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}
Norkasihan Ibrahim PhD, Muhammad Firdaus Afandi BPharm, Karmila Abu Bakar MD, Caroline Eng MD, Shamala Balan PhD, Mohd Shahezwan Abd Wahab PhD, Janattul-Ain Jamal PhD
<div> <section> <h3> Background</h3> <p>The safety and efficacy of COVID-19 vaccinations are crucial factors that parents consider when deciding whether to vaccinate their children.</p> </section> <section> <h3> Aim</h3> <p>This study aimed to investigate parents' understanding of COVID-19 vaccines and its association with the degree of willingness to vaccinate their young children.</p> </section> <section> <h3> Method</h3> <p>A cross-sectional survey was conducted among the public with children younger than 12 years old. Information on parents' demography, understanding of COVID-19 vaccines and their willingness to get their children vaccinated were collected. The association between the level of understanding and willingness was tested using the One-way analysis of variance (ANOVA) test. Predictors of good understanding and high willingness were investigated using multiple linear regression. Ethics approval was granted by the Research Ethics Committee of Universiti Teknologi MARA (Reference no: REC [PH]/012/2022) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants. A web-based survey link was distributed through social media platforms. The initial section of the survey included a project information sheet including the purpose of the study, length of questionnaire, identity of researchers and measures taken to ensure data confidentiality and anonymity of participants. Participants provided their consent electronically prior to being granted access to the questionnaire.</p> </section> <section> <h3> Results</h3> <p>Of the 386 respondents, 53.4% had a good understanding, and 74.6% had a high willingness. Only 42.5% agreed that the vaccines are effective in protecting children from getting COVID-19, 79.5% and 73.3% misunderstood the severity and tendency to experience the side effects, respectively. A better understanding was associated with a higher willingness to vaccinate ([<i>F</i>(4381) = 54.417, p = 0.000). A higher understanding was significantly associated with higher educational status (postgraduate [<i>β</i> = 0.297, p = 0.028] and bachelor [<i>β</i> = 0.275, p = 0.034], work in a health-related field [<i>β</i> = 0.300, p < 0.001]) and have received a COVID-19 booster (<i>β</i> = 0.347, p < 0.001). A high willingness was prevalent among parents working in a health-related field, had received a COVID-19 booster and had medical condition. Low willingness was observed among parents aged above 30 years old and those who have used herbal medicines.</p> </section> <section> <h3> Conclusion</h3>
{"title":"Willingness and understanding of the safety and effectiveness of COVID-19 vaccines in young children: a cross-sectional study among parents in Malaysia","authors":"Norkasihan Ibrahim PhD, Muhammad Firdaus Afandi BPharm, Karmila Abu Bakar MD, Caroline Eng MD, Shamala Balan PhD, Mohd Shahezwan Abd Wahab PhD, Janattul-Ain Jamal PhD","doi":"10.1002/jppr.1901","DOIUrl":"10.1002/jppr.1901","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The safety and efficacy of COVID-19 vaccinations are crucial factors that parents consider when deciding whether to vaccinate their children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to investigate parents' understanding of COVID-19 vaccines and its association with the degree of willingness to vaccinate their young children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cross-sectional survey was conducted among the public with children younger than 12 years old. Information on parents' demography, understanding of COVID-19 vaccines and their willingness to get their children vaccinated were collected. The association between the level of understanding and willingness was tested using the One-way analysis of variance (ANOVA) test. Predictors of good understanding and high willingness were investigated using multiple linear regression. Ethics approval was granted by the Research Ethics Committee of Universiti Teknologi MARA (Reference no: REC [PH]/012/2022) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants. A web-based survey link was distributed through social media platforms. The initial section of the survey included a project information sheet including the purpose of the study, length of questionnaire, identity of researchers and measures taken to ensure data confidentiality and anonymity of participants. Participants provided their consent electronically prior to being granted access to the questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 386 respondents, 53.4% had a good understanding, and 74.6% had a high willingness. Only 42.5% agreed that the vaccines are effective in protecting children from getting COVID-19, 79.5% and 73.3% misunderstood the severity and tendency to experience the side effects, respectively. A better understanding was associated with a higher willingness to vaccinate ([<i>F</i>(4381) = 54.417, p = 0.000). A higher understanding was significantly associated with higher educational status (postgraduate [<i>β</i> = 0.297, p = 0.028] and bachelor [<i>β</i> = 0.275, p = 0.034], work in a health-related field [<i>β</i> = 0.300, p < 0.001]) and have received a COVID-19 booster (<i>β</i> = 0.347, p < 0.001). A high willingness was prevalent among parents working in a health-related field, had received a COVID-19 booster and had medical condition. Low willingness was observed among parents aged above 30 years old and those who have used herbal medicines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 ","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"158-169"},"PeriodicalIF":2.1,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139778686","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}
<div> <section> <h3> Background</h3> <p>People living with schizophrenia frequently exhibit poor medication adherence because of adverse drug reactions (ADRs) or lack of disease awareness. This prospective randomised controlled trial investigated the benefits of pharmaceutical care delivered by hospital pharmacists for improving pharmacotherapy-related quality of life and medication adherence among this patient group.</p> </section> <section> <h3> Aim</h3> <p>The purpose of this study was to evaluate the effectiveness of pharmaceutical care interventions in enhancing medication adherence and improving the quality of life of people living with schizophrenia.</p> </section> <section> <h3> Method</h3> <p>Data were collected during inpatient and subsequent outpatient treatment from 6 January–8 June 2021. Participants were divided into two groups via block randomisation: a control group receiving standard treatment; and an intervention group receiving pharmaceutical care combined with standard treatment. The pharmaceutical care comprised medication review, monitoring of drug-related problems (including ADRs), adjustment of the dose of antipsychotic medicines in collaboration with psychiatrists, and counselling of participants and caregivers about disease management before discharge. Pharmacotherapy-related quality of life was assessed using the short version of the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL), whereas medication adherence was evaluated using the Medication Taking Behaviour in Thai Patients (MTB-Thai). The primary outcomes were the average change in the PROMPT-QoL score from inpatient to outpatient care and the average outpatient MTB-Thai score. Ethical approval was granted by the Srithanya Hospital Office of the Ethics Commission for Human Research (Reference no: STY.COA008/2564) and the study conforms to the Declaration of Helsinki. Informed consent was obtained from all patient and caregiver participants via a project information sheet and the completion of a written consent form.</p> </section> <section> <h3> Results</h3> <p>At the end of the study, compared with the control group, the intervention group exhibited a significantly lower ADR prevalence (57.90% vs 79.70%, p < 0.05) and a greater change in the mean PROMPT-QoL scores pertaining to ‘obtaining information of medicines and diseases’, ‘impact of medicine side effects’, ‘ease of use of medicines’, and ‘therapeutic relationship’. In addition, the intervention group achieved a significantly higher mean of medicine adherence score than the control group (22.81 ± 1.61 vs 16.85 ± 3.00, p < 0.001).</p>
{"title":"Effectiveness of pharmaceutical care for improving medication-related quality of life and adherence to treatment among people living with schizophrenia: a randomised controlled trial","authors":"Tatta Sriboonruang PhD, Wasanan Phonphairin MSc (Pharm), Siripan Phattanarudee PhD, Sirichai Chusiri PharmD, BCP","doi":"10.1002/jppr.1909","DOIUrl":"10.1002/jppr.1909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>People living with schizophrenia frequently exhibit poor medication adherence because of adverse drug reactions (ADRs) or lack of disease awareness. This prospective randomised controlled trial investigated the benefits of pharmaceutical care delivered by hospital pharmacists for improving pharmacotherapy-related quality of life and medication adherence among this patient group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to evaluate the effectiveness of pharmaceutical care interventions in enhancing medication adherence and improving the quality of life of people living with schizophrenia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data were collected during inpatient and subsequent outpatient treatment from 6 January–8 June 2021. Participants were divided into two groups via block randomisation: a control group receiving standard treatment; and an intervention group receiving pharmaceutical care combined with standard treatment. The pharmaceutical care comprised medication review, monitoring of drug-related problems (including ADRs), adjustment of the dose of antipsychotic medicines in collaboration with psychiatrists, and counselling of participants and caregivers about disease management before discharge. Pharmacotherapy-related quality of life was assessed using the short version of the Patient-Reported Outcomes Measure of Pharmaceutical Therapy for Quality of Life (PROMPT-QoL), whereas medication adherence was evaluated using the Medication Taking Behaviour in Thai Patients (MTB-Thai). The primary outcomes were the average change in the PROMPT-QoL score from inpatient to outpatient care and the average outpatient MTB-Thai score. Ethical approval was granted by the Srithanya Hospital Office of the Ethics Commission for Human Research (Reference no: STY.COA008/2564) and the study conforms to the Declaration of Helsinki. Informed consent was obtained from all patient and caregiver participants via a project information sheet and the completion of a written consent form.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At the end of the study, compared with the control group, the intervention group exhibited a significantly lower ADR prevalence (57.90% vs 79.70%, p < 0.05) and a greater change in the mean PROMPT-QoL scores pertaining to ‘obtaining information of medicines and diseases’, ‘impact of medicine side effects’, ‘ease of use of medicines’, and ‘therapeutic relationship’. In addition, the intervention group achieved a significantly higher mean of medicine adherence score than the control group (22.81 ± 1.61 vs 16.85 ± 3.00, p < 0.001).</p>\u0000 ","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 3","pages":"217-227"},"PeriodicalIF":1.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139840191","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}
Sara Yeganeh BPharm, AAHIVP, Arron Sparkes BPharm(Hons), AAHIVP
Human immunodeficiency virus (HIV) infection is now considered a manageable chronic condition. With the tolerable and highly active antiretroviral therapies that are available today, people diagnosed with HIV can experience longevity and good health-related quality of life. As a result, the number of older people living with HIV, including in aged care, is increasing. There are, however, challenges and barriers to successful ageing for people living with HIV. These include persistent chronic inflammation and immune dysfunction, earlier occurrence of complex comorbidities, and additional exacerbators such as polypharmacy. To mitigate these factors, clinicians should implement evidenced-based interventions and adopt a multidisciplinary and collaborative approach to management so that people living with HIV have the best chance of ageing well.
{"title":"Ageing well with human immunodeficiency virus","authors":"Sara Yeganeh BPharm, AAHIVP, Arron Sparkes BPharm(Hons), AAHIVP","doi":"10.1002/jppr.1894","DOIUrl":"https://doi.org/10.1002/jppr.1894","url":null,"abstract":"<p>Human immunodeficiency virus (HIV) infection is now considered a manageable chronic condition. With the tolerable and highly active antiretroviral therapies that are available today, people diagnosed with HIV can experience longevity and good health-related quality of life. As a result, the number of older people living with HIV, including in aged care, is increasing. There are, however, challenges and barriers to successful ageing for people living with HIV. These include persistent chronic inflammation and immune dysfunction, earlier occurrence of complex comorbidities, and additional exacerbators such as polypharmacy. To mitigate these factors, clinicians should implement evidenced-based interventions and adopt a multidisciplinary and collaborative approach to management so that people living with HIV have the best chance of ageing well.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"53 6","pages":"337-349"},"PeriodicalIF":1.0,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1894","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143252556","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}
There is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.
Aim
The project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.
Method
A retrospective pre- and post-implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) Ethical considerations in quality assurance and evaluation activities; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.
Results
For all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).
Conclusion
The introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.
{"title":"Improving the antibiotic duration of therapy with the implementation of antimicrobial lanyard cards and education in a regional hospital","authors":"Lisa Ball MPharm (Hons), Tyrone Fowler BPharm, Kathryn Daveson MBBS, FRACP","doi":"10.1002/jppr.1902","DOIUrl":"10.1002/jppr.1902","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is increasing evidence to support reducing antibiotic duration of therapy (DoT). The Therapeutic Guidelines: Antibiotic (version 16 [TG]) have been updated accordingly. However, these recommendations are not consistently followed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The project aimed to reduce antibiotic DoT for common infections using antimicrobial lanyard cards and education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective pre- and post-implementation audit was undertaken to examine whether antimicrobial stewardship education and lanyard cards defined DoT per infection and severity in accordance with the TG improved antibiotic DoT for common respiratory, urinary, abdominal, and skin infections. Cards were distributed to doctors and pharmacists, with education delivered by an antimicrobial stewardship (AMS) pharmacist. This project was exempt due to the local policy requirements that constitute research by the Darling Downs Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2022/QTDD/86644). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) <i>Ethical considerations in quality assurance and evaluation activities</i>; education was incorporated as part of routine, scheduled sessions ran at Toowoomba hospital and staff were provided with information on the project as part of the education; consent was not required from staff to attend the education nor for using the lanyard cards; the research did not include any assessment of the education program, use of lanyard cards, or involvement of staff.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For all patients an improvement was found in the percentage of antibiotics prescribed per the TG (55–72%, p = 0.0095). This included statistically significant differences for respiratory (42–89%, p = 0.0002), but not for urinary (87–91%, p = 0.99), skin (58–77%, p = 0.3039), or abdominal infections (48–44%, p = 0.6990). The mean total excess treatment days decreased across all infections from 1.86 to 0.95 days (p = 0.0036, 95% confidence interval = −1.52 to −0.30).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The introduction of antibiotic DoT cards, with AMS education, can improve antimicrobial prescribing in line with the TG in a regional hospital.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"151-157"},"PeriodicalIF":2.1,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139844250","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}
Wejdan Shahin PhD, Sandra Jnoub BPharm, Ghufran Al Khaqane BPharm, Evet Matti BPharm, M. Kay Dunkley BPharm, Thilini Thrimawithana PhD
Background
The expanding scope of practice for pharmacists in Australia now includes the provision of vaccination services. Therefore, it is crucial to understand the perceptions of pharmacists regarding vaccination services and the impact of providing this service on their job satisfaction and well-being.
Aim
This study aims to evaluate the job satisfaction and well-being of pharmacists in Australia regarding the provision of vaccination services. Additionally, it aims to determine the barriers to administering vaccines by pharmacists.
Method
A mixed-methods study was conducted among pharmacists in Australia. An anonymous survey was distributed to pharmacies via email and advertised on social media sites. Ethics approval was granted by the RMIT Research Ethics Committee (Reference no: 24747) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent was obtained for all participants via a project information sheet and voluntary completion of an anonymous survey.
Results
The study found that community pharmacists experienced moderate job satisfaction levels, with mean job satisfaction and well-being scores of 17.6 (±6.2) and 17.0 (±6.50) respectively. A correlation was identified between job satisfaction and well-being, indicating that lower job satisfaction corresponded to lower well-being. Factors such as years of experience (p = 0.001), work-related stress (p = 0.001), willingness to vaccinate (p = 0.001), workload (p = 0.001) and lack of support and reimbursement for vaccinating pharmacists influenced job satisfaction and well-being levels.
Conclusion
The study highlights the median to minimal job satisfaction levels among pharmacists in Australia and the correlation between pharmacists' willingness to administer vaccines and their job satisfaction and well-being. Additionally, the study underscores the need for additional support and reimbursement for vaccinating pharmacists. To enhance the pharmacy profession's role in the healthcare system, new strategies are required to support pharmacists in providing vaccination services.
{"title":"Provision of vaccination service in a community pharmacy: impact on pharmacists' job satisfaction and well-being","authors":"Wejdan Shahin PhD, Sandra Jnoub BPharm, Ghufran Al Khaqane BPharm, Evet Matti BPharm, M. Kay Dunkley BPharm, Thilini Thrimawithana PhD","doi":"10.1002/jppr.1895","DOIUrl":"https://doi.org/10.1002/jppr.1895","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The expanding scope of practice for pharmacists in Australia now includes the provision of vaccination services. Therefore, it is crucial to understand the perceptions of pharmacists regarding vaccination services and the impact of providing this service on their job satisfaction and well-being.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to evaluate the job satisfaction and well-being of pharmacists in Australia regarding the provision of vaccination services. Additionally, it aims to determine the barriers to administering vaccines by pharmacists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A mixed-methods study was conducted among pharmacists in Australia. An anonymous survey was distributed to pharmacies via email and advertised on social media sites. Ethics approval was granted by the RMIT Research Ethics Committee (Reference no: 24747) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained for all participants via a project information sheet and voluntary completion of an anonymous survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study found that community pharmacists experienced moderate job satisfaction levels, with mean job satisfaction and well-being scores of 17.6 (±6.2) and 17.0 (±6.50) respectively. A correlation was identified between job satisfaction and well-being, indicating that lower job satisfaction corresponded to lower well-being. Factors such as years of experience (p = 0.001), work-related stress (p = 0.001), willingness to vaccinate (p = 0.001), workload (p = 0.001) and lack of support and reimbursement for vaccinating pharmacists influenced job satisfaction and well-being levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights the median to minimal job satisfaction levels among pharmacists in Australia and the correlation between pharmacists' willingness to administer vaccines and their job satisfaction and well-being. Additionally, the study underscores the need for additional support and reimbursement for vaccinating pharmacists. To enhance the pharmacy profession's role in the healthcare system, new strategies are required to support pharmacists in providing vaccination services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 1","pages":"61-69"},"PeriodicalIF":2.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1895","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139942921","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>Pneumococcal disease continues to be a large source of morbidity and mortality despite the availability of effective prevention via immunisation and treatment measures.</p> </section> <section> <h3> Aim</h3> <p>To assess the impact of a pharmacist-led opportunistic inpatient pneumococcal vaccination intervention on overall 13-valent pneumococcal conjugate vaccine (13vPCV) rates in eligible hospitalised subacute patients, aged 70 years and above.</p> </section> <section> <h3> Method</h3> <p>This study was a pre- and post-intervention study conducted across two study sites at Monash Health, a large metropolitan health service in Victoria, Australia. Phase 1 (pre-intervention, August–October 2022) involved auditing the vaccine-eligibility of patients on admission and subsequent administration during inpatient stay. Phase 2 (intervention phase, October–December 2022) implemented the pharmacist-led opportunistic inpatient pneumococcal vaccine intervention. Following screening, identified vaccine-eligible patients were recommended to the treating physician via verbal discussion and Microsoft Teams for consideration of vaccination administration in hospital. The proportion of eligible patients vaccinated was compared between the pre-intervention and intervention groups. This project was exempt for ethics approval due to the local policy requirements that constitute research by the Monash Health Human and Research Ethics Committee (Reference no: RES-22-0000-454Q). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's <i>Ethical considerations in quality assurance and evaluation activities</i>; auditing the percentage of vaccine-eligible and non-vaccinated patients did not require written consent per local requirements; and it is standard practice to obtain verbal consent, followed by documentation on electronic medical records, for inpatient vaccinations. Informed consent was obtained from participants via verbal consent after the distribution of written medical information on the 13vPCV, as well as verbal information provided by the medical team.</p> </section> <section> <h3> Results</h3> <p>A total of 360 patients were included in the study. Overall, 139 (77.2%) patients in the pre-intervention and 143 (79.4%) patients in the intervention phase were eligible for vaccination (non-vaccinated with age indication). The proportion of patients receiving inpatient 13vPCV was higher in the intervention group compared to the pre-intervention group (43.4 vs 2.2%, p < 0.001).</p> </section> <s
背景 尽管有通过免疫接种和治疗措施进行有效预防的方法，但肺炎球菌疾病仍然是发病率和死亡率的主要来源。 目的 评估以药剂师为主导的住院病人肺炎球菌疫苗接种干预措施对符合条件的 70 岁及以上亚急性住院病人接种 13 价肺炎球菌结合疫苗 (13vPCV) 的总体比例的影响。 方法 本研究是一项干预前和干预后研究，在澳大利亚维多利亚州的大型医疗服务机构莫纳什卫生院的两个研究点进行。第一阶段（干预前，2022 年 8 月至 10 月）包括审核患者入院时的疫苗接种资格以及住院期间的后续接种情况。第二阶段（干预阶段，2022 年 10 月至 12 月）实施由药剂师主导的住院病人肺炎球菌疫苗机会性干预。筛查后，通过口头讨论和 Microsoft Teams 向主治医生推荐符合疫苗接种条件的患者，供其考虑在住院期间接种疫苗。比较了干预前和干预后两组符合条件的患者接种疫苗的比例。由于莫纳什卫生部人类与研究伦理委员会（Monash Health Human and Research Ethics Committee，简称 "伦理委员会"，参考编号：RES-22-0000-454Q）对构成研究的当地政策要求，本项目免于伦理审批。获得伦理豁免的理由如下：该项目符合国家健康与医学研究委员会的《质量保证与评估活动中的伦理考虑因素》；根据当地要求，审核符合接种条件和未接种疫苗的患者比例不需要书面同意；住院病人接种疫苗的标准做法是先获得口头同意，然后在电子病历上进行记录。在分发有关 13vPCV 的书面医疗信息以及医疗团队提供的口头信息后，通过口头同意获得参与者的知情同意。 结果 共有 360 名患者参与了研究。总体而言，干预前和干预阶段分别有 139 名（77.2%）和 143 名（79.4%）患者符合接种条件（未接种但有年龄指征）。与干预前相比，干预组接受住院 13vPCV 的患者比例更高（43.4% vs 2.2%，p < 0.001）。 结论 结果表明，由药剂师主导的住院病人肺炎球菌疫苗接种机会性干预措施能显著提高医院的肺炎球菌疫苗接种率。
{"title":"Pharmacist impact on pneumococcal vaccination rates through incorporation of pharmacist-led opportunistic inpatient vaccination intervention","authors":"Tinh Nguyen BPharm, GradCertPharmPrac, Patrick Lam BPharm, GradCertPharmPrac, MClinPharm, MHlthServMt, FSHP","doi":"10.1002/jppr.1891","DOIUrl":"https://doi.org/10.1002/jppr.1891","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pneumococcal disease continues to be a large source of morbidity and mortality despite the availability of effective prevention via immunisation and treatment measures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the impact of a pharmacist-led opportunistic inpatient pneumococcal vaccination intervention on overall 13-valent pneumococcal conjugate vaccine (13vPCV) rates in eligible hospitalised subacute patients, aged 70 years and above.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This study was a pre- and post-intervention study conducted across two study sites at Monash Health, a large metropolitan health service in Victoria, Australia. Phase 1 (pre-intervention, August–October 2022) involved auditing the vaccine-eligibility of patients on admission and subsequent administration during inpatient stay. Phase 2 (intervention phase, October–December 2022) implemented the pharmacist-led opportunistic inpatient pneumococcal vaccine intervention. Following screening, identified vaccine-eligible patients were recommended to the treating physician via verbal discussion and Microsoft Teams for consideration of vaccination administration in hospital. The proportion of eligible patients vaccinated was compared between the pre-intervention and intervention groups. This project was exempt for ethics approval due to the local policy requirements that constitute research by the Monash Health Human and Research Ethics Committee (Reference no: RES-22-0000-454Q). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's <i>Ethical considerations in quality assurance and evaluation activities</i>; auditing the percentage of vaccine-eligible and non-vaccinated patients did not require written consent per local requirements; and it is standard practice to obtain verbal consent, followed by documentation on electronic medical records, for inpatient vaccinations. Informed consent was obtained from participants via verbal consent after the distribution of written medical information on the 13vPCV, as well as verbal information provided by the medical team.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 360 patients were included in the study. Overall, 139 (77.2%) patients in the pre-intervention and 143 (79.4%) patients in the intervention phase were eligible for vaccination (non-vaccinated with age indication). The proportion of patients receiving inpatient 13vPCV was higher in the intervention group compared to the pre-intervention group (43.4 vs 2.2%, p < 0.001).</p>\u0000 </section>\u0000 \u0000 <s","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 1","pages":"48-54"},"PeriodicalIF":2.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139942920","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}
Clinical practice after hours and attendance at medical emergency team (MET) calls are two novel and emerging areas of pharmacy practice. During the COVID-19 pandemic, our institution's pharmacy services expanded from 8 am–5 pm to 24 h daily, including MET call attendance.
Aim
This study aimed to describe pharmacist roles, including medications charted by the general medicine and intensive care unit pharmacists during the period of extended-hours pharmacy practice and the characteristics of MET calls attended.
Method
This descriptive, cross-sectional study included patients admitted to the Alfred Hospital, Victoria, Australia between 3 April 2020–28 February 2021, when a MET was called between 5 pm–8 am, a pharmacist attended, and medication changes occurred. Data collected included whether the MET call was medication related and a description of medication changes. Ethics approval was granted by the Alfred Hospital Human Research Ethics Committee (Reference no: 297/21).
Results
One thousand six hundred and forty-four MET calls (average 5.4 calls per night) were attended by pharmacists during extended hours. Medication changes were made in response to clinical deterioration at 627 (38%) calls. The most frequent change was the initiation of cardiovascular medications (n = 206). Partnered pharmacist medication charting, including commencing, ceasing, or changing medications, occurred at 39% of MET calls with therapy changes.
Conclusion
Pharmacists can play a key role in managing deteriorating patients as part of a MET team. Medications may be implicated in clinical deterioration of patients and are frequently administered at MET calls. The expansion of pharmacy services provided the opportunity for pharmacists to contribute to MET calls across the 24-h period.
下班后的临床实践和参加医疗急救小组（MET）呼叫是药学实践的两个新兴领域。在 COVID-19 大流行期间，我院的药学服务从上午 8 点至下午 5 点扩展到每天 24 小时，包括参加医疗急救小组的呼叫。本研究旨在描述药剂师的角色，包括普通内科和重症监护室药剂师在延时药学实践期间的用药记录，以及参加医疗急救小组呼叫的特点。这项描述性横断面研究包括澳大利亚维多利亚州阿尔弗雷德医院在 2020 年 4 月 3 日至 2021 年 2 月 28 日期间收治的患者，这些患者在下午 5 点至上午 8 点之间接到医疗急救小组的呼叫，药剂师参加了呼叫，并发生了用药变化。收集的数据包括 MET 呼叫是否与用药有关以及用药变化的描述。药剂师在延长时间内接听了 1644 次 MET 电话（平均每晚 5.4 次）。在 627 次（38%）呼叫中，药剂师根据临床病情的恶化情况对药物进行了调整。最常见的用药变化是开始使用心血管药物（n = 206）。在 39% 的 MET 呼叫中，药剂师合作进行了用药记录，包括开始用药、停止用药或更换药物。药剂师作为 MET 团队的一员，可在管理病情恶化的患者方面发挥关键作用。药物可能与患者的临床病情恶化有关，因此在 MET 呼叫中经常会使用药物。药房服务的扩展为药剂师在 24 小时内参与 MET 呼叫提供了机会。
{"title":"The medical emergency team pharmacist: describing an overnight service","authors":"Lauren Crawley BPharm(Hons), GradCertPharmPrac, Gail Edwards BPharm, MClinPharm, Harry Gibbs MBBS FRACP FCSANZ, Erica Tong BPharm(Hons), MClinPharm, PhD","doi":"10.1002/jppr.1888","DOIUrl":"10.1002/jppr.1888","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clinical practice after hours and attendance at medical emergency team (MET) calls are two novel and emerging areas of pharmacy practice. During the COVID-19 pandemic, our institution's pharmacy services expanded from 8 am–5 pm to 24 h daily, including MET call attendance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to describe pharmacist roles, including medications charted by the general medicine and intensive care unit pharmacists during the period of extended-hours pharmacy practice and the characteristics of MET calls attended.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This descriptive, cross-sectional study included patients admitted to the Alfred Hospital, Victoria, Australia between 3 April 2020–28 February 2021, when a MET was called between 5 pm–8 am, a pharmacist attended, and medication changes occurred. Data collected included whether the MET call was medication related and a description of medication changes. Ethics approval was granted by the Alfred Hospital Human Research Ethics Committee (Reference no: 297/21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand six hundred and forty-four MET calls (average 5.4 calls per night) were attended by pharmacists during extended hours. Medication changes were made in response to clinical deterioration at 627 (38%) calls. The most frequent change was the initiation of cardiovascular medications (<i>n</i> = 206). Partnered pharmacist medication charting, including commencing, ceasing, or changing medications, occurred at 39% of MET calls with therapy changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pharmacists can play a key role in managing deteriorating patients as part of a MET team. Medications may be implicated in clinical deterioration of patients and are frequently administered at MET calls. The expansion of pharmacy services provided the opportunity for pharmacists to contribute to MET calls across the 24-h period.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 2","pages":"145-150"},"PeriodicalIF":2.1,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140470794","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}
<p>It has been 20 years since Michael Woodward wrote, as part of the ‘Geriatric Therapeutics’ series, the first article on deprescribing.<span><sup>1</sup></span> Since then, the term ‘deprescribing’ has become part of the medical lexicon, and by October 2023 more than 1000 articles had appeared in PubMed with ‘deprescribing’ in the title. While several definitions of deprescribing have appeared, at its heart it represents a process, supervised by a health professional and using a shared decision-making approach, for identifying and withdrawing (or dose reducing) medications which are not indicated or are ineffective or where potential harm outweighs potential benefit, with the aim of improving patient health.<span><sup>2</sup></span></p><p>Numerous studies have documented the burden and ill-effects of inappropriate prescribing and polypharmacy, particularly among older, frail and multimorbid patients. The expectation that clinicians should adhere to various single-disease guidelines, derived from clinical trials involving mostly younger people, has led to an increase in exposure to polypharmacy. Older people, especially those who are frail, tend to experience lower efficacy of chronic medications and higher risk of adverse effects.<span><sup>3</sup></span> Among people taking multiple medicines, many feel burdened by their treatment.<span><sup>4</sup></span></p><p>In response to these observations, a plethora of deprescribing tools, protocols, guidelines and checklists have appeared to assist clinicians and patients in countering polypharmacy, treatment burden and medication-related harm.<span><sup>2, 5, 6</sup></span> These aids can be broadly categorised as implicit or holistic approaches which consider all medications a patient is taking or more specific aids targeting high-risk medications, such as benzodiazepines, anticoagulants and oral hypoglycaemics.</p><p>In addition, ‘deprescribing networks’ have been established in various countries which comprise geriatricians, general physicians, primary care clinicians, clinical pharmacologists, pharmacists and other discipline representatives committed to researching and implementing ways of reducing inappropriate medication. The first deprescribing network was established in Australia in 2014.<span><sup>7</sup></span> Subsequently, similar networks were established in the United States,<span><sup>8</sup></span> Canada,<span><sup>9</sup></span> England<span><sup>10</sup></span> and Northern Europe.<span><sup>11</sup></span> These networks have been instrumental in producing and disseminating drug-specific, evidence-based deprescribing guidelines for clinicians, providing consumer-facing resources and support, developing national action plans for improving quality use of medications, promoting deprescribing research and convening national and international deprescribing conferences to share knowledge and forge collaborations.</p><p>Evidence has shown that deprescribing interventions can be feasibly
{"title":"Deprescribing: a 20-year retrospective","authors":"Ian A. Scott MBBS, FRACP, MHA, MEd","doi":"10.1002/jppr.1906","DOIUrl":"10.1002/jppr.1906","url":null,"abstract":"<p>It has been 20 years since Michael Woodward wrote, as part of the ‘Geriatric Therapeutics’ series, the first article on deprescribing.<span><sup>1</sup></span> Since then, the term ‘deprescribing’ has become part of the medical lexicon, and by October 2023 more than 1000 articles had appeared in PubMed with ‘deprescribing’ in the title. While several definitions of deprescribing have appeared, at its heart it represents a process, supervised by a health professional and using a shared decision-making approach, for identifying and withdrawing (or dose reducing) medications which are not indicated or are ineffective or where potential harm outweighs potential benefit, with the aim of improving patient health.<span><sup>2</sup></span></p><p>Numerous studies have documented the burden and ill-effects of inappropriate prescribing and polypharmacy, particularly among older, frail and multimorbid patients. The expectation that clinicians should adhere to various single-disease guidelines, derived from clinical trials involving mostly younger people, has led to an increase in exposure to polypharmacy. Older people, especially those who are frail, tend to experience lower efficacy of chronic medications and higher risk of adverse effects.<span><sup>3</sup></span> Among people taking multiple medicines, many feel burdened by their treatment.<span><sup>4</sup></span></p><p>In response to these observations, a plethora of deprescribing tools, protocols, guidelines and checklists have appeared to assist clinicians and patients in countering polypharmacy, treatment burden and medication-related harm.<span><sup>2, 5, 6</sup></span> These aids can be broadly categorised as implicit or holistic approaches which consider all medications a patient is taking or more specific aids targeting high-risk medications, such as benzodiazepines, anticoagulants and oral hypoglycaemics.</p><p>In addition, ‘deprescribing networks’ have been established in various countries which comprise geriatricians, general physicians, primary care clinicians, clinical pharmacologists, pharmacists and other discipline representatives committed to researching and implementing ways of reducing inappropriate medication. The first deprescribing network was established in Australia in 2014.<span><sup>7</sup></span> Subsequently, similar networks were established in the United States,<span><sup>8</sup></span> Canada,<span><sup>9</sup></span> England<span><sup>10</sup></span> and Northern Europe.<span><sup>11</sup></span> These networks have been instrumental in producing and disseminating drug-specific, evidence-based deprescribing guidelines for clinicians, providing consumer-facing resources and support, developing national action plans for improving quality use of medications, promoting deprescribing research and convening national and international deprescribing conferences to share knowledge and forge collaborations.</p><p>Evidence has shown that deprescribing interventions can be feasibly","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"53 6","pages":"320-327"},"PeriodicalIF":1.0,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139604383","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}
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