Journal of Pharmacy Practice and Research最新文献

This issue of the Journal includes a paper titled ‘Time for change: Improving neuromuscular blocking agent safety in Australia’.¹ The lead author, Amy McRae, sadly passed away last year on 15 December, at home peacefully with her family by her side.

Amy had a passion and determination to improve the safe use of medicines and this influenced the many pharmacists, nurses, doctors, and patients who had the pleasure of interacting with her during her career. This included in her early role as a clinical pharmacist, through to more recently as Senior Medication Safety Pharmacist at Alfred Health. In addition, Amy was also the Senior Pharmacist, Quality Use of Medicines, Western Health and Senior Lecturer, Post-Graduate Studies and Professional Development Unit, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University.

Her contribution to improving the care of patients and reducing the risks associated with medication will be one of her many legacies. Amy was central in Australia-wide improvements to reduce neuromuscular blocking agent (NMBA) administration errors, which can cause unintended paralysis, respiratory arrest, severe permanent harm, and death. These endeavours included the publication of a national report Time for change: proposed improvements to the labelling and packaging of neuromuscular blocking agents in Australia.² This work, supported by the Victorian Therapeutics Advisory Group and many other national organisations, resulted in the introduction of mandatory warning statements for the labels of NMBAs in Australia. Amy was also pivotal in a range of other initiatives, including reducing potentially fatal errors associated with high doses of insulin, the introduction of Tall Man lettering to reduce medication selection errors, and patient education and empowerment strategies to improve prophylaxis for venous thromboembolism.

We are very saddened that Amy is not here to share in this milestone but know that her impact and legacy will continue. Amy was a wonderful person whose courage and determination to live a full life was inspirational to many of us who knew her. Amy will continue to be missed by many and her impact on making care safer will be felt far into the future.

The author complies with the Journal's authorship policy.

Michael Dooley is the Editor-in-Chief of the Journal of Pharmacy Practice and Research.

Ethics approval was not required for this announcement.

The objective of this narrative review was to determine the facilitators and barriers identified in pharmacy-led interventions that improve outcomes in patients with asthma and support the implementation of interventions in practice. EMBASE, Web of Science, Google Scholar, and PubMed were used to identify 17 relevant articles. Seven studies were randomised controlled studies and 10 were one-arm, pre-post evaluations of all participants enrolled. Questionnaires assessing asthma control, medicine adherence, and knowledge about asthma were used, while checklists were used to assess inhaler technique. Studies with planned interventions in a clinic or general practice setting and lasting for 6 months (compared to longer interventions of 48 weeks) were more successful in retaining participation in the program. Education was the key intervention in which inhaler technique training was the most common. Knowledge about the disease, its aetiology, trigger factors, and medication used were covered in 10 of the studies. Fifteen of the articles reported an improvement in the asthma of patients receiving intervention by the pharmacist, measured by their asthma control test scores, emergency department visits, or reduced emergency steroid prescriptions. This review highlights five key requirements for the success of pharmacy-based interventions for asthma management: (a) developing and maintaining a skilled workforce; (b) close proximation of a general practitioner practice or clinic to the pharmacy; (c) patient education on the disease and medicine; (d) structured and standardised intervention and assessment; and (e) length of the intervention suitable to the pharmacist and the patient.

Opioid prescribing requires careful planning to minimise the risk of serious adverse outcomes. However, documentation of discharge opioid plans for patients and their general practitioners (GPs) is inconsistent, particularly when opioids are commenced in the emergency department or after surgery. We describe an initiative to promote consistent discharge opioid plan communication by implementing an opioid management plan (OMP) in our hospital's electronic medical record. Completion of an electronic form by the prescriber generates an OMP note in the medical history, which is used by the pharmacist to provide tailored opioid patient education. The OMP also populates the discharge summary that is sent to the GP and the Australian national digital health record platform, My Health Record. Preliminary evaluation shows incorporating OMP documentation into routine workflows has assisted prescribers to consistently document the plan for supplied opioids, supporting continuity of care. Workflow optimisation is ongoing to further improve discharge summary documentation and provision of patient-friendly written information. This study was conducted as a quality improvement project and audits conducted as part of the project were approved by Austin Health's Office for Research (Project No: LNR/18/Austin/155). Informed patient consent was not required by Austin Health.