International Journal of Pharmacy Practice最新文献

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.

Objectives: Minor ailments are a significant burden on primary care services globally. In Saudi Arabia's evolving healthcare landscape, pharmacists play a crucial informal role, but no coordinated national approach exists. Understanding pharmacists' preparedness is thus vital to optimize successful integration. This study evaluated Saudi community pharmacists' perceptions, barriers, and facilitators related to minor ailment services (MAS) for capacity-building strategies.

Methods: A cross-sectional survey was conducted from April to July 2023. Data were collected from participants using a self-administered, anonymous questionnaire with 48 questions. The data were analyzed using descriptive and inferential statistics in SPSS v.27.

Key findings: Of the 720 pharmacists invited to participate, 442 completed the questionnaire, yielding an overall response rate of 61.4% (442/720). Most pharmacists recognized the value of accessible self-care support using their skills (92.6%), but 26.9% feared misdiagnosis risks. Most (93.9%) emphasized prudent triage and history-taking, and yet 22.2% were ambivalent on referrals. Key barriers that were identified included the lack of patient information (71.5%), lack of reimbursement for MAS (61.8%), lack of a private/counseling area (59.5%), and lack of knowledge for minor ailment management (48.2%). Pharmacists who work in rural areas, work part-time, and have not attended any training or education programs also tend to display a more uncertain attitude toward delivering services for minor ailments.

Conclusions: Pharmacists in Saudi Arabia can play a significant role in managing minor ailments, but the identified barriers must be addressed to integrate their services thoroughly. That can be done through comprehensive training, allocating resources, and establishing structured communication and referral pathways. This integration can improve healthcare accessibility, reduce costs, and better utilize pharmacists' expertise for delivering patient care.

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.

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: Smoking remains a significant public health concern, necessitating effective smoking cessation interventions. This study explores the barriers community pharmacists face in delivering smoking cessation services in Malaysia and potential solutions to improve their contribution to public health.

Methods: This qualitative study employed purposive and snowball sampling to recruit community pharmacists in Malaysia. Semi-structured interviews were conducted, exploring pharmacists' perspectives on barriers, counselling approaches, follow-up strategies, and opinions on smoking cessation services. Thematic analysis was employed to identify key themes and sub-themes.

Key findings: Three main themes emerged from the data analysis: barriers, counselling and enhancing follow-up, and pharmacists' opinions on professional fees. Under the theme of barriers, sub-themes included underutilization by the public, poor follow-up by customers, time constraints, lack of educational materials and support, and customer perception. The counselling and enhancing follow-up theme encompassed shared decision-making, motivational intervention, follow-up via phone calls or messaging apps, and providing rebate vouchers. Pharmacists' opinions on professional fees revealed mixed perspectives, with some advocating for fees to recognize the professional service provided, while others expressed concerns about access barriers.

Conclusions: Community pharmacists face challenges in delivering smoking cessation services, such as underutilization, poor follow-up, time constraints, and affordability. However, strategies like shared decision-making and proactive communication can enhance effectiveness. Addressing professional fees and collaborative efforts are essential to optimising these services.

Objectives: Community pharmacists modify prescriptions to solve or prevent drug-related problems. To assess the relevance of prescription modifications, they are usually judged on clinical outcomes only, overlooking their humanistic and economic impact. This study aims to evaluate therapeutic prescription modifications performed by Dutch community pharmacists in terms of clinical outcome, along with the humanistic aspect "usability" and economic aspect "efficiency."

Methods: A multidisciplinary panel evaluated the relevance of 160 cases of therapeutic prescription modifications collected in community pharmacies. Cases were stratified for type of drug-related problem based on their frequency in the original set of modifications. Both the relevance in general and the impact on the individual aspects of effectiveness and medication safety, usability, and efficiency were evaluated.

Key findings: Sixteen cases (10.0%) were excluded because of insufficient information for evaluation. Sixty percent of the 144 cases were evaluated as relevant (56.3% relevant and 4.2% highly relevant). The remaining cases (31.9%) were moderately relevant. For 7.6% of the cases, evaluations were inconclusive. In 25.0% of the cases, there was a major improvement on at least one of the aspects effectiveness, medication safety, usability, or efficiency.

Conclusions: The majority of therapeutic prescription modifications performed by Dutch community pharmacists were evaluated as relevant or highly relevant by a multidisciplinary panel. Modifications improved clinical, humanistic, and economic aspects. This shows the important role of community pharmacists in primary healthcare. Sharing more clinical information like indication, illness severity, and treatment plan will enable pharmacists to improve their contribution to safe medication use.

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: There is little known regarding prescription and nonprescription medicine nonmedical use (abuse and misuse) in Iraq, with limited treatment. Pharmacists could be a valuable source of information in the absence of any national monitoring system.

Aims: This study aimed to explore Iraqi community pharmacists' perspectives on prescription and nonprescription medicine abuse/misuse, including motives for use and how often they encounter people whom they think are misusing or abusing medicines.

Methods: A cross-sectional survey was undertaken between November 2020 and February 2021. Community pharmacists in Iraq were asked to complete a prepiloted self-administered questionnaire, distributed through online social media platforms.

Results: 300 pharmacists completed the questionnaire. The most commonly reported nonprescription drugs suspected of abuse/misuse were cough and cold medications (n = 80, 26.6%), topical corticosteroids (n = 54, 17.9%), and allergy products (n = 33, 11%). The most common reported prescription drugs suspected of abuse/misuse were systemic antibiotics (n = 111, 36.9%), gabapentinoids (n = 56, 18.6%), and moderate-weak opioids (n = 34, 11.3%). The most commonly method used by pharmacists to limit access to such drugs was responding that the requested medication was unavailable (n = 273, 51.7%), followed by advising on risks (n = 152, 33.2%).

Conclusions: Prescription/nonprescription medicine abuse and misuse are suspected in community pharmacies in Iraq. Current methods for controlling the problem are likely to be ineffective in the absence of prescription drug enforcement. Pharmacists could have a more proactive role in managing this issue, networking with other pharmacists, and referring suspected users to support.

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.