Research in Social & Administrative Pharmacy最新文献

Background: Pharmacy technicians are increasingly recognized as essential healthcare professionals who contribute significantly to the delivery of pharmacy services. However, in Europe, the education, training, and regulatory frameworks governing pharmacy technicians vary substantially, influencing their scope of practice and integration within healthcare systems.

Objective: This review maps the education, qualifications, and scope of practice of PTs across Europe, highlighting differences in professional titles and regulatory approaches.

Methods: A review was conducted using publicly available data from the EU Regulated Professions Database and data collected from national organizations representing pharmacy technicians across Europe. Data on professional titles, qualification levels, regulations, program duration, and role delineation were extracted and summarized for comparison.

Results: Findings from 28 European countries revealed significant variability in pharmacy technician qualification levels (EQF 4-6), training duration (2-4.5 years), and national regulation. Regulation ranges from mandatory licensing with protected titles to a lack of regulation. The scope of practice differs, from basic dispensing and inventory tasks to broader clinical and technical responsibilities.

Conclusion: The landscape of pharmacy technician education and regulation in Europe remains fragmented. Although PTs share core responsibilities, qualification levels, program durations, and regulatory protections vary widely, limiting professional identity, mobility, and workforce planning. Developing a shared European framework for education and professional recognition could facilitate professional mobility, reduce professional and skill disparities, and support safe, high-quality pharmacy services, ultimately optimizing the contribution of PTs to healthcare systems.

Background: The aging U.S. immigrant population exhibits higher rates of dementia than U.S.-born residents, yet traditional diagnostic methods often fail to detect decline due to cultural and linguistic barriers. Unintentional medication non-adherence (MNA) may serve as an early, noninvasive marker of cognitive decline, but little is known about how immigration timing and other modifiers shape this relationship.

Methods: We analyzed data from 10,854 participants aged ≥65 years in the Health and Retirement Study (2012-2016). Cognitive function was assessed using standardized latent cognitive scores. Immigration status was classified as U.S.-born or immigrant, with immigrants further stratified by age at arrival (child/adolescent, early, middle, and late adulthood). Unintentional and intentional MNA were investigated separately, and a moderated moderation regression on cognitive function tested interactions between unintentional MNA, immigration status/timing, and education adjusted for demographic, socioeconomic, and health covariates.

Results: Unintentional MNA, being an immigrant (compared to non-immigrants), and older age at immigration were associated with lower cognitive scores, while higher education was protective. Significant two-way interactions indicated that immigration status (β = -0.38 ± 0.14, p = 0.0006), timing (β = -0.13 ± 0.03, p < 0.0001), and education (β = -0.09 ± 0.03, p = 0.003) moderated the MNA-cognition association, though three-way interaction was not significant. Subgroup analysis showed that unintentional MNA was generally linked to poorer cognition, but the moderating roles of immigration timing and education varied across ethnicity-immigration subgroups. The potential for residual confounding and other study limitations should be considered when interpreting these results.

Conclusion: In conclusion, unintentional MNA is a sensitive marker of cognitive decline, with risk magnified among immigrants who arrived in middle-late adulthood. Integrating adherence and immigration history into clinical assessments may improve early identification and guide targeted interventions for diverse older adults.

The EAHOP trial (Enhancing Allied Health for Older People in Residential Care) Outcomes of pharmacist interventions.

Background: The pharmacist has a critical role in the multidisciplinary team (MDT) when contributing to the care of older people living in residential aged care. The EAHOP study is a clinical trial that embedded a pharmacist within an MDT in a residential aged care home. This abstract reports on the pharmacy results of the study.

Method: This study used a mixed method to describe key pharmacy outcome measures of direct and indirect time per resident, number of recommendations accepted and to describe the thoughts, opinions and experience of key stakeholders.

Results: There were 124 recommendations made by the pharmacist for 34 residents, an average of 3.65 per resident, higher than the usual 2.7 recommendations per RMMR. At the GP case conferences 70 % were accepted, 9 % were declined and 21 % were not discussed. An average of 61 min direct time and 246 min of indirect time was spent per resident. Qualitative findings showed the pharmacy role improved care for residents by enhancing communication between health professionals, staff, residents and families.

Conclusion: The EAHOP model can supplement existing models of pharmacy intervention in residential care by providing organised multidisciplinary collaboration between the General Practitioner, nursing, pharmacist and allied health disciplines.

Objectives: Given the expansion of pharmacist prescribing, this study aims to identify and categorise outcomes reported in research evaluating impacts of pharmacist prescribing specifically for minor ailments (or common conditions) and in other broader contexts.

Methods: A rapid overview of reviews was conducted, searching PubMed, Embase, Cochrane Database of Systematic Reviews, and Epistemonikos using keywords relating to pharmacy/pharmacists, prescribing or minor ailments schemes, and evidence syntheses. Reviews evaluating the impact of any aspect of pharmacist prescribing were included if they reported ≥1 outcome assessing the impact of pharmacist prescribing. Data extraction focused on the clinical settings, disease areas/conditions, prescribing models and reported outcomes.

Results: Of 43 reviews included, 14 reported on outcomes of pharmacist prescribing in minor ailments, and 35 reviews in broader contexts (6 reporting both). Outcomes were categorised as clinical, drug-related/prescribing, patient-reported/experience, and economic/other outcomes. For minor ailments, 14 outcomes were identified, most frequently clinical cure or symptom resolution, and cost of service delivery (both reported in n = 8 reviews). In other prescribing contexts, 12 outcomes were reported, with general satisfaction being the most common (n = 18), followed by clinical effectiveness and healthcare resource use (both n = 15).

Conclusions: Capturing impact of pharmacist prescribing requires assessment of outcomes across multiple dimensions.

Background: Estimating the cost of providing healthcare services for minor ailments (MA) is essential to address the impact of newly legislated pharmacist prescribing on the burden these conditions place on healthcare budgets.

Objectives: This study aims to quantify the healthcare costs associated with minor ailment management in Ontario, describe patient characteristics by cost burden, and identify predictors of high-cost encounters.

Methods: This study employed a population-based retrospective cohort design, utilizing linked health administrative data from 2011 to 2019. The cost of care, in 2019 Canadian dollars, for up to 30 days after seeing a physician for MA was estimated from the perspective of a public payer. It included expenses from inpatient or physician visits, prescribed medication and emergency department visits. A gamma regression model with a logarithmic link was used to evaluate the impact of age, sex, income, residence, and a history of comorbidities on total cost.

Results: Over 34 million cases of MA were identified during the study period, with musculoskeletal sprains and strains accounting for 23.7 % of these cases. This ailment was also the costliest ($15.8 billion). Inpatient and physician care were the most expensive services. Higher costs were associated with older population groups, males, individuals with lower incomes, those living in urban spaces, and those with comorbidities.

Conclusion: Hospital and physician-based care pose a substantial financial burden to the Ontario government. An understanding of how the determinants of cost and care pathways influence health budgets is essential to inform decisions on more efficient yet equally effective strategies, such as pharmacist prescribing for MA.

Objectives: Given that a most clinical trials investigate potential or established medicines, it should be obvious that pharmacists, as 'medicines experts', would play a key role in such. The aim of this article was to narrate a perspective on the role of the pharmacist in clinical trials, drawing out the way that pharmacists are currently represented within clinical trials guidance documents.

Methods: This narrated review and perspective explored relevant international literature relating to clinical trial governance, particularly from the Australian setting where such documents have been recently developed and/or revised, providing a contemporary representation.

Results: Clinical trial guidance documents describing the role of pharmacists show that quality use of medicines principles are not well applied to the trial context. As such, pharmacists are underutilised in their role as medicines experts and as clinicians supporting optimal medicines use along the medication management pathway. Presently, guidance documents portray pharmacists as having largely administrative roles, focused on compliance with trial protocols, policies and legislation. Any clinical role appears relatively limited to drug handling. There is a need for capacity building in clinical trial to better recognise and utilise pharmacists' expertise, including them in the design, conduct, and leadership of clinical trials.

Conclusions: There is both scope and need to more directly include pharmacists in clinical trials. Wherever medicines are used, a pharmacist should be present and/or substantively involved in assuring the quality use of medicines, including within the full range of clinical trials. To support pharmacists, part of the global investment into clinical research should include an investment into clinical pharmacy services to ensure the quality use of medicines throughout the trial process alongside effective translation into clinical practice.