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From theory to practice: A critical review and meta-framework for operationalising person-centredness, therapeutic alliance and empathy in pharmacist-led mental health consultations. 从理论到实践:在药剂师主导的心理健康咨询中实施以人为中心、治疗联盟和共情的关键审查和元框架。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-12-26 DOI: 10.1016/j.sapharm.2025.12.012
Balazs Adam, Kinda Ibrahim, Fiona Stevenson, Geraldine Leydon

Despite their expanding patient-facing roles and increased involvement in mental health services, pharmacists' interactions with clients remain largely medicines-focused. This limitation is compounded by a reported lack of pharmacists' confidence and inadequate training in both mental health conditions and communication skills. The interrelated concepts of person-centredness, therapeutic alliance, and empathy play a pivotal role in effective mental health consultations, positive client outcomes, and high-quality care delivery. Grounded in the interpretivist and pragmaticist paradigms, this critical review of the literature enabled the development of a meta-framework that unifies this triad. The resulting model conceptualises person-centredness across three interconnected levels: the Consultation (analogous to the therapeutic alliance), the Systems (focusing on multidisciplinary collaboration and leadership), and the Intrapersonal (encompassing the practitioner's intellectual, practical, and phenomenological attributes). Functioning as an integral, unifying component across the entire model, empathy is detailed as a three-stage process at the Consultation level between pharmacist and client, involving exploration, shared understanding, and optional therapeutic action. Presented both as a conceptual model and comprehensive series of targeted recommendations, this work provides timely guidance, enabling pharmacists to deliver high-quality, holistic, and meaningful mental health care, with the aim of improving client outcomes and fostering effective interprofessional working relationships.

尽管药剂师面对病人的角色越来越大,并且越来越多地参与心理健康服务,但他们与客户的互动仍然主要集中在药物上。据报告,药剂师缺乏信心,在精神健康状况和沟通技巧方面培训不足,使这一限制更加严重。以人为中心、治疗联盟和共情等相互关联的概念在有效的心理健康咨询、积极的客户结果和高质量的护理提供中起着关键作用。在解释主义和实用主义范式的基础上,这种对文献的批判性回顾使统一这三个方面的元框架得以发展。由此产生的模型在三个相互关联的层面上概念化了以人为中心的概念:咨询(类似于治疗联盟),系统(专注于多学科合作和领导),以及个人(包括从业者的智力,实践和现象学属性)。共情是贯穿整个模型的一个完整的、统一的组成部分,在药剂师和客户之间的咨询层面上,共情被详细描述为一个三阶段的过程,包括探索、共同理解和可选的治疗行动。作为一个概念模型和一系列全面的有针对性的建议,这项工作提供了及时的指导,使药剂师能够提供高质量的,整体的,有意义的精神卫生保健,目的是改善客户的结果,促进有效的跨专业工作关系。
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引用次数: 0
The feasibility of implementing a hospital deprescribing behaviour change intervention and undertaking trial processes: A mixed methods evaluation 实施医院处方行为改变干预和进行试验的可行性:一种混合方法评价。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-11-26 DOI: 10.1016/j.sapharm.2025.11.005
Sion Scott , Jacqueline Martin-Kerry , Megan Pritchard , Bethany Atkins , Allan B. Clark , Kelly Grant , David P. Alldred , Antony Colles , Amber Hammond , Katherine Murphy , Victoria L. Keevil , Ian Kellar , Martyn Patel , Erika Sims , Jo Taylor , David A. Turner , Miles Witham , David Wright , Debi Bhattacharya

Background

CompreHensive geriAtRician-led MEdication Review (CHARMER) is a behaviour change intervention designed to address the determinants of geriatricians and pharmacists deprescribing in hospital. CHARMER comprises a deprescribing action plan, deprescribing briefings, videos of successful deprescribing consultations, deprescribing case studies workshop and a deprescribing performance dashboard. This study aimed to evaluate the feasibility of undertaking a CHARMER definitive trial and inform primary outcome measure selection (90-day hospital readmission or patient quality of life (QoL)).

Methods

A two-arm purposive allocation feasibility study was undertaken in four hospitals (three intervention, one control). Intervention fidelity and acceptability, outcome data completeness and quality were evaluated alongside acceptability of data collection methods. The process evaluation explored these via interviews with staff and patients. Data were used to inform primary outcome measure selection.

Results

Eighteen geriatricians and pharmacists received the CHARMER intervention and 318 patients admitted to study wards were enrolled. 90-day hospital readmission data were available for 290 (91.2 %) patients. Sixty-six (20.8 %) were approached for consent to complete QoL measures; 25 (37.9 %) consented and 13 (52 %) completed at baseline and 90-day follow up.
All intervention components were implemented with acceptable fidelity; hospitals were unfamiliar with implementing action plans and unclear who should be involved with implementing the dashboard, leading to delays.

Conclusions

The CHARMER intervention is feasible to implement and given the low patient consent rate, 90-day readmission rate is the most appropriate primary outcome measure. Minor refinements to guidance will facilitate hospitals to undertake activities for implementation that are unfamiliar.

Clinical trial registration

The study was registered on ISRCTN (ISRCTN11899506).
背景:综合老年医生主导的药物审查(CHARMER)是一项行为改变干预措施,旨在解决老年医生和药剂师在医院开处方的决定因素。CHARMER包括处方解除行动计划、处方解除简报、处方解除成功咨询视频、处方解除案例研究研讨会和处方解除绩效仪表板。本研究旨在评估开展CHARMER最终试验的可行性,并为主要结局指标选择(90天再入院或患者生活质量(QoL))提供信息。方法:在4家医院(3个干预组,1个对照组)进行两组有目的分配可行性研究。评估干预的保真度和可接受性、结果数据的完整性和质量以及数据收集方法的可接受性。过程评估通过与工作人员和患者的访谈来探讨这些问题。数据用于主要结局测量指标的选择。结果:18名老年医师和药师接受了CHARMER干预,318名患者被纳入研究病房。290例(91.2%)患者可获得90天再入院数据。66例(20.8%)被要求同意完成生活质量测量;25人(37.9%)同意,13人(52%)完成了基线和90天的随访。所有干预成分均以可接受的保真度实施;医院不熟悉实施行动计划,也不清楚谁应该参与实施仪表板,这导致了延误。结论:CHARMER干预是可行的,考虑到患者同意率低,90天再入院率是最合适的主要结局指标。对指南稍加改进将有助于医院开展不熟悉的执行活动。临床试验注册:该研究在ISRCTN上注册(ISRCTN11899506)。
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引用次数: 0
Screening for, and overcoming, ‘pill aversion’ in community pharmacy using a novel educational tool: Hard pill to swallow?™ 筛选,并克服,“药丸厌恶”在社区药房使用一种新的教育工具:硬药丸吞?
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-11-26 DOI: 10.1016/j.sapharm.2025.11.007
Alice. P. McCloskey , Johanne Nesbit , A.P. Rathbone , Nicola Vasey , Philippa. G. McCabe , Susan Flynn , Simran Bal , Katie Mulraney , Sarah Hamilton , Hashim Ali , Kyle Holebrooke-Steele , Yincent Tse , Emma. J. Lim

Background

Solid oral dosage forms (pills) are commonly dispensed but frequently patients struggle to take these (pill aversion). This is rarely identified or addressed in clinical practice. The KidzMed programme teaches children to swallow pills, but to date it has not been used to support adults with pill aversion.

Objectives

  • Assess in community pharmacy the acceptability of screening for pill aversion
  • Test an educational leaflet tailored for adults to support with pill swallowing

Methods

Participants were recruited via pre-defined inclusion and exclusion criteria using convenience sampling at three Liverpool-based community pharmacies over a one-month period. A screening questionnaire was completed and adults >18 years identified with pill aversion (score of 6+ on the PILL-5 screening tool) supplied with an adapted educational leaflet from the KidzMed programme. Successful pill swallowing using the leaflet was assessed via phone-call two weeks later. Institutional ethics reference (PBS/2023-23/01).

Results

Overall, 246 participants were screened, 9 % (n = 22) were identified as having pill aversion. There was an association with younger age and female gender. Follow-up showed that the leaflet was well received, participants found it useful, had changed their pill swallowing technique because of it, and shared this knowledge with others.

Conclusions

Pill aversion is an underexplored issue. The positive impact of the adapted leaflet in adults reflects the success of KidzMed for children. Further work is needed to confirm the association of age and gender with pill aversion, and determine translatability of the adapted leaflet to a wider audience and other healthcare settings.
背景:固体口服剂型(药片)通常被分配,但患者经常难以服用这些(药丸厌恶)。这在临床实践中很少被发现或解决。KidzMed项目教孩子们吞下药片,但迄今为止,它还没有被用来支持有药物厌恶症的成年人。目的:方法:参与者通过预先定义的纳入和排除标准,使用方便抽样在利物浦的三个社区药房招募,为期一个月。研究人员完成了一份筛查问卷,并向年龄在0岁至18岁之间的成年人(在pill -5筛查工具上得分为6+)提供了一份改编自KidzMed项目的教育传单。两周后,通过电话评估使用传单成功吞咽药丸的情况。机构伦理参考(PBS/2023-23/01)。结果:总的来说,246名参与者被筛选,9% (n = 22)被确定为有药丸厌恶。这与年龄较小和女性性别有关。随访结果显示,该传单反响良好,参与者发现它很有用,因此改变了他们的服药技巧,并与他人分享这些知识。结论:药物厌恶是一个未被充分探讨的问题。改编后的传单在成人中的积极影响反映了KidzMed在儿童中的成功。需要进一步的工作来确认年龄和性别与避孕药厌恶的关系,并确定改编后的传单对更广泛的受众和其他医疗保健机构的可翻译性。
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引用次数: 0
Effects of pharmacist prescribing on health-related outcomes in secondary care compared with medical prescribing or no treatment: A systematic review 与内科处方或不治疗相比,二级保健中药剂师处方对健康相关结果的影响:一项系统综述。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-11-24 DOI: 10.1016/j.sapharm.2025.11.003
Amina Omosalewa Akintunde, Ajlin Karaxhija, Raisa Laaksonen

Background

Pharmacist prescribing has gained momentum over the years and is currently utilised in Brazil, Canada, New Zealand, Poland, South Africa, United Kingdom (UK), and the United States of America (USA). While pharmacist prescribing has been associated with symptom improvement, reduced prescribing error rates, medication omissions, and improved medication access, the effects of pharmacist prescribing in secondary care have not been previously evaluated.

Objectives

This systematic review aimed to assess the effects of pharmacist prescribing on health-related outcomes in secondary care.

Methods

MEDLINE, Cochrane, CINAHL, Scopus, and Web of Science Core Collection databases were searched for studies published in English from database inception to October 3, 2024. Studies were included if the intervention was pharmacist prescribing and the outcomes were health-related and measurable. Narrative synthesis of the outcomes from included studies was conducted.

Results

A total of 21 studies from five countries (Australia, Egypt, Hong Kong, UK, USA) were included. Pharmacist prescribing significantly improved disease management, reduced the number of hospital revisits, improved blood pressure control, international normalised ratio control and decreased the number of adverse events when compared to medical prescribing. The evidence further suggests that the healthcare costs per patient per month, median cost of treatment, inpatient hospitalisations and emergency department admissions were significantly lower when pharmacists prescribed medicines. The evidence was low to moderate quality.

Conclusion

This systematic review provides evidence that pharmacist prescribing has a positive effect on therapeutic outcomes, and that pharmacist prescribing is comparable or better than medical prescribing in secondary care.
背景:药剂师处方多年来发展势头强劲,目前在巴西、加拿大、新西兰、波兰、南非、英国和美利坚合众国使用。虽然药剂师处方与症状改善、减少处方错误率、药物疏漏和改善药物可及性有关,但药剂师处方在二级保健中的效果此前尚未得到评估。目的:本系统综述旨在评估药师处方对二级保健中健康相关结局的影响。方法:检索MEDLINE、Cochrane、CINAHL、Scopus和Web of Science Core Collection数据库自建库至2024年10月3日发表的英文研究。如果干预是药剂师处方,并且结果与健康相关且可测量,则纳入研究。对纳入研究的结果进行叙述性综合。结果:共纳入来自5个国家(澳大利亚、埃及、香港、英国、美国)的21项研究。与内科处方相比,药剂师处方显著改善了疾病管理,减少了医院就诊次数,改善了血压控制,国际标准化比率控制,减少了不良事件的数量。证据进一步表明,当药剂师开药时,每位患者每月的医疗保健费用、治疗费用中位数、住院和急诊住院费用显著降低。证据质量为低到中等。结论:本系统评价提供了药师处方对治疗结果有积极影响的证据,并且药师处方在二级保健中与内科处方相当或更好。
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引用次数: 0
From pill to purpose: Rethinking outcomes evaluation through patient-centered metrics in pharmacoepidemiology and chronic disease management 从药丸到目的:通过药物流行病学和慢性疾病管理中以患者为中心的指标重新思考结果评估。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-11-17 DOI: 10.1016/j.sapharm.2025.11.001
Mohamed AbdElrahman , Mohammed D. Al-Rekabi , Mohamed E.A. Abdelrahim
Despite progress in medication and evidence-based protocols, a disparity persists between clinical outcomes and patients lived experiences. Conventional pharmacoepidemiologic metrics—such as biomarker targets or hospitalization rates—frequently do not capture what patients prioritize: functionality, autonomy, and quality of life. This article promotes a transition to patient-centered measures, such as patient-reported outcomes (PROs), goal attainment scaling (GAS), and behavioral adherence models. By incorporating these approaches into research and practice, healthcare systems can more effectively assess therapy efficacy in real-world settings. The opinion emphasizes data that supports Patient-Reported Outcomes (PROs) and Goal Attainment Scaling (GAS), addresses implementation problems, and advocates for the realignment of assessment systems towards purpose-driven care. Ultimately, aligning outcome evaluation with patients' objectives promotes relevance, equity, and participation in chronic disease management—prompting pharmacoepidemiology to evaluate not only the efficacy of pharmaceuticals but also their meaningful impact on the lives of users.
尽管在药物治疗和循证协议方面取得了进展,但临床结果和患者生活经历之间仍然存在差距。传统的药物流行病学指标——如生物标志物目标或住院率——经常不能捕捉到患者优先考虑的问题:功能、自主性和生活质量。本文促进了向以患者为中心的措施的过渡,例如患者报告的结果(PROs)、目标实现缩放(GAS)和行为依从性模型。通过将这些方法纳入研究和实践,医疗保健系统可以更有效地评估现实世界环境中的治疗效果。该意见强调支持患者报告结果(PROs)和目标实现尺度(GAS)的数据,解决实施问题,并倡导将评估系统重新调整为目的驱动型护理。最终,将结果评估与患者的目标相一致,促进了慢性病管理的相关性、公平性和参与性——促使药物流行病学不仅评估药物的疗效,而且评估它们对使用者生活的有意义的影响。
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引用次数: 0
A survey of open science attitudes and behaviors among US pharmacy faculty 美国药学教师开放科学态度和行为的调查。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-11-07 DOI: 10.1016/j.sapharm.2025.10.012
Spencer E. Harpe

Objectives

To describe the attitudes, behaviors, and perceived disciplinary norms for open science practices among US pharmacy faculty and examine differences across pharmacy disciplines.

Methods

This cross-sectional study used the Center for Open Science's Open Scholarship Survey modules on data sharing, code sharing, materials sharing, preregistration, preprints, and open access publishing. Attitudes were measured using a scale from 1 (Very much against) to 5 (Very much in favor). The study questionnaire was administered to a random sample of 3200 faculty from the AACP Roster of Pharmacy Faculty as of February 2022. Individuals with ≥0.8 full-time equivalent faculty appointment in pharmacy practice or one of the pharmaceutical sciences were eligible to participate.

Results

Responses were obtained from 663 faculty (389 complete; 274 partial). Open access publishing (mean [SD]: 4.1 [0.9]) showed the most positive attitudes. Study preregistration (3.2 [0.9]) and posting preprints (3.1 [1.1]) were the least positive. Attitudes for data sharing, code sharing, and study preregistration were statistically significant across disciplines. The most commonly reported open science practice was open access publishing (mean [SD], 27.7 % [29.1 %]). Study preregistration was the least common (mean [SD], 1.7 % [7.0 %]). After accounting for respondent and institutional characteristics, disciplinary differences in data sharing, study preregistration, and posting preprints were noted.

Conclusion

This study provides a baseline assessment of attitudes towards and engagement in open science practices among US pharmacy faculty. Given the relatively low frequency with which open science practices were reported, there is considerable room for improvement in the uptake of open science practices.
目的:描述美国药学教师对开放科学实践的态度、行为和感知的学科规范,并检查药学学科之间的差异。方法:这项横断面研究使用了开放科学中心的开放奖学金调查模块,包括数据共享、代码共享、材料共享、预注册、预印本和开放获取出版。态度是用1(非常反对)到5(非常赞成)的等级来衡量的。截至2022年2月,该研究问卷随机抽取了AACP药学院名单中的3200名教师。在药学实践或某一药学科学领域拥有≥0.8个全职同等教员职位的个人有资格参加研究。结果:663名教师(389名完整,274名不完整)回复。开放获取出版(mean [SD]: 4.1[0.9])表现出最积极的态度。研究预注册(3.2[0.9])和发布预印本(3.1[1.1])是最不积极的。对数据共享、代码共享和研究预注册的态度在各学科之间具有统计学意义。最常报道的开放科学实践是开放获取出版(mean [SD], 27.7%[29.1%])。研究预登记是最不常见的(平均[SD], 1.7%[7.0%])。在考虑了调查对象和机构的特点后,我们注意到在数据共享、研究预登记和发布预印本方面的学科差异。结论:本研究提供了对开放科学实践的态度和参与在美国药学教师的基线评估。鉴于开放科学实践报告的频率相对较低,在开放科学实践的吸收方面有相当大的改进空间。
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引用次数: 0
Racial and socioeconomic disparities in the utilization of diabetes medication: A comprehensive analysis of NHANES 2011–2023 糖尿病药物使用中的种族和社会经济差异:NHANES 2011-2023的综合分析
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-31 DOI: 10.1016/j.sapharm.2025.10.013
Rawan O. Almadfaa

Objective

To examine the association between racial and socioeconomic health disparities and diabetes medications utilization using a nationally representative sample of the US population.

Method

This study included 4469 diabetic patients (weighted N = 23,678,032) aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) 2011–2023. Patients were classified into four groups based on medication use: insulin only, noninsulin glucose-lowering drugs (GLDs), both, or none. Univariate, bivariate, and multinomial logistic regression analyses were performed to assess associations between medication use and health disparities. All analyses were weighted for the survey's complex, multistage design of NHANES.

Results

Among the 4469 patients, 579 used insulin, 2411 used noninsulin GLDs, 754 used both, and 725 were untreated. Older patients had higher odds of using non-insulin GLDs (OR = 1.018, 95 % CI: 1.009–1.027) and both therapies (OR = 1.012, 95 % CI: 1.001–1.022) compared with younger adults. Males were more likely to use diabetes medications than females. Asians had higher odds of medication use, while other racial groups had lower odds than Whites. Participants with income higher income had lower odds of using both insulin and non-insulin GLDs (OR = 0.708, 95 % CI: 0.521–0.964) compared with those with lower income. Insured patients were more likely to use medications than the uninsured. Education level and marital status were not significantly associated with diabetes medication utilization.

Conclusion

This study identified demographic and socioeconomic differences in diabetes medication utilization among U.S. adults. Lower odds of medication use were observed among Mexican American, other Hispanic, other race group, females, and uninsured participants, as well as those with higher income, indicating potential gaps in equitable diabetes management. Targeted interventions to improve medication access and adherence among these groups are needed to promote more equitable diabetes care in the U.S.
目的:研究种族和社会经济健康差异与糖尿病药物使用之间的关系,使用具有全国代表性的美国人口样本。方法:本研究纳入2011-2023年全国健康与营养调查(NHANES)中年龄≥20岁的4469例糖尿病患者(加权N = 23,678,032)。根据用药情况将患者分为四组:仅使用胰岛素、非胰岛素降糖药物(GLDs)、两者都使用或不使用。采用单变量、双变量和多项逻辑回归分析来评估药物使用与健康差异之间的关联。所有的分析都是加权的,因为调查是复杂的,NHANES的多阶段设计。结果:4469例患者中,579例使用胰岛素,2411例使用非胰岛素gld, 754例两者都使用,725例未经治疗。与年轻人相比,老年患者使用非胰岛素GLDs (OR = 1.018, 95% CI: 1.009-1.027)和两种治疗方法(OR = 1.012, 95% CI: 1.001-1.022)的几率更高。男性比女性更有可能使用糖尿病药物。亚洲人使用药物的几率更高,而其他种族的几率低于白人。与收入较低的参与者相比,收入较高的参与者使用胰岛素和非胰岛素GLDs的几率较低(OR = 0.708, 95% CI: 0.521-0.964)。有保险的患者比没有保险的患者更有可能使用药物。教育程度、婚姻状况与糖尿病药物使用无显著相关。结论:本研究确定了美国成年人糖尿病药物使用的人口统计学和社会经济差异。在墨西哥裔美国人、其他西班牙裔、其他种族、女性、无保险参与者以及高收入人群中观察到较低的药物使用几率,这表明在公平的糖尿病管理方面存在潜在差距。在美国,需要有针对性的干预措施来改善这些群体的药物获取和依从性,以促进更公平的糖尿病护理
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引用次数: 0
A multisite pilot type 2 hybrid implementation-effectiveness trial of a community pharmacist-led model of collaborative care for Medication Assisted Treatment for Opioid Dependence: outcomes of the EPIC-MATOD trial 一项社区药剂师主导的阿片类药物依赖药物辅助治疗协同护理模式的多站点2型混合实施-有效性试验:EPIC-MATOD试验的结果
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-29 DOI: 10.1016/j.sapharm.2025.10.009
Suzanne Nielsen , Francis Graham , Mohammad Hossein Hadi , Elizabeth Grist , Bosco Rowland , John Jackson , Sarah Lord , Jana Dostal , Pene Wood , Kirsty Morgan , Dennis Petrie , Ali Cheetham

Background

Australia faces a critical challenge with access to opioid dependence treatment, particularly in regional areas where treatment shortages are amplified.

Objective

(s): To assess outcomes of a collaborative care model for opioid dependence treatment where community pharmacists work to their full scope of practice, in partnership with prescribers.

Methods

Community pharmacists and prescribers were recruited from the south-eastern suburbs of Melbourne, Victoria, Australia, to take part in a prospective, multisite, Type 2 hybrid implementation-effectiveness trial. Patients received collaborative prescriber/pharmacist care over a 6-month period, with outcomes compared to a non-randomised comparison group receiving usual care. Data was collected using a mixed methods approach with outcomes mapped to the RE-AIM framework. A health economics evaluation established time and costs associated with collaborative care.

Results

Collaborative care provided comparable outcomes on retention in treatment (97.2 %, 35/36) compared to the control cohort (89.8 %, 44/49) with no significant differences between groups on substance use or mental or physical health outcomes. Collaborative care was associated with significant increases in treatment satisfaction and quality adjusted life years (QALYs) and was cost-effective when compared to treatment as usual. The model was implemented with relatively high fidelity, with high levels of satisfaction among pharmacists, prescribers, and patients. Considerations for broader implementation included pharmacist workload, the need for secure communication software, and a mechanism to remunerate pharmacists for their time providing clinical care.

Conclusion

Pharmacist-led collaborative care for opioid dependence is feasible and acceptable and can provide an at least equivalent standard of care to usual care. Further research is required to establish how collaborative care can maximise prescriber capacity at scale.

Clinical Trial registration

ACTRN12621000871842.
背景:澳大利亚在获得阿片类药物依赖治疗方面面临严峻挑战,特别是在治疗短缺加剧的区域地区。目的:评估阿片类药物依赖治疗的合作护理模式的结果,在这种模式下,社区药剂师与开处方者合作,充分发挥其实践范围。方法:从澳大利亚维多利亚州墨尔本东南郊区招募社区药剂师和开处方者,参与一项前瞻性、多地点、2型混合实施-有效性试验。患者在6个月的时间里接受了处方医生/药剂师的合作护理,结果与接受常规护理的非随机对照组相比。采用混合方法收集数据,并将结果映射到RE-AIM框架。卫生经济学评估确定了与协作护理相关的时间和成本。结果:与对照组(89.8%,44/49)相比,协作治疗在治疗保留率(97.2%,35/36)方面提供了相当的结果,两组之间在药物使用或精神或身体健康结果方面没有显著差异。与常规治疗相比,协作治疗与治疗满意度和质量调整生命年(QALYs)的显著增加有关,并且具有成本效益。该模型的实施具有较高的保真度,药师、开处方者和患者的满意度较高。更广泛实施的考虑因素包括药剂师的工作量,对安全通信软件的需求,以及对药剂师提供临床护理的时间进行奖励的机制。结论:药师主导的阿片类药物依赖协同护理是可行和可接受的,可以提供至少相当于常规护理标准的护理。需要进一步的研究来确定协作护理如何在规模上最大化开处方者的能力。临床试验注册:ACTRN12621000871842。
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引用次数: 0
Causes and management of drug shortages: A scoping review 药品短缺的原因和管理:范围审查。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-25 DOI: 10.1016/j.sapharm.2025.10.008
N. Cornelissen , S.W. Zielhuis , P.M.L.A. van den Bemt , B.J.F. van den Bemt

Background

Drug shortages form a significant global challenge and may lead to treatment delays, increased healthcare costs, and negative health outcomes. Gaining more insight into the causes is crucial to develop interventions to prevent shortages and manage their consequences. This scoping review aims to provide an overview of the causes and management of drug shortages in high-income countries.

Methods

This scoping review was conducted in accordance with the JBI methodology. A comprehensive search was performed in PubMed, EMBASE, Web of Science, and CENTRAL on December 21, 2023. Studies published in English or Dutch on the causes and management of drug shortages in high-income countries were included. Two reviewers independently screened titles/abstracts and full texts. Relevant data on study characteristics, causes, and interventions were extracted using a standardized form. Findings were analysed descriptively.

Results

Thirty-six studies were included out of 4531 citations. Causes of drug shortages included manufacturing issues, fluctuating demand and market forces, poor supply chain management, political and strategic decisions, and external influences. Several studies emphasized that causes were frequently unknown. Interventions to manage shortages focused on alternatives and substitutions, inventory management, communication and coordination, regulatory and policy measures, and forecasting. While causes are primarily linked to early stages of the product life cycle, most interventions occur at later stages and tend to be reactive.

Conclusions

Most current interventions focus on temporary solutions at the end of the supply chain, while shortages often originate earlier. A focus on early-stage causes is needed for more effective, preventive solutions.
背景:药物短缺是一项重大的全球挑战,可能导致治疗延误、医疗保健费用增加和负面的健康结果。深入了解原因对于制定预防短缺和管理其后果的干预措施至关重要。这一范围审查的目的是概述高收入国家药物短缺的原因和管理。方法:本综述按照JBI方法学进行。我们于2023年12月21日在PubMed、EMBASE、Web of Science和CENTRAL进行了全面的检索。以英语或荷兰语发表的关于高收入国家药品短缺原因和管理的研究也包括在内。两位审稿人独立筛选标题/摘要和全文。使用标准化表格提取有关研究特征、原因和干预措施的相关数据。对研究结果进行描述性分析。结果:在4531次引用中,共纳入36篇研究。药品短缺的原因包括生产问题、需求和市场力量波动、供应链管理不善、政治和战略决策以及外部影响。几项研究强调,原因往往是未知的。管理短缺的干预措施侧重于替代品和替代、库存管理、沟通和协调、监管和政策措施以及预测。虽然原因主要与产品生命周期的早期阶段有关,但大多数干预措施发生在后期阶段,往往是被动的。结论:目前大多数干预措施侧重于供应链末端的临时解决方案,而短缺往往发生在更早的时候。需要把重点放在早期原因上,以获得更有效的预防性解决办法。
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引用次数: 0
Academic community pharmacy: A pilot Delphi study aimed at establishing a future common definition at the international level 学术社区药房:一项试点德尔菲研究,旨在建立未来国际层面的共同定义。
IF 2.8 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-23 DOI: 10.1016/j.sapharm.2025.10.011
Clémence Perraudin , Noelia Amador-Fernandez , Marie Paule Schneider , Florent Macé , Ralitza Gauthier , Alice Panchaud , Samuel Allemann , Stefan Erni , Jérôme Berger

Introduction

The Granada statements promote the consistent use of appropriate terminology in pharmacy practice research. This pilot study aims to define the term Academic Community Pharmacy (ACP), providing a foundation for a forthcoming international study aimed at establishing a globally accepted definition.

Methodology

A Delphi study was conducted in 2023 among academic entities from all five Swiss universities involved in pharmacy practice research and education. The first definition comprised four kex elements: place of practice, clinical and academic activities and links with universities. Anonymous survey rounds were conducted where panellists assessed agreement with and clarity of the statements using a Likert scale. Additionally, free comments and proposals for changes were allowed. Consensus for each statement was defined as ≥66 % agreement.

Results

The panel consisted of nine members. Two Delphi rounds were needed to reach consensus for the final definition: “An ACP is a facility providing professional pharmacy services (according to a commonly accepted definition in the location of the considered ACP) to the community, conducting research and education on such services, and that has formal links (e.g., financial or contractual) with a university”.

Conclusion

Establishing a clear and consistent definition of ACPs will support their characterization and further development.
简介:格拉纳达声明促进了在药学实践研究中适当术语的一致使用。本试点研究旨在定义学术社区药学(ACP)一词,为即将开展的旨在建立全球公认定义的国际研究奠定基础。方法:在2023年对瑞士所有五所涉及药学实践研究和教育的大学的学术实体进行了德尔菲研究。第一个定义包括四个关键要素:实践地点、临床和学术活动以及与大学的联系。进行了几轮匿名调查,小组成员使用李克特量表评估对陈述的同意程度和清晰度。此外,还允许对更改提供免费评论和建议。每个陈述的一致性定义为≥66%的一致性。结果:小组由九名成员组成。最后的定义需要经过两轮德尔菲讨论才能达成共识:“ACP是向社区提供专业药学服务(根据考虑的ACP所在地普遍接受的定义),并就此类服务进行研究和教育的设施,并且与大学有正式联系(例如,财务或合同)”。结论:建立一个清晰、一致的acp定义将有助于其表征和进一步发展。
{"title":"Academic community pharmacy: A pilot Delphi study aimed at establishing a future common definition at the international level","authors":"Clémence Perraudin ,&nbsp;Noelia Amador-Fernandez ,&nbsp;Marie Paule Schneider ,&nbsp;Florent Macé ,&nbsp;Ralitza Gauthier ,&nbsp;Alice Panchaud ,&nbsp;Samuel Allemann ,&nbsp;Stefan Erni ,&nbsp;Jérôme Berger","doi":"10.1016/j.sapharm.2025.10.011","DOIUrl":"10.1016/j.sapharm.2025.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The Granada statements promote the consistent use of appropriate terminology in pharmacy practice research. This pilot study aims to define the term <em>Academic Community Pharmacy</em> (ACP), providing a foundation for a forthcoming international study aimed at establishing a globally accepted definition.</div></div><div><h3>Methodology</h3><div>A Delphi study was conducted in 2023 among academic entities from all five Swiss universities involved in pharmacy practice research and education. The first definition comprised four kex elements: place of practice, clinical and academic activities and links with universities. Anonymous survey rounds were conducted where panellists assessed agreement with and clarity of the statements using a Likert scale. Additionally, free comments and proposals for changes were allowed. Consensus for each statement was defined as ≥66 % agreement.</div></div><div><h3>Results</h3><div>The panel consisted of nine members. Two Delphi rounds were needed to reach consensus for the final definition: “An ACP is a facility providing professional pharmacy services (according to a commonly accepted definition in the location of the considered ACP) to the community, conducting research and education on such services, and that has formal links (e.g., financial or contractual) with a university”.</div></div><div><h3>Conclusion</h3><div>Establishing a clear and consistent definition of ACPs will support their characterization and further development.</div></div>","PeriodicalId":48126,"journal":{"name":"Research in Social & Administrative Pharmacy","volume":"22 2","pages":"Pages 357-361"},"PeriodicalIF":2.8,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145373047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Research in Social & Administrative Pharmacy
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