International Journal of Pharmacy Practice最新文献

Objectives: To explore the perspectives of stakeholders on the General Pharmaceutical Council's revised Standards for the Initial Education and Training of Pharmacists that enable pharmacists to prescribe at the point of registration, from 2026.

Methods: This qualitative study used the Theoretical Domains Framework (TDF) to develop schedules for structured interviews that were conducted with various stakeholders and recorded via Microsoft Teams. Recordings were transcribed verbatim, checked for accuracy, and then analysed using the Framework approach, facilitated by NVIVO® software.

Key findings: In total, 43 participants (patients, community, hospital and primary care pharmacists, GPs, and nurses) were interviewed. Eleven out of the fourteen TDF domains were identified, the most frequently cited being 'beliefs about consequences', e.g. reducing pressure on the healthcare service, and concerns that non-prescribing pharmacists will be disadvantaged by the change. The domain 'environmental context and resources' was also cited where increasing placement opportunities to develop the required clinical skills were key enablers to implementation, while a lack of confidence, and lack of space, equipment and commercial pressures were considered barriers.

Conclusions: Overall, stakeholders in the study were supportive of pharmacists registering as independent prescribers upon qualification, however, there were concerns raised regarding their readiness, as well as preparedness of employers for this change. These concerns must be addressed to reassure stakeholders and to ensure that universities and employers adequately prepare pharmacists to prescribe at the point of registration and provide them with support and the necessary infrastructure to do so safely.

Objectives: To explore the need for a specialization in clinical pharmacy and the model to be adopted, as perceived by Portuguese stakeholders.

Methods: A nominal group technique through two online meetings addressed four questions: pros and cons of specialization models used internationally; preferred model for Portugal; and success factors for implementation.

Key findings: All nine stakeholders recognized the need to train pharmacists in clinical pharmacy and agreed specialization is essential, through a model including strong clinical undergraduate education, supplemented with postgraduate training. The postgraduate component considered most suited comprised a balanced approach to theoretical and practical training, where the relative weigh of theory (20%-60%) could progressively decrease with the implementation of the European directive 2024/782 establishing the minimum training requirements for the professions of pharmacists, where the clinical pharmacy is to be strengthened at the undergraduate level. Success factors for implementing this model include, establishing a regulatory framework for the career and the desired characteristics of the graduates from the postgraduate programme.

Conclusions: This study led to a consensus among key Portuguese stakeholders on the model to be adopted for a clinical pharmacy specialization in Portugal and, the information gathered will be used to guide future implementation.

Human-use medicines are introduced into surface water throughout their entire life cycle, from manufacturing and consumption to improper disposal, resulting in negative effects on aquatic flora and fauna. Sustainability approaches have addressed this issue, proposing frameworks like the One Health approach. A revised definition of the rational use of medicines has also been proposed, taking into account their environmental sustainability. Building on this updated definition, this paper presents a decision-making flowchart to integrate the assessment of the impact of human medicines on surface water, outlining existing actions and proposing new ones. These actions are categorized into those with primary clinical benefits and those focused solely on environmental concerns. They include both upstream and downstream measures, such as implementing regulations similar to those in the EU and the USA, educating future healthcare practitioners, promoting green pharmacy innovations, and establishing proper disposal practices.

Objectives: The Objective Structured Clinical Examination (OSCE) is a key tool in healthcare education, assessing clinical skills and competencies. This study explores OSCE's impact on pharmacists' competence, confidence, and practice readiness, focusing on its role in professional development and long-term practice improvement.

Methods: A cross-sectional survey was conducted among Qatar University pharmacy graduates with at least a year of practice experience. The survey included 10 items on a 4-point Likert scale to capture quantitative data, along with open-ended questions for more detailed reflections and qualitative insights. Quantitative data were analyzed using SPSS, and qualitative data were thematically analyzed through an inductive approach, with two researchers independently coded responses and identifying themes.

Key findings: Out of 75 eligible pharmacists, 46 responded (61.3% response rate). Over 85% reported that OSCE improved communication and interprofessional collaboration skills, and 80% felt it helped apply essential professional skills effectively. However, opinions varied on making OSCE a licensure requirement. Six main themes emerged: (i) Enhanced Interprofessional Collaboration Skills, (ii) Application of Professional Skills, (iii) Practical Application of Pharmacy Education, (iv) Adaptability for Evolving Healthcare Challenges, (v) Enhancement of Patient-Facing Communication Skills, and (vi) Identification of Personal Strengths and Weaknesses.

Conclusions: This study demonstrates that OSCEs enhance pharmacists' clinical skills, communication, and practice readiness. Pharmacy programs should continue integrating OSCEs alongside other assessments for comprehensive evaluation. Policymakers are encouraged to explore OSCEs for licensure, ensuring standardization and evaluator training. Future research should assess OSCE's long-term impact on pharmacists' career development and patient outcomes.

Objectives: To develop a tool to 'risk score' the potential harm of a medication error by estimating the probability of a range of potential consequences, and assess its feasibility, validity, and reliability.

Methods: The risk score tool described five levels of potential harm developed from an existing risk matrix. Judges estimated the likelihood of harm matching each level, from which a risk score (0-10) was calculated. Thirty judges (doctors, nurses, and pharmacists) used this risk score and the existing Dean and Barber scale to estimate the potential harm of 50 medication errors, 15 with a known outcome. Two weeks later, the judges re-scored ten of the errors. Reliability was investigated using generalizability theory.

Key findings: Fifty medication errors were judged in a mean of 49 minutes with ≤0.7% missing data. There were no significant differences in the judges' rating of the realism and ease of use of the two tools. Fifty-nine per cent of judges preferred the risk score tool. For both tools, there was a clear relationship between mean score and known outcomes, with no overlap between outcome categories, confirming discriminative validity. The correlation between scores from both tools (R2 = 0.99) confirmed the concurrent criterion validity of the risk score. For both tools, at least three judges would need to score an error to obtain a generalizability coefficient of ≥0.8 using the mean score as an indicator of potential harm.

Conclusions: The risk score was feasible, valid, and reliable. Its performance was comparable with, but did not exceed, the Dean and Barber scale.

Objectives: Pregabalin abuse is increasing in prevalence and is associated with significant harm. This study aimed to assess community pharmacists' perceptions of pregabalin abuse and their recommendations to address this issue.

Methods: This was a descriptive cross-sectional study conducted in the Omdurman locality, Khartoum in 2022. Community pharmacies were selected randomly and surveyed using a pre-tested and self-administered questionnaire held on a smartphone. Chi-squared and Fisher's exact tests were run using the Statistical Package for Social Sciences version 26.

Key findings: A total of 172 community pharmacists completed the questionnaire (77.8% aged 22-30 years, 65.1% females, 79.1% holding bachelor's degrees, and 57.6% having ≤ 5 years of work experience). Most participants (81.4%) perceived that they had observed pregabalin abuse in the last 6 months. Participants indicated that they were aware of the abuse potential of pregabalin (97.7%) and that they routinely dispensed pregabalin only by prescription (92.4%). Most participants reported that people they suspected of abusing pregabalin were mainly men (98.8%), aged 21-30 years (90.7%), and did not regularly visit the pharmacy (72.7%). Actions taken for such customers included stating the product was not available (64.0%) and refusing to dispense (56.4%). The most recommended solutions were raising community awareness about the risks and consequences of pregabalin abuse (35.8%) and maximizing pharmacists' adherence to dispensing regulations (36.5%).

Conclusions: Most pharmacists believed that they had observed pregabalin abuse and that it was increasing. They managed the situation primarily by reporting the drug was unavailable and refusing to dispense it. Effective community pharmacy-based interventions are strongly needed to tackle the issue of pregabalin abuse.

Objectives: Although most qualitative research is cross-sectional, particularly in social pharmacy/pharmacy practice, there are many advantages of using a longitudinal qualitative research (LQR) design, i.e. re-interviewing participants over a period of time.

Methods: This paper describes some advantages and challenges of LQR using our 'Access to Medicines: Exploring Lived Experience to inform policy and programmes' study as an illustration.

Key findings: Advantages of LQR include obtaining richer and more complete data, providing a greater understanding of change and lack of change, understanding pathways through complex systems, including people facing difficult social circumstances, and contributing to evaluation research. Challenges to be addressed include the implications of developing friendships with participants, deciding whether to assist participants, maintaining participant anonymity, the impact of the research on the researchers, and how to analyse the large volume of data generated.

Conclusions: We recommend piloting methods before starting a study, considering the resource implications of LQR, planning the analysis in advance, planning for how to deal with developing friendships with participants, considering threats to participant anonymity, and supporting researchers doing fieldwork.

Background: Cost-related nonadherence (CRN) to prescription medication has been shown to affect healthcare outcomes. While CRN has been reported in many countries globally, it has not been fully characterized in Vietnam.

Objectives: This study was conducted to determine CRN rates and factors associated with CRN among pharmacy customers in the Mekong Delta, Vietnam.

Methods: A cross-sectional research design used printed self-administered questionnaires in Vietnamese distributed to customers of private pharmacies and pharmacy chains in the Mekong Delta from January to March 2024.

Results: Of the 1546 respondents, 49.9% reported experiencing CRN, with the most commonly reported action being delaying filling a prescription (38.2%). Compared to participants aged ≥65 years, those aged 18-44 years were 2.5 times more likely to report CRN, with an adjusted odds ratio (aOR) of 2.51 (95% confidence interval [CI]: 1.55-4.06). Poorer self-reported health status was a strong predictor of CRN (aOR = 3.72; 95% CI: 2.32-5.95) compared to better self-reported health status. Having more prescriptions was a strong predictor of CRN (aOR = 2.25; 95% CI: 1.70-2.98) compared to having fewer prescriptions. The presence of chronic conditions was associated with being 2.5 times more likely to report CRN (aOR = 2.46; 95% CI: 1.71-3.55) compared to those without chronic conditions.

Conclusions: Nearly half of the participants experienced CRN. The findings of this study showed that implementing public health initiatives, such as routine care, in-person and telephone counseling, and educational programs by pharmacists, is necessary to reduce CRN among the population of the Mekong Delta. More studies are needed to help inform policymakers on how to reduce CRN and improve access to medications.