Pharmacy最新文献

Emerging evidence suggested a potential link between lipid-lowering therapies and neurocognitive effects, raising concerns regarding the possible adverse impact of PCSK9 inhibitors on memory loss. We extracted adverse events associated with memory loss for PCSK9 inhibitors from the Food and Drug Administration Adverse Event Reporting System (FAERS), covering the period from the first quarter (Q1) of 2022 to Q1 of 2025. Reporting odds ratio (ROR), Medicines and Healthcare Products Regulatory Agency (MHRA), empirical Bayesian geometric mean (EBGM), and information component (IC) were used for pharmacovigilance analysis. Drug target Mendelian randomization (MR) was utilized to assess the causal association between PCSK9 inhibitors and memory loss. A total of 389 occurrences of memory loss associated with PCSK9 inhibitors were recorded among 388 patients. In the pharmacovigilance analysis, memory loss did not show a significant signal for PCSK9 inhibitors in both the full dataset [ROR (95% CI): 0.79 (0.72, 0.88); PRR = 0.79, χ² = 20.64; EBGM05 = 0.73; IC025 = -2.00] and the lipid-lowering targets dataset [ROR (95%CI): 0.59 (0.53, 0.66); PRR = 0.59, χ² = 95.33; EBGM05 = 0.59; IC025 = -2.30]. The drug target MR revealed no causal association between PCSK9 inhibitors and memory loss (p < 0.05). The present study failed to establish a causal relationship between PCSK9 inhibitors and memory loss. By providing both real-world and genetic evidence, our findings might help alleviate concerns and support the notion that PCSK9 inhibitors were relatively safe regarding memory function.

Heartburn is a prevalent and frequently self-managed condition, with a myriad of over-the-counter (OTC) treatment options available for self-care. The potential for misinterpretation of drug labels and improper OTC medication selection may result in inadequate treatment, potential drug interactions, as well as medication overuse, misuse, or delay in seeking treatment for a more serious health condition. As highly accessible healthcare professionals, pharmacists play a crucial role in validating self-diagnoses, in guiding appropriate OTC medication selection and use, and in educating patients on both pharmacologic and non-pharmacologic management strategies for heartburn. It is essential for pharmacists to remain informed about the latest developments in disease management and treatment options. This narrative review provides an updated perspective on the epidemiology, risk factors, pathophysiology, and clinical manifestations associated with heartburn while underscoring the expanding role of pharmacists in patient care. This review includes a structured assessment framework and clinical management algorithm designed to enhance pharmacists' ability to identify red flag symptoms, optimize OTC medication use, and facilitate timely referrals when necessary. By incorporating evidence-based guidance with patient-centered counseling, pharmacists can enhance treatment outcomes, optimize, medication use, promote adherence, and ensure safer self-care practices. As self-medication trends and the role of pharmacists evolves, this review offers a comprehensive resource to equip pharmacists with the latest knowledge and practical tools for optimizing heartburn management and promoting patient safety.

Radical prostatectomy is the standard of care for the treatment of early, clinically localized prostate cancer (PC). In addition to known clinical prognosticators, perioperative conditions and the type of anesthesia may affect clinical outcomes through several mechanisms that favor a tumor-propagating state, including activation of the sympathetic system, increased opioid requirements, and inflammation. In this review, we provide an overview of the impact of the perioperative period on PC prognosis and patient outcomes. A non-systematic literature review was conducted to investigate the possible association between neuraxial anesthesia and outcomes after radical prostatectomy (RP) for prostate cancer. The following keywords were used: "cancer recurrence" OR "cancer prognosis" OR "metastasis" AND "neuraxial anesthesia" AND "prostate cancer". Eligible studies were summarized in the form of a narrative review. In the era of limited use of ERAS protocols, the implementation of neuraxial anesthesia was found to reduce mortality after RP for primary prostate cancer when compared to general anesthesia. Although there was no significant association between anesthetic technique and radiological or biochemical-free survival, regional anesthesia may have an impact on short-term survival in patients with severe comorbidities, involving pulmonary complications and thrombosis. The effect of anesthetic technique on PC patient outcomes remains elusive, although preliminary retrospective evidence suggests a possible positive effect of neuraxial anesthesia on patient outcomes. As the perioperative period is considered a vulnerable timeframe for these patients, the role of the leadership dyad of surgeon and onco-anesthesiologist is crucial.

Background: Pharmacy schools in the United Kingdom (UK) are required by the regulator to train pharmacy students to be culturally competent. To meet this requirement, the Reading School of Pharmacy (RSoP) incorporated an inaugural, stand-alone, introductory session on intercultural competency. This study aimed to gather students' experiences of the lecture. Methods: A qualitative study documented the experiences of students in Years 2 and 3 of the Master of Pharmacy (MPharm) at the RSoP from 15 September to 31 December 2023. Semi-structured interviews were conducted online via Microsoft Teams^®. A demographic form was prepared and sent as an online survey link on the Online Surveys^® platform. All eligible students were invited to participate in the study via student mailing lists. An interview guide was prepared. Thematic analysis was conducted to identify key themes related to students' awareness, the perceived importance of the subject in healthcare, and students' preferred learning methods. The transcripts were coded, and similar codes were grouped to form sub-themes and themes. The study was approved by a research ethics committee. Results: A total of 11 students attended the interviews. Three major themes emerged: (1) awareness of and reflection on cultural competence, (2) understanding cultural competence and its importance, and (3) student-preferred pedagogy. The students suggested incorporating workshops and simulation-based assessments. Conclusions: MPharm pharmacy students at the RSoP appear to be receptive to new educational interventions aimed at enhancing cultural competence. They prefer practice-based learning and assessment methods when it comes to developing this skill.

Background: Electronic monitoring adherence devices (EAMDs) are increasingly being utilized in various healthcare settings to track medication adherence.

Objective: To determine the accuracy of the Sensal Health MyAide™ Smart Doc in capturing dose removal from the vial, specifically the time of dose removal and the number of pills removed for each actuation of the device.

Methods: This validation study compares the device's recording of dose withdrawals from a prescription vial by simulated patients against reference documentation reported using MS Forms by the participants. Three participants completed a 4-day study consisting of two non-consecutive 1 h sessions per day encompassing six actuations from the prescription vial to be captured by the Sensal Health MyAide™ Smart Dock after their informed consent was obtained. Statistical analysis included percent agreement and Cohen's kappa assessing agreement between user-reported data and electronic measurement data recorded by the MyAide™ Smart Dock. Outcome measures included confirmation of the specific user, time of dose removal (±1 min), and the number of pills withdrawn.

Results: Three subjects were recruited to provide data for a total of 144 actuations. The study found perfect 100% agreement across the number of pills withdrawn and specific users withdrawing the pills and 99% agreement for the time of administration. The Cohen's kappa values for the outcome measures were 1.00 (95%CI [1.00, 1.00]) for the number of pills dispensed and specific user and 0.993 (95%CI [0.990, 0.996]) for the time of administration.

Conclusions: This study found that the Sensal Health MyAide™ Smart Dock can accurately record the time of administration, the number of pills dispensed, and the identity of the user dispensing the pills.

Intravenous push (IVP) administration of controlled substances in hospital settings presents operational challenges related to medication waste, documentation, and diversion risk. This multi-site observational study aimed to quantify the pharmacy workforce time and associated costs linked to IVP waste management across a 16-hospital health system in Southwest Florida. Data were collected from over 4400 controlled substance transactions involving fentanyl, midazolam, hydromorphone, morphine, ketamine, and lorazepam. Methods included automated transaction analysis, manual chart reviews, and software-based compliance case evaluations. Results indicated patterns of partial dose waste, particularly for midazolam (85.2%) and hydromorphone (78.8%), and identified opportunities where documentation efforts could be further optimized through automation. Manual review of 333 incidents required an average of 6 min and 43 s per case, extrapolating to over 496 h of quarterly pharmacy labor or nearly 1985 h annually. Software-based case reviews added another 32 h per quarter or 130 h annually. Additionally, waste receptacle systems incurred over USD 1.1 million in capital costs and USD 322,500 in annual maintenance, with technician labor contributing further operational burden. These findings underscore the resource demands of IVP waste management and support the need for standardized dosing, enhanced documentation workflows, and pharmacy-led interventions to improve efficiency and reduce diversion risk.

Background: Pharmacy professionals have an important role in delivering patient-centred care, with effective communication skills forming the foundation of interactions with patients. This study aimed to explore how pharmacy students perceived their own communication skills; along with the communication skills education and training experiences in their undergraduate pharmacy degree in the UK. Methods: A 22-item questionnaire was designed and piloted before being distributed online. Snowball sampling was employed to recruit participants undertaking an undergraduate pharmacy degree. Quantitative statistical and qualitative thematic analysis was conducted. Results: A range of pharmacy schools were represented in the data set (n = 10) with 217 responses collected. Participants rated their communication skills highly (53.03%, n = 114), but stated they still required improvement (79.72%, n = 173). A proportion of participants stated that they could appropriately make professional decisions (52.08%, n = 100) and that their communication skills had facilitated their professional decision-making skills (57.89%, n = 110). Effective teaching methods reported included role play with peers (80%, n = 156) and small-group teaching sessions (64.10%, n = 125). Participants felt that interprofessional education and simulated patients could help improve their communication skills further. Conclusions: Communication education is a crucial element in developing future healthcare professionals. Thus, investment in resources is required to facilitate communication skills in the earlier stages of the undergraduate pharmacy degree.

In this multicenter, nonrandomised comparative study, we evaluated the potential effectiveness of a program to promote the safe use of dipeptidyl peptidase-4 (DPP-4) inhibitors led by community pharmacists. The program facilitated early detection of gastrointestinal adverse events (GIAEs) in patients newly prescribed DPP-4 inhibitors and facilitated timely communication with physicians. Community pharmacists reviewed patient conditions and provided relevant information to physicians as needed. GIAE monitoring based on the program was conducted in 35 patients at 10 pharmacies in Japan (intervention group) between March and August 2024. The proportion of pharmacist interventions was compared with that in 451 patients from March to August 2023, before program implementation (baseline cohort). The primary outcome, pharmacist intervention rate, was significantly higher in the intervention group (5 out of 35 patients, 14.3%) than in the baseline cohort (0 out of 451 patients, 0.0%) (p < 0.001). GIAEs were identified in 13 out of 35 patients (37.1%) in the intervention group; information for five patients (14.3%) was shared with physicians, resulting in discontinuation of the DPP-4 inhibitor in one patient and addition of supportive therapy in others. Most GIAEs occurred within the first 1-2 weeks of therapy, highlighting the need for early intervention. Thus, proactive involvement of community pharmacists may improve the care process in these cases and contribute to healthcare coordination and diabetes care quality.

In pharmacy, theoretical and methodological approaches from anthropology and the social sciences have been increasingly used to understand the complexity of health-disease processes and their relationship with medicines and social practices. Ethnography offers a critical and in-depth lens for analyzing phenomena in Primary Health Care (PHC), bridging persistent gaps between theory and method in health research. This article presents the theoretical and methodological trajectory of an ethnographic study on pharmaceutical services in PHC, conducted through participant observation in three Units in São Paulo, totaling 166 h of fieldwork. Data were recorded in field diaries and analyzed using a thematic inductive approach, leading to the development of conceptual categories and an analytical framework. Reflections on the method enabled interpretive analyses based on assumptions that were confronted with national and international trends in pharmacy literature. Constructing the method in a non-isolated, context-sensitive way was essential to understanding how pharmacists actively shape their practices in PHC. The study reinforces the relevance of participant observation as both a methodological and interpretive strategy, revealing that pharmaceutical services are being constructed through culturally situated practices that respond to health needs with the pharmacist's active involvement.

Introduction: Prescribing errors are the most common cause of preventable patient harm. In recent years, interprofessional education (IPE) has been increasingly utilised to improve knowledge and skills through promoting interprofessional collaboration. This scoping review aimed to evaluate the effectiveness of IPE interventions for pharmacological knowledge and prescribing skills in medical students and doctors-in-training. Methods: MEDLINE, EMBASE, CENTRAL, CINAHL, PsycINFO, ERIC and Scopus were searched on 18 February 2025 for studies published since 2020. Keywords included interprofessional education, medical student, medical trainee, pharmacology and prescribing. Results: Of the 2254 citations identified, 42 studies were included. There were four main types of IPE interventions: case-based learning, work-integrated-learning, didactic, and simulation and role-plays. Outcomes were spread across pharmacological knowledge, prescribing skills and interprofessional attitudes, and all studies reported one or more positive findings at Kirkpatrick IPE level 1, 2a, 2b, 3 or 4b. No study reported outcomes at Kirkpatrick IPE 4a. Conclusions: IPE interventions targeting pharmacology and prescribing are positively viewed by medical learners. IPE is effective in improving interprofessional attitudes and collaboration, as well as pharmacological knowledge and prescribing competency. Logistical challenges can be barriers to larger-group IPE implementation; nonetheless, IPE work-integrated learning in authentic clinical settings may overcome these challenges.