Exploratory research in clinical and social pharmacy最新文献_第9页

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。

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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。

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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。

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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。

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引用次数: 0

Shortening emergency department length of stay: Fast track, short-stay unit and acute medical unit 缩短急诊科住院时间：快速通道、短期住院单位和急症医疗单位

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-19 DOI: 10.1016/j.rcsop.2025.100626

Bei Huang

Emergency department (ED) length of stay (EDLOS) refers to the waiting time experienced by patients at various stages of the ED. It serves as an indicator of ED overcrowding. Prolonged EDLOS can lead to delays in assessment and care, negatively impacting patient satisfaction, and is associated with a poor prognosis. ED overcrowding may result in higher rates of medical errors, adverse events, and mortality. The crude mortality rate for patients with EDLOS <6 h was significantly lower than for those with EDLOS of 12–24 h and > 24 h. Multiple factors influence EDLOS before admission, including limited medical resources and a high volume of non-emergency cases. Hospitals should develop personalized strategies to reduce EDLOS by analyzing patient volumes and resource demands. In this narrative review, measures involving alternatives to ward admission from the ED such as an emergency fast track (FT), an emergency short-stay ward (ESSW)/emergency short-stay unit (ESSU), and an acute medical unit (AMU)/acute medical admissions unit (AMAU), are summarized, aiming to serve as a reference for shortening EDLOS, improving emergency care efficiency, and optimizing service quality.

急诊科（ED）住院时间（EDLOS）是指患者在急诊科不同阶段的等待时间。它是急诊科过度拥挤的一个指标。延长的EDLOS可导致评估和护理的延迟，对患者满意度产生负面影响，并与预后不良有关。急诊科过度拥挤可能导致更高的医疗差错、不良事件和死亡率。EDLOS 6 h患者的粗死亡率显著低于EDLOS 12 ~ 24 h和EDLOS 12 ~ 24 h患者。24 h.入院前影响EDLOS的因素多种多样，包括医疗资源有限、非急诊病例量大等。医院应该通过分析患者数量和资源需求来制定个性化策略，以减少EDLOS。本文总结了急诊快速通道（FT）、急诊短期住院病房(ESSW)/急诊短期住院单元（ESSU）、急症医疗单元(AMU)/急症医疗住院单元（AMAU）等替代急症住院的措施，旨在为缩短急症住院时间、提高急诊护理效率和优化服务质量提供参考。

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引用次数: 0

Stevens-Johnson syndrome triggered by phenytoin in a patient with type 2 diabetes and seizures 史蒂文斯-约翰逊综合征由苯妥英引起的2型糖尿病和癫痫患者

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-13 DOI: 10.1016/j.rcsop.2025.100624

Mohammed Misbah Ul Haq, Mohammed Ansar, Aieman Siddiqua, Mohd Mudaseer

This case report describes a unique and severe instance of Stevens-Johnson syndrome (SJS) triggered by a combination of phenytoin, levetiracetam, glimepiride, and metformin in a patient with type 2 diabetes. SJS is a serious condition that affects the skin and mucous membranes and is often induced by various medications. The report underscores the critical importance of promptly identifying and managing SJS, as well as the need for careful monitoring of patients on multiple drugs, especially those with prior drug allergies. It also adds valuable insights to the existing literature on drug-induced SJS, emphasizing the role of a multidisciplinary approach in improving patient care and outcomes.

本病例报告描述了一例独特且严重的史蒂文斯-约翰逊综合征（SJS），由苯妥英、左乙拉西坦、格列美脲和二甲双胍联合引起的2型糖尿病患者。SJS是一种影响皮肤和粘膜的严重疾病，通常由各种药物引起。该报告强调了及时识别和管理SJS的重要性，以及对使用多种药物的患者进行仔细监测的必要性，特别是那些先前有药物过敏的患者。它还为现有的药物性SJS文献增加了有价值的见解，强调了多学科方法在改善患者护理和预后方面的作用。

引用次数: 0

Using simulated patient methodology to assess sick day guidance in community pharmacy: The case of an elderly patient with diabetes 用模拟病人方法评估社区药房的病假指导：以一位老年糖尿病患者为例

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-11 DOI: 10.1016/j.rcsop.2025.100623

Tristan Coppes , Hetty Prins , Kees A. van Amerongen , Teun van Gelder , Ellen S. Koster , Marcel L. Bouvy

Background

Certain high-risk medication, such as diuretics, should be temporarily adjusted during sick days (diarrhoea, vomiting or fever) to reduce the risk of adverse drug events. Guidelines refer to this as ‘sick day guidance’. Prior research has shown limited awareness among pharmacy staff of these recommendations.

Objective

This study assessed how community pharmacies in the Netherlands address a simulated self-care inquiry related to diarrhoea from a 71-year-old patient with diabetes.

Methods

Three trained simulated informal caregivers visited community pharmacies unannounced to seek an antidiarrheal product for a 71-year-old family member with diabetes and high-risk medication. Data were collected through a data collection form with audio recording.

Results

A total of 64 pharmacies were visited. Current comorbidities and medications were identified in 59 % (38/64) of the pharmacies. Sixteen out of 64 pharmacies (25 %) provided sick day guidance either through temporary medication adjustment or GP referral. In more than 80 % of the pharmacies, a pharmaceutical product was dispensed, most often loperamide. The pharmacies that did not identify current comorbidities and medications (n = 26), did not provide sick day guidance nor referred to the GP.

Conclusions

Sick day guidance was applied in one in four cases. Identifying current comorbidities and medications is essential for providing sick day guidance.

背景：某些高风险药物，如利尿剂，应在病假期间（腹泻、呕吐或发烧）临时调整，以减少药物不良事件的风险。指导方针将此称为“病假指导”。先前的研究表明，药房工作人员对这些建议的认识有限。目的：本研究评估荷兰社区药房如何处理与71岁糖尿病患者腹泻有关的模拟自我保健询问。方法三名训练有素的模拟非正式护理人员未经通知前往社区药房，为一位患有糖尿病和高危药物的71岁家庭成员寻求止泻产品。数据通过带有录音的数据收集表收集。结果共走访药店64家。59%（38/64）的药房发现了目前的合并症和药物治疗。64家药房中有16家（25%）通过临时用药调整或全科医生转诊提供病假指导。在80%以上的药店中，配发了一种药品，最常见的是洛哌丁胺。没有确定当前合并症和药物的药房（n = 26），没有提供病假指导，也没有转介给全科医生。结论1 / 4的病例采用病日指导。确定当前的合并症和药物对于提供病假指导至关重要。

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引用次数: 0

Evaluating health-related quality of life and health resource utilization among Gabapentinoid users with substance use disorder in the US: Trends, co-prescriptions, and cost analysis 评估美国加巴喷丁类药物使用障碍患者的健康相关生活质量和健康资源利用：趋势、联合处方和成本分析

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-08 DOI: 10.1016/j.rcsop.2025.100618

Saba Dangpiaei, Mohammad A. Al-Mamun

Background

Gabapentinoid, including Gabapentin and Pregabalin, are commonly used for approved and off-label health conditions, but their misuse with opioid among individuals with substance use disorder (SUD) increases the risk of respiratory depression and death. Thus, we investigated the impact of SUD on different health outcomes among the Gabapentinoid users in the U.S.

Methods

We used Medical Expenditure Panel Survey data (2015 to 2021) to identify Gabapentinoid users and categorized them into SUD and Non-SUD groups. The primary aim was to investigate the association between SUD and health related quality of life measured through physical component score (PCS) and mental component score (MCS) while secondary aim was to compare healthcare utilization between these groups. The prescription trends and related costs were also examined.

Results

Total 164 Gabapentinoid users had SUD who had lower MCS compared to the Non-SUD group (β = −3.83 [−6.24, −1.41], p = 0.002). Additionally, SUD was associated with a higher number of outpatient visits (β = 0.35 [0.02, 0.68], p = 0.04). The SUD group incurred higher total expenditure ($10,671.4, SE = 970.6) compared to the Non-SUD group ($9166.7, SE = 714.7). Gabapentinoid use increased from 2015 to 2021, with Pregabalin prescriptions rising from 0.98 % to 2.24 % and Gabapentin from 4.37 % to 10.16 %. Among users with SUD, common co-prescriptions included Tramadol (46.59 %), Oxycodone (35.62 %), and Lorazepam (34.78 %).

Conclusion

Our results suggest the critical need to monitor and assess the Gabapentinoid prescription among individuals with SUD, further warrant to develop and implement new policies and guidelines at both federal and state levels in the U.S.

加巴喷丁类药物，包括加巴喷丁和普瑞巴林，通常用于批准的和标签外的健康状况，但它们与阿片类药物在物质使用障碍（SUD）患者中的滥用增加了呼吸抑制和死亡的风险。因此，我们调查了SUD对美国加巴喷丁类药物使用者不同健康结果的影响。方法我们使用医疗支出小组调查数据（2015年至2021年）来识别加巴喷丁类药物使用者，并将其分为SUD和非SUD组。主要目的是通过身体成分评分（PCS）和精神成分评分（MCS）来调查SUD与健康相关生活质量之间的关系，而次要目的是比较这两组之间的医疗保健利用情况。还审查了处方趋势和相关费用。结果164例加巴喷丁类药物使用者有SUD， MCS低于非SUD组（β = - 3.83 [- 6.24, - 1.41], p = 0.002）。此外，SUD与较高的门诊就诊次数相关（β = 0.35 [0.02, 0.68], p = 0.04）。SUD组的总支出（10,671.4美元，SE = 970.6）高于非SUD组（9166.7美元，SE = 714.7）。从2015年到2021年，加巴喷丁类药物的使用有所增加，普瑞巴林的使用率从0.98%上升到2.24%，加巴喷丁的使用率从4.37%上升到10.16%。在SUD使用者中，常见的合用处方为曲马多（46.59%）、羟考酮（35.62%）和劳拉西泮（34.78%）。结论我们的研究结果表明，迫切需要监测和评估加巴喷丁类药物在SUD患者中的处方，并进一步保证在美国联邦和州一级制定和实施新的政策和指南

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引用次数: 0

A qualitative study of community pharmacists in New Zealand: mental health literacy and the barriers and facilitators to providing and receiving mental healthcare in community pharmacies 新西兰社区药剂师的定性研究：心理健康素养以及社区药房提供和接受心理保健的障碍和促进因素

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-08 DOI: 10.1016/j.rcsop.2025.100621

Frederick Sundram , Amy Hai Yan Chan , Joanne C. Lin , Retina Rimal , Timothy F. Chen , Jane L. Sheridan

Background

Community pharmacists (CPs) play a valuable role in the provision of mental healthcare in primary care settings; however, CPs may not be comfortable or confident doing so. Mental health literacy (MHL) of CPs and consumers, alongside factors in community pharmacies may contribute to this.

Objective

The aims of this study were to explore how MHL may affect the provision and receipt of mental healthcare in community pharmacies, and the perceived barriers and facilitators for CPs in providing mental healthcare.

Methods

Participants were recruited from a sample of respondents to a prior national survey of MHL in CPs. Thirteen CPs with a mean age of 40 years, comprising participants from both independent and chain pharmacies were recruited. Individual, semi-structured interviews were conducted, followed by professional transcription and thematic analysis.

Results

Analysis revealed five main themes describing factors related to MHL and also the provision of mental healthcare services in community pharmacies: 1) Complexities in the understanding of and recognition and management of mental illness; 2) Attitudes and experiences of CPs in supporting mental health needs; 3) Prevention and management of mental illness needing a collaborative approach; 4) Opportunities and challenges within community pharmacies to support mental healthcare needs; and 5) Preparedness and willingness of CPs to provide mental healthcare.

Conclusions

CPs identified several MHL-related factors that could affect mental healthcare delivery by CPs and consumers receiving care. CPs also described several ways to enhance preparedness to deliver mental healthcare in community pharmacies including working collaboratively with other healthcare providers.

社区药剂师（CPs）在初级保健机构提供精神卫生保健方面发挥着宝贵的作用；然而，CPs可能不舒服或有信心这样做。CPs和消费者的心理健康素养（MHL）以及社区药房的因素可能导致这种情况。目的本研究的目的是探讨MHL对社区药房提供和接受精神卫生保健服务的影响，以及社区药房提供精神卫生保健服务的障碍和促进因素。方法从先前全国CPs MHL调查的应答者样本中招募参与者。招募了13名平均年龄为40岁的药剂师，包括来自独立和连锁药店的参与者。进行个人半结构化访谈，然后进行专业转录和专题分析。结果分析显示，社区药房对精神疾病的认识、认识和管理较为复杂；2) CPs在支持心理健康需求方面的态度和经验；3)精神疾病的预防和管理需要协作；4)社区药房支持精神卫生保健需求的机遇和挑战；5) CPs提供心理保健的准备和意愿。结论scp确定了几个与mhl相关的因素，这些因素可能影响CPs和接受护理的消费者提供精神卫生保健服务。CPs还描述了在社区药房加强精神卫生保健准备工作的几种方法，包括与其他卫生保健提供者合作。

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引用次数: 0

A mixed-methods study investigating the potential and challenges of generic substitution of controlled substances in community pharmacies 一项混合方法研究，调查社区药房管制物质通用替代的潜力和挑战

IF 1.8 Q3 PHARMACOLOGY & PHARMACY

Exploratory research in clinical and social pharmacy

Pub Date : 2025-06-06 DOI: 10.1016/j.rcsop.2025.100622

I.M. Keller , J.M. Alexa , M.W. Meier , S.S. Allemann

Background

Using generics became an established practice. Studies about dispensing practices of generic controlled substances are scarce.

Objective

We investigated dispensing practices of generic controlled substances compared to non-controlled substances, challenges community pharmacists face when substituting them, and how they can be better supported.

Methods

A mixed-methods approach was employed. We descriptively analyzed prescribing and dispensing rates of originals and generics of controlled and non-controlled substances. Ten community pharmacists were interviewed to investigate challenges and support options.

Results

Seven hundred eight prescriptions were included in the data analysis. Physicians prescribed 54 % (167/307) of originals for controlled substances and 50 % (202/401) of originals for non-controlled substances (p > 0.05). A total of 37 % (62/167) of prescriptions for original controlled substances were substituted with generics in community pharmacies in contrast to 74 % (149/202) of prescriptions for original non-controlled substances (p < 0.001). Challenges mentioned by the interviewees included gaining trust in the context of generic controlled substance use, meeting patients' needs, and legal regulations. They named support measures, such as patient education by physicians, and reduction of the administrative workload.

Conclusion

The analysis revealed a significantly lower substitution rate for controlled substances compared to non-controlled substances in pharmacies. Yet, physicians showed similar prescribing rates of originals and generics. The findings support the need to strengthen the collaboration between healthcare providers, and to improve education as well as awareness to ensure adequate patient care when substituting generic controlled substances.

使用泛型已经成为一种惯例。关于非专利管制物质配药实践的研究很少。目的了解非管制药品与非管制药品的配药情况，社区药师在替代管制药品时面临的挑战，以及如何更好地支持非管制药品配药。方法采用混合方法。我们描述性地分析了管制药品和非管制药品的原料药和仿制药的处方和配药率。十位社区药剂师接受了访谈，以调查挑战和支持选择。结果共纳入处方778张。医生为管制药物开出54%（167/307）的正本，为非管制药物开出50%（202/401）的正本(p >；0.05)。在社区药房，有37%（62/167）的原始管制药物处方被仿制药替代，而74%（149/202）的原始非管制药物处方被仿制药替代(p <；0.001)。受访者提到的挑战包括在使用非专利受控物质的背景下获得信任、满足患者需求和法律法规。他们列举了支持措施，如医生对患者的教育，以及减少行政工作量。结论分析显示，药店管制药品的替代率明显低于非管制药品。然而，医生们显示出原创和仿制药的处方率相似。研究结果支持有必要加强卫生保健提供者之间的合作，并改进教育和认识，以确保在替代非专利受控物质时对患者提供充分的护理。

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