Exploratory research in clinical and social pharmacy最新文献_第8页

Improved medication adherence and health literacy in parents of children with ADHD: Effects of a targeted educational program 改善ADHD儿童父母的药物依从性和健康素养：目标教育计划的效果

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-09 DOI: 10.1016/j.rcsop.2025.100634

Nafiseh Valaei Sharif , Peivand Ghasemzadeh , Niayesh Mohebbi , Sogand Ghasemzadeh

Background

Although medication is important for children with Attention Deficit Hyperactivity Disorder (ADHD), medication adherence is low among parents. One of the key factors affecting medication adherence and disorder management is health literacy.

Objective

This study aimed to assess the effectiveness of an educational program for parents of children with ADHD in improving medication adherence and health literacy.

Methods

An educational program was developed that covered four main topics: general disorder information, treatment, parenting based on emotional needs, and basic health information. A total of 191 parents were screened and assigned 108 eligible participants to either the intervention group (n = 74) or the control group (n = 35). The intervention group received a two-month educational program delivered via messenger application, while the control group received general counseling. Medication adherence and health literacy were measured before and after the intervention. t-test, ANOVA, ANCOVA, and chi-square test were used to compare group differences.

Results

Post-intervention, the intervention group showed significantly higher medication adherence (6.87 ± 1.36) than the control group (5.46 ± 1.45). The intervention group also demonstrated higher health literacy scores (82.34 ± 6.96) than the control group (72.15 ± 6.52). Covariance analysis revealed significant improvements in health literacy (F = 162.73, p < 0.001, eta squared = 0.657) and medication adherence (F = 40.41, p < 0.001, eta squared = 0.322) scores. A significant difference was found in medication adherence improvement based on economic status (p = 0.037) in the intervention group. However, no significant differences in medication adherence and health literacy were observed based on parental gender, education level, or insurance status.

Conclusion

The educational program showed improvement in medication adherence and health literacy among parents of children with ADHD.

背景：虽然药物治疗对患有注意缺陷多动障碍（ADHD）的儿童很重要，但家长的药物依从性很低。影响药物依从性和障碍管理的关键因素之一是健康素养。目的本研究旨在评估ADHD儿童家长教育计划在提高药物依从性和健康素养方面的有效性。方法制定了一个教育计划，包括四个主要主题：一般障碍信息、治疗、基于情感需求的养育和基本健康信息。共筛选了191名家长，并将108名符合条件的参与者分配到干预组（n = 74）和对照组（n = 35）。干预组通过信使应用程序接受为期两个月的教育计划，而对照组接受一般咨询。在干预前后测量药物依从性和健康素养。采用t检验、ANOVA、ANCOVA、卡方检验比较组间差异。结果干预后，干预组患者的药物依从性（6.87±1.36）明显高于对照组（5.46±1.45）。干预组健康素养得分（82.34±6.96）高于对照组（72.15±6.52）。协方差分析显示健康素养显著提高(F = 162.73, p <；0.001， eta平方= 0.657)和药物依从性(F = 40.41, p <；0.001， eta平方= 0.322)分数。干预组经济状况对药物依从性的改善差异有统计学意义（p = 0.037）。然而，在药物依从性和健康素养方面，没有观察到基于父母性别、教育水平或保险状况的显著差异。结论该教育方案提高了ADHD患儿家长的药物依从性和健康素养。

{"title":"Improved medication adherence and health literacy in parents of children with ADHD: Effects of a targeted educational program","authors":"Nafiseh Valaei Sharif , Peivand Ghasemzadeh , Niayesh Mohebbi , Sogand Ghasemzadeh","doi":"10.1016/j.rcsop.2025.100634","DOIUrl":"10.1016/j.rcsop.2025.100634","url":null,"abstract":"<div><h3>Background</h3><div>Although medication is important for children with Attention Deficit Hyperactivity Disorder (ADHD), medication adherence is low among parents. One of the key factors affecting medication adherence and disorder management is health literacy.</div></div><div><h3>Objective</h3><div>This study aimed to assess the effectiveness of an educational program for parents of children with ADHD in improving medication adherence and health literacy.</div></div><div><h3>Methods</h3><div>An educational program was developed that covered four main topics: general disorder information, treatment, parenting based on emotional needs, and basic health information. A total of 191 parents were screened and assigned 108 eligible participants to either the intervention group (<em>n</em> = 74) or the control group (<em>n</em> = 35). The intervention group received a two-month educational program delivered via messenger application, while the control group received general counseling. Medication adherence and health literacy were measured before and after the intervention. <em>t</em>-test, ANOVA, ANCOVA, and chi-square test were used to compare group differences.</div></div><div><h3>Results</h3><div>Post-intervention, the intervention group showed significantly higher medication adherence (6.87 ± 1.36) than the control group (5.46 ± 1.45). The intervention group also demonstrated higher health literacy scores (82.34 ± 6.96) than the control group (72.15 ± 6.52). Covariance analysis revealed significant improvements in health literacy (F = 162.73, <em>p</em> < 0.001, eta squared = 0.657) and medication adherence (F = 40.41, p < 0.001, eta squared = 0.322) scores. A significant difference was found in medication adherence improvement based on economic status (<em>p</em> = 0.037) in the intervention group. However, no significant differences in medication adherence and health literacy were observed based on parental gender, education level, or insurance status.</div></div><div><h3>Conclusion</h3><div>The educational program showed improvement in medication adherence and health literacy among parents of children with ADHD.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100634"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656294","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

Streamlining one-dose package-handling process improves operational efficiency when dispensing drugs: A retrospective study 简化单剂量包装处理过程可提高配药时的操作效率：一项回顾性研究

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-07 DOI: 10.1016/j.rcsop.2025.100635

Takahiro Kato , Miki Kato , Kazuyo Nagashiba , Masayuki Takeuchi , Masafumi Onishi

Background

Japanese pharmacists aim to improve efficiency and communication by simplifying work processes and developing protocols. While assistants and robots have been shown to improve drug dispensing, reports on the efficiency of pharmacies with automated dispensing systems are limited. This study explores factors affecting pharmacist efficiency in dispensing.

Methods

77Daily reports from our hospital pharmacy (December 1, 2020–November 30, 2021) were retrospectively analyzed. The primary outcome was the mean duration of drug dispensing. Multiple regression analyses identified factors affecting dispensing time. Strategies to address these factors were implemented, and outcomes were evaluated using data from December 1, 2021–November 30, 2022.

Results

Univariate analysis identified that the prescription/pharmacist ratio, number of one-dose package (ODP) prescriptions, and powdered drugs significantly influenced dispensing time. Multivariate analysis confirmed that the prescription/pharmacist ratio (p < 0.001), ODP prescriptions (p < 0.001), and powdered drugs (p = 0.02) were key factors. A higher number of ODP prescriptions generally increased dispensing time. After implementing a new strategy for checking ODP, mean dispensing time decreased from 20.0 ± 4.0 to 18.5 ± 3.6 min (p < 0.001), and the percentage of tasks completed in under 20 min increased from 56.3 % to 73.6 % (p < 0.001). Dispensing times were reduced without changing staffing levels by reallocating tasks.

Conclusions

Optimizing the ODP verification workflow enhances dispensing efficiency without increasing pharmacist workload, highlighting the importance of prioritizing ODP prescriptions and implementing support tools for final checks, while further multicenter studies are needed to confirm these findings across diverse settings.

日本药剂师旨在通过简化工作流程和制定协议来提高效率和沟通。虽然助手和机器人已被证明可以改善药物分配，但关于使用自动分配系统的药房效率的报告有限。本研究探讨药师调剂效率的影响因素。方法回顾性分析我院2020年12月1日- 2021年11月30日的每日药学报告77份。主要观察指标为平均配药时间。多元回归分析确定了影响配药时间的因素。实施了解决这些因素的策略，并使用2021年12月1日至2022年11月30日的数据对结果进行了评估。结果单因素分析发现，处方/药师比例、单剂量包装（ODP）处方数量和粉末状药物对调剂时间有显著影响。多因素分析证实，处方/药师比(p <；0.001)， ODP处方(p <；0.001)，粉状药物（p = 0.02）是关键因素。较高的ODP处方数量通常会增加配药时间。在实施新的ODP检查策略后，平均点胶时间从20.0±4.0分钟减少到18.5±3.6分钟(p <；0.001)，在20分钟内完成任务的百分比从56.3%增加到73.6% (p <；0.001)。通过重新分配任务，在不改变人员配置水平的情况下减少了分配时间。结论：优化ODP验证工作流程可以在不增加药师工作量的情况下提高调剂效率，强调了ODP处方优先排序和实施最终检查支持工具的重要性，而进一步的多中心研究需要在不同环境下证实这些发现。

{"title":"Streamlining one-dose package-handling process improves operational efficiency when dispensing drugs: A retrospective study","authors":"Takahiro Kato , Miki Kato , Kazuyo Nagashiba , Masayuki Takeuchi , Masafumi Onishi","doi":"10.1016/j.rcsop.2025.100635","DOIUrl":"10.1016/j.rcsop.2025.100635","url":null,"abstract":"<div><h3>Background</h3><div>Japanese pharmacists aim to improve efficiency and communication by simplifying work processes and developing protocols. While assistants and robots have been shown to improve drug dispensing, reports on the efficiency of pharmacies with automated dispensing systems are limited. This study explores factors affecting pharmacist efficiency in dispensing.</div></div><div><h3>Methods</h3><div>77Daily reports from our hospital pharmacy (December 1, 2020–November 30, 2021) were retrospectively analyzed. The primary outcome was the mean duration of drug dispensing. Multiple regression analyses identified factors affecting dispensing time. Strategies to address these factors were implemented, and outcomes were evaluated using data from December 1, 2021–November 30, 2022.</div></div><div><h3>Results</h3><div>Univariate analysis identified that the prescription/pharmacist ratio, number of one-dose package (ODP) prescriptions, and powdered drugs significantly influenced dispensing time. Multivariate analysis confirmed that the prescription/pharmacist ratio (<em>p</em> < 0.001), ODP prescriptions (p < 0.001), and powdered drugs (<em>p</em> = 0.02) were key factors. A higher number of ODP prescriptions generally increased dispensing time. After implementing a new strategy for checking ODP, mean dispensing time decreased from 20.0 ± 4.0 to 18.5 ± 3.6 min (p < 0.001), and the percentage of tasks completed in under 20 min increased from 56.3 % to 73.6 % (p < 0.001). Dispensing times were reduced without changing staffing levels by reallocating tasks.</div></div><div><h3>Conclusions</h3><div>Optimizing the ODP verification workflow enhances dispensing efficiency without increasing pharmacist workload, highlighting the importance of prioritizing ODP prescriptions and implementing support tools for final checks, while further multicenter studies are needed to confirm these findings across diverse settings.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100635"},"PeriodicalIF":1.8,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614678","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

Implementing six sigma management to shorten the time of taking medicine from intelligent medicine cabinet in inpatient ward 实施六西格玛管理，缩短住院病房智能药柜取药时间

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-05 DOI: 10.1016/j.rcsop.2025.100631

Dan Zhao, Jie Wang, Mengting Sun, Tao Wu, Yingxin Peng

Background

Medication errors and delays in drug dispensing are persistent challenges in traditional pharmacy systems. Automated Dispensing Cabinets (ADCs) were introduced at the study hospital in July 2022 to improve medication safety and efficiency. However, the initial implementation phase revealed several issues, including prolonged medication retrieval times, suboptimal cabinet layout, system interface limitations, and inconsistent user operations. These challenges highlighted the need for further system optimization using a structured improvement approach.

Objective

This study aims to implement an inpatient pharmacy management system based on Six Sigma methodology and compare its effectiveness with TPS in terms of medication convenience and error reduction.

Methods

Starting in July 2022, an intelligent pharmacy management model was implemented in inpatient wards, centered around ADCs and guided by the Six Sigma methodology. Comprehensive improvements were made to address issues such as baseline medication management inefficiencies and delays in retrieving medications for temporary orders. The study compared various metrics, including the time required for retrieving medications for temporary orders, medication administration time, medication error rates before after one month of implementing the intelligent system and nurses' satisfaction with the intelligent system.

Results

Compared with the pre-implementation phase, the intelligent system significantly reduced the time required for nurses to retrieve medications and execute orders (P < 0.05). The rates of medication retrieval and administration errors also decreased (P < 0.05). A majority of nurses (86.96 %) reported that the intelligent system improved work efficiency, 92.40 % found it easier to retrieve medications during emergencies, and 97.82 % expressed high satisfaction with the system.

Conclusion

The application of an intelligent inpatient pharmacy management system based on the Six Sigma methodology effectively reduced the time nurses needed to retrieve medications, enhanced overall nurse satisfaction, lowered error rates caused by human factors.

配药过程中的用药错误和延迟是传统药房系统面临的持续挑战。自动配药柜（adc）于2022年7月在研究医院引入，以提高药物安全性和效率。然而，最初的实施阶段暴露了几个问题，包括延长的药物检索时间、次优的机柜布局、系统接口限制和不一致的用户操作。这些挑战突出了使用结构化改进方法进一步优化系统的必要性。目的实施基于六西格玛方法的住院药房管理系统，并比较其与TPS在用药便捷性和减少差错方面的效果。方法自2022年7月起，在住院部实施以adc为中心，以六西格玛方法为指导的智能化药房管理模式。进行了全面改进，以解决诸如基线药物管理效率低下和为临时订单检索药物的延误等问题。该研究比较了各种指标，包括临时订单取药所需的时间、给药时间、实施智能系统一个月前的用药错误率和护士对智能系统的满意度。结果与实施前相比，智能系统显著减少了护士检索药品和执行医嘱所需的时间(P <；0.05)。药物回收率和给药错误率也有所下降(P <；0.05)。大多数护士（86.96%）反映智能系统提高了工作效率，92.40%的护士认为在紧急情况下更容易取回药品，97.82%的护士对系统表示高度满意。结论基于六西格玛方法的智能住院药房管理系统的应用，有效减少了护士取药时间，提高了护士整体满意度，降低了人为因素造成的错误率。

{"title":"Implementing six sigma management to shorten the time of taking medicine from intelligent medicine cabinet in inpatient ward","authors":"Dan Zhao, Jie Wang, Mengting Sun, Tao Wu, Yingxin Peng","doi":"10.1016/j.rcsop.2025.100631","DOIUrl":"10.1016/j.rcsop.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Medication errors and delays in drug dispensing are persistent challenges in traditional pharmacy systems. Automated Dispensing Cabinets (ADCs) were introduced at the study hospital in July 2022 to improve medication safety and efficiency. However, the initial implementation phase revealed several issues, including prolonged medication retrieval times, suboptimal cabinet layout, system interface limitations, and inconsistent user operations. These challenges highlighted the need for further system optimization using a structured improvement approach.</div></div><div><h3>Objective</h3><div>This study aims to implement an inpatient pharmacy management system based on Six Sigma methodology and compare its effectiveness with TPS in terms of medication convenience and error reduction.</div></div><div><h3>Methods</h3><div>Starting in July 2022, an intelligent pharmacy management model was implemented in inpatient wards, centered around ADCs and guided by the Six Sigma methodology. Comprehensive improvements were made to address issues such as baseline medication management inefficiencies and delays in retrieving medications for temporary orders. The study compared various metrics, including the time required for retrieving medications for temporary orders, medication administration time, medication error rates before after one month of implementing the intelligent system and nurses' satisfaction with the intelligent system.</div></div><div><h3>Results</h3><div>Compared with the pre-implementation phase, the intelligent system significantly reduced the time required for nurses to retrieve medications and execute orders (<em>P</em> < 0.05). The rates of medication retrieval and administration errors also decreased (P < 0.05). A majority of nurses (86.96 %) reported that the intelligent system improved work efficiency, 92.40 % found it easier to retrieve medications during emergencies, and 97.82 % expressed high satisfaction with the system.</div></div><div><h3>Conclusion</h3><div>The application of an intelligent inpatient pharmacy management system based on the Six Sigma methodology effectively reduced the time nurses needed to retrieve medications, enhanced overall nurse satisfaction, lowered error rates caused by human factors.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100631"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614679","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

Multidisciplinary perspective on a pharmacist-led vaccination clinic in a regional cancer care setting: A qualitative study 多学科的观点在药剂师主导的疫苗接种诊所在区域癌症护理设置：一个定性研究

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-05 DOI: 10.1016/j.rcsop.2025.100633

Kristoffer Johnstone , Joyce Cooper , John Smithson , Beverley Glass

Background

Immunosuppression in patients with cancer increases susceptibility to vaccine-preventable diseases, with suboptimal vaccination rates attributed to complex treatment schedules, timing of vaccination and uncertainty in relation to vaccination effectiveness. While pharmacists are routinely vaccinating patients in the community, high-risk cohorts, such as oncology patients, often lack access to dedicated vaccine services in hospital outpatient settings. Pharmacist-led vaccination clinics offer a promising solution to overcome existing barriers by integrating accessible, trusted healthcare professionals into patients' treatment location, to improve uptake through timely, co-located, and coordinated care. This study aimed to explore the perspectives of healthcare professionals regarding the implementation of a pharmacist-led vaccine clinic in an outpatient oncology unit.

Methods

Semi-structured interviews were conducted with pharmacists, nurses, and doctors from a single site regional referral hospital. Interviews were audio-recorded, transcribed verbatim, deductively and inductively coded and thematically analysed, with emerging themes mapped to the constructs of the Diffusion of Innovation Theory: relative advantage, complexity, compatibility, observability and trialability.

Results

Nineteen interviews were conducted with healthcare professionals, including seven pharmacists, six nurses and six doctors. Factors identified for successful implementation of a pharmacist-led vaccination clinic included patient-centred models, improved convenience and reduced complexity for patients, and compatibility with pharmacists' existing knowledge and role in outpatient units. Barriers were found to be work overload for pharmacists, reduced interaction with general practitioners, and lack of understanding of pharmacists' vaccination training.

Conclusion

Healthcare professionals expressed strong support for a pharmacist-led vaccine clinic in an outpatient oncology unit, recognising the potential to improve vaccination rates. Future research should however focus on assessing patient acceptance of such a service and the impact of such a clinic on vaccination rates.

癌症患者的免疫抑制增加了对疫苗可预防疾病的易感性，由于复杂的治疗计划、疫苗接种时间和疫苗接种有效性的不确定性，疫苗接种率不理想。虽然药剂师在社区定期为患者接种疫苗，但高风险人群，如肿瘤患者，往往无法在医院门诊环境中获得专门的疫苗服务。药剂师领导的疫苗接种诊所提供了一种很有希望的解决方案，通过将可获得的、值得信赖的医疗保健专业人员整合到患者的治疗地点，以通过及时、共同定位和协调的护理提高患者的接受程度，从而克服现有的障碍。本研究旨在探讨医疗保健专业人员对在门诊肿瘤科实施药剂师主导的疫苗诊所的看法。方法采用半结构化访谈法，对来自单一站点地区转诊医院的药师、护士和医生进行访谈。访谈录音，逐字抄录，演绎和归纳编码，主题分析，新主题映射到创新扩散理论的结构：相对优势，复杂性，兼容性，可观察性和可试验性。结果共对19名医护人员进行了访谈，其中药师7名，护士6名，医生6名。确定的成功实施药剂师主导的疫苗接种诊所的因素包括以患者为中心的模式，提高了便利性并降低了患者的复杂性，以及与药剂师在门诊单位的现有知识和作用相兼容。发现障碍是药剂师的工作过载，与全科医生的互动减少，以及缺乏对药剂师疫苗接种培训的了解。结论卫生保健专业人员强烈支持在门诊肿瘤科设立药剂师主导的疫苗诊所，认识到提高疫苗接种率的潜力。然而，未来的研究应侧重于评估患者对这种服务的接受程度以及这种诊所对疫苗接种率的影响。

{"title":"Multidisciplinary perspective on a pharmacist-led vaccination clinic in a regional cancer care setting: A qualitative study","authors":"Kristoffer Johnstone , Joyce Cooper , John Smithson , Beverley Glass","doi":"10.1016/j.rcsop.2025.100633","DOIUrl":"10.1016/j.rcsop.2025.100633","url":null,"abstract":"<div><h3>Background</h3><div>Immunosuppression in patients with cancer increases susceptibility to vaccine-preventable diseases, with suboptimal vaccination rates attributed to complex treatment schedules, timing of vaccination and uncertainty in relation to vaccination effectiveness. While pharmacists are routinely vaccinating patients in the community, high-risk cohorts, such as oncology patients, often lack access to dedicated vaccine services in hospital outpatient settings. Pharmacist-led vaccination clinics offer a promising solution to overcome existing barriers by integrating accessible, trusted healthcare professionals into patients' treatment location, to improve uptake through timely, co-located, and coordinated care. This study aimed to explore the perspectives of healthcare professionals regarding the implementation of a pharmacist-led vaccine clinic in an outpatient oncology unit.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with pharmacists, nurses, and doctors from a single site regional referral hospital. Interviews were audio-recorded, transcribed verbatim, deductively and inductively coded and thematically analysed, with emerging themes mapped to the constructs of the Diffusion of Innovation Theory: relative advantage, complexity, compatibility, observability and trialability.</div></div><div><h3>Results</h3><div>Nineteen interviews were conducted with healthcare professionals, including seven pharmacists, six nurses and six doctors. Factors identified for successful implementation of a pharmacist-led vaccination clinic included patient-centred models, improved convenience and reduced complexity for patients, and compatibility with pharmacists' existing knowledge and role in outpatient units. Barriers were found to be work overload for pharmacists, reduced interaction with general practitioners, and lack of understanding of pharmacists' vaccination training.</div></div><div><h3>Conclusion</h3><div>Healthcare professionals expressed strong support for a pharmacist-led vaccine clinic in an outpatient oncology unit, recognising the potential to improve vaccination rates. Future research should however focus on assessing patient acceptance of such a service and the impact of such a clinic on vaccination rates.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100633"},"PeriodicalIF":1.8,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144604626","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

Assessment of patient perception and administration technique of vaginal tablets at a tertiary care women's hospital 某三级保健妇女医院对阴道片剂的患者认知和给药技术的评估

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-03 DOI: 10.1016/j.rcsop.2025.100632

Nirmal Raj Marasine , Garima Kunwar , Manisha Chaudhary , Anjana Adhikari , Sabina Sankhi

Background

Vaginal tablets offer an effective and patient-friendly route for both localized and systemic therapies, bypassing hepatic first-pass metabolism and minimizing gastrointestinal side effects. However, in low-resource settings like Nepal, their optimal use is often hindered by patient's perception and administration techniques.

Objective

This study aimed to assess patient perception and administration technique of vaginal tablets at a tertiary women's hospital in Nepal.

Methods

A hospital-based cross-sectional study was conducted from February to July 2024 among 117 women of reproductive age visiting a tertiary care women's hospital in Kathmandu. Data were collected through face-to-face interviews using a validated 8-item perception questionnaire and an 8-item administration technique checklist. Bivariate analysis using Pearson's chi-square test and binary logistic regression were performed to identify factors associated with patients' perceptions and administration techniques.

Results

More than half (56.4 %) of the patient's demonstrated adequate administration techniques (scores ≥6), yet a striking 76.1 % exhibited suboptimal perceptions towards vaginal tablet use. Factors such as being unmarried, having lower educational attainment (illiterate or school level education), being unemployed or a housemaker, residing in rural areas, and lacking prior experience were significantly associated with poorer perceptions. Notably, younger age, prior use and counseling by pharmacists were positively linked to better administration techniques.

Conclusion

Despite adequate administration practices among most women, suboptimal perceptions persist, influenced by demographic and experiential factors. Tailored, provider-led educational interventions focusing on counseling and user-friendly instructions are essential to enhance patient understanding, comfort, and adherence, thereby improving therapeutic outcomes and empowering women in their reproductive health decisions.

阴道片为局部和全身治疗提供了一种有效且患者友好的途径，绕过肝脏第一过代谢并最大限度地减少胃肠道副作用。然而，在尼泊尔等资源匮乏的环境中，它们的最佳使用往往受到患者感知和管理技术的阻碍。目的了解尼泊尔某三级妇女医院患者对阴道片的认知和给药技术。方法对2024年2月至7月在加德满都一家三级保健妇女医院就诊的117名育龄妇女进行了以医院为基础的横断面研究。数据通过面对面访谈收集，使用一份经过验证的8项感知问卷和一份8项管理技术清单。采用皮尔逊卡方检验和二元逻辑回归进行双变量分析，以确定与患者感知和给药技术相关的因素。结果超过一半（56.4%）的患者表现出适当的给药技术（得分≥6），但令人震惊的是，76.1%的患者表现出对阴道片剂使用的不理想看法。未婚、受教育程度较低（文盲或中等教育程度）、失业或家庭主妇、居住在农村地区以及缺乏先前的经验等因素与较差的看法显著相关。值得注意的是，更年轻的年龄，以前的使用和咨询药剂师正相关的更好的管理技术。结论：尽管在大多数妇女中有充分的管理实践，但受人口统计学和经验因素的影响，次优认知仍然存在。量身定制的、由提供者主导的教育干预措施，侧重于咨询和用户友好的指导，对于增强患者的理解、舒适和依从性至关重要，从而改善治疗结果，增强妇女作出生殖健康决定的权能。

{"title":"Assessment of patient perception and administration technique of vaginal tablets at a tertiary care women's hospital","authors":"Nirmal Raj Marasine , Garima Kunwar , Manisha Chaudhary , Anjana Adhikari , Sabina Sankhi","doi":"10.1016/j.rcsop.2025.100632","DOIUrl":"10.1016/j.rcsop.2025.100632","url":null,"abstract":"<div><h3>Background</h3><div>Vaginal tablets offer an effective and patient-friendly route for both localized and systemic therapies, bypassing hepatic first-pass metabolism and minimizing gastrointestinal side effects. However, in low-resource settings like Nepal, their optimal use is often hindered by patient's perception and administration techniques.</div></div><div><h3>Objective</h3><div>This study aimed to assess patient perception and administration technique of vaginal tablets at a tertiary women's hospital in Nepal.</div></div><div><h3>Methods</h3><div>A hospital-based cross-sectional study was conducted from February to July 2024 among 117 women of reproductive age visiting a tertiary care women's hospital in Kathmandu. Data were collected through face-to-face interviews using a validated 8-item perception questionnaire and an 8-item administration technique checklist. Bivariate analysis using Pearson's chi-square test and binary logistic regression were performed to identify factors associated with patients' perceptions and administration techniques.</div></div><div><h3>Results</h3><div>More than half (56.4 %) of the patient's demonstrated adequate administration techniques (scores ≥6), yet a striking 76.1 % exhibited suboptimal perceptions towards vaginal tablet use. Factors such as being unmarried, having lower educational attainment (illiterate or school level education), being unemployed or a housemaker, residing in rural areas, and lacking prior experience were significantly associated with poorer perceptions. Notably, younger age, prior use and counseling by pharmacists were positively linked to better administration techniques.</div></div><div><h3>Conclusion</h3><div>Despite adequate administration practices among most women, suboptimal perceptions persist, influenced by demographic and experiential factors. Tailored, provider-led educational interventions focusing on counseling and user-friendly instructions are essential to enhance patient understanding, comfort, and adherence, thereby improving therapeutic outcomes and empowering women in their reproductive health decisions.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100632"},"PeriodicalIF":1.8,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144588038","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

Not so great expectations: The role of price and name information in the nocebo effect 不太大的期望：价格和名称信息在反安慰剂效应中的作用

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-28 DOI: 10.1016/j.rcsop.2025.100630

Kiarne Humphreys , Michelle Lin , Kirsten Barnes , Yasmin Hasan , Ashwin Vignaraja , Kritika Sarna , Andrew L. Geers , Kate Faasse

Background

The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exacerbate negative expectations and cause nocebo effects.

Methods

Healthy participants (N = 196) were randomised to receive sham-oxytocin nasal spray associated with either a generic (complex name, low price; n = 66) or brand (simple name, high price; n = 68) cue, or to no treatment control (n = 62). Participants were informed that oxytocin could enhance trust and cooperation, but might cause side effects of headache, nausea, vomiting, rapid heartbeat, feeling faint or light-headed, and skin itching or rash. Treatment-related side effects were assessed at baseline, and after 3 days of sham-oxytocin use.

Results

Nocebo effects were observed across sham-treated participants relative to control (p = .015; d = 0.28). Association with a generic relative to branded cue significantly enhanced nocebo effects (p = .042; d = 0.36). Negative expectations mediated the observed nocebo and branding effects.

Conclusions

Cues associated with generic medications can exacerbate nocebo effects and these findings may explain clinical observations of increased side effects from generic medications. Results have important implications for medical care, and interventions to mitigate nocebo effects from generic medications are needed.

在双盲条件下，服用非专利药物可能导致疗效降低和副作用增加，尽管与品牌药物相同。这可能是通常与仿制药相关的线索，包括更低的价格和更复杂的名称，加剧了负面预期并导致反安慰剂效应。方法健康受试者（N = 196）随机接受假催产素鼻喷雾剂，该喷雾剂的名称复杂，价格低廉；N = 66)或品牌(名称简单，价格高；N = 68)提示，或无治疗对照（N = 62）。参与者被告知催产素可以增强信任和合作，但可能会导致头痛、恶心、呕吐、心跳加快、头晕目眩、皮肤瘙痒或皮疹等副作用。在基线和使用假催产素3天后评估治疗相关副作用。结果与对照组相比，假药治疗的受试者存在反安慰剂效应(p = 0.015；d = 0.28)。与品牌线索相关的非专利亲属显著增强了反安慰剂效应(p = 0.042；d = 0.36)。负面预期介导观察到的反安慰剂和品牌效应。结论与非专利药物相关的并发症可加重反安慰剂效应，这些发现可以解释非专利药物副作用增加的临床观察结果。研究结果对医疗保健具有重要意义，需要采取干预措施减轻仿制药的反安慰剂效应。

{"title":"Not so great expectations: The role of price and name information in the nocebo effect","authors":"Kiarne Humphreys , Michelle Lin , Kirsten Barnes , Yasmin Hasan , Ashwin Vignaraja , Kritika Sarna , Andrew L. Geers , Kate Faasse","doi":"10.1016/j.rcsop.2025.100630","DOIUrl":"10.1016/j.rcsop.2025.100630","url":null,"abstract":"<div><h3>Background</h3><div>The perception of taking a generic medication can result in reduced efficacy and increased side effects, despite equivalence to brand name medications under double blind conditions. It may be that cues typically associated with generics, including lower price and more complex name, exacerbate negative expectations and cause nocebo effects.</div></div><div><h3>Methods</h3><div>Healthy participants (<em>N</em> = 196) were randomised to receive sham-oxytocin nasal spray associated with either a generic (complex name, low price; <em>n</em> = 66) or brand (simple name, high price; <em>n</em> = 68) cue, or to no treatment control (<em>n</em> = 62). Participants were informed that oxytocin could enhance trust and cooperation, but might cause side effects of headache, nausea, vomiting, rapid heartbeat, feeling faint or light-headed, and skin itching or rash. Treatment-related side effects were assessed at baseline, and after 3 days of sham-oxytocin use.</div></div><div><h3>Results</h3><div>Nocebo effects were observed across sham-treated participants relative to control (<em>p</em> = .015; <em>d</em> = 0.28). Association with a generic relative to branded cue significantly enhanced nocebo effects (<em>p</em> = .042; <em>d</em> = 0.36). Negative expectations mediated the observed nocebo and branding effects.</div></div><div><h3>Conclusions</h3><div>Cues associated with generic medications can exacerbate nocebo effects and these findings may explain clinical observations of increased side effects from generic medications. Results have important implications for medical care, and interventions to mitigate nocebo effects from generic medications are needed.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100630"},"PeriodicalIF":1.8,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144580915","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

Self-reported treatment burden: A comparison between vitamin K and non-vitamin K oral anticoagulants 自我报告的治疗负担：维生素K和非维生素K口服抗凝剂的比较

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-25 DOI: 10.1016/j.rcsop.2025.100628

Miroslav Mihajlovic , Nevena Zec , Jelena Simic , Aleksandar Mihajlovic , Milan Marinkovic , Nebojsa Mujovic , Tatjana Potpara

Introduction

Treatment burden (TBN) refers to the impact of patients' healthcare-related workload on their functioning and well-being. A high TBN has been associated with lower adherence to treatment and increased risk of major adverse events, and patients considered a TBN score of ≥59 points as unacceptably high. In the present analysis, we explored differences in TBN, the prevalence of unacceptably high TBN score and discern the contributory factors associated with TBN among patients receiving vitamin K oral anticoagulants (VKA) or non-vitamin K oral anticoagulants (NOAC).

Methods

In a single-centre cross-sectional study from April to June 2019, consecutive patients receiving medical care at the Cardiology Clinic of University hospital were invited to fulfil the TBN Questionnaire encompassing 17 questions assessing TBN.

Results

Of 514 study patients, 320 (62.3 %) were taking oral anticoagulant therapy (OAC) and were included in the present analysis. Of those, 206 patients (64.4 %) were prescribed a VKA. The mean TBN score was significantly higher in VKA versus NOAC patients (48.8 ± 26.5 vs. 41.8 ± 19.7, P = 0.014). Patients taking VKA reported a TBN of ≥59 points significantly more often than those taking NOAC (30.1 % vs 18.4 %, P = 0.024). The VKA patients reported significantly higher TBN score values for questions related to self-monitoring, including INR monitoring (3.85 ± 3.32 vs. 1.62 ± 1.38, P < 0.001) and diet restrictions (3.98 ± 3.43 vs. 2.48 ± 2.49, P < 0.001) compared with NOAC patients.

Conclusion

In the present study, VKA patients reported significantly higher TBN and more frequently unacceptably high TBN compared to NOAC, primarily due to numerous VKA-food interactions and the need for regular INR monitoring. Our findings suggest that the prescription of NOAC could reduce the TBN, which could translate to improved patient outcomes.

治疗负担（TBN）是指患者的医疗相关工作量对其功能和福祉的影响。高TBN与较低的治疗依从性和主要不良事件风险增加相关，患者认为TBN评分≥59分是不可接受的高。在本分析中，我们探讨了在服用维生素K口服抗凝剂（VKA）或非维生素K口服抗凝剂（NOAC）的患者中TBN的差异，TBN评分过高的患病率，并辨别与TBN相关的因素。方法采用单中心横断面研究方法，于2019年4月至6月邀请连续在大学医院心脏病科门诊就诊的患者填写TBN问卷，问卷包含17个问题，评估TBN。结果514例患者中，320例（62.3%）接受口服抗凝治疗（OAC），纳入本分析。其中，206例患者（64.4%）使用了VKA。VKA患者TBN平均评分明显高于NOAC患者（48.8±26.5比41.8±19.7,P = 0.014）。VKA组患者TBN≥59分的发生率明显高于NOAC组（30.1% vs 18.4%, P = 0.024）。VKA患者在自我监测相关问题（包括INR监测）的TBN评分值显著高于对照组(3.85±3.32 vs. 1.62±1.38,P <；0.001)和饮食限制(3.98±3.43比2.48±2.49,P <；0.001)，与NOAC患者相比。在本研究中，与NOAC相比，VKA患者报告的TBN明显更高，而且更频繁地出现不可接受的高TBN，这主要是由于VKA-食物之间的大量相互作用以及需要定期监测INR。我们的研究结果表明，NOAC处方可以减少TBN，这可以转化为改善患者的预后。

{"title":"Self-reported treatment burden: A comparison between vitamin K and non-vitamin K oral anticoagulants","authors":"Miroslav Mihajlovic , Nevena Zec , Jelena Simic , Aleksandar Mihajlovic , Milan Marinkovic , Nebojsa Mujovic , Tatjana Potpara","doi":"10.1016/j.rcsop.2025.100628","DOIUrl":"10.1016/j.rcsop.2025.100628","url":null,"abstract":"<div><h3>Introduction</h3><div>Treatment burden (TBN) refers to the impact of patients' healthcare-related workload on their functioning and well-being. A high TBN has been associated with lower adherence to treatment and increased risk of major adverse events, and patients considered a TBN score of ≥59 points as unacceptably high. In the present analysis, we explored differences in TBN, the prevalence of unacceptably high TBN score and discern the contributory factors associated with TBN among patients receiving vitamin K oral anticoagulants (VKA) or non-vitamin K oral anticoagulants (NOAC).</div></div><div><h3>Methods</h3><div>In a single-centre cross-sectional study from April to June 2019, consecutive patients receiving medical care at the Cardiology Clinic of University hospital were invited to fulfil the TBN Questionnaire encompassing 17 questions assessing TBN.</div></div><div><h3>Results</h3><div>Of 514 study patients, 320 (62.3 %) were taking oral anticoagulant therapy (OAC) and were included in the present analysis. Of those, 206 patients (64.4 %) were prescribed a VKA. The mean TBN score was significantly higher in VKA versus NOAC patients (48.8 ± 26.5 vs. 41.8 ± 19.7, <em>P</em> = 0.014). Patients taking VKA reported a TBN of ≥59 points significantly more often than those taking NOAC (30.1 % vs 18.4 %, <em>P</em> = 0.024). The VKA patients reported significantly higher TBN score values for questions related to self-monitoring, including INR monitoring (3.85 ± 3.32 vs. 1.62 ± 1.38, <em>P</em> < 0.001) and diet restrictions (3.98 ± 3.43 vs. 2.48 ± 2.49, P < 0.001) compared with NOAC patients.</div></div><div><h3>Conclusion</h3><div>In the present study, VKA patients reported significantly higher TBN and more frequently unacceptably high TBN compared to NOAC, primarily due to numerous VKA-food interactions and the need for regular INR monitoring. Our findings suggest that the prescription of NOAC could reduce the TBN, which could translate to improved patient outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100628"},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519184","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

A qualitative exploration of community pharmacist views on providing a mental health and well-being intervention for long-term condition patients 社区药师对长期疾病患者提供心理健康和幸福干预意见的定性探讨

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-25 DOI: 10.1016/j.rcsop.2025.100629

Patrick Cabasag , Kebede Beyene , Frederick Sundram , Amy Hai Yan Chan , Holly Wilson , Jeff Harrison

Background

Subthreshold depression and anxiety are common, affecting up to 24 % of people over their lifetime and are often associated with long-term conditions. Community pharmacists, who often have an established relationship with people who have long-term conditions, are well placed to identify and address subthreshold depression and anxiety and reduce the risk of progression to clinical mental health disorders.

Methods

Semi-structured individual qualitative interviews were conducted with community pharmacists to explore their perspectives on a pharmacy service for long-term condition patients with subthreshold depression and anxiety. Interviews were audio recorded, transcribed in intelligent verbatim and analysed using a General Inductive Approach.

Results

Eleven purposively selected community pharmacists from diverse backgrounds were interviewed. Four main themes were identified, each with several subthemes. These related to existing support mechanisms for delivering long-term condition and mental health services in community pharmacies, pharmacists' perceptions and attitudes toward service delivery, barriers and facilitators to service implementation, and the design and implementation of a service.

Conclusions

This is the first study to explore community pharmacists' perspectives on a pharmacy intervention for long-term condition patients with subthreshold depression and anxiety. Overall, community pharmacists expressed positive attitudes toward delivering an intervention for people with long-term conditions and subthreshold depression and anxiety. Future work would involve taking a co-design approach to developing and evaluating such an intervention.

阈下抑郁和焦虑很常见，影响了24%的人的一生，并且通常与长期疾病有关。社区药剂师往往与患有长期疾病的人建立了牢固的关系，他们能够很好地识别和处理阈下抑郁和焦虑，并降低发展为临床精神健康障碍的风险。方法对社区药师进行半结构化的个人定性访谈，探讨他们对长期阈下抑郁和焦虑患者的药学服务的看法。访谈录音，以智能逐字转录，并使用一般归纳方法进行分析。结果有针对性地选取不同背景的社区药师进行访谈。确定了四个主要主题，每个主题又有若干次主题。这些问题涉及社区药房提供长期疾病和精神卫生服务的现有支持机制、药剂师对提供服务的看法和态度、服务实施的障碍和促进因素，以及服务的设计和实施。结论本研究首次探讨了社区药师对长期阈下抑郁和焦虑患者的药物干预。总的来说，社区药剂师对长期患有阈下抑郁和焦虑的人表达了积极的态度。未来的工作将涉及采取共同设计的方法来开发和评估这种干预措施。

{"title":"A qualitative exploration of community pharmacist views on providing a mental health and well-being intervention for long-term condition patients","authors":"Patrick Cabasag , Kebede Beyene , Frederick Sundram , Amy Hai Yan Chan , Holly Wilson , Jeff Harrison","doi":"10.1016/j.rcsop.2025.100629","DOIUrl":"10.1016/j.rcsop.2025.100629","url":null,"abstract":"<div><h3>Background</h3><div>Subthreshold depression and anxiety are common, affecting up to 24 % of people over their lifetime and are often associated with long-term conditions. Community pharmacists, who often have an established relationship with people who have long-term conditions, are well placed to identify and address subthreshold depression and anxiety and reduce the risk of progression to clinical mental health disorders.</div></div><div><h3>Methods</h3><div>Semi-structured individual qualitative interviews were conducted with community pharmacists to explore their perspectives on a pharmacy service for long-term condition patients with subthreshold depression and anxiety. Interviews were audio recorded, transcribed in intelligent verbatim and analysed using a General Inductive Approach.</div></div><div><h3>Results</h3><div>Eleven purposively selected community pharmacists from diverse backgrounds were interviewed. Four main themes were identified, each with several subthemes. These related to existing support mechanisms for delivering long-term condition and mental health services in community pharmacies, pharmacists' perceptions and attitudes toward service delivery, barriers and facilitators to service implementation, and the design and implementation of a service.</div></div><div><h3>Conclusions</h3><div>This is the first study to explore community pharmacists' perspectives on a pharmacy intervention for long-term condition patients with subthreshold depression and anxiety. Overall, community pharmacists expressed positive attitudes toward delivering an intervention for people with long-term conditions and subthreshold depression and anxiety. Future work would involve taking a co-design approach to developing and evaluating such an intervention.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100629"},"PeriodicalIF":1.8,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523667","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

Building primary care providers' confidence in deprescribing opioids and benzodiazepines in older adults 建立初级保健提供者对老年人处方阿片类药物和苯二氮卓类药物的信心

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-24 DOI: 10.1016/j.rcsop.2025.100627

Stefanie P. Ferreri , Lori T. Armistead , Ben Urick , Tamera D. Hughes , Anne-Therese Hunt , J. Marvin McBride , Joshua Niznik , Ellen Roberts , Kimberly A. Sanders , Jan Busby-Whitehead

Background

Opioids and benzodiazepines (BZDs) are among the most prescribed medications that contribute to falls in older adults; however, little guidance exists on their safe prescribing and deprescribing. Although some resources are available to assist providers with opioid and BZD deprescribing, many report lack of confidence as a barrier. The objective of this study was to assess PCPs' confidence in their ability to deprescribe opioids and BZDs before and after an intervention.

Methods

We modified a validated deprescribing self-efficacy survey to assess primary care provider (PCP) confidence in deprescribing opioids and BZDs in older adults before and after a consultant pharmacist educational intervention. The survey consisted of 35 questions divided into three sections: deprescribing opioids (10 questions), deprescribing BZDs (10 questions), and deprescribing under potentially impeding circumstances [UPIC] (15 questions). The survey was sent to 88 PCPs using a modified Dillman method. We evaluated providers' confidence on a 100-point scale pre- and post-intervention, comparing the difference-in- differences (DID) in scores between the intervention and control groups.

Results

A total of 41 PCPs (46.6 %) completed the survey both pre-and post-intervention. The intervention group (n = 21) showed an improvement in their knowledge and self-efficacy skills by an average of 19.7 out of 100 points, while the control group (n = 20) improved by an average of 5.2 points. The DID in self-efficacy improvement between the two groups was +14.5 points (p = 0.003) overall. For each of the opioid-, BZD-, and UPIC-specific scores, the intervention group had a statistically significant DID compared to the control group (+15.8, p = 0.004; +14.2, p = 0.017; +13.9, p = 0.016, respectively).

Conclusion

This consultant pharmacist educational intervention improved PCPs' confidence in deprescribing opioids and BZDs in older adults.

阿片类药物和苯二氮卓类药物（BZDs）是导致老年人跌倒的最常用药物之一；然而，关于它们的安全处方和解除处方的指导很少。虽然有一些资源可以帮助阿片类药物和BZD处方的提供者，但许多人报告缺乏信心是一个障碍。本研究的目的是评估pcp在干预前后解除阿片类药物和BZDs处方能力的信心。方法我们修改了一项经过验证的处方自我效能感调查，以评估初级保健提供者（PCP）在咨询药师教育干预前后对老年人阿片类药物和bzd处方的信心。调查包括35个问题，分为三个部分：处方阿片类药物（10个问题），处方bzd（10个问题），以及在潜在阻碍情况下处方[UPIC]（15个问题）。使用改进的Dillman方法将调查结果发送给88个pcp。我们在干预前和干预后以100分制评估了提供者的信心，比较了干预组和对照组之间的得分差异（DID）。结果干预前和干预后共有41名pcp（46.6%）完成了调查。干预组（n = 21）在知识和自我效能技能方面平均提高了19.7分（满分100分），而对照组（n = 20）平均提高了5.2分。两组患者自我效能改善DID总分为+14.5分（p = 0.003）。对于阿片类药物、BZD和upic特异性评分，干预组的DID与对照组相比具有统计学意义(+15.8,p = 0.004；+14.2, p = 0.017；+13.9, p = 0.016)。结论咨询药师教育干预提高了pcp对老年人阿片类药物处方和BZDs的信心。

{"title":"Building primary care providers' confidence in deprescribing opioids and benzodiazepines in older adults","authors":"Stefanie P. Ferreri , Lori T. Armistead , Ben Urick , Tamera D. Hughes , Anne-Therese Hunt , J. Marvin McBride , Joshua Niznik , Ellen Roberts , Kimberly A. Sanders , Jan Busby-Whitehead","doi":"10.1016/j.rcsop.2025.100627","DOIUrl":"10.1016/j.rcsop.2025.100627","url":null,"abstract":"<div><h3>Background</h3><div>Opioids and benzodiazepines (BZDs) are among the most prescribed medications that contribute to falls in older adults; however, little guidance exists on their safe prescribing and deprescribing. Although some resources are available to assist providers with opioid and BZD deprescribing, many report lack of confidence as a barrier. The objective of this study was to assess PCPs' confidence in their ability to deprescribe opioids and BZDs before and after an intervention.</div></div><div><h3>Methods</h3><div>We modified a validated deprescribing self-efficacy survey to assess primary care provider (PCP) confidence in deprescribing opioids and BZDs in older adults before and after a consultant pharmacist educational intervention. The survey consisted of 35 questions divided into three sections: deprescribing opioids (10 questions), deprescribing BZDs (10 questions), and deprescribing under potentially impeding circumstances [UPIC] (15 questions). The survey was sent to 88 PCPs using a modified Dillman method. We evaluated providers' confidence on a 100-point scale pre- and post-intervention, comparing the difference-in- differences (DID) in scores between the intervention and control groups.</div></div><div><h3>Results</h3><div>A total of 41 PCPs (46.6 %) completed the survey both pre-and post-intervention. The intervention group (<em>n</em> = 21) showed an improvement in their knowledge and self-efficacy skills by an average of 19.7 out of 100 points, while the control group (<em>n</em> = 20) improved by an average of 5.2 points. The DID in self-efficacy improvement between the two groups was +14.5 points (<em>p</em> = 0.003) overall. For each of the opioid-, BZD-, and UPIC-specific scores, the intervention group had a statistically significant DID compared to the control group (+15.8, <em>p</em> = 0.004; +14.2, <em>p</em> = 0.017; +13.9, <em>p</em> = 0.016, respectively).</div></div><div><h3>Conclusion</h3><div>This consultant pharmacist educational intervention improved PCPs' confidence in deprescribing opioids and BZDs in older adults.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100627"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519185","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

The role of U.S. pharmacists in deprescribing: Recommendations based on a systematic literature review of qualitative studies 美国药剂师在处方中的作用：基于定性研究的系统文献综述的建议

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-24 DOI: 10.1016/j.rcsop.2025.100625

Alina Cernasev , Devin Scott , Becka Eckert , Hilary Jasmin , David R. Axon

Purpose

Deprescribing is increasingly investigated through a qualitative lens, yet no evidence synthesis of the extant qualitative deprescribing literature exists. This study aimed to identify and synthesize relevant qualitative data about the role of the pharmacist or pharmacy profession in deprescribing in the United States.

Methods

A systematic literature review was conducted in July 2024 in MEDLINE (PubMed), Scopus (Elsevier), and Embase (Elsevier). The primary search concepts included terms around pill burden, cessation and de-prescription, as well as a search string to narrow results to qualitative reports. From 4410 unique records after deduplication, 46 abstracts were included for full text review.

Results

After full text review, 11 records were deemed suitable for inclusion in this review. Three used interviews, five used focus groups, and three used both. Three studies used the theory of planned behavior, two studies used the capability, opportunity, and motivation behavior model, one used the chronic care model, one used the interprofessional shared decision-making model, one used grounded theory, and three did not use a framework. Studies were conducted in New York (n = 3), Arizona, Maine, and Tennessee (n = 3), California (n = 1), Iowa (n = 1), Massachusetts (n = 1), North Carolina (n = 1), and Rhode Island (n = 1). Key themes identified across the studies included enablers, obstacles, process of deprescribing, and deprescribing in pharmacy education.

Conclusions

Deprescribing is a complex process that involves the entire healthcare team, including pharmacists who have unique expertise to support the team through education and information about medication and disease states.

目的越来越多地通过定性视角来研究处方，但没有证据综合现有的定性处方文献。本研究旨在识别和综合美国药剂师或药学专业在处方中的作用的相关定性数据。方法于2024年7月在MEDLINE （PubMed）、Scopus （Elsevier）和Embase （Elsevier）进行系统文献综述。主要的搜索概念包括围绕药片负担、戒烟和去处方的术语，以及将搜索结果缩小到定性报告的搜索字符串。从4410条重复数据删除后的唯一记录中，选取46篇摘要进行全文审查。结果经全文审阅后，11条记录被认为适合纳入本综述。三个使用访谈，五个使用焦点小组，三个两者都使用。3项研究使用计划行为理论，2项研究使用能力、机会和动机行为模型，1项研究使用慢性护理模型，1项研究使用跨专业共同决策模型，1项研究使用扎根理论，3项研究未使用框架。研究在纽约州（n = 3）、亚利桑那州、缅因州和田纳西州（n = 3）、加利福尼亚州（n = 1）、爱荷华州（n = 1）、马萨诸塞州（n = 1）、北卡罗来纳州（n = 1）和罗德岛州（n = 1）进行。研究中确定的关键主题包括促进因素、障碍、处方解除过程和药学教育中的处方解除。结论开处方是一个复杂的过程，涉及整个医疗团队，包括药剂师，他们有独特的专业知识，通过教育和药物和疾病状态的信息来支持团队。

{"title":"The role of U.S. pharmacists in deprescribing: Recommendations based on a systematic literature review of qualitative studies","authors":"Alina Cernasev , Devin Scott , Becka Eckert , Hilary Jasmin , David R. Axon","doi":"10.1016/j.rcsop.2025.100625","DOIUrl":"10.1016/j.rcsop.2025.100625","url":null,"abstract":"<div><h3>Purpose</h3><div>Deprescribing is increasingly investigated through a qualitative lens, yet no evidence synthesis of the extant qualitative deprescribing literature exists. This study aimed to identify and synthesize relevant qualitative data about the role of the pharmacist or pharmacy profession in deprescribing in the United States.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted in July 2024 in MEDLINE (PubMed), Scopus (Elsevier), and Embase (Elsevier). The primary search concepts included terms around pill burden, cessation and de-prescription, as well as a search string to narrow results to qualitative reports. From 4410 unique records after deduplication, 46 abstracts were included for full text review.</div></div><div><h3>Results</h3><div>After full text review, 11 records were deemed suitable for inclusion in this review. Three used interviews, five used focus groups, and three used both. Three studies used the theory of planned behavior, two studies used the capability, opportunity, and motivation behavior model, one used the chronic care model, one used the interprofessional shared decision-making model, one used grounded theory, and three did not use a framework. Studies were conducted in New York (<em>n</em> = 3), Arizona, Maine, and Tennessee (<em>n</em> = 3), California (<em>n</em> = 1), Iowa (<em>n</em> = 1), Massachusetts (<em>n</em> = 1), North Carolina (<em>n</em> = 1), and Rhode Island (<em>n</em> = 1). Key themes identified across the studies included enablers, obstacles, process of deprescribing, and deprescribing in pharmacy education.</div></div><div><h3>Conclusions</h3><div>Deprescribing is a complex process that involves the entire healthcare team, including pharmacists who have unique expertise to support the team through education and information about medication and disease states.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100625"},"PeriodicalIF":1.8,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144513882","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