Innovations in Pharmacy最新文献

Pharmacists, student pharmacists, and other healthcare providers are frequent participants on short-term medical service trips (MSTs) to medically underserved areas. Many such MSTs take place in areas like sub-Saharan Africa where cultural beliefs about healthcare and society may be very different from what volunteers from the Global North believe. These cultural divergences may then give rise to ethical problems MST volunteers need to navigate. This case study provides an example of such an ethical problem developing from a difference in cultures - the case of female genital cutting. Often, the ethical training that most MST volunteers receive during their clinical education is inadequate to help them address these kinds of cultural differences and the problems that result. A six-step process to provide MST volunteers with the tools to address such cultural-ethical problems is included. Medical, Public Health, and Microfinance Teams with local interpreters in Nana Kenieba, Cercle of Kati, Koulikoro Region, Southwest Mali.

High dose ascorbic acid may increase risk of phenytoin toxicity. This case report demonstrates high phenytoin levels resulting in adverse drug reactions subsequent to dosing concomitantly with high dose vitamin C, or ascorbic acid (AA), as a precaution against acquiring corona virus (COVID) infection. This patient suffered from a major seizure when he ran out of his phenytoin prescription. Subsequent initiation of phenytoin and later addition of high dose AA resulted in truncal ataxia and falls with bilateral wrist and finger extension weakness. Phenytoin and AA were discontinued, and the patient returned to baseline on a new medication regimen of lacosamide and gabapentin without any other major seizures one year later.

Objective: The primary objective was to assess presence of community-based pharmacist practitioner burnout and workplace stress through administration of validated tools. Methods: Pharmacists licensed in Ohio received an invitation to participate in the anonymous online assessment via Qualtrics™ using emails available via the State Board of Pharmacy listserv. The survey assessed emotional exhaustion, depersonalization, and personal accomplishment using a validated tool, the Maslach Burnout Inventory (MBI). The Areas of Worklife Survey (AWS) was used to assess stressors as they relate to burnout and job stress. This study was approved by The Ohio State University Institutional Review Board. Results: There were 1,425 complete responses. Based on the study sample, 67.2% of community-based pharmacists are experiencing burnout. When asked to self-identify workplace stressors, respondents primarily described the Workload, Control, and Reward dimensions of the AWS. The most commonly reported coping mechanisms were self-care strategies (28.4%), mindfulness (17.6%), and personal time/time off (15.3%). Respondents suggested that organizations address staffing (50.2%) and development of a culture of well-being (17.2%) to promote well-being. Conclusion: This study allowed insight into workplace stressors for community-based pharmacists and strategies organizations can employ to improve their well-being. Future studies are needed to assess the efficacy of these interventions.

Background: Conversion disorder (CD) is a relatively common psychiatric disorder likely encountered by clinical pharmacists but probably not easily identified by pharmacists. Case Summary: This is a patient case where a patient with a tremor was referred to the pharmacist led, polypharmacy, pharmacogenomics (PGx) service to rule out a PGx cause due to medication metabolism. No pharmacologic or PGx cause was found for the tremor which helped support and confirm a diagnosis of CD. Practice Implications: By working collaboratively with psychiatrists, neurologists, physical medicine colleagues, clinical pharmacists may add value to patient care by assisting with diagnoses and appropriate treatment.

Pharmacogenomics (PGx) melds well with polypharmacy as another tool to identify medication related problems (MRPs) more specifically so they may be solved most effectively. PGx can pre-emptively assist in medication selection, medication dosing or identify better medications for patients already taking a medication. PGx can also confirm suspect medications of causing MRPs such as adverse drug reactions (ADRs) or drug interactions. In this case, PGx testing confirmed presence of a serious human leukocyte antigen (HLA) drug reaction with eosinophilia and systemic symptoms (DRESS) after a suspect medication had been stopped.

Introduction: The purpose of this mixed-methods study was to evaluate an interprofessional academic-practice partnership in end of life care by examining patient medication outcomes, the contributions of student pharmacists and a pharmacy preceptor to care teams, and student learning experiences. Methods: Retrospective chart review assessed polypharmacy differences in hospice patients with a primary terminal diagnosis of non-Alzheimer's dementia between two patient groups; Group 1 managed on interprofessional care teams within the pharmacy partnership, and Group 2, managed on teams without a pharmacist. Team members who interacted with student pharmacists and the pharmacy preceptor participated in semi-structured key informant interviews to document perceptions of pharmacy contributions to care teams and the organization. At the end of their APPE, students completed reflective writings regarding their learning. Results: Patients in Group 1 were on statistically significant fewer medications than Group 2 at both week 4 and weeks 7-12 following admission. Five conceptual themes emerged from interviews: pharmacists as team medication experts, improved patient outcomes, interprofessional collaboration, patient/caregiver trust in medication regimens, and desire for sustainability. Student reflections included the following learning themes: teamwork, respect, value, and patient-centered care. Conclusions: The addition of a pharmacist on interprofessional care teams decreased the average number of medications in the non-Alzheimer's end of life patient population. Team members identified value-added contributions of student pharmacists and the pharmacy preceptor that enhanced team efficiency and patient care. Student pharmacists recognized these contributions and the experience served as an exemplar of interprofessional practice.

With over 115 registered pharmaceutical manufacturers, Nigeria still depends on other countries for the supply of active pharmaceutical ingredients and excipients. Significant attention has not been paid to the local production of raw materials, pharmaceutical dosage formulations, or processing equipment, which has resulted in a decline in the country's pharmaceutical manufacturing capacity. Owing to the overall importance of the pharmaceutical industry, it is, therefore, essential to pay close attention to developmental issues affecting this sector. In this commentary, we explore why Nigeria must boost its local pharmaceutical manufacturing capacity.

It has been demonstrated conclusively that value and utility preference scores have only ordinal properties. This means, as has been pointed out on numerous occasions, that the quality adjusted life year (QALY) is a mathematically impossible construct. The implications are profound: Some 30 years of health technology assessment is called into question due to a failure to recognize the well-documented limitations imposed by the axioms of fundamental measurement. The purpose of this commentary is provide a critical examination of this practice in recommendations for atopic dermatitis.

Background: Little attention has been given to characterizing the roles of pharmacists in disasters even though the importance of pharmacists' involvement is widely acknowledged. Objective: We amid to review a broad range of pharmacists roles in disasters and their response by numerous reports in the literature. Method: A quantitative content analysis technique was used to gather data consisting of words and phrases from literature regarding pharmacists' roles and their response in disasters. Results: A total of 106 reports were reviewed and screened based on titles and abstracts. Of these, only 20 studies were determined to meet the eligibility criteria for discussion. A total of 7 natural disasters (pandemics, tornadoes, fires, earthquakes, floods, hurricanes and storms) were found in the literature. Roles were classified using the Setlak classification scheme, which includes descriptors such as pharmaceutical supply, patient management, policy coordination, and response integration. Pharmaceutical supply was remains the pharmacists' preferred role. Conclusion: It is evident from the literature that pharmacists are uniquely positioned during disasters to provide healthcare continuity and medication.

Background: Research is warranted to define the role of affordable pharmacy programs in optimizing healthcare utilization for uninsured patients. Methods: This was a pre-post study including uninsured patients from an internal medicine residency clinic who enrolled in free or low-cost pharmacy programs with clinical pharmacist support. Results: In the period following program enrollment (N=116), there was a mean decrease of 0.23 acute care encounters (hospitalizations and emergency department [ED] visits) per patient (p=0.0210, 95% CI 0.04-0.43). The mean decrease for hospitalizations was also statistically significant (0.17, p=0.0052, 95% CI 0.05-0.28), but the mean decrease for ED visits was not (0.06, p=0.3771, 95% CI -0.08-0.21). Using the national average hospitalization cost of $10,700, the decrease in hospitalizations represents an estimated savings of $246,100. Conclusions: Enrollment in affordable pharmacy programs was found to be associated with decreased acute care encounters.