Journal of Pharmaceutical Policy and Practice最新文献

Introduction: The occurrence of antibiotic resistance (AR) has become a critical issue during the Novel coronavirus disease 2019 (COVID-19) pandemic. This study explores the experiences of healthcare commissioners with AR during the COVID-19 pandemic, identifies challenges, and provides recommendations for combating AR during pandemics.

Methods: This qualitative study was multi-centered and used a phenomenological approach. Semi-structured interviews were conducted between December 2022 and January 2023 among 11 health commissioners using video calls.

Results: Seven themes emerged from the data, including knowledge of AR and its consequences, the antibiotic prescription system, the future of AR and potential contributory factors, the impact of COVID-19 on AR and their relationship, the experience of AR during the COVID-19 pandemic in healthcare facilities, barriers that prevent the misuse of antibiotics during pandemics, and recommendations regarding antibiotic resistance during pandemics.

Conclusion: The findings of this study could be used to inform policy and practice for government healthcare workers (HCWs) and the public. Furthermore, this study identified the main challenges of AR during the pandemic, and the recommendations of health commissioners were provided accordingly. Such recommendations could be beneficial on a national and international scale to reduce the impact of future pandemics on AR.

Abbreviations: COVID-19: Novel coronavirus disease 2019; AR: Antibiotic Resistance; IPC: Infection prevention and control; MDRO: multi-drug resistant organism; ASP: Antimicrobial Stewardship Program; HCW: Healthcare worker; KSA: Kingdom of Saudi Arabia; WHO: World Health Organization; MOH: Ministry of Health; MOEWA: Ministry of Environment, Water, and Agriculture; AMR: Antimicrobial Resistance; PHCC: Primary Healthcare Center.

Background: The prevalence of potentially inappropriate medications (PIMs), including NSAIDs, first-generation antihistamines, tricyclic antidepressants (TCAs), and benzodiazepines among elderly inpatients in Thailand, based on the 2019 Beers criteria, is insufficiently investigated.

Methods: This study retrospectively examined 300 elderly patients in a Thai tertiary hospital, assessing four PIM classes based on the 2019 Beers criteria and exploring factors and variations in PIM prescription patterns across different phases of hospitalisation.

Results: The study found an overall PIM prescription rate of 28%, consisting of: benzodiazepines (14%), first-generation antihistamines (9%), NSAIDs (3%), and TCAs (2%). Patients taking at least 5 medications prior to admission were more likely to receive PIMs (OR 3.77, 95% CI 1.15-12.35). Furthermore, PIM prescription was significantly associated with age, showing a 4.8% yearly increase (p = 0.01), and the number of comorbidities increased by 16.2% per unit (p = 0.021). Additionally, PIM use during admission was significantly linked to a longer hospital stay (OR 3.32, 95% CI 1.50-7.33).

Conclusions: These findings emphasise the need for continued monitoring and optimisation of medication management, and collaboration between pharmacists and physicians to review and adjust prescriptions, especially in elderly inpatients experiencing polypharmacy and multiple comorbidities.

Background: Self-medication and lack of patient adherence contribute to antibiotic misuse. This article describes parents' attitudes and practices regarding use of antibiotics by their children in Kosovo.

Methods: A cross-sectional survey was conducted during data collection. We surveyed a total of 453 parents of children aged 0-15 years, who had experiences with using antibiotics for their children. Correlation tests and regression analysis were used to explore the relationship between variables.

Results: Our findings showed that 42.2% of parents strongly agreed or agreed with the use of antibiotics as a means to cure a cold or flu in their child more quickly. In addition, 29.8% were not aware of antibiotic side effects. Non-compliance with antibiotic treatment was 35.8%, and 28.9% of surveyed parents suggested that they had pressured their pediatricians to prescribe antibiotics for their children. A total of 10.15% of parents had no information on antibiotic resistance, and 34.38% of parents responded that they did not believe that self-medication with antibiotics could lead to resistance. Regression analysis results indicated that gender and age group have a significant influence on the parents' decision that an antibiotic should be used in children with high fever (p < 0.001).

Conclusions: Our findings suggest that antibiotic management by parents in Kosovo is not satisfactory, and more attention should be given to their knowledge of the side effects of antibiotics, bacterial resistance and reduction in the self-medication. Health education, adequate measures and interventions are needed to overcome this situation and ensure rational use of antibiotics in Kosovo.

Background: Since the introduction of the 'Test and treat' approach in the Human Immunodeficiency Virus (HIV) management, various strategies have been devised and implemented by countries to relieve public health facilities of the large numbers of people coming for medicine refills and clinical follow-up. One of the strategies is the dispensing of antiretroviral medicines through community pharmacies. In Rwanda, community pharmacies are not yet involved in antiretrovirals (ARVs) dispensing, and no study has assessed their readiness to provide this service. This study aimed to assess the readiness of community pharmacy staff and infrastructure to implement a decentralised model of antiretroviral medicines dispensing.

Methods: This cross-sectional study included data from 262 community pharmacies sampled across all districts of Rwanda. Primary data were collected using a structured questionnaire, from February to March 2023. Responses were received for 262 community pharmacies, representing the total sample size. Data analysis was done using quantitative descriptive and inferential statistical approaches. Frequency tables and graphs were produced using STATA15 and the outputs were exported to MS Excel as well as MS Word to allow document framing and designing.

Results: The research has shown a high proportion of community pharmacy staff trained in HIV prevention (82.4% trained on HIV testing), but a low level of training in treatment (30.5%) and psychosocial support of people living with HIV (29.8%). Infrastructure and storage conditions were found to be adequate, with 99.6% of surveyed Pharmacies having sufficient storage space. Majority (93.9%) expressed their willingness to dispense ARVs in the pharmacy premises. A large number of respondents (92.4%) felt that dispensing of antiretroviral medicines through community pharmacies would lead to an increase in sales of over the counter and other non-HIV related medicines. The main anticipated challenge that should be addressed to ensure effective implementation is the lack of interoperability between reporting systems used by community pharmacies and those used by health facilities providing HIV services (76.7% of respondents).

Conclusion: Community pharmacies in Rwanda have majority of staff trained in various areas of HIV prevention, but a small proportion have been trained in HIV care and treatment. Community pharmacies have the necessary infrastructure to dispense ARVs, and those with shortcomings, such as the lack of a separate room for individual patient counselling, are willing to obtain such a room if they are authorised to dispense ARVs. Staffs are willing to dispense ARVs in community pharmacies if the model is recommended by policymakers. The model could have several benefits for community pharmacies and the public health system in general, but there are also challenges that should be mitigated to ensu

Introduction: Clinical pharmacists' participation in ward rounds (WRs) has been a great chance to contribute to team-based care in the hospital setting and significantly improve patient outcomes and quality of life. Hence, the objective of this investigation was to explore the perceptions of clinical pharmacists in Yemen regarding their participation in WRs and the factors influencing their involvement.

Methods: An online survey of Yemeni clinical pharmacists was conducted and lasted for two months. Descriptive statistics were used to analyse the survey responses.

Results: a total of 120 participants were involved. About 3 out of 10 pharmacists had not previously participated in WRs, with only 30% having always or most of the time participated in word rounds alongside physicians. The results showed a positive perception of WR participation, with a median and IQR of 5(4-5). However, a lack of awareness of WR roles and the time-consuming nature of participation were the reasons for non-involvement.

Conclusion: The study highlights the positive perceptions of Yemeni clinical pharmacists towards ward rounds, but emphasises the need to address awareness and time constraints. Emphasising patient-centered care and longer internship durations can improve clinical pharmacist involvement. Future research should focus on optimising clinical pharmacist participation for better patient outcomes and care quality.

Background: Measles became a public health important disease in sub-Saharan Africa. World Health Organization recommended measles-containing vaccine dose 2 (MCV2) through routine service delivery. This study aims to determine coverage of second-dose measles vaccination uptake and its predictors among children aged 24-35 months in sub-Saharan Africa.

Methods and materials: We conducted an extensive search of literature as indicated in the guideline of reporting systematic review and meta-analysis (PRISMA). The databases used were PubMed, Google Scholar, and HINARI literature.

Results: The overall uptake of the second dose of measles vaccine uptake was 41% (95% CI: 28.90-53.47). Caregiver's awareness of the importance of the second dose of measles (2.51, 95% CI 1.77, 3.25), educational status of mothers (1.30, 95% CI 1.16, 1.45), distance from vaccination site (1.22, 95% CI 1.12, 1.32), and attending four and above ANC visit (2.72, 95% CI 2.29, 3.15) were determinants for second dose measles vaccine uptake.

Conclusion: Coverage of the second dose of measles uptake in Sub-Saharan Africa was low (41%) which is lower than the recommendation from WHO. Therefore policymakers and stakeholders should increase mother's awareness. Also, special strategies should be developed for those who are far from the vaccination site.

Abbreviation and acronyms: ANC: Ante Natal Care; JBI: Joanna Briggs Institute; MCV1: Measles containing vaccine dose 1; MCV2: Measles containing vaccine dose 2; WHO: World Health Organization.

Background: Under-utilisation of immunisation services remains a public health challenge. Pharmacists act as facilitators and increasingly as immunisers, yet relatively little robust evidence exists of the impact elicited on patient health outcome and vaccination uptake.

Objective: To evaluate the influence of pharmacist interventions on public vaccination rate.

Methods: SCOPUS, PubMed, and Web of Science were searched from inception to April 2023 to retrieve non- and randomised controlled clinical trials (RCTs). Studies were excluded if no comparator group to pharmacist involvement was reported. Data extraction, risk of bias assessments, and meta-analyses using random-effect models, were performed.

Results: Four RCTs and 15 non-RCTs, encompassing influenza, pneumococcal, herpes zoster, and tetanus-diphtheria and pertussis vaccine types, and administered in diverse settings including community pharmacies, were included. Pooled effect sizes revealed that, as compared to usual care, pharmacists, regardless of their intervention, improved the overall immunisation uptake by up to 51% [RR 1.51 (1.28, 1.77)] while immunisation frequency doubled when pharmacists acted specifically as advocators [RR 2.09 (1.42, 3.07)].

Conclusion: While the evidence for pharmacist immunisers was mixed, their contribution to immunisation programmes boosted public vaccination rate. Pharmacists demonstrated leadership and acquired indispensable advocator roles in the community and hospital settings. Future research could explore the depth of engagement and hence the extent of influence on immunisation uptake.

Background: Pharmaceutical companies are increasingly leveraging machine learning techniques to optimize healthcare research, drug development, and medical affairs activities. AI (artificial intelligence) tools such as chatbots, virtual digital assistants, and research tools have been explored to varying degrees of maturity in industries such as consumer goods or software technology. However, there continues to be untapped opportunities within the pharmaceutical industry to employ these technologies for enhanced engagement and education with healthcare professionals (HCPs). Pharmacists, situated at the crossroads of clinical sciences and innovation, have the potential to elevate their role and significance within the pharmaceutical industry by developing and leveraging such technologies.

Methods: To address this, the python-coded tool, Medical Information (MI) Data Uses For AI Semantic Analysis (MUFASA), utilizes state-of-the-art Sentence Transformer library, clustering, and visualization techniques. MUFASA harnesses unsolicited MI data with AI technology, improving efficiency and providing actionable medical affairs intelligence for targeted content delivery to HCPs.

Results: MUFASA optimizes medical affairs activities through its distinctive features: semantic search, cluster analysis, and visualization. Its proficiency in understanding inquiries, as demonstrated through 3D vector mapping and clustering tests, enhances the efficiency of MI and Medical Science Liaison (MSL) case handling. It proves invaluable in training new staff, bolstering response uniformity, and mitigating compliance risks. Leveraging the HDBSCAN algorithm, MUFASA's cluster analysis uncovers deep insights and discerns actionable themes from large inquiry data sets. The visualization graphs, generated from semantic searches, support evidence-based decisions by tracking the effectiveness of initiatives and monitoring trend shifts. Collectively, MUFASA enriches strategic decision-making, cultivates actionable insights, and bolsters healthcare professional engagement.

Conclusion: There are numerous opportunities for innovation within the intersection of healthcare and data science. Pharmaceutical manufacturers, with one of their medical affairs responsibilities being the collection of unsolicited inquiries, particularly from HCPs, stand poised to leverage machine learning capabilities to optimize its processes. The abundance of data generated by the growing effort to use it in meaningful ways presents an opportunity for pharmaceutical companies to harness machine learning techniques.