Pharmacy最新文献

This narrative review seeks to delve into the different on and off-label medications commonly used with intrathecal drug delivery systems (IDDS) and their clinical applications specifically in pain management settings. This review utilizes a variety of studies including reviews, retrospective chart analyses, and more to analyze the current effectiveness of various pharmacological agents on reducing chronic pain through IDDS. The initial results of intrathecal delivery of these medications have provided benefit in pain reduction and overall patient satisfaction; however, this review will seek to analyze the current data and understanding and suggest areas of strength and improvement within the field and our current understanding.

Objective: This study aims to evaluate pharmacy students' perceptions regarding the integration of generative artificial intelligence (GenAI) into pharmacy curricula, providing evidence to inform future curriculum development. Methods: A cross-sectional survey of Doctor of Pharmacy (PharmD) students at a single U.S. College of Pharmacy was conducted in April 2025. Students from all four professional years (P1-P4) were invited to participate. The 10-item survey assessed four domains: (1) General GenAI Use, (2) Knowledge and Experience with GenAI Tools, (3) Learning Preferences with GenAI, and (4) Perspectives on GenAI in the curriculum. Results: A total of 110 students responded (response rate = 12.4%). Most were P1 students (56/110, 50.9%). Many reported using GenAI tools for personal (65/110, 59.1%) and school-related purposes (64/110, 58.1%) sometimes, often, or frequently. ChatGPT was the most used tool. While 40% (40/99) agreed or strongly agreed that GenAI could enhance their learning, 62.6% (62/99) preferred traditional teaching methods. Open-ended responses (n = 25) reflected a mix of positive, neutral, and negative views on GenAI in education. Conclusions: Many pharmacy students in this cohort reported using GenAI tools and demonstrated a basic understanding of GenAI functions, yet students also reported that they preferred traditional learning methods and expressed mixed views on incorporating GenAI into teaching. These findings provide valuable insights for faculty and schools of pharmacy as they develop strategies to integrate GenAI into pharmacy education.

The increasing use of multiple medications among older adults raises concerns about potentially inappropriate medications (PIMs), which are associated with adverse health outcomes and increased healthcare costs. This study aimed to assess the prevalence and types of PIMs dispensed to older adults living in Northwest Italy using real-world pharmacy claims data. An observational, retrospective analysis was conducted on anonymized drug dispensing datasets from two local health authorities, covering individuals aged 65 years or older between 2018 and 2021. PIMs were identified according to the 2019 American Geriatrics Society Beers Criteria, focusing on drugs that are inappropriate or should be used with caution in older adults or have anticholinergic properties. Over half of older adults who received medications during the study period were dispensed at least one PIM, with stable or slight increased prevalence over time with no differences by sex or region. Proton-pump inhibitors used for more than 8 weeks and paroxetine were the most common PIMs, while furosemide and sulfonylureas were also frequently reported PIMs. These findings indicate a persistently high burden of inappropriate prescribing in older adults and highlight the need for coordinated deprescribing interventions and prescriber education to promote safer, evidence-based pharmacotherapy in aging populations.

The task of repackaging resident's medication into medication organizers is increasingly outsourced from nursing homes to pharmacies, presenting an opportunity to redefine the interaction between nursing and pharmaceutical staff. This study investigated whether outsourcing medication repackaging changes the quality and subjects of collaboration between the two professions. A cross-sectional survey was developed targeting heads of nursing in German nursing homes. A simple random sample of 1415 nursing homes was contacted by phone. Respondents participated either by phone or by online survey. Quality of collaboration was measured using Kenaszchuk's Interprofessional Collaboration Scale (ICS) with its subscales Communication, Accommodation and Isolation. Topics of interaction were ascertained using items along a medication management phase model. Differences in response frequencies were analyzed using Fisher's exact test. A total of 268 nursing homes participated (response: 18.9%). Of these, 132 (49.3%) had outsourced repackaging. Respondents at nursing homes with in-house medication repackaging rated the subscale Accommodation more favorably (p = 0.008), while Communication and Isolation showed no difference. Of the 13 individual ICS items, "passing on information" (Communication) was rated better by respondents at homes with outsourced repackaging (p = 0.019) and "consideration of convenience" (Accommodation) more favorably by respondents at homes with in-house repackaging (p = 0.042). Nursing staff at homes with outsourced medication repackaging interacted with pharmaceutical staff more frequently on medication changes (p < 0.001), but less frequently on tablet splitting (p = 0.035). In conclusion, outsourcing medication repackaging has a limited impact on the quality of interprofessional collaboration between the two professions but may have the potential to reduce ambiguities regarding splitting tablets.

Introduction: During pharmaceutical care, community pharmacists play a crucial role by carrying out interventions aimed at preventing, detecting, and resolving drug-related problems (DRPs) and negative outcomes associated with medication (NOM), simultaneously enhancing patients' knowledge about their treatments. The chronic use of Benzodiazepines (BZDs) is known to be associated with risks such as tolerance, dependence, and cognitive impairment. Furthermore, the combined use of BZDs with other medications or alcohol may expose patients to significant drug interactions.

Objectives: This study aimed to characterize and describe the clinical profile of patients using BZDs, to evaluate the extent of polypharmacy and potential drug interactions, to investigate their level of knowledge regarding BZD treatment, and ultimately, to propose evidence-based interventions from the community pharmacy to contribute to improving patient safety and minimizing risks associated with BZD use.

Method: A cross-sectional, descriptive study was conducted in a single community pharmacy in Gran Canaria (Canary Islands, Spain). The study population comprised 125 adult patients with active BZD prescriptions. Data collection was performed through pharmacist-patient structured interviews using a questionnaire that included sociodemographic, clinical, and BZD knowledge variables.

Results: Lormetazepam and alprazolam were the BZDs most frequently prescribed and dispensed. Potential drug interactions with other medications were detected in 38.4% of BZD users. Notably, 61.5% of patients using BZDs also reported the concurrent use of opioid analgesics, with tramadol being the most common opioid (48.1% of BZD users were also treated with tramadol). Statistically significant differences were observed between patients with and without BZD and other drug interactions in several adverse outcome variables, including the risk of falls (p = 0.003), cognitive impairment (p = 0.047), and urinary incontinence (p = 0.016). Existing BZD dependence is detected in 25% and 22.1% of cases, respectively. Patients' knowledge of their BZD treatment revealed critical gaps, which are identified as a challenge and a clear opportunity for intervention through pharmaceutical care services.

Conclusions: The findings underscore the essential and proactive role of community pharmacists in identifying and managing drug interactions, as well as in supporting deprescribing strategies through collaborative and interprofessional care models.

As one of the biggest challenges for healthcare in the 21st century, COVID-19 placed a sustained and intense demand on the European Medicines Agency's resources and required constant adaptation and mobilization of different regulatory processes. In this situation, drug repurposing appeared as a promising potential approach in quickly emerging health crises due to its main advantage of reducing the time and cost for addition of new indications since it uses products proven to be of high quality, safe, and effective. We performed an analysis of European Public Assessment Reports for medicinal products authorized for the SARS-CoV-2 infection by the European Medicines Agency, showing a total of eight products with this indication, three (37.5%) of which used repurposing as a mechanism for development (remdesivir, tocilizumab, and anakinra). The application of this mechanism by these medicines highlights the importance of the life cycle stage at which repositioning is undertaken, which resulted in different volumes of data submitted in the respective European Public Assessment Reports. The participation of organizations other than the marketing authorization holder in key stages in the drug development process of repurposed products was once again confirmed, which emphasizes the need to regulate this interaction.

Chronic obstructive pulmonary disease (COPD) is a major global health burden. The fluticasone furoate (FF)/umeclidinium (UMEC)/vilanterol (VI) triple therapy provides new treatment, but its long-term real-world safety lacks evidence. A post-marketing analysis used the FAERS database to identify adverse event (AE) signals for FF/UMEC/VI. Disproportionality methods including reporting odds ratio (ROR), proportional reporting ratio (PRR), information component (IC), and empirical Bayesian geometric mean (EBGM), were applied to detect AE signals, focusing on reports from third quarter (Q3) 2019 to Q3 2024. Among 16,238 reports listing FF/UMEC/VI as primary suspect, significant AE signals occurred in 'injury, poisoning and procedural complications' (n = 9067, ROR 2.46, PRR 2.08, IC 1.06, EBGM 2.08), and 'respiratory, thoracic and mediastinal disorders' (n = 6567, ROR 4.87, PRR 4.15, IC 2.05, EBGM 4.13). A total of 196 significantly disproportionate preferred terms (PTs) were identified, including previously undocumented AEs such as chronic eosinophilic rhinosinusitis, dysphonia, and vocal cord dysfunction. This post-marketing safety study revealed significant signals for dysphonia and vocal cord dysfunction associated with FF/UMEC/VI, suggesting that clinicians should remain vigilant for these events.

The transition toward wide-scale use of single-dose administration systems such as prefilled syringes has primarily occurred in high-income countries due to economic considerations. This has resulted in a disparity of access to such technologies in low- and middle-income countries, which continue to utilize multi-dose vial-based presentations and syringes for parenteral delivery. Single-dose innovations currently available or in the product development pipeline represent the promise of enhanced access globally and the potential for public health impact. This perspective article discusses the reported benefits of pre-filled single-dose delivery systems compared to multi-dose vials, as well as the higher standards of infection control regulations and practices that resulted in the increasing use of and benefit from single-dose administration systems in high-income countries. We evaluated how these benefits and standards could enhance health initiatives in low- and middle-income countries. Finally, we explored the potential for making pre-filled single-dose delivery methods both accessible and affordable in low- and middle-income countries.

Background: Telepharmacy consultations (TPCs) became a routine element of pharmacy operations. However, there is limited data available on local pharmacy customer feedback related to TPC. Methods: A customer survey was developed seeking feedback on TPC. The pharmacy customers were invited to complete the survey in two local pharmacies in Germany. The survey and corresponding informed consent form were approved by the Ethics Committee. Results: In total, 178 pharmacy customers were enrolled (median age 41-50 years). From those, 37% agreed when asked whether they were generally interested in TPC. A total of 37% had the nearest pharmacy 5-15 min from their home. A total of 42% visited their pharmacy quarterly. A total of 36% used technical devices in median 1-2 h per days. A total of 33% classified their own digital skills at least as sufficient. A total of 59% would use their smartphone as a potential device for TPC. A total of 83% rated it as (slightly) important that the pharmacist providing TPC can be heard clearly. A total of 76% each (strongly) agreed that an argument for TPC would include limited mobility or pandemic/quarantine. A total of 33% (strongly) agreed that a key argument against TPC were technical requirements. A total of 75% considered situations of immobility to be the most important future perspective for TPC. Conclusions: Many pharmacy customers see TPC as an opportunity, e.g., in cases of limited mobility or during pandemic or quarantine. However, the use of appropriate technology can be a limiting factor.

Preventable medication harm in oncology is often driven by drug-related adverse events (AEs) that trigger order changes such as holds, dose reductions, delays, rechallenges, and enhanced monitoring. Much of the evidence needed to make these decisions lives in unstructured clinical texts, where large language models (LLMs), a type of artificial intelligence (AI), now offer extraction and reasoning capabilities. In this narrative review, we synthesize empirical studies evaluating LLMs and related NLP systems applied to clinical text for oncology AEs, focusing on three decision-linked tasks: (i) AE detection from clinical documentation, (ii) Common Terminology Criteria for Adverse Events (CTCAE) grade assignment, and (iii) grade-aligned actions. We also consider how these findings can inform pharmacist-facing recommendations for order-level safety. We conducted a narrative review of English-language studies indexed in PubMed, Ovid MEDLINE, and Embase. Eligible studies used LLMs on clinical narratives and/or authoritative guidance as model inputs or reference standards; non-text modalities and non-empirical articles were excluded. Nineteen studies met inclusion criteria. LLMs showed the potential to detect oncology AEs from routine notes and often outperformed diagnosis codes for surveillance and cohort construction. CTCAE grading was feasible but less stable than detection; performance improved when outputs were constrained to CTCAE terms/grades, temporally anchored, and aggregated at the patient level. Direct evaluation of grade-aligned actions was uncommon; most studies reported proxies (e.g., steroid initiation or drug discontinuation) rather than formal grade-to-action correctness. While prospective, real-world impact reporting remained sparse, several studies quantified scale advantages and time savings, supporting an initial role as high-recall triage with pharmacist adjudication. Overall, the evidence supports near-term, pharmacist-in-the-loop use of AI for AE surveillance and review, with CTCAE-structured, citation-backed outputs delivered into the pharmacist's electronic health record order-verification workspace as reviewable artifacts. Future work must standardize reporting and CTCAE/version usage, and measure grade-to-action correctness prospectively, to advance toward order-level decision support.