International Journal of Pharmacy Practice最新文献

Objectives: We evaluated the impact of pharmacist-led interprofessional medication reviews in nursing homes on the optimization of drug therapy, inappropriate medication use, and costs.

Methods: Polypharmacy concerns more than 80% of Swiss nursing home residents, and approximately three-quarters of them receive at least one potentially inappropriate medication (PIM). The residents living in nursing homes where medication reviews by pharmacists were usually performed were allocated to the intervention group if they were included in a medication review during the study period (from July 2020 to September 2021). The control group included residents living in nursing homes where medication reviews were never performed. The primary outcomes were the change in the number of regular drugs prescribed, the number of PIMs, and drug costs over 12 months.

Key findings: Eighty-nine residents were included in the intervention group and 85 in the control group. Over 12 months, a truncated negative binomial regression analysis showed a significant decrease of 204 Swiss francs in drug costs per 6 months and a reduction in the number of drugs prescribed over 12 months (mean difference 0.8) in the intervention group compared with the control group. We also found a significant reduction in PIMs in the intervention group.

Conclusions: Pharmacist-led interprofessional medication reviews may reduce drug costs and the number of unnecessary and potentially harmful drugs in nursing homes.

Objectives: The environmental impact of healthcare systems represents a significant global challenge. Evaluating how pharmacy students and pharmacy professionals understand and perceive environmentally sustainable practices is crucial for reducing the healthcare industry's ecological footprint. This systematic review aimed to critically assess and synthesize the existing evidence on the knowledge, attitudes, and perceptions of pharmacy students and pharmacy professionals regarding environmental sustainability (ES) in pharmacy practice, identifying facilitators and barriers that influence their engagement.

Methods: A systematic review was conducted following Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines. Seven databases were searched using a prespecified search string for studies published in English between 2011 and 2024. Quality assessment was performed using the National Heart, Lung, and Blood Institute tool for cross-sectional studies, Consolidated Criteria for Reporting Qualitative Research checklist for qualitative research, and Mixed Methods Appraisal Tool for mixed-methods studies. Data were synthesized narratively due to methodological heterogeneity.

Key findings: Fifteen studies from 11 countries were included. While most pharmacy students and pharmacy professionals recognized environmental risks associated with pharmaceutical waste, significant knowledge gaps existed regarding proper disposal practices, ecopharmacovigilance, and broader ES concepts. Despite positive attitudes toward ES, participants often struggled to translate awareness into action, citing barriers such as a lack of formal training, unclear guidelines, and limited systemic support. Both students and pharmacy professionals expressed a strong interest in enhancing ES education and training.

Conclusions: This review highlighted the need for comprehensive integration of ES principles in pharmacy education and practice using a structured approach. Additionally, future efforts should focus on developing clear guidelines, enhancing professional training, and establishing supportive infrastructure for ES in pharmacy practices.

Objectives: To assess the perceptions, practices, and awareness of patients with chronic diseases in Jordan regarding Ramadan self-management, and to identify factors influencing their quality of life based on utility scores.

Methods: A cross-sectional, survey-based study was conducted in outpatient clinics and hospital pharmacies across multiple centres in Jordan, following Ramadan. Muslim patients who self-reported having chronic diseases and had been receiving their regular medications for at least one year were included and interviewed face-to-face.

Key findings: A total of 900 patients were included in the study. Most participants (82.9%) fasted during Ramadan, of whom 90.8% did not consult a physician beforehand, and 69.4% did not undergo laboratory testing to assess disease control before fasting. Most patients (94%) considered physicians as their main source of information on medication use during Ramadan (94%). Participants generally showed good awareness of medications and procedures that break fasting. Higher levels of agreement with the Jordanian General Iftaa' Department on fasting were significantly linked to having a university education and an income of ≥500 JOD (P value < .5). Additionally, male gender, university degree, income of ≥500 JOD, village residency, non-smoking status, and fewer comorbidities or medications were predictors of higher utility scores (P value <.5).

Conclusions: Most participants were able to carry out daily activity, despite few seeking medical advice or undergoing lab tests to assess disease control before fasting. They were generally aware of medication routes and clinical procedures that break the fast. Emphasizing pre-Ramadan physician consultations and educational programs is recommended.

In the United Kingdom (UK), the vision is to further develop the pharmacy workforce through career development pathways aligning to the Royal Pharmaceutical Society's post-registration foundation, advanced, and consultant practice curricula, which align with the four pillars of advanced practice recognized across multiple healthcare professionals-clinical practice, leadership and management, education, and research. However, it has been recognized that research capacity, competency, and confidence within the pharmacy profession require development. It has been noted that it is this 'pillar' that most frequently impedes successful credentialing at both 'Core advanced' and 'Consultant levels'. A report presenting the findings of a UK-wide call for evidence on clinical academic careers in pharmacy outlines recommendations to embed a research culture in pharmacy careers, develop a clinical academic pathway for pharmacy, and provide a pipeline of pharmacy research leaders. The establishment of such pathways would provide opportunities for building capacity within the profession. The Scottish Pharmacist Clinical Academic Fellowship (SPCAF) programme was created to develop a network of Clinical Academic Pharmacist posts; a collaborative initiative between National Health Service Education for Scotland and the two Pharmacy Higher Education Institutions in Scotland is aimed at developing pharmacists as researchers to advance pharmaceutical care within the National Health Service in Scotland. This commentary presents a summary of an archival review completed as part of a wider research programme that adopted a case study approach with the purpose of evaluating the SPCAF programme cohort 1 (2021-23). The scope is to support others looking to develop similar practice-based research programmes aiming to build research capacity, competence, and confidence in the pharmacy workforce.

Background: Nigeria, Africa's most populous country, faces major challenges in delivering equitable healthcare due to workforce shortages, weak regulation, and inadequate training structures. Pharmacists, as accessible healthcare professionals, are uniquely positioned to address these gaps, but pharmacy education and practice frameworks require reform.

Objective: This report provides a comprehensive overview of pharmacy education, career pathways, regulatory structures, research culture, and future directions in Nigeria, with a view to aligning the profession with global standards and national health needs.

Key findings: The pharmacy undergraduate programme of study in Nigeria is undergoing a transition from the Bachelor of Pharmacy (BPharm) to the Doctor of Pharmacy (PharmD) degree, aiming to enhance clinical competence. However, training remains largely focused on basic science rather than clinical practice, and research capacity is underdeveloped outside academia. Postgraduate opportunities exist, including Master of Science, Master of Public Health, Doctor of Philosophy, and fellowships, though structured clinical residencies are scarce. Pharmacists pursue careers in community, hospital, academic, industrial, and regulatory settings, but face limitations in scope of practice, particularly around MTM and prescribing. A national research strategy is absent, and clinician-researcher roles remain undefined. Regulatory functions are fragmented, and reimbursement models for pharmaceutical services are lacking.

Conclusions: To advance pharmacy's role in healthcare delivery, a context-sensitive, systems-level approach is essential to unlocking the profession's full potential and improving population health outcomes.Nigeria must adopt a dual-competency educational model that prepares pharmacists as both clinicians and researchers. This will require curriculum reform, interprofessional collaboration, structured postgraduate pathways, and investment in research infrastructure.

Objectives: Over and behind-the-counter medicines are among the most used medicines globally, but their availability differs across countries. While they offer convenient access and fill critical gaps in healthcare, their misuse or improper administration poses risks. This study aimed to assess the inclusion patterns of over-the-counter (OTC) and behind-the-counter (BTC) medicines on essential medicines lists worldwide and examine their effect on public health in terms of accessibility and affordability, as well as the common medical conditions they are intended to address. Additionally, the study examines the regulatory frameworks governing these medicines to understand how healthcare systems balance accessibility with safety. Findings are intended to inform policy decisions aimed at optimizing medicine availability while minimizing potential harms.

Methods: This cross-sectional study involved a comparative analysis of essential medicines lists from 158 countries with publicly accessible lists. Main outcomes included the proportion of essential medicines classified as OTC or BTC, variations in their availability across countries, and a comparison with the World Health Organization's model list.

Key findings: Findings suggest significant variability in the availability of both prescription and non-prescription medicines across countries. While some nations prioritize accessibility by classifying a larger proportion of essential medicines as OTC, others implement stricter regulations to mitigate risks of misuse.

Conclusions: This study highlights the critical role of regulatory frameworks in shaping access to medicines and ensuring their safe use. Understanding global patterns in over or behind-the-counter medicine availability and their inclusion in essential medicines lists can inform policy decisions to optimize healthcare delivery.