International Journal of Pharmacy Practice最新文献

Introduction: In Australia, 64% of pharmacists are women but continue to be under-represented. Generative artificial intelligence (AI) is potentially transformative but also has the potential for errors, misrepresentations, and bias. Generative AI text-to-image production using DALL-E 3 (OpenAI) is readily accessible and user-friendly but may reinforce gender and ethnicity biases.

Methods: In March 2024, DALL-E 3 was utilized to generate individual and group images of Australian pharmacists. Collectively, 40 images were produced with DALL-E 3 for evaluation of which 30 were individual characters and the remaining 10 images were comprised of multiple characters (N = 155). All images were independently analysed by two reviewers for apparent gender, age, ethnicity, skin tone, and body habitus. Discrepancies in responses were resolved by third-observer consensus.

Results: Collectively for DALL-E 3, 69.7% of pharmacists were depicted as men, 29.7% as women, 93.5% as a light skin tone, 6.5% as mid skin tone, and 0% as dark skin tone. The gender distribution was a statistically significant variation from that of actual Australian pharmacists (P < .001). Among the images of individual pharmacists, DALL-E 3 generated 100% as men and 100% were light skin tone.

Conclusions: This evaluation reveals the gender and ethnicity bias associated with generative AI text-to-image generation using DALL-E 3 among Australian pharmacists. Generated images have a disproportionately high representation of white men as pharmacists which is not representative of the diversity of pharmacists in Australia today.

Background: Domestic abuse (DA) and suicidal ideation (SI) are prevalent and often co-occur. Numerous practical and psychosocial barriers inhibit help-seeking, including accessibility and confidentiality concerns. Pharmacies are accessible and may be perceived as a discreet venue for a DA and SI response service.

Objective: To co-develop a community pharmacy response service for people experiencing domestic abuse or suicidal ideation.

Methods: Overall, 36 unique individuals contributed at least once to a series of focus groups, interviews or workshops to co-develop the service components. Participants had lived experience of DA/SI or were professionals from DA/SI support services or pharmacies. Audio recordings and field notes from events were thematically analysed. Specific themes were identified and informed the development of the service components.

Key findings: Participants supported the development of this new service and considered community pharmacies to be an ideal setting. They thought of the service as a lifeline, that would offer hope. Under this main concept of hope, five main themes were identified: Safety, Empathy, Empowerment, Equity, and Discretion. Participants' practical considerations were incorporated into the service design, including the name choice of "Lifeguard Pharmacy", the strapline "Bringing Hope to Life", and the development of a "Client Flowchart" outlining how to welcome a client, arrange for a consultation, and then guide clients out of the pharmacy afterwards.

Conclusions: Overall, the findings supported the development and introduction of this pharmacy-based intervention, which may help overcome barriers to help-seeking for DA or SI due to its sense of hope, accessibility, and discretion.

Objectives: An independent evaluation was undertaken to investigate the perceived impact of installing digital screens in a group of community pharmacies as an approach to provide public health messaging.

Methods: Community pharmacy staff were interviewed prior to screen installation to investigate experience and perceptions of conventional public health campaigns using written materials. Staff were interviewed after the digital screen installation to investigate their opinions of the installation and its impact on public health delivery in the pharmacy. Patients and public representatives were recruited to visit the pharmacies and asked to complete a survey about what they observed and thought about the public health messaging. Interviews were transcribed verbatim and thematically analysed. Surveys consisted of open, closed, and rating questions. The results of which were descriptively analysed.

Key findings: Community pharmacy staff found paper-based campaigns work-intensive and created paper wastage. The digital screen installation was received positively by pharmacy staff and patient, and public representatives found them eye-catching and engaging. Staff were unable to report any conversations with members of the public triggered by the screens, but the patient and public volunteers were able to recall some of the health messages.

Conclusions: Digital messaging is common practice and digital screens are already in use in areas where patients and the public have conventionally been in attendance, e.g. GP surgeries. Digital screens in community pharmacy for public health messaging could be considered an inevitable progression for public health messaging given concerns about wastage and up-to-date information. The impact, however, on triggering healthier choices and lifestyles requires further investigation.

Objectives: This study aimed to investigate and provide insight into the prevalence and patterns of off-label drug use in the pediatric population from the perspective of community pharmacists, addressing the existing data gap in a developing setting.

Methods: A questionnaire-based cross-sectional study was conducted on Albanian community pharmacists in June 2021. The online administered survey explored the participants' demographic details, perceptions, and experiences with off-label prescriptions in pediatric patients. The statistical analysis conducted on the survey data comprised the construction of frequency tables and the application of the chi-square test for independence.

Key findings: Three hundred and thirty-six community pharmacists nationwide completed the survey, out of which 186 (55.3%) were practiced in Tirana, the capital of Albania. Over 80% of surveyed pharmacists (n = 275) had encountered off-label drug prescriptions in pediatric patients, yet only 40% of participants reported dispensing medicines for off-label use. Community pharmacists reported that general pediatricians tended to prescribe off-label medications more frequently than pediatric subspecialists or general practitioners. It was found that off-label prescriptions were more frequently observed among children aged between 2 and 11 years. Antibiotics were the most reported medicines for off-label use in this study mentioned in almost all off-label categories.

Conclusions: Prescribing medicines for unapproved uses for the treatment of pediatric patients is present in community settings in Albania. This indicates the need for further data collection and analysis to understand off-label practices in our country's pediatric population comprehensively.

Background: The final prescription check is a mandatory but time-consuming process in Dutch community pharmacies. A safer dispensing process may have made the final prescription check obsolete.

Objective: To describe the final prescription check in Dutch community pharmacies and explore pharmacists' attitudes towards changing this.

Methods: A cross-sectional survey among Dutch community pharmacists. The online questionnaire was based on literature and previous qualitative research, piloted in three pharmacies, and took 10 min to complete. Results were analysed descriptively.

Results: A total of 409 pharmacists participated. They saw the final prescription check as an important quality assurance of the dispensing process. Nevertheless, most pharmacists agreed that the final prescription check could be optimized as they thought that the time invested outweighed the benefits. Automation of the dispensing process, only checking selected high-risk prescriptions, and more in-process checks could reduce the need for an extensive final prescription check, rather than delegating the task to assistants. To implement changes, most pharmacists felt current dispensing guidelines needed to be adapted.

Conclusion: There was a widespread consensus that optimizing the final prescription check could enhance efficiency and allow more time for person-centred care. Most pharmacists expressed a preference for updated guidelines before implementing such changes.

Objective: The CombiConsultation is an innovative concise clinical pharmacy service by the community pharmacist for patients with a chronic condition. We aimed to identify relevant factors influencing the implementation of the CombiConsultation in Dutch clinical practice.

Methods: A mixed-methods study involving interviews and a questionnaire. Content analysis topics within TDF domains were derived from the interview data and were related to the COM-B-model (capability-opportunity-motivation-Behaviour). The relevance of the resulting topics was explored using a questionnaire with 19 statements administered to all 27 pharmacists who performed CombiConsultations.

Key findings: Eighteen topics emerged from the interviews. The questionnaire was completed by 23 of the 27 pharmacists. In the domain 'capability', a small number of participants indicated that they need more expertise in pharmacotherapy (13%) and training in consultation skills (35%). In the domain 'opportunity', all participants indicated that an existing good collaboration with the general practitioner/practice nurse and access to all relevant medical data were necessary to implement the CombiConsultation. In terms of motivation, job satisfaction was most important to all participants, followed by adequate reimbursement (83%) and improving collaboration with other healthcare providers and the relationship with patients (78%).

Conclusions: Capability, opportunity, and motivation were all considered relevant for the implementation of the CombiConsultation. There were crucial factors on the level of the individual pharmacist, on the level of the local collaboration and organization, and on the health system level.

Objectives: Digital literacy is increasingly crucial in pharmacy practice, and relevant education and training are required to prepare the future workforce. This study aims to explore the current and planned inclusion of digital literacy education in the undergraduate curricula of UK pharmacy schools.

Methods: A mixed-methods approach was conducted with two phases. The first involved a content analysis of published curricula from all 30 UK pharmacy schools. The second phase included a survey based on the Health Education England Digital Capabilities Framework, distributed to academic staff across all pharmacy schools.

Key findings: Data from 14 pharmacy schools' curricula were included in the analysis, with 10 reporting digital literacy education. Key themes identified from the analysed documents included understanding of health informatics, applied informatics, information technology skills, and the emerging digital health technology. Nineteen respondents from 16 schools participated in the survey; digital literacy inclusion was reported by 18 participants. There was variable alignment of digital literacy competencies with the Health Education England framework. Digital literacy was mainly integrated into existing teaching sessions, predominantly through self-learning (n = 12). Electronic Health Records and remote counselling were the main focus areas within the curricula. Challenges in implementing digital literacy include a lack of expertise (n = 13), and time constraints (n = 10).

Conclusions: The trend towards embedding digital literacy in UK pharmacy curricula is clear, but disparities suggest the need for a more unified strategy. Recommendations include establishing a specific digital literacy framework aligned with professional needs, improving accessibility and transparency in curricula documents, and investing in faculty development.

Objectives: Continuous subcutaneous infusions (CSCIs) are indicated as an alternative therapy when the oral route is not viable. However, despite their widespread use in palliative care, the evidence for admixture compatibility remains a limitation. It is estimated that a significant number of admixtures used in practice are not supported by laboratory studies, which may lead to suboptimal clinical outcomes. The study aimed to determine the frequency of admixtures used in clinical practice without compatibility data generated by laboratory studies, and thereby identifying the most commonly prescribed admixtures that require laboratory data, which can help to guide the prioritization of future testing.

Methods: This study was conducted across five palliative care services (three inpatients and two communities) in Victoria, Australia between May and July 2021. Electronic or paper medication charts of CSCIs were reviewed across all participating sites for all infusions administered. Data collected included medication combinations, dose, diluent, final volume, duration of infusion, reports of infusion-related reactions, and observed incompatibility.

Key findings: A total of 616 infusions containing two to three medications were assessed. Only 60% of these infusions were validated by laboratory data. Eleven most commonly prescribed admixtures with no laboratory compatibility data were identified over the 3-month period.

Conclusion: Laboratory testing for the identified admixtures should be advocated to promote the safe and effective use of these medications.