Pharmacy

11 pages, 651 KiB

Open AccessArticle

Operational Definitions of Polypharmacy and Their Association with All-Cause Hospitalization Risk: A Conceptual Framework Using Administrative Databases

by Stefano Scotti, Lorenza Scotti, Federica Galimberti, Sining Xie, Manuela Casula and Elena Olmastroni

Pharmacy 2025, 13(1), 15; https://doi.org/10.3390/pharmacy13010015 - 2 Feb 2025

Abstract

Polypharmacy, defined as the concurrent use of multiple medications, increases the risk of various adverse outcomes. However, the variability in definitions across the literature contributes to substantial heterogeneity. Building on the published literature, this study aimed to identify a set of operational definitions [...] Read more.

Polypharmacy, defined as the concurrent use of multiple medications, increases the risk of various adverse outcomes. However, the variability in definitions across the literature contributes to substantial heterogeneity. Building on the published literature, this study aimed to identify a set of operational definitions of polypharmacy applicable to administrative databases and to assess their association with all-cause hospitalization. Data from the pharmacy refill and hospitalization databases of the Local Health Unit (LHU) of Bergamo, Lombardy, were analyzed. Patients aged ≥40 with at least one reimbursed drug prescription in 2017 were included. Prescription coverage was evaluated using total defined daily doses (DDDs), and all-cause hospitalizations from January to June 2018 were considered. Definitions explored included (i) the WHO’s criterion of ≥5 medications by ATC fourth-level code; (ii) the exclusion of prescriptions usually for short-term treatments; and (iii) drugs with cumulative annual DDD ≥ 60. Approaches were assessed annually, quarterly, and monthly, and logistic regression was used to estimate odds ratios (ORs) for hospitalization risk. Among 431,620 patients, the DDD ≥ 60 definition showed the least variability (20.47–21.16%) and identified an older more complex cohort. All definitions showed a dose-dependent association with hospitalization risk. Different definitions of polypharmacy result in varying prevalence, with DDD ≥ 60 being the most consistent. A patient-centric approach is crucial to assess the appropriateness of polypharmacy. Full article

► Show Figures

Figure 1

15 pages, 684 KiB

Open AccessArticle

Impact and Enablers of Pharmacogenetic-Informed Treatment Decisions—A Longitudinal Mixed-Methods Study Exploring the Patient Perspective

by Anna Bollinger, Melissa Semedo Fortes, Henriette E. Meyer zu Schwabedissen, Kurt E. Hersberger, Céline K. Stäuble and Samuel S. Allemann

Pharmacy 2025, 13(1), 14; https://doi.org/10.3390/pharmacy13010014 - 31 Jan 2025

Abstract

Pharmacogenetic (PGx) testing is a promising approach for optimizing drug therapies. However, there is limited knowledge regarding its real-world utilization and long-term impact in clinical practice. This study assessed how often PGx information informs treatment decisions and evaluated patients’ perspectives on its use [...] Read more.

Pharmacogenetic (PGx) testing is a promising approach for optimizing drug therapies. However, there is limited knowledge regarding its real-world utilization and long-term impact in clinical practice. This study assessed how often PGx information informs treatment decisions and evaluated patients’ perspectives on its use and non-use, identifying enablers for PGx implementation. A mixed-methods study was conducted with 24 patients with a median of 1 year after PGx testing. Medication and health-related data were collected at enrollment and at the follow-up 1 year later using a semi-structured questionnaire. At the follow-up, 62 medication changes were identified in 18 patients. A median of four medication changes per patient were initiated mainly by medical specialists (58%). PGx information was considered for 15 patients in 39 medication changes (63%). Patient-reported factors contributing to the non-use of PGx information included a lack of knowledge and interest among healthcare professionals (HCPs), structural and administrative barriers, and an over-reliance on patient advocacy. Potential enablers should address targeted PGx education, interprofessional collaboration, awareness among policymakers, and concise recommendations focused on PGx-actionable drugs from testing providers. By implementing these interdependent enablers, PGx can evolve into a long-term, clinically integrated cornerstone of individualized pharmacotherapy. Full article

► Show Figures

Figure 1

11 pages, 856 KiB

Open AccessArticle

Using Healthcare Redesign to Identify Medication Management Issues in Parkinson’s Disease

by Susan Williams, Marissa A. Iannuzzi and Sarah J. Prior

Pharmacy 2025, 13(1), 13; https://doi.org/10.3390/pharmacy13010013 - 30 Jan 2025

Abstract

Background: Parkinson’s disease (PD) is a neurodegenerative disorder that is predominantly controlled through pharmacotherapy. People with PD have highly complex medication regimens that are often poorly managed during hospital admissions. This project aims to understand the issues experienced by patients with PD and [...] Read more.

Background: Parkinson’s disease (PD) is a neurodegenerative disorder that is predominantly controlled through pharmacotherapy. People with PD have highly complex medication regimens that are often poorly managed during hospital admissions. This project aims to understand the issues experienced by patients with PD and healthcare staff that impacted their medication management during their hospital admission at a tertiary metropolitan hospital in New South Wales, Australia. Methods: This project focuses on the mixed-methods diagnostics phase of the healthcare redesign approach to health service improvement, utilising organisational data, online surveys, interviews, and focus groups. Results: The findings from this project highlight key areas to address to improve the medication management of patients with PD admitted to hospital. The organisational data (n = 222) showed that the identification of PD patients, untimely medication reviews, prescribing errors, and untimely medication administration all contributed to poor patient experience. The staff surveys (n = 81) highlighted that a lack of knowledge of PD medications and poor patient identification impacted patient experience. The patient surveys (n = 18) and patient interviews (n = 16) suggested that confidence around medication management and administration timing could be improved. Conclusions: Poor PD medication management in hospital impacts the patient experience and should be improved to ensure better outcomes for patients and the health services. Full article

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

► Show Figures

Figure 1

21 pages, 595 KiB

Open AccessArticle

Exploring the Benefits, Barriers and Improvement Opportunities in Implementing Automated Dispensing Cabinets: A Qualitative Study

by Abbas Al Mutair, Alya Elgamri, Kawther Taleb, Batool Mohammed Alhassan, Mohamed Alsalim, Horia Alduriahem, Chandni Saha and Kawthar Alsaleh

Pharmacy 2025, 13(1), 12; https://doi.org/10.3390/pharmacy13010012 - 29 Jan 2025

Abstract

Technology has increasingly influenced the provision of healthcare services by enhancing patient safety, optimising workflows, and improving efficiency. Large healthcare facilities have adopted automated dispensing cabinets (ADCs) as an advanced technological solution. A key gap exists in understanding the ADC implementation experience in [...] Read more.

Technology has increasingly influenced the provision of healthcare services by enhancing patient safety, optimising workflows, and improving efficiency. Large healthcare facilities have adopted automated dispensing cabinets (ADCs) as an advanced technological solution. A key gap exists in understanding the ADC implementation experience in different contexts. Therefore, this study seeks to fill this literature gap by exploring key stakeholders’ perspectives on the benefits, barriers, and improvement opportunities related to ADCs, offering valuable insights to support their effective integration across various healthcare settings. This qualitative study was conducted in Saudi Arabia. The implementation of ADCs generally has positive outcomes for all staff. The system has brought about enhanced medication tracking, greater time efficiency, along with reduced workload and medication errors. However, there are barriers to their implementation, including changes in workflow and workload distribution, cabinet design, technical medication management challenges, and the need for staff training. To maximise the effectiveness of ADCs, healthcare organisations should focus on improving operational workflows, providing ongoing staff training, and maintaining robust system monitoring. Additionally, manufacturers should focus on advancing technology to further enhance the efficiency and functionality of ADCs. Full article

21 pages, 445 KiB

Open AccessArticle

Pharmacists’ Perspectives on Nicotine Vaping Products (NVPs) for Smoking Cessation in Australia: A Qualitative Analysis

by David Le, Maya Saba, Habib Bhurawala, Muhammad Aziz Rahman, Smita Shah and Bandana Saini

Pharmacy 2025, 13(1), 11; https://doi.org/10.3390/pharmacy13010011 - 29 Jan 2025

Abstract

Vaping, particularly the use of nicotine vaping products (NVPs), has emerged as a public health concern. The regulatory environment surrounding NVPs in Australia has rapidly evolved, shifting from a prescription-only model to availability through community pharmacies. Pharmacists play a critical role in addressing [...] Read more.

Vaping, particularly the use of nicotine vaping products (NVPs), has emerged as a public health concern. The regulatory environment surrounding NVPs in Australia has rapidly evolved, shifting from a prescription-only model to availability through community pharmacies. Pharmacists play a critical role in addressing vaping-related health concerns. This study explores Australian pharmacists’ perspectives on their professional roles and the support needed to manage vaping-related enquiries. Qualitative semi-structured interviews were conducted with 25 practicing pharmacists using a topic guide developed from the current literature and team expertise. The interviews were transcribed verbatim and analysed thematically using an inductive approach to identify key themes. Key themes included risk perception, professional vaping health-related services, professional practice and other support-related needs. Pharmacists expressed significant uncertainty about the risks and harms associated with vaping. There was apprehension around the regulatory complexity of supplying NVPs, and participants called for greater education and support, particularly around NVP’s place in smoking cessation and potential vaping cessation services. Effective public health messaging and risk communication about vaping are crucial. At the centre of recent legislative changes, pharmacists require training and professional support to address vaping-related scenarios and provide counselling that aligns with individual risk perceptions, ensuring NVP use is clinically appropriate. Full article

10 pages, 826 KiB

Open AccessArticle

Closing Tobacco Treatment Gaps for Rural Populations: The Role of Clinic-Based Pharmacists at a Federally Qualified Health Center

by Lavinia Salama, Karen Suchanek Hudmon, Leena Myran and Nervana Elkhadragy

Pharmacy 2025, 13(1), 10; https://doi.org/10.3390/pharmacy13010010 - 26 Jan 2025

Abstract

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed [...] Read more.

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients’ interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas. Full article

(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)

► Show Figures

Figure 1

10 pages, 217 KiB

Open AccessOpinion

Ultraviolet C Decontamination Devices in a Hospital Pharmacy: An Evaluation of Their Contribution

by Clara Baudart and Thomas Briot

Pharmacy 2025, 13(1), 9; https://doi.org/10.3390/pharmacy13010009 - 25 Jan 2025

Abstract

Purpose: The COVID-19 pandemic led to a major interest in ultraviolet C (UVC) disinfection devices and accelerated the implementation of UVC devices in healthcare facilities due to their proven efficacy in the inactivation of various pathogens. While UVC technology offers several advantages, some [...] Read more.

Purpose: The COVID-19 pandemic led to a major interest in ultraviolet C (UVC) disinfection devices and accelerated the implementation of UVC devices in healthcare facilities due to their proven efficacy in the inactivation of various pathogens. While UVC technology offers several advantages, some drawbacks remain. This report, drawing on studies, guidelines, and practical experiences related to the use of UVC technology in healthcare settings, examines the efficacy, advantages, and drawbacks of UVC devices, and their applications in aseptic drug-compounding pharmaceutical units. Summary: Studies, guidelines, and practical experiences were selected. UVC technology offers advantages such as rapid disinfection, reduced reliance on chemical agents, minimal waste, and freedom from manual disinfection variability, making it particularly valuable for maintaining aseptic conditions in compounding environments. However, some drawbacks persist, as it is a germ-dependent method and there is currently no standardized method for ensuring effectiveness. Conclusions: This opinion paper highlights the effectiveness of UCV technology in pharmaceutical compounding units, proving that it is a viable alternative to the traditionally used manual and operator-dependent methods. However, there is a need for standardized methods to evaluate UVC devices. Full article

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

13 pages, 191 KiB

Open AccessArticle

Integrating Domestic Violence Education into the Pharmacy Curriculum

by Harjit K. Khera, Rita Wardan, Hiu Tek Wu, Andy Ling and Suzanne M. Caliph

Pharmacy 2025, 13(1), 8; https://doi.org/10.3390/pharmacy13010008 - 22 Jan 2025

Abstract

Domestic violence (DV) is a pervasive issue with significant implications for public health, yet it remains under-addressed in healthcare systems. Pharmacists, as accessible healthcare providers, are in a unique position to identify and support individuals affected by DV, but training in this area [...] Read more.

Domestic violence (DV) is a pervasive issue with significant implications for public health, yet it remains under-addressed in healthcare systems. Pharmacists, as accessible healthcare providers, are in a unique position to identify and support individuals affected by DV, but training in this area is often lacking in pharmacy education. This study explores the challenges of and opportunities for integrating DV education into the pharmacy curriculum by interviewing twelve pharmacy educators from Monash University. Using semi-structured interviews, data were analyzed thematically to identify key barriers and facilitators. The findings highlight several benefits of integrating DV education, including pharmacists’ accessibility to patients and their ability to play a vital role in recognizing and responding to DV. However, challenges such as time constraints, lack of confidence, insufficient training, and perceived limitations on pharmacists’ scope of practice were noted. Ethical and legal concerns regarding pharmacists’ roles in DV cases were also identified. This study concludes that integrating DV education into pharmacy curricula is essential; however, it requires significant barriers to be overcome, including the need for specialised training and collaboration with DV experts. This study recommends interdisciplinary workshops and greater faculty support to equip future pharmacists with the necessary skills to address DV effectively. Full article

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

58 pages, 1984 KiB

Open AccessReview

Unveiling the Complexities of Medications, Substance Abuse, and Plants for Recreational and Narcotic Purposes: An In-Depth Analysis

by Iasmina-Alexandra Predescu, Alex-Robert Jîjie, Dalia Pătraşcu, Aida-Luisa-Vanessa Pasc, Elisaveta-Ligia Piroş, Cristina Trandafirescu, Cristian Oancea, Cristina Adriana Dehelean and Elena-Alina Moacă

Pharmacy 2025, 13(1), 7; https://doi.org/10.3390/pharmacy13010007 - 22 Jan 2025

Abstract

The complexities surrounding the use of medications, substance abuse, and the recreational use of plants are multifaceted and warrant a comprehensive examination. This review highlights the complexities surrounding the consumption of chemical substances in excess or for non-medical purposes, obtained through legal prescriptions, [...] Read more.

The complexities surrounding the use of medications, substance abuse, and the recreational use of plants are multifaceted and warrant a comprehensive examination. This review highlights the complexities surrounding the consumption of chemical substances in excess or for non-medical purposes, obtained through legal prescriptions, over-the-counter purchases, or illicit means, with an emphasis on the predictive role of stressors and individual-level variables in the development of substance use disorders, as well as the influence of the regulatory environment on patterns of consumption. Additionally, the alarming escalation in the mortality rate associated with illicit drug and opioid overdoses is also underscored. The recreational use of prescription medications can lead to significant health risks, particularly when combined with other substances; therefore, the need for interventions and preventive measures to address substance abuse among various populations is imperative. Furthermore, novel insights on substance abuse addiction, exploring the neurobiological mechanisms underlying addiction, and discussing treatment approaches and interventions are elucidated. Advancements in technology for detecting substance abuse are also highlighted, displaying innovative tools for more effective identification and monitoring. In conclusion, the complexities of medications, substance abuse, and the recreational use of plants reveal a landscape marked by overlapping motivations and health implications. The distinction between medical and recreational use is critical for understanding user behavior and addressing public health concerns. Full article

► Show Figures

Figure 1

7 pages, 187 KiB

Open AccessArticle

Optimising Asthma Self-Management: Preliminary Validation of an Arabic Version of the Inhaler Technique Questionnaire

by Malath Al-Juhaishi, Chiao Xin Lim, Ieva Stupans, Wejdan Shahin, Thilini R. Thrimawithana and Vincent Chan

Pharmacy 2025, 13(1), 6; https://doi.org/10.3390/pharmacy13010006 - 20 Jan 2025

Abstract

Background: Correct inhaler technique is vital for managing respiratory conditions like asthma. Patients from culturally and linguistically diverse backgrounds are at higher risk of sub-optimal adherence and errors in inhaler technique. This study aimed to validate an Arabic version of the inhaler technique [...] Read more.

Background: Correct inhaler technique is vital for managing respiratory conditions like asthma. Patients from culturally and linguistically diverse backgrounds are at higher risk of sub-optimal adherence and errors in inhaler technique. This study aimed to validate an Arabic version of the inhaler technique questionnaire for self-assessment of the metered-dose inhaler (MDI) technique by assessing agreement between observed and self-reported techniques among Arabic-speaking individuals with asthma in Australia. Methods: Observational assessments of 30 participants using an MDI, followed by completion of the translated inhaler technique questionnaire by the same participants. The questionnaire comprised nine questions pertaining to the inhaler technique. The level of agreement between the observed and self-reported technique for each of the nine MDI technique steps was subsequently determined using intraclass correlation. Results: The majority of participants were women, aged 25–44 years (70%). An overall Kappa score of 0.768 indicated good agreement between observed and self-reported datasets, with stepwise agreement ranging from 52.4–100%. Steps involving taking a big breath before inhaler use (step 2) and exhaling slowly (step 8) were the least well correlated. Conclusions: The preliminary validated MDI inhaler technique questionnaire may be used as a self-assessment tool by Arabic speakers, aiding healthcare professionals, and empowering individuals living with asthma to self-manage their condition. Full article

14 pages, 571 KiB

Open AccessReview

Exploring the Desirable Attributes and Competencies of Pharmacy Clinical Preceptors: A Scoping Review

by Haneen Alrawashdeh, Ahsan Sethi, Ahmed Awaisu and Banan Mukhalalati

Pharmacy 2025, 13(1), 5; https://doi.org/10.3390/pharmacy13010005 - 15 Jan 2025

Abstract

Background: Experiential learning is a vital component of health-professional education. It provides students with the opportunity to apply their knowledge in real-life settings before becoming licensed practitioners. Preceptors (i.e., practice educators) play a crucial role in developing students’ professional skills and competencies, as [...] Read more.

Background: Experiential learning is a vital component of health-professional education. It provides students with the opportunity to apply their knowledge in real-life settings before becoming licensed practitioners. Preceptors (i.e., practice educators) play a crucial role in developing students’ professional skills and competencies, as well as shaping their attitude during their clinical training. Ensuring preceptors’ quality and preparedness is a key aspect in students’ experiential learning due to the important impact of the provided training on the quality of the students’ learning experience. There is a knowledge gap about the desired attributes of pharmacy preceptors in the Gulf region, specifically Qatar, highlighting the need to explore preceptors’ views on this topic. Purpose: The aim of this scoping review is to identify the available tools in the literature to explore the desirable attributes of pharmacy preceptors as clinical educators. The objectives are to explore the reported desirable attributes of clinical preceptors in the published literature and select and utilize an appropriate tool to identify the desirable attributes of pharmacy preceptors in Qatar. Methods: The scoping review was designed to identify the relevant original research articles, which were published in English language, utilizing CINAHL, ERIC, ProQuest, and PubMed databases. Key concepts were preceptorship, attributes, pharmacy, and tools. Quantitative and mixed-methods study designs were included. The included articles were summarized according to their design, setting, population, and outcomes. The validity of the used instruments in these studies was reported. Results: A total of six articles qualified for inclusion into the full screening and were used to inform the results of this review. Skills like being a role model, assessment, and feedback expertise were of the highly important attributes to different populations (i.e., students, graduates, and preceptors). The review revealed the need for more validated tools in pharmacy research to increase the knowledge about the desired qualities of preceptors. Finally, a list of the most reported attributes in the literature was created after grouping all the reported attributes into five categories: (1) knowledge, teaching, and presentation skills; (2) professionalism and development skills; (3) communication skills; (4) supportive mentoring; and (5) enthusiasm and interest. Conclusions: the top three identified attributes were related to communication, assessment and feedback, and professionalism. The results of this review demonstrated a lack of well-designed and validated tools in pharmacy research that can be used to explore the desirable attributes of pharmacy preceptors. This necessitates further research to develop and validate a new appropriate tool to ultimately understand the perceptions of pharmacy preceptors on this topic. Including more databases in the research could have enriched the findings. Full article

► Show Figures

Figure 1

13 pages, 2017 KiB

Open AccessArticle

A Practical Guide to Grade Adjustment or Curving for Pharmacy and Other Professional Health Programs

by Reza Mehvar

Pharmacy 2025, 13(1), 4; https://doi.org/10.3390/pharmacy13010004 - 10 Jan 2025

Abstract

The peer-reviewed literature on the adjustment or curving of assessments in health profession programs is almost non-existent. This communication aims to present potential methods of grade adjustment for individual questions or entire assessments. Simulated data for a 25-item assessment were used as an [...] Read more.

The peer-reviewed literature on the adjustment or curving of assessments in health profession programs is almost non-existent. This communication aims to present potential methods of grade adjustment for individual questions or entire assessments. Simulated data for a 25-item assessment were used as an example to analyze the effects of different methods of grade adjustment on students’ scores. Grade adjustments were made by adjusting the points for individual questions or the scores for the entire assessment. Adjustment for the individual questions was carried out by dropping the question, adding points to those who missed the question, or adding a bonus point to all students. Grade adjustment methods for the entire assessment included adjusting the mean or mean plus distribution (i.e., standard deviation) of the assessment score. Different methods of grade adjustments or curving for individual questions or the entire assessment resulted in drastically different outcomes for individual students’ scores. The justifications for selecting the appropriate method for adjustment of the individual scores are presented based on item analysis statistics. Curving or adjusting the score for the entire exam may be justified when there is a need for consistency in grade distribution among the assessments across the years or different sections of the course. Although methods for adjustment of grades are relatively easy to implement, instructors should have reasonable educational justification for deciding whether to adjust grades or which method to use. Full article

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

► Show Figures

Figure 1

15 pages, 699 KiB

Open AccessSystematic Review

Pharmacist-Mediated Deprescribing in Long-Term Care Facilities: A Systematic Review

by João Rafael Gonçalves, Neuza Magalhães, Sara Machado, Isabel Ramalhinho and Afonso Miguel Cavaco

Pharmacy 2025, 13(1), 3; https://doi.org/10.3390/pharmacy13010003 - 4 Jan 2025

Abstract

Multimorbidity and polypharmacy are prevalent among Long-Term Care (LTC) users. Older people, who most use LTC services, are more prone to drug-related problems, which polypharmacy aggravates. Deprescribing is a key intervention to address polypharmacy and inappropriate medication. Evidence shows that pharmacists’ expertise in [...] Read more.

Multimorbidity and polypharmacy are prevalent among Long-Term Care (LTC) users. Older people, who most use LTC services, are more prone to drug-related problems, which polypharmacy aggravates. Deprescribing is a key intervention to address polypharmacy and inappropriate medication. Evidence shows that pharmacists’ expertise in medicines and their growing involvement in clinical-oriented activities have proven to play an essential role across many healthcare settings, including LTC. Thus, this study aimed to identify and assess LTC pharmacist-mediated deprescribing. A systematic review was undertaken following the PRISMA checklist, using three literature databases (PubMed, Scopus, and Web of Knowledge). A set of 18 keywords, divided into three domains (professional, type of care, and type of setting), were combined into search equations. The studies selected were assessed through the Quality Assessment Tool for Quantitative Studies. Fifteen studies met the inclusion criteria out of 288 initial hits. Pharmacist-mediated deprescribing was divided into specific (targeted to a medicine group) and non-specific. Half of the studies were graded as low quality (53%). In total, the studies enrolled 6928 patients and 45 pharmacists. The ATC groups A, C, M, and N, as well as medicines with anticholinergic properties, were the most addressed medicines groups. Acceptance rates of pharmacists’ recommendations ranged between 30% and 100%. Generically, the number of medicines was reduced after the intervention. Mixed results were found for falls and quality of life outcomes. Cost savings associated with the interventions ranged from neutral to as high as 3800 €/patient/year. Barriers to deprescribing were mainly linked to patients’ or family members’ refusal to change. In conclusion, pharmacist-mediated deprescribing seems feasible in LTC. The studies’ methodological heterogeneity hampers robust comparisons and conclusions. The medicine groups targeted by deprescribing can help tailor interventions to optimize the use of medicines in LTC. A detailed understanding of barriers and enablers to deprescribing would support developing and implementing these interventions. Full article

► Show Figures

Figure 1

12 pages, 232 KiB

Open AccessArticle

Pharmacy Customers’ Attitudes Towards Expanded Pharmacy Services in Croatia

by Josipa Bukic, Doris Rusic, Toni Durdov, Kristian Tarabaric, Darko Modun, Dario Leskur, Ana Seselja Perisin, Martin Kondza and Josko Bozic

Pharmacy 2025, 13(1), 2; https://doi.org/10.3390/pharmacy13010002 - 31 Dec 2024

Abstract

Pharmacists have been recognized as the most accessible healthcare professionals, and research has been carried out on expanded pharmacy services they could provide. Additional pharmacy services are a cost-effective way to prevent medication errors, reduce the number of drug-related problems, and prevent chronic [...] Read more.

Pharmacists have been recognized as the most accessible healthcare professionals, and research has been carried out on expanded pharmacy services they could provide. Additional pharmacy services are a cost-effective way to prevent medication errors, reduce the number of drug-related problems, and prevent chronic disease progression. Therefore, this study aims to evaluate pharmacy service users’ views of expanded pharmacy services in Croatia. This study included 745 participants. Patients who have a healthcare professional in their family more frequently knew of the existence of e-health records and the option to share it with their pharmacists (134, 56.3% vs. 229, 45.2%, p = 0.005), while persons that have chronic illness more frequently visit the same pharmacy (176, 77.9% vs. 178, 34.3%, p < 0.001). Participants are confident that pharmacists can provide screening services and education on inhaler usage; however, only around 60% agreed that pharmacists can independently lead therapy adjustment, medication substitution, or monitor therapy based on test results. Our findings should be supported with projects evaluating the cost-effectiveness of such services as they would be accepted by a greater number of pharmacy service users if covered by the national health insurer. Full article

11 pages, 223 KiB

Open AccessArticle

Empowering Patient Safety: Assessment of Adverse Drug Reaction Knowledge and Practice Among Pharmacy Professionals

by Josipa Bukić, Dario Leskur, Toni Durdov, Joško Božić, Darko Modun, Ana Šešelja Perišin, Daniela Ančić, Martina Šepetavc, Ante Mihanović and Doris Rušić

Pharmacy 2025, 13(1), 1; https://doi.org/10.3390/pharmacy13010001 - 29 Dec 2024

Abstract

Despite technological advancements, healthcare professionals must actively prioritize patient safety. Reporting adverse drug reactions is a critical aspect of this responsibility, and the most accessible healthcare providers, community pharmacists, and pharmacy technicians play a key role. Therefore, this study assessed their knowledge and [...] Read more.

Despite technological advancements, healthcare professionals must actively prioritize patient safety. Reporting adverse drug reactions is a critical aspect of this responsibility, and the most accessible healthcare providers, community pharmacists, and pharmacy technicians play a key role. Therefore, this study assessed their knowledge and practices regarding adverse drug reaction reporting in Croatia. A total of 180 participants were included. Pharmacists demonstrated significantly better knowledge than technicians (94.78 vs. 73.97, p = 0.024). Chronic medication users also showed greater understanding compared to non-users (104.96 vs. 85.39, p = 0.021). Knowledge improved with the number of adverse drug reactions reported, and most participants (72.78%) had reported adverse drug reactions. Pharmacists were 83.60% more likely to report adverse drug reactions than technicians (p < 0.001). These findings reveal a gap in pharmacy technicians’ integration into pharmacovigilance, underscoring a need to strengthen their role in adverse drug reaction reporting and patient safety. Full article

(This article belongs to the Special Issue Pharmacovigilance and Pharmacists’ Role)

14 pages, 1297 KiB

Open AccessArticle

Education for Healthcare Providers: Impact of Academic Detailing on Reducing Misinformation and Strengthening Influenza Vaccine Recommendations

by Kimberly C. McKeirnan, Megan E. Giruzzi, Damianne C. Brand, Nick R. Giruzzi, Kavya Vaitla and Juliet Dang

Pharmacy 2024, 12(6), 188; https://doi.org/10.3390/pharmacy12060188 - 23 Dec 2024

Abstract

Background: Recommendations from a trusted healthcare provider have been shown to be the most effective intervention for encouraging patients to be vaccinated. However, providers have reported feeling less prepared to address vaccination questions and having less time to discuss vaccines with patients than [...] Read more.

Background: Recommendations from a trusted healthcare provider have been shown to be the most effective intervention for encouraging patients to be vaccinated. However, providers have reported feeling less prepared to address vaccination questions and having less time to discuss vaccines with patients than before the COVID-19 pandemic. Providers may benefit from a brief update about the available influenza vaccines and vaccination guidelines. Academic detailing is an evidence-based approach for preparing healthcare providers to discuss getting vaccinated with patients. Methods: An academic detailing presentation was developed using influenza statistics, vaccination recommendations, and recent local and national immunization rate data. Academic detailing was conducted with physicians and community pharmacy personnel in Yakima County, Washington, between November 2023 and January 2024. Yakima County is designated as a medically underserved area due to a lack of providers. A pre-detailing survey was conducted to evaluate participant knowledge of current ACIP recommendations and gather opinions about local resident vaccination barriers. A post-detailing survey was conducted to gather participants’ opinions about the value of detailing. Results: Prior to the training, 73% of providers believed it was important to discuss influenza vaccination with patients, but only 52% felt confident in combating misinformation. Healthcare providers believed misinformation and vaccine hesitancy are the most common barriers for Yakima County patients, but recent survey results showed that online scheduling systems, long wait times, and limited appointment hours were the predominant issues reported locally. Two out of 12 community pharmacy personnel and zero resident physicians correctly named all three preferentially recommended influenza vaccines for patients 65 years and older. Overall, 96% of detailing participants reported that the session was valuable, 87% believed it would help them combat vaccine misinformation, and 65% reported planning to have more conversations with patients about influenza vaccination after participating. Conclusion: Physicians and community pharmacy immunizers found the influenza vaccines academic detailing to be valuable. Staying up to date on vaccination guidelines can prepare providers to be confident in having informed conversations with patients about getting vaccinated. Full article

► Show Figures

Figure 1

11 pages, 224 KiB

Open AccessArticle

AIHEMAF–P: An Innovative Healthcare Model for Atrial Fibrillation Patients

by Raffaele La Regina, Pasquale Innelli, Fulvio Glisenti, Gianbattista Bollani, Eugenio Leopardi, Gian Franco Gensini, Savina Nodari, Giuseppe La Regina, Micaela La Regina and Francesco Gabbrielli

Pharmacy 2024, 12(6), 187; https://doi.org/10.3390/pharmacy12060187 - 15 Dec 2024

Abstract

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics [...] Read more.

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias of clinical relevance and a major cause of cardiovascular morbidity and mortality. Following a diagnosis of AF, patients are directed towards therapy with anticoagulant drugs to reduce the thromboembolic risk and antiarrhythmics to control their cardiac rhythm, with periodic follow-up checks. Despite the great ease of handling these drugs, we soon realized the need for follow-up models that would allow the appropriateness and safety of these pharmacological treatments to be monitored over time. This pilot study was conducted at a rural pharmacy. The study comprised 47 patients (average age 71.22 years) with nonvalvular atrial fibrillation (68% being paroxysmal) on NOACs. Twenty percent of the enrolled subjects lived alone and fifty-four percent of the participants stated that they were not independent in managing their treatment. The primary aim was to describe the implementation and the outcomes of an innovative smart clinic model in which a local trained pharmacist is a case manager, and the patient carries out the required checks via telemedicine and point-of-care testing systems (POCT) under the service pharmacy regime; the results of the checks could be shared in real time with the attending general practitioner and the relevant specialist. The secondary aims of this study were to evaluate adherence to the planned controls, the prescriptive appropriateness of the dosages and drugs and adherence to the prescribed therapy, the occurrence of pharmacological problems linked to drug type interactions, the occurrence of hemorrhagic and/or thromboembolic complications, the acceptance by the general practitioners and/or the specialists of the reports made by the pharmacist on the subsequent actions undertaken, the economic and social impact of this model on the National Health Service and on the patient, and the impact on the quality perceived by the patients involved in this innovative monitoring process. Compliance with the planned checks was 93%. The dosage of the anticoagulant drug during enrollment was found to be inappropriate, without apparent clinical reasons, in 11% of the sample. Adherence to the anticoagulant therapy was found to be 98%. In total, 214 drug–drug interactions of varying clinical relevance were detected. No embolic events were detected; however, 13% of the sample reported a major hemorrhagic event, which came to light thanks to the close monitoring of hemoglobinemia. A total of 109 reports were made to the patients’ referring doctors in relation to the summarized anomalies, and 84% were accepted by the referring clinicians. Therefore, community pharmacists and pharmacy services represent ideal actors and contexts that, when integrated into the care network, can really favor individual care plan adherence and achieve daily morbidity reductions and cost savings through proper disease control and the early diagnosis of complications. Full article

12 pages, 245 KiB

Open AccessArticle

Objectively-Measured Sedentary Time and Self-Reported Prescription Medication Use Among Adults: A Pilot Study

by Ciarra A. Boyne, Tammie M. Johnson, Lindsay P. Toth, Michael R. Richardson and James R. Churilla

Pharmacy 2024, 12(6), 186; https://doi.org/10.3390/pharmacy12060186 - 10 Dec 2024

Abstract

While previous research has linked physical activity (PA) with lower prescription medication consumption, limited evidence has investigated sedentary time (ST) as a major contributor to medication use, despite ST’s known association with chronic disease and mortality risk, even when PA volume is considered. [...] Read more.

While previous research has linked physical activity (PA) with lower prescription medication consumption, limited evidence has investigated sedentary time (ST) as a major contributor to medication use, despite ST’s known association with chronic disease and mortality risk, even when PA volume is considered. This study aimed to examine the independent associations between objectively measured ST, patterns of sedentary bouts, and self-reported prescription medication use among adults ≥25 years of age. Thirty-two participants reported the number and type of medications they were currently prescribed and wore an accelerometer continuously on their hip for seven days to detect their ST. Poisson regression analysis was used to assess how average daily ST, sedentary bout frequency, and sedentary bout duration influenced medication use. The results revealed a significant association between greater ST and higher medication consumption. Specifically, each additional hour of ST per day, each sedentary bout, and each one-minute increase in bout duration were linked to a 66% (PR 1.66; 95% CI 1.25–2.19; p < 0.001), 36% (PR 1.36; 95% CI 1.12–1.64; p < 0.01), and 9% (PR 1.09; 95% CI 1.03–1.16; p < 0.01) higher prevalence of prescription medications, respectively. These findings suggest that higher ST is associated with a greater prevalence of using prescription medications in adults. Full article

25 pages, 363 KiB

Open AccessReview

Rationale and Logistics of Continuous Infusion Cephalosporin Antibiotics

by Abbie L. Blunier, R. Jake Crocker, Rachel Foster, Stephanie S. May, Caroline E. Powers and P. Brandon Bookstaver

Pharmacy 2024, 12(6), 185; https://doi.org/10.3390/pharmacy12060185 - 5 Dec 2024

Abstract

Cephalosporins have traditionally been administered as an intermittent infusion. With the knowledge that cephalosporins demonstrate a time-dependent pharmacodynamic profile, administration via continuous infusion may provide more effective antibiotic exposure for successful therapy. Proposed benefits of administration via continuous infusion include less IV manipulation, [...] Read more.

Cephalosporins have traditionally been administered as an intermittent infusion. With the knowledge that cephalosporins demonstrate a time-dependent pharmacodynamic profile, administration via continuous infusion may provide more effective antibiotic exposure for successful therapy. Proposed benefits of administration via continuous infusion include less IV manipulation, decreased potential for antibiotic resistance, and potential cost savings. The objective of this review was to provide a detailed assessment of available evidence for the use of continuous infusion cephalosporins and practical dosing and administration recommendations. Studies were gathered and assessed for inclusion via a literature search of PubMed and Ovid MEDLINE using mesh terms [“continuous infusion” and “cephalosporin”], “intermittent infusion”, [“intermittent versus continuous” and “cephalosporin”], “continuous infusion cephalosporin”, as well as specific drug names. References from included studies were also evaluated for inclusion. Data which compared the two administration methods (continuous infusion vs. intermittent infusion) were evaluated. Thirty-five studies were analyzed among several cephalosporins with variable delivery. Dosing regimens utilized in the selected studies were assessed with known compatibility and stability data and further summarized. Full article

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

Journal Description

Pharmacy

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI