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Graham M, Bird S, Howard Z, Dobson M, Palazzi K, Lucas CJ, Schneider J, Eagar K, Martin JH. NSW Cannabis Medicines Advisory Service preliminary survey results - Enquirer perceptions and patient outcomes. Intern Med J 2021; 52:228-237. [PMID: 34837455 PMCID: PMC9304266 DOI: 10.1111/imj.15635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/04/2021] [Accepted: 11/23/2021] [Indexed: 11/28/2022]
Abstract
Background In 2018, an innovative, State government‐funded cannabis medicines drug information service was established for health professionals in New South Wales (NSW). The NSW Cannabis Medicines Advisory Service (CMAS) provides expert clinical guidance and support to medical practitioners considering prescribing a cannabis medicine to their patient(s). Aims This research examines quality assurance and patient outcomes related to enquirers' experience with NSW CMAS. Methods Data collection involved an online, anonymous survey with two components. Following a health professional enquiry, quality assurance data were collected about the enquirers' experience with NSW CMAS. The second survey focussed on patient outcomes and provides real‐world observational data about cannabis medicines safety and effectiveness across a wide range of indications. Results Data collection occurred between January 2020 and June 2021. Preliminary analyses were based on 68 quality assurance and 50 patient outcomes survey responses. General practitioners represented the highest proportion of survey responses (n = 33; 49%). The most common enquiry involved ‘patient‐specific advice’ (n = 50; 74%). Patient‐specific information provided by the service was mainly used for prescribing decision support (n = 45; 90%). Conclusions Preliminary findings highlight the impact of an innovative cannabis medicines drug information service in supporting health professional clinical practice in an area of rapid knowledge translation. Quality assurance data indicate that the service is perceived well by the majority of enquirers. Patient outcomes data across a wide range of indications suggest some effectiveness and a reasonable safety profile for prescribed cannabis medicines for most patients.
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Affiliation(s)
- M Graham
- NSW Cannabis Medicines Advisory Service, Newcastle, New South Wales, Australia.,Australian Centre for Cannabinoid Clinical and Research Excellence, Newcastle, New South Wales, Australia.,Centre for Drug Repurposing & Medicines Research, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.,John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - S Bird
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - Z Howard
- School of Psychological Science, University of Western Australia, Western Australia, Australia
| | - M Dobson
- John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - K Palazzi
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - C J Lucas
- Australian Centre for Cannabinoid Clinical and Research Excellence, Newcastle, New South Wales, Australia.,Centre for Drug Repurposing & Medicines Research, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia.,John Hunter Hospital, Hunter New England Local Health District, New Lambton, New South Wales, Australia
| | - J Schneider
- Australian Centre for Cannabinoid Clinical and Research Excellence, Newcastle, New South Wales, Australia.,Centre for Drug Repurposing & Medicines Research, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia
| | - K Eagar
- Australian Health Services Research Institute, University of Wollongong, New South Wales, Australia
| | - J H Martin
- Australian Centre for Cannabinoid Clinical and Research Excellence, Newcastle, New South Wales, Australia.,Centre for Drug Repurposing & Medicines Research, School of Medicine and Public Health, The University of Newcastle, New South Wales, Australia.,Hunter Medical Research Institute, Newcastle, New South Wales, Australia
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Hajj A, Azzo C, Hallit S, Salameh P, Sacre H, Abdou F, Naaman N, Khabbaz LR. Assessment of drug-prescribing perception and practice among dental care providers: a cross-sectional Lebanese study. Pharm Pract (Granada) 2021; 19:2234. [PMID: 33777263 PMCID: PMC7979316 DOI: 10.18549/pharmpract.2021.1.2234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 02/28/2021] [Indexed: 12/04/2022] Open
Abstract
Background: Dentists play an essential role in providing high-quality dental care, taking
into consideration the clinical context and concomitant medications taken by
the patients. Objective: This study aimed to assess drug-prescribing perception and practices in
addition to drug-related educational needs among Lebanese dentists; it also
evaluated the need for interprofessional collaboration between dentists and
pharmacists. Methods: An exploratory cross-sectional study using an online questionnaire targeted a
sample of dentists from all Lebanese districts. Participants gave their
consent by accepting to complete the survey (ethics approval reference:
USJ-2016-63). The questionnaire consisted of closed-ended questions
exploring: 1) drug-prescribing perception, 2) drug-prescribing practice, and
3) collaboration with pharmacists regarding their respective roles in
providing appropriate counseling to patients. Two indexes were created: the
first evaluated self-confidence in prescribing medications, and the second
assessed dentists’ confidence in pharmacists. Logistic regressions
were performed, taking each index as a dependent variable. Results A total of 137 dentists completed the survey (59% females; mean age:
42.17; SD: 13.78 years). The majority had a fair to good perceived knowledge
in pharmacology and therapeutics (80.3%), only 30.7% reported
to be sufficiently equipped to prescribe safely. Dentists exhibited
particularly low perceived knowledge about prescribing in elderly patients,
dosing, medication use in pregnancy, drug interactions, and adverse
reactions. Dentists specialized in periodontics had the lowest odds of
having self-confidence in prescribing drugs (aOR=0.25; p<0.001).
Also, 64.3% declared that they routinely check a reference source
before prescribing, and 78% relied on pharmaceutical companies and
medical representatives to get information on medications. While 61%
declared that pharmacists should provide oral care counseling, only half of
them encouraged their patients to talk to their pharmacists about their
medications. Only 15% considered that patients are getting enough
counseling from the pharmacist, with a global confidence index below the
median value, suggesting the need for more collaboration, especially with
periodontists who exhibited the lowest confidence in pharmacists
(aOR=0.45). Conclusions Lebanese dentists reported some lack of knowledge and confidence in
prescribing practices. Education, training, and close collaboration between
pharmacists and dentists are essential to overcome these problems and avoid
potential harm to patients.
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Affiliation(s)
- Aline Hajj
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Christel Azzo
- PharmD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Souheil Hallit
- PharmD, PhD. Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK) . Jounieh ( Lebanon ).
| | - Pascale Salameh
- PharmD, PhD. School of Medicine, University of Nicosia . Nicosia ( Cyprus ).
| | - Hala Sacre
- PharmD. National Institute of Public Health, Clinical Epidemiology, and Toxicology-Lebanon (INSPECT-LB) . Beirut ( Lebanon ).
| | - Frederic Abdou
- PharmD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
| | - Nada Naaman
- DDS, PhD. Faculty of Dental medicine, Saint-Joseph University . Beirut ( Lebanon ).
| | - Lydia R Khabbaz
- PharmD, PhD. Laboratory of Pharmacology, Clinical Pharmacy and Drug Quality Control, Faculty of Pharmacy, Saint-Joseph University . Beirut ( Lebanon ).
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Salat D, Llop R, Aguilera C, Danés I, Bosch M, Asensio C, Castañeda F, Esterlich E, Vallano A. Therapeutic enquiries about biological agents as a tool to identify safety aspects and patterns of use. Eur J Hosp Pharm 2015; 23:161-165. [PMID: 31156839 DOI: 10.1136/ejhpharm-2015-000770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 09/22/2015] [Accepted: 10/12/2015] [Indexed: 12/12/2022] Open
Abstract
Background Biotechnological agents (BA) are increasingly being used in clinical practice. We aimed to determine, whether enquiries about them to a therapeutic consultation service have also become more frequent, and to describe the information requested in these consultations. Methods We retrospectively reviewed 14 104 therapeutic consultations collected in a computerised database between 2000 and 2014. Enquiries about BA (monoclonal antibodies, fusion proteins or cytokine antagonists) were chosen. Information on the type of BA, underlying condition, type of enquiry and affiliation of the enquirer was retrieved and compared with data from consultations about other agents. Results During the study period, 365 enquiries about 30 different BA were received. Only 4% of them were received before 2004, while 48.8% were received after 2010. Rituximab, infliximab, adalimumab and etanercept were most frequently enquired about. Agent selection (n=184) and/or adverse effects (n=174) were the most frequent reasons for making an enquiry. Most enquiries about an agent selection were made about an off-label use (n=164), mainly for systemic autoimmune diseases (n=61). Over half of the enquiries about adverse effects were about their teratogenic potential (n=96). Enquiries about BA more often requested an opinion (87.7% vs 77.7%) were made by physicians (89.9% vs 76.9%), from a hospital (81.6% vs 44.5%) and regarded a specific patient (87.4% vs 74.5%). Conclusions Therapeutic consultations about BA are increasing. Most of them are related to uncertainties of health professionals regarding any new medicine: their off-label use, actual adverse effects or the teratogenic potential of the involved agents.
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Affiliation(s)
- D Salat
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain
| | - R Llop
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Aguilera
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - I Danés
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Bosch
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain.,Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Asensio
- Clinical Pharmacology Service, Hospital Universitari Vall d'Hebron, Fundació Institut Català de Farmacologia, Barcelona, Spain
| | - F Castañeda
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - E Esterlich
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - A Vallano
- Clinical Pharmacology Service, IDIBELL, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain.,Department of Pathology and Experimental Therapeutics, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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Raj DV, Abuzar M, Borromeo GL. Bisphosphonates, healthcare professionals and oral health. Gerodontology 2014; 33:135-43. [DOI: 10.1111/ger.12141] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2014] [Indexed: 11/26/2022]
Affiliation(s)
| | - Menaka Abuzar
- Melbourne Dental School; University of Melbourne; Victoria Vic. Australia
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Martin MV. Summary of: Time-dependent recontamination rates of sterilised dental instruments. Br Dent J 2011; 211:376-7. [DOI: 10.1038/sj.bdj.2011.872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2011] [Indexed: 11/09/2022]
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