Pharmacy

11 pages, 281 KiB

Open AccessArticle

Pharmacists’ Perceptions on Nutritional Counseling of Oral Nutritional Supplements in the Community Pharmacy: An Exploratory Qualitative Study

by João Gregório, Patricia Tavares and Emilia Alves

Pharmacy 2023, 11(2), 78; https://doi.org/10.3390/pharmacy11020078 - 20 Apr 2023

Viewed by 1843

Abstract

Malnutrition has important health impacts, especially in the elderly. Oral nutritional supplements (ONS) are effective strategies to help balance the nutritional needs of malnourished persons. Multiple ONS are available at community pharmacies, enabling pharmacists to have the possibility to implement strategies for prevention [...] Read more.

Malnutrition has important health impacts, especially in the elderly. Oral nutritional supplements (ONS) are effective strategies to help balance the nutritional needs of malnourished persons. Multiple ONS are available at community pharmacies, enabling pharmacists to have the possibility to implement strategies for prevention and monitoring of malnourished patients. The aim of this study was to characterize the experience of community pharmacists with the counseling and follow-up of users of ONS. A sample of 19 pharmacists from 19 different community pharmacies were interviewed. Apart from dispensing ONS to support patients that are preparing for diagnostic tests, the most frequently mentioned clinical condition for ONS counseling was malnutrition and dysphagia. When pharmacists consider dispensing ONS, three themes emerge: patient care, related to counselling tailored ONS to each patient’s needs; interprofessional collaboration, with a special focus in the collaboration with registered dietitians; and training and education on ONS, looking to improve their knowledge and skills in ONS counselling and follow-up. Future studies exploring new forms of interaction between pharmacists and dietitians in this context should be developed, aiming to determine the workflow of an interdisciplinary service addressing the needs of community dwelling malnourished patients. Full article

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

13 pages, 281 KiB

Open AccessArticle

From Identity to Ambugity: Exploring Interprofessional Collaboration Opportunities for Pharmacists in Rural and Remote Australia

by Selina Taylor, Alannah Franich, Sophie Jones and Beverley D. Glass

Pharmacy 2023, 11(2), 77; https://doi.org/10.3390/pharmacy11020077 - 20 Apr 2023

Viewed by 1784

Abstract

Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and [...] Read more.

Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and remote communities. This study aims to explore exercise physiologist and podiatrist perceptions of interprofessional practice opportunities with pharmacists. Role theory provided a framework for this qualitative study. Interviews were conducted, recorded, transcribed, and thematically analysed according to the constructs of role theory (role identity, role sufficiency, role overload, role conflict, and role ambiguity). The perceptions of participants varied, largely due to the lack of understanding of the role and scope of the practice of a pharmacist. Participants acknowledged and adopted a flexible approach to the way in which they delivered health services to meet the needs of the community. They also described a more “generalist” approach to care, owing to the high prevalence of disease and disease complexity, along with a lack of staffing and resources. The potential for increased interprofessional collaboration was supported and identified as a strategy to manage significant workloads and provide improved patient healthcare. The application of role theory to this qualitative study provides insight into perceptions of interprofessional practice that may inform future development of remote practice models of care. Full article

(This article belongs to the Special Issue Expanding Pharmacists’ Role in Primary Care Setting among Rural and Low-Income Communities)

14 pages, 1080 KiB

Open AccessArticle

An Integrated Multidisciplinary Circuit Led by Hospital and Community Pharmacists to Implement Clopidogrel Pharmacogenetics in Clinical Practice

by Joan Francesc Mir, Cristina Rodríguez-Caba, Maria Estrada-Campmany, Edurne Fernández de Gamarra-Martínez, Maria Antònia Mangues, Guillermo Bagaría and Pau Riera

Pharmacy 2023, 11(2), 76; https://doi.org/10.3390/pharmacy11020076 - 17 Apr 2023

Cited by 3 | Viewed by 2176

Abstract

The use of pharmacogenetics to optimize pharmacotherapy is growing rapidly. This study evaluates the feasibility and operability of a collaborative circuit involving hospital and community pharmacists to implement clopidogrel pharmacogenetics in Barcelona, Catalonia, Spain. We aimed to enroll patients with a clopidogrel prescription [...] Read more.

The use of pharmacogenetics to optimize pharmacotherapy is growing rapidly. This study evaluates the feasibility and operability of a collaborative circuit involving hospital and community pharmacists to implement clopidogrel pharmacogenetics in Barcelona, Catalonia, Spain. We aimed to enroll patients with a clopidogrel prescription from cardiologists at the collaborating hospital. Community pharmacists collected patients’ pharmacotherapeutic profiles and saliva samples, which were then sent to the hospital for CYP2C19 genotyping. Hospital pharmacists collated the obtained data with patients’ clinical records. Data were analyzed jointly with a cardiologist to assess the suitability of clopidogrel. The provincial pharmacists’ association coordinated the project and provided IT and logistic support. The study began in January 2020. However, it was suspended in March 2020 due to the COVID-19 pandemic. At that moment, 120 patients had been assessed, 16 of whom met the inclusion criteria and were enrolled in the study. The processing of samples obtained before the pandemic had an average delay of 13.8 ± 5.4 days. A total of 37.5% patients were intermediate metabolizers and 18.8% were ultrarapid metabolizers. No poor metabolizers were detected. Pharmacists rated their experience with a 7.3 ± 2.7 likelihood of recommending that fellow pharmacists participate. The net promoter score among participating pharmacists was +10%. Our results show that the circuit is feasible and operable for further initiatives. Full article

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

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8 pages, 816 KiB

Open AccessBrief Report

Residual Infusion Performance Evaluation (RIPE): A Single-Center Evaluation of Residual Volume Post-Intravenous Eravacycline Infusion

by Alysa J. Baumann, Kerry O. Cleveland, Michael S. Gelfand, Nicholson B. Perkins III, Angela D. Covington and Athena L. V. Hobbs

Pharmacy 2023, 11(2), 75; https://doi.org/10.3390/pharmacy11020075 - 13 Apr 2023

Cited by 2 | Viewed by 2459

Abstract

Intravenous (IV) drugs are administered through infusion pumps and IV administration sets for patients who are seen in healthcare settings. There are multiple areas of the medication administration process that can influence the amount of a drug a patient receives. For example, IV [...] Read more.

Intravenous (IV) drugs are administered through infusion pumps and IV administration sets for patients who are seen in healthcare settings. There are multiple areas of the medication administration process that can influence the amount of a drug a patient receives. For example, IV administration sets that deliver a drug from an infusion bag to a patient vary in terms of length and bore. In addition, fluid manufacturers report that the total acceptable volume range for a 250 mL bag of normal saline can be anywhere from 265 to 285 mL. At the institution chosen for our study, each 50 mg vial of eravacycline is reconstituted using 5 mL of diluent, and the total dose is administered as a 250 mL admixture. This single-center, retrospective, quasi-experimental study evaluated the residual medication volume after the completion of an IV eravacycline infusion in patients admitted during the pre-intervention study period compared to those in the post-intervention study period. The primary outcome of the study was to compare the residual antibiotic volume remaining in the bags following IV infusions of eravacycline before and after the implementation of interventions. The secondary outcomes included the following: comparing the amount of the drug lost in the pre- and post-intervention periods, determining whether the amount of residual volume was affected by nursing shifts (day versus night), and lastly assessing the cost of facility drug waste. On average, approximately 15% of the total bag volume was not infused during the pre-intervention period, which was reduced to less than 5% in the post-intervention period. Clinically, the average estimated amount of eravacycline discarded decreased from 13.5 mg to 4.7 mg in the pre- and post-intervention periods, respectively. Following the statistically significant results of this study, the interventions were expanded at this facility to include all admixed antimicrobials. Further studies are needed to determine the potential clinical impact when patients do not receive complete antibiotic infusions. Full article

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

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11 pages, 280 KiB

Open AccessArticle

Risk Factors for Bloodstream Infections Due to ESBL-Producing Escherichia coli, Klebsiella spp., and Proteus mirabilis

by Mary Kathryn Vance, David A. Cretella, Lori M. Ward, Prakhar Vijayvargiya, Zerelda Esquer Garrigos and Mary Joyce B. Wingler

Pharmacy 2023, 11(2), 74; https://doi.org/10.3390/pharmacy11020074 - 13 Apr 2023

Cited by 4 | Viewed by 4165

Abstract

(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January [...] Read more.

(1) Background: Risk factors for extended-spectrum beta-lactamase (ESBL) infections could vary geographically. The purpose of this study was to identify local risk factors for ESBL production in patients with Gram-negative bacteremia. (2) Methods: This retrospective observational study included adult patients admitted from January 2019 to July 2021 and had positive blood cultures for E. coli, K. pneumoniae, K. oxytoca, and P. mirabilis. Patients with ESBL infection were matched to a non-ESBL-producing infection with the same organism. (3) Results: A total of 150 patients were included: 50 in the ESBL group and 100 in the non-ESBL group. Patients in the ESBL group had a longer length of stay (11 vs. 7 days, p < 0.001), but not increased mortality (14% vs. 15%, p = 0.87) Multivariate analysis identified the receipt of >1 antibiotic in the last 90 days as a risk factor for ESBL infection (OR = 3.448, 95% CI = 1.494–7.957; p = 0.004); (4) Conclusions: Recent antimicrobial use was identified as an independent risk factors for ESBL-producing Enterobacterales infections. Knowledge of this risk may improve empirical therapy and reduce inappropriate use. Full article

(This article belongs to the Special Issue Improving Antimicrobial Use in Hospitalized Patients 2.0)

10 pages, 758 KiB

Open AccessArticle

Japanese Pharmacists’ Perceptions of Self-Development Skills and Continuing Professional Development

by Kayoko Takeda Mamiya, Kiyoshi Takahashi, Tatsuyuki Iwasaki and Tetsumi Irie

Pharmacy 2023, 11(2), 73; https://doi.org/10.3390/pharmacy11020073 - 11 Apr 2023

Cited by 1 | Viewed by 2547

Abstract

Background: The role of healthcare professionals, including pharmacists, is changing. Lifelong learning and continuing professional development (CPD) are more critical than ever for both current and future pharmacists in the face of global health challenges and new technologies, services and therapies that are [...] Read more.

Background: The role of healthcare professionals, including pharmacists, is changing. Lifelong learning and continuing professional development (CPD) are more critical than ever for both current and future pharmacists in the face of global health challenges and new technologies, services and therapies that are continually and rapidly introduced into their daily practice. Currently, Japanese pharmacists’ licences are not renewable, although most developed countries have a renewal system. Therefore, understanding Japanese pharmacists’ perceptions of CPD is the first step in reviewing undergraduate and postgraduate education. Methods: The target population was Japanese pharmacists, i.e., community pharmacy pharmacists and hospital pharmacists. The participants were administered a questionnaire with 18 items related to continuing professional development. Results: Our study found that regarding item “Q16 Do you think you need further education in your undergraduate education to continue your professional development?”, (a) the ability to identify one’s own problems and issues, (b) the ability to make plans to solve problems and issues, (c) the ability to carry out plans to solve problems and issues and (d) the ability to repeat steps of self-development, approximately 60% of pharmacists answered that these aspects were “necessary” or “quite necessary”. Conclusion: As part of universities’ responsibility for the lifelong education of pharmacists, it is necessary to systematically conduct teaching seminars or undergraduate education or postgraduate education on self-development while training pharmacists to meet the needs of citizens. Full article

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

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7 pages, 676 KiB

Open AccessCommunication

Pharmacist-Led Implementation of Brief Tobacco Cessation Interventions during Mobile Health Access Events

by Karen Suchanek Hudmon, Julia S. Czarnik, Alexa M. Lahey, Susie J. Crowe, Megan Conklin, Robin L. Corelli, Jasmine D. Gonzalvo and Katy Ellis Hilts

Pharmacy 2023, 11(2), 72; https://doi.org/10.3390/pharmacy11020072 - 7 Apr 2023

Cited by 1 | Viewed by 2129

Abstract

To address gaps in care for individuals from under-resourced communities disproportionately affected by tobacco use, this pharmacist-led demonstration project evaluated the feasibility of implementing tobacco use screening and brief cessation interventions during mobile health access events. A brief tobacco use survey was administered [...] Read more.

To address gaps in care for individuals from under-resourced communities disproportionately affected by tobacco use, this pharmacist-led demonstration project evaluated the feasibility of implementing tobacco use screening and brief cessation interventions during mobile health access events. A brief tobacco use survey was administered verbally during events at two food pantries and one homeless shelter in Indiana to assess the interest and potential demand for tobacco cessation assistance. Individuals currently using tobacco were advised to quit, assessed for their readiness to quit, and, if interested, offered a tobacco quitline card. Data were logged prospectively, analyzed using descriptive statistics, and group differences were assessed by site type (pantry versus shelter). Across 11 events (7 at food pantries and 4 at the homeless shelter), 639 individuals were assessed for tobacco use (n = 552 at food pantries; n = 87 at the homeless shelter). Among these, 189 self-reported current use (29.6%); 23.7% at food pantries, and 66.7% at the homeless shelter (p < 0.0001). About half indicated readiness to quit within 2 months; of these, 9 out of 10 accepted a tobacco quitline card. The results suggest that pharmacist-led health events at sites serving populations that are under-resourced afford unique opportunities to interface with and provide brief interventions for people who use tobacco. Full article

(This article belongs to the Special Issue Pharmacist-Based Interventions for Health Behavior Change 2.0)

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16 pages, 302 KiB

Open AccessReview

Addressing the Opioid Crisis—The Need for a Pain Management Intervention in Community Pharmacies in Canada: A Narrative Review

by Ashley Cid, Angeline Ng and Victoria Ip

Pharmacy 2023, 11(2), 71; https://doi.org/10.3390/pharmacy11020071 - 6 Apr 2023

Cited by 1 | Viewed by 3529

Abstract

Background: The opioid crisis is a public health concern in Canada with a continued rise in deaths and presents a significant economic impact on the healthcare system. There is a need to develop and implement strategies for decreasing the risk of opioid overdoses [...] Read more.

Background: The opioid crisis is a public health concern in Canada with a continued rise in deaths and presents a significant economic impact on the healthcare system. There is a need to develop and implement strategies for decreasing the risk of opioid overdoses and other opioid-related harms resulting from the use of prescription opioids. Pharmacists, as medication experts and educators, and as one of the most accessible frontline healthcare providers, are well positioned to provide effective opioid stewardship through a pain management program focused on improving pain management for patients, supporting appropriate prescribing and dispensing of opioids, and supporting safe and appropriate use of opioids to minimize potential opioid misuse, abuse, and harm. Methods: A literature search was conducted in PubMed, Embase and grey literature to determine the characteristics of an effective community pharmacy-based pain management program, including the facilitators and barriers to be considered. Discussion: An effective pain management program should be multicomponent, address other co-morbid conditions in addition to pain, and contain a continuing education component for pharmacists. Solutions to implementation barriers, including pharmacy workflow; addressing attitudes beliefs, and stigma; and pharmacy remuneration, as well as leveraging the expansion of scope from the Controlled Drugs and Substances Act exemption to facilitate implementation, should be considered. Conclusions: Future work should include the development, implementation, and evaluation of a multicomponent, evidence-based intervention strategy in Canadian community pharmacies to demonstrate the impact pharmacists can have on the management of chronic pain and as one potential solution to helping curb the opioid crisis. Future studies should measure associated costs for such a program and any resulting cost-savings to the healthcare system. Full article

7 pages, 1602 KiB

Open AccessBrief Report

Leveling Up: Evaluation of IV v. PO Linezolid Utilization and Cost after an Antimicrobial Stewardship Program Revision of IV to PO Conversion Criteria within a Healthcare System

by Jessica Jaggar, Kerry O. Cleveland, Jennifer D. Twilla, Shanise Patterson and Athena L. V. Hobbs

Pharmacy 2023, 11(2), 70; https://doi.org/10.3390/pharmacy11020070 - 5 Apr 2023

Cited by 1 | Viewed by 1784

Abstract

The CDC’s Core Elements of an Antimicrobial Stewardship Program (ASP) lists intravenous (IV) to oral (PO) conversion as an important pharmacy-based intervention. However, despite the existence of a pharmacist-driven IV to PO conversion protocol, conversion rates within our healthcare system remained low. We [...] Read more.

The CDC’s Core Elements of an Antimicrobial Stewardship Program (ASP) lists intravenous (IV) to oral (PO) conversion as an important pharmacy-based intervention. However, despite the existence of a pharmacist-driven IV to PO conversion protocol, conversion rates within our healthcare system remained low. We aimed to evaluate the impact of a revision to the current conversion protocol on conversion rates, using linezolid as a marker due to its high PO bioavailability and high IV cost. This retrospective, observational study was conducted within a healthcare system composed of five adult acute care facilities. The conversion eligibility criteria were evaluated and revised on 30 November 2021. The pre-intervention period started February 2021 and ended November 2021. The post-intervention period was December 2021 to March 2022. The primary objective of this study was to establish if there was a difference in PO linezolid utilization reported as days of therapy per 1000 days present (DOT/1000 DP) between the pre- and post-intervention periods. IV linezolid utilization and cost savings were investigated as secondary objectives. The average DOT/1000 DP for IV linezolid decreased from 52.1 to 35.4 in the pre- and post-intervention periods, respectively (p < 0.01). Inversely, the average DOT/1000 DP for PO linezolid increased from 38.9 in the pre-intervention to 58.8 for the post-intervention period, p < 0.01. This mirrored an increase in the average percentage of PO use from 42.9 to 62.4% for the pre- and post-intervention periods, respectively (p < 0.01). A system-wide cost savings analysis showed projected total annual cost savings of USD 85,096.09 for the system, with monthly post-intervention savings of USD 7091.34. The pre-intervention average monthly spend on IV linezolid at the academic flagship hospital was USD 17,008.10, which decreased to USD 11,623.57 post-intervention; a 32% reduction. PO linezolid spend pre-intervention was USD 664.97 and increased to USD 965.20 post-intervention. The average monthly spend on IV linezolid for the four non-academic hospitals was USD 946.36 pre-intervention, which decreased to USD 348.99 post-intervention; a 63.1% reduction (p < 0.01). Simultaneously, the average monthly spend for PO linezolid was USD 45.66 pre-intervention and increased to USD 71.19 post-intervention (p = 0.03) This study shows the significant impact that an ASP intervention had on IV to PO conversion rates and subsequent spend. By revising criteria for IV to PO conversion, tracking and reporting results, and educating pharmacists, this led to significantly more PO linezolid use and reduced the overall cost in a large healthcare system. Full article

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

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9 pages, 637 KiB

Open AccessArticle

The Effect of Genotyping on the Number of Pharmacotherapeutic Gene–Drug Interventions in Chronic Kidney Disease Patients

by Catharina H. M. Kerskes, Carien J. M. E. van den Eijnde, Albert-Jan L. H. J. Aarnoudse, René J. E. Grouls, Birgit A. L. M. Deiman and Maarten J. Deenen

Pharmacy 2023, 11(2), 69; https://doi.org/10.3390/pharmacy11020069 - 4 Apr 2023

Cited by 4 | Viewed by 2183

Abstract

Patients with chronic kidney disease (CKD) stage 3–5 are polypharmacy patients. Many of these drugs are metabolized by cytochrome P450 (CYP450) and CYP450. Genetic polymorphism is well known to result in altered drug metabolism capacity. This study determined the added value [...] Read more.

Patients with chronic kidney disease (CKD) stage 3–5 are polypharmacy patients. Many of these drugs are metabolized by cytochrome P450 (CYP450) and CYP450. Genetic polymorphism is well known to result in altered drug metabolism capacity. This study determined the added value of pharmacogenetic testing to the routine medication evaluation in polypharmacy patients with CKD. In adult outpatient polypharmacy patients with CKD3-5 disease, a pharmacogenetic profile was determined. Then, automated medication surveillance for gene–drug interactions was performed based on the pharmacogenetic profile and the patients’ current prescriptions. Of all identified gene–drug interactions, the hospital pharmacist and the treating nephrologist together assessed clinical relevance and necessity of a pharmacotherapeutic intervention. The primary endpoint of the study was the total number of applied pharmacotherapeutic interventions based on a relevant gene–drug interaction. A total of 61 patients were enrolled in the study. Medication surveillance resulted in a total of 66 gene–drug interactions, of which 26 (39%) were considered clinically relevant. This resulted in 26 applied pharmacotherapeutic interventions in 20 patients. Systematic pharmacogenetic testing enables pharmacotherapeutic interventions based on relevant gene–drug interactions. This study showed that pharmacogenetic testing adds to routine medication evaluation and could lead to optimized pharmacotherapy in CKD patients. Full article

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

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12 pages, 524 KiB

Open AccessArticle

Antimicrobial Stewardship and Dose Adjustment of Restricted Antimicrobial Drugs in Hospital Setting

by Iva Vlak, Ivana Samardžić, Ivana Marinović, Nikolina Bušić and Vesna Bačić Vrca

Pharmacy 2023, 11(2), 68; https://doi.org/10.3390/pharmacy11020068 - 2 Apr 2023

Cited by 1 | Viewed by 2747

Abstract

Antimicrobial consumption is increasing. In order to maximize the effectiveness of antimicrobial stewardship and provide safe and optimal use of restricted antimicrobial drugs, renal dosing should be evaluated. The aim of this study was to determine the prevalence of restricted antimicrobial drugs that [...] Read more.

Antimicrobial consumption is increasing. In order to maximize the effectiveness of antimicrobial stewardship and provide safe and optimal use of restricted antimicrobial drugs, renal dosing should be evaluated. The aim of this study was to determine the prevalence of restricted antimicrobial drugs that required dose adjustment according to renal function. A retrospective, consecutive study was conducted at University Hospital Dubrava. This study analyzed requests for restricted antimicrobial drugs (n = 2890) during a 3-month period. Requests for antimicrobial agents were evaluated by the antimicrobial therapy management team (A-team). This study included 412 restricted antimicrobial drug requests requiring dose adjustment, of which 39.1% did not have an adjusted dose. Meropenem, Ciprofloxacin, Piperacillin/Tazobactam, Vancomycin, Colistin and the antimycotic Fluconazole were the most frequent restricted antimicrobial drugs that required dose adjustment according to impaired renal function. The results of this research highlight the importance of the A-team in the optimization of restricted antimicrobial therapy. Non-adjusted doses of restricted antimicrobial drugs increase the possibility of adverse drug reactions and therefore jeopardize pharmacotherapy outcomes and patient safety. Full article

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

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12 pages, 456 KiB

Open AccessArticle

Establishing the Approach of Norm Balance toward Intention Prediction across Six Behaviors under the Theory of Planned Behavior

by Yifei Liu, Karen B. Farris, Dhananjay Nayakankuppam and William R. Doucette

Pharmacy 2023, 11(2), 67; https://doi.org/10.3390/pharmacy11020067 - 31 Mar 2023

Cited by 2 | Viewed by 2085

Abstract

Background: An innovative approach of Norm Balance is proposed under the Theory of Planned Behavior (TPB). In this approach, the measurement score of subjective norm is weighted by the relative importance of others, and the measurement score of self-identity is weighted by [...] Read more.

Background: An innovative approach of Norm Balance is proposed under the Theory of Planned Behavior (TPB). In this approach, the measurement score of subjective norm is weighted by the relative importance of others, and the measurement score of self-identity is weighted by the relative importance of self. The study objective was to examine the effect of Norm Balance to predict behavioral intentions in two groups of college students. Methods: Cross-sectional surveys were used in two studies. For 153 business undergraduates, Study 1 examined three common intentions: eating a low-fat diet, exercising regularly, and dressing business-like. For 176 PharmD students, Study 2 examined three pharmacy-related intentions: informing relatives about counterfeit medications, buying prescription medications online, and completing a pharmacy residency. The relative importance of others vs. self was measured by asking study subjects to allocate 10 points between important others and oneself. Two sets of regressions were conducted and compared across six intentions using the traditional model and the Norm Balance model. Results: The 12 regressions explained 59–77% of intention variance. The variance explained by the two models was similar. When subjective norm or self-identity was non-significant in the traditional model, the corresponding Norm Balance component was significant in the Norm Balance model, except for eating a low-fat diet. When both subjective norm and self-identity were significant in the traditional model, the two Norm Balance components were significant in the Norm Balance model with increased coefficients. Conclusions: The proposed approach of Norm Balance provides a different view about the significance and coefficients of subjective norm and self-identity toward intention prediction. Full article

(This article belongs to the Topic Advancing the Knowledge and Application of Health Behavior Theories)
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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10 pages, 238 KiB

Open AccessArticle

Impact of the Novel CoronaviruS (COVID-19) on Frontline PharmacIsts Roles and ServicEs: INSPIRE Worldwide Survey

by Kaitlyn E. Watson, Dillon H. Lee, Mohammad B. Nusair and Yazid N. Al Hamarneh

Pharmacy 2023, 11(2), 66; https://doi.org/10.3390/pharmacy11020066 - 29 Mar 2023

Cited by 3 | Viewed by 1982

Abstract

Background: Pharmacy has been recognized as a vital healthcare profession during the COVID-19 pandemic. The primary objective of the INSPIRE Worldwide survey was to determine the impact of COVID-19 on pharmacy practice and pharmacists’ roles around the world. Methods: A cross-sectional online questionnaire [...] Read more.

Background: Pharmacy has been recognized as a vital healthcare profession during the COVID-19 pandemic. The primary objective of the INSPIRE Worldwide survey was to determine the impact of COVID-19 on pharmacy practice and pharmacists’ roles around the world. Methods: A cross-sectional online questionnaire with pharmacists who provided direct patient care during the pandemic. Participants were recruited through social media, with assistance from national and international pharmacy organizations between March 2021–May 2022. The questionnaire was divided into (1) demographics, (2) pharmacists’ roles, (3) communication strategies, and (4) practice challenges. The data were analyzed using SPSS 28, and descriptive statistics were used to report frequencies and percentages. Results: A total of 505 pharmacists practicing in 25 countries participated. The most common role that pharmacists undertook was responding to drug information requests (90%), followed by allaying patients’ fears and anxieties about COVID-19 (82.6%), and addressing misinformation about COVID-19 treatments and vaccinations (80.4%). The most common challenges were increased stress levels (84.7%), followed by medication shortages (73.8%), general supply shortages (71.8%), and inadequate staffing (69.2%). Conclusions: Pharmacists within this study were significantly impacted by the COVID-19 pandemic and took on new or adapted roles (e.g., providing COVID-specific information, managing patients’ emotions, and educating on public health measures) to meet the needs of their communities. Despite, the significant challenges (e.g., increased stress, supply chain challenges, addressing misinformation, and staffing shortages) faced by pharmacists, they continued to put their patients’ needs first and to provide pharmacy services. Full article

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

11 pages, 244 KiB

Open AccessArticle

Impact of an Interprofessional Education Activity on Student Knowledge and Attitudes Regarding Patient Safety

by Deepti Vyas, Tracey DelNero and Benjamin Reece

Pharmacy 2023, 11(2), 65; https://doi.org/10.3390/pharmacy11020065 - 24 Mar 2023

Viewed by 1617

Abstract

This study aimed to measure the impact of an interprofessional education (IPE) activity on student knowledge and attitudes regarding patient safety. Two 4 h IPE activities were designed to provide students with foundational information regarding patient safety. Interprofessional teams discussed the individual curricula [...] Read more.

This study aimed to measure the impact of an interprofessional education (IPE) activity on student knowledge and attitudes regarding patient safety. Two 4 h IPE activities were designed to provide students with foundational information regarding patient safety. Interprofessional teams discussed the individual curricula and roles/responsibilities of each represented health profession. Teams then served on a mock committee tasked with completing a root cause analysis of a fictitious sentinel event. Students completed a pre/post-quiz and pre/post-attitudes survey to measure knowledge and attitudes. Five months later, students reconvened to serve on a second mock sentinel event committee. Students completed a post-activity survey after the second activity. Four hundred and seven students participated in the first activity, while two hundred and eighty participated in the second activity. Quiz score comparisons revealed improved knowledge, with post-quiz scores being significantly higher. Pre- and post-attitude survey comparisons indicated a significant improvement in participant attitudes towards interprofessional teamwork. Seventy-eight percent of students reported the IPE activity enhanced their ability to “engage other health professions students in shared patient-centered care”. This IPE activity resulted in knowledge and attitude improvement related to patient safety. Full article

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

13 pages, 723 KiB

Open AccessReview

Pharmacists’ Mental Health during the First Two Years of the Pandemic: A Socio-Ecological Scoping Review

by Liam Ishaky, Myuri Sivanthan, Mina Tadrous, Behdin Nowrouzi-Kia, Lisa McCarthy, Andrew Papadopoulos and Basem Gohar

Pharmacy 2023, 11(2), 64; https://doi.org/10.3390/pharmacy11020064 - 24 Mar 2023

Cited by 6 | Viewed by 3163

Abstract

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the [...] Read more.

Healthcare workers have been under a great deal of stress and have been experiencing burnout throughout the COVID-19 pandemic. Among these, healthcare workers are pharmacists who have been instrumental in the fight against the pandemic. This scoping review examined the impact of the pandemic on pharmacists’ mental health and their antecedents using three databases (CINAHL, MEDLINE, and PsycINFO). Eligible studies included primary research articles that examined the mental health antecedents and outcomes among pharmacists during the first two years of the pandemic. We used the Social Ecological Model to categorize antecedents per outcome. The initial search yielded 4165 articles, and 23 met the criteria. The scoping review identified pharmacists experiencing poor mental health during the pandemic, including anxiety, burnout, depression, and job stress. In addition, several individual, interpersonal, organizational, community, and policy-level antecedents were identified. As this review revealed a general decline in pharmacists’ mental health during the pandemic, further research is required to understand the long-term impacts of the pandemic on pharmacists. Furthermore, we recommend practical mitigation strategies to improve pharmacists’ mental health, such as implementing crisis/pandemic preparedness protocols and leadership training to foster a better workplace culture. Full article

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

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15 pages, 792 KiB

Open AccessArticle

Medication-Related Complaints in Residential Aged Care

by Juanita L. Breen, Kathleen V. Williams and Melanie J. Wroth

Pharmacy 2023, 11(2), 63; https://doi.org/10.3390/pharmacy11020063 - 23 Mar 2023

Cited by 2 | Viewed by 3880

Abstract

Complaints reflect a person’s or family’s experience within the aged care system and provide important insight into community expectations and consumer priorities. Crucially, when aggregated, complaints data can serve to indicate problematic trends in care provision. Our objective was to characterize the areas [...] Read more.

Complaints reflect a person’s or family’s experience within the aged care system and provide important insight into community expectations and consumer priorities. Crucially, when aggregated, complaints data can serve to indicate problematic trends in care provision. Our objective was to characterize the areas of medication management most frequently complained about in Australian residential aged care services from 1 July 2019 to 30 June 2020. A total of 1134 complaint issues specifically referenced medication use. Using content analysis, with a dedicated coding framework, we found that 45% of these complaints related to medicine administration processes. Three categories received nearly two thirds of all complaints: (1) not receiving medication at the right time; (2) inadequate medication management systems; and (3) chemical restraint. Half of the complaints described an indication for use. These were, in order of frequency: ‘pain management’, ‘sedation’, and ‘infectious disease/infection control’. Only 13% of medication-related complaints referred to a specific pharmacological agent. Opioids were the most common medication class referred to in the complaint dataset, followed by psychotropics and insulin. When compared to complaint data composition overall, a higher proportion of anonymous complaints were made about medication use. Residents were significantly less likely to lodge complaints about medication management, probably due to limited engagement in this part of clinical care provision. Full article

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

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13 pages, 747 KiB

Open AccessPerspective

The Pharmacist Prescriber: A Psychological Perspective on Complex Conversations about Medicines: Introducing Relational Prescribing and Open Dialogue in Physical Health

by David Rogalski, Nina Barnett, Amanda Bueno de Mesquita and Barry Jubraj

Pharmacy 2023, 11(2), 62; https://doi.org/10.3390/pharmacy11020062 - 22 Mar 2023

Viewed by 3573

Abstract

Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to [...] Read more.

Pharmacists have traditionally supported the prescribing process, arguably in reactive or corrective roles. The advent of pharmacist prescribing in 2004 represented a major shift in practice, leading to greater responsibility for making clinical decisions with and for patients. Prescribing rights require pharmacists to take a more prescriptive role that will allow them to contribute to long-standing prescribing challenges such as poor medication adherence, overprescribing, and the need for shared decision-making and person-centered care. Central to these endeavors are the development and possession of effective consultation skills. University schools of pharmacists in the UK now routinely include consultation skills training, which is also provided by national education bodies. These challenges remain difficult to overcome, even though it is understood, for example, that increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments. More recently, a concerted effort has been made to tackle overprescribing and the harm that may occur through the inappropriate use of medication. In routine pharmacy work, these priorities may linger at the bottom of the list due to the busy and complex nature of the work. Solutions to these problems of adherence, optimizing benefits of medication, and overprescribing have typically been pragmatic and structured. However, an arguably reductionist approach to implementation fails to address the complex patient interactions around prescribing and taking medication, and the heterogeneity of the patient’s experience, leaving the answers elusive. We suggest that it is essential to explore how person-centered care is perceived and to emphasize the relational aspects of clinical consultations. The development of routine pharmacist prescribing demands building on the core values of person-centered care and shared decision making by introducing the concepts of “relational prescribing” and “open dialogue” to cultivate an essential pharmacotherapeutic alliance to deliver concrete positive patient outcomes. We provide a vignette of how a clinical case can be approached using principles of relational prescribing and open dialogue. We believe these are solutions that are not additional tasks but must be embedded into pharmacy practice. This will improve professional satisfaction and resilience, and encourage curiosity and creativity, particularly with the advent of all pharmacists in Great Britain becoming prescribers at graduation from 2026. Full article

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

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17 pages, 549 KiB

Open AccessArticle

SMART Pharmacists Serving the New Needs of the Post-COVID Patients, Leaving No-One Behind

by Tatjana Šipetić, Dragana Rajković, Nataša Bogavac Stanojević, Valentina Marinković, Arijana Meštrović and Michael J. Rouse

Pharmacy 2023, 11(2), 61; https://doi.org/10.3390/pharmacy11020061 - 22 Mar 2023

Cited by 1 | Viewed by 2062

Abstract

This study aims to demonstrate the improvements in clinical symptoms in patients with post-COVID syndrome after a community pharmacy-based intervention in Serbia. The Pharmaceutical Chamber of Serbia (“Chamber”) invited pharmacists to deliver post-COVID patient care counselling, supported by the SMART Pharmacist Program, offering [...] Read more.

This study aims to demonstrate the improvements in clinical symptoms in patients with post-COVID syndrome after a community pharmacy-based intervention in Serbia. The Pharmaceutical Chamber of Serbia (“Chamber”) invited pharmacists to deliver post-COVID patient care counselling, supported by the SMART Pharmacist Program, offering education and guidance. Present symptoms, duration and patient self-reported severity of symptoms on a scale of 1–5 on the first visit were recorded. After the counselling and proposed self-medication treatment, the time of the follow-up visit and the severity of the recorded symptoms were also recorded. The prospective data collection lasted from December 2021 to September 2022. In total, 871 patients with post-COVID symptoms were included in the study, served by 53 pharmacists. The most frequently reported post-COVID symptoms coincided with the literature, mostly related to the respiratory system (51.2%), immunity status (32.2%), fatigue and exhaustion (30.7%), skin, hair and nails (27.4%) and cognitive functions (27.9%). A total of 26.5% of patients were referred to their family physician (general practitioner), and 69.5% returned to the pharmacist for a follow-up visit. On the first visit, the median severity of patients’ symptoms was three, while on the second visit it dropped to one. The pharmacists’ intervention led to a significant improvement in the post-COVID patients’ condition. Full article

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

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12 pages, 592 KiB

Open AccessReview

Medication-Related Outcomes and Health Equity: Evidence for Pharmaceutical Care

by Tamasine Grimes, Romaric Marcilly, Lorna Bonnici West and Maria Cordina

Pharmacy 2023, 11(2), 60; https://doi.org/10.3390/pharmacy11020060 - 22 Mar 2023

Cited by 1 | Viewed by 3533

Abstract

Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities [...] Read more.

Marginalised people experience diminished access to pharmaceutical care and worse medication-related outcomes than the general population. Health equity is a global priority. This article explores the key evidence of health inequity and medication use, structures the causes and contributory factors and suggests opportunities that can be taken to advance the pharmaceutical care agenda so as to achieve health equity. The causes of, and contributors to, this inequity are multi-fold, with patient- and person-related factors being the most commonly reported. Limited evidence is available to identify risk factors related to other aspects of a personal medication use system, such as technology, tasks, tools and the internal and the external environments. Multiple opportunities exist to enhance equity in medication-related outcomes through pharmaceutical care research and practice. To optimise the effects and the sustainable implementation of these opportunities, it is important to (1) ensure the meaningful inclusion and engagement of members of marginalised groups, (2) use a person-centred approach and (3) apply a systems-based approach to address all of the necessary components of a system that interact and form a network as work processes that produce system outcomes. Full article

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

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12 pages, 1703 KiB

Open AccessArticle

Pre-Professional International Mobility of European Pharmacy Students—A French Example

by Mihayl Varbanov, Danièle Bensoussan and Marc Devocelle

Pharmacy 2023, 11(2), 59; https://doi.org/10.3390/pharmacy11020059 - 20 Mar 2023

Viewed by 2181

Abstract

Internationalisation, as well as the need to interact with international partners in academia and in the pharmaceutical industry, brings an international experience to the pharmacist’s career, which is essential. The objective of present work is to provide a preliminary study of the current [...] Read more.

Internationalisation, as well as the need to interact with international partners in academia and in the pharmaceutical industry, brings an international experience to the pharmacist’s career, which is essential. The objective of present work is to provide a preliminary study of the current situation of the pre-professional mobility of pharmacy students. It represents the first case study of the international pre-professional mobility of pharmacy students in France, and in north-eastern France in particular. The study is based on a recent preliminary survey among pharmacy students, conducted in 2020 at the University of Lorraine’s Faculty of Pharmacy, reflecting the impact of international mobility programmes, such as the European Union educational and training mobility programme Erasmus+, on the pharmacy curriculum. The results of the present work tend to show that, despite a number of barriers to the international mobility of pharmacy students, the outcomes of international pre-professional mobility are rather positive in their globality. Full article

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11 pages, 288 KiB

Open AccessReview

Sodium-Glucose Cotransporter-2 (SGLT-2) Inhibitors Use among Heart Failure Patients and the Role of Pharmacists in Early Initiation of Therapy

by Mohammed Aldhaeefi, Brandon Beers, Jenny Shah, Saba Saeidi Rizi, Dhakrit Rungkitwattanakul, Oliver Nimoh, Victoria Frimpong, Jackie Gonzalez, Sanaa Belrhiti, Fatima Urooj and Deborah Williams

Pharmacy 2023, 11(2), 58; https://doi.org/10.3390/pharmacy11020058 - 17 Mar 2023

Cited by 3 | Viewed by 2742

Abstract

Heart failure (HF) is a growing major public health and economic concern in the United States and worldwide. Heart failure mortality rates can be as high as 75% despite advances in therapies. HF is expected to be the fastest growing among all cardiovascular [...] Read more.

Heart failure (HF) is a growing major public health and economic concern in the United States and worldwide. Heart failure mortality rates can be as high as 75% despite advances in therapies. HF is expected to be the fastest growing among all cardiovascular diseases, with HF-associated direct medical costs projected to nearly double over the next 10 years. Hospital admissions, re-admission, and medical cost are a huge burden to the healthcare system, and this is estimated to have increased gradually over the past decades despite the available advances in HF treatment and prevention. Many heart failure therapies have shown improvement in terms of mortality, morbidity, and symptomatic management. Guideline-directed medical therapy (GDMT) for heart failure has proven its ability to reduce morbidity and mortality by 66%. GDMT is recommended to be used among all HF patients when appropriate. In recent years, two new drug classes, angiotensin receptor-neprilysin inhibitor (ARNi) and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, were approved by the United States Food and Drug Administration (US FDA) for the management of heart failure. The exact mechanism by which the SGLT-2 inhibitors attenuate the inflammatory process remains unclear. Several mechanisms have been suggested related to the cardiovascular benefit of SGLT-2 inhibitors, including a reduction in inflammation, improvement in natriuresis/diuresis, and promotion of the use of ketones as a secondary energy source. Clinical data showed that SGLT-2 inhibitors have morbidity and mortality benefits within 30 days of initiation. Studies have proven that clinical pharmacists practicing in HF inpatient and outpatient settings resulted in a reduction of HF hospitalization and an increase in the uptake of GDMT by initiating or up-titrating GDMT agents as well as providing patient education. Full article

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

12 pages, 260 KiB

Open AccessArticle

Drug Information Sources for Patients with Chronic Conditions in the Qassim Region, Saudi Arabia

by Saeed Alfadly, Mohammed Anaam, Mohammed Alshammari, Saud Alsahali, Ejaz Ahmed, Abdulkareem Bin Mubarak, Abdullah Aldahouk and Muhanna Aljameeli

Pharmacy 2023, 11(2), 57; https://doi.org/10.3390/pharmacy11020057 - 16 Mar 2023

Cited by 1 | Viewed by 2185

Abstract

Appropriate drug information is vital for the correct use of drugs in pharmaceutical practice. Providing patients with educational advice on prescribed medication and on proper medication administration has become an essential part of the pharmaceutical care process. The objectives of this study were [...] Read more.

Appropriate drug information is vital for the correct use of drugs in pharmaceutical practice. Providing patients with educational advice on prescribed medication and on proper medication administration has become an essential part of the pharmaceutical care process. The objectives of this study were to identify patients’ knowledge of prescribed medications, their desire for more information, and the sources of medication information in a population from Qassim, Saudi Arabia, using a cross-sectional descriptive study. Our target population consisted of adult patients with chronic illnesses receiving drugs at outpatient pharmacies. Nineteen pharmacies were selected based on convenience. After collecting their prescriptions, patients were asked to take part in the study by interviewers as they were leaving the pharmacies. The questionnaire used was pretested on 18 patients and then modified accordingly. questions investigated participants’ knowledge of drug information, their wish for more information, and their sources of drug information, other than clinicians. Descriptive analysis was used to describe patients’ physical details. The effect of sex, education, diagnosis, number of drugs, and age on knowledge of the purpose of drugs and the need for additional information were tested using Chi-square test. A total of 270 patients were interviewed, of whom 29.7% reported not knowing the purpose of at least one of their medications, and only reading a portion of the PILs. Of the patients sampled, 56.7% said they read the side effects section of the PIL, 43.3% reported reading the uses, while 27% read the contraindications. The drug -interactions section was the least read, with only 18.9% reporting reading it. A total of 57% of the patients reported that they needed more information about their medications. Highly educated patients reported using the PIL, social media, family and friends, TV, and newspapers as sources of drug information at significantly higher rates than patients with lower levels of education. Healthcare professionals should assess patient comprehension and the need for additional drug information, especially among patients with low levels of education. Additionally, healthcare professionals should consider other information sources used by their patients. Full article

5 pages, 202 KiB

Open AccessEditorial

Advancing Public Health through Community Pharmacy Practice

by Natalie DiPietro Mager and David Bright

Pharmacy 2023, 11(2), 56; https://doi.org/10.3390/pharmacy11020056 - 15 Mar 2023

Cited by 4 | Viewed by 4231

Abstract

The overarching goal of public health is to advance the health of individuals, communities, and populations [...] Full article

(This article belongs to the Special Issue Advancing Public Health Through Community Pharmacy Practice)

7 pages, 240 KiB

Open AccessCommunication

In-Person or Online? Exploring Student Pharmacists’ Perceived Change in Interprofessional Skills between Two Delivery Formats

by Jared Van Hooser and Anthony W. Olson

Pharmacy 2023, 11(2), 55; https://doi.org/10.3390/pharmacy11020055 - 14 Mar 2023

Cited by 3 | Viewed by 1528

Abstract

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education [...] Read more.

The COVID-19 pandemic drastically changed how education is delivered. Many academic programs quickly transformed their curriculum to online distance learning. This rapid transition may have compromised the rigor and fidelity of these activities. The Interprofessional Standardized Patient Experience (ISPE) is an interprofessional education activity (IPE) involving a team of students from six different healthcare professions that switched to an online delivery format. This manuscript compares pharmacy students’ perceived change in interprofessional skills between the two formats. Following the ISPE, second-year pharmacy students completed the revised Interprofessional Collaborative Competencies Attainment Survey (ICCAS-R). The ICCAS-R assesses the change in interprofessional collaboration-related competencies in healthcare students before and after IPE training using a retrospective pre–post approach. For each ICCAS-R item and each delivery format (44 in-person and 51 online), paired Student’s t-test on pre- and post-ISPE scores, and Cohen’s d were calculated. Every item of the ICCAS-R was significant (p < 0.001), regardless of delivery format. Nearly all ICCAS-R items had a large effect size, and the remaining items had a medium effect size. The amount of change pre- and post-ISPE for each ICCAS-R item was calculated. Student’s t-test was used to compare the magnitude of change in interprofessional skills between the two delivery formats. Only one difference was noted between the two delivery formats—ICCAS-R item 16, which measured actively listening to interprofessional team members (p = 0.0321). When switching to an online format, the high-fidelity dimension of the ISPE was retained. The ISPE is an effective IPE activity at increasing pharmacy students’ self-perceived interprofessional collaboration skills regardless of delivery format. Even though students reported the ISPE increased their ability to actively listen to the perspectives of interprofessional team members in both formats, the magnitude of the benefit was more profound in the in-person group. Full article

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

16 pages, 319 KiB

Open AccessArticle

Perceptions of and Preparedness for the Application of Pharmacoeconomics in Practice, among Final Year Bachelor of Pharmacy Students in South Africa: A National Cross-Sectional Study

by Carlien Schmidt, Moliehi Matlala, Brian Godman, Amanj Kurdi and Johanna C. Meyer

Pharmacy 2023, 11(2), 54; https://doi.org/10.3390/pharmacy11020054 - 14 Mar 2023

Viewed by 1856

Abstract

For the improvement of access to health, many countries including South Africa, have adopted universal healthcare. However, this requires skills to apply health technology assessments for the facilitation of investment decisions. This study aimed to ascertain final year Bachelor of Pharmacy (BPharm) students’ [...] Read more.

For the improvement of access to health, many countries including South Africa, have adopted universal healthcare. However, this requires skills to apply health technology assessments for the facilitation of investment decisions. This study aimed to ascertain final year Bachelor of Pharmacy (BPharm) students’ perceptions of the relevance of pharmacoeconomics in pharmacy practice, and their level of preparedness to apply pharmacoeconomic principles, using a quantitative, cross-sectional, and descriptive design. Data were collected using a self-administered questionnaire over 12 months, and included student demographics, knowledge about pharmacoeconomics and its applicability in practice, as well as students’ satisfaction with the appropriateness of the curriculum content. Five of nine universities offering pharmacy education took part. The overallstudent response rate was 38.1% (189/496), with 26.2% (45/172) of students signifying a good understanding of basic pharmacoeconomic concepts. Pharmacoeconomics application in South Africa was perceived to be relevant by 87.5% (140/160); however, 47.0% (79/168) felt they were not prepared to apply pharmacoeconomic principles in medicine management, and 86.7% (137/158) wanted to acquire additional pharmacoeconomic knowledge. Whilst students’ perceptions of the relevance of pharmacoeconomics were positive, results indicated a gap in knowledge, understanding, and application. Addressing this gap may increase students’ preparedness to apply pharmacoeconomic principles and better equip them for the practical application of pharmacoeconomics post qualification. Consequently, we have started this process. Full article

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

17 pages, 275 KiB

Open AccessArticle

Comparison of Fracture Identification Using Different Definitions in Healthcare Administrative (Claims) Data

by Natalia Konstantelos, Andrea M. Burden, Angela M. Cheung, Sandra Kim, Paul Grootendorst and Suzanne M. Cadarette

Pharmacy 2023, 11(2), 53; https://doi.org/10.3390/pharmacy11020053 - 14 Mar 2023

Viewed by 1819

Abstract

We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older [...] Read more.

We identified inconsistency in fracture definitions in a prior review of studies that utilized claims data. Here, we aimed to compare fracture rates estimated using thirteen hip and seven radius/ulna fracture definitions. Our primary analysis compared results in a cohort of 120,363 older adults treated with oral bisphosphonates for ≥3 years. The most inclusive definition (hip: inpatient or emergency diagnosis; radius/ulna: inpatient, emergency, or outpatient diagnosis) served as a referent to compare the number and proportion of fractures captured. In sensitivity analyses, we considered a 180-day washout, excluded fractures associated with trauma; and hip only, excluded: (1) subtrochanteric fractures, and (2) hip replacement procedures. Hip fractures varied by definition in number (52–8058) and incidence (0.7–111.8/10,000 person-years). The second most inclusive definition required one inpatient diagnosis and identified 8% fewer hip fractures than the referent. Excluding hip replacements missed 33% of hip fractures relative to the primary analysis. Radius/ulna fractures also ranged in number (1589–6797) and incidence (22.0–94.3/10,000 person-years). Outpatient data were important, when restricted to inpatient or emergency data, only 78% of radius/ulna fractures were identified. Other than hip replacement procedures, sensitivity analyses had minimal impact on fracture identification. Analyses were replicated in a cohort of patients treated with long-term glucocorticoids. This study highlights the importance and impact of coding decisions on fracture outcome definitions. Further research is warranted to inform best practice in fracture outcome identification. Full article

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

16 pages, 2637 KiB

Open AccessArticle

Community-Centered Patient Journey Map in Opioid Use Disorder: A Tool to Address Compassion Fatigue among Community Pharmacists

by Kenneth Charles Hohmeier, Alina Cernasev, Christina Leibold, Todd M. Moore, Erica Schlesinger, Gerald Cochran, Ileana Arce, Wesley Geminn and Marie Chisholm-Burns

Pharmacy 2023, 11(2), 52; https://doi.org/10.3390/pharmacy11020052 - 14 Mar 2023

Cited by 2 | Viewed by 2710

Abstract

Community pharmacists have become increasingly exposed to opioid use disorders in recent decades. However, both pharmacist training and traditional practice environments have not been adequate to prepare the pharmacist for both the patient care needs and regulatory barriers of patients experiencing opioid use [...] Read more.

Community pharmacists have become increasingly exposed to opioid use disorders in recent decades. However, both pharmacist training and traditional practice environments have not been adequate to prepare the pharmacist for both the patient care needs and regulatory barriers of patients experiencing opioid use disorders (OUD). As a result, there is a need to increase pharmacists’ awareness of both the overall patient experience as they navigate their OUD and the role of the community pharmacy as a touchpoint within that experience. To this end, a Community-Centered Patient Journey in Drug Addiction Treatment journey map was developed with expert insights, clinical experience, and in-depth interviews (conducted in spring of 2021) with 16 participants enrolled in licensed opioid treatment programs in Tennessee. Patients, policymakers, clinicians, and academic researchers were involved in the map development. Lived experiences of key informants were captured via in-depth interviews. A consensus decision-making approach was used throughout the patient journey map development process. The final patient journey map illustrates a non-linear pathway, describes the central role of the patient’s community, and emphasizes three major “pain points” within the system (access, adherence, and affordability). Future research should investigate the impact of such a journey map on pharmacy personnel’s knowledge, attitudes, and behaviors. Full article

(This article belongs to the Special Issue Advancing Public Health Through Community Pharmacy Practice)

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11 pages, 252 KiB

Open AccessArticle

Consumer Impressions of the Safety and Effectiveness of OTC Medicines

by Jeffrey Gordon Taylor, Stephen Ayosanmi and Sujit S. Sansgiry

Pharmacy 2023, 11(2), 51; https://doi.org/10.3390/pharmacy11020051 - 10 Mar 2023

Cited by 1 | Viewed by 2752

Abstract

The public generally believes OTC medicines to be helpful for treating minor ailments. From a survey point of view, that position often originates from feedback obtained when these medicines are considered as one broad category. The objective of the study was to assess [...] Read more.

The public generally believes OTC medicines to be helpful for treating minor ailments. From a survey point of view, that position often originates from feedback obtained when these medicines are considered as one broad category. The objective of the study was to assess the properties of 15 categories of agents across three dimensions—effectiveness, safety, and familiarity. Data were gathered via an online non-random survey in one Canadian province, where residents were asked to consider 15 OTC medicine categories in terms of those dimensions. Five hundred and seventy-five completed surveys were obtained out of 3000 sent. On the 10-point effectiveness scale, values ranged from 5.1 (Athlete’s foot cream) to 7.3 (headache medicine). For safety, the medicines were closely grouped (6.0 to 7.4). Cough syrups for children were perceived as less safe than those for adults. There was a trend in that, as product familiarity grew, so did impressions of safety and effectiveness. The results support other reports where OTC medicines are described as safe and effective, although safety ratings were not particularly high. Responders considered these medicines to generally be higher in safety than effectiveness. Full article

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

9 pages, 256 KiB

Open AccessArticle

Cultivating COVID-19 Vaccine Confidence in Pharmacy Professionals

by Osama Aqel, Banin Alqadheeb, Mariana Felix, Collin Amundson, Jennifer M. Bingham, Katie Meyer, Terri Warholak and David R. Axon

Pharmacy 2023, 11(2), 50; https://doi.org/10.3390/pharmacy11020050 - 7 Mar 2023

Viewed by 2183

Abstract

Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists’ knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists’ knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education [...] Read more.

Pharmacists promote vaccinations and challenge misconceptions about vaccine hesitancy, yet pharmacists’ knowledge of vaccine confidence has not been assessed. The objective of this study was to compare pharmacists’ knowledge of coronavirus disease 2019 (COVID-19) vaccine confidence before and after a live continuing education (CE) session. This pretest–posttest study evaluated the differences before and after a live CE session on COVID-19 vaccine confidence provided to pharmacists at a nationwide health technology company. Participants’ total pretest and posttest scores were compared using paired t-tests, while pretest and posttest scores for each item were compared using chi-squared tests. A Bonferroni correction was applied, resulting in an alpha level of 0.005. A total of 279 pharmacists participated in this study. After the CE session, mean knowledge scores increased (5.2 ± 1.5 to 7.4 ± 1.35, p < 0.0001). After the CE session, there was no significant increase in pharmacists’ knowledge about the approach that is not recommended when discussing vaccination beliefs with a patient (71.3% to 77.4%, p = 0.099), determinants of vaccine uptake (83.9% to 87.8%, p = 0.182), and social determinants of health that can influence vaccination rates (93.6% to 96.4%, p = 0.121). There was a significant change in pre- and posttest knowledge for the remaining seven items. Full article

15 pages, 1065 KiB

Open AccessArticle

Evaluation of Medication Prescribing Applications Available in Australia

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

Pharmacy 2023, 11(2), 49; https://doi.org/10.3390/pharmacy11020049 - 6 Mar 2023

Cited by 1 | Viewed by 2962 | Correction

Abstract

Prescription request applications (apps) have changed the way consumers can obtain prescription-only medications. However, there is a lack of research surrounding such apps and their potential risks to consumers. We conducted an Australian study to (1) identify and characterise prescription request apps available [...] Read more.

Prescription request applications (apps) have changed the way consumers can obtain prescription-only medications. However, there is a lack of research surrounding such apps and their potential risks to consumers. We conducted an Australian study to (1) identify and characterise prescription request apps available in Australia and (2) assess whether prescription request apps in Australia adhere to guidelines for safe prescribing. Three online platforms (iOS App Store, Google Play store and Google search engine) were searched using 14 different search terms. Prescription request apps were identified based on pre-defined inclusion criteria. To determine whether the prescription request apps adhere to a safe prescribing framework, five medications were selected, and their corresponding consultation questionnaires were assessed against the Australian National Prescribing Service MedicineWise 12 core competencies for safe prescribing. A total of seven prescription request apps were identified. Assessment of the prescription request apps revealed that none of the apps provided prescribers with sufficient information to meet all the competencies required for safe prescribing; rather, they inconsistently adhered to the safe prescribing framework. Thus, consumers and healthcare professionals should consider the implications and safety concerns of obtaining medications via prescription request apps. Full article

(This article belongs to the Special Issue Digital Health in Pharmacy Practice and Education)

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