, Saima Hamid and Zaheer-Ud-Din Babar

Pharmacy 2023, 11(1), 10; https://doi.org/10.3390/pharmacy11010010 - 06 Jan 2023

Cited by 3 | Viewed by 3650

Abstract

The world bank has classified 80 economies based on their Gross National Income (GNI) per capita as High-Income. European Medicines Agency (EMA), Food and Drug Administration (FDA), and Pharmaceuticals and Medical Devices Agency (PMDA) are the major regulatory stakeholders driving global pharmacovigilance regulations. [...] Read more.

The world bank has classified 80 economies based on their Gross National Income (GNI) per capita as High-Income. European Medicines Agency (EMA), Food and Drug Administration (FDA), and Pharmaceuticals and Medical Devices Agency (PMDA) are the major regulatory stakeholders driving global pharmacovigilance regulations. The purpose of this article is to describe pharmacovigilance systems and processes in high-income countries, particularly those that are also members of the International Conference on Harmonization (ICH). All high-income countries are members of the WHO PIDM. The income level of a country has a direct relationship with medicine safety measures. All ten pioneering members of the Uppsala monitoring centre are from high-income countries and were the first responders after the thalidomide tragedy by making drug evaluation committees, introducing the ADR reporting forms and taking safety measures. Despite access to the VigiBase, some countries have separate databases for managing and analyzing data like Canada Vigilance online database, FDA Adverse Event Reporting System, the French pharmacovigilance database and European Union’s system Eudravigilance. All high-income countries have robust pharmacovigilance systems. USFDA and EMA are the world leaders in the field of pharmacovigilance. Most high-income countries follow EMA guidelines. Medicine safety is directly influenced by a country’s income level. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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Pharmacy, Volume 11, Issue 1 (February 2023) – 39 articles

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