International Journal of Pharmacy Practice最新文献

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.

Objectives: Australians living in rural and remote communities have inadequate access to health services, contributing to poorer health outcomes compared to their metropolitan counterparts. This study investigated consumers' and pharmacists' perspectives of expanded pharmacy services in rural and remote communities in Australia. It aims to identify the role of the pharmacist in addressing the inequity of access to healthcare through the provision of expanded services in rural and remote practice.

Methods: A concurrent parallel mixed-methods study was undertaken in rural Western Queensland, Australia to include a survey of 167 consumers and in-depth interviews with 10 pharmacists. Quantitative data analysis employed descriptive statistics and chi-square tests, while qualitative data were analysed thematically against the constructs of the Diffusion of Innovations Theory.

Key findings: Consumers indicated that they would like to access weight management services (53%), whereas pharmacists thought it was important to offer respiratory clinics and services. Both pharmacists and consumers would like to see diabetes checks (30% and 56%, respectively) and vision, hearing, and ear checks (40% and 53%, respectively) implemented as services in community pharmacies. Most consumers (97%) believe pharmacists have the skills and knowledge to deliver expanded services and in doing so, they would improve the overall health of the community. Pharmacists reported staffing availability, workload and time constraints, cost, and jeopardizing inter-professional relationships as barriers to implementing expanded services.

Conclusions: Consumers were supportive of pharmacists working to their full scope of practice to provide expanded services, whereas pharmacists, while open to the idea, highlighted that there were barriers to overcome.

Objectives: To assess the content and frequency of advice community pharmacists (CPs) provide to pregnant women with nausea and vomiting, their confidence in providing advice, and their knowledge of the safety of medication used to manage the condition.

Methods: An online questionnaire of closed- and open-ended questions was distributed to CPs in the UK in May 2023. Closed-ended questions were analysed quantitatively, and conventional content analysis was utilised for open-ended responses.

Key findings: One hundred and eighty-one respondents completed the questionnaire, 24 responses were excluded, leaving data from 157 available for analysis. The majority (90.4%) of participants reported having experience in providing advice on nausea and vomiting with varying levels of confidence. Advice provided included using over-the-counter products, lifestyle modifications, reassurance, medication advice, and referring to other healthcare professionals. Knowledge of first-line antiemetics considered safe in pregnancy varied; cyclizine was correctly identified as safe during pregnancy by 57.3%, followed by 37.6% for promethazine and 31.2% for prochlorperazine. Self-reported confidence and having experience providing advice were related to higher medication safety identification rates. Five percent of participants reported previous training on the condition, while 70% reported wanting further education, preferably delivered via an online medium.

Conclusions: This study showed that although 90% of CPs provide advice on nausea and vomiting in pregnancy, their medication safety knowledge varied. The majority of CPs reported wanting further education that would ensure women could access reliable information and evidence-based advice to optimise management of the condition.

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.

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.

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.