Pharmacy最新文献

Sustaining a well-designed healthcare intervention justifies the resources allocated during its conceptualization and implementation and maximizes its clinical benefits, but staff influences on sustainment have been studied insufficiently. This study evaluates the effects of pharmacy staff (i.e., pharmacists/technicians) perceptions about the sustainability of Senior Safe^TM, a U.S. pharmacy-based intervention to reduce older adult over-the-counter (OTC) medication misuse. Three months after introducing Senior Safe into 67 pharmacies in a large Midwestern health-system, all pharmacy staff (N = 279) received a survey invitation. Fifty-nine pharmacists and 94 technicians completed the survey. Using logistic regression modeling for the 14 belief-based survey items, and staff roles (pharmacist or technician), the final factors significantly predicting staff views that Senior Safe was sustainable were as follows: perceiving Senior Safe as well-integrated into leadership operations (OR = 5.606, p < 0.001) and believing the intervention reduced OTC misuse (OR = 8.217, p < 0.001). Also, technicians were more confident than pharmacists about Senior Safe's sustainment and its OTC misuse reduction success. Overall, an intervention's sustainability relies on those using it. Since the principal predictor of maintaining Senior Safe was its perceived effectiveness, increasing staff buy-in and awareness of an intervention's benefits may be central to its long-term viability. With an aging U.S. population, sustainable solutions to older adult medication misuse remain critical.

Background: Community pharmacies are increasingly delivering structured services to support chronic disease management, such as Multidose Drug Dispensing (MDD). This strategy can improve adherence and safety, but evidence of its economic feasibility in Portuguese pharmacies remains limited.

Objective: To estimate the cost of implementing and operating an MDD system in a community pharmacy, informing reimbursement models and policy.

Methods: A micro-costing approach assessed fixed and variable expenses for serving polymedicated elderly patients. Costs were calculated in euros (2024/2025) and expressed per working day based on 253 annual preparation days.

Results: First-year costs totaled €70,985.68, including €8184.00 for setup, €21,579.00 for supplies, and €41,222.68 for staff salaries. The daily operating cost was €280.58, with labour representing the major expense. A break-even analysis indicated sustainability with around 700 users at €10/month.

Conclusion: Although requiring significant initial investment, MDD can become financially viable through scaling, workflow efficiency, and supportive reimbursement strategies.

Introduction: Cancer pain remains a critical issue for patients' quality of life, affecting their physiology, psychology, and social relationships. Despite the widely recognized role of pharmacists in pain management, their involvement in palliative care in Greece remains limited. This study focuses on exploring the perceptions and experiences of pharmacists regarding their role in cancer pain management, identifying barriers, required skills, and proposing strategies for their integration in the multidisciplinary team. Μaterials and Μethods: Qualitative research was conducted through semi-structured interviews with seven pharmacists in the Attica region. The interviews were recorded, transcribed, and thematically analyzed. Results: The analysis revealed four main themes: (1) limited access to medical records and challenges in pharmaceutical decision-making, (2) lack of institutional frameworks and a culture of collaboration, (3) need for specialized education and continuous training, and (4) understaffing and bureaucracy, faced by pharmacists. Discussion: This study highlights the underutilized role of pharmacists in cancer pain management in Greece. Barriers such as restricted access to patient records, weak interdisciplinary collaboration, insufficient training, and bureaucratic constraints limit their contribution. Structured frameworks and collaborative cultures can enhance pharmacists' involvement, while education and continuous training are essential to strengthen their legitimacy within care teams. Digital tools can improve access to patient information and support evidence-based decisions. Conclusions: Pharmacists' integration in the patient's management team has significant benefits for the patient's quality of life. Strengthening pharmacists' involvement in cancer pain management requires the establishment of collaborations, continuous education, bureaucratic simplification, and the integration of digital tools. The development of practical resources, such as educational guides, can play a pivotal role in enhancing the quality of care provided.

Standardized pharmacist intervention practices and documentation among health-system specialty pharmacies could improve understanding of the pharmacists' role and value in this setting. This study describes current health-system specialty pharmacies' intervention practices. A survey developed by a volunteer committee subgroup was distributed to two health-system specialty pharmacy group email distribution lists. The survey evaluated the types of tasks considered to be clinical or non-clinical interventions; who could perform interventions; where and how they were documented; data elements included in documentation; and how intervention data were classified, used, reviewed, and shared with internal or external stakeholders. Twenty-four institutions responded to the survey. Tasks within medication management, adverse drug events/monitoring, and education domains were more commonly considered clinical interventions; tasks in the health maintenance and coordination of care domains were more frequently considered non-clinical interventions or not considered to be interventions. Interventions were completed by pharmacists (at 100% of sites) and were mostly documented in the electronic health record (92%). Intervention data were primarily collected to meet accreditation purposes (96%) or for quality auditing and review (88%). No respondents shared intervention data with patients. Results demonstrate areas of alignment and variance in intervention definition and documentation among health-system specialty pharmacies.

Job satisfaction plays a critical role in shaping professional outcomes, as it has been positively associated with enhanced performance and greater motivation. Conversely, insufficient job satisfaction may contribute to higher rates of staff turnover, professional burnout, and intentions to leave the profession. The objective was to investigate job satisfaction among pharmacists educated at Umeå University in Sweden over time and to explore factors affecting job satisfaction. A survey was distributed to pharmacy graduates who had completed web-based pharmacy programs at Umeå University between 2019 and 2023. Questions regarding job satisfaction and factors related to it were included. The response rate was 38%. The results were compared with results from a previous investigation (graduation years 2015-2018) to enable comparisons over time. Compared to findings from the previous survey, job satisfaction was lower in the present study (76.4% vs. 91.4%, p = 0.004). Both greater opportunities for continuing professional development (CPD) and the perception that the knowledge and skills gained during education are beneficial in the current job were associated with high job satisfaction (OR: 5.360; 95% CI: 1.896-15.156 and OR: 3.983; 95% CI: 1.255-12.642, respectively). Understanding factors contributing to job satisfaction can help employers improve retention and work environment.

Frailty among older adults heightens their risk of negative health outcomes, and medication use plays a major role in this increased vulnerability. Various aspects of medication use elevate the risk of poor outcomes in individuals with frailty. The current scoping review was designed to explore medication use in older adults with frailty in primary care, focusing on the prevalence of potentially inappropriate medications (PIMs), polypharmacy, medication adherence, and their role in contributing to adverse drug events. This scoping review was conducted using the Arksey and O'Malley, supplemented by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews (PRISMA-ScR) guidelines. A search of the literature was conducted from inception to November 2023 in Ovid EMBASE, PubMed (MEDLINE), Scopus, EBSCOhost CINAHL, and Ovid International Pharmaceutical Abstracts. Studies which met the eligibility criteria included older adults with frailty (≥65 years) living at home, defined frailty criteria, and assessment of medication use. Out of the 4726 studies screened, 223 were included, conducted across 39 countries. Frailty prevalence varied widely from 0.9% to 89.2%. Polypharmacy (5-9 medications) and hyper-polypharmacy (≥10 medications) were notably more common among individuals with frailty, with polypharmacy rates ranging from 1.3% to 96.4%. Twelve studies reported PIM prevalence among individuals with varying levels of frailty, ranging from 2.4% to 95.9%. This scoping review highlights the challenges and complexities involved in understanding the relationship between medication use and frailty in older adults.

Monoclonal antibodies (mAbs) are an important medical innovation in modern medicine. They are an effective therapy for several subtypes of leukaemia but may have undesirable effects, which may be minimised through the provision of interdisciplinary care including a pharmacist. The goals of this narrative review were twofold: first, to summarise the literature on the side effects of mAbs and the challenges of their preparation, and to provide recommendations for the safe preparation of mAb drug formulations for clinicians. Second, to suggest clinical roles for pharmacists to improve patient safety and clinical outcomes for leukaemia patients receiving mAb therapy. The review covers data from 178 scientific and official sources of information on the types of targeted immunobiological drugs for the treatment of various types of leukaemia. The results are a detailed description of the possible side effects from mAb therapy and a list of suggested actions that can be taken to prevent them. Pharmaceutical aspects of the use of mAbs, such as pharmacoeconomics, compounding and stability, are also discussed. The discussion is organised according to the current classification of leukaemia. The drugs considered include blinatumomab, inotuzumab ozogamicin, gemtuzumab ozogamicin, rituximab, ofatumumab, obinutuzumab, and alemtuzumab. The review offers a comprehensive resource to equip pharmacists and other clinicians to optimise mAb therapy and promote the safe use of these novel therapies.

Chemotherapy for breast cancer includes pertuzumab and trastuzumab regimens with docetaxel (PHD) or paclitaxel (PHP). Current approaches for using supportive care drugs to manage the side effects of PHD and PHP are unclear. Here, we investigated the occurrence of side effects before and after supportive care medications were modified by discontinuing antipyretic analgesics. We retrospectively analyzed adverse events that occurred within 24 h of treating 76 patients with PHD or PHP. The frequencies of adverse effects in the groups before and after modification did not differ significantly (45.5% [15/33] and 44.2% [19/43], respectively). Severity also did not significantly differ between the groups. Therefore, discontinuing antipyretic analgesics as supportive care drugs had little effect on the frequency of side effects. Symptoms of feeling hot, pyrexic, and flushed were frequent, and their severity increased in the group after the support drugs were modified. Discontinuation of supportive care medications, including antipyretic analgesics, might affect the severity of certain symptoms and lead to the development of side effects that require medical intervention. Overall, our findings indicate the need to consider premedication with antipyretic analgesics, including further analysis of the risk factors that can predict symptoms.

Drug-drug interactions (DDIs) are one of the most common problems related to drug administration which represent a risk for patient safety. Considering their position in the healthcare system, pharmacists should be more proactively involved in DDI management. The paper shows representation of DDI intervention models in each DDI category. This research enrolled outpatients prescribed pharmacotherapies from 40 randomly selected community pharmacies. DDIs were analyzed using Lexicomp^® Lexi-InteractTM Online (Lexi-Comp, Inc., Hudson, NY, USA) software. Clinical pharmacists' panel, according to the necessary interventions, determined an independent model of pharmacist interventions (category 1) and models that require cooperation with physicians (category 2) for DDI management. In total, 4107 patients were enrolled in the study. Mean patient age was 67.5; they were mostly women (56.5%) and had on average of 3.4 diagnosis and 5.5 prescription drugs. Overall, 14,175 potential clinically significant DDIs were identified: 83.3% of C, 15.4% of D, and 1.3% of X category. At least one potential DDI was found in 78.6% of patients. Models of pharmacist DDI interventions in collaboration with a physician (category 2) were more prevalent than independent models (category 1): 57.5% vs. 42.5% in C category DDIs, 97.8% vs. 2.2% in D category, and 100% vs. 0% in category X DDIs. This research aimed to gain an insight into the distribution of interventions in DDI management models between physicians and pharmacists, which can contribute to more efficient pharmaceutical care and visibility.

(1) Background: Medication shortages have become increasingly common in the UK. However, there is limited evidence regarding the experiences of people with epilepsy and their caregivers during these shortages. The aim of this study is to explore the extent and impact of ASM shortages on people with epilepsy and their caregivers across the UK. (2) Methods: A cross-sectional online survey was distributed between January and April, 2024 by epilepsy charities. Participants included people with epilepsy and caregivers. The survey collected demographic information, types of ASM respondents were prescribed, experiences of shortages, and the impact of shortages. Data were analysed descriptively, and subgroup analyses were conducted by medication type. (3) Results: A total of 1549 responded, of whom 1312 were people with epilepsy and their carers who were included in the analysis with a mean age of 43 years. A total of 941 respondents (71.7%) reported difficulty obtaining their prescribed ASM in the past year. Shortages were most frequently reported for sodium valproate (60.8%), lamotrigine (65.2%), carbamazepine (92.6%), clobazam (82.6%), topiramate (81.5%), zonisamide (74.0%), levetiracetam (62.8%), lacosamide (71.0%), and brivaracetam (70.5%). A total of 529 (40.4%) of the participants reported that stress and/or anxiety caused by medication shortages was associated with recurrent seizures. We did not ask whether patients missed medications because of these difficulties. (4) Conclusions: ASM shortages are a widespread issue for people with epilepsy in the UK, leading to treatment disruptions and psychological distress. Addressing supply change limitations and identifying effective approaches to preventing the substitution of ASMs brands by clinicians may potentially reduce this problem.