International Journal of Pharmacy Practice最新文献

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.

Objective: To assess the public perception of the role of hospital pharmacists, their satisfaction with the pharmacy service provided, and the factors associated with their perception and satisfaction.

Methods: A cross-sectional, questionnaire survey was conducted on adults older than 18 years who utilized public pharmacy services. A self-developed, validated questionnaire consisting of three parts was used, i.e., demographic data, perception, and satisfaction. The questionnaire was tested in a pilot study of 50 study participants and demonstrated good reliability results of 0.900 for the perception section and 0.836 for the satisfaction section. Therefore, all items were used in the final questionnaire.

Key findings: Four hundred and seventy-nine completed questionnaires were collected with a response rate of 91.6%. The Cronbach's α for perception and satisfaction scores were 0.938 and 0.841, respectively. The median total score for public perception was 83 (interquartile range [IQR]: 15), whereas the median total score for public satisfaction was 38 (IQR: 33). The level of public perception was significantly associated with the age groups (P = .009), ethnic groups (P < .001), respondents' locality groups (P < .001), the level of education achieved group (P = .017), and the income groups (P = .006). Satisfaction was not significantly associated with any sociodemographic factors.

Conclusions: This study has found that the general public had a favorable perception of the role of hospital pharmacists, and they were generally satisfied with the pharmacy service provided.

Objectives: This study aimed to evaluate the knowledge of community pharmacists toward acute uncomplicated cystitis regarding diagnosis, referral, and conformity to guidelines of the chosen antibiotic and to identify the associated factors with the pharmacist's knowledge.

Methods: This was a descriptive cross-sectional survey using a questionnaire. Data was collected from 349 community pharmacies in upper southern Thailand between December 2021 and February 2022. Univariate logistic regression analysis was used to assess factors associated with an inappropriate diagnosis of acute uncomplicated cystitis. The variables with P-value < 0.2 were included in the multivariate model. The statistically significant level was set as P-value < 0.05.

Key findings: Three hundred and forty-nine pharmacists from 349 community pharmacies were included. Approximately 65% and 69% of the participants had the knowledge to identify which patients should be considered for cystitis and which patients should be considered for acute uncomplicated cystitis. Ninety eight percentage of pharmacists could select the appropriate antibiotic for uncomplicated cystitis patients. The most prescribed antibiotics were ciprofloxacin (44.7%), norfloxacin (40.7%), and ofloxacin (10.3%). Inappropriate diagnosis was significantly related to age (P = 0.016) and role in the community pharmacy (P = 0.033).

Conclusion: The majority of participants had misconceptions about the differential diagnosis between complicated and uncomplicated cystitis. These were related to the community pharmacists' advanced age. Continuous pharmacy education should be established to advocate rational antibiotic use, especially in a country where community pharmacists are legally allowed to dispense antimicrobials without a prescription.

Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in an increased need for essential community services including new roles for pharmacists. Globally, community pharmacists are a highly accessible point of contact for referral.

Objective: To assess the preparedness of and facilitators to community pharmacists referring patients with suspected COVID-19 symptoms for testing.

Methods: A cross-sectional survey was administered using a structured questionnaire to 1023 pharmacists (one respondent in each pharmacy) in Egypt between 17 and 30 May 2020.

Results: Pharmacists who had received pandemic referral training were significantly more familiar with the referral system in comparison to those who had not (n = 180; 17.6% vs. n = 841; 82.4%, P = .014). Case referral was significantly associated with the referrer (n = 161, 15.8%), demographics of region (P = .001), graduation year (P = .035), and gender (P = .015). The vast majority of respondents identified facilitators to referring, namely university-level teaching (n = 984, 96.7%), continuing professional development (n = 958, 94.3%), smartphone app (n = 809, 80.5%) or telephone hotline (n = 933, 91.5%), IT access (n = 861, 84.7%), and managing patients' attitudes through the media in terms of the importance of declaring symptoms to (n = 998, 97.7%) and cooperating with (n = 977, 96.2%) referrers.

Conclusions: Pharmacists' lack of preparedness to engage with the referral process and related roles contributing to tracking the national COVID-19 infection rate could be mitigated by the provision of facilitators suggested by respondents. These included improved cooperation from local healthcare authorities, educational interventions, technological solutions, and the use of the media. Demographics associated with pharmacists' attitudes to referral, and hence the reliability and validity of the national infection rate, demand further investigation.

Background: Pharmacist supply of non-prescription sildenafil was initiated in Norway in 2019, and continuous evaluation of the service is warranted.

Objectives: To map how the service checklist is used, evaluate the counselling and information given in consultations, get an insight into pharmacist assessments during consultations, and explore the pharmacists' experiences with the service.

Methods: A mixed-method approach of simulated patient visits with feedback combined with qualitative interviews was used. One 24-year-old simulated patient visited pharmacies requesting sildenafil in a scenario that ended before purchase. Visits were audio-recorded and evaluated. Post-visit, pharmacists were invited to get feedback and participate in an audio-recorded interview. Visits, feedback, and interviews were transcribed and analysed by descriptive statistics and systematic text condensation.

Key findings: Of 39 visits, 26 were analysed and 13 were excluded because the pharmacists did not give consent. Six (23%) pharmacists asked all the checklist questions, while 15 (58%) asked some of them. None of the pharmacists provided all the guideline counselling points. The counselling most provided was 'See your general practitioner within 6 months for a health check' (N = 7, 27%). Interviews (N = 19) elicited that pharmacists assessed the patients, with adaptations in the use of the checklist. Several barriers affecting the service were identified, including time pressure, pharmacist competence, and the task being uncomfortable and challenging.

Conclusions: Most pharmacists did not completely adhere to the mandatory checklist on non-prescription sildenafil and the counselling and information given were limited. The pharmacy sector must increase awareness of how best to assess and manage patients requesting non-prescription sildenafil.

Objectives: Breast cancer remains a prevalent disease in women worldwide. Though advancements in breast cancer care have improved patient survival, a breast cancer diagnosis, and subsequent interventions have a lasting impact on patients' lived experiences during the pandemic.

Methods: We present the collaborative learning process from this patient engagement workshop series as a community-academic partnership. Narrative medicine tools were used to recount patients' lived experiences following diagnosis, where both patients and researchers shared their cancer research activities in each workshop, and the role of the multidisciplinary healthcare team was discussed.

Key findings: We used an iterative approach to cohort building, narrative development, and the use of multiple media formats to capture stories. Over 20 patients with breast cancer shared their stories for the first time since their diagnosis with a wider audience. Here, we present the learning process and considerations from this event.

Conclusions: Understanding patients' lived experiences can support researchers and healthcare professionals in developing an empathetic approach to shared healthcare decision making. Moreover, understanding the lived experiences of patients is critical to addressing disparities in healthcare.

Background: The symptomatic management of Parkinson's disease (PD) relies heavily on medications, which increase in complexity as the disease progresses.

Objectives: To describe (i) the extent, range, and nature of research describing the experience and challenges people with PD and their carers have with their medicines for symptomatic treatment, and (ii) any interventions that have been reported in a community setting that address medicine-related challenges experienced by people with PD.

Methods: The scoping review searched electronic databases (EMBASE, PubMed, and CINAHL). The studies included were full-text articles in English only, including conference abstracts that focussed on patients with PD or their carers and discussed medicines in the primary care setting, even where this was not the primary focus.

Results: Thirty-nine papers were taken forward for data extraction. Twenty described patient experience and challenges. Although none were explicitly focussed on medications, they did highlight challenges including the work of taking multiple medications and a desire for non-oral formulations. Nineteen described or tested interventions to support people with PD with their medication including community pharmacist-led reviews, medication compliance aids, and the use of text message reminders. These were all small-scale feasibility and pilot studies, and none were grounded in a methodological framework. Positive outcomes were reported against various scales, but no evidence of scaling up any of the interventions was found.

Conclusion: There is very little published research surrounding the challenges people with PD have with their medicines. The published research that does exist alludes to challenges with medicines taking in people with PD but identifies a gap in the detail and understanding. Further work is required to improve our understanding and allow the development of sustainable interventions that support people with PD and their carers.

Objectives: There is no report on the initial antiepileptic drug (AED) treatment of older Thai epileptic patients. This study aimed to determine the trends, prescribing patterns, and determinants of initial AED treatment.

Methods: This cross-sectional study used data on older (≥60 years) epileptic patients gathered from one tertiary-care hospital's database from 2012 to 2022. We evaluated the trends and prescribing patterns for starting AED treatment. We used logistic regression to identify the determinants of the initial treatment with new-generation AEDs.

Key findings: This study comprised 919 participants (59.19% men, 70.99 ± 8.00 years old). Between 2012 and 2022, we observed a decreasing trend in starting therapy with old-generation AEDs, from 89.16% to 64.58%. In contrast, there was an increasing trend in initiating treatment with new-generation AEDs, from 10.84% to 35.72% (P for trend <0.001 for both). Each assessment year, the most prescribed treatment pattern was monotherapy. The determinants of initial therapy with new-generation AEDs included the year treatment began (adjusted odds ratios [AOR] = 1.0006; 95% confidence intervals [CI] 1.0003-1.0008), non-Universal Coverage Scheme (AOR = 1.94; 95% CI 1.26-3.00), liver disease (AOR = 6.44; 95% CI 2.30-18.08), opioid use (AOR = 2.79; 95% CI 1.28-6.09), and statin use (AOR = 0.59; 95% CI 0.36-0.95).

Conclusions: There is a growing trend of initiating treatment with new-generation AEDs in older Thai patients with epilepsy. Factors positively associated with starting new-generation AEDs include the year treatment began, non-Universal Coverage Scheme, liver disease, and opioid use, while statin use is a negatively associated factor.

Objectives: To evaluate the effect of a clinician-designed digital notification system on the use of intravenous paracetamol during a medication shortage.

Methods: An in-house digital notification platform was designed through multidisciplinary collaboration. A 4-week pre- and post-implementation methodology was employed to evaluate the effect of the intervention.

Key findings: There was significantly lower use of intravenous paracetamol in the post-implementation period compared to the pre-implementation period (median 80 doses per day, interquartile range 58 to 93, vs 94, interquartile range 83 to 122, P < .001).

Conclusions: Multidisciplinary clinician-designed digital notification platforms may assist during times of medication shortage.