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Wirth F, Cadogan CA, Fialová D, Hazen A, Lutters M, Paudyal V, Weidmann AE, Okuyan B, Henman MC. Correction: Writing a manuscript for publication in a peer-reviewed scientific journal: Guidance from the European Society of Clinical Pharmacy. Int J Clin Pharm 2024; 46:558. [PMID: 38430339 PMCID: PMC10960877 DOI: 10.1007/s11096-024-01712-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Affiliation(s)
- Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Cathal A Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ankie Hazen
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, UK
| | - Anita E Weidmann
- Department of Clinical Pharmacy, Innsbruck University, Innsbruck, Austria
| | - Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Türkiye
| | - Martin C Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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Wirth F, Cadogan CA, Fialová D, Hazen A, Lutters M, Paudyal V, Weidmann AE, Okuyan B, Henman MC. Writing a manuscript for publication in a peer-reviewed scientific journal: Guidance from the European Society of Clinical Pharmacy. Int J Clin Pharm 2024; 46:548-554. [PMID: 38332208 PMCID: PMC10960906 DOI: 10.1007/s11096-023-01695-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
Publishing in reputable peer-reviewed journals is an integral step of the clinical pharmacy research process, allowing for knowledge transfer and advancement in clinical pharmacy practice. Writing a manuscript for publication in a journal requires several careful considerations to ensure that research findings are communicated to the satisfaction of editors and reviewers, and effectively to the readers. This commentary provides a summary of the main points to consider, outlining how to: (1) select a suitable journal, (2) tailor the manuscript for the journal readership, (3) organise the content of the manuscript in line with the journal's guidelines, and (4) manage feedback from the peer review process. This commentary reviews the steps of the writing process, identifies common pitfalls, and proposes ways to overcome them. It aims to assist both novice and established researchers in the field of clinical pharmacy to enhance the quality of writing in a research paper to maximise impact.
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Affiliation(s)
- Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Cathal A Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ankie Hazen
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Anita E Weidmann
- Department of Clinical Pharmacy, Innsbruck University, Innsbruck, Austria
| | - Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Türkiye
| | - Martin C Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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Paudyal V, Okuyan B, Henman MC, Stewart D, Fialová D, Hazen A, Lutters M, Oleárová A, Weidmann AE, Wirth F, Cadogan CA, Nazar Z. Scope, content and quality of clinical pharmacy practice guidelines: a systematic review. Int J Clin Pharm 2024; 46:56-69. [PMID: 37991663 PMCID: PMC10830799 DOI: 10.1007/s11096-023-01658-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/05/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Guidelines for pharmacy practitioners regarding various clinical pharmacy activities have been published in a number of countries. There is a need to review the guidelines and identify the scope of activities covered as a prelude to developing internationally acceptable common guidelines. AIM To review the scope of clinical pharmacy guidelines and assess the extent to which these guidelines conform to quality standards as per the AGREE II instrument. METHOD Medline, Embase, Guideline Central, International Pharmaceutical Abstracts, Google Scholar and Google (for grey literature) were searched for the period 2010 to January 2023. Guidelines which focused on any health care setting and any clinical pharmacy activity were included. Data were extracted and quality assessed independently by two reviewers using the English version of the AGREE II instrument. RESULTS Thirty-eight guidelines were included, mostly originating from Australia (n = 10), Ireland (n = 8), UK (n = 7) and USA (n = 5). Areas covered included medication reconciliation, medicines optimisation, medication management and transition of care. As per the AGREE II assessment, the highest score was obtained for the scope and purpose domain and the lowest score for rigour of development, mainly due to non-consideration of literature/evidence to inform guideline development. CONCLUSION Clinical pharmacy guidelines development processes need to focus on all quality domains and should take a systematic approach to guideline development. Guidelines need to further emphasise person-centred care and clinical communication. There is a scope to harmonise the guidelines internationally considering the diverse practices, standards and legislations across different geographies.
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Affiliation(s)
- Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham, Edgbaston, Birmingham, UK.
| | - Betul Okuyan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Marmara University, Istanbul, Türkiye
| | | | - Derek Stewart
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Daniela Fialová
- Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University, Hradec Králové, Czech Republic
- Department of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ankie Hazen
- Julius Centre for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Anna Oleárová
- Department of Clinical Pharmacology, Bratislava University Hospital, Bratislava, Slovakia
| | - Anita E Weidmann
- Department of Clinical Pharmacy, Innsbruck University, Innsbruck, Austria
| | | | - Cathal A Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Zachariah Nazar
- College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Zaccomer A, Wirth F, Camilleri L, Azzopardi LM. Perception of Interprofessional Education among Students Following Pharmacy Studies. J Pharm Pract 2023; 36:1498-1504. [PMID: 35711170 DOI: 10.1177/08971900221104254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Interprofessional Education (IPE) activities are a first experience of real-world patient care practice for students, where collaboration with different professions is appreciated. Methods and timing of inclusion of IPE are not well-defined, and it is interesting to assess students' perception on IPE activities. OBJECTIVE To assess changes in pharmacy students' perception of IPE before (t0) and after (t1) an IPE activity. METHODS The 'Student Perceptions of Interprofessional Clinical Education-Revised 2' (SPICE-R2) tool was adopted to assess perception of IPE activities in third year pharmacy students, final year pharmacy students and in postgraduate Doctorate in Pharmacy (PharmD) students at t0 and t1. RESULTS The SPICE-R2 tool was completed at t0 and t1 by 61 students: 12 third year pharmacy students, 13 final year students and 36 PharmD students. A significant improvement between t0 and t1 (P < .05) was measured in the three groups of students for all three subscales of the tool. The largest improvement was observed in the 'Roles/Responsibilities for Collaborative Practice' subscale in all three groups of students. CONCLUSION Perception of IPE was positively increased in all three student groups. The results could be useful to support the design of IPE activities within pharmacy programmes.
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Affiliation(s)
- Alessandro Zaccomer
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Bruno Xuereb AM, Wirth F, Mifsud Buhagiar L, Camilleri L, Azzopardi LM, Serracino-Inglott A. Pharmacist and physician perception of pharmacogenetic testing. Int J Pharm Pract 2022; 30:188-191. [PMID: 35225344 DOI: 10.1093/ijpp/riab080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/09/2021] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To assess the perception of pharmacists and physicians towards pharmacogenetic testing. METHODS A self-administered questionnaire was developed, validated, tested for reliability and disseminated to pharmacists and physicians in Malta. KEY FINDINGS The study population consisted of 292 participants; 61% pharmacists (64% female, 38% practicing >10 years) and 39% physicians (50% female, 54% practicing >10 years). Pharmacists and physicians felt they lack sufficient competence in the area (95.0% and 97.4%, respectively; P > 0.05) and agreed that further training is required (92.7% and 91.2%, respectively; P > 0.05). CONCLUSIONS The need for further training was identified by the participants to support competency development and sustain confidence on the topic, hence facilitating the clinical implementation of pharmacogenetic testing.
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Affiliation(s)
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | | | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Scala D, Mucherino S, Wirth F, Orlando V, Polidori P, Faggiano ME, Iovine D, Saturnino P, Cattel F, Costantini A, Giua C, Makoul G, Azzopardi LM, Menditto E. Developing and piloting a communication assessment tool assessing patient perspectives on communication with pharmacists (CAT-Pharm). Int J Clin Pharm 2022; 44:1037-1045. [PMID: 35211832 PMCID: PMC9393125 DOI: 10.1007/s11096-022-01382-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/24/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Effective communication strategies in health care help to enhance patient empowerment and improve clinical outcomes. OBJECTIVE Adapt the original Communication Assessment (CAT) instrument for the pharmacist profession (CAT-Pharm) and to test its validity and reliability in two different settings. SETTING Five hospital pharmacies in Italy and five community pharmacies in Malta. METHOD Pilot study involving a standardized multi-step process adhering to internationally accepted and recommended guidelines. Corrections and adjustments to the translation addressed linguistic factors and cultural components. CAT-Pharm, compared to the original CAT, maintained 10 out of the 14 items: one was slightly modified; three were changed to better fit the pharmacist role; one was added. MAIN OUTCOME MEASURES CAT-Pharm development and testing its practicality to assess patient perceptions of pharmacists' interpersonal and communication skills. RESULTS CAT-Pharm was tested on 97 patients in the Italian setting and 150 patients in the Maltese setting to assess the practicality of the tool and its usefulness in investigating gaps and priorities for improving pharmacist-patient communication. Results Show reliability and internal validity of the CAT-Pharm tool. The analysis of patient perceptions of communication with the pharmacist in Italy indicated differences from that in Malta. The different settings provided insight into the utility of CAT-Pharm. CONCLUSION This study provided a valid and reliable tool that could be applied to assess patient perception of the pharmacist's communication abilities.
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Affiliation(s)
- Daniela Scala
- Nuclear Medicine, AORN “A. Cardarelli”, Naples, Italy
| | - Sara Mucherino
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Valentina Orlando
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | | | - Daniela Iovine
- Pharmacy Department, AORN “A. Cardarelli”, Naples, Italy
| | | | - Francesco Cattel
- Farmacia Ospedaliera A.O.U. Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Alberto Costantini
- U.O.C. Farmacia Ospedaliera Aziendale Ospedale “Santo Spirito” ASL Pescara, Pescara, Italy
| | - Corrado Giua
- Società Italiana Farmacia Clinica (SIFAC), Cagliari, Italy
| | - Gregory Makoul
- PatientWisdom, Inc., Madison CT USA and Yale School of Medicine, New Haven, CT USA
| | - Lilian M. Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Enrica Menditto
- CIRFF, Center of Pharmacoeconomics and Drug Utilization Research, Department of Pharmacy, University of Naples Federico II, Naples, Italy.
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Vella J, Attard Pizzuto M, Sammut Bartolo N, Wirth F, Grech L, Pham J, Mactal Haaf C, Lau A, Serracino Inglott A, Azzopardi LM. A three-year post-graduate Doctorate in Pharmacy course incorporating professional, experiential and research activities: A collaborative innovative approach. MedEdPublish (2016) 2021; 10:93. [PMID: 38486515 PMCID: PMC10939653 DOI: 10.15694/mep.2021.000093.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. Background A three-year post-graduate international Doctorate in Pharmacy collaborative course, was launched by the Department of Pharmacy, University of Malta in collaboration with the College of Pharmacy, University of Illinois at Chicago. Aim and rationale To demonstrate that the professional Doctorate in Pharmacy (i) fits the requirements of a Level 8 degree according to the Bologna process, (ii) helps graduates develop competencies and attributes in proficiency in clinical and professional aspects, (iii) has a research component that provides the right level of abilities to participate in research initiatives and to interpret research outcomes, (iv) enables graduates to obtain leadership characteristics. Approach The unique characteristics of the course were evaluated through an outcomes result-oriented measurement. Leadership aspects were measured through policies and strategies presented by students and graduates. Outcomes i) course is in line with the Bologna declaration, ii) research work shown in the dissertation satisfied competencies required iii) research abilities have been examined through a third party and found to be compliant with acquiring of concepts in the design, carrying out, assessment of outcomes and interpretation of results of the research study carried out by each student, and iv) leadership characteristics were shown by the positions taken up by the graduates and early outcomes from these positions. Conclusion Learning activities enable development of professionals able to merge scientific and practice aspects in the evaluation of innovative therapies, the use of medicines and patient monitoring, and in pharmaceutical policy development and regulation. Leadership positions taken up by graduates point to the acquisition of leadership skills by graduates. Next Steps The authors are happy to extend collaboration for this model to be adapted by other institutions for the curricular development entailed in this programme to enhance and improve an innovative aspect in the evolvement of the pharmacy profession on the international scenario.
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Lahm H, Wirth F, Dreßen M, Jia M, Puluca N, Cleuziou J, Doppler S, Lange R, Müller-Myhsok B, Krane M. Functional Analysis of Candidate Genes Associated with Congenital Heart Disease during Differentiation of Induced Pluripotent Stem Cells and in the Human Embryonic and Adult Heart at Single-Cell Resolution. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Osama S, Wirth F, Zahra G, Barbara C, Xuereb RG, Camilleri L, Azzopardi LM. CYP2C19*2 genetic polymorphism and incidence of in-stent restenosis in patients on clopidogrel: a matched case-control study. Drug Metab Pers Ther 2021; 37:155-161. [PMID: 34851561 DOI: 10.1515/dmpt-2021-0160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/01/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The cytochrome P450 2C19*2 (CYP2C19*2) genetic polymorphism is associated with reduced clopidogrel bioactivation, increasing the risk of atherothrombotic complications after percutaneous coronary intervention (PCI). In-stent restenosis (ISR) is a complication that limits the long-term prognosis of PCI. The aim was to investigate the association between presence of the CYP2C19*2 allele and ISR within one-year after PCI in patients prescribed dual antiplatelet therapy with aspirin and clopidogrel. METHODS Sixty patients with angiographically-confirmed drug eluting stent (DES)-ISR within 12 months post-PCI when on DAPT with aspirin and clopidogrel were retrospectively identified (Cases). Another 60 patients with no documented ISR post-PCI in the study period (Controls) were case-matched for age, gender, ethnicity, diabetes mellitus and estimated glomerular filtration rate value, and were invited for CYP2C19*2 genotyping. The association between presence of the CYP2C19*2 allele and ISR was analysed using the Fisher's Exact test and binary logistic regression. RESULTS Twenty-six (43.3%) cases and 5 (8.3%) controls were carriers of one or two CYP2C19*2 alleles. As to non-carrier status of the CYP2C19*2 allele, 34 (56.7%) cases and 55 (91.7%) controls were identified. The association between CYP2C19*2 carrier status and DES-ISR within one-year post-PCI was statistically significant (p<0.001) in both the univariate and multivariate analysis. CONCLUSIONS The proportion of patients who were carriers of one or two CYP2C19*2 alleles who presented with DES-ISR within one-year post-PCI while on clopidogrel was significantly higher compared to patients with no documented ISR.
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Affiliation(s)
- Sara Osama
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Graziella Zahra
- Department of Pathology, Molecular Diagnostics Unit, Mater Dei Hospital, Msida, Malta
| | - Christopher Barbara
- Department of Pathology, Molecular Diagnostics Unit, Mater Dei Hospital, Msida, Malta
| | | | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Vitanova K, Wirth F, Böhm J, Lange R, Krane M. Surgical Aortic Valve Replacement: Prosthesis Type Is Still a Topic of Discussion. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sammut Bartolo N, Ignas L, Wirth F, Attard Pizzuto M, Vella Szijj J, Camilleri L, Serracino-Inglott A, Azzopardi LM. Public perception of generic medicines in Malta. Journal of Pharmaceutical Health Services Research 2020. [DOI: 10.1111/jphs.12366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AbstractObjectivesTo assess the perception of generic medicines among the general public in Malta.MethodsA self-administered questionnaire was developed to assess knowledge, attitudes and use of generic medicines. The questionnaire was disseminated to a sample of the public recruited by convenience sampling in five localities in Malta. Descriptive statistics were undertaken.Key findingsA total of 228 participants completed the questionnaire; 54% were female, 42% were ≥60 years old, and 37% had up to secondary education level. Sixty-one per cent of the participants were aware of the correct definition of a generic medicine, and 55% stated that they had previously used generic medicines. Twenty per cent of the participants had never used generic medicines since they perceived them to be inferior in quality or less effective compared to their originator counterparts. Fifty-four per cent of the participants would switch to a generic medicine if the originator product was out-of-stock and 38% would pay between 1% and 20% less for a generic medicine compared to the originator product.ConclusionsParticipants in this study exhibited a positive overall perception regarding generic medicines, demonstrating improvement in perception from a previous local study. The majority of participants were knowledgeable about generic medicines, had previously used generic medicines and would switch to a generic medicine if the originator product was not in stock.
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Affiliation(s)
| | - Louella Ignas
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Maresca Attard Pizzuto
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Janis Vella Szijj
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | | | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Gauci M, Wirth F, Azzopardi LM, Serracino-Inglott A. Clinical pharmacist implementation of a medication assessment tool for long-term management of atrial fibrillation in older persons. Pharm Pract (Granada) 2019; 17:1349. [PMID: 31015870 PMCID: PMC6463411 DOI: 10.18549/pharmpract.2019.1.1349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 02/24/2019] [Indexed: 11/14/2022] Open
Abstract
Background: Optimisation of drug therapy is important in the older population and may be facilitated by medication assessment tools (MATs). Objective: The purpose of the study was to evaluate whether appropriateness of drug therapy and clinical pharmacist intervention documentation improved following implementation of a previously developed MAT for the long-term management of atrial fibrillation (MAT-AF). Methods: Adherence to MAT-AF review criteria and clinical pharmacist intervention documentation was assessed by the researcher pre-MAT implementation in 150 patients aged ≥60 years admitted to a rehabilitation hospital with a diagnosis of atrial fibrillation. MAT-AF was introduced as a clinical tool in the hospital for identification of pharmaceutical care issues in atrial fibrillation patients. Adherence to MAT-AF and pharmacist intervention documentation were assessed by the researcher post-MAT implementation for a further 150 patients with the same inclusion criteria. Logistic regression analysis and measurement of odds ratio was used to identify differences in adherence to MAT-AF pre- and post-MAT implementation. The differences between two population proportions z-test was used to compare pharmacist intervention documentation pre- and post-MAT implementation. Results: Adherence to MAT-AF criteria increased from 70.9% pre-implementation to 89.6% post-implementation. MAT-AF implementation resulted in a significant improvement in prescription of anticoagulant therapy (OR 4.07, p<0.001) and monitoring of laboratory parameters for digoxin (OR 10.40, p<0.001). Clinical pharmacist intervention documentation improved significantly post-implementation of MAT-AF (z-score 20.249, p<0.001). Conclusions: Implementation of MAT-AF within an interdisciplinary health care team significantly improved the appropriateness of drug therapy and pharmacist intervention documentation in older patients with atrial fibrillation.
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Affiliation(s)
- Marise Gauci
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta; & Senior Principal Pharmacist, Department of Pharmacy, Karin Grech Hospital, Pieta (Malta).
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
| | - Lilian M Azzopardi
- Head of the Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
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Mifsud EM, Wirth F, Camilleri L, Azzopardi LM, Serracino-Inglott A. Pharmacist-led medicine use review in community pharmacy for patients on warfarin. Int J Clin Pharm 2019; 41:741-750. [PMID: 31006832 DOI: 10.1007/s11096-019-00824-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/10/2019] [Indexed: 01/03/2023]
Abstract
Background Medicine use review by pharmacists has the potential to improve anticoagulation therapy management in patients on warfarin. Objective To develop, implement and evaluate a pharmacist-led medication use review service for patients on warfarin. Setting Six community pharmacies in Malta. Method Patients (N = 100) aged 18 or older and on warfarin were recruited through pre-selected community-pharmacies. These patients were then invited to attend two sessions: a review session (t1) and a follow-up session after 2 months (t2). During the medication use review session, medication reconciliation was performed (a) to detect drug-related problems using the DOCUMENT classification system, (b) to develop an individualised care plan for each patient and (c) to recommend an action for each identified problem for physician, pharmacist or patient consideration. At t2, the degree of acceptance of the recommendations was determined by assessing the number of drug-related problems for which action was taken to address the problem. International normalisation ration (INR) control was evaluated by calculating the percentage Time in Therapeutic Range (TTR) at t1 and t2 using the Rosendaal linear interpolation method. Main outcome measures Frequency and type of drug-related problems detected; percentage of accepted recommendations; and INR control. Results A total of 481 drug-related problems were identified; 40% (n = 190) were related to warfarin treatment. Need for monitoring (30%; n = 145), lack of compliance (20%; n = 97) and need for patient education (19%; n = 90) were the top three problems identified. There was a significant correlation between frequency of the problems and number of chronic medications (Spearman Correlation 0.583, p < 0.001), number of comorbidities (Spearman Correlation 0.327, p = 0.001) and older age (Spearman Correlation 0.285, p = 0.04). A total of 475 recommendations were followed-up; 49% (n = 234) were referred for consideration by the physician. The percentage of recommendations accepted (84%; n = 397) was significantly higher than the percentage of recommendations not accepted (16%; n = 78) (p < 0.001). The time in therapeutic range improved significantly from 68.7% at t1 to 79.8% at t2 (p = 0.01). Conclusions The high percentage of accepted recommendations and the improvement in INR control indicate that a pharmacist-led medication use review service in community pharmacy contributes to improving anticoagulation therapy management in patients on warfarin.
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Affiliation(s)
- Elena M Mifsud
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta.
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Gauci M, Wirth F, Azzopardi LM, Serracino-Inglott A. Clinical pharmacist implementation of a medication assessment tool for secondary prevention of stroke in older persons. J Pharm Health Serv Res 2018. [DOI: 10.1111/jphs.12235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Marise Gauci
- Department of Pharmacy; Rehabilitation Hospital Karin Grech; Pietà Malta
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Francesca Wirth
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Lilian M. Azzopardi
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
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Aquilina A, Wirth F, Attard Pizzuto M, Grech L, Camilleri L, Azzopardi LM, Serracino-Inglott A. Preparing for pharmacist prescribing in Maltese hospitals. J Pharm Health Serv Res 2018. [DOI: 10.1111/jphs.12239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Abigail Aquilina
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Francesca Wirth
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Maresca Attard Pizzuto
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Louise Grech
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research; Faculty of Science; University of Malta; Msida Malta
| | - Lilian M. Azzopardi
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
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Wirth F, Zahra G, Xuereb RG, Barbara C, Camilleri L, Fenech A, Azzopardi LM. CYP2C19*2 Allele Carrier Status and Coronary In-stent Restenosis: Is There an Association? Journal of Exploratory Research in Pharmacology 2018; 3:55-60. [DOI: 10.14218/jerp.2018.00002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Cilia M, Ruiz S, Richardson P, Salmonson T, Serracino-Inglott A, Wirth F, Borg JJ. Quality Issues Identified During the Evaluation of Biosimilars by the European Medicines Agency's Committee for Medicinal Products for Human Use. AAPS PharmSciTech 2018; 19:489-511. [PMID: 29027130 DOI: 10.1208/s12249-017-0892-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/24/2017] [Indexed: 11/30/2022] Open
Abstract
The aim of this study was to identify trends in deficiencies raised during the EU evaluation of the quality part of dossiers for marketing authorisation applications of biosimilar medicinal products. All adopted day 120 list of questions on the quality module of 22 marketing authorisation applications for biosimilars submitted to the European Medicines Agency and concluded by the end of October 2015 was analysed. Frequencies of common deficiencies identified were calculated and summarised descriptions included. Frequencies and trends on quality deficiencies were recorded and presented for 22 biosimilar applications. Thirty-two 'major objections' for 9 products were identified from 14 marketing authorisation applications with 15 raised for drug substance and 17 for drug product. In addition, 547 'other concerns' for drug substance and 495 for drug product were also adopted. The frequencies and trends of the identified deficiencies together with their impact were discussed from a regulatory perspective and how these impact key manufacturing processes and key materials used in the production of biosimilars. This study provides an insight to the regulatory challenges prospective companies need to consider when developing biosimilars; it also helps elucidate common pitfalls in the development and production of biosimilars and in the submission of dossiers for their marketing authorisations. The results are expected to be of interest to pharmaceutical companies but also to regulators to obtain consistent information on medicinal products based on transparent rules safeguarding the necessary pharmaceutical quality of medicinal products.
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Gauci M, Wirth F, Camilleri L, Azzopardi LM, Serracino-Inglott A. Assessing appropriateness of drug therapy in older persons: Development and application of a medication assessment tool for long-term management of atrial fibrillation. Pharm Pract (Granada) 2018; 15:1021. [PMID: 29317917 PMCID: PMC5741994 DOI: 10.18549/pharmpract.2017.04.1021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 11/15/2017] [Indexed: 11/17/2022] Open
Abstract
Background: Atrial fibrillation (AF) is highly prevalent in older persons and is associated with considerable morbidity and mortality. Assessing appropriateness of drug therapy in AF may be facilitated by application of medication assessment tools (MATs). Objective: To develop, psychometrically evaluate and apply an innovative MAT for the long-term management of AF with particular relevance to older persons. Methods: Key recommendations from clinical practice guidelines for the long-term management of AF were selected and review criteria defining appropriate drug therapy were constructed as a ‘qualifying statement’ followed by a ‘standard’. The developed MAT was given the designation MAT-AF. An application guide was compiled where justifications for non-adherence were specified. Content validity was tested by an expert group using a three-round Delphi process. Inter- and intra-observer reliability testing was conducted with agreement expressed by Cohen’s kappa and application time measured to assess feasibility. MAT-AF was applied to 150 patients with a diagnosis of AF admitted to a rehabilitation hospital. Results: MAT-AF consists of 15 criteria sectioned into antithrombotic, rate control and rhythm control therapy. Content validity was demonstrated for all criteria. Reliability was confirmed with kappa values of 0.84 and 0.91 for inter- and intra-observer agreements. Mean application time for the two observers was 3.9 and 2.4 minutes, which decreased significantly in the second application conducted after a four-week interval (p<0.001). Overall adherence to applicable criteria was 59.8%. Non-adherence was evident for prescription of anticoagulation in patients with a CHA2DS2VASc score ≥1 (29.5%). Monitoring of laboratory parameters for digoxin was suboptimal. Ophthalmic and pulmonary monitoring and patient counselling regarding amiodarone therapy could not be assessed since relevant records were not readily available. Conclusion: MAT-AF application highlighted key aspects which need to be addressed to improve patient care.
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Affiliation(s)
- Marise Gauci
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida; & Senior Principal Pharmacist, Department of Pharmacy, Rehabilitation Hospital Karin Grech. Pieta, (Malta).
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta. Msida (Malta).
| | - Liberato Camilleri
- Associate Professor and Head. Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida (Malta).
| | - Lilian M Azzopardi
- Professor and Head. Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida (Malta).
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19
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Gauci M, Wirth F, Camilleri L, Azzopardi LM, Serracino-Inglott A. Design and application of a medication assessment tool for secondary prevention of stroke. Int J Clin Pharm 2017; 39:1008-1012. [PMID: 28756578 DOI: 10.1007/s11096-017-0515-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 07/19/2017] [Indexed: 11/30/2022]
Abstract
Background Optimisation of drug therapy is essential in the care of older persons and may be facilitated by application of medication assessment tools (MATs). Objective To design, psychometrically evaluate and apply an innovative MAT for secondary prevention of ischaemic stroke with particular relevance to older persons. Method Review criteria were selected from clinical practice guidelines and MAT-CVA was developed, validated and tested for reliability and feasibility. MAT-CVA was applied to 150 patients with a diagnosis of ischaemic stroke or transient ischaemic attack admitted to a rehabilitation hospital. Results MAT-CVA consists of 17 criteria sectioned into antithrombotic, lipid lowering, antihypertensive and glycaemic therapy. Content validity was demonstrated for all criteria. Reliability was confirmed with kappa values of 0.80 for both inter- and intraobserver agreements. Mean application time for the two observers was 5.55 and 6.56 min. Adherence to applicable criteria was 55% and justified non-adherence was 22.3%. Non-adherence was predominantly evident for prescription of anticoagulation in concurrent atrial fibrillation (36.4%), thiazide diuretics ± angiotensin converting enzyme inhibitors for hypertension (26.8%) and dipyridamole at the recommended dose (24.0%). Conclusion Application of MAT-CVA indicated good overall adherence and identified gaps in clinical performance which may be targeted to enhance drug therapy optimisation.
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Affiliation(s)
- Marise Gauci
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta. .,Department of Pharmacy, Rehabilitation Hospital Karin Grech, Pieta, Malta.
| | - Francesca Wirth
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research, Faculty of Science, University of Malta, Msida, Malta
| | - Lilian M Azzopardi
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
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Maciel RA, Ferreira LS, Wirth F, Rosa PD, Aves M, Turra E, Goldani LZ. Corticosteroids for the management of severe intracranial hypertension in meningoencephalitis caused by Cryptococcus gattii: A case report and review. J Mycol Med 2016; 27:109-112. [PMID: 27818191 DOI: 10.1016/j.mycmed.2016.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 09/15/2016] [Accepted: 09/16/2016] [Indexed: 01/09/2023]
Abstract
Immune reconstitution inflammatory syndrome in meningitis caused by Cryptococcus gattii in immunocompetent patients after initiation of antifungal therapy appears to be the result of paradoxical antifungal treatment-induced clinical deterioration due to improved local immune responses to cryptococcal organisms. Recent anecdotal reports have suggested a favorable clinical response to corticosteroids in select patients with C. gattii central nervous system (CNS) infections. In this report, we describe a 65-year-old patient with meningoencephalitis caused by C. gattii who developed persistent intracranial hypertension and was successfully managed with antifungal therapy, repeated lumbar puncture and corticosteroids. Our observations suggest a possible benefit of dexamethasone in the management of select cases of C. gattii CNS infection with intracranial hypertension. Further studies are necessary to evaluate the long-term use of steroids in select patients with C. gattii with intracranial hypertension.
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Affiliation(s)
- R-A Maciel
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - L-S Ferreira
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - F Wirth
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - P-D Rosa
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - M Aves
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - E Turra
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil
| | - L-Z Goldani
- Section of Infectious Diseases, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Ramiro Barcelos, 2350, 90035-903 Porto Alegre, RS, Brazil.
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Wirth F, Xuereb RG, Fenech A, Azzopardi LM. PKP-007 Pharmacist led rapid point of care cytochrome p 2C19 genotyping for individualisation of antiplatelet therapy. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Vella M, Grima M, Wirth F, Attard Pizzuto M, Sammut Bartolo N, Vella J, Azzopardi LM. Consumer perception of community pharmacist extended professional services. Journal of Pharmaceutical Health Services Research 2015. [DOI: 10.1111/jphs.12094] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Maria Vella
- Department of Pharmacy; University of Malta; Msida Malta
| | - Michael Grima
- Department of Pharmacy; University of Malta; Msida Malta
| | | | | | | | - Janis Vella
- Department of Pharmacy; University of Malta; Msida Malta
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Mamo M, Wirth F, Azzopardi LM, Serracino-Inglott A. Standardising pharmacist patient-profiling activities in a rehabilitation hospital in Malta. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000351] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ozsoy O, Ozsoy U, Stein G, Semler O, Skouras E, Schempf G, Wellmann K, Wirth F, Angelova S, Ankerne J, Ashrafi M, Schönau E, Papamitsou-Sidoropolou T, Jaminet P, Sarikcioglu L, Irintchev A, Dunlop S, Angelov D. Functional deficits and morphological changes in the neurogenic bladder match the severity of spinal cord compression. Restor Neurol Neurosci 2012; 30:363-81. [DOI: 10.3233/rnn-2012-110203] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- O. Ozsoy
- Faculty of Medicine, Department of Physiology, Akdeniz University, Antalya, Turkey
| | - U. Ozsoy
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - G. Stein
- Department of Orthopedics and Trauma Surgery, University of Cologne, Cologne, Germany
| | - O. Semler
- Children's Hospital, University of Cologne, Cologne, Germany
| | - E. Skouras
- Department of Orthopedics and Trauma Surgery, University of Cologne, Cologne, Germany
| | - G. Schempf
- Department of Anatomy I, University of Cologne, Cologne, Germany
| | - K. Wellmann
- Department of Anatomy I, University of Cologne, Cologne, Germany
| | - F. Wirth
- Department of Anatomy I, University of Cologne, Cologne, Germany
| | - S. Angelova
- Jean-Uhrmacher Institut for Clinical ENT-Research, University of Cologne, Cologne, Germany
| | - J. Ankerne
- Department of Anatomy I, University of Cologne, Cologne, Germany
| | - M. Ashrafi
- Department of Anatomy I, University of Cologne, Cologne, Germany
| | - E. Schönau
- Children's Hospital, University of Cologne, Cologne, Germany
| | | | - P. Jaminet
- Department of Hand-, Plastic-, and Reconstructive Surgery with Burn Unit, BG-Trauma Centre, University of Tuebingen, Tuebingen, Germany
| | - L. Sarikcioglu
- Faculty of Medicine, Department of Anatomy, Akdeniz University, Antalya, Turkey
| | - A. Irintchev
- Department of Oto-Rhino-Laryngology, University of Jena, Jena, Germany
| | - S.A. Dunlop
- School of Animal Biology and Western Australian Institute for Medical Research, University of Western Australia, WA, Australia
| | - D.N. Angelov
- Department of Anatomy I, University of Cologne, Cologne, Germany
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Wirth F, Tabone F, Azzopardi LM, Gauci M, Zarb-Adami M, Serracino-Inglott A. Consumer perception of the community pharmacist and community pharmacy services in Malta. Journal of Pharmaceutical Health Services Research 2011. [DOI: 10.1111/j.1759-8893.2010.00034.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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26
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Wirth F, Azzopardi LM, Gauci M, Adami MZ, Serracino-Inglott A. Time and motion study for pharmacists' activities in a geriatric hospital. International Journal of Pharmacy Practice 2010. [DOI: 10.1211/ijpp.17.06.0010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objectives
This study aimed to identify and quantify activities undertaken by pharmacists in a geriatric hospital.
Methods
A data collection form was developed, validated and tested for applicability and practicality. Pharmacist activities were organised into three categories: Clinical, Administration and Others. Clinical activities incorporated patient discharge, patient admission, checking the ward controlled drugs record book, emergency trolley and patient medication trolley, prescription monitoring, ward round, discussion with health care professionals, and other professional activities; Administration activities included checking the ward medication stock and medication order; Others included break and inactive time. Observers conducted 6000 min of direct observation using a time and motion technique and observed the work activities of three pharmacists on three wards. Data were analysed using Microsoft Excel 2007 and SPSS version 16.0. Descriptive statistics were carried out.
Key findings
The time dedicated to Clinical activities was 3636 min (60.60%), Administration activities 1646 min (27.43%) and Others 718 min (11.97%). When considering total time in minutes for Clinical and Administration activities, ward round (1348 min), medication order (1255 min), patient discharge (723 min) and prescription monitoring (562 min) occupied most of the pharmacists' time. Ward round activities were subdivided into: patient profiling (545 min), actual ward round (668 min) and conference (135 min).
Conclusions
The time and motion study indicated that the pharmacists' time is mainly allocated to clinical activities. However, there is still a large proportion of time taken up by administrative activities, which can be conducted by non-pharmacist personnel, allowing more time to be directed to patient care.
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Affiliation(s)
| | | | - Marise Gauci
- Department of Pharmacy, University of Malta, Msida, Malta
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Muntean E, Wirth F. Zur klinischen Anwendung der Schichtuntersuchung des Kiefergelenkes. ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1226449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wirth F, Bakke B. Untersuchung über Ferrisulfate. Darstellung und Eigenschaften der verschiedenen normalen, basischen und sauren Ferrisulfate. Löslichkeits- und Stabilitätsverhältnisse in Wasser und Schwefelsäure. Kristallisationsgang. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/zaac.19140870105] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Hauser O, Wirth F. Löslichkeitsstudien an den Oxalaten der seltenen Erden und der diesen analytisch nahestehenden Elemente. ACTA ACUST UNITED AC 2004. [DOI: 10.1002/prac.19090790121] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Karp D, Ferrante K, Tensfeldt T, Thurer R, LoCicero J, Huberman M, Wirth F, Hellman R, Poulin P, Silberman S, Redifer P, Allen L, Posner M, Schnipper L. A phase I dose escalation study of epidermal growth factor receptor (EGFR) tyrosine kinase (TK) inhibitor CP-358,774 in patients (pts) with advanced solid tumors. Lung Cancer 2000. [DOI: 10.1016/s0169-5002(00)80208-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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35
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Wirth F, Perry R, Eskenazi A, Schwalbe R, Kao G. Cutaneous mucormycosis with subsequent visceral dissemination in a child with neutropenia: a case report and review of the pediatric literature. J Am Acad Dermatol 1997; 36:336-41. [PMID: 9039214 DOI: 10.1016/s0190-9622(97)80412-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Primary cutaneous mucormycosis is a rare opportunistic fungal infection that is usually limited to the skin. We describe a primary cutaneous Rhizopus infection occurring at a site occluded by a sterile adhesive dressing in which the disease was viscerally disseminated at the time fo diagnosis. Mucormycosis should be considered in all ecthyma-like lesions in immunocompromised patients. It may be rapidly diagnosed by examination of hematoxylin-eosin and PAS-stained sections of the eschar base and a culture of a leading edge tissue aspirate. We review 21 cases of primary cutaneous mucormycosis in children and compare them with the present case.
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Affiliation(s)
- F Wirth
- Department of Dermatology, University of Maryland School of Medicine, Baltimore, USA
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36
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Mojaverian P, Reynolds JC, Ouyang A, Wirth F, Kellner PE, Vlasses PH. Mechanism of gastric emptying of a nondisintegrating radiotelemetry capsule in man. Pharm Res 1991; 8:97-100. [PMID: 2014217 DOI: 10.1023/a:1015894626403] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We studied the mechanism of gastric emptying of a pH-sensitive radiotelemetry capsule with respect to phases of the interdigestive migrating motor complex (IMMC) in fasting normal volunteers and the effect of the Heidelberg capsule (HC) on the duration or timing of the IMMC phases. A manometric catheter with eight mounted solid-state strain gauges was passed transnasally and positioned fluoroscopically in the duodenum and jejunum in four normal, fasted male volunteers, in their right lateral position. The HC was administered orally following the establishment of one complete IMMC cycle (defined by the recording time between the end of two subsequent phase III activity fronts) and during the beginning of Phase I of the next cycle. The gastric residence time (GRT) of the HC was measured as the time of a gastric pH rise of greater than or equal to 3.0 units. In three subjects, GRT of the HC lasted to within 5 min of the onset of the next duodenal phase III of the IMMC, while in the fourth subject, the HC passed during the second phase III activity front. There were no significant differences in the duration of each phase of duodenal IMMC in the presence or absence of the HC (Phase I, 54 +/- 9.3 vs 31.6 +/- 10.1; Phase II, 22 +/- 8.1 vs 58.9 +/- 32; Phase III, 5.3 +/- 0.7 vs 4.2 +/- 0.7 min; mean +/- SE; P greater than 0.1 in all phases). In addition, the HC had no effect on motility index or patterns of contractions.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- P Mojaverian
- Division of Clinical Pharmacology, Jefferson Medical College, Philadelphia, Pennsylvania
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Abstract
The nephrotoxicity of the aminoglycoside gentamicin was evaluated in an open, controlled study of newborn infants randomly allocated to receive either combination drug therapy with gentamicin and ampicillin or single drug therapy with mezlocillin for treatment of presumed neonatal sepsis. There were no significant differences in initial clinical characteristics between the groups. Neonates receiving gentamicin, in contrast to those receiving mezlocillin, had significant nephrotoxicity manifested by a smaller postnatal fall in mean serum creatinine concentration (-9%, P NS vs -21%, P less than 0.005, respectively) and a diminished postnatal rise in mean creatinine clearance (+ 21%, P NS vs + 51%, P less than 0.01, respectively). In neonates with a fall in creatinine clearance, the mean decline was significantly greater in those receiving gentamicin (44% vs 20%, P less than 0.01). There was no relationship between the incidence of gentamicin nephrotoxicity and either peak or trough gentamicin levels. For treatment of presumed neonatal sepsis, gentamicin proved more nephrotoxic than mezlocillin.
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Affiliation(s)
- R D Adelman
- Department of Pediatrics, University of California, Davis 95817
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Abstract
The nephrotoxicity of the aminoglycoside amikacin sulfate was evaluated in an open, controlled study of newborns with presumed neonatal sepsis. One hundred twelve neonates were randomly allocated to receive either amikacin-ampicillin or mezlocillin, a semisynthetic penicillin. Neonates receiving amikacin, in contrast to those receiving mezlocillin, showed significant nephrotoxicity as evidenced by a delayed postnatal fall in mean serum creatinine level (82 to 80 mumol/L [0.93 to 0.90 mg/dL] vs 84 to 72 mumol/L [0.95 to 0.82 mg/dL]) and a delayed postnatal rise in mean creatinine clearance per kilogram of body weight (12% vs 38%). Furthermore, 40% of neonates receiving amikacin-ampicillin compared with 19% of neonates receiving mezlocillin had a decline in creatinine clearance (greater than 25%). There was no relationship between amikacin nephrotoxicity and either peak or trough amikacin levels. In summary, in a controlled study of the use of amikacin and mezlocillin in neonates, the combination of amikacin and ampicillin proved more nephrotoxic to the newborn kidney.
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Affiliation(s)
- R D Adelman
- Department of Pediatrics, University of California, Davis 95817
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Gulamali F, Keegan TE, Numerof B, Chrenka B, Wirth F, Pleban PA. Kinetic nephelometric determination of transthyretin and retinol-binding protein in neonatal serum. Clin Chim Acta 1985; 147:197-204. [PMID: 3922651 DOI: 10.1016/0009-8981(85)90200-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We have developed a kinetic immunonephelometric method for the determination of retinol-binding protein and modified the method of Jacob et al (Clin Chem 1983; 29: 564) for the determination of transthyretin (prealbumin) in neonatal serum specimens from small, premature infants. The methodologies allow detection of 17.5 mg/l transthyretin and 1.7 mg/l retinol-binding protein in 25 microliter of serum. Between-run precision studies using pooled neonatal serum gave CV values of 3% and 5-6% for transthyretin and retinol-binding protein, respectively. Results obtained for neonatal specimens using this method agreed well with those obtained for the same specimens using radial immunodiffusion. Mean (SD) serum concentrations for 39 neonatal specimens were 100.4 (46.6) and 26.3 (10.8) mg/l for transthyretin and retinol-binding protein, respectively.
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Wirth F. [Curing from the current viewpoint]. SCHWEIZ ARCH TIERH 1985; 127:109-27. [PMID: 3983605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Wirth F. [Technology of processing meat of varying quality]. SCHWEIZ ARCH TIERH 1985; 127:83-97. [PMID: 3983612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Real-time cranial ultrasonography (cranial sector [CS] scan) was prospectively evaluated for its usefulness in identifying irreversible cerebral injury in critically ill children admitted to the neonatal and pediatric ICUs at our institution. Absence of pulsatile movement of the anterior and middle cerebral arteries was determined to represent absent cerebral perfusion and thus profound irreversible injury. Of 800 consecutive patients representing 1900 CS scans, 12 met the criteria. Six were neonates and 6 were older infants. Mechanisms of injury included severe hypoxia, head trauma, and CNS infection. Absence of brain function by clinical examination and EEG confirmed CS findings in 11 who expired. One neonate survived with intact brainstem function but no identifiable cerebral function or growth. No false positives were demonstrated. We found the CS scan to be a reliable bedside adjunct in the determination of irreversible cerebral injury or cerebral death.
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Wirth F, Kenderesi P. [Letter: The value of preventive lidocaine therapy in acute myocardial infarct]. Orv Hetil 1975; 116:2975. [PMID: 1196637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Wirth F, Kenderesi P. [Treatment of Amanita phalloides poisoning with thioctic acid]. Orv Hetil 1974; 115:1677. [PMID: 4601622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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46
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Wirth F. [Modern heat sterilization of meat preserves]. SCHWEIZ ARCH TIERH 1973; 115:301-20. [PMID: 4725284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Wirth F, Kenderesi P, Hajducki I. [Anuria following oral cholecystography]. Orv Hetil 1970; 111:1760-3. [PMID: 5457700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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Wirth F. [Pneumonia and the antibiotics]. Orv Hetil 1970; 111:631-4. [PMID: 5420811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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49
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Wirth F, Fekees B. [Data on the internal treatment of acute pancreatitis]. Orv Hetil 1965; 106:2127-30. [PMID: 5294943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Wirth F. Über die Krystallisation reiner Aluminiumsalze aus eisenhaltigen Lösungen, sowie über die künstliche Darstellung des Halotrichits. Angew Chem Int Ed Engl 1913. [DOI: 10.1002/ange.19130261104] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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