Journal of Pharmacy Practice and Research最新文献_第6页

Scoping the barriers to influenza and pneumococcal vaccinations from the perspectives of patients with cancer: is there a role for the pharmacist? 从癌症患者的角度确定流感和肺炎球菌疫苗接种的障碍：药剂师是否可以发挥作用？

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-11-02 DOI: 10.1002/jppr.1940

Kristoffer Johnstone BPharm, GDPHTM, MSHP, FANZCAP (OncHaem), John Smithson BNSc, BPharm, PhD, Joyce Cooper PhD, BSc (Pharmacy), GDCLinPharm, GCClinEpi, GCTertiaryTeach, FSHP, Beverley Glass BPharm, BSc (Chemistry), PhD, ARPharmS, FPS

Background

Routine immunisation for influenza and pneumococcal disease has the potential to reduce morbidity and mortality in patients with cancer.

Aim

This scoping review aims to determine barriers to influenza and pneumococcal vaccinations from the perspective of patients with cancer and to discuss the potential role of the pharmacist in impacting these barriers.

Design

A systematic search of seven databases, including MEDLINE (Ovid), Cochrane Library, Informit (health), PubMed, and CINAHL (complete), from database inception to 6 June 2023 was conducted. Search terms included: 'cancer', 'vaccination', 'influenza', 'pneumococcal', and 'barrier'. Articles published in English that describe barriers to receiving vaccinations from the perspectives of patients with cancers were included. Barriers were thematically analysed.

Results

Twenty-five articles met the inclusion criteria. Barriers identified in the literature were analysed into three key themes: healthcare professionals, patients, and healthcare system barriers. A key healthcare professional barrier was lack of recommendations from the treating oncologist or haematologist. Patient barriers included lack of information about the indication for vaccination as part of patients' cancer treatment and fear of side effects. Access to vaccination services was reported as a healthcare system barrier.

Conclusion

This scoping review highlights the significant barriers to influenza and pneumococcal vaccination according to patients with cancer. Healthcare professionals, patients, and health systems were identified as key barriers. Enablers to improve vaccination rates include patient education, increased healthcare professional vaccine recommendations, and improved access. Although pharmacists have a potential role to play in addressing these barriers, the feasibility and impact of their involvement requires further research.

背景：流感和肺炎球菌疾病的常规免疫接种有可能降低癌症患者的发病率和死亡率。目的：本综述旨在从癌症患者的角度确定流感和肺炎球菌疫苗接种的屏障，并讨论药师在影响这些屏障方面的潜在作用。系统检索MEDLINE （Ovid）、Cochrane Library、Informit （health）、PubMed和CINAHL （complete）等7个数据库，检索时间为数据库建立至2023年6月6日。搜索词包括：“癌症”、“疫苗”、“流感”、“肺炎球菌”和“屏障”。用英文发表的文章从癌症患者的角度描述了接种疫苗的障碍。对障碍进行了专题分析。结果25篇文章符合纳入标准。在文献中确定的障碍被分析为三个关键主题：医疗保健专业人员，患者和医疗保健系统障碍。一个关键的卫生保健专业障碍是缺乏来自治疗肿瘤学家或血液学家的建议。患者的障碍包括缺乏关于作为患者癌症治疗一部分的疫苗接种指征的信息以及对副作用的恐惧。据报告，获得疫苗接种服务是卫生保健系统的一个障碍。结论本综述强调了癌症患者接种流感和肺炎球菌疫苗的重大障碍。医疗保健专业人员、患者和卫生系统被确定为主要障碍。提高疫苗接种率的推动因素包括对患者进行教育、增加卫生保健专业人员的疫苗建议以及改善获取途径。尽管药剂师在解决这些障碍方面有潜在的作用，但他们参与的可行性和影响需要进一步研究。

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引用次数: 0

Assessment of enoxaparin-related knowledge, administration technique, and self-reported adherence among women after caesarean section delivery 评估剖宫产后妇女依诺肝素相关知识、给药技术和自我报告依从性

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-10-25 DOI: 10.1002/jppr.1943

Sutha Rajakumar BPharm, Retha Rajah PhD, Nur Alia Razali BPharm, Tan Xin Yan BPharm, Ooi Guat Tee BPharm

Background

Venous thromboembolism is among the main causes of maternal morbidity and mortality, with caesarean section (CS) delivery carrying greater risk. Outpatient thromboprophylaxis, such as enoxaparin, is administered subcutaneously and prescribed as an outpatient; raising the issue of medication adherence.

Aim

This study aimed to evaluate women's adherence to enoxaparin administration after CS delivery, explore the reasons for non-adherence, and assess the factors associated with patients' adherence to enoxaparin.

Method

Women after CS delivery, who had been given enoxaparin at discharge were included in the study. Eligible patients were contacted via telephone at the middle and the end of the enoxaparin treatment. Syringe count determined the main outcome of adherence during direct telephone interviews with the patient. Optimal adherence was defined as all the doses of enoxaparin being administered and suboptimal adherence was at least one dose not administered. Ethical approval was granted by the Malaysian Registry Ethics Committee belonging to National Medical Research Registry (Reference no: NMRR ID-22-02859-P41) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants through completion of written consent forms, after an explanation of the study was provided by investigators.

Results

Out of 201 women included, the majority (91.5%) were fully adherent to enoxaparin, while 8.5% missed at least one dose. Most patients administering at home missed the dose due to reporting they were unwell (n = 6), busy (n = 4), or forgot to administer (n = 2). Among missed doses in patients administered in a healthcare setting, all participants (n = 5) forgot to bring their medication to the appointment. Only medication knowledge had a significant association with adherence to enoxaparin administration (p = 0.008).

Conclusion

The study raised concern about the substantial percentage of patients missing at least one dose of enoxaparin, particularly among patients injecting at home. Initiatives should focus on customised enoxaparin administration counselling and providing educational materials.

背景：静脉血栓栓塞是孕产妇发病和死亡的主要原因之一，剖腹产（CS）分娩风险更大。门诊血栓预防，如依诺肝素，是皮下给药和门诊处方；提出了药物依从性的问题。目的本研究旨在评价CS分娩后妇女对依诺肝素的依从性，探讨不依从性的原因，并评估患者对依诺肝素依从性的相关因素。方法：选取CS分娩后出院时给予依诺肝素治疗的产妇为研究对象。在依诺肝素治疗中期和结束时通过电话联系符合条件的患者。在与患者的直接电话访谈中，注射器数量决定了依从性的主要结果。最佳依从性定义为给予所有剂量的依诺肝素，次优依从性是至少不给予一个剂量。属于国家医学研究登记处的马来西亚登记处伦理委员会（参考编号：NMRR ID-22-02859-P41）批准了伦理批准，该研究符合赫尔辛基宣言。在研究者对研究进行解释后，通过填写书面同意书获得所有参与者的知情同意。结果在纳入的201名妇女中，大多数（91.5%）完全坚持使用依诺肝素，而8.5%的妇女至少错过了一次剂量。大多数在家给药的患者由于报告自己身体不适（n = 6）、忙碌（n = 4）或忘记给药（n = 2）而错过给药。在医疗保健机构给药的患者中，所有参与者（n = 5）都忘记将药物带到预约地点。只有药物知识与依诺肝素给药依从性有显著相关性（p = 0.008）。该研究引起了人们对大量患者缺少至少一剂依诺肝素的关注，特别是在家中注射的患者中。倡议应侧重于定制依诺肝素给药咨询和提供教育材料。

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引用次数: 0

Evaluation of a weight-based process for real-time accurate confirmation of oral liquid controlled drug balances 实时准确确认口服液控药物平衡的称重方法的评价

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-10-21 DOI: 10.1002/jppr.1955

Paul Wembridge BPharm (Hons), MClinPharm, FANZCAP (Lead&Mgmt, MedSafety), Linda Ta BPharm (Hons), Meegan Callinan BN, MHPEd, GradCertPallCare, Kayin Chan BPharm, Aliesha-jane Fejgl BN, PostGradNursPrac (Cancer and Palliative Care), Joshua Colaci BPharm (Hons), BSc, GradCertPharmPrac, Mazdak Zamani PharmD, MHM, CHE, FCHSM, FANZCAP (MedsMgmt, MedSafety)

To meet legislative requirements in Australia, the balance of controlled drugs (CDs) must be confirmed after completion of each transaction. This is particularly challenging for liquid CD formulations, and over the years, health organisations have implemented various methods of performing this task, including the use of visual aids or conversion of bulk formulations to individual unit doses. These methods have a number of limitations. Therefore, this study aimed to evaluate the accuracy and feasibility of a weight-based method for confirming oral liquid CD balances packed in multidose containers. This study was conducted in a palliative care ward of a metropolitan hospital over a 41-day period. Morphine mixture 5 mg/1 mL transactions and balance checks were confirmed using weight calculations of the product bottle. The weights were then converted to volume using a locally developed electronic application, which was recorded in the relevant CD registers. The acceptable tolerance per transaction (±0.1 mL) was determined prior to commencement based on 80 test transactions. Throughout the trial period, 407 transactions were undertaken, among which there were no CD discrepancies. Nine nurses provided feedback via an anonymous online survey after the trial, mostly reporting that the new method was more accurate. However, participants also reported that it took on average 3 min longer to complete each transaction. In conclusion, utilising a weight-based method of confirming liquid CD balances may present a feasible method of meeting legislative requirements related to the recording and accountability of CDs. This project was exempt due to the local policy requirements that constitute research by the Eastern Health Office of Research and Ethics (Reference no: QA24-100-111698). 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 and did not directly affect patient care; written consent was not required from participants per local requirements, however staff were provided verbal and written project information and were informed their participation in the survey was voluntary and anonymous.

为了满足澳大利亚的立法要求，每笔交易完成后都必须确认受控药物（cd）的余额。这对于液体乳糜泻配方来说尤其具有挑战性，多年来，卫生组织已经实施了各种方法来执行这项任务，包括使用视觉辅助工具或将散装配方转换为单个单位剂量。这些方法有一些局限性。因此，本研究旨在评估一种基于重量的方法来确定多剂量容器包装的口服液CD平衡的准确性和可行性。本研究是在大都会医院的姑息治疗病房进行的，为期41天。吗啡混合物5mg / 1ml的交易和平衡检查使用产品瓶的重量计算进行确认。然后使用当地开发的电子应用程序将重量转换为体积，并将其记录在有关的CD寄存器中。在开始之前，根据80个测试事务确定每个事务的可接受容差（±0.1 mL）。在整个试验期间，进行了407笔交易，其中没有存单不符点。试验结束后，九名护士通过匿名在线调查提供了反馈，大多数人都表示新方法更准确。然而，参与者也报告说，完成每笔交易平均要多花3分钟。总之，利用基于重量的方法确认液体CD余额可能是一种可行的方法，可以满足与CD记录和问责制有关的立法要求。由于东部卫生研究和伦理办公室（参考编号：QA24-100-111698）的当地政策要求，该项目被豁免。这项伦理豁免的理由如下：该研究符合国家卫生和医学研究委员会（NHMRC）在质量保证和评估活动中的伦理考虑，不会直接影响患者的护理；根据当地要求，不需要参与者的书面同意，但向工作人员提供了口头和书面的项目信息，并告知他们自愿和匿名参与调查。

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引用次数: 0

Impact of sacubitril/valsartan on atrial fibrillation burden in heart failure: a retrospective observational study 沙比利/缬沙坦对心力衰竭患者房颤负担的影响：一项回顾性观察研究

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-10-04 DOI: 10.1002/jppr.1942

Ana Barradas MD, Diogo de Almeida Fernandes MD, Inês Fonseca BHSc, Natália António MD, PhD, Luís Elvas MD, Lino Gonçalves MD, PhD

Background

Sacubitril/valsartan (an angiotensin receptor-neprilysin inhibitors [ARNI]) might improve atrial fibrillation (AF) condition, but its added value remains controversial.

Aim

We aimed to analyse the effect of ARNI on AF burden.

Method

We conducted a single-centre, retrospective self-controlled study in a tertiary centre. Data were retrieved from January 2019–January 2023. All cardiac resynchronisation therapy-implantable cardioverter defibrillator (CRT-D) carriers on ARNI were included if implantation had been at least 3 months before drug initiation. Proarrhythmic events, equal time length control (before ARNI initiation), and exposure (after ARNI initiation) periods were defined. Echocardiographic data were retrieved if they were up to 1 year old before ARNI initiation and if they were available 3 months to 1 year after initiation. AF burden was defined by frequency and median value of paroxysmal events and the overall variation in AF status was determined. Ethical approval was granted by the Ethics Committee of the Centro Hospitalar e Universitário de Coimbra (Reference no: PI OBS.SF.174-2022) and the study conforms with the Declaration of Helsinki.

Results

Seventy-two patients were included in the study (73.3% men). After ARNI, there was a reduction in New York Heart Association functional class ± standard deviation (2.00 ± 0.75 to 1.85 ± 0.61, p = 0.043) and an increase in left ventricular ejection fraction ± standard deviation (from 31.67% ± 9.28% vs 37.33% ± 14.49%, p = 0.027). Before ARNI initiation, 34 patients did not have AF, 19 had paroxysmal AF, 15 had permanent AF, and 2 had persistent AF. The total amount of AF episodes (91 vs 44, p = 0.808) and median paroxysmal episodes (among those with paroxysmal AF or no AF) (5 vs 3, p = 0.121) were numerically reduced after ARNI initiation, though variation was not statistically significant. No differences were found as well regarding ventricular arrhythmias or device therapies.

Conclusion

ARNI did not significantly decrease the number of AF paroxysmal episodes or median number of paroxysmal events per patient. Even though ARNI may have a positive impact on AF burden of heart failure patients, larger studies are needed to provide unequivocal evidence.

Sacubitril/缬沙坦（一种血管紧张素受体-neprilysin抑制剂[ARNI]）可能改善心房颤动（AF）病情，但其附加价值仍存在争议。目的分析ARNI对房颤负担的影响。方法在某三级医学中心进行单中心、回顾性自我对照研究。数据检索时间为2019年1月至2023年1月。所有心脏再同步治疗-植入式心律转复除颤器（CRT-D）的ARNI携带者，如果在药物开始前植入式心律转复除颤器至少3个月被纳入研究。定义心律失常事件、等时间长度控制（ARNI开始前）和暴露（ARNI开始后）周期。如果他们在ARNI开始前1岁，如果他们在开始后3个月至1年可用，则检索超声心动图数据。通过发作事件的频率和中位数来定义房颤负担，并确定房颤状态的总体变化。该研究得到了Universitário科英布拉医院中心伦理委员会的伦理批准（参考编号：PI OBS.SF.174-2022），该研究符合赫尔辛基宣言。结果共纳入72例患者，男性占73.3%。ARNI后，纽约心脏协会功能分级±标准差（2.00±0.75）降低至1.85±0.61,p = 0.043)，左室射血分数±标准差（31.67%±9.28% vs 37.33%±14.49%,p = 0.027）增加。ARNI开始前，34例患者无房颤，19例为阵发性房颤，15例为永久性房颤，2例为持续性房颤。ARNI开始后，房颤总发作次数（91次vs 44次，p = 0.808）和中位发作次数（阵发性房颤或无房颤）（5次vs 3次，p = 0.121）均有所减少，但差异无统计学意义。在室性心律失常或器械治疗方面也没有发现差异。结论ARNI未显著降低AF发作次数或每位患者发作次数的中位数。尽管ARNI可能对心力衰竭患者的心房颤动负担有积极影响，但需要更大规模的研究来提供明确的证据。

{"title":"Impact of sacubitril/valsartan on atrial fibrillation burden in heart failure: a retrospective observational study","authors":"Ana Barradas MD, Diogo de Almeida Fernandes MD, Inês Fonseca BHSc, Natália António MD, PhD, Luís Elvas MD, Lino Gonçalves MD, PhD","doi":"10.1002/jppr.1942","DOIUrl":"https://doi.org/10.1002/jppr.1942","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sacubitril/valsartan (an angiotensin receptor-neprilysin inhibitors [ARNI]) might improve atrial fibrillation (AF) condition, but its added value remains controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to analyse the effect of ARNI on AF burden.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a single-centre, retrospective self-controlled study in a tertiary centre. Data were retrieved from January 2019–January 2023. All cardiac resynchronisation therapy-implantable cardioverter defibrillator (CRT-D) carriers on ARNI were included if implantation had been at least 3 months before drug initiation. Proarrhythmic events, equal time length control (before ARNI initiation), and exposure (after ARNI initiation) periods were defined. Echocardiographic data were retrieved if they were up to 1 year old before ARNI initiation and if they were available 3 months to 1 year after initiation. AF burden was defined by frequency and median value of paroxysmal events and the overall variation in AF status was determined. Ethical approval was granted by the Ethics Committee of the Centro Hospitalar e Universitário de Coimbra (Reference no: PI OBS.SF.174-2022) and the study conforms with the Declaration of Helsinki.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seventy-two patients were included in the study (73.3% men). After ARNI, there was a reduction in New York Heart Association functional class ± standard deviation (2.00 ± 0.75 to 1.85 ± 0.61, p = 0.043) and an increase in left ventricular ejection fraction ± standard deviation (from 31.67% ± 9.28% vs 37.33% ± 14.49%, p = 0.027). Before ARNI initiation, 34 patients did not have AF, 19 had paroxysmal AF, 15 had permanent AF, and 2 had persistent AF. The total amount of AF episodes (91 vs 44, p = 0.808) and median paroxysmal episodes (among those with paroxysmal AF or no AF) (5 vs 3, p = 0.121) were numerically reduced after ARNI initiation, though variation was not statistically significant. No differences were found as well regarding ventricular arrhythmias or device therapies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ARNI did not significantly decrease the number of AF paroxysmal episodes or median number of paroxysmal events per patient. Even though ARNI may have a positive impact on AF burden of heart failure patients, larger studies are needed to provide unequivocal evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"53-60"},"PeriodicalIF":1.0,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423579","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}

引用次数: 0

A retrospective study of duloxetine for phantom limb pain post lower-limb amputation 度洛西汀治疗下肢截肢后幻肢痛的回顾性研究

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-10-04 DOI: 10.1002/jppr.1937

Duncan Long BPharm, Jonathon Beck BPharm, Nazanin Falconer BPharm, PhD, Salih Salih MBCHB, MBH, FRACP

Background

Phantom limb pain (PLP) refers to the painful sensory perception of a missing limb after amputation, which can have physical and psychological impacts.

Aim

To determine the effectiveness of duloxetine for pain management in PLP by the reduction of opioid doses and other neuropathic analgesics when introduced into multimodal pain management strategies in the subacute rehabilitation setting.

Method

This was a retrospective observational case-matched cohort study of patients who were admitted to a geriatric and rehabilitation unit at a tertiary Australian hospital from January 2005–December 2017 with PLP after lower-limb amputation. Patients were included if they had a new amputation and experienced PLP. The primary outcome was a difference in oxycodone dose equivalents at discharge between the two cohorts. Univariable analysis was used to compare groups. Ethical approval was granted by the Metro South Low Negligible Risk Ethics Committee (Reference no: LNR/2018/QMS/47370) and the study conforms with the National statement on ethical conduct in human research.

Results

Thirty patients from the duloxetine treatment cohort and 57 patients from the non-duloxetine cohort were identified. Participants were predominantly male (81%) and had a median age of 63 years (interquartile range = 10.7). Both populations showed a similar rate of opioid dose reduction comparing doses at admission with those at discharge. There were no significant differences in absolute oxycodone equivalent doses at the two observed check points: admission and discharge.

Conclusion

This study demonstrated that opioid consumption in post-surgical lower-limb amputees reporting PLP was not significantly different between populations that used and did not use duloxetine. Future research should evaluate the efficacy of duloxetine in PLP pain management using a multisite prospective study design.

背景幻肢痛（PLP）是指截肢后对缺失肢体的疼痛感觉，会对患者的身体和心理造成影响。目的通过在亚急性康复环境中采用多模式疼痛管理策略，减少阿片类药物和其他神经病理性镇痛药的剂量，确定度洛西汀对幻肢痛的疼痛管理效果。方法这是一项回顾性观察病例匹配队列研究，研究对象为 2005 年 1 月至 2017 年 12 月期间入住澳大利亚一家三级医院老年病与康复科的下肢截肢后 PLP 患者。新截肢并经历过PLP的患者均被纳入研究范围。主要结果是两组患者出院时羟考酮剂量当量的差异。采用单变量分析对两组进行比较。该研究获得了大都会南部低轻微风险伦理委员会的伦理批准（参考编号：LNR/2018/QMS/47370），并符合国家人类研究伦理行为声明。结果从度洛西汀治疗队列中确定了 30 名患者，从非度洛西汀队列中确定了 57 名患者。参与者主要为男性（81%），中位年龄为 63 岁（四分位数间距 = 10.7）。入院时与出院时的阿片类药物剂量比较显示，两种人群的阿片类药物剂量减少率相似。入院和出院这两个观察点的羟考酮绝对当量剂量没有明显差异。结论本研究表明，在使用和未使用度洛西汀的人群中，手术后下肢截肢者报告 PLP 时的阿片类药物消耗量没有明显差异。今后的研究应采用多地点前瞻性研究设计，评估度洛西汀在 PLP 疼痛治疗中的疗效。

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引用次数: 0

Active Ingredient Prescribing in Australia: exploring pharmacists' experiences 澳大利亚的活性成分处方：探索药剂师的经验

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-10-04 DOI: 10.1002/jppr.1935

Taylah Swifte BPharm, MPharm, Michelle Bowden BPharm, GradDipClinPharm, Henry Ndukwe BPharm, MSc, PhD

Background

The Active Ingredient Prescribing (AIP) mandate was introduced Australia-wide on 1 February 2021. The AIP legislation makes the pharmacist a stakeholder who can provide valuable information to customers and patients.

Aim

To explore the experiences of community pharmacists with AIP legislation with a focus on attitude, health literacy, and medication safety.

Method

Semi-structured, in-depth interviews were conducted and guided by the Theoretical Domains Framework (TDF). Transcripts were analysed using a deductive approach to categorise data and inductive thematic analysis to identify concepts and themes. Ethical approval was granted by the Griffith University Human Research Ethics Committee (Reference no: 2021/878) and the study conforms to the Australian National Statement on Ethical Conduct in Human Research. Informed consent from all participants was obtained via a study information sheet distributed to all potential participants and completion of written consent forms prior to participation in the study. Participants received gift cards as compensation for their time.

Results

Six pharmacists participated, and thematic analysis of collected data revealed three main themes. These included education, integration, and trust. Insights on patients' acceptance of their prescriptions and the expanded patient-facing opportunities were highlighted. Participants' opinions leaned towards enhancing the smooth integration into the AIP process of other stakeholders like prescribers and regulatory bodies. Establishing multilevel communication between stakeholders and customers was pivotal to improving health literacy and medication safety. Pharmacists' views on process integration provided unique insight into the practical challenges with the AIP mandate. In addition, ‘trust’ in the prescriber enhanced patient acceptance of generic medicines.

Conclusion

The study provided baseline evidence to show that the AIP mandate enhances health literacy and empowers patients to know the active ingredients in their medicines, which in turn supports medication safety. Examining the implementation of the AIP legislation facilitated a nuanced understanding of the effect that these AIP changes have on patients.

背景 2021 年 2 月 1 日，活性成分处方 (AIP) 法在澳大利亚全境实施。AIP 法规使药剂师成为能够为顾客和患者提供有价值信息的利益相关者。目的探讨社区药剂师在 AIP 立法方面的经验，重点关注态度、健康知识和用药安全。方法以理论领域框架 (TDF) 为指导，进行半结构式深入访谈。采用演绎法和归纳法对访谈记录进行分析，演绎法用于对数据进行分类，归纳法用于确定概念和主题。本研究获得了格里菲斯大学人类研究伦理委员会的伦理批准（参考编号：2021/878），并符合澳大利亚国家人类研究伦理行为声明。通过向所有潜在参与者分发研究信息表以及在参与研究前填写书面同意书，获得了所有参与者的知情同意。参与者获得了礼品卡作为时间补偿。结果六名药剂师参与了研究，对收集到的数据进行的主题分析揭示了三大主题。这些主题包括教育、整合和信任。其中，关于患者对处方的接受程度以及扩大面向患者的机会的见解得到了强调。与会者的意见倾向于加强其他利益相关者（如处方者和监管机构）与 AIP 流程的顺利整合。在利益相关者和客户之间建立多层次的沟通对于提高健康知识水平和用药安全至关重要。药剂师对流程整合的看法为了解 AIP 任务所面临的实际挑战提供了独特的见解。此外，对处方者的 "信任 "也提高了患者对非专利药品的接受度。结论该研究提供的基线证据表明，AIP 规定提高了健康素养，使患者有能力了解药品中的有效成分，进而支持了用药安全。对 AIP 法规实施情况的研究有助于深入了解这些 AIP 变化对患者的影响。

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引用次数: 0

A surgical preadmission pharmacist service in a tertiary paediatric hospital: a pilot study 一家三级儿科医院的入院前手术药剂师服务：一项试点研究

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-09-10 DOI: 10.1002/jppr.1933

Bruce Chio BPharm, GDipClinPharm, Syeda Farah Zahir PhD, MSc(HM), MBBS, Jenny Lee-Peters BPharm, GDipClinPharm, CHIA, Emily Elliott BPharm, BPharm(Hons), Lana Steward-Harrison BPharm, GDipClinPharm, MHLM, MSHP, Gemma Burns BPharmSci, MPharm, Sonya Stacey BPharm, PhD, FANZCAP

Background

Pharmacist surgical preadmission review is common in adult healthcare settings, however there is little evidence of this practice in the paediatric setting. This research describes a pilot surgical preadmission pharmacist service in a paediatric hospital.

Aim

To evaluate the impact of a surgical preadmission pharmacist service on patient flow and the quality of medication management.

Method

A retrospective review (2 months) was conducted to compare an intervention group (1 May 2019–30 June 2019) to historical baseline (1 October 2018–30 November 2018). Children and adolescents (aged 0–18 years) presenting for elective surgery and overnight admission were included. Relevant clinical data and timestamps were extracted from the electronic medical record. Multiple linear regression models were built to examine the difference in outcomes between the control and intervention groups. This project was exempt due to the local policy requirements that constitute research by the Queensland Children's Hospital Human Research Ethics Committee (Reference no: LNR/19/QCHQ/53406). The justification for this exemption was as follows: the study presented no foreseeable risk of patient harm as it involved evaluation of an established standard of clinical care and involved the use of existing collections of records that contain only non-identifiable patient data.

Results

In total, 135 patients were included in the baseline and 96 patients were included in the intervention group. The intervention group had statistically significant lower time to best possible medication history (BPMH) by 47.57 h (95% confidence interval [CI] −53.25 to −41.89, p < 0.001). Time to prescription of home medications was significantly reduced in the intervention group by 5.26 h (95% CI −10.45 to −0.08, p = 0.05). There was no difference in proportion of patients with home medications omitted (71–62%, p = 0.38) or requiring modification (14–12%, p = 0.58) between the two groups.

Conclusion

Implementation of a surgical preadmission pharmacist service in our paediatric hospital demonstrated earlier BPMH documentation and prescription of home medications, without negative effects on perioperative patient flow.

背景药剂师的手术入院前审查在成人医疗机构中很常见，但在儿科医疗机构中却鲜有这种做法的证据。本研究介绍了在一家儿科医院试行的入院前手术药剂师服务。目的评估手术入院前药剂师服务对患者流程和药物管理质量的影响。方法对干预组（2019 年 5 月 1 日至 2019 年 6 月 30 日）与历史基线（2018 年 10 月 1 日至 2018 年 11 月 30 日）进行回顾性审查（2 个月）。纳入了前来接受择期手术和过夜入院的儿童和青少年（0-18 岁）。从电子病历中提取了相关临床数据和时间戳。建立多元线性回归模型，以检验对照组和干预组之间的结果差异。根据昆士兰儿童医院人类研究伦理委员会（参考编号：LNR/19/QCHQ/53406）的当地研究政策要求，该项目获得豁免。豁免理由如下：该研究不存在可预见的伤害患者的风险，因为它涉及对既定临床护理标准的评估，并涉及使用仅包含不可识别患者数据的现有记录集。结果共有 135 名患者被纳入基线组，96 名患者被纳入干预组。干预组的最佳用药史（BPMH）时间明显缩短了 47.57 小时（95% 置信区间 [CI] -53.25 至 -41.89，p < 0.001）。干预组开具家庭用药处方的时间明显缩短了 5.26 小时（95% 置信区间 -10.45 至 -0.08，P = 0.05）。两组患者省略家庭用药的比例（71-62%，p = 0.38）或需要修改的比例（14-12%，p = 0.58）没有差异。结论在我们的儿科医院实施手术入院前药剂师服务后，可以更早地记录 BPMH 和开具家庭用药处方，而不会对围手术期患者的流程产生负面影响。

{"title":"A surgical preadmission pharmacist service in a tertiary paediatric hospital: a pilot study","authors":"Bruce Chio BPharm, GDipClinPharm, Syeda Farah Zahir PhD, MSc(HM), MBBS, Jenny Lee-Peters BPharm, GDipClinPharm, CHIA, Emily Elliott BPharm, BPharm(Hons), Lana Steward-Harrison BPharm, GDipClinPharm, MHLM, MSHP, Gemma Burns BPharmSci, MPharm, Sonya Stacey BPharm, PhD, FANZCAP","doi":"10.1002/jppr.1933","DOIUrl":"https://doi.org/10.1002/jppr.1933","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pharmacist surgical preadmission review is common in adult healthcare settings, however there is little evidence of this practice in the paediatric setting. This research describes a pilot surgical preadmission pharmacist service in a paediatric hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the impact of a surgical preadmission pharmacist service on patient flow and the quality of medication management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective review (2 months) was conducted to compare an intervention group (1 May 2019–30 June 2019) to historical baseline (1 October 2018–30 November 2018). Children and adolescents (aged 0–18 years) presenting for elective surgery and overnight admission were included. Relevant clinical data and timestamps were extracted from the electronic medical record. Multiple linear regression models were built to examine the difference in outcomes between the control and intervention groups. This project was exempt due to the local policy requirements that constitute research by the Queensland Children's Hospital Human Research Ethics Committee (Reference no: LNR/19/QCHQ/53406). The justification for this exemption was as follows: the study presented no foreseeable risk of patient harm as it involved evaluation of an established standard of clinical care and involved the use of existing collections of records that contain only non-identifiable patient data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total, 135 patients were included in the baseline and 96 patients were included in the intervention group. The intervention group had statistically significant lower time to best possible medication history (BPMH) by 47.57 h (95% confidence interval [CI] −53.25 to −41.89, p < 0.001). Time to prescription of home medications was significantly reduced in the intervention group by 5.26 h (95% CI −10.45 to −0.08, p = 0.05). There was no difference in proportion of patients with home medications omitted (71–62%, p = 0.38) or requiring modification (14–12%, p = 0.58) between the two groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of a surgical preadmission pharmacist service in our paediatric hospital demonstrated earlier BPMH documentation and prescription of home medications, without negative effects on perioperative patient flow.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 5","pages":"393-401"},"PeriodicalIF":1.0,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664788","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}

引用次数: 0

The pharmacologic management of status epilepticus in pregnant patients: a scoping review 妊娠患者癫痫状态的药物治疗：范围界定综述

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-09-05 DOI: 10.1002/jppr.1934

Emily M. Laswell PharmD, BCPS, David Peters Jr PharmD, BCCCP, Jordan Orchard PharmD

Background

Status epilepticus (SE) is defined as 5 min or more of seizure activity or two recurrent seizures without a return to baseline. Healthcare providers encounter a challenge when a patient with SE is pregnant. SE is not only detrimental to the mother but can also put the baby at risk of severe harm. SE must be treated rapidly and therefore healthcare providers have very little time to thoroughly review the risk and benefits of available antiseizure medication in this population.

Aim

To evaluate the current available evidence related to the management of SE in pregnancy.

Design

A literature search of PubMed, CINAHL, ProQuest Nursing & Allied Health Source, and Web of Science databases was conducted (2012–2022) using the following search terms: ‘pregnancy’, ‘pregnant women’ OR ‘gestation’ AND ‘status epilepticus’, ‘generalized status epilepticus’, ‘generalized convulsive status epilepticus’, ‘non convulsive status epilepticus’ OR ‘non-convulsive status epilepticus’. Full-text randomised controlled trials, clinical trials, observational studies, and case reports published in English were included. Data were extracted and the quality of the studies was evaluated using the Mixed Methods Appraisal Tool.

Results

The literature described 29 pregnancies and 30 total foetuses. Intravenous benzodiazepine use for emergent control was reported in 45% of patients. Phenytoin and levetiracetam were primarily utilised for urgent control, with a variety of agents used for refractory SE. Ninety-seven percent of maternal outcomes were reported as positive. The most common outcome was the birth of a healthy term infant. There were seven cases of pregnancy loss.

Conclusion

Publications pertaining to the treatment of SE in pregnancy are limited to case reports and small observational studies. Use of a benzodiazepine followed by levetiracetam or phenytoin is appropriate, whereas valproic acid should be utilised only when necessary due to the risk of major congenital malformation.

背景癫痫状态（SE）的定义是发作活动持续 5 分钟或更长时间，或两次反复发作且未恢复到基线。当 SE 患者怀孕时，医疗服务提供者会遇到一个难题。SE 不仅对母亲有害，还可能使婴儿面临严重伤害的风险。SE 必须得到快速治疗，因此医疗服务提供者几乎没有时间来彻底审查抗癫痫药物在这一人群中的风险和益处。目的评估与妊娠期 SE 的治疗相关的现有证据。设计使用以下检索词对 PubMed、CINAHL、ProQuest Nursing & Allied Health Source 和 Web of Science 数据库进行文献检索（2012-2022 年）：妊娠"、"孕妇 "或 "妊娠 "和 "癫痫状态"、"全身性癫痫状态"、"全身性惊厥性癫痫状态"、"非惊厥性癫痫状态 "或 "非惊厥性癫痫状态"。研究对象包括用英语发表的全文随机对照试验、临床试验、观察性研究和病例报告。采用混合方法评估工具（Mixed Methods Appraisal Tool）提取数据并评估研究质量。结果文献中描述了 29 例妊娠和 30 个胎儿。据报道，45%的患者使用静脉注射苯二氮卓类药物进行紧急控制。苯妥英和左乙拉西坦主要用于紧急控制，各种药物用于难治性 SE。据报告，97%的孕产妇结果为阳性。最常见的结果是产下健康足月婴儿。有 7 例妊娠失败。结论有关治疗妊娠期 SE 的文献仅限于病例报告和小型观察性研究。在使用苯二氮卓类药物后再使用左乙拉西坦或苯妥英是合适的，而丙戊酸由于有导致重大先天性畸形的风险，只有在必要时才能使用。

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引用次数: 0

Pharmacotherapy profile for mothers with schizophrenia and bipolar affective disorder in a psychiatric mother–baby unit 精神科母婴单元中精神分裂症和双相情感障碍母亲的药物治疗概况

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-08-28 DOI: 10.1002/jppr.1939

Anna Cooter BArts (Hons), BPharm, BMedSt, MD, Sushreya Saluja BMedSt, MD, Susan Roberts MBBS, FRANZCP, Grace Branjerdporn BOccThy(Hons), PhD

Background

Pharmacotherapy treatment is used to manage women with schizophrenia and bipolar affective disorder admitted to a mother–baby unit (MBU).

Aim

The aims of this study were (1) to examine prescribing practices for women with schizophrenia and bipolar affective disorder in an MBU, (2) to assess alignment with the Mental health care in the perinatal period: Australian clinical practice guideline and (3) to examine the classes of typical and atypical antipsychotics prescribed to mothers with schizophrenia.

Method

A retrospective audit of women with schizophrenia and bipolar affective disorder admitted to a psychiatric MBU, located in Queensland, Australia, was conducted from March 2017–July 2019. The exclusion criteria included women admitted with depression, anxiety, personality disorders, and postpartum psychosis. Pharmacotherapy treatment details were extracted at commencement of admission, mid-way through admission, and discharge. Descriptive statistics were completed. This project was exempt due to the local policy requirements that constitute research by the Gold Coast Hospital and Health Service Human Research Ethics Committee (Reference no: EX/2023/QGC/102306). The justification for this exemption was as follows: the study was deemed a quality improvement activity and complied with Chapter 2.3 of the National Statement of Ethical Conduct in Research and involved only routinely collected data.

Results

Of the 53 mothers included in the study, 29 (55%) had schizophrenia and 24 (45%) had bipolar affective disorder. In addition, 97% of women with schizophrenia received atypical antipsychotics. Five women (21%) with bipolar affective disorder (mean age = 31.60 years, standard deviation = 6.19 years) were prescribed sodium valproate, with four women given contraception. Sodium valproate or lamotrigine were prescribed to four women (67%) with bipolar affective disorder whilst breastfeeding. Of mothers prescribed lithium, 92% did not breastfeed. Overall, 44% of women involuntarily admitted received antipsychotic depot medication compared with 38% of voluntary patients. Results are discussed in relation to the national guidelines.

Conclusion

This is the first naturalistic study to examine the pharmacotherapy management of postpartum women admitted to a psychiatric MBU with schizophrenia and bipolar affective disorder. The study highlights that prescribing p

背景：药物治疗用于管理母亲-婴儿病房（MBU）收治的精神分裂症和双相情感障碍妇女。目的本研究的目的是：(1)检查MBU中患有精神分裂症和双相情感障碍的妇女的处方做法，(2)评估与围产期精神卫生保健的一致性：澳大利亚临床实践指南，(3)检查给患有精神分裂症的母亲开的典型和非典型抗精神病药物的类别。方法对2017年3月至2019年7月在澳大利亚昆士兰州一家精神科MBU住院的精神分裂症和双相情感障碍女性患者进行回顾性审计。排除标准包括患有抑郁、焦虑、人格障碍和产后精神病的妇女。在入院开始、入院中途和出院时提取药物治疗细节。完成描述性统计。由于黄金海岸医院和卫生服务人类研究伦理委员会（参考编号：EX/2023/QGC/102306）的当地政策要求，该项目被豁免。这项豁免的理由如下：该研究被认为是一项质量改进活动，符合《国家研究道德行为声明》第2.3章，只涉及常规收集的数据。结果在研究的53位母亲中，29位（55%）患有精神分裂症，24位（45%）患有双相情感障碍。此外，97%的精神分裂症女性患者接受了非典型抗精神病药物治疗。5例（21%）双相情感障碍患者（平均年龄31.60岁，标准差6.19岁）服用丙戊酸钠，4例患者服用避孕措施。四名（67%）患有双相情感障碍的妇女在母乳喂养期间服用丙戊酸钠或拉莫三嗪。在服用锂的母亲中，92%没有母乳喂养。总体而言，44%的女性非自愿接受了抗精神病药物治疗，而自愿接受治疗的女性只有38%。结果与国家指导方针的关系进行了讨论。结论：本研究首次探讨了产后精神分裂症合并双相情感障碍的MBU患者的药物治疗管理。该研究强调，在入院期间的三个时间点的处方模式总体上与澳大利亚国家指南一致。

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引用次数: 0

Person- and carer-centred palliative care: consensus for the pharmacy profession 以人和照护者为中心的姑息关怀：药学专业的共识

IF 1 Q4 PHARMACOLOGY & PHARMACY

Journal of Pharmacy Practice and Research

Pub Date : 2024-08-21 DOI: 10.1002/jppr.1944

Michael J. Dooley BPharm, GradDipHospPharm, PhD, FSHP, AdvPracPharm

<p>In the previous issue of the <i>Journal of Pharmacy Practice and Research</i>, the Society of Hospital Pharmacists of Australia (SHPA) Standard of practice in palliative care for pharmacy services was published.<span><sup>1</sup></span> This Standard describes current best practice for the provision of palliative care pharmacy services and demonstrates the depth and breadth of these services that have continued to evolve over the recent decade. This includes describing essential and emerging services and challenges the profession to strive to provide emerging services, in addition to essential services wherever possible. This is indeed a challenge when these services are provided in non-specialist and specialist palliative care settings by individual practitioners with varying degrees of experience and expertise. This professional Practice Standard sets the scene and provides guidance to pharmacists within palliative care interdisciplinary teams, through to those working in more generalist roles in settings with clinicians without palliative expertise and, most importantly, entrenches the essence of the palliative care approach in the profession.</p><p>Fundamental to this approach is the description within the Standard that everyone shares a fundamental right to safe and high-quality health care, including palliative care services, as is clearly prioritised in the <i>Australian Charter of Healthcare Rights</i>.<span><sup>2</sup></span> However, there is clear evidence both internationally and within Australia that many patients who would benefit from palliative care service unfortunately do not have access to these.<span><sup>3, 4</sup></span> This includes the continued lack of awareness within the healthcare sector and the wider community that palliative care services can be complementary to active treatment and not reserved for end-of-life care.<span><sup>5</sup></span> Continued effort must be made to reduce these barriers to care and integrate palliative care services as early as possible, from when curative or life-prolonging (disease-modifying) treatment is occurring through to when death may be imminent. This is addressed within the Standard where the benefits of palliative care are highlighted for patients first diagnosed with a life-limiting condition receiving active interventions through to patients with progressive, advanced disease with little to no prospect of cure.</p><p>A conceptual framework to underpin access to palliative care services has also been developed to help guide health professionals.<span><sup>6</sup></span> This, along with key messaging to facilitate engagement with and promotion of palliative care services, has been advocated as an approach to improve the care of individuals with serious illness. There remain significant challenges to adopting these concepts into routine clinical practice. Unfortunately, palliative care, for many healthcare professionals and patients, is perceived to be only for end-of-life ca

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