Journal of Research in Pharmacy Practice最新文献

Objective: There is no evidence regarding the efficacy of bamboo salt in the treatment of recurrent aphthous ulceration. The objective of the present study was to investigate the effect of bamboo salt mouthwash in comparison to benzydamine hydrochloride in the treatment of recurrent aphthous ulceration.

Methods: This randomized double-blind clinical trial was performed on 40 patients diagnosed with minor recurrent aphthous ulceration. Patients were randomized to use bamboo salt or benzydamine mouthwashes for 5 days. Patients in both groups were instructed to use 30 mL of mouthwash every 8 h for 30 s each day. Study outcomes, comprising ulcer size, pain, healing time, and patients' satisfaction, were recorded by investigators.

Findings: The adjusted between-group analyses showed that the mean ulcer size reduction was significantly greater in the bamboo salt group than the benzydamine hydrochloride group (mean difference: -1.40 ± 0.53; P = 0.01) on day 3. In addition, a marginally significant difference was observed between the two groups in terms of ulcer size reduction on day 5 (P = 0.07) and pain score reduction on day 3 (P = 0.06). There was a significant difference between the two groups in the mean duration of ulcer healing, both in the crude and adjusted analyses (P < 0.05). Patients' satisfaction was significantly higher in the bamboo salt group than in the benzydamine hydrochloride group (P = 0.03).

Conclusion: The present study demonstrated that the mouthwash of bamboo salt may be considered an effective option in the management of recurrent aphthous ulceration. However, further studies are needed to confirm our findings.

This review aimed to comprehensively evaluate the impact of artificial intelligence (AI) on the future of clinical pharmacy practice and hospital settings. To achieve this, a thorough literature search was conducted across major databases, including PubMed, Scopus, Web of Science, Embase, and Google Scholar, covering studies published up to July 2025. Relevant keywords - such as "artificial intelligence," "machine learning," "clinical pharmacy," "hospital pharmacy," "medication management," and "decision support systems" - were used to identify studies assessing the applications, challenges, and outcomes of AI in these contexts. All eligible articles were narratively analyzed. The findings indicated that AI has a significant role in optimizing pharmaceutical inventory management, reducing medication errors, enhancing the accuracy and safety of drug dispensing, and streamlining drug distribution processes in hospital environments. Advancements in machine learning algorithms and clinical decision support systems not only assist pharmacists in selecting optimal therapeutic regimens and detecting drug-drug interactions but also facilitate the delivery of personalized patient care and prediction of medication needs. In addition, AI integration was shown to improve workflow efficiency, reduce administrative workload, and enhance both pharmacist training and job satisfaction. In conclusion, the integration of AI into clinical pharmacy and hospital settings emerges as a transformative factor, promising to elevate the quality of pharmaceutical care, improve patient outcomes, and shape a more dynamic and efficient future for the pharmacy profession.

Objective: Mobile health (mHealth) applications are widely acknowledged as beneficial interventions for enhancing medication adherence in patients with chronic conditions, including type 2 diabetes mellitus (T2DM). Despite the extensive smartphone prevalence in Saudi Arabia, the practical utilization of mHealth applications for diabetes self-management remains constrained. This study aimed to investigate the attitudes, willingness, and obstacles regarding the use of mHealth applications for medication adherence among patients with type 2 diabetes mellitus in Saudi Arabia.

Methods: A cross-sectional study was performed with 489 adult patients with type 2 diabetes mellitus across healthcare facilities and digital platforms in Saudi Arabia. The questionnaire had five domains: demographics, technological utilization, attitudes, willingness, and perceived obstacles. Descriptive analyses were conducted with SPSS.

Findings: The majority of participants had a favorable disposition toward mHealth tools. The majority concurred that applications may facilitate adherence and favored interfaces in Arabic. Whereas 71.0% indicated a readiness to utilize mHealth, barely 37.0% were actively employing such applications. Principal obstacles encompassed forgetfulness, feelings of being overwhelmed, adverse effects, financial constraints, and restricted digital accessibility. Cultural and behavioral factors, including the utilization of herbal treatments and religious considerations, also impacted app usage.

Conclusion: mHealth possesses significant potential to enhance medication adherence among Saudi patients with type 2 diabetes mellitus. However, successful implementation relies on overcoming behavioral, cultural, and infrastructural obstacles. These findings underscore the necessity for customized, Arabic-compatible digital health solutions that match with the objectives of Saudi Vision 2030.

Objective: In many emerging economies, simple cost-plus markups push medicine prices far above reference benchmarks, undermining affordability and access. Iran exemplifies this problem, with a public sector median price ratio (MPR) of 6.70 - nearly seven times the reference price - and an out-of-pocket (OOP) burden exceeding 50%. This study aims to benchmark Iran's cost-plus pricing framework against international alternatives, quantify the independent effects of cost-plus dominance and inflation on relative prices, and model policy scenarios to reduce household spending.

Methods: We compared eleven countries (high-income: Germany, France, UK; upper-middle-income: South Korea, China, Brazil, Turkey, South Africa, Thailand; lower-middle-income: Iran, India) using WHO/HAI surveys (2023) to derive public/private MPRs, OOP percentages, and availability metrics. An ordinary-least-squares regression of ln (MPR) on cost-plus dominance (binary), log GDP per capita, and consumer-price-index (CPI) inflation quantified key drivers. Scenario modeling for Iran estimated OOP impacts under (i) a 30% CPI-adjusted cap (MPR = 4.69) and (ii) an health-technology assessment (HTA)-linked value-based regime (MPR = 2.00).

Findings: Iran's cost-plus system predicts a 178% higher MPR (β = 1.02; P < 0.001); each 1% inflation adds 2% to ln (MPR) (β = 0.02; P < 0.001). Under a CPI cap, OOP falls from 52% to 35%; HTA-based pricing could halve OOP to 20%.

Conclusion: Static cost-plus pricing perpetuates catastrophic patient costs. Phased reforms - beginning with CPI-indexed ceilings and advancing to HTA-driven value pricing - can transform unaffordable systems into sustainable, equitable models for emerging markets.

Objective: Methadone treatment is effective for managing opioid use disorder (OUD) but raises concerns about its impact on cardiac function. This study aimed to assess the prevalence of cardiac dysfunction among individuals under methadone treatment.

Methods: This cross-sectional study involved 200 OUD patients admitted to addiction treatment centers of Kerman, Iran, who were at least 1 year under methadone maintenance therapy. Participants were enrolled using a convenience sampling method. Exclusion criteria included concurrent alcohol or nonopioid drug abuse, underlying diseases affecting cardiac function (diabetes, hypertension, and chronic renal failure), hepatic diseases, or use of drugs affecting methadone metabolism. Data on methadone dose, treatment duration, and cardiac parameters assessed through echocardiography and electrocardiography were collected.

Findings: A total of 200 OUD patients aged 46.34 ± 13.93 years (72% male) were included. The average duration of methadone use was 2.17 ± 1.34 years, and the average dose was 52.10 ± 27.46 mg/day. 38% of subjects had QT prolongation, while echocardiographic assessment revealed various cardiac abnormalities: 17.5% with systolic dysfunction, 12.5% with abnormal left ventricular end-diastolic diameter, 66.5% with diastolic dysfunction, and 15.5% with increased systolic pulmonary artery pressure. Significant correlations were observed between methadone dose and duration with all measured cardiac parameters.

Conclusion: This study demonstrated an association between methadone treatment characteristics (higher dose and longer duration) and cardiac dysfunction. These findings suggest dose- and time-dependent cardiotoxic effects of methadone. Clinicians should implement cardiac monitoring, dose minimization, and risk-reduction strategies for patients on long-term methadone therapy.

Objective: This study investigated the impact of soft skills on the performance of medical representatives (MRs), aimed to identify key competencies deemed essential for success, and explored effective training methods to develop these skills.

Methods: A cross-sectional survey was designed to gather insights from leaders across various departments in Saudi pharmaceutical companies, including sales, marketing, medical affairs, and human resources (HR). Using purposive non-probability sampling, the survey was distributed to 80 potential participants through email and LinkedIn. Data were analyzed using descriptive statistics and thematic analysis of open-ended responses.

Findings: Fifty-five leaders responded (69% response rate), representing diverse departments and geographic locations. Communication skills and emotional intelligence were ranked as the most critical soft skills (mean ratings: 4.8 ± 0.4 and 4.7 ± 0.5 out of 5, respectively), followed by negotiation (4.6 ± 0.6), problem-solving (4.5 ± 0.5), and time management (4.4 ± 0.6). The majority (96.4% [n = 53]) of respondents agreed that MRs with strong soft skills perform better, particularly in client interaction (mean impact: 4.9 ± 0.3) and relationship building (4.8 ± 0.4). Managerial performance reviews (74.1%, n = 40) and sales growth (70.4%, n = 38) were identified as the primary metrics for evaluating soft skills. Communication workshops (83.6%, n = 46) and role-playing sessions (72.7%, n = 40) were deemed the most effective training methods. However, challenges such as time constraints (50.9%, n = 28), lack of employee interest (43.6%, n = 24), and resistance to change (41.8%, n = 23) were identified as significant barriers to skill development.

Conclusion: This study underscores the pivotal role of soft skills in enhancing employee performance and driving business success in Saudi Arabia's pharmaceutical industry. It highlights the need for structured training programs during onboarding and continuous development to equip MRs with essential soft skills. The findings offer actionable insights for leaders and HR professionals, paving the way for further research in this domain.

Objective: The services of pharmacists in the hospital go beyond the distribution of medicine, and today, it means the role of pharmacists in the optimal use of medicines by patients and improving their health outcomes. The purpose of this research is to monitor pharmaceutical services in the inpatient departments of Imam Hossein Hospital using a standardized authoring tool.

Methods: In this research, two questionnaires were compiled and validated, and different departments of Imam Hossein Hospital in Tehran, which is the largest tertiary hospital in Iran, were monitored in terms of pharmaceutical services. Correct answers below 50% were classified as "Inappropriate," between 50% and 70% as "Relatively Appropriate" and above 70% as "Appropriate."

Findings: The findings indicate that the highest risk points included absence of drug combination at the beginning of the patient's hospitalization in all departments, absence of drug calculation tables in 90%, absence of control protocol for the abuse of narcotic drugs and their prescription in 90%, absence of quick preparation guide and how to use injectable medicines in 80%, absence of stock list in 75%, and the absence of a control protocol for controlled medicines in 60% of inpatient departments.

Conclusion: The study conducted is the first comprehensive study of monitoring pharmaceutical services in hospital wards. The unique features of this study, such as the breadth, comprehensiveness and selection of the largest medical, educational and therapeutic center, and the largest tertiary hospital in Iran, can be generalized to all hospitals and benefit from it.

Objective: This study evaluated pharmacists' and pharmacy technicians' knowledge, attitudes, and practices (KAPs) regarding pharmacovigilance and adverse drug reaction (ADR) reporting at a tertiary care facility in Saudi Arabia. It also sought to identify the barriers to ADR reporting and propose strategies to improve pharmacovigilance practices. This study is timely given recent initiatives by the Saudi Vision 2030 to strengthen medication safety practices nationwide.

Methods: A cross-sectional survey was conducted among pharmacists and pharmacy technicians at a tertiary care hospital in Saudi Arabia. A structured, self-administered questionnaire collected data on participants' KAPs regarding pharmacovigilance. Descriptive and inferential statistical analyses were conducted to identify the trends and associations between demographic variables and KAP scores.

Findings: A total of 200 healthcare professionals participated in the study. While 87% of participants were aware of pharmacovigilance and 91% were familiar with ADRs, only 47.5% had ever reported an ADR. Positive attitudes were observed, with 94% agreeing that ADR reporting is an essential role of pharmacists and 90% supporting its inclusion in pharmacy curricula. However, key barriers to ADR reporting included lack of time (65%), insufficient training (58%), and uncertainty about reporting procedures (49%). Significant associations were found between knowledge levels, age, gender, and educational qualifications (P < 0.05).

Conclusion: Despite high levels of knowledge and positive attitudes, ADR reporting practices remain suboptimal due to structural and procedural barriers. To enhance pharmacovigilance practices in Saudi Arabia, targeted training programs, simplified reporting systems, and mandatory reporting policies are recommended.

Objective: Medication Decision Support Systems (MDSS) are increasingly integrated into hospital information systems to reduce prescribing errors and enhance evidence-based clinical decision-making. This study evaluates the effect of MDSS implementation on albumin prescribing in two intensive care units (ICUs) at Imam Reza Hospital, Mashhad, Iran.

Methods: A quasi-experimental pre-post design was applied. Albumin prescription data were collected over two 3-month phases, before and after MDSS implementation. Total population sampling was used. Statistical analyses included Chi-square and independent-sample t-tests to assess differences in guideline adherence, alert responsiveness, and patient safety. P < 0.05 was considered significant, and 95% confidence intervals were reported where applicable.

Findings: A total of 311 albumin prescription requests were reviewed. Following MDSS implementation, 60.15% of alerts led to prescription modification. Guideline adherence improved significantly (from 47.64% to 68.26%, P = 0.014), and patient safety rates increased (63.33% to 82.61%, P = 0.009). Alert responsiveness was highest in critical conditions such as acute respiratory distress syndrome and lowest in elective scenarios such as paracentesis.

Conclusion: MDSS significantly improved guideline adherence and prescribing quality in ICU settings. However, system limitations such as alert fatigue and physician override in specific scenarios remain. Further research is warranted to evaluate MDSS scalability, long-term clinical impact, and application to broader drug categories.

Objective: Paclitaxel-induced peripheral neuropathy (PIPN) is a disabling condition that leads to discontinuation or dose reduction of chemotherapy and reduces the patient's quality of life (QOL). We investigated the effect of N-acetylcysteine (NAC) in preventing PIPN.

Methods: This study was a randomized, double-blind, and placebo-controlled clinical trial conducted at a chemotherapy center of Mazandaran University of Medical Sciences. Breast cancer patients receiving the Adriamycin/Cyclophosphamide-Taxol regimen were enrolled. All patients received 1200 mg NAC or placebo in two doses before each cycle of paclitaxel. Response to treatment was assessed based on improvements in the Numeric Pain Rating Scale (NRS), NCI-CTCAE, NPS, FACT/GOG-Ntx, and EORTC-QLQ. Two blood samples were taken at baseline and last cycle to determine the oxidative factors.

Findings: Sixty patients were enrolled. At the last cycle, changes in NRS were decreasing in the NAC group but increasing in the placebo group. Thirteen patients (44.8%) in the NAC group and only one patient (3.4%) in the placebo group still reported no neuropathy in the end. A significant difference was observed between the two groups in the Ntx subscale and the Fact-G total score at the last cycle (P < 0.001). The QOL increased in the NAC and decreased in the placebo group. Glutathione levels, MDA, and TAC differed significantly between the two groups (P < 0.001, <0.001, and 0.04, respectively), but no significant difference in NO levels (P = 0.5).

Conclusion: Oral NAC at a dose of 1200 mg daily for two doses can reduce the incidence and severity of PIPN and improve patients' QOL.