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

Prevalence and determinants of unused medicines among households in Ethiopia: A systematic review and meta-analysis 埃塞俄比亚家庭中未使用药物的流行情况和决定因素：系统回顾和荟萃分析

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-31 DOI: 10.1016/j.rcsop.2025.100639

Tekletsadik Tekleslassie Alemayehu , Gebremariam Wulie Geremew , Eskedar Dires Gebremeskel , Zemenu Wube Bayleyegn , Ayelign Eshete Fitgu , Tefera Minwagaw , Mulugojjam Jegnie Tagele , Rahel Belete Abebe , Tirsit Ketsela Zeleke , Abaynesh Fentahun Bekalu , Masho Tigabie Tekle , Mekonnen Derese Mekete , Mulugeta Assefa Estifo , Abebech Tewabe Gelaye , Tadele Mesfin Demelash , Fraol Zeleke Desta , Elsabeth Alemayehu Haile , Simon Zemenfes Hailu , Adugna Tadesse Gemeda , Tesfaye Birhanu Abebe

Background

Unused medicines present significant public health, environmental risks and economic challenges. Understanding their prevalence and determinants is crucial for designing appropriate interventions. This systematic review and meta-analysis aimed to estimate the pooled prevalence and determinants of unused medicines among households in Ethiopia.

Method

A comprehensive search was conducted across major databases, including Scopus, Science Direct, Embase, PubMed/MEDLINE, Google Scholar, and Research Gate, to identify relevant studies published up to January 10, 2025. Eligible studies reporting the prevalence and determinants of unused medicines in Ethiopian households were included. Data were extracted via a Microsoft Excel spreadsheet and analyzed using STATA version 11.0, applying a random-effects model to estimate the pooled prevalence and account for heterogeneity. Subgroup and sensitivity analyses were performed to explore variations across studies.

Result

A total of 12 studies involving 6123 households were included. The pooled prevalence of unused medicines was estimated at 44.34 % (95 % CI: 32.83, 55.84), with substantial heterogeneity among studies (I² = 99.0 %, p value =0.000). Subgroup analyses revealed higher prevalence rates in urban households at 47.8 % compared to rural households at 26.89 % and regional disparities. Antibiotics were the most frequently unused class of medications, accounting for 31.49 % of all unused medicines in households, followed by analgesics at 26.14 %, while antacids constituted 8.7 %. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief at 34.21 %, while anticipation of future use constitute 20.47 %. Factors such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines among households in Ethiopia.

Conclusion

This systematic review and meta-analysis revealed that unused medicines among households in Ethiopian was prevalent, with significant regional variations. Antibiotics were the most commonly unused medications, followed by analgesics, while cardiovascular medicines and dietary supplements were the least reported. The primary reasons for the accumulation of unused medicines included self-discontinuation upon symptom relief, and anticipation of future use. Key determinants such as self-medication with NSAIDs, acquisition of medications without prescriptions, and higher household income were significantly associated with the prevalence of unused medicines. These findings underscore the need for context specific interventions to address the high prevalence of unused medicines in Ethiopia, particularly in urban settings and regions with higher rates.

使用过的药物带来了重大的公共卫生、环境风险和经济挑战。了解其流行情况和决定因素对于设计适当的干预措施至关重要。本系统综述和荟萃分析旨在估计埃塞俄比亚家庭中未使用药物的总流行率和决定因素。方法对Scopus、Science Direct、Embase、PubMed/MEDLINE、谷歌Scholar、Research Gate等主要数据库进行综合检索，确定截至2025年1月10日发表的相关研究。纳入了报告埃塞俄比亚家庭中未使用药物的流行情况和决定因素的合格研究。通过Microsoft Excel电子表格提取数据，并使用STATA 11.0版本进行分析，应用随机效应模型估计合并患病率并解释异质性。进行亚组和敏感性分析以探索研究间的差异。结果共纳入12项研究，涉及6123户家庭。未使用药物的总患病率估计为44.34% (95% CI: 32.83, 55.84)，研究之间存在很大的异质性（I2 = 99.0%， p值=0.000）。亚组分析显示，城市家庭的患病率为47.8%，高于农村家庭的26.89%，而且存在地区差异。抗生素是最常被使用的一类药物，占家庭所有未使用药物的31.49%，其次是镇痛药，占26.14%，而抗酸药占8.7%。未用药物积累的主要原因是症状缓解后自行停药，占34.21%，预期再次用药占20.47%。在埃塞俄比亚，使用非甾体抗炎药自我药疗、在没有处方的情况下获得药物以及较高的家庭收入等因素与家庭中未使用药物的流行程度显著相关。本系统综述和荟萃分析显示，埃塞俄比亚家庭中未使用药物的情况普遍存在，且存在显著的地区差异。抗生素是最常见的未使用药物，其次是镇痛药，而心血管药物和膳食补充剂的报告最少。未使用药物积累的主要原因包括症状缓解后自行停药和预期将来使用。关键决定因素，如非甾体抗炎药自我药疗、无需处方获得药物以及较高的家庭收入与未使用药物的流行率显著相关。这些发现强调需要针对具体情况采取干预措施，以解决埃塞俄比亚，特别是在城市环境和使用率较高的地区未使用药物的高流行率问题。

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引用次数: 0

Community pharmacy working conditions: Is stress impacting patient care? 社区药房工作条件：压力是否影响病人护理？

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-31 DOI: 10.1016/j.rcsop.2025.100641

Goar Alvarez , Taylor Harris , Erika Zwachte Fennick , Leanne Lai , Jesús Sánchez , Rawan Alkhamisi

Background

Community pharmacists have expanded their roles beyond traditional medication dispensing to include various clinical services. They play a critical role in reducing medication-related errors and enhancing patient safety. However, their effectiveness is significantly influenced by their work environment and associated challenges.

Objectives

This cross-sectional study evaluates the stress levels of community pharmacists in Florida, USA, and examines how stress impacts patient care.

Methods

A survey was developed and emailed to 23,016 licensed pharmacists in Florida. Responses were collected from March 9 to April 15, 2022. The primary outcomes measured were workplace stressor frequency in community pharmacies and the relationship between work environment factors and patient care quality. Secondary outcomes assessed differences in average Perceived Stress Scores (PSS) between chain and independent pharmacists and between those in managerial versus non-managerial roles.

Results

Of 361 responses, 257 pharmacists completed the survey. Most (84.8 %) were chain pharmacists, 15.2 % independent. The primary stressor was staffing issues (57.98 %). Additionally, 71.9 % deemed working conditions unsafe, and 78.4 % struggled to provide quality care due to work stress. Chain pharmacists had significantly different PSS scores (22.72) versus independent pharmacists (22.82, p = 0.0034). No difference existed between managerial (25.44) and non-managerial pharmacists (25.11, p = 0.5962). Spearman correlations showed significant negative associations between PSS scores and difficulty providing quality care (ρ = −0.47, p < 0.0001) and unsafe conditions perceptions (ρ = −0.51, p < 0.0001). Patient care measures correlated positively (ρ = 0.71, p < 0.0001).

Conclusion

Stress significantly impacts community pharmacists' ability to provide quality care.

社区药剂师已经扩大了他们的角色，超越了传统的药物分配，包括各种临床服务。它们在减少与药物有关的错误和加强患者安全方面发挥着关键作用。然而，他们的工作效率受到工作环境和相关挑战的显著影响。目的：本横断面研究评估美国佛罗里达州社区药剂师的压力水平，并探讨压力如何影响患者护理。方法开展了一项调查，并通过电子邮件向佛罗里达州23,016名有执照的药剂师进行了调查。调查于2022年3月9日至4月15日进行。主要测量结果是社区药房工作场所压力源频率以及工作环境因素与患者护理质量的关系。次要结果评估连锁药剂师和独立药剂师以及管理角色和非管理角色之间的平均感知压力得分（PSS）差异。结果361份问卷中，完成调查的药师257名。连锁药师占84.8%，独立药师占15.2%。主要压力源为人员配备问题（57.98%）。此外，71.9%的人认为工作条件不安全，78.4%的人由于工作压力而难以提供高质量的护理。连锁药师的PSS评分为22.72分，独立药师的PSS评分为22.82分，p = 0.0034分。管理药师（25.44）与非管理药师（25.11,p = 0.5962）差异无统计学意义。Spearman相关性显示PSS评分与提供优质护理的难度呈显著负相关(ρ = - 0.47, p <；0.0001)和不安全条件感知(ρ = - 0.51, p <；0.0001)。患者护理措施正相关(ρ = 0.71, p <；0.0001)。结论应激对社区药师提供优质护理的能力有显著影响。

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引用次数: 0

Can a national storage obligation for medicines prevent shortages? Evidence from the Finnish experience 国家药品储存义务能否防止短缺？来自芬兰经验的证据

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-22 DOI: 10.1016/j.rcsop.2025.100637

Reko Ravela , Timi Aaltonen , Marja Airaksinen , Alan Lyles

Background

Since 1984, Finland has used storage obligations for essential medicines, requiring manufacturers and importers to maintain storage of certain medicines. This study aimed to investigate whether this type of obligatory storage system for human medicines is effective in preventing and mitigating medicine shortages.

Methods

This is a retrospective register study, utilizing open data from Finnish, Norwegian, and Swedish national medicines authorities. We compared the proportion and median durations of shortages between medicines with and without storage obligations within Finland, and the proportion of shortages across Finland, Sweden, and Norway.

Results

A total of 1910 shortage notifications met the inclusion criteria for the analysis of shortages within Finland. Medicines not subject to storage obligations experienced between 1.8 and 2.3 times more shortages during the study period compared to those covered by storage obligations. Additionally, the median duration of short-term shortages (lasting less than 21 days) was shorter for medicines that are subject to storage obligations.

The inter-country analysis included 1230 shortage notifications from Sweden, 1075 from Norway, and 1369 from Finland. In comparison to Finland, shortages of products equivalent to those subject to storage obligations were 2.5 times more common in Sweden, where no storage obligations are in place, and 2.4 times more common in Norway, where storage obligations are more limited.

Conclusions

Our findings suggest that storage obligations for essential human medicines are associated with a lower frequency of shortages. This evidence provides support for other nations considering taking similar policy measures to reduce such shortages.

自1984年以来，芬兰对基本药物实行储存义务，要求制造商和进口商保持某些药物的储存。本研究旨在探讨这种人用药品强制储存制度是否能有效预防和缓解药品短缺。方法：这是一项回顾性登记研究，利用芬兰、挪威和瑞典国家药品管理局的公开数据。我们比较了芬兰有和没有储存义务的药品之间的短缺比例和中位数持续时间，以及芬兰、瑞典和挪威的短缺比例。结果共有1910份短缺报告符合芬兰短缺分析的纳入标准。在研究期间，与有储存义务的药品相比，不受储存义务约束的药品的短缺程度高出1.8至2.3倍。此外，对于有储存义务的药品，短期短缺（持续时间少于21天）的中位数持续时间较短。国家间分析包括来自瑞典的1230份短缺通知，来自挪威的1075份，来自芬兰的1369份。与芬兰相比，在没有储存义务的瑞典，相当于有储存义务的产品短缺的发生率是芬兰的2.5倍，在储存义务较为有限的挪威，这一比例是芬兰的2.4倍。结论人类基本药物的储存义务与较低的短缺频率相关。这一证据为其他考虑采取类似政策措施来减少此类短缺的国家提供了支持。

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引用次数: 0

Identification and follow up of cardiovascular disease risk factors among participants at a pharmacy student-led screening program 在药学学生主导的筛查项目中，参与者心血管疾病危险因素的识别和随访

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-07-22 DOI: 10.1016/j.rcsop.2025.100636

Umara Bibi Qureshi , Dineo Mpanya , Razeeya Khan , Muhammed Vally , Ané Orchard

Background

The increased prevalence of cardiovascular disease (CVD) and associated risk factors like hypertension, type 2 diabetes, dyslipideamia, and obesity underscores the need for proactive screening. Given the insidious progression of these conditions, early detection is paramount. The Screening and Testing Programme for Pharmacy Students (STEPPS) is a pharmacy student-led, work-based learning initiative at the University of the Witwatersrand that provides preventive cardiovascular risk screening to university staff and students.

Aim

To identify the occurrence of underlying and uncontrolled risk factors for cardiovascular disease from a convenience sample of participants who attended the STEPPS screening events at the University of the Witwatersrand in year 2022. The study further determined whether the referral of the identified participants led to a diagnosis and intervention.

Methodology

A cross-sectional study was conducted in a screening event called STEPPS at the University of the Witwatersrand. A convenience sample of university staff and students aged 18 years and older who voluntarily participated was included. Fourth-year pharmacy students conducted screenings, including blood pressure, blood glucose, cholesterol, and anthropometric measurements. Participants with abnormal results were referred for further care, and follow-up was conducted via telephone interviews several months later. Quantitative data were analysed using descriptive and inferential statistics in STATA® 18.0.

Results

There was a self-reported occurrence of hypertension (6.5 %), diabetes (2.09 %), dyslipideamia (2.87 %), and obesity (3.91 %). Elevated readings were observed among 136 (18.25 %) participants for blood pressure, 13 (2.83 %) participants for blood glucose and, 50 (11.36 %) participants for blood cholesterol. Among the CVD-related referrals based on abnormal screening results (33 participants), 75 % complied. Of these, 35 % exhibited significant findings, including newly diagnosed cases (43 %), disease escalation (29 %) and lifestyle modifications (29 %). Among follow-up participants, 16 (80 %) participants reported undergoing interventions post-screening.

Conclusion

The student-led initiative effectively identified the occurrences of undiagnosed and uncontrolled cases at the university with 80 % of referrals leading to a medical intervention.

背景：心血管疾病（CVD）和相关危险因素如高血压、2型糖尿病、血脂异常和肥胖的患病率增加，强调了主动筛查的必要性。鉴于这些疾病的潜伏进展，早期发现是至关重要的。药学学生筛查和测试计划（STEPPS）是威特沃特斯兰德大学药学学生主导的、基于工作的学习计划，为大学教职员工和学生提供预防性心血管风险筛查。目的从2022年在威特沃特斯兰德大学参加STEPPS筛查活动的参与者的方便样本中确定心血管疾病潜在和未控制的危险因素的发生。该研究进一步确定了被识别的参与者的转诊是否导致了诊断和干预。方法一项横断面研究是在威特沃特斯兰德大学的一项名为STEPPS的筛查活动中进行的。方便的样本包括自愿参加的18岁及以上的大学教职员工和学生。四年级的药学学生进行了筛查，包括血压、血糖、胆固醇和人体测量。结果异常的参与者被转介进一步治疗，并在几个月后通过电话访谈进行随访。定量数据采用STATA®18.0的描述性和推断性统计进行分析。结果自报有高血压（6.5%）、糖尿病（2.09%）、血脂异常（2.87%）、肥胖（3.91%）。136人（18.25%）血压升高，13人（2.83%）血糖升高，50人（11.36%）血胆固醇升高。在基于异常筛查结果的cvd相关转诊中（33名参与者），75%的人遵守。其中，35%表现出显著的发现，包括新诊断病例（43%）、疾病升级（29%）和生活方式改变（29%）。在随访参与者中，16名（80%）参与者报告在筛查后接受了干预。结论学生主导的倡议有效地识别了大学中未确诊和无法控制病例的发生，80%的转诊导致医疗干预。

{"title":"Identification and follow up of cardiovascular disease risk factors among participants at a pharmacy student-led screening program","authors":"Umara Bibi Qureshi , Dineo Mpanya , Razeeya Khan , Muhammed Vally , Ané Orchard","doi":"10.1016/j.rcsop.2025.100636","DOIUrl":"10.1016/j.rcsop.2025.100636","url":null,"abstract":"<div><h3>Background</h3><div>The increased prevalence of cardiovascular disease (CVD) and associated risk factors like hypertension, type 2 diabetes, dyslipideamia, and obesity underscores the need for proactive screening. Given the insidious progression of these conditions, early detection is paramount. The Screening and Testing Programme for Pharmacy Students (STEPPS) is a pharmacy student-led, work-based learning initiative at the University of the Witwatersrand that provides preventive cardiovascular risk screening to university staff and students.</div></div><div><h3>Aim</h3><div>To identify the occurrence of underlying and uncontrolled risk factors for cardiovascular disease from a convenience sample of participants who attended the STEPPS screening events at the University of the Witwatersrand in year 2022. The study further determined whether the referral of the identified participants led to a diagnosis and intervention.</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted in a screening event called STEPPS at the University of the Witwatersrand. A convenience sample of university staff and students aged 18 years and older who voluntarily participated was included. Fourth-year pharmacy students conducted screenings, including blood pressure, blood glucose, cholesterol, and anthropometric measurements. Participants with abnormal results were referred for further care, and follow-up was conducted via telephone interviews several months later. Quantitative data were analysed using descriptive and inferential statistics in STATA® 18.0.</div></div><div><h3>Results</h3><div>There was a self-reported occurrence of hypertension (6.5 %), diabetes (2.09 %), dyslipideamia (2.87 %), and obesity (3.91 %). Elevated readings were observed among 136 (18.25 %) participants for blood pressure, 13 (2.83 %) participants for blood glucose and, 50 (11.36 %) participants for blood cholesterol. Among the CVD-related referrals based on abnormal screening results (33 participants), 75 % complied. Of these, 35 % exhibited significant findings, including newly diagnosed cases (43 %), disease escalation (29 %) and lifestyle modifications (29 %). Among follow-up participants, 16 (80 %) participants reported undergoing interventions post-screening.</div></div><div><h3>Conclusion</h3><div>The student-led initiative effectively identified the occurrences of undiagnosed and uncontrolled cases at the university with 80 % of referrals leading to a medical intervention.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"19 ","pages":"Article 100636"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144722572","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

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。

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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。

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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。

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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。

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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。

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引用次数: 0