Toni Docherty BPharm, PostGradDipComPharm, Michael David PhD, MBiostat, MEd, MEpi, MSc, BSc (Hons), BEd, DipEd, Jennifer Schneider BPharm (Hons), PhD, Gabrielle O'Kane BMed, BSurg (MBBS), Joni Morris Cert IV (Hospital/Health Services Pharmacy Support), Catherine Paavola BNurs, Janelle Sawers BNurs, Deirdre O'Mahony BNurs, Joyce Cooper BPharm, PhD
<div> <section> <h3> Background</h3> <p>Elastomeric infusion devices or ‘Infusors’ are commonly used to administer 24-h continuous intravenous infusions to hospital patients at home, a service which can increase hospital capacity.</p> </section> <section> <h3> Aim</h3> <p>This study sought to determine Infusor efficiency by measuring infusion lengths administered by Infusors to patients in the community setting and reviewing any impacting factors on varying infusion rates, if observed.</p> </section> <section> <h3> Method</h3> <p>Patients and nurses completed data collection forms daily over a 12-month period. The following information was recorded: time Infusor attached to patient, time Infusor emptied, Infusor ‘empty’ or ‘not empty’ when removed, volume of antibiotic solution remaining, Infusor storage details, antibiotic solution and dose, indication for treatment, and date (season). Statistical analyses was conducted using Stata. Data were analysed using descriptive statistics, including median and range for continuous variables, and frequency counts and percentages for categorical variables. Ethical approval was granted by Northern Sydney Local Health District (NSLHD) Research Office (Reference no: RESP/14/184), the Human Research Ethics Committee (HREC) (Reference no: LNR/14/HAWKE/265) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via a study information leaflet that was provided with the patient questionnaire and patients were informed that their participation in the study was optional. Patients indicated their consent by completing the data collection form for each day of treatment.</p> </section> <section> <h3> Results</h3> <p>A significant number of Infusors (27%) emptied outside the expected infusion duration of 24 h ± 10% (21.6–26.4 h) and Infusors were removed ‘not empty’ when the nurse visited >24 h on 35% of occasions. Infusors were more likely to empty >24 h if they contained piperacillin-tazobactam 13.5 g (predicted probability = 1.0), in winter (predicted probability = 0.83), and in cooler overnight storage locations (predicted probability = 0.64). Infusors were more likely to empty <24 h if they contained vancomycin (predicted probability = 0.12).</p> </section> <section> <h3> Conclusion</h3> <p>Infusors delivering 24-h continuous intravenous infusions in the home setting may empty at unpredictable times and may
{"title":"Antibiotics administered as continuous intravenous infusion over 24 hours by elastomeric devices to patients treated at home: a study of infusion efficiency","authors":"Toni Docherty BPharm, PostGradDipComPharm, Michael David PhD, MBiostat, MEd, MEpi, MSc, BSc (Hons), BEd, DipEd, Jennifer Schneider BPharm (Hons), PhD, Gabrielle O'Kane BMed, BSurg (MBBS), Joni Morris Cert IV (Hospital/Health Services Pharmacy Support), Catherine Paavola BNurs, Janelle Sawers BNurs, Deirdre O'Mahony BNurs, Joyce Cooper BPharm, PhD","doi":"10.1002/jppr.1918","DOIUrl":"10.1002/jppr.1918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elastomeric infusion devices or ‘Infusors’ are commonly used to administer 24-h continuous intravenous infusions to hospital patients at home, a service which can increase hospital capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study sought to determine Infusor efficiency by measuring infusion lengths administered by Infusors to patients in the community setting and reviewing any impacting factors on varying infusion rates, if observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients and nurses completed data collection forms daily over a 12-month period. The following information was recorded: time Infusor attached to patient, time Infusor emptied, Infusor ‘empty’ or ‘not empty’ when removed, volume of antibiotic solution remaining, Infusor storage details, antibiotic solution and dose, indication for treatment, and date (season). Statistical analyses was conducted using Stata. Data were analysed using descriptive statistics, including median and range for continuous variables, and frequency counts and percentages for categorical variables. Ethical approval was granted by Northern Sydney Local Health District (NSLHD) Research Office (Reference no: RESP/14/184), the Human Research Ethics Committee (HREC) (Reference no: LNR/14/HAWKE/265) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via a study information leaflet that was provided with the patient questionnaire and patients were informed that their participation in the study was optional. Patients indicated their consent by completing the data collection form for each day of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant number of Infusors (27%) emptied outside the expected infusion duration of 24 h ± 10% (21.6–26.4 h) and Infusors were removed ‘not empty’ when the nurse visited >24 h on 35% of occasions. Infusors were more likely to empty >24 h if they contained piperacillin-tazobactam 13.5 g (predicted probability = 1.0), in winter (predicted probability = 0.83), and in cooler overnight storage locations (predicted probability = 0.64). Infusors were more likely to empty <24 h if they contained vancomycin (predicted probability = 0.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Infusors delivering 24-h continuous intravenous infusions in the home setting may empty at unpredictable times and may","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"242-251"},"PeriodicalIF":1.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Geordan Papacostas BMedSci, Gary D. Grant PhD, Susan Hall PhD
Background
Antimicrobial resistance is emerging as one of the most potentially disastrous threats of the 21st century. Pseudomonas aeruginosa (P. aeruginosa) is a leading resistant pathogen and is clinically significant due to its limited available treatment using antibiotics. Rising resistance of P. aeruginosa is of increasing concern and it is currently listed as one of the top three critically resistant pathogens by the World Health Organization. It is currently known that resistance in P. aeruginosa is significantly linked with the consumption of all antibiotics, making usage surveillance of particular concern.
Aim
The aim of the current study was to model current and future antibiotic usage using available prescription data for antipseudomonal antibiotics.
Method
A time-series analysis was performed on Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme data from January 2000–June 2020 using Facebook Prophet time-series methods in Python 3.9.14 to analyse and forecast trends to 2025. Ethical approval was not required for this research article as it used publicly available data and did not involve human subjects.
Results
The usage of antipseudomonal antibiotics decreased by 14.3% from 2014 to 2020 (95% confidence interval [CI] −30.4% to 2.3%) and is projected to further decrease by 11.7% by 2025 (95% CI −30.6% to 7.3%).
Conclusion
The current study showed a decline in the use of certain antipseudomonal antibiotics in Australia since 2015 and projects that their use will continue to decline. This is likely due to an increased judicious use of these antibiotics.
{"title":"Risk of Pseudomonas aeruginosa antimicrobial resistance using time series analysis of antibiotic usage","authors":"Geordan Papacostas BMedSci, Gary D. Grant PhD, Susan Hall PhD","doi":"10.1002/jppr.1911","DOIUrl":"10.1002/jppr.1911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antimicrobial resistance is emerging as one of the most potentially disastrous threats of the 21st century. <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) is a leading resistant pathogen and is clinically significant due to its limited available treatment using antibiotics. Rising resistance of <i>P. aeruginosa</i> is of increasing concern and it is currently listed as one of the top three critically resistant pathogens by the World Health Organization. It is currently known that resistance in <i>P. aeruginosa</i> is significantly linked with the consumption of all antibiotics, making usage surveillance of particular concern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of the current study was to model current and future antibiotic usage using available prescription data for antipseudomonal antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A time-series analysis was performed on Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme data from January 2000–June 2020 using Facebook Prophet time-series methods in Python 3.9.14 to analyse and forecast trends to 2025. Ethical approval was not required for this research article as it used publicly available data and did not involve human subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The usage of antipseudomonal antibiotics decreased by 14.3% from 2014 to 2020 (95% confidence interval [CI] −30.4% to 2.3%) and is projected to further decrease by 11.7% by 2025 (95% CI −30.6% to 7.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study showed a decline in the use of certain antipseudomonal antibiotics in Australia since 2015 and projects that their use will continue to decline. This is likely due to an increased judicious use of these antibiotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"209-216"},"PeriodicalIF":1.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1911","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
<div> <section> <h3> Background</h3> <p>Due to the addition of multiple new medicines following an acute myocardial infarction (MI), medication non-adherence occurs frequently. Medication education can improve adherence, comprehension, and health-related outcomes. There is currently limited literature about individualised pharmacist-led medication education post-hospital discharge following an MI.</p> </section> <section> <h3> Aim</h3> <p>To assess whether individualised, pharmacist-led education increased patient adherence and comprehension of cardiovascular medicines over a 12-week period following an MI.</p> </section> <section> <h3> Method</h3> <p>All participants completed the Morisky Medication Assessment Scale (MMAS) of self-reported adherence at 1 week and 12 weeks post-hospital discharge. Alongside this, a questionnaire was completed to quantify comprehension of their treatment plan. Participants were randomised to receive individualised pharmacist-led education directed at their medication regimen at 4–6 weeks post-discharge. Data were analysed using paired <i>t</i>-tests and mixed-design analysis of variance (ANOVA). Ethical approval was granted by the Monash Health Human and Research Ethics Committee (Reference no: RES-21-0000234L) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via project information sheets, verbal explanations by recruiting pharmacists with reassurance there would be no difference in standard treatment should patients decline involvement in the project, and written consent forms were completed by all participants.</p> </section> <section> <h3> Results</h3> <p>Of the 29 participants, 15 (51%) received pharmacist-led education. The intervention group's mean MMAS score increased from 6.7 (moderate adherence) at week 1 to 7.6 (moderate adherence) at week 12 post-hospital discharge (p = 0.009). At 12 weeks, the intervention group demonstrated a statistically significant and greater mean MMAS score compared to the control group (7.6 moderate adherence and 6.9 moderate adherence respectively, p = 0.003). The intervention group's mean comprehension level increased from 58% at 1 week to 90% at 12 weeks (p < 0.05). The intervention group demonstrated a greater mean comprehension level at 12 weeks compared to the control group (90% and 48.21% respectively, p < 0.001).</p> </section> <section> <h3> Conclusion</h3> <p>This pilot study demonstrated that individualised, pharmacist-led education may improve self-reported m
{"title":"Assessing adherence and comprehension of cardiovascular medicines with pharmacist intervention post-acute myocardial infarction: a pilot study","authors":"Samia Goni BPharm, GradCertPharmPrac, Adeline Roussety BPharm, PGDipClinPharm, Marianne Jovanovic BPharm (Hons), GradCertPharmPrac, MPharmPrac","doi":"10.1002/jppr.1898","DOIUrl":"10.1002/jppr.1898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Due to the addition of multiple new medicines following an acute myocardial infarction (MI), medication non-adherence occurs frequently. Medication education can improve adherence, comprehension, and health-related outcomes. There is currently limited literature about individualised pharmacist-led medication education post-hospital discharge following an MI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess whether individualised, pharmacist-led education increased patient adherence and comprehension of cardiovascular medicines over a 12-week period following an MI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>All participants completed the Morisky Medication Assessment Scale (MMAS) of self-reported adherence at 1 week and 12 weeks post-hospital discharge. Alongside this, a questionnaire was completed to quantify comprehension of their treatment plan. Participants were randomised to receive individualised pharmacist-led education directed at their medication regimen at 4–6 weeks post-discharge. Data were analysed using paired <i>t</i>-tests and mixed-design analysis of variance (ANOVA). Ethical approval was granted by the Monash Health Human and Research Ethics Committee (Reference no: RES-21-0000234L) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via project information sheets, verbal explanations by recruiting pharmacists with reassurance there would be no difference in standard treatment should patients decline involvement in the project, and written consent forms were completed by all participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 29 participants, 15 (51%) received pharmacist-led education. The intervention group's mean MMAS score increased from 6.7 (moderate adherence) at week 1 to 7.6 (moderate adherence) at week 12 post-hospital discharge (p = 0.009). At 12 weeks, the intervention group demonstrated a statistically significant and greater mean MMAS score compared to the control group (7.6 moderate adherence and 6.9 moderate adherence respectively, p = 0.003). The intervention group's mean comprehension level increased from 58% at 1 week to 90% at 12 weeks (p < 0.05). The intervention group demonstrated a greater mean comprehension level at 12 weeks compared to the control group (90% and 48.21% respectively, p < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study demonstrated that individualised, pharmacist-led education may improve self-reported m","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"135-144"},"PeriodicalIF":2.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy Szmerling BPharm (Hons), GradCertPharmPrac, ANZCAP-Reg (PainMgmt, Steward), Sam Maleki BPharm, MPharmPrac, FANZCAP (OncHaem, Research), Gordon Mar BA, MB, Mmed, FANZCA, Anne Goulopoulos BPharm(Hons), GradCertPharmPrac, MClinPharm, AdvPracPharm, FANZCAP (Lead&Mgmt)
Background
The increasing incidence of opioid-related harm associated with inappropriate opioid prescription underscores the need for effective interventions directed at enhancing analgesic prescribing practices. Analgesic stewardship (AGS) programs have emerged to facilitate appropriate analgesic use, reducing analgesic-related harm and optimising patient outcomes.
Aim
This study aimed to assess the impact of an AGS program on the appropriateness of opioid analgesia prescribing for adult inpatients within a metropolitan health network during the initial two months following program implementation.
Method
This retrospective audit examined de-identified aggregate data of 100 adult inpatients of a major Australian metropolitan hospital network between August–September 2022. The multidisciplinary AGS program involving pharmacy, nursing, and medical staff provided clinical interventions and recommendations for patients, supported by organisational interventions, including education and guideline reinforcement. Data collection included patient demographics, clinical data, and AGS program recommendations documented in patient medical records. Ethical approval was granted by the Eastern Health Office of Research and Ethics (Reference no: QA23-015-91886) and the study confirms to the Australian Statement on Ethical Conduct in Human Research.
Results
It was found that 51% of opioid-naïve patients were prescribed modified-release opioids for acute non-cancer pain, contrary to local guidelines. The AGS program recommendations resulted in an 89.7% cessation of these prescriptions. For non-opioid-naïve patients, there was a statistically significant reduction in mean Oral Morphine Equivalent Daily Dose of 19.85 mg (95% confidence interval [CI] 10.3–29.4 mg, p < 0.05). AGS recommendations were predominantly adhered to, with 82% showing full or partial compliance.
Conclusion
This study highlights the positive impact of an AGS program on the appropriateness of opioid analgesic prescribing for adult inpatients. These findings support the implementation of AGS programs into healthcare systems to mitigate opioid-related harm and improve patient outcomes.
{"title":"Cultivating optimal analgesic prescribing practices in a metropolitan hospital network: evaluating an analgesic stewardship program","authors":"Jeremy Szmerling BPharm (Hons), GradCertPharmPrac, ANZCAP-Reg (PainMgmt, Steward), Sam Maleki BPharm, MPharmPrac, FANZCAP (OncHaem, Research), Gordon Mar BA, MB, Mmed, FANZCA, Anne Goulopoulos BPharm(Hons), GradCertPharmPrac, MClinPharm, AdvPracPharm, FANZCAP (Lead&Mgmt)","doi":"10.1002/jppr.1914","DOIUrl":"10.1002/jppr.1914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The increasing incidence of opioid-related harm associated with inappropriate opioid prescription underscores the need for effective interventions directed at enhancing analgesic prescribing practices. Analgesic stewardship (AGS) programs have emerged to facilitate appropriate analgesic use, reducing analgesic-related harm and optimising patient outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess the impact of an AGS program on the appropriateness of opioid analgesia prescribing for adult inpatients within a metropolitan health network during the initial two months following program implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This retrospective audit examined de-identified aggregate data of 100 adult inpatients of a major Australian metropolitan hospital network between August–September 2022. The multidisciplinary AGS program involving pharmacy, nursing, and medical staff provided clinical interventions and recommendations for patients, supported by organisational interventions, including education and guideline reinforcement. Data collection included patient demographics, clinical data, and AGS program recommendations documented in patient medical records. Ethical approval was granted by the Eastern Health Office of Research and Ethics (Reference no: QA23-015-91886) and the study confirms to the <i>Australian Statement on Ethical Conduct in Human Research</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>It was found that 51% of opioid-naïve patients were prescribed modified-release opioids for acute non-cancer pain, contrary to local guidelines. The AGS program recommendations resulted in an 89.7% cessation of these prescriptions. For non-opioid-naïve patients, there was a statistically significant reduction in mean Oral Morphine Equivalent Daily Dose of 19.85 mg (95% confidence interval [CI] 10.3–29.4 mg, p < 0.05). AGS recommendations were predominantly adhered to, with 82% showing full or partial compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the positive impact of an AGS program on the appropriateness of opioid analgesic prescribing for adult inpatients. These findings support the implementation of AGS programs into healthcare systems to mitigate opioid-related harm and improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"228-235"},"PeriodicalIF":1.0,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140377960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adults living with intellectual disability experience higher rates of preventable adverse medication events across the medicine pathway compared to their peers without disability.
Source of information
The Medication Safety Standard, developed by the Australian Commission on Safety and Quality in Health Care, describes systems and strategies to ensure that clinicians and health organisations safely prescribe, dispense, administer appropriate medications to informed patients, and monitor their use.
Key findings
Optimal application of the Medication Safety Standard for this population requires the development of reasonable adjustments to its action which take into account the barriers to safe medication management experienced by them in hospital settings. Design of such reasonable adjustments is influenced by consideration of the experiences of medicine management within with people living with intellectual disability, with intellectual disability, the roles of disability supports, and the disability-health sector interface in relation to medication management.
Conclusion
This review describes the formulation of a range of practice point reasonable adjustments to the usual clinical processes, content, knowledge, and organisation required in application of the Medication Safety Standard for adult patients living with intellectual disability.
{"title":"Reasonable adjustments to application of the Medication Safety Standard for adult patients living with intellectual disability in Australian hospital settings","authors":"Robyn Anne Wallace BSc(Hons), DipEd, MSc, MBBS, FRACP, CF, PhD, FAFRM, GDipNeurosci, ClinDipPallCare, MDisPrac, GChPom, GCertHealthMment","doi":"10.1002/jppr.1889","DOIUrl":"10.1002/jppr.1889","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose of review</h3>\u0000 \u0000 <p>Adults living with intellectual disability experience higher rates of preventable adverse medication events across the medicine pathway compared to their peers without disability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Source of information</h3>\u0000 \u0000 <p>The Medication Safety Standard, developed by the Australian Commission on Safety and Quality in Health Care, describes systems and strategies to ensure that clinicians and health organisations safely prescribe, dispense, administer appropriate medications to informed patients, and monitor their use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key findings</h3>\u0000 \u0000 <p>Optimal application of the Medication Safety Standard for this population requires the development of reasonable adjustments to its action which take into account the barriers to safe medication management experienced by them in hospital settings. Design of such reasonable adjustments is influenced by consideration of the experiences of medicine management within with people living with intellectual disability, with intellectual disability, the roles of disability supports, and the disability-health sector interface in relation to medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This review describes the formulation of a range of practice point reasonable adjustments to the usual clinical processes, content, knowledge, and organisation required in application of the Medication Safety Standard for adult patients living with intellectual disability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"110-124"},"PeriodicalIF":2.1,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1889","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140228778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chih Yuan Wang BPharm, MClinPharm, Alexandra Clavarino BA(Hons), BSocWk, PhD, Karen Luetsch BPharm, GradCertClinEd, PhD
Background
The Australian Foundation Residency Program prepares new-to-hospital and early career pharmacists for extended roles and advanced pharmacy practice. An understanding of the outcomes residents perceive they achieve through completion of a residency and what supports them in their achievements is limited.
Aim
To explore pharmacists' experiences during their residency and what they perceive as its outcomes and their achievements.
Method
Focus groups and interviews were conducted and recorded with 12 early career or new-to-hospital pharmacists who recently completed a residency program in an Australian hospital. Recordings were transcribed and analysed using inductive thematic analysis. Ethical approval was granted by the University of Queensland Human Research Ethics Committee (Reference no: 2021/HE001225) and the study conforms to the Australian Statement on Ethical Conduct in Human Research. Informed consent was obtained from all participants via the distribution of project information sheets and completion of written consent forms.
Results
Five distinct themes were generated from participants' discussions of their experiences and achievements throughout their residency. The outcomes and achievements they described included gaining the confidence to take on new and challenging roles as well as advancing their career by developing a deeper understanding of their role and potential in the healthcare system. Skill development was accelerated by the structure and assessment requirements of the residency program and by support from mentors, which positively influenced their attitudes towards feedback and competency assessments. Participants reflected on the differences between postgraduate university-based learning and workplace-based learning and saw benefits in both.
Conclusion
The residency was reported to offer a structured and supportive training pathway for pharmacists in the early stages of their hospital pharmacy career. Completion of residency facilitates pharmacists' skill development and a deeper understanding of their roles. Dedicated and qualified mentorship and routine networking events between peers and past residents enhance these experiences and outcomes for residents.
{"title":"Opportunities and achievements — experiences of pharmacists as Foundation Residency Program residents — a qualitative study","authors":"Chih Yuan Wang BPharm, MClinPharm, Alexandra Clavarino BA(Hons), BSocWk, PhD, Karen Luetsch BPharm, GradCertClinEd, PhD","doi":"10.1002/jppr.1903","DOIUrl":"10.1002/jppr.1903","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Australian Foundation Residency Program prepares new-to-hospital and early career pharmacists for extended roles and advanced pharmacy practice. An understanding of the outcomes residents perceive they achieve through completion of a residency and what supports them in their achievements is limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore pharmacists' experiences during their residency and what they perceive as its outcomes and their achievements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Focus groups and interviews were conducted and recorded with 12 early career or new-to-hospital pharmacists who recently completed a residency program in an Australian hospital. Recordings were transcribed and analysed using inductive thematic analysis. Ethical approval was granted by the University of Queensland Human Research Ethics Committee (Reference no: 2021/HE001225) and the study conforms to the <i>Australian Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via the distribution of project information sheets and completion of written consent forms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five distinct themes were generated from participants' discussions of their experiences and achievements throughout their residency. The outcomes and achievements they described included gaining the confidence to take on new and challenging roles as well as advancing their career by developing a deeper understanding of their role and potential in the healthcare system. Skill development was accelerated by the structure and assessment requirements of the residency program and by support from mentors, which positively influenced their attitudes towards feedback and competency assessments. Participants reflected on the differences between postgraduate university-based learning and workplace-based learning and saw benefits in both.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The residency was reported to offer a structured and supportive training pathway for pharmacists in the early stages of their hospital pharmacy career. Completion of residency facilitates pharmacists' skill development and a deeper understanding of their roles. Dedicated and qualified mentorship and routine networking events between peers and past residents enhance these experiences and outcomes for residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"170-178"},"PeriodicalIF":2.1,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140251457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ross Wagner PharmD, BCPS, Ruchira Mahashabde MS, Jacob Painter PharmD, MBA, PhD, Kaci Boehmer PharmD, BCACP
<div> <section> <h3> Background</h3> <p>Metformin is used to treat type 2 diabetes mellitus, but prolonged use has been associated with vitamin B<sub>12</sub> deficiency. Many other factors have also been associated with vitamin B<sub>12</sub> deficiency. Studies on the possible additive effect of risk factors for developing a vitamin B<sub>12</sub> deficiency are lacking.</p> </section> <section> <h3> Aim</h3> <p>The objective of this study was to assess the correlation between other known risk factors for vitamin B<sub>12</sub> deficiency among patients with type 2 diabetes mellitus prescribed metformin who had a vitamin B<sub>12</sub> deficiency.</p> </section> <section> <h3> Method</h3> <p>For inclusion in this single-centre, retrospective cohort study, patients needed to be at least 18 years old, diagnosed with type 2 diabetes, taking metformin for at least 2 years and actively taking metformin during the study period. The primary outcome was the rate of low B<sub>12</sub> levels with metformin. Secondary outcomes were risk factors associated with B<sub>12</sub> deficiency. The patient and clinical characteristics were compared between the two study groups using Student's t-test for continuous variables and chi-squared tests for categorical variables. This project was exempt due to the local policy requirements that constitute research by the University of Arkansas for Medical Sciences Institutional Review Board (IRB) (IRB Program Manager, 11 August 2021). The justification for this ethics exemption was as follows: the project was determined to be of minimal risk to privacy of subjects because the research team had mechanisms to protect the personal health identifiers from improper use or disclosure; to destroy the identifiers at the earliest opportunity consistent with the conduct of research, and provided assurance that the identifiers will not be re-used or disclosed to any other person or entity, except as required by law, for authorised oversight of the research project, or for other research as permitted by the HIPAA regulations.</p> </section> <section> <h3> Results</h3> <p>A total of 387 patients were included in this study, from which 364 patients had a vitamin B<sub>12</sub> deficiency. The cohort was an average 69-years-old and predominantly female (66%). No risk factors were associated with a higher incidence of B<sub>12</sub> deficiency. Patient age (p = 0.0063) and time on metformin (p = 0.0144) were significantly and negatively correlated with B12 deficiency.</p> </section> <section> <h3> Conclusion</h3> <p>Younger age and shorter
{"title":"Factors associated with an increased risk of vitamin B12 deficiency in patients with type 2 diabetes mellitus on metformin","authors":"Ross Wagner PharmD, BCPS, Ruchira Mahashabde MS, Jacob Painter PharmD, MBA, PhD, Kaci Boehmer PharmD, BCACP","doi":"10.1002/jppr.1913","DOIUrl":"10.1002/jppr.1913","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Metformin is used to treat type 2 diabetes mellitus, but prolonged use has been associated with vitamin B<sub>12</sub> deficiency. Many other factors have also been associated with vitamin B<sub>12</sub> deficiency. Studies on the possible additive effect of risk factors for developing a vitamin B<sub>12</sub> deficiency are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The objective of this study was to assess the correlation between other known risk factors for vitamin B<sub>12</sub> deficiency among patients with type 2 diabetes mellitus prescribed metformin who had a vitamin B<sub>12</sub> deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>For inclusion in this single-centre, retrospective cohort study, patients needed to be at least 18 years old, diagnosed with type 2 diabetes, taking metformin for at least 2 years and actively taking metformin during the study period. The primary outcome was the rate of low B<sub>12</sub> levels with metformin. Secondary outcomes were risk factors associated with B<sub>12</sub> deficiency. The patient and clinical characteristics were compared between the two study groups using Student's t-test for continuous variables and chi-squared tests for categorical variables. This project was exempt due to the local policy requirements that constitute research by the University of Arkansas for Medical Sciences Institutional Review Board (IRB) (IRB Program Manager, 11 August 2021). The justification for this ethics exemption was as follows: the project was determined to be of minimal risk to privacy of subjects because the research team had mechanisms to protect the personal health identifiers from improper use or disclosure; to destroy the identifiers at the earliest opportunity consistent with the conduct of research, and provided assurance that the identifiers will not be re-used or disclosed to any other person or entity, except as required by law, for authorised oversight of the research project, or for other research as permitted by the HIPAA regulations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 387 patients were included in this study, from which 364 patients had a vitamin B<sub>12</sub> deficiency. The cohort was an average 69-years-old and predominantly female (66%). No risk factors were associated with a higher incidence of B<sub>12</sub> deficiency. Patient age (p = 0.0063) and time on metformin (p = 0.0144) were significantly and negatively correlated with B12 deficiency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Younger age and shorter ","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"236-241"},"PeriodicalIF":1.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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