International Journal of Pharmacy Practice最新文献

Objectives: This study explored how community pharmacies in the English National Health Service responded to a referral from one hospital in the south west of England for a discharge medicines service for patients on oral anticoagulants.

Methods: Analysis of PharmOutcomes™ for a 12-month period commencing 1 April 2023. The download was interrogated for relevant entries for patients discharged on apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin.

Key findings: Approximately one-third of community pharmacies recorded entries on PharmOutcomes™ that point to their involvement in monitoring of appropriate prescribing and active counselling of patients about their anticoagulants at transition of care.

Conclusions: There is increased scope for community pharmacists to be involved more formally in anticoagulant stewardship activities.

Objectives: To find a novel way to successfully transition patients from methadone to buprenorphine and in turn reduce the percentage of methadone prescribed within National Health Service Dumfries & Galloway (NHS D&G).

Methods: Three micro-dosing schedules were developed. Outcomes measured: patient numbers, success rates, prior methadone dose, Opiate Substitution Therapy following micro-dosing. A patient feedback questionnaire was developed.

Key findings: 177 patients micro-dosed between 06/09/21 and 28/05/24. Around 132 patients successfully transitioned from methadone to buprenorphine through micro-dosing (74.5%). Shift in prescribing: 60.5% buprenorphine/39.5% methadone.

Conclusion: Micro-dosing is now a standardized approach to transitioning from methadone to buprenorphine in NHS Dumfries & Galloway.

Objectives: To assess environmental, financial, and workload impacts of removing maintenance inhalers (MIs) from wardstock.

Methods: Wardstock MIs were removed at a community hospital in British Columbia, Canada. Waste, cost, and environmental impact were assessed through pharmacy dispensing and restocking data. Staff workload was assessed through a survey.

Key findings: There was a significant and sustained reduction in MI dispensing with a 30% reduction in cost and a 37% reduction in carbon emissions, without a perceived change to staff workload that persisted 16 months following the intervention.

Conclusion: Removal of wardstock MIs is a financially advantageous way to decrease healthcare-related carbon footprint without impacting workload or patient care.

Objectives: To reduce the carbon footprint of inhalers by formulary optimization.

Methods: The carbon footprint of inhalers dispensed in 2023 was audited.The preferred salbutamol metered dose inhaler was changed in March 2024. After 5 months, a second audit was done to assess this intervention.

Key findings: The carbon footprint was 109 tonnes of CO2 equivalents in 2023. Metered dose inhalers accounted for 97.8% of emissions (107 t CO2 equivalents) but only 55% (n = 4149) of inhalers dispensed.Following the intervention, monthly emissions were significantly lower (P = .048).

Conclusions: Inhaler formulary optimization significantly reduced the carbon footprint.

Objectives: Previous studies have highlighted inconsistencies in dosage instructions on dispensed medicine labels, increasing the risk of medication errors. This challenge is especially relevant in paediatrics, where instructions often convey more complex numerical values and use of measuring devices. This study aimed to investigate parents' and carers' preferences and understanding of dosage instructions on dispensed paediatric medicine labels.

Methods: An anonymous, paper-based, self-administered 9-item survey was conducted at 14 hospitals in England in 2024. Each hospital received 25 questionnaires, which were distributed to a convenience sample of parents and carers for completion during their child's hospital visit. Participants' socio-demographic and educational characteristics were collected. The study was approved as a quality improvement project; ethical approval was not required.

Key findings: Two hundred and fifty respondents (71.4% response rate) from 12 hospitals were included in the analysis. 72.8% (150/206) of respondents without a healthcare background preferred millilitre (ml) alone for expressing oral liquid medication doses, compared to 46.9% (15/32) of those with healthcare backgrounds (P = 0.004). A greater proportion of non-healthcare respondents preferred the numerical format '1 tablet' over the word form 'one tablet' (121/203 vs 11/33, P = 0.005). Overall, the proportion of respondents who correctly interpreted oral liquid medication doses expressed as '…ml', '…ml (…mg)' and '…mg (…ml)' was 98.8%, 96.3%, and 74.5%, respectively (P < 0.05 for all pairwise comparisons).

Conclusions: This study provides important insights, showing that parents and carers prefer simpler wording for dosage instructions and that the measurement unit in which doses are expressed can hinder comprehension.

Objectives: The perceptions of community pharmacists and patients regarding a new pharmaceutical service implemented in Gipuzkoa (Spain) aimed at improving medication adherence, safety, and understanding of medicines under additional monitoring for patients with chronic diseases were assessed.

Methods: Twenty-seven community pharmacists and 145 patients in Gipuzkoa participated in the implementation of the new pharmacy service and self-administered questionnaires about their perceived satisfaction and overall evaluation were completed. Descriptive statistics were used to analyse the data.

Key findings: High satisfaction with the service was reported by both patients and pharmacists (mean patients' satisfaction score = 8.9/10; percentage of patients that positively rated the attention received from pharmacists = 97.7%). Better understanding and use of their medications was reported by 88.5%, >60.7% of the patients showed improved adherence and 84.6% felt more informed about side effects, indicating the service's positive effect on medication knowledge and safety. The service was rated 8.7/10 by pharmacists; they reported improvements in patient adherence, quality of life, and medication knowledge. Nearly, all pharmacists observed enhanced reporting of adverse drug reaction integration into daily practice, with the role of the 'practice change facilitator' being emphasized as vital for successful implementation.

Conclusions: The service was positively evaluated by community pharmacists and patients for enhancing medication management and patient outcomes. Expanding this service could lead to improvements in the quality of pharmaceutical care and patient safety from the stakeholders' perspective. Future efforts should focus on refining training, support, and integration into routine healthcare practice to ensure sustained success.