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Impact of pharmacist-led chemotherapy counseling on health-related quality of life and psychological outcomes of oncology patients in cancer hospital: A single center, open-label, randomized controlled trial 药师主导的化疗咨询对肿瘤医院肿瘤患者健康相关生活质量和心理结局的影响:一项单中心、开放标签、随机对照试验
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-26 DOI: 10.1016/j.rcsop.2025.100649
Barsha Poudel , Sabina Sankhi , Nabin Pathak , Bijaya Basyal , Shishir Paudel , Nirmal Raj Marasine

Background

Chemotherapy often imposes significant psychological distress and impairs the health-related quality of life (HRQoL) of oncology patients. This study aimed to assess the impact of pharmacist-led chemotherapy counseling on HRQoL and psychological outcomes among oncology patients in a cancer hospital in Nepal.

Methods

A single-blind, randomized controlled trial was conducted from December 2022 to July 2023 among 128 patients receiving chemotherapy. Patients were randomly allocated in a 1:1 ratio to a control group (usual care) or an intervention group (pharmacist-led counseling plus usual care). The intervention comprised a structured 20–25 min face-to-face counseling session and an educational leaflet addressing cancer, chemotherapy, psychological aspects, and lifestyle modifications. Primary outcomes—anxiety (GAD-7), depression (PHQ-9), and HRQoL (EQ-5D-3L)—were measured at baseline and three months post-intervention. For GAD-7 and PHQ-9, lower scores indicate fewer symptoms; for EQ-5D-3L, higher scores reflect poorer quality of life. Data were analyzed using an intention-to-treat approach and a generalized estimating equation (GEE) model.

Results

The intervention group demonstrated significant improvements in anxiety (GAD-7: 13.57 ± 4.08 to 10.90 ± 3.79; p < 0.001), depression (PHQ-9: 17.71 ± 4.57 to 13.50 ± 4.17; p < 0.001), and HRQoL (EQ-5D-3L: 11.82 ± 3.41 to 9.85 ± 2.51; p < 0.001) at three months. The control group showed no significant changes in GAD-7 or EQ-5D-3L scores, but a small increase in PHQ-9 scores was observed. Adjusted GEE analyses confirmed significant reductions in anxiety and depression symptoms, as well as improvements in HRQoL for the intervention group compared with the control group.

Conclusion

Pharmacist-led chemotherapy counseling significantly improved psychological well-being and HRQoL among oncology patients, highlighting the valuable role of pharmacists in comprehensive cancer care, especially in low-resource settings.
化疗通常会给肿瘤患者带来显著的心理困扰,并损害与健康相关的生活质量(HRQoL)。本研究旨在评估药师主导的化疗咨询对尼泊尔一家肿瘤医院肿瘤患者HRQoL和心理结局的影响。方法于2022年12月至2023年7月对128例化疗患者进行单盲、随机对照试验。患者按1:1的比例随机分配到对照组(常规护理)或干预组(药剂师主导的咨询加常规护理)。干预包括结构化的20-25分钟面对面咨询会议和关于癌症、化疗、心理方面和生活方式改变的教育传单。主要结局-焦虑(GAD-7),抑郁(PHQ-9)和HRQoL (EQ-5D-3L) -在基线和干预后三个月进行测量。对于GAD-7和PHQ-9,得分越低表明症状越少;EQ-5D-3L得分越高,生活质量越差。使用意向治疗方法和广义估计方程(GEE)模型分析数据。结果干预组患者3个月时焦虑(GAD-7: 13.57±4.08 ~ 10.90±3.79;p < 0.001)、抑郁(PHQ-9: 17.71±4.57 ~ 13.50±4.17;p < 0.001)、HRQoL (EQ-5D-3L: 11.82±3.41 ~ 9.85±2.51;p < 0.001)均有显著改善。对照组患者GAD-7和EQ-5D-3L评分无明显变化,但PHQ-9评分有小幅升高。调整后的GEE分析证实,与对照组相比,干预组的焦虑和抑郁症状显著减少,HRQoL也有所改善。结论药师主导的化疗咨询显著改善了肿瘤患者的心理健康状况和HRQoL,凸显了药师在肿瘤综合护理中的重要作用,特别是在资源匮乏的环境中。
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引用次数: 0
Stakeholder feedback regarding a statewide protocol for pharmacists to prescribe tobacco cessation medications 利益相关者对药剂师开出戒烟药物的全州协议的反馈
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-25 DOI: 10.1016/j.rcsop.2025.100650
Lindsey Votaw , Karen Suchanek Hudmon , Tiffany R. Shin , Elizabeth Ablah

Background

Smoking contributes to negative clinical and economic outcomes in the United States, yet most adults who smoke and report wanting to quit do not access counseling or use medications to assist cessation. In rural states, such as Kansas, access to evidence-based tobacco treatment is more challenging, and most quit attempts go unassisted. Although legislation introducing a statewide policy for pharmacists to prescribe all FDA-approved tobacco cessation medications has been implemented in other states, it is unknown if such legislation would be supported in Kansas.

Objective

The objective of this study was to characterize stakeholder perceptions of model language for a statewide policy permitting pharmacists to prescribe medications for tobacco cessation in Kansas.

Methods

A cross-sectional survey was administered to tobacco control stakeholders, who were asked to review the Indiana Statewide Protocol for Dispensing Tobacco Cessation Products by Pharmacists and provide feedback on each section, via a web-based survey. Associations, insurance carriers, governmental entities, and community pharmacies were approached for recruitment. Collected data were analyzed to identify sections receiving support and to summarize feedback for recommendations to modify the protocol language.

Results

Fifteen surveys (34 %) were completed, representing various stakeholder organizations and community pharmacies in Kansas. Sections receiving the most feedback include the introduction, purpose, pharmacist qualifications, products covered, health screening, and referral of high-risk patients.

Conclusion

Findings suggest that most tobacco control stakeholders in Kansas will be supportive of a statewide protocol for pharmacists to independently prescribe tobacco cessation products. Sections will be modified, based on respondents' feedback, to create a revised protocol that will be mutually acceptable to all stakeholders.
在美国,吸烟会导致负面的临床和经济结果,然而大多数吸烟并报告想要戒烟的成年人没有获得咨询或使用药物来帮助戒烟。在农村地区,如堪萨斯州,获得基于证据的烟草治疗更具挑战性,大多数戒烟尝试都没有得到帮助。尽管其他州已经实施了一项立法,要求药剂师开出所有经fda批准的戒烟药物,但尚不清楚堪萨斯州是否会支持这一立法。本研究的目的是表征利益相关者对堪萨斯州允许药剂师开戒烟药物的全州政策的模式语言的看法。方法对烟草控制利益相关者进行横断面调查,要求他们审查印第安纳州药剂师分发戒烟产品的协议,并通过基于网络的调查对每个部分提供反馈。与协会、保险公司、政府机构和社区药房接洽进行招募。对收集到的数据进行分析,以确定得到支持的部分,并总结反馈意见,提出修改协议语言的建议。结果完成了15项调查(34%),代表了堪萨斯州的各种利益相关者组织和社区药房。收到最多反馈的部分包括介绍、目的、药剂师资格、涵盖的产品、健康筛查和高危患者的转诊。结论:研究结果表明,堪萨斯州的大多数烟草控制利益相关者将支持药剂师独立开戒烟产品的全州协议。将根据受访者的反馈修改部分内容,以创建所有利益相关者都能接受的修订协议。
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引用次数: 0
Driven to stay or leave: Exploring motivation, engagement, and turnover intentions among pharmacists in the healthcare system 驱动留下或离开:探索动机,参与,并在医疗保健系统的药剂师更替意图
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-22 DOI: 10.1016/j.rcsop.2025.100645
Muna Sabah Murad , Mohammad Waheedi , Fatima Jeragh Alhaddad , Maryam Yousef Baqer , Farah Atallah Alenezi

Background

High pharmacist turnover remains a global concern, as pharmacists' intention to leave their jobs can lead to increased financial burdens and reduced quality of pharmaceutical care. Understanding the psychological and organizational factors that drive this intention to leave is essential for designing effective retention strategies.

Objectives

This study aimed to identify the variables related to motivational needs and work engagement which are associated with pharmacists' intention to leave.

Methods

A cross-sectional study was conducted using a self-administered questionnaire among 288 pharmacists in eight hospitals. The survey assessed multidimensional work motivation, job engagement (UWES-9), and turnover intention. Structural equation modeling (SEM) was used to analyze the interrelations between constructs and demographic variables.

Results

Work engagement was negatively associated with turnover intention (β = −0.49), Amotivation was directly associated with higher turnover intention (β = 0.17) and lower engagement (β = − 0.10). Intrinsic motivation had a statistically significant and positive effect on work engagement (β = 0.81). Pharmacists in public hospitals reported higher turnover intention than those in private hospitals (β = − 0.19). Pharmacists less than 40 years old and those in certain hospitals exhibited higher amotivation and intention to leave. Organizational setting influenced several motivational types, with intrinsic, extrinsic social motivation and identified motivation more prevalent among public sector pharmacists.

Conclusion

Work engagement and motivation were critical factors impacting pharmacists' turnover intention, with organizational context and age acting as important moderators. Strategies aimed at boosting intrinsic motivation and work engagement, particularly for younger pharmacists, are vital for decreasing turnover and fostering a more stable pharmacy workforce within healthcare systems.
药剂师的高流失率仍然是一个全球关注的问题,因为药剂师离职的意图可能导致财务负担增加和药学服务质量下降。了解导致这种离职倾向的心理和组织因素对于设计有效的留存策略至关重要。目的本研究旨在找出与药师离职意向相关的动机需求和工作投入变量。方法采用自填问卷对8所医院288名药师进行横断面调查。该调查评估了多维工作动机、工作投入(UWES-9)和离职意向。结构方程模型(SEM)用于分析构念与人口学变量之间的相互关系。结果工作投入与离职倾向呈负相关(β = - 0.49),激励与高离职倾向(β = 0.17)和低敬业度(β = - 0.10)直接相关。内在动机对工作投入有显著的正向影响(β = 0.81)。公立医院药师离职意向高于私立医院药师(β = - 0.19)。40岁以下药师和部分医院药师离职动机和离职意向较高。组织环境影响多种动机类型,其中内在动机、外在社会动机和识别动机在公共部门药剂师中更为普遍。结论工作投入和工作动机是影响药师离职意向的关键因素,组织背景和年龄是影响药师离职意向的重要调节因素。旨在促进内在动机和工作投入的战略,特别是对年轻药剂师来说,对于减少人员流动和在医疗保健系统内培养更稳定的药房劳动力至关重要。
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引用次数: 0
Australian pharmacists' experiences and perspectives in implementing a chronic kidney disease screening service in community pharmacies: A qualitative study 澳大利亚药剂师在社区药房实施慢性肾脏疾病筛查服务的经验和观点:一项定性研究
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-21 DOI: 10.1016/j.rcsop.2025.100643
Ayana Korsa , Ines Krass , Connie Van , Wubshet Tesfaye , Natasa Gisev , Anh Tran , Rita McMorrow , Breonny Robson , Judith Fethney , Vincent Versace , Kamal Sud , Lukas Kairaitis , David Johnson , Judy Mullan , Sanjyot Vagholkar , Ronald L. Castelino

Background

The emerging role of pharmacists in chronic kidney disease (CKD) care prompted the pharmacy-led screening and quality use of medicines in CKD trial (QUM-CKD), a pharmacy-led screening initiative to detect previously undiagnosed CKD and improve medication safety.Objective: To explore pharmacists' experiences and perspectives on the implementation of the QUM-CKD trial in Australian community pharmacies.

Methods

A descriptive phenomenological qualitative approach was employed, involving in-depth, semi-structured telephone interviews with thirteen metropolitan and rural community pharmacists in the trial. Pharmacists were selected via purposive maximum variation sampling and were recruited mid-trial. Interviews were audio- recorded, transcribed verbatim, and thematically analysed using both deductive and inductive approaches in NVivo 14.

Results

Most participating pharmacists reported having positive experiences with the trial's implementation. Facilitators of implementation included pharmacists' knowledge and beliefs, the availability of resources, support and training. The alignment with roles, values, and systems, along with perceived benefits of the service, the point-of-care testing service, a whole-team approach, and patient acceptance coupled with positive feedback, also facilitated implementation. Barriers included insufficient pharmacist staffing, time constraints, heavy workload, trial software and documentation issues, patients' lack of time, interest or unfavourable perceptions of the service, and interprofessional communication challenges between pharmacists and general practitioners (GPs). Pharmacists also suggested several potential improvements and expressed concerns about the sustainability of the service.

Conclusions

Australian community pharmacists generally reported positive experiences in implementing the QUM-CKD trial. To ensure the service's success and sustainability, we recommend adequate pharmacy staffing, appropriate pharmacist remuneration, active stakeholder promotion and strong interprofessional collaboration. Pharmacists' suggestions for service improvement should also be considered.
背景:药剂师在慢性肾脏疾病(CKD)治疗中的新作用促进了CKD试验(QUM-CKD)中以药学为主导的筛查和药物质量使用,这是一项以药学为主导的筛查倡议,旨在发现以前未诊断的CKD并提高用药安全性。目的:探讨澳大利亚社区药房实施QUM-CKD试验的经验和观点。方法采用描述现象学定性方法,对13名城市和农村社区药师进行深度半结构化电话访谈。通过有目的的最大变异抽样选择药师,并在试验中期招募。访谈录音,逐字转录,并在NVivo 14中使用演绎和归纳方法进行主题分析。结果大多数参与试验的药剂师报告说,他们对试验的实施有积极的体验。促进实施的因素包括药师的知识和信念、资源的可得性、支持和培训。与角色、价值观和系统的一致,以及服务的感知利益、即时护理测试服务、全团队方法和患者接受以及积极反馈也促进了实施。障碍包括药剂师人手不足、时间限制、工作量大、试验软件和文件问题、患者缺乏时间、对服务的兴趣或不利看法,以及药剂师和全科医生(gp)之间的跨专业沟通挑战。药剂师还提出了几项可能的改进措施,并对该服务的可持续性表示担忧。结论澳大利亚社区药剂师普遍报告了实施QUM-CKD试验的积极经验。为了确保服务的成功和可持续发展,我们建议配备足够的药房人员,适当的药剂师薪酬,积极促进利益相关者和强有力的跨专业合作。还应考虑药师对服务改进的建议。
{"title":"Australian pharmacists' experiences and perspectives in implementing a chronic kidney disease screening service in community pharmacies: A qualitative study","authors":"Ayana Korsa ,&nbsp;Ines Krass ,&nbsp;Connie Van ,&nbsp;Wubshet Tesfaye ,&nbsp;Natasa Gisev ,&nbsp;Anh Tran ,&nbsp;Rita McMorrow ,&nbsp;Breonny Robson ,&nbsp;Judith Fethney ,&nbsp;Vincent Versace ,&nbsp;Kamal Sud ,&nbsp;Lukas Kairaitis ,&nbsp;David Johnson ,&nbsp;Judy Mullan ,&nbsp;Sanjyot Vagholkar ,&nbsp;Ronald L. Castelino","doi":"10.1016/j.rcsop.2025.100643","DOIUrl":"10.1016/j.rcsop.2025.100643","url":null,"abstract":"<div><h3>Background</h3><div>The emerging role of pharmacists in chronic kidney disease (CKD) care prompted the pharmacy-led screening and quality use of medicines in CKD trial (QUM-CKD), a pharmacy-led screening initiative to detect previously undiagnosed CKD and improve medication safety.Objective: To explore pharmacists' experiences and perspectives on the implementation of the QUM-CKD trial in Australian community pharmacies.</div></div><div><h3>Methods</h3><div>A descriptive phenomenological qualitative approach was employed, involving in-depth, semi-structured telephone interviews with thirteen metropolitan and rural community pharmacists in the trial. Pharmacists were selected via purposive maximum variation sampling and were recruited mid-trial. Interviews were audio- recorded, transcribed verbatim, and thematically analysed using both deductive and inductive approaches in NVivo 14.</div></div><div><h3>Results</h3><div>Most participating pharmacists reported having positive experiences with the trial's implementation. Facilitators of implementation included pharmacists' knowledge and beliefs, the availability of resources, support and training. The alignment with roles, values, and systems, along with perceived benefits of the service, the point-of-care testing service, a whole-team approach, and patient acceptance coupled with positive feedback, also facilitated implementation. Barriers included insufficient pharmacist staffing, time constraints, heavy workload, trial software and documentation issues, patients' lack of time, interest or unfavourable perceptions of the service, and interprofessional communication challenges between pharmacists and general practitioners (GPs). Pharmacists also suggested several potential improvements and expressed concerns about the sustainability of the service.</div></div><div><h3>Conclusions</h3><div>Australian community pharmacists generally reported positive experiences in implementing the QUM-CKD trial. To ensure the service's success and sustainability, we recommend adequate pharmacy staffing, appropriate pharmacist remuneration, active stakeholder promotion and strong interprofessional collaboration. Pharmacists' suggestions for service improvement should also be considered.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100643"},"PeriodicalIF":1.8,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144902165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors affecting career-related decisions within the contemporary pharmacy workforce in Australia 影响职业相关决策的因素在澳大利亚当代药房劳动力
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-21 DOI: 10.1016/j.rcsop.2025.100648
Jocelyn Bussing, Lorraine Smith, Bandana Saini

Introduction

Pharmacists are essential to healthcare delivery in Australia, making effective workforce planning critical to ensure equitable health outcomes. This study explores factors influencing the career decisions of Australian pharmacists from diverse demographic and geographical backgrounds with implications for recruitment, retention and policy strategies to address workforce shortages.

Method

We conducted semi-structured interviews between November 2022–February 2024. An interview guide informed by relevant literature was used to facilitate the interview process. Participants were recruited through purposive convenience sampling complemented by passive snowballing. All interviews were recorded, field notes were taken and the data transcribed, deidentified, and analysed using NVivo software through an inductive thematic process.

Results

Participants exhibited a range of ages, genders, practice settings and locations, which revealed distinct career trajectories and decision-making influences. Three main themes emerged: career initiation (choosing pharmacy as a profession), career development, satisfaction and retention, and the roles of gender, geography and other life issues. Findings indicate that the initial choice to pursue pharmacy was driven by personal aptitude, accessible training locations, promising employability, gender-suitable work configurations, flexibility, and early educational exposure. Early career decisions were shaped by factors such as mentorship, specialised roles, employee benefits, and supportive work environments, while personal life factors further influenced career trajectories. Leadership or ownership aspirations were notably tied to mentors and role models. Limitations include underrepresented perspectives, limited gender diversity among participants, and an all-female research team.

Conclusion

These nuanced insights offer Australian pharmacy leaders and policy makers factors to address or capitalise on, to ensure a robust, equitably distributed and motivated workforce.
药剂师对澳大利亚的医疗保健服务至关重要,有效的劳动力规划对确保公平的健康结果至关重要。本研究探讨了影响澳大利亚药剂师职业决策的因素,这些因素来自不同的人口和地理背景,对招聘、保留和解决劳动力短缺的政策策略具有影响。方法于2022年11月至2024年2月进行半结构化访谈。为了方便访谈过程,我们使用了一份参考相关文献的访谈指南。参与者是通过有目的的方便抽样和被动滚雪球的方式招募的。所有访谈都被记录下来,现场笔记被记录下来,数据被转录、去识别,并通过归纳主题过程使用NVivo软件进行分析。结果被试具有不同的年龄、性别、执业背景和地点,其职业轨迹和决策影响具有明显的差异性。三个主要主题出现了:职业开始(选择药学作为职业),职业发展,满意度和保留,以及性别,地理和其他生活问题的作用。研究结果表明,最初选择药学是由个人能力、可获得的培训地点、有前途的就业能力、适合性别的工作配置、灵活性和早期教育背景驱动的。早期的职业决定受导师、专业角色、员工福利和支持性工作环境等因素的影响,而个人生活因素进一步影响了职业轨迹。领导或所有权的愿望明显与导师和榜样联系在一起。限制包括未被充分代表的观点,参与者的性别多样性有限,以及全女性研究团队。这些细致入微的见解为澳大利亚药房领导者和政策制定者提供了解决或利用的因素,以确保强大,公平分配和积极的员工队伍。
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引用次数: 0
Impact of pharmaceutical care interventions on antidepressants adherence and clinical outcomes in depressed patients: A systematic review 药物护理干预对抑郁症患者抗抑郁药物依从性和临床结局的影响:一项系统综述
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-20 DOI: 10.1016/j.rcsop.2025.100644
Nirmal Raj Marasine , Sabina Sankhi , Shishir Paudel , Anisha Chalise , Rajendra Lamichhane

Background

Medication non-adherence, impaired health-related quality of life (HRQoL), increased depression severity, and patient dissatisfaction are common challenges among patients with depression. This systematic review aimed to evaluate the impact of pharmaceutical care interventions (PCIs) on antidepressant adherence, HRQoL, depression severity, and patient satisfaction.

Methods

This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted across PubMed, EMBASE, Web of Science, Scopus, PsycINFO, and CINAHL for randomized controlled trials (RCTs) published between 2000 and 2024. Studies evaluating pharmacist-led pharmaceutical care interventions aimed at improving antidepressant use and related outcomes were included. Data extraction and risk of bias assessment were performed using standardized forms and the Cochrane Collaboration's Risk of Bias tool.

Results

Fifteen RCTs met the inclusion criteria. Common intervention strategies included patient education, counseling, telephone follow-ups, and drug monitoring. Nine studies reported statistically significant improvements in antidepressant adherence. Of the three studies assessing HRQoL, one demonstrated significant improvement. Four of thirteen studies showed a significant reduction in depression severity, and three of five studies reported increased patient satisfaction in the intervention group compared to controls.

Conclusion

Pharmaceutical care interventions, particularly patient education and counseling, contribute meaningfully in improving antidepressant adherence and related patient outcomes. However, findings across studies are inconsistent due to variability in intervention components, measurement tools, delivery methods, and outcome measures. Further research should focus on well-designed, large randomized trials with standardized, therory-based interventions.
研究背景:药物依从性差、健康相关生活质量(HRQoL)受损、抑郁严重程度增加和患者不满是抑郁症患者面临的共同挑战。本系统综述旨在评估药学服务干预(PCIs)对抗抑郁药物依从性、HRQoL、抑郁严重程度和患者满意度的影响。方法本综述遵循系统评价和荟萃分析的首选报告项目(PRISMA)指南。综合检索PubMed、EMBASE、Web of Science、Scopus、PsycINFO和CINAHL,检索2000年至2024年间发表的随机对照试验(rct)。评估以药剂师为主导的旨在改善抗抑郁药使用和相关结果的药学服务干预措施的研究被纳入其中。使用标准化表格和Cochrane协作的偏倚风险工具进行数据提取和偏倚风险评估。结果15项rct符合纳入标准。常见的干预策略包括患者教育、咨询、电话随访和药物监测。9项研究报告了抗抑郁药物依从性的统计学显著改善。在评估HRQoL的三项研究中,一项研究显示有显著改善。13项研究中有4项显示抑郁症严重程度显著降低,5项研究中有3项报告说,与对照组相比,干预组的患者满意度提高。结论药学服务干预,特别是患者教育和咨询,对改善抗抑郁依从性和相关患者预后有重要作用。然而,由于干预成分、测量工具、交付方法和结果测量的可变性,研究结果不一致。进一步的研究应侧重于设计良好的大型随机试验,采用标准化的、基于理论的干预措施。
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引用次数: 0
Criteria pharmacists use to refer patients to a post discharge pharmacist review clinic 标准药剂师使用转介病人出院后药剂师审查诊所
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-20 DOI: 10.1016/j.rcsop.2025.100647
Adrienne Kostellar , Michael Barras , Ian Coombes , Andrew Hale , Carla Scuderi , Neil Cottrell , Nazanin Falconer

Background

The transition from hospital discharge to primary care is a critical period in a patient's healthcare journey. Health system errors occur, due to a breakdown in communication or lack of structured planning which can lead to medication related harm or hospital readmission. At a quaternary referral hospital in Australia, pharmacists refer Internal Medicine patients to a pharmacist-led clinic for post-discharge medication review. While clinical resources exist to guide identification of at-risk patients, it remains unclear if and to what extent, pharmacists incorporate these criteria into their referral.

Aim

To determine the criteria and reasons used by pharmacists to refer Internal Medicine patients to a post discharge pharmacist review clinic.

Methods

Semi-structured interviews were conducted with hospital pharmacists who had worked in Internal Medicine and previously referred patients to the post discharge review clinic. Interviews were conducted until data saturation was obtained. Interviews were audio recorded, transcribed and coded using NVivo®. Themes and subthemes were identified through inductive thematic analysis and finalised via discussion within the research team.

Results

Eleven pharmacists were interviewed. Five themes emerged describing referral criteria and reasons: (1) medication criteria including the use of high-risk medications and adjustments; (2) patient criteria including health status, frailty and social aspects of health including carer supports; (3) system pressures including patient flow and time constraints in care delivery; (4) post-discharge care including medication liaison and evaluation of tolerability and; (5) clinical judgement described as “worry” about the patient, highlighting the role of clinical reasoning.

Conclusion

Pharmacists used established criteria from clinical resources to identify high-risk patients for referral; however, they also relied on clinical judgement. Referrals aimed to prevent medication related harm and improve communication with patients and healthcare providers. Future research should evaluate the effectiveness of clinical judgement to ensure high-risk patients are identified for transition of care services.
从出院到初级保健的过渡是患者医疗保健旅程中的关键时期。由于沟通中断或缺乏结构化规划,可能导致与药物有关的伤害或再次住院,从而发生卫生系统错误。在澳大利亚的一家四级转诊医院,药剂师将内科患者转介到药剂师领导的诊所进行出院后药物审查。虽然存在临床资源来指导识别高危患者,但尚不清楚药剂师是否以及在多大程度上将这些标准纳入其转诊。目的确定药师将内科患者转介至出院后药师复查门诊的标准和原因。方法采用半结构化访谈法,对曾在内科工作过的医院药师和以前转介到出院复查门诊的患者进行访谈。访谈一直进行到数据饱和为止。使用NVivo®对访谈进行录音、转录和编码。主题和副主题通过归纳主题分析确定,并通过研究团队内部的讨论最终确定。结果6名受访药师。出现了五个主题,描述了转诊标准和原因:(1)用药标准,包括高危药物的使用和调整;(2)患者标准,包括健康状况、虚弱和健康的社会方面,包括照顾者的支持;(3)系统压力,包括患者流量和护理服务的时间限制;(4)出院后护理,包括药物联络和耐受性评估;(5)临床判断描述为“担心”患者,突出临床推理的作用。结论药师使用临床资源中建立的标准识别高危患者进行转诊;然而,他们也依赖于临床判断。转诊旨在预防药物相关伤害,并改善与患者和医疗保健提供者的沟通。未来的研究应评估临床判断的有效性,以确保高危患者被识别并转移护理服务。
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引用次数: 0
From the patient point of view: Using eye tracking to evaluate older adult shopping behavior change with a community pharmacy OTC intervention 从患者的角度:使用眼动追踪评估老年人购物行为改变与社区药房OTC干预
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-19 DOI: 10.1016/j.rcsop.2025.100646
Emily L. Hoffins , Jamie A. Stone , Aaron M. Gilson , Taylor L. Watterson , Jason S. Chladek , Michelle A. Chui

Background

Over-the-counter medications are an integral component of community pharmacies, providing patients with accessible options for addressing health concerns independently. However, this increases the potential for adverse drug events, particularly among older adults, due to overestimating medication safety. Pharmacy layouts, often informed by retail store principles, frequently prioritize product profitability over patient safety.

Objective

This study evaluates the impact of Senior Safe™, a physical redesign of pharmacy aisles, on older adults' visual attention during medication selection to enhance patient safety.

Methods

Senior Safe rearranged over-the-counter products based on safety designation and human factors engineering principles. Older adult participants wore eye-tracking glasses and engaged in a scenario-based simulation to measure gaze behavior during medication selection. Simulations were conducted pre- and post-intervention to analyze fixation durations within each medication safety category.

Results

Thirty-eight older adult participants completed this portion of the study. Post-intervention participants spent significantly more time fixating on Senior Safe medications (μ = 25.17 s) compared to pre-implementation participants (μ = 9.40s). Post-intervention participants also spent more time selecting OTCs overall.

Conclusion

This study demonstrates how environmental redesign influences patient visual attention behavior. These findings emphasize the role of environmental design in enhancing patient safety and support eye-tracking as an effective method for measuring patient behavior in community pharmacy settings.
非处方药物是社区药房的一个组成部分,为患者提供可获得的选择,以独立解决健康问题。然而,这增加了药物不良事件的可能性,特别是在老年人中,由于高估了药物安全性。药房的布局,通常根据零售商店的原则,经常优先考虑产品的盈利能力,而不是患者的安全。目的:本研究旨在评估老年人在选择药物时视觉注意力的影响,以提高患者的安全性。方法基于安全标识和人因工程原理对非处方药进行重新排序。老年参与者戴着眼球追踪眼镜,参与基于场景的模拟,以测量药物选择过程中的凝视行为。在干预前和干预后进行模拟,分析每个药物安全类别的固定时间。38名老年参与者完成了研究的这一部分。干预后受试者对高级安全药物的注视时间(μ = 25.17 s)显著高于干预前受试者(μ = 9.40s)。总体而言,干预后的参与者也花了更多的时间选择otc。结论本研究揭示了环境再造对患者视觉注意行为的影响。这些研究结果强调了环境设计在提高患者安全方面的作用,并支持眼动追踪作为衡量社区药房患者行为的有效方法。
{"title":"From the patient point of view: Using eye tracking to evaluate older adult shopping behavior change with a community pharmacy OTC intervention","authors":"Emily L. Hoffins ,&nbsp;Jamie A. Stone ,&nbsp;Aaron M. Gilson ,&nbsp;Taylor L. Watterson ,&nbsp;Jason S. Chladek ,&nbsp;Michelle A. Chui","doi":"10.1016/j.rcsop.2025.100646","DOIUrl":"10.1016/j.rcsop.2025.100646","url":null,"abstract":"<div><h3>Background</h3><div>Over-the-counter medications are an integral component of community pharmacies, providing patients with accessible options for addressing health concerns independently. However, this increases the potential for adverse drug events, particularly among older adults, due to overestimating medication safety. Pharmacy layouts, often informed by retail store principles, frequently prioritize product profitability over patient safety.</div></div><div><h3>Objective</h3><div>This study evaluates the impact of Senior Safe™, a physical redesign of pharmacy aisles, on older adults' visual attention during medication selection to enhance patient safety.</div></div><div><h3>Methods</h3><div>Senior Safe rearranged over-the-counter products based on safety designation and human factors engineering principles. Older adult participants wore eye-tracking glasses and engaged in a scenario-based simulation to measure gaze behavior during medication selection. Simulations were conducted pre- and post-intervention to analyze fixation durations within each medication safety category.</div></div><div><h3>Results</h3><div>Thirty-eight older adult participants completed this portion of the study. Post-intervention participants spent significantly more time fixating on Senior Safe medications (μ = 25.17 s) compared to pre-implementation participants (μ = 9.40s). Post-intervention participants also spent more time selecting OTCs overall.</div></div><div><h3>Conclusion</h3><div>This study demonstrates how environmental redesign influences patient visual attention behavior. These findings emphasize the role of environmental design in enhancing patient safety and support eye-tracking as an effective method for measuring patient behavior in community pharmacy settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100646"},"PeriodicalIF":1.8,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144890940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparison of length of stay in community-acquired pneumonia patients who fit protocol for pharmacy driven de-escalation of ceftriaxone to standard of care 社区获得性肺炎患者住院时间的比较,这些患者符合药房驱动的头孢曲松降压至标准治疗方案
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-07 DOI: 10.1016/j.rcsop.2025.100640
Brady Raab , Faith Furst , Katelyn Zumpf , Tina Samson , Timothy F. Murrey

Purpose

Community-acquired pneumonia (CAP) represents a significant burden on healthcare systems, often necessitating prolonged hospital stays and substantial costs. Studies have demonstrated the safety and efficacy of early switching from intravenous (IV) to oral antibiotics in CAP, yet there remains underutilization of this practice, particularly for antibiotics with no bioequivalent analogs like ceftriaxone. This study evaluated the outcomes of pharmacy driven protocol to switch patients from IV to oral antibiotics in CAP.

Methods

This retrospective, multi-center, observational cohort study evaluated the impact of a pharmacy-led protocol for IV to oral de-escalation of ceftriaxone in CAP patients within a large healthcare system. A collaborative drug therapy management agreement enabled pharmacists to initiate de-escalation in eligible patients meeting pre-specified stability criteria.

Results

Analysis of 2314 participants (pre-implementation n = 1735; post-implementation n = 579) revealed a modest but statistically significant reduction in length of stay (4.87 to 4.57 days, p = 0.0461) and duration of ceftriaxone therapy (3.24 to 2.77 days, p < 0.01) post-implementation. Total antibiotic duration increased slightly post-implementation without statistical significance (12.7 to 13.3 days, p = 0.11), and there was no significant difference in all-cause 30-day readmission rates (p = 0.36).

Conclusion

These findings underscore the potential benefits of pharmacist driven IV to oral de-escalation protocols in optimizing antibiotic and resource utilization in CAP management. Future prospective studies are needed to validate these findings and explore broader implementation strategies in diverse healthcare settings.
社区获得性肺炎(CAP)是卫生保健系统的一个重大负担,通常需要长时间住院和大量费用。研究已经证明了CAP早期从静脉注射(IV)转为口服抗生素的安全性和有效性,但这种做法仍未得到充分利用,特别是对于没有头孢曲松等生物等效类似物的抗生素。本研究评估了药物驱动方案将CAP患者从静脉注射转为口服抗生素的结果。方法:本研究是一项回顾性、多中心、观察性队列研究,评估了在大型医疗保健系统中,药物驱动方案对CAP患者静脉注射到口服头孢曲松降压的影响。合作药物治疗管理协议使药剂师能够在符合预先指定的稳定性标准的合格患者中启动降级。结果分析2314名参与者(实施前n = 1735;实施后n = 579)显示住院时间(4.87至4.57天,p = 0.0461)和头孢曲松治疗持续时间(3.24至2.77天,p <;0.01)实现后。实施后总抗生素使用时间略有增加,但无统计学意义(12.7 ~ 13.3天,p = 0.11),全因30天再入院率无统计学差异(p = 0.36)。结论药师驱动的静脉注射与口服降压方案在优化CAP管理中的抗生素和资源利用方面具有潜在的优势。需要未来的前瞻性研究来验证这些发现,并探索在不同医疗保健环境中更广泛的实施策略。
{"title":"Comparison of length of stay in community-acquired pneumonia patients who fit protocol for pharmacy driven de-escalation of ceftriaxone to standard of care","authors":"Brady Raab ,&nbsp;Faith Furst ,&nbsp;Katelyn Zumpf ,&nbsp;Tina Samson ,&nbsp;Timothy F. Murrey","doi":"10.1016/j.rcsop.2025.100640","DOIUrl":"10.1016/j.rcsop.2025.100640","url":null,"abstract":"<div><h3>Purpose</h3><div>Community-acquired pneumonia (CAP) represents a significant burden on healthcare systems, often necessitating prolonged hospital stays and substantial costs. Studies have demonstrated the safety and efficacy of early switching from intravenous (IV) to oral antibiotics in CAP, yet there remains underutilization of this practice, particularly for antibiotics with no bioequivalent analogs like ceftriaxone. This study evaluated the outcomes of pharmacy driven protocol to switch patients from IV to oral antibiotics in CAP.</div></div><div><h3>Methods</h3><div>This retrospective, multi-center, observational cohort study evaluated the impact of a pharmacy-led protocol for IV to oral de-escalation of ceftriaxone in CAP patients within a large healthcare system. A collaborative drug therapy management agreement enabled pharmacists to initiate de-escalation in eligible patients meeting pre-specified stability criteria.</div></div><div><h3>Results</h3><div>Analysis of 2314 participants (pre-implementation <em>n</em> = 1735; post-implementation <em>n</em> = 579) revealed a modest but statistically significant reduction in length of stay (4.87 to 4.57 days, <em>p</em> = 0.0461) and duration of ceftriaxone therapy (3.24 to 2.77 days, <em>p</em> &lt; 0.01) post-implementation. Total antibiotic duration increased slightly post-implementation without statistical significance (12.7 to 13.3 days, <em>p</em> = 0.11), and there was no significant difference in all-cause 30-day readmission rates (<em>p</em> = 0.36).</div></div><div><h3>Conclusion</h3><div>These findings underscore the potential benefits of pharmacist driven IV to oral de-escalation protocols in optimizing antibiotic and resource utilization in CAP management. Future prospective studies are needed to validate these findings and explore broader implementation strategies in diverse healthcare settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100640"},"PeriodicalIF":1.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Does pharmacist–patient gender discordance influence medication guidance for gender-specific diseases? 药师-患者性别不一致是否会影响针对性别特异性疾病的用药指导?
IF 1.8 Q3 PHARMACOLOGY & PHARMACY Pub Date : 2025-08-05 DOI: 10.1016/j.rcsop.2025.100642
Manato Nomi , Ryota Kumaki , Rieko Takehira , Etsuko Arita , Keiko Kishimoto

Background

This study aimed to determine whether community pharmacists perceive barriers to providing medication guidance for gender-specific diseases and to clarify whether these perceived barriers are influenced by pharmacist and patient gender concordance or discordance.

Methods

A web-based survey was conducted with pharmacists from five pharmacy groups in Japan. The questionnaire evaluated pharmacists' hesitancy and uncertainty in knowledge using a 7-point Likert scale across 10 gender-specific and three nongender-specific diseases. Each disease was examined under conditions of gender concordance and discordance between a pharmacist and patient. Results were visualized using scatter plots, and the factors contributing to barriers were examined using multivariable logistic regression.

Results

A total of 1315 responses were obtained, including 696 from female pharmacists and 583 from male pharmacists. Among the 10 gender-specific diseases, 9 were in the first quadrant, indicating high hesitancy and uncertainty under gender discordance. However, some diseases exhibited high perceived barriers even under gender concordance. Multivariate logistic regression analysis revealed that pharmacists' implicit assumptions, such as perceiving patients' unwillingness to receive guidance, significantly contributed to stronger perceived barriers. Furthermore, neither years of professional experience nor medication guidance frequency was associated with reduced barriers.

Conclusion

Community pharmacists perceived significant barriers to providing medication guidance for certain gender-specific diseases. These barriers existed in cases of gender discordance and concordance with patients. Pharmacists' experience alone is insufficient to reduce these perceptions, highlighting the need for educational interventions addressing implicit assumptions related to gender-specific care.
背景本研究旨在确定社区药剂师是否感知到障碍,以提供针对性别特异性疾病的药物指导,并澄清这些感知障碍是否受到药剂师和患者性别一致性或不一致性的影响。方法采用网络调查方法,对日本5个药局药师进行调查。问卷使用7分李克特量表评估药剂师在10种性别特异性疾病和3种非性别特异性疾病方面的犹豫和不确定性。每种疾病都是在药剂师和患者性别一致和不一致的条件下进行检查的。结果用散点图可视化,并使用多变量逻辑回归检查导致障碍的因素。结果共收到问卷1315份,其中女药师696份,男药师583份。在10种性别特异性疾病中,有9种在第一象限,表明性别不一致下的高犹豫性和不确定性。然而,即使在性别一致的情况下,一些疾病也表现出高度的感知障碍。多因素logistic回归分析显示,药师的内隐假设(如感知患者不愿接受指导)显著促进了感知障碍的增强。此外,专业经验的年数和药物指导的频率都与障碍的减少无关。结论社区药师对某些性别疾病的用药指导存在较大障碍。这些障碍存在于性别不一致和与患者一致的情况下。仅凭药剂师的经验不足以减少这些看法,强调需要进行教育干预,解决与性别特异性护理相关的隐性假设。
{"title":"Does pharmacist–patient gender discordance influence medication guidance for gender-specific diseases?","authors":"Manato Nomi ,&nbsp;Ryota Kumaki ,&nbsp;Rieko Takehira ,&nbsp;Etsuko Arita ,&nbsp;Keiko Kishimoto","doi":"10.1016/j.rcsop.2025.100642","DOIUrl":"10.1016/j.rcsop.2025.100642","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to determine whether community pharmacists perceive barriers to providing medication guidance for gender-specific diseases and to clarify whether these perceived barriers are influenced by pharmacist and patient gender concordance or discordance.</div></div><div><h3>Methods</h3><div>A web-based survey was conducted with pharmacists from five pharmacy groups in Japan. The questionnaire evaluated pharmacists' hesitancy and uncertainty in knowledge using a 7-point Likert scale across 10 gender-specific and three nongender-specific diseases. Each disease was examined under conditions of gender concordance and discordance between a pharmacist and patient. Results were visualized using scatter plots, and the factors contributing to barriers were examined using multivariable logistic regression.</div></div><div><h3>Results</h3><div>A total of 1315 responses were obtained, including 696 from female pharmacists and 583 from male pharmacists. Among the 10 gender-specific diseases, 9 were in the first quadrant, indicating high hesitancy and uncertainty under gender discordance. However, some diseases exhibited high perceived barriers even under gender concordance. Multivariate logistic regression analysis revealed that pharmacists' implicit assumptions, such as perceiving patients' unwillingness to receive guidance, significantly contributed to stronger perceived barriers. Furthermore, neither years of professional experience nor medication guidance frequency was associated with reduced barriers.</div></div><div><h3>Conclusion</h3><div>Community pharmacists perceived significant barriers to providing medication guidance for certain gender-specific diseases. These barriers existed in cases of gender discordance and concordance with patients. Pharmacists' experience alone is insufficient to reduce these perceptions, highlighting the need for educational interventions addressing implicit assumptions related to gender-specific care.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"20 ","pages":"Article 100642"},"PeriodicalIF":1.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144831193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Exploratory research in clinical and social pharmacy
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