Pharmacy最新文献

Foundational biomedical sciences are commonly taught without routine integration of local population health contexts, limiting students' ability to connect mechanisms to community disease burden and practice responsibilities. In this method paper, we developed and piloted an AI-enabled "Sacramento County Public Health (SACPH)" AI workflow and app prototype, a structured, faculty-authored prompt sequence designed to guide population-to-practice reasoning using publicly available data. The workflow was implemented during a TBL session with first-year PharmD students in an immunology course. Using splenectomy and risk of overwhelming post-splenectomy infection (OPSI) as an illustrative use case, students executed a standardized prompt sequence addressing data source identification, coding logic (diagnosis vs. procedure codes), population-level estimation with uncertainty framing, and translation to pharmacist-relevant prevention and counseling implications. Feasibility was defined by conceptual convergence. The validated reasoning workflow was subsequently translated into a prototype, app-style interface using generative design prompts. Across student teams, outputs converged on similar categories, consistent recognition of coding frameworks and verification steps, and directionally similar interpretations of local burden and pharmacist responsibilities. The prototype demonstrated successful externalization of the reasoning workflow into a modular, reproducible artifact. SACPH demonstrates a feasible, reproducible method for using generative AI to integrate foundational science instruction with local population health context and pharmacist practice reasoning, while supporting AI literacy competencies.

Psychosis is a frequent and disabling non-motor complication of Parkinson's disease (PD). Clozapine and quetiapine are widely used in the treatment of Parkinson's disease psychosis (PDP). We conducted an exploratory study to compare patient experiences with physician prescribing practices. Patients with PDP hospitalized at a university center completed semi-structured interviews on perceived efficacy, adverse effects, and daily functioning. Neurologists and geriatricians attending training sessions completed a structured questionnaire on prescribing patterns, attitudes toward clozapine, and perceived treatment burden. Data were analyzed thematically and triangulated across cohorts. Eleven patients (mean age 81 years; nine treated with quetiapine, two with clozapine) were included. Most quetiapine-treated patients reported persistent hallucinations, sedation, dizziness, and reduced autonomy. Fourteen physicians completed the survey and most preferred quetiapine, citing monitoring logistics and agranulocytosis risk as barriers to clozapine. Overall, patient priorities centered on symptom control and independence, whereas physician decisions emphasized feasibility and safety. Facilitating clozapine monitoring and incorporating patient-reported outcomes into routine care may improve patient-centered PDP management.

Artificial Intelligence (AI) has increasingly contributed to advancements in pharmaceutical practice, particularly by enhancing the pharmacist-patient relationship and improving medication adherence. This quantitative, descriptive, cross-sectional study investigated Eastern Romanian pharmacists' perception of AI-based applications as effective optimization tools, correlating it with disruptive communication factors. An anonymous and online questionnaire was distributed to community pharmacists, examining sociodemographic characteristics, awareness of disruptive factors, and the perceived usefulness of AI. The sample included 437 respondents: pharmacists (55.6%), mostly female (83.8%), and aged between 25 and 44 (52.6%). Data analysis involved descriptive statistics and independent t-tests. The statistical analysis revealed a significantly positive perception (p < 0.001) of AI on pharmacist-patient communication. Respondents viewed AI as a valuable tool for reducing medication errors and optimizing counseling time, though they maintain a strong emphasis on genuine human interaction. Significant correlations were found between disruptive factors-such as noise and high patient volume-and the quality of communication. Participants also expressed an increased interest in applications like automatic prescription scheduling and the use of chatbots. The study concludes that a balanced implementation of AI technologies is necessary, one that runs parallel with the continuous development of pharmacists' communication skills. Future research should focus on validating AI's impact on clinical outcomes and establishing clear ethical guidelines regarding the use of patient data.

People with intellectual disabilities frequently use psychotropic and other medications, sometimes inappropriately. To promote shared decision-making, they require accessible information about their medication. This study combined data from two similar intervention studies, conducted in two different settings, to assess the appropriateness of medication use and the shared decision-making process among adults with mild intellectual disabilities who used psychotropic medication. The intervention consisted of a structured, multidisciplinary medication review, including the provision of accessible psychotropic medication leaflets, and a discussion of the pharmacotherapeutic treatment plan with the patient by either a pharmacist or physician, depending on the setting. Outcomes included medication use, pharmacotherapeutic problems, implementation of recommendations, and perceived shared decision-making, measured with the Shared Decision-Making Questionnaire Q9. The 15 included participants used an average of nearly seven medications, which were mainly neurotropic, gastrointestinal, cardiovascular, and respiratory agents. On average, two pharmacotherapeutic problems were identified; the most common were overtreatment, side effects, and administration difficulties. Recommendations often involved dose reduction or tapering, and about 75% were fully or partially implemented. Both participants and clinicians reported high satisfaction with shared decision-making. Multidisciplinary, structured medication reviews, incorporating accessible medication leaflets, may enhance appropriate medication use and shared decision-making, but more research is needed.

Substance use disorder (SUD) is a chronic and clinically complex condition, frequently complicated by significant organic and psychiatric comorbidities. Most patients are polymedicated and require opioid substitution programs (OSPs). This complexity is further exacerbated by drug-drug interactions, therapeutic duplication, and fragmentation of the healthcare system. This retrospective observational study analyses the prevalence of polypharmacy and associated pharmacotherapeutic risks in a cohort of 1050 patients with SUD treated at Drug Care Units (DCUs) in Tenerife (Canary Islands, Spain). Prescriptions were dominated by methadone (62%), antidepressants, and antipsychotics, often in combination with benzodiazepines. Significant polypharmacy (>10 active prescriptions) was observed in 2.3% of patients, while 8.1% received 6-10 medications and 37.2% were using 2-5 medications. Women showed a higher pharmacological burden, with 3.5% experiencing significant polypharmacy (>10 different prescriptions) compared with 1.1% of men. Overall, 31% of patients received antidepressants, 31% were treated with antipsychotics-frequently with concurrent use of multiple agents-and 6.4% received opioids outside the OSP. Therapeutic duplication was observed in 15.6% of patients for psycholeptics, 14.2% for psychoanaleptics, and 3.2% for antiepileptics. Additionally, 25.2% of patients reported self-medication, predominantly with benzodiazepines. These findings underscore the need for integrated pharmaceutical care programs incorporating individualized therapeutic review and deprescribing strategies to enhance the safety and efficacy of SUD treatment.

Opioid overdoses in the United States remain a significant public health concern. Opioid use disorder (OUD) is stigmatized, exacerbating negative health outcomes. Reducing stigma in healthcare, including in pharmacies, is critical. The "Let's Talk Stigma" program was collaboratively developed with two schools of pharmacy, a local health department, and individuals with lived drug use experience. It aimed to reduce OUD-related stigma among pharmacists, pharmacy technicians, student pharmacists, and other allied health professionals. The program included six core components: a podcast, continuing education, a standardized curriculum for student pharmacists, training for pharmacy technicians and medical assistants, pharmacy outreach by student pharmacists, and partnerships with chain pharmacies. The anti-stigma podcast reached a global audience with nearly 22,000 listens, while local sessions engaged over 5000 individuals. These initiatives were integrated into Doctor of Pharmacy curricula, with student pharmacists distributing stigma-reduction kits in local pharmacies. A mixed-methods approach, incorporating qualitative data from participant reflections and quantitative data from surveys, podcast analytics, and attendance records, was used for program evaluation. Participants reported increased awareness of stigma, improved attitudes, and greater professional responsibility to reduce stigma. The program successfully leveraged partnerships, flexible delivery methods, and inclusion of people with lived drug use experience in its design.

Background: Pediatric patients often receive medicines manipulated from adult formulations due to a lack of age-appropriate products. While such practices are clinically routine, they may reflect deeper systemic deficiencies in pediatric pharmacotherapy.

Objective: This scoping review aimed to map the prevalence, definitions, and types of pediatric drug manipulation and to conceptualize manipulation as an indicator of structural gaps in formulation science, regulation, and access.

Methods: A systematic search of PubMed (January 2014-July 2024) included 10 studies reporting the frequency of drug manipulation in children aged ≤18 years. Eligible studies were synthesized narratively according to PRISMA-ScR guidelines.

Results: Ten studies from nine countries were included, reporting manipulation frequencies ranging from 6.4% to 62% of all drug administrations and up to 60% at the patient level. Manipulated formulations most commonly included oral solid doses, altered through dispersing, splitting, or crushing. Definitions and methodologies varied considerably. The findings revealed five recurring structural gaps: limited pediatric formulations, inconsistent regulatory implementation, lack of standardized definitions and guidance, insufficient evidence on manipulation safety, and inequitable access across regions.

Conclusion: Manipulation of finished dosage forms for use in children is a widespread, measurable phenomenon reflecting systemic inadequacies in formulation development, regulation, and access. Recognizing manipulation as a structural indicator may guide policy, innovation, and equitable pediatric pharmacotherapy worldwide.

This study evaluated the accuracy and educational potential of three generative AI models, ChatGPT 3.5, ChatGPT 4o, and Gemini 2.5, by addressing pharmacy-related content across three key areas: biostatistics, pharmaceutical calculations, and therapeutics. A total of 120 exam-style questions, categorized by Bloom's Taxonomy levels (Remember, Understand, Apply, and Analyze), were administered to each model. Overall, the AI models achieved a combined accuracy rate of 77.5%, with ChatGPT 4o consistently outperforming ChatGPT 3.5 and Gemini 2.5. The highest accuracy was observed in therapeutics (83.3%), followed by biostatistics (81.7%) and calculations (67.5%). Performance was strongest at lower Bloom levels, reflecting proficiency in recall and conceptual understanding, but declined at higher levels requiring analytical reasoning. These findings suggest that generative AI tools can serve as effective supplementary aids for pharmacy education, particularly for conceptual learning and review. However, their limitations in quantitative and higher-order reasoning highlight the need for guided use and faculty oversight. Future research should expand to additional subject areas and assess longitudinal learning outcomes to better understand AI's role in improving critical thinking and professional competence among pharmacy students.