International Journal of Pharmacy Practice最新文献

Background: Cancer treatment has become a significant health challenge, with notable changes in recent years due to increasing knowledge of cancer biology. The use of immune checkpoint inhibitors (ICIs) has shown promising results, but they can induce adverse events (AEs), resulting in serious consequences for patients. Pharmaceutical care aims to prevent, identify, and address issues related to medications, such as AEs.

Aim: The objective of this scoping review was to assess the contribution of pharmacists to the intervention and care of cancer patients undergoing treatment with ICIs.

Methods: The PubMed, Scopus, Embase, and Web of Science databases were searched for studies on the treatment of cancer patients treated with ICIs in which pharmacists participated. No time frame or language restriction was applied. Article screening was performed independently by two authors, with any discrepancies resolved by a third author. The studies were analyzed and included in this review following the inclusion and exclusion criteria.

Results: Nine studies fulfilled the inclusion criteria. Pharmaceutical care encompasses a variety of interventions, including providing guidance to patients and to the multidisciplinary team, monitoring and managing AEs, conducting pharmaceutical consultations, and recommending over-the-counter medications and laboratory tests, among other actions. Pharmaceutical recommendations led to better outcomes regarding AEs.

Conclusions: Pharmaceutical care has a positive impact on oncological immunotherapy with ICIs, contributing to both health institutions through cost reduction and, most importantly, patients by improving treatment outcomes and enhancing the quality of life.

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: Reducing the rate and impact of unintended pregnancy through effective contraception is a public health goal. Since deregulation, globally, ease of access to community pharmacists has enabled them to play a key role in the provision of emergency hormonal contraceptive pills (ECP). The aim of this scoping review is to explore pharmacists' overall knowledge of and attitudes and practices towards the provision of emergency contraception.

Methods: A systematic literature search for the period from 1999 to 2023 was conducted using Scopus, Medline (Ovid), CINAHL, Emcare, Web of Science, and Google Scholar. Keywords such as emergency contraception, emergency contraceptive, morning after pill, plan B, pharmacist, community pharmacist, and pharmacy were applied. Articles published only in English that described the knowledge, attitudes, and practices of community pharmacists providing emergency contraception were included in this review.

Key findings: Twenty studies met the inclusion criteria. Despite positive attitudes towards the provision of ECP, there is a clear deficit in both the knowledge and counselling practices of pharmacists, with some pharmacists lacking an open attitude towards the supply of ECP to adolescents and third parties. Usage of a private counselling area ranged from 0% to 90% highlighting privacy for patients seeking ECPs is lacking during consultations. In countries where practice guidelines are available, these are often not being optimally utilized.

Conclusions: This review has highlighted gaps in pharmacists' knowledge and counselling practices, demonstrating shortcomings in pharmacists' education, training, and application of professional practice guidelines. Future research on ECP guidelines is recommended to improve implementation and usability in practice.

Background: Deprescribing, a process of dose reduction or withdrawal of inappropriate medication that no longer has benefit, is a proposed intervention in the care of older adults living with frailty.

Objective/aim: To evaluate the safety, effectiveness, and clinical impact of deprescribing services in frail patients.

Methods: A systematic literature search was performed in November 2023 using Scopus, CINAHL PLUS (EBSCO), MEDLINE (OVID and EMBASE), and Cochrane Library. The Mixed Methods Appraisal tool was used for appraising the methodological quality of the included papers. Studies were selected after title, abstract, and full-text screening, with independent review. Thematic analysis was used for analysing data from the selected articles.

Results: Five hundred ninety unique titles were identified, with nine (six trials, one interview, one survey, and one designed-delay study) meeting inclusion and exclusion criteria. Four main descriptive themes have been identified: challenges of deprescribing in frailty, facilitators of deprescribing in frailty, deprescribing processes in current practice in frail patients, and deprescribing outcomes. Additionally, two analytical themes have been identified: safety and quality.

Conclusion: A number of issues have been highlighted that impact the implementation of deprescribing services in frail patients. Currently, there is limited evidence showing strong benefits of such deprescribing services, such as reducing the number of potentially inappropriate medications and medication costs.

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: The aim of this work was to evaluate the performance of UK MPharm graduates on the General Pharmaceutical Council's (GPhC) registration assessment, between the years 2011-2024, to explore the factors that impact student performance in this examination.

Methods: Student performance in the GPhC registration assessment was contextualized with factors like alma mater, Foundation Training placement, NSS, and HESA data. Relationships between these factors and the weighted average passing rates and raw scores were analysed using a range of statistical methods including correlation analysis, ANOM, Tukey-Kramer, and t-tests.

Key findings: Year on year, students from top performing Schools of Pharmacy consistently perform well and performance becomes less consistent as average passing rate decreases (R2 = 0.89; Prob > F < 0.0001). To best discriminate between MPharm programmes and placement type, students can be grouped by their raw score. We also find that students are more likely to pass in hospital compared to community placements, independent of institution. These relationships hold true for the best- and worst-performing students.

Conclusions: Our analysis highlights substantial differences in performance levels between the highest and lowest-performing schools and placement types. While not always the case, it appears that pharmacy students should seek to obtain a pre-registration placement in the hospital environment to maximise their chances of success in the GPhC exam. Moving forward, we advocate for better quality data which could link each individual (and their demographic characteristics) as they move through university right through to their performance on each question in the registration exam.

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: 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.