Pharmacy

13 pages, 1023 KiB

Open AccessReview

Medication Reviews and Clinical Outcomes in Persons with Dementia: A Scoping Review

by Rishabh Sharma, Neil Mahajan, Sarah Abu Fadaleh, Hawa Patel, Jessica Ivo, Sadaf Faisal, Feng Chang, Linda Lee and Tejal Patel

Pharmacy 2023, 11(5), 168; https://doi.org/10.3390/pharmacy11050168 - 20 Oct 2023

Viewed by 1724

Abstract

Persons diagnosed with dementia are often faced with challenges related to polypharmacy and inappropriate medication use and could benefit from regular medication reviews. However, the benefit of such reviews has not been examined in this population. Therefore, the current scoping review was designed [...] Read more.

Persons diagnosed with dementia are often faced with challenges related to polypharmacy and inappropriate medication use and could benefit from regular medication reviews. However, the benefit of such reviews has not been examined in this population. Therefore, the current scoping review was designed to identify the gaps in the current knowledge regarding the impact of medication reviews on the clinical outcomes in older adults with dementia. Relevant studies were identified by searching three databases (Ovid MEDLINE, Ovid EMBASE, and Scopus) from inception to January 2022 with a combination of keywords and medical subject headings. After the removal of duplicates and ineligible articles, 22 publications of the initial 8346 were included in this review. A total of 57 outcomes were identified, including those pertaining to the evaluation of medication use (n = 17), drug-related interventions (n = 11), drug-related problems (n = 10), dementia-related behavioral symptoms (n = 8), cost-effectiveness (n = 2), drug-related hospital admissions (n = 1), as well as outcomes classified as other (n = 7). Gaps identified through this scoping review included the paucity of studies measuring the impact of medication reviews on the medication management capacity and medication adherence, quality of life, and mortality. Full article

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

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15 pages, 663 KiB

Open AccessReview

Adult Patients with Difficulty Swallowing Oral Dosage Forms: A Systematic Review of the Quantitative Literature

by Anne Harnett, Stephen Byrne, Jennifer O’Connor, Declan Lyons and Laura J. Sahm

Pharmacy 2023, 11(5), 167; https://doi.org/10.3390/pharmacy11050167 - 19 Oct 2023

Cited by 3 | Viewed by 2047

Abstract

The aim of this systematic review was to identify and critically appraise the available evidence regarding solid oral dosage forms (SODFs), e.g., tablets, and challenges regarding the oral administration of medicine to inpatients in a variety of healthcare settings such as (1) hospitals, [...] Read more.

The aim of this systematic review was to identify and critically appraise the available evidence regarding solid oral dosage forms (SODFs), e.g., tablets, and challenges regarding the oral administration of medicine to inpatients in a variety of healthcare settings such as (1) hospitals, (2) nursing homes and (3) long-term stay units (LTSUs). A literature search was undertaken in September 2021 and repeated in June 2023 in the following databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, The Cochrane Library, PsycINFO and ProQuest. A Microsoft Excel^® spreadsheet was devised to collate the following data from each eligible study: study author and year, country, number of participants, title, duration (follow-up period), study design, inclusion and exclusion criteria, method and data collection, relevant outcomes, and key findings. A total of 3023 records were identified, with 12 articles being included in the final systematic review. Seven of the twelve studies reported on the prevalence of difficulties swallowing SODFs, which varied from 10–34.2%. Nine of the twelve studies reported the methods used to manipulate SODFs, with the most reported method being tablet crushing. Given the prevalence of swallowing difficulties and the subsequent crushing of medicines in response to this, it is evident that concerns should be raised regarding the potential for a medication administration error to occur. Full article

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

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10 pages, 839 KiB

Open AccessArticle

Exploring Drug Shortages in the United Kingdom

by Mohamed Obiedalla, Nilesh Patel and Parastou Donyai

Pharmacy 2023, 11(5), 166; https://doi.org/10.3390/pharmacy11050166 - 18 Oct 2023

Cited by 1 | Viewed by 1908

Abstract

Drugs can become short in supply for many reasons including increased demand and reduced production. Drug shortages have the potential to impact patients and pharmacists. This study aimed to highlight the challenges pharmacists face and the constraints of how they manage drug shortages. [...] Read more.

Drugs can become short in supply for many reasons including increased demand and reduced production. Drug shortages have the potential to impact patients and pharmacists. This study aimed to highlight the challenges pharmacists face and the constraints of how they manage drug shortages. An online survey was designed with its link distributed electronically to community pharmacists in the UK with the assistance of pharmacy organizations during the period from September to December 2021. Survey data were analysed using descriptive statistics. A total of 83% of the respondents (n= 100) were experiencing drug shortages three or more times per week, and more than 70% of these spent 1–3 h per week dealing with them. A total of 93% of the respondents indicated that the issue of drug shortages was a problem for them, and 61% reported that it has worsened since the start of the pandemic. In addition, 65% of the respondents believed that drug shortages had had an impact on patient care. Drug shortages were shown to impact on the pharmacists’ workloads with a potential to affect the quality of patient care. There was a variation between how pharmacists dealt with drug shortages, which needs to be explored further with the reasons behind it. Full article

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2 pages, 169 KiB

Open AccessCorrection

Correction: Amin et al. Evaluation of Medication Prescribing Applications Available in Australia. Pharmacy 2023, 11, 49

by Riya Amin, Melissa Cato, Sasha Rahavi, Kristin Tran, Kenneth Lee, Elton Lobo, Deanna Mill, Amy Page and Sandra Salter

Pharmacy 2023, 11(5), 165; https://doi.org/10.3390/pharmacy11050165 - 13 Oct 2023

Viewed by 986

Abstract

The authors wish to make the following corrections to this paper [...] Full article

11 pages, 273 KiB

Open AccessArticle

Identifying Prescription-Opioid-Related Risks Using Prescription Drug Monitoring Programs’ Algorithms and Clinical Screening Tools

by Louisa Picco, Monica Jung, Helena Cangadis-Douglass, Tina Lam and Suzanne Nielsen

Pharmacy 2023, 11(5), 164; https://doi.org/10.3390/pharmacy11050164 - 13 Oct 2023

Viewed by 1466

Abstract

Background: Pharmacists adopt various approaches to identifying prescription-opioid-related risks and harms, including prescription drug monitoring programs (PDMPs) and clinical screening tools. This study aims to compare ‘at-risk’ patients according to the published Australian PDMP algorithms with the validated Routine Opioid Outcome Monitoring (ROOM) [...] Read more.

Background: Pharmacists adopt various approaches to identifying prescription-opioid-related risks and harms, including prescription drug monitoring programs (PDMPs) and clinical screening tools. This study aims to compare ‘at-risk’ patients according to the published Australian PDMP algorithms with the validated Routine Opioid Outcome Monitoring (ROOM) clinical screening tool. Methods: Data were used from an implementation study amongst people who had been prescribed regular opioids. We examined the results from ROOM and the patients’ dispensing history over the previous 90 days. A chi-squared test was used to examine the association between risk according to (i) a PDMP alert and a clinical risk per ROOM; (ii) a PDMP alert and positive screening for opioid use disorder; and (iii) a PDMP ‘high-dose’ alert (average of >100 mg OME/day in the past 90 days) and any ROOM-validated risk. Results: No significant associations were found between being ‘at-risk’ according to any of the PDMP alerts and clinical risk as identified via the ROOM tool (x² = 0.094, p = 0.759). There was only minimal overlap between those identified as ‘at-risk’ via PDMP alerts and those meeting the clinical risk indicators; most patients who were ‘at-risk’ of clinical opioid-related risk factors were not identified as ‘at-risk’ based on PDMP alerts. Conclusions: PDMP alerts were not predictive of clinical risk (as per the ROOM tool), as many people with well-established clinical risks would not receive a PDMP alert. Pharmacists should be aware that PDMPs are limited to identifying medication-related risks which are derived using algorithms; therefore, augmenting PDMP information with clinical screening tools can help create a more detailed narrative of patients’ opioid-related risks. Full article

(This article belongs to the Special Issue Pharmacists’ Role in Reducing Problematic Opioid Use)

11 pages, 273 KiB

Open AccessArticle

Empowering Sustainable Growth and Workforce: Unveiling Challenges and Strategies for Retaining Community Pharmacists in Malaysia

by Khim Lynn Ooi, Kingston Rajiah, Mari Kannan Maharajan and Pe Sei Wong

Pharmacy 2023, 11(5), 163; https://doi.org/10.3390/pharmacy11050163 - 12 Oct 2023

Cited by 1 | Viewed by 1571

Abstract

Background: Community pharmacists face challenges in job retention due to compensation, work–life balance, and career growth concerns. With pharmacists’ evolving roles in healthcare, retaining them becomes crucial for maintaining quality service. Addressing their needs is vital for a skilled healthcare workforce. This study [...] Read more.

Background: Community pharmacists face challenges in job retention due to compensation, work–life balance, and career growth concerns. With pharmacists’ evolving roles in healthcare, retaining them becomes crucial for maintaining quality service. Addressing their needs is vital for a skilled healthcare workforce. This study evaluates job retention among community pharmacists, considering various workforce management domains and demographic characteristics. Materials and Methods: A cross-sectional study was employed with a self-administered questionnaire among community pharmacists in Kuala Lumpur and Selangor, Malaysia. Spearman’s correlations and ordinal logistic regression analysed job retention relationships with workforce domains and predicted the demographic characteristics. Results: A total of 414 participants attempted the survey, of which 311 completed the study. Strong correlations linked job retention with value, trust, and work–life balance. Female pharmacists had higher retention odds, while younger pharmacists had lower retention odds. Pharmacists with over 10 years of experience showed higher retention odds. Discussion: ‘Value and trust’ and ‘work–life balance’ were pivotal for the job retention of community pharmacists. Strategies boosting value, trust, and work–life balance was vital. Gender, age, and experience also predicted job retention. Conclusions: Cultivating trust, valuing contributions, and providing a work–life balance can enhance job retention and commitment. Full article

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

13 pages, 274 KiB

Open AccessArticle

Antipsychotic Use: Cross-Sectional Opinion Survey of Psychiatrists in India and United Kingdom

by Zina Sherzad Qadir, Nilamadhab Kar, Patrick Anthony Ball and Hana Morrissey

Pharmacy 2023, 11(5), 162; https://doi.org/10.3390/pharmacy11050162 - 09 Oct 2023

Cited by 1 | Viewed by 2024

Abstract

The aim of this survey of psychiatrists from the UK and India was to compare their opinions on antipsychotic medication choice and their experiences of such medications’ effectiveness and tolerability in patients who were newly diagnosed with acute schizophrenia. Following ethical approval, a [...] Read more.

The aim of this survey of psychiatrists from the UK and India was to compare their opinions on antipsychotic medication choice and their experiences of such medications’ effectiveness and tolerability in patients who were newly diagnosed with acute schizophrenia. Following ethical approval, a cross-sectional online survey of psychiatrists from the UK and India was conducted. Ninety-five responses were received from each country. The most selected first-line APDs in both countries were olanzapine (47.5%), risperidone (42.8%) and aripiprazole (25.3%). A total of 60% of psychiatrists from India (60%) and 48% from the UK (48%) selected ‘medication efficacy’ as the main factor in their choice. Reassessment and consideration to switch most often took place within 4–6 weeks (53.7%) and 3–6 months (11.6%). The major reasons for switching antipsychotic medications were poor clinical efficacy (69%) and lack of tolerability (45%). Nonadherence was the most common reason for relapse (90% of UK psychiatrists and 70% of Indian psychiatrists), followed by illicit drug use (27.6%). The most commonly reported side effects that led to nonadherence were weight gain (10.8%), drowsiness (10.4%), erectile dysfunction and movement disorders (equally 8.7%). It was concluded that olanzapine, risperidone and aripiprazole are the most commonly selected as the initial treatment choice by psychiatrists from India and the UK. They are perceived as widely effective and well tolerated. Full article

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

11 pages, 625 KiB

Open AccessArticle

Evidence-Based Pharmaceutical Care in Community Pharmacies: A Survey of 595 French Pharmacists

by Louis Bosson, Francesca Veyer, Jean-Didier Bardet, Céline Vermorel, Alison Foote, Benoit Allenet and Jean-Luc Bosson

Pharmacy 2023, 11(5), 161; https://doi.org/10.3390/pharmacy11050161 - 07 Oct 2023

Viewed by 1530

Abstract

We assessed the use of evidence-based practice (EBP) among pharmacists working in community pharmacies in France and the factors linked to this practice. During 3 months in 2018, an online survey was sent to over 7000 active pharmacists and posted on pharmacists’ social [...] Read more.

We assessed the use of evidence-based practice (EBP) among pharmacists working in community pharmacies in France and the factors linked to this practice. During 3 months in 2018, an online survey was sent to over 7000 active pharmacists and posted on pharmacists’ social media sites. In total, 595 pharmacists completed the questionnaire. The responders were on average younger than the general population of community pharmacists. The 40-item questionnaire described four fictional clinical cases reflecting typical situations (conventional medicine and complementary and alternative medicine) encountered daily by community pharmacists. Multiple-choice responses were proposed and scored according to whether they reflected EBP. A high total score indicated behaviour in line with EBP. We observed 344/595 participants with a positive EBP score (57.8% [53.7–61.8%]). Univariate and multivariate analyses were used to evaluate factors that might explain adherence to EPB (the pharmacy’s characteristics, the pharmacist’s status, the mode of continuing education and sources of information). The majority relied on pharmaceutical industry and other biased and/or non-evidence-based sources, particularly concerning information on homeopathic products. The consultation of independent reviews, health agency recommendations and peer-reviewed scientific journals was associated with evidence-based decisions. In contrast, reliance on pharmaceutical industry documents, personal experience and informal handbooks was linked to lower EBP scores. The level of EBP use by French community pharmacists needs to be improved to ensure that good-quality, science-based advice is given to customers. Full article

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14 pages, 2061 KiB

Open AccessArticle

Drug Therapy Safety in Palliative Care—Pharmaceutical Analysis of Medication Processes in Palliative Care

by Lisa Krumm, Claudia Bausewein and Constanze Rémi

Pharmacy 2023, 11(5), 160; https://doi.org/10.3390/pharmacy11050160 - 07 Oct 2023

Viewed by 1580

Abstract

Pharmacotherapy plays a crucial role in symptom management in palliative care and is associated with risks potentially leading to drug-related problems (DRP). Pharmacists can identify DRPs and advise prescribers on optimizing drug therapy. The aim of this study was to identify DRP in [...] Read more.

Pharmacotherapy plays a crucial role in symptom management in palliative care and is associated with risks potentially leading to drug-related problems (DRP). Pharmacists can identify DRPs and advise prescribers on optimizing drug therapy. The aim of this study was to identify DRP in a palliative care unit (PCU) and evaluate corresponding pharmaceutical interventions. A non-randomized before-and-after study in a PCU starts with a control phase, an interphase, and an intervention phase. Primary endpoint: DRP, including pharmaceutical interventions and their acceptance. The medication of all inpatients was recorded at set time points, assessed for potential and manifest DRP, and categorized. In the control phase, the ward pharmacist did not interfere with the clinical team. In the intervention phase, the pharmacist could intervene when a DRP was identified and give recommendations. During the 12-month period, 284 patients were included (control phase n = 138; intervention phase n = 146) and 1079 DRPs were identified (control phase n = 634; intervention phase n = 445). The number of DRPs/patient was significantly reduced by the pharmacist’s interventions between the control and intervention phases (4 vs. 3 DRPs, p = 0.001). Overall acceptance of pharmaceutical interventions by prescribers was very high (227/256; 88%). DRPs are hardly preventable. With a clinical pharmacist as a member of the palliative care team, it is possible to reduce the number of DRPs and identify potential problems earlier. Full article

(This article belongs to the Special Issue Medicine Use and Management in Palliative Care)

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11 pages, 736 KiB

Open AccessArticle

A Point Prevalence Survey of Antimicrobial Use at Geita Regional Referral Hospital in North-Western Tanzania

by Lutugera Kihwili, Vitus Silago, Emiliana N. Francis, Vicent A. Idahya, Zabron C. Saguda, Siana Mapunjo, Martha F. Mushi and Stephen E. Mshana

Pharmacy 2023, 11(5), 159; https://doi.org/10.3390/pharmacy11050159 - 07 Oct 2023

Cited by 1 | Viewed by 1851

Abstract

We conducted a point prevalence survey (PPS) to determine the prevalence of antibiotic use at Geita Regional Referral Hospital (GRRH) located along the shores of Lake Victoria in north-western Tanzania. This has led to the identification of gaps for improvement. This PPS study [...] Read more.

We conducted a point prevalence survey (PPS) to determine the prevalence of antibiotic use at Geita Regional Referral Hospital (GRRH) located along the shores of Lake Victoria in north-western Tanzania. This has led to the identification of gaps for improvement. This PPS study was conducted on 9–10 March 2023. Patient-related information, including sociodemographic and clinical data, was collected from medical records. STATA software version 15.0 was used to perform descriptive data analysis. About 94.8% (55/58) patients were on antibiotics with a mean (±SD) prescription of 2 (±0.5) antibiotic agents ranging from 1 to 4 different agents. The commonest indications of the antibiotic prescription were medical prophylaxis 47.3% (26/55) followed by empiric treatment 41.8% (23/55). In total, 110 prescriptions were made, of which metronidazole (25.5%; n = 28), ceftriaxone (23.6%; n = 26), and ampicillin–cloxacillin (23.6%; n = 26) were frequently observed. Only 67.3% (n = 74) of prescriptions complied with Tanzania Standard Treatment Guidelines. Moreover, according to the WHO-AWaRe classification, 50.9%, 23.6%, and 25.5% were under the Access category, Watch category, and Not Recommended category, respectively. The prevalence of antibiotic use among patients admitted to GRRH was high, whereby medical prophylaxis and empiric treatment were the commonest indications for antibiotic prescription. To support rational therapy and antimicrobial stewardship initiatives, we recommend that laboratories in regional hospitals be equipped to conduct sustained routine culture and antimicrobial susceptibility testing. Full article

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14 pages, 2179 KiB

Open AccessArticle

Development of a Self-Assessment Audit Instrument to Support Climate-Conscious Community Pharmacy Practice and Education

by Stella Fisher, Annalise Mathers and Zubin Austin

Pharmacy 2023, 11(5), 158; https://doi.org/10.3390/pharmacy11050158 - 29 Sep 2023

Viewed by 1440

Abstract

Climate breakdown continues to occur at an alarming pace, and the need for all citizens and professionals to respond has never been so urgent. Healthcare work contributes significantly to greenhouse gas (GHG) emissions, representing an opportunity and responsibility for pharmacists to engage in [...] Read more.

Climate breakdown continues to occur at an alarming pace, and the need for all citizens and professionals to respond has never been so urgent. Healthcare work contributes significantly to greenhouse gas (GHG) emissions, representing an opportunity and responsibility for pharmacists to engage in more climate-conscious practices. A key informant interview-based qualitative research method was undertaken to identify options and strategies for community pharmacists to contribute positively to achieving climate-related carbon footprint reduction goals. A total of 10 thought leaders in climate-conscious pharmacy practice were interviewed using a semi-structured protocol, and a constant comparative data analysis method was used to identify common themes and priorities. A self-assessment audit instrument (SAAI) was identified as a positive first step to build awareness, knowledge, skills, and confidence amongst community pharmacists regarding actionable climate-conscious community pharmacy practice. The SAAI supported both self-reflection and self-assessment, while signposting additional resources that could be accessed by pharmacists to continue their learning and professional development. Further work in this area is required if community pharmacy is to contribute positively to climate reduction targets locally and globally. Full article

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

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13 pages, 472 KiB

Open AccessArticle

COVID-19 Patients’ Medication Management during Transition of Care from Hospital to Virtual Care: A Cross-Sectional Survey and Audit

by H. Laetitia Hattingh, Catherine Edmunds, Saberina Buksh, Sean Cronin and Brigid M. Gillespie

Pharmacy 2023, 11(5), 157; https://doi.org/10.3390/pharmacy11050157 - 28 Sep 2023

Cited by 1 | Viewed by 1323

Abstract

Background: Virtual models of care were implemented to ease hospital bed pressure during COVID-19. We evaluated the medication management of COVID-19 patients transferred to virtual models of care. Method: A retrospective audit of COVID-19 patients transferred from inpatient units to virtual care during [...] Read more.

Background: Virtual models of care were implemented to ease hospital bed pressure during COVID-19. We evaluated the medication management of COVID-19 patients transferred to virtual models of care. Method: A retrospective audit of COVID-19 patients transferred from inpatient units to virtual care during January 2022 and surveys from patients transferred during December 2021–February 2022 was carried out. Results: One hundred patients were randomly selected: mean age 59 years (SD: 19.8), mean number of medicines at admission 4.3 (SD: 4.03), mean length of virtual ward stay 4.4 days (SD: 2.1). Pharmacists reviewed 43% (43/100) of patients’ medications during their hospital stay and provided 29% (29/100) with discharge medicine lists at transfer. Ninety-two (92%) patients were prescribed at least one new high-risk medicine whilst in hospital, but this was not a factor considered to receive a pharmacist medication review. Forty patients (40%) were discharged on newly commenced high-risk medicines, and this was also not a factor in receiving a pharmacist discharge medication list. In total, 25% of patient surveys (96/378) were returned: 70% (66/96) reported adequate medicine information at transfer and 55% (52/96) during the virtual model period. Conclusion: Patient survey data show overall positive experiences of medication management and support. Audit data highlight gaps in medication management during the transfer to a virtual model, highlighting the need for patient prioritisation. Full article

(This article belongs to the Special Issue Medication Management and Pharmaceutical Care in Clinical Pharmacy)

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12 pages, 275 KiB

Open AccessArticle

Cost Evaluation of Professional Services in a Rural Community Pharmacy: A Monocentric Exploratory Approach

by Luis A. Martínez, Cristina García and Lucrecia Moreno

Pharmacy 2023, 11(5), 156; https://doi.org/10.3390/pharmacy11050156 - 26 Sep 2023

Viewed by 1206

Abstract

The increasing pressure on healthcare systems (HCSs) is a cause for concern worldwide. Rising costs, uncertainty about sustainability, and aging populations are the main issues that make it challenging to allocate scarce resources to the needs of HCSs. Clinical professional pharmacy services (PSs) [...] Read more.

The increasing pressure on healthcare systems (HCSs) is a cause for concern worldwide. Rising costs, uncertainty about sustainability, and aging populations are the main issues that make it challenging to allocate scarce resources to the needs of HCSs. Clinical professional pharmacy services (PSs) have been shown to help alleviate system stress and to reach the entire population, although a cost of provision is borne. The objective of this study was to evaluate the provision costs of three PSs, a medicine-dispensing service (MDS), a multicompartmental compliance aid system service (MCAS), and a cognitive impairment screening service (CISS), in a rural community pharmacy. A cost analysis was performed using a time-driven activity-based costing model. The time dedicated to PS provision was appropriately recorded, and the corresponding expenses were extracted from the accounting records. A provision time of 4.80 min and a cost of EUR 2.24 were estimated for the MDS, while 18.33 min and EUR 8.73 were calculated for the MCAS, and 122.20 min and EUR 56.72 were calculated for the CISS. The total provision time represented 85% of the pharmacist’s effective working time. Tailored cost analysis is a useful tool for making decisions on the implementation of a PS. Larger studies including a variety of pharmacies and locations are necessary to accurately assess costs and engage in discussions on funding and remuneration. Full article

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

14 pages, 282 KiB

Open AccessArticle

Migraine Management in Community Pharmacies: Knowledge, Attitude and Practice Patterns of Pharmacists in Saudi Arabia

by Fahad Alzahrani, Yaser M. Alahmadi, Sultan S. Al Thagfan, Sultan Alolayan and Hossein M. Elbadawy

Pharmacy 2023, 11(5), 155; https://doi.org/10.3390/pharmacy11050155 - 24 Sep 2023

Viewed by 1820

Abstract

In Saudi Arabia, community pharmacies offer healthcare services for different conditions. However, clarity of the competence of pharmacists in managing migraines is lacking. This study aimed to explore the current knowledge, attitude, and practice patterns of community pharmacists concerning migraine management in the [...] Read more.

In Saudi Arabia, community pharmacies offer healthcare services for different conditions. However, clarity of the competence of pharmacists in managing migraines is lacking. This study aimed to explore the current knowledge, attitude, and practice patterns of community pharmacists concerning migraine management in the northwestern part of Saudi Arabia. A cross-sectional study was carried out between June and September 2022 among 215 Saudi community pharmacists. Data analysis was performed by descriptive and inferential statistics using SPSS version 27. Most community pharmacists (87.9%) feel that migraine management is essential to their practice, and 83.3% suggest between one and five over-the-counter (OTC) migraine products daily. Among the study pharmacists, 83.7% feel migraine patients should try OTC before prescription medications. Only 9.3% of the community pharmacists do not believe that migraine is a neurological disorder. The medications most prescribed for migraine were triptans, representing 52.1% of prescriptions. There were significant differences between the gender of the pharmacists and their knowledge, attitude, and practice overall score (p-value = 0.04). Male pharmacists exhibited higher knowledge, attitude, and practice scores than female pharmacists. Although many community pharmacists acknowledge their expertise and involvement in managing migraines, there is a requirement for further education and training to enhance their capacity to offer complete care to migraine patients. Pharmacists should also consider non-pharmacological interventions and complementary therapies when treating migraine symptoms. Full article

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

26 pages, 2567 KiB

Open AccessArticle

Notifications and Health Consequences of Unauthorized Pharmaceuticals in Food Supplements

by Maja Amidžić, Jelena Banović Fuentes, Jovica Banović and Ljilja Torović

Pharmacy 2023, 11(5), 154; https://doi.org/10.3390/pharmacy11050154 - 23 Sep 2023

Cited by 3 | Viewed by 1949

Abstract

Health concerns associated with the consumption of food supplements rise in parallel with the rise in the popularity and market availability of these products. In pursuit of data related to the unauthorized presence of pharmaceuticals in food supplements, the Rapid Alert System for [...] Read more.

Health concerns associated with the consumption of food supplements rise in parallel with the rise in the popularity and market availability of these products. In pursuit of data related to the unauthorized presence of pharmaceuticals in food supplements, the Rapid Alert System for Food and Feed (RASFF) database was searched for the 2011–2022 period. The most “popular” pharmaceuticals for the adulteration of food supplements were phosphodiesterase-5 inhibitors (235 records); anorexics and laxatives (76), including sibutramine and its active metabolite N-didesmethyl sibutramine, phenolphthalein and 2,4-dinitrophenol; stimulants, among which 1,3-dimethylamine (97), and synephrine (53) were the most numerous; nootropic drugs (24); anabolics and prohormones (16); and cannabinoid cannabidiol (14) (pending authorization as a novel food ingredient). Over 65% of notifications of interest were classified as serious risks, and over 80% of these were alert or border rejection notifications, mainly generated as a result of official control on the market. The alarming number of RASFF notifications should be considered a public health issue, demanding clear and targeted recommendation for action for the legislature and authorities. A harmonized nutrivigilance system should be considered as a tool to detect and scrutinize the adverse health effects of food supplements, along with measures to improve their safety, quality, and testing. Full article

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

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13 pages, 733 KiB

Open AccessArticle

Patients’ Perspectives on Commencing Oral Anticoagulants in Atrial Fibrillation: An Exploratory Qualitative Descriptive Study

by Eyob Alemayehu Gebreyohannes, Sandra M. Salter, Leanne Chalmers, Jan Radford, Kenneth Lee and Danielle D’Lima

Pharmacy 2023, 11(5), 153; https://doi.org/10.3390/pharmacy11050153 - 23 Sep 2023

Viewed by 1391

Abstract

Background: Oral anticoagulants (OACs) are prescribed to patients with atrial fibrillation (AF) in order to lower stroke risk. However, patient refusal to commence OACs hinders effective anticoagulation. This study aimed to explore barriers and facilitators to patient agreement to commence OACs from the [...] Read more.

Background: Oral anticoagulants (OACs) are prescribed to patients with atrial fibrillation (AF) in order to lower stroke risk. However, patient refusal to commence OACs hinders effective anticoagulation. This study aimed to explore barriers and facilitators to patient agreement to commence OACs from the perspectives of patients with AF attending Australian general practices. Methods: A qualitative descriptive study utilising semi-structured individual interviews was conducted from March to July 2022. Results: Ten patients (60% male, median age = 78.5 years) completed interviews. Patients’ passive roles in decision-making were identified as a facilitator. Other prominent facilitators included doctors explaining adequately and aligning their recommendations with patients’ overall health goals, including the prevention of stroke and associated disabilities, and a clear understanding of the pros and cons of taking OACs. Reportedly insufficient explanation from doctors and the inconvenience associated with taking warfarin were identified as potential barriers. Conclusion: Addressing factors that influence patient agreement to commence OACs should be an essential aspect of quality improvement interventions. Subsequent studies should also delve into the perspectives of eligible patients with AF who choose not to commence OACs as well as the perspectives of both patients and doctors regarding the decision to continue OAC treatment. Full article

(This article belongs to the Special Issue Optimising Medication Management and Use of Antithrombotic Agents)

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11 pages, 503 KiB

Open AccessArticle

Perceptions of Community Pharmacists toward the National E-Prescribing Service (Wasfaty) and Exploring the Benefits and Challenges of the Service: A Descriptive Study from Qassim Region, Saudi Arabia

by Saud Alsahali, Ghazwaa Almutairi, Raghad Aedh, Sarah Alanezi, Hanan Almutairi, Mohammed Anaam, Mohammed Alshammari, Abdulmalik Alhabib, Abdullah Alowayed and Suhaj Abdulsalim

Pharmacy 2023, 11(5), 152; https://doi.org/10.3390/pharmacy11050152 - 21 Sep 2023

Cited by 1 | Viewed by 1915

Abstract

Background: Electronic prescribing systems (e-prescription) for medications have many benefits, including patient safety, increase in patient satisfaction, efficiency of pharmacy work, and quality of patient care. However, few studies have been conducted to evaluate the national e-prescription system “Wasfaty” service in [...] Read more.

Background: Electronic prescribing systems (e-prescription) for medications have many benefits, including patient safety, increase in patient satisfaction, efficiency of pharmacy work, and quality of patient care. However, few studies have been conducted to evaluate the national e-prescription system “Wasfaty” service in Saudi Arabia, which was recently adopted. Objective: The aims of this study were to explore the benefits observed through the use of the system and most frequent challenges experienced by community pharmacists in the Qassim region of Saudi Arabia. Methods: This study was conducted using a descriptive survey on a web-based platform. The target population of the study included community pharmacists in the Qassim region of Saudi Arabia who worked in pharmacy chains utilizing the e-prescription service between September 2022 and November 2022. Descriptive statistics along with multiple ordinal regression were used for data analysis. Results: The study population consisted of 124 pharmacists, of which 62.9% (78/124) were males and 37.1% (46/124) were females. Most of the participants had a positive perception of the e-prescription system with regard to medication safety, with 68.6% (85/124) indicating that e-prescriptions reduce the risk of dispensing errors. However, 81.5% (101/124) did not agree that the e-prescription system resulted in a reduction in workload, and 70.2% (87/124) disagreed that the service increased patient satisfaction. Conclusions: The results of this study indicated that the national e-prescription system has many benefits to healthcare employees and improves their work, particularly for patient safety, reducing medication errors, and improving the management of patient medications. The participants believe that there is a need to improve communication with prescribers, showing concern about the unavailability of some medications; thus, it is important for policymakers to encourage other pharmacy chains and suppliers to join the service to increase patient access to medications. Full article

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13 pages, 652 KiB

Open AccessReview

Expanding Pharmacists’ Role in the Management of Non-Alcoholic Fatty Liver Disease

by Majid Mufaqam Syed-Abdul

Pharmacy 2023, 11(5), 151; https://doi.org/10.3390/pharmacy11050151 - 21 Sep 2023

Cited by 1 | Viewed by 1649

Abstract

Non-alcoholic fatty liver disease (NAFLD) stands as an increasingly pressing global health challenge, underscoring the need for timely identification to facilitate effective treatment and prevent the progression of chronic liver disorders. Given the projected scarcity of specialized healthcare professionals, particularly hepatologists and gastroenterologists, [...] Read more.

Non-alcoholic fatty liver disease (NAFLD) stands as an increasingly pressing global health challenge, underscoring the need for timely identification to facilitate effective treatment and prevent the progression of chronic liver disorders. Given the projected scarcity of specialized healthcare professionals, particularly hepatologists and gastroenterologists, the role of pharmacists emerges as pivotal in NAFLD management. This article sheds light on the potential of pharmacists within community pharmacy settings, not as diagnostic entities, but as facilitators in recognizing and screening individuals at elevated NAFLD risk using validated non-invasive tools like portable devices and calculators. By prioritizing patient education, referrals, and continuous monitoring, pharmacists can refine NAFLD management, ultimately advancing patient outcomes. Enhancing pharmacists’ impact in early NAFLD detection and management can be facilitated through collaborations with healthcare institutions and the incorporation of patient self-assessment tools. This collaborative approach holds promise for further promoting improved liver health within the community. Full article

(This article belongs to the Special Issue Delivery of Pharmaceutical Care—Leaving No One Behind)

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24 pages, 327 KiB

Open AccessArticle

Mindfulness-Based Stress Reduction (MBSR) for Chronic Pain Management in the Community Pharmacy Setting: A Cross-Sectional Survey of the General Public’s Knowledge and Perceptions

by Klaudia Harris, Jazmyne Jackson, Holly Webster, Jillian Farrow, Yi Zhao and Lindsey Hohmann

Pharmacy 2023, 11(5), 150; https://doi.org/10.3390/pharmacy11050150 - 21 Sep 2023

Cited by 1 | Viewed by 1610

Abstract

Patient access to mindfulness-based stress reduction (MBSR), a complementary and integrative health approach that is proven to reduce chronic pain, can be increased via community pharmacy-based implementation. However, the general public’s awareness and preferences regarding MBSR as a treatment option for chronic pain, [...] Read more.

Patient access to mindfulness-based stress reduction (MBSR), a complementary and integrative health approach that is proven to reduce chronic pain, can be increased via community pharmacy-based implementation. However, the general public’s awareness and preferences regarding MBSR as a treatment option for chronic pain, including provider roles (pharmacist vs. non-pharmacist), are unclear. Therefore, the purpose of this study was to assess the U.S. general public’s knowledge, attitudes, barriers, and programmatic preferences regarding MBSR for chronic pain management, particularly in the community pharmacy setting. A cross-sectional, anonymous online survey was distributed to U.S. adults ≥18 years via the Amazon Mechanical Turk (MTurk) online survey platform. The survey instrument was informed by Anderson’s framework for health service utilization. Measures were assessed using multiple-choice and 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree). Primary outcome measures included: (1) knowledge and awareness of MBSR (12-items); (2) confidence in seeking out MBSR for pain (5-items); (3) barriers to receiving MBSR (11-items); (4) beliefs about MBSR in general (12-items); (5) beliefs about community pharmacy-delivered MBSR (15-items); and (6) preferences for MBSR classes/programs (6-items). Outcomes were analyzed using descriptive statistics, and influential factors associated with mean beliefs regarding community pharmacy-delivered MBSR for chronic pain management were assessed via multiple linear regression. Of the 302 survey respondents, the majority were white (79.1%) and female (50.7%), with a mean age of 44.65 years. Respondents’ self-rated MBSR knowledge (mean [SD] scale score: 2.30 [0.68]) and confidence (2.65 [0.87]) were low, although perceived barriers to access were low overall (2.22 [0.53]). Beliefs regarding the use of MBSR for treatment of chronic pain were positive in general (3.67 [0.71]), but more negative regarding community pharmacy-delivered MBSR (2.38 [0.56]). Confidence in seeking out MBSR (β = 0.297, 95% CI = 0.219 to 0.375; p < 0.001) and current opioid use (β = 0.419, 95% CI = 0.147 to 0.690; p = 0.003) were positively associated with beliefs regarding pharmacy-delivered MBSR, while annual household income (β = −0.124, 95% CI = −0.244 to −0.004; p = 0.043) and level of bodily pain (β = −0.149, 95% CI = −0.291 to −0.008; p = 0.039) exerted statistically significant negative influences. Respondents preferred a hybrid MBSR class format including both online and in-person components (29.7%) as well as both group and individual session options (43.7%). In conclusion, further education is necessary to increase the public’s perception of community pharmacies as a resource for complementary and integrative health. Full article

(This article belongs to the Special Issue Pharmacists: Key Players in a Changing Health Care System)

18 pages, 1303 KiB

Open AccessArticle

Development and Refinement of a Matrix Competency Framework, with Associated Entrustable Professional Activities, to Support Initial Pharmacy Education in Kuwait

by Pierre Moreau, Mohammad Qaddoumi, Dalal Al-Taweel, Sarah Alghanem, Tania Bayoud, Maryam Alowayesh, Monerah Al-Soraj, Mohsen Hedaya, Asmaa Al-Haqan and Danah Alsane

Pharmacy 2023, 11(5), 149; https://doi.org/10.3390/pharmacy11050149 - 19 Sep 2023

Viewed by 1221

Abstract

The development of competency frameworks serves as the foundation for the development of competency-based education. It is vital to develop a country-specific framework to address the specific needs of the local population for pharmacy services. This study aimed to describe the development process [...] Read more.

The development of competency frameworks serves as the foundation for the development of competency-based education. It is vital to develop a country-specific framework to address the specific needs of the local population for pharmacy services. This study aimed to describe the development process of a competency framework for undergraduate pharmacy education in Kuwait with a unique matrix structure. The process started with the development of guiding principles for curriculum revision and implementation, as well as the identification of global educational outcomes. This process was followed by: (A) a needs assessment with key stakeholders; (B) development of the initial competency framework; and (C) refinement of the framework. Qualitative data were thematically analyzed to identify the main competency domains that students need to perform the identified entrustable professional activities (EPAs). Five population needs were identified by the needs assessment, with 17 EPAs suggested to fulfill those needs. In addition, 11 competency domains were identified. The initial competency framework was created as a 3 × 8 matrix, with 3 professional and 8 transversal competency domains. Refinement of the framework resulted in the removal of redundancies and the development of a global behavior competency profile. The development of a matrix competency framework and associated EPAs for Kuwait serves as a foundation for preparing pharmacists to fulfill local population needs and expanding the scope of practice in the country. Full article

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

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15 pages, 942 KiB

Open AccessArticle

How Should We Prepare Our Pharmacist Preceptors? Design, Development and Implementation of a Training Program in a Regional Australian University

by Gillian J. Knott, Martina F. Mylrea and Beverley D. Glass

Pharmacy 2023, 11(5), 148; https://doi.org/10.3390/pharmacy11050148 - 17 Sep 2023

Cited by 2 | Viewed by 1706

Abstract

Increased experiential learning within pharmacy education has highlighted the need for quality preceptors, leading to a recent focus on their development and training. This study describes the design, development and implementation of a pharmacist preceptor training program in a regional Australian University. The [...] Read more.

Increased experiential learning within pharmacy education has highlighted the need for quality preceptors, leading to a recent focus on their development and training. This study describes the design, development and implementation of a pharmacist preceptor training program in a regional Australian University. The design of this program utilized the results of a previously conducted scoping review of preceptor training programs and a comprehensive preceptor training needs analysis. In addition, participation was sought from an expert advisory group, comprising preceptors and pharmacy professional organizations. Program materials were developed and transferred onto a suitable online learning platform for implementation. Post-training program evaluation will follow Kirkpatrick’s model of training evaluation criteria, gaining feedback from both preceptors and students. The four flexible online modules that were designed are aligned with the main preceptor roles: role model, educator, mentor and assessor. The program also included a small-group online interactive networking session and an online discussion forum. Following implementation, 28 pharmacist preceptors completed the training. Preliminary feedback on the training program was extremely positive, particularly to the interactive networking activity. Future programs will continue to be adapted to reflect stakeholder feedback and optimize student placement experiences. Full article

(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)

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12 pages, 280 KiB

Open AccessArticle

Community Pharmacists’ Knowledge, Attitudes and the Perceived Safety and Effectiveness of Melatonin Supplements: A Cross-Sectional Survey

by Mansour Tobaiqy, Faris A. AlZahrani, Abdulrahman S. Hassan, Abdullah H. Alirbidi, Osama A. Alraddadi, Omar A. AlSadah, Mohammad B. Yamani and Sulafa T. Alqutub

Pharmacy 2023, 11(5), 147; https://doi.org/10.3390/pharmacy11050147 - 15 Sep 2023

Cited by 1 | Viewed by 4028

Abstract

Melatonin, which is classified as a dietary supplement by the Saudi Food and Drug Authority, is used to manage sleep disorders. In this study, community pharmacists’ knowledge and attitudes about dispensing melatonin supplements and the perceived safety and effectiveness of melatonin were assessed. [...] Read more.

Melatonin, which is classified as a dietary supplement by the Saudi Food and Drug Authority, is used to manage sleep disorders. In this study, community pharmacists’ knowledge and attitudes about dispensing melatonin supplements and the perceived safety and effectiveness of melatonin were assessed. A cross-sectional survey of community pharmacists in Jeddah, Saudi Arabia was conducted from March–June 2023. Community pharmacists’ knowledge and attitudes towards prescribing and dispensing melatonin supplements, the methods of dispensing melatonin supplements (prescription, over the counter, self-administered), indications, ages of users, dosage forms, and adverse drug reactions related to melatonin use among consumers were surveyed using a questionnaire. Potential participants were approached face to face, a questionnaire was administered to those agreeing to participate in the study, and responses were recorded electronically. The response rate of the 300 community pharmacists who participated in this study was 83.5%. The mean age of participants was 33.6 years, and 89.3% (n = 268) of community pharmacists reported dispensing melatonin supplements. Self-medication and over the counter (n = 213; 71.2%) were the most common dispensing and prescribing patterns (p = 0.001). Awareness rates about melatonin supplement pharmacokinetics and pharmacodynamics among community pharmacists were 38% and 37%, respectively. Despite its popularity, community pharmacists reported relatively low rates of awareness of melatonin supplement pharmacokinetics and pharmacodynamics. Further attention to this issue is needed. Full article

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

9 pages, 237 KiB

Open AccessReview

Intersection and Considerations for Patient-Centered Care, Patient Experience, and Medication Experience in Pharmacogenomics

by Logan T. Murry, Lisa A. Hillman, Josiah D. Allen and Jeffrey R. Bishop

Pharmacy 2023, 11(5), 146; https://doi.org/10.3390/pharmacy11050146 - 14 Sep 2023

Cited by 1 | Viewed by 1668

Abstract

As healthcare continues to embrace the concept of person- and patient-centered care, pharmacogenomics, patient experience, and medication experience will continue to play an increasingly important role in care delivery. This review highlights the intersection between these concepts and provides considerations for patient-centered medication [...] Read more.

As healthcare continues to embrace the concept of person- and patient-centered care, pharmacogenomics, patient experience, and medication experience will continue to play an increasingly important role in care delivery. This review highlights the intersection between these concepts and provides considerations for patient-centered medication and pharmacogenomic experiences. Elements at the patient, provider, and system level can be considered in the discussion, supporting the use of pharmacogenomics, with components of the patient and medication experience contributing to the mitigation of barriers surrounding patient use and the valuation of pharmacogenomic testing. Full article

(This article belongs to the Special Issue An Exploration of the Confluence between Pharmacogenomics and the Medication Experience)

11 pages, 268 KiB

Open AccessReview

Management Considerations for Pulmonary Arterial Hypertension Pharmacotherapy in the Intensive Care Unit

by Elizabeth M. Foster, Danine Sullinger and James C. Coons

Pharmacy 2023, 11(5), 145; https://doi.org/10.3390/pharmacy11050145 - 13 Sep 2023

Viewed by 1613

Abstract

Pulmonary arterial hypertension is a rare and progressive disease with significant morbidity and mortality risk. Several medications targeting three major disease pathways are approved for treatment. However, the management of pulmonary arterial hypertension pharmacotherapies in a patient admitted to an intensive care unit [...] Read more.

Pulmonary arterial hypertension is a rare and progressive disease with significant morbidity and mortality risk. Several medications targeting three major disease pathways are approved for treatment. However, the management of pulmonary arterial hypertension pharmacotherapies in a patient admitted to an intensive care unit poses unique challenges. Factors such as intubation and altered mental status may prevent the continuation of home oral and/or inhaled therapy, and the progression of the disease may require escalation of therapy. This review will focus on practical management strategies for the continuation of home pulmonary arterial hypertension pharmacotherapy and escalation of therapy. Full article

(This article belongs to the Special Issue Advances in Cardiovascular Disease Management by Pharmacists)

17 pages, 1250 KiB

Open AccessReview

The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S

by Susanne B. Haga

Pharmacy 2023, 11(5), 144; https://doi.org/10.3390/pharmacy11050144 - 10 Sep 2023

Cited by 3 | Viewed by 1680

Abstract

Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The [...] Read more.

Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The early involvement of pharmacists in clinical studies and the establishment of organizations to support the dissemination of information about PGx variants have naturally resulted in leaders in clinical implementation. This paper presents an overview of the evolving role of pharmacists, and discusses potential challenges and future paths, primarily focused in the U.S. Pharmacists have positioned themselves as leaders in clinical PGx testing, and will prepare the next generation to utilize PGx testing in their scope of practice. Full article

(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)

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14 pages, 317 KiB

Open AccessArticle

MedSMA℞T Adventures in PharmaCity Game: Youth Experiences and Recommendation for Use in Opioid Safety Education

by Olufunmilola Abraham, Courtney R. Koeberl and Tyler J. McCarthy

Pharmacy 2023, 11(5), 143; https://doi.org/10.3390/pharmacy11050143 - 10 Sep 2023

Viewed by 1706

Abstract

Adolescents are often excluded from the creation of opioid safety interventions; therefore, it is crucial to design evidence-based interventions tailored for and with youth. Video games are ubiquitous and approachable to adolescents making them an accessible educational modality. MedSMA℞T: Adventures in PharmaCity is [...] Read more.

Adolescents are often excluded from the creation of opioid safety interventions; therefore, it is crucial to design evidence-based interventions tailored for and with youth. Video games are ubiquitous and approachable to adolescents making them an accessible educational modality. MedSMA℞T: Adventures in PharmaCity is a serious game that educates adolescents and their families on the safe, appropriate, and responsible use of opioid prescriptions. The first objective of the study was to elucidate adolescents’ experiences and perceptions of the game. The second objective was to elicit their recommendations for use and suggestions for improvement. Adolescents were recruited through Qualtrics research panels, social media, listservs, and snowball sampling. Recruitment occurred between April 2021 and October 2021. Eligible adolescents played the game and completed a follow-up virtual semi-structured interview with a study team member. Interviews were transcribed verbatim and uploaded to NVivo for data analysis. A thematic content analysis was performed. A total of seventy-two adolescents participated. Analysis yielded four themes: prior gaming experience, educational salience, game design impressions, and recommendations for improvement. Most adolescents approached MedSMA℞T with prior gaming experience. The youth correctly identified the game’s intended objective: the promotion of opioid medication safety. Adolescents had overarchingly positive impressions of the game’s levels, characters, and graphics. Study participants suggested expanded game levels, improved controls, and more instructions for gameplay. In summary, adolescents had favorable experiences using the MedSMA℞T game which allude to the wide-spread acceptability of this intervention among young people. Full article

12 pages, 584 KiB

Open AccessArticle

Best Possible Medication History Collection by Clinical Pharmacist in a Preoperative Setting: An Observational Prospective Study

by Daniele Mengato, Lisa Pivato, Lorenzo Codato, Fernanda Fabiola Faccioli, Laura Camuffo, Maria Cecilia Giron and Francesca Venturini

Pharmacy 2023, 11(5), 142; https://doi.org/10.3390/pharmacy11050142 - 08 Sep 2023

Viewed by 1794

Abstract

Background: A Best Possible Medication History (BPMH) collected by clinical pharmacists is crucial for effective medication review, but, in Italy, it is often left to the nursing staff. This study aims to compare the quality and accuracy of a clinical pharmacist-documented BPMH with [...] Read more.

Background: A Best Possible Medication History (BPMH) collected by clinical pharmacists is crucial for effective medication review, but, in Italy, it is often left to the nursing staff. This study aims to compare the quality and accuracy of a clinical pharmacist-documented BPMH with the current standard practice of ward staff-collected BPMH in an Italian preoperative surgical setting. Methods: A 20-week prospective observational non-profit study was conducted in a major university hospital. The study comprised three phases: a feasibility, an observational, and an interventional phase. During the feasibility phase, 10 items for obtaining a correct BPMH were identified. The control group consisted of retrospectively analyzed BPMHs collected by the ward staff during the observational phase, while interventions included BPMHs collected by the clinical pharmacist during the third phase. Omissions between the two groups were compared. Results: 14 (2.0%) omissions were found in the intervention group, compared with 400 (57.4%) found in the controls (p < 0.05); data collection was more complete when collected by pharmacists compared to the current modality (98.0% of completed information for the intervention versus 42.6%; p < 0.05). Conclusions: The involvement of a pharmacist significantly reduced the number of omissions in preoperative surgical-collected BPMHs. This intervention holds the potential to decrease the risk of medication errors associated with inaccurate or incomplete BPMHs prior to surgical hospitalization. Full article

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19 pages, 466 KiB

Open AccessArticle

Development of a Questionnaire to Measure Public Perceptions of the Role of Community Pharmacy in Public Health (PubPharmQ)

by Delyth H. James, Rose Rapado, Sarah L. Brown, Joanne Kember, Karen L. Hodson and Amie-Louise Prior

Pharmacy 2023, 11(5), 141; https://doi.org/10.3390/pharmacy11050141 - 08 Sep 2023

Viewed by 1549

Abstract

Background: Community pharmacies are well placed to provide public-health interventions within primary care settings. This study aimed to establish the general public’s perceptions of community pharmacy-based public-health services in the UK by designing a structured questionnaire to assess the barriers and facilitators to [...] Read more.

Background: Community pharmacies are well placed to provide public-health interventions within primary care settings. This study aimed to establish the general public’s perceptions of community pharmacy-based public-health services in the UK by designing a structured questionnaire to assess the barriers and facilitators to optimizing this role. Methods: A standardized questionnaire was developed informed by the literature, additional semi-structured interviews, and synthesis of key findings with the authors’ previous research based on data generated from eight focus groups. The original 42-item questionnaire was distributed online from May to June 2021 via social media platforms to capture the views of non-regular pharmacy users. Following exploratory factor analysis, and Cronbach’s alpha analysis, total Likert scale response scores were calculated. Results: Of the 306 responders, 76.8% were female with a mean age of 34.5 years (SD = 15.09). The most prevalent pharmacy use reported was 1–2 times a year (28.1%). Exploratory factor analysis revealed four scales: Expertise, Role in Public Health, Privacy, and Relationship (18 items) with acceptable internal consistency and good face and content validity. Awareness of well-established pharmacy services was high; however, responders demonstrated poor awareness of public-health-related services and low recognition of pharmacy expertise for this role. A lack of an established relationship with community pharmacies and privacy concerns were also perceived barriers. Conclusions: Based on these findings, considerable effort is needed to increase public awareness and address these concerns if strategic plans to utilize community pharmacy in the delivery of public-health policy are to be successful. The PubPharmQ provides a novel, structured questionnaire to measure the public’s perceptions of community pharmacy’s role in public health. Full article

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

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8 pages, 218 KiB

Open AccessBrief Report

Exploring Concomitant Acetylcholinesterase Inhibitor and Overactive Bladder Anticholinergic Use and Risk of Hospitalization in Medicare and Dual-Eligible Medicare–Medicaid Populations in a Historic Database

by Jonathan H. Watanabe and Tu Hoang

Pharmacy 2023, 11(5), 140; https://doi.org/10.3390/pharmacy11050140 - 07 Sep 2023

Viewed by 936

Abstract

Overactive bladder prevalence increases in older adults often complicating the management of other comorbidities. The theoretical antagonism between the parasympathetic-blocking anticholinergic agent and the parasympathetic stimulatory agents concomitantly used by patients is only recently being explored. The primary aim was to determine the [...] Read more.

Overactive bladder prevalence increases in older adults often complicating the management of other comorbidities. The theoretical antagonism between the parasympathetic-blocking anticholinergic agent and the parasympathetic stimulatory agents concomitantly used by patients is only recently being explored. The primary aim was to determine the frequency of the annual use of acetylcholinesterase inhibitors, overactive bladder anticholinergics, and the use of both agents in the same year. The secondary aim was measurement of the association between annual hospitalization and same-year use of both acetylcholinesterase inhibitors and anticholinergics. The US nationally representative MarketScan^® Medicare databases were analyzed. In the Medicare enrollees, there were 122 020, 141 920, and 15 639 users of acetylcholinesterase inhibitors, anticholinergics, and both agents, respectively. The percentage of acetylcholinesterase inhibitor users who also used anticholinergics was 12.8%. Comparing users of both acetylcholinesterase inhibitors and anticholinergics to those using AChEI alone, 5 608 of the former experienced a hospitalization (35.9%) compared to 33 182 of the latter (31.2%). There was an increased risk of hospitalization for those using both acetylcholinesterase inhibitors and anticholinergics in the same year, with an odds ratio (OR) of 1.23 (95% CI, 1.19, 1.28). Clinicians should consider improved monitoring of the usage of both medications and clarify alternative regimens that avoid anticholinergics in at-risk older adults. Full article

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

13 pages, 270 KiB

Open AccessArticle

A Cross-Sectional Survey Exploring Australian Pharmacists’ and Students’ Management of Common Oral Mucosal Diseases

by Meng-Wong Taing, Joshua Choong, Vijayaprakash Suppiah, Sarira El-Den, Joon Soo Park, Michael McCullough and Leanne Teoh

Pharmacy 2023, 11(5), 139; https://doi.org/10.3390/pharmacy11050139 - 01 Sep 2023

Viewed by 1149

Abstract

Background: Oral mucosal conditions are commonly experienced in the general population and can have a negative impact on one’s quality of life. This study evaluated the ability of Australian pharmacists and final-year pharmacy students to recognise and manage these common oral mucosal diseases [...] Read more.

Background: Oral mucosal conditions are commonly experienced in the general population and can have a negative impact on one’s quality of life. This study evaluated the ability of Australian pharmacists and final-year pharmacy students to recognise and manage these common oral mucosal diseases through the use of case vignettes. Methods: Australian pharmacists and final-year pharmacy students were invited through social media, university learning management systems, or email to complete an online questionnaire consisting of six case vignettes covering topics relating to common oral mucosal presentations. Results: A total of 65 pharmacists and 78 students completed the questionnaire. More than 50% of the participants reported having seen all types of oral mucosal presentations, except for denture stomatitis, in their practice. The provision of best practice recommendations was reported by only 14%, 15%, 8%, and 6% of the participants for geographic tongue, hairy tongue, angular cheilitis, and denture-associated stomatitis, respectively, whereas 82% offered an appropriate anti-viral treatment for cold sore and 33% provided the best practice recommendations for oral thrush. Conclusion: This study emphasised the importance of further developing and integrating best practice oral healthcare training programs specifically tailored to the Australian pharmacy profession. Full article

(This article belongs to the Special Issue Pharmacists: Key Players in a Changing Health Care System)

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Pharmacy, Volume 11, Issue 5 (October 2023) – 38 articles

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