International Journal of Pharmacy Practice最新文献

Objectives: Multicompartment compliance aids (MCAs) are widely used to assist patient medication adherence. However, there is limited evidence on the challenges associated with use. The aim of this review was to determine the barriers to the use of MCAs and propose how they can be overcome.

Methods: A methodical search strategy was conducted across Medline, Emcare, CINAHL, and Scopus (inception to June 2024), with articles screened against inclusion and exclusion criteria. Data analysis was guided by a multilevel, socio-institutional lens of mega-, macro-, meso-, and micro-perspectives.

Key findings: Eleven studies were included in the review reporting on use in clinical and experimental settings, including in residential aged care, community pharmacy, independent at home use, and laboratory settings. At the mega-level, barriers have emerged including lack of guidelines and government funding, while at the macro-level miscommunication between prescribers and the pharmacy were identified. The lack of patient involvement in the decision to commence use and the perceived loss of autonomy, which increases a lack of adherence has been confirmed at the meso-level. The actual device which is neither designed to adequately protect the medicines from the environment nor fully consider the physical and cognitive impediments associated with advancing age and technological complexity has emerged as a barrier at the micro-level.

Conclusions: This review has identified that there are barriers to the use of MCAs. Current recommendations call for revision of multicompartment compliance aids service guidelines and remuneration to enhance their use through optimising multi-disciplinary communication, alongside device remodelling to improve medication stability and user uptake.

Objectives: To systematically evaluate the management effectiveness of pharmacist involvement in clinical oncology drug therapy and elucidate the unique value of pharmacists in cancer treatment.

Methods: We conducted systematic searches in PubMed, Embase, and Web of Science to identify randomized controlled trials (RCTs) and non-randomized intervention studies (NRSIs), evaluating the impact of pharmacist interventions on clinical outcomes in cancer patients. Following rigorous evaluation of titles/abstracts and full texts, literature screening, data extraction, and quality assessment using validated assessment scales were performed. The meta-analyses were conducted utilizing the RevMan 5.4 software.

Key findings: The analysis encompassed 20 RCTs and 6 NRSIs with a total of 3859 participants. Meta-analysis demonstrated statistically significant reductions in the pharmacist interventions group for adverse reaction incidence rates, particularly nausea (OR = 0.55, 95% CI (0.44, 0.70), P < .00001), and vomiting [OR = 0.45, 95% CI (0.28, 0.73), P = .001]. The pharmacist intervention group had a higher pain relief rate [OR = 1.99, 95% CI (1.06, 3.76), P = .03], medication compliance [OR = 4.11, 95% CI (2.40, 7.02), P < .00001], and quality of life (QoL) indicators.

Conclusions: Current evidence confirms that pharmacist-led Interventions (including pharmacovigilance, medication counseling, pain management, therapeutic education, and medication reconciliation) effectively reduce adverse events and pain burden in cancer patients while enhancing treatment adherence and QoL. These findings substantiate the critical role of pharmacists as integral members of multidisciplinary teams in optimizing oncology therapeutic outcomes.

Objectives: Healthy nutrition, in addition to medicines, is essential for the management of non-communicable diseases like heart disease and diabetes. Primary healthcare professionals (PHCPs), including pharmacists, are well positioned to provide nutrition advice to patients. However, they also report to be time poor and lack sufficient nutrition education and knowledge. Therefore, access to reliable, evidence-based nutrition educational resources is important for the ability of this essential workforce to deliver nutrition counseling to patients. This systematic search and review aimed to explore brief nutrition resources utilized by PHCPs for patient education, including resource design, content, and outcomes of resource use.

Methods: A systematic search was conducted across the databases Scopus, Medline, Embase, and CINAHL of studies published in the past 20 years.

Key findings: Of 1914 papers, 19 papers matched the inclusion criteria. Written, verbal, and digital nutrition resources were utilized in various formats, including pamphlets (n = 14), videos (n = 1), websites (n = 2), Apps (n = 2), booklets (n = 1), webinars (n = 1), and sheets to record information (n = 1). Three important resource characteristics were identified: (i) specific nutrient and food group advice, (ii) illustrations and population-specific language, and (iii) elements to foster behavior change. Most studies (n = 18) reported positive outcomes, including improved attitudes and patient knowledge about nutrition as well as better self-reported dietary habits and overall health.

Conclusion: Brief nutrition resources utilized by pharmacists, doctors, nurses, and dentists were effective in delivering nutrition information, resulting in improved self-reported outcomes for patients. In addition, combining written resources with brief counseling increased patient understanding of nutrition information.

Background: Climate change threatens health and the safe and effective operation of health services, including pharmacy care. Given the critical and increasing role of community pharmacy in providing accessible and community-based care, their role in addressing climate risks and pollution impacts warrants investigation.

Objective: To catalogue actionable resources available to support community pharmacists and learn about opportunities for incorporation into climate-conscious pharmacy practice.

Methods: We used a multi-method sequential design, with an environmental scan of resources for climate-conscious pharmacy practice across selected international jurisdictions, followed by qualitative interviews with key informants in Canada, UK, Ireland, and Norway. Resources identified through the environmental scan were categorized based on frequency of appearance and similarity of considerations seen across sources. Semi-structured interviews generated feedback on the resources identified, their categorization, and identified opportunities for implementing climate-conscious pharmacy practice.

Results: 115 sources were included from the environmental scan and 12 key informants were interviewed. Resources were initially classified into clinical and operational considerations they implied for practice and further sub-classified into mitigation and/or adaptation strategies. Key informants supported or did not disagree with the considerations that were identified. They shared resource constraints as a challenge in implementing climate-conscious practice and highlighted the importance of a patient-centred approach to support the implementation.

Conclusion: Overall, actionable considerations for climate-conscious community pharmacy have been identified internationally. Pharmacists are continuing to contribute to planetary health as they are already engaged in many of the suggested considerations. Raising awareness of potential co-benefits may help further equip pharmacists to incorporate climate-conscious pharmacy practices.

Objectives: To explore the recall of United States Pharmacopeia pharmaceutical pictograms among Spanish adolescents completing formal education, with an emphasis on evaluating the impact of prior exposure on their comprehension.

Methods: A cohort study was conducted among 62 secondary education students during the 2021-2022 academic year. Two sessions were conducted: an initial assessment of pictogram comprehension and a recall assessment after 4 weeks. The evaluation of pictograms from the United States Pharmacopeia was conducted in compliance with the International Organization for Standardization 9186-1 standard. Statistical analyses included McNemar's tests for paired proportions and a one-way repeated measures analysis of variance to compare comprehension rates between sessions.

Key findings: The mean comprehension rate increased from 68.35% in the transparency test to 80.57% in the recall test, representing a significant improvement (P = 0.041). Specific pictograms, such as 'Do not use additional salt' (P = 0.003) and 'Do not take other medicines with this medicine' (P = 0.001), demonstrated significant improvements in recall, while others did not show notable changes.

Conclusions: Prior exposure was found to significantly enhance the recall of pharmaceutical pictograms among adolescents. The implementation of a dual strategy combining visual aids and educational interventions is recommended to optimize the use of pictograms and support proper medication use among future end-users.

Medication adherence is an important determinant of validity in clinical trials but has been underappreciated and incompletely measured. Nonadherence can bias efficacy and safety results, increase trial costs, and undermine regulatory conclusions. This commentary reviews the effects of nonadherence, addresses shortcomings of the conventional self-report methods, and reviews newer tools like electronic monitoring, serum drug concentrations, and ingestible sensors. Behavioral interventions, digital tools, and trial design changes are emphasized as ways to improve adherence. Practicality, cost-effectiveness, and feasibility differ across patient populations and study environments, highlighting the importance of customized approaches. Frameworks such as EMERGE seek to harmonize reporting on adherence, but additional validation is necessary. Scalable real-time tracking, predictive modeling, and harmonized definitions are areas that future research needs to address to enhance comparability and decision-making. Addressing adherence in a comprehensive manner will enhance the consistency of clinical trials and the generalizability of results to everyday practice.

Objective: The Hedgehog pathway inhibitors (HPIs) are effectively used to treat basal cell carcinoma (BCC). Despite the benefits, HPIs are reported to cause various gastrointestinal adverse events (GIAEs). The study was conducted to detect possible safety signals of HPIs concerning GIAE through disproportionality analysis.

Methods: A retrospective case/non-case disproportionality analysis was performed in the USFDA Adverse Event Reporting System database using OpenVigil 2.1, a web-based pharmacovigilance tool. All the GIAEs reported due to the HPIs, like vismodegib, sonidegib, and glasdegib, were extracted and analysed. The reporting odds ratio (ROR) > 1 was considered the reporting threshold.

Key findings: The HPIs accounted for 6781 adverse events, with 1196 GIAEs distributed across vismodegib (18.56%), sonidegib (13.89%), and glasdegib (5.39%). A potential safety signal was portrayed with atrophic glossitis [ROR: 181.88 (95% CI: 72.73-454.83)] and ageusia [153.34 (141.20-166.52)] from vismodegib. The study identified concerns of dysgeusia [17.39 (11.72-25.81)] from sonidegib and hepatotoxicity [20.25 (9.02-45.46)] from glasdegib.

Conclusions: HPIs had triggered various types of GIAEs. Liver injuries were a safety concern for the HPI-treated patient, which was not listed by the USFDA. Further researches are needed to confirm these findings.

Objectives: The Royal Pharmaceutical Society has developed a new curriculum and credentialling process for advanced pharmacist practice. The aim of this study was to understand the self-reported advanced practice capability of UK pharmacists using this curriculum.

Methods: The study was a cross-sectional electronic survey. The inclusion criterion was that the participants be registered pharmacists practising in the UK in any professional sector. Participants rated, on a 5-point Likert scale, their confidence that their current practice aligns to the described level in the Royal Pharmaceutical Society Core Advanced Curriculum. Predictors of overall confidence that their current practice aligned to all curriculum outcomes were analysed using binomial regression.

Key findings: Nine hundred and eighty-eight pharmacists participated. The median age was 42 years; 75.2% were female and the median length of registration was 17 years. A low proportion of pharmacists reported confidence across all outcomes (19.8%). The research domain had the lowest self-reported confidence (26.9%). Other domains had higher levels of reported confidence: professional practice (40.9%); leadership and management (43.8%); person-centred care and collaboration (54.3%); and education (57.6%). The strongest predictors of overall confidence across the whole curriculum were completion of an advanced clinical assessment skills module, being a frequent prescriber, and self-identifying as an advanced practice pharmacist.

Conclusion: Only a minority of respondents self-reported confidence across the whole Core Advanced Curriculum. A strategy to develop and embed four pillar working for all pharmacists, as well as approaches to address systemic barriers for those working less than full-time may help deliver more 'advanced practice-ready' pharmacists.