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Houle SKD, Johal A, Roumeliotis P, Roy B, Boivin W. Co-Administration of Influenza and COVID-19 Vaccines: A Cross-Sectional Survey of Canadian Adults' Knowledge, Attitudes, and Beliefs. Pharmacy (Basel) 2024; 12:70. [PMID: 38668096 PMCID: PMC11054434 DOI: 10.3390/pharmacy12020070] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/07/2024] [Accepted: 04/13/2024] [Indexed: 04/29/2024] Open
Abstract
Vaccination rates against both influenza and COVID-19 fall short of targets, especially among persons at risk of influenza complications. To gain insights into strategies to boost influenza vaccine coverage, we surveyed 3000 Canadian residents aged ≥ 18 years and examined their knowledge and receipt of co-administered influenza and COVID-19 vaccines. During the 2022-2023 influenza season, 70% of respondents reported being aware the influenza and COVID-19 vaccines could be co-administered, but only 26.2% (95% CI, 23.6% to 28.8%) of respondents received them together. The most common reason for not getting the vaccines together was receipt of the COVID-19 vaccine before the annual influenza vaccine was available (reported by 34.5% [31.2% to 37.7%]). Lack of interest in co-administration was reported by 22.6% (20.8% to 24.3%); of this group, 20.8% (17.1% to 24.5%) reported seeing no benefit in receiving the two vaccines together and 17.2% (13.5% to 20.9%) were concerned about compounded adverse effects from the two vaccines. These results support the willingness of most Canadians to receive COVID-19 and influenza vaccines at the same time. Co-administration is a viable strategy to improve uptake of influenza vaccines, especially if health professionals proactively offer education and co-administration of influenza and COVID-19 (or other) vaccines as appropriate to clinical need.
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Affiliation(s)
| | - Ajit Johal
- Travelrx and Immunize.io, Vancouver, BC V5Z 3Y1, Canada;
| | - Paul Roumeliotis
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
| | - Bertrand Roy
- CSL Seqirus/Medical Affairs Americas, 16766 TransCanada, Suite 504, Kirkland, QC H9H 4M7, Canada;
| | - Wendy Boivin
- CSL Seqirus/Medical Affairs Americas, 16766 TransCanada, Suite 504, Kirkland, QC H9H 4M7, Canada;
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Wells C, Warren AC, Ashe Scott M. Development and implementation of ambulatory care pharmacy services at an internal medicine clinic. Am J Health Syst Pharm 2024:zxae102. [PMID: 38613410 DOI: 10.1093/ajhp/zxae102] [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: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE This report describes the step-by-step process that led to expansion of ambulatory care pharmacy services at a newly established internal medicine clinic within a patient-centered medical home in North Carolina. SUMMARY Implementation of clinical pharmacist services at the clinic was led by a postgraduate year 2 (PGY2) pharmacy resident and guided by the 9 steps described in the book Building a Successful Ambulatory Care Practice: A Complete Guide for Pharmacists. After a needs assessment and review of the demographics and insurance status of the clinic's target population, it was determined that pharmacist services would focus on quality measures including diabetes nephropathy screening, diabetes eye examination, blood glucose control in diabetes, discharge medication reconciliation, annual wellness visits, and medication adherence in diabetes, hypercholesterolemia, and hypertension. Clinic appointments were conducted under 3 models: a pharmacist-physician covisit model, a "floor model" of pharmacist consultation on drug information or medication management issues during medical resident sign-out sessions with supervising physicians (medical residents could also see patients along with the pharmacist at a covisit appointment), and a covisit model of stacked physician and pharmacist appointments. The pharmacist's services were expanded from 2 half-day clinic sessions per week initially to 5 or 6 half-day clinic sessions by the end of the residency year. CONCLUSION By the fourth quarter of the first PGY2 residency year in which ambulatory care pharmacy services were provided in the clinic, the clinical and financial impact of those services justified the addition of a second full-time pharmacist to the clinic team.
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Affiliation(s)
- Casey Wells
- Department of Pharmacotherapy, Mountain Area Health Education Center, Asheville, NC, and Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Anne Carrington Warren
- Department of Pharmacotherapy, Mountain Area Health Education Center, Asheville, NC, and Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Mollie Ashe Scott
- Department of Pharmacotherapy, Mountain Area Health Education Center, Asheville, NC, and Practice Advancement and Clinical Education, University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
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Dalton H, Hinely MT, Kostelic EM. Evaluation of the impact of a pharmacy transitions of care program. Am J Health Syst Pharm 2024; 81:e180-e185. [PMID: 38070166 DOI: 10.1093/ajhp/zxad306] [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: 03/22/2024] Open
Abstract
PURPOSE Pharmacist-driven transitions of care interventions have been shown to improve patient clinical outcomes. However, the evidence in the literature on the impact of pharmacy transitions of care services on hospitalization and emergency department visit rates is inconclusive. The purpose of this study is to determine the impact of a pharmacist-driven transitions of care program on hospitalization and emergency department visit rates at an academic medical center. METHODS This retrospective observational cohort study was conducted via pre- and postintervention analyses. The data collection period included 30 days before the date of pharmacist intervention and 30 days after the date of intervention. The study evaluated patients who were enrolled in the Transitional Inpatient Rounding Experience (TIRE) program at Wake Forest Baptist Health between August 2017 and September 2020. Patients excluded were less than 18 years old, in hospice care, discharged to long-term care, or did not have a hospitalization within 90 days of intervention. The Wilcoxon signed rank test was utilized to analyze continuous data. Standard descriptive statistics were used for categorical data. RESULTS One hundred patients met the inclusion criteria for this study. For the primary outcome, the TIRE intervention resulted in a reduction of 31 hospitalizations, or 50% (62 prior hospitalizations in the 30 days before the intervention vs 31 admissions in the 30 days after the intervention; P < 0.001). There were significant reductions in the secondary outcomes of 90-day hospitalizations (24% fewer with intervention; P = 0.028) and 30-day emergency department visits (65% fewer with intervention; P =0.006). For the outcome of 90-day emergency department visits, there was a 36% reduction (P = 0.240). CONCLUSION The results of the study demonstrate that a pharmacy transitions of care program may lead to a reduction in hospitalization and emergency department visit rates. The study also found potential cost savings associated with a pharmacy transitions of care program.
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Affiliation(s)
- Heather Dalton
- Froedtert and the Medical College of Wisconsin, Milwaukee, WI, USA
| | - Molly T Hinely
- Atrium Health Wake Forest Baptist, Winston Salem, NC, USA
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Alhmoud EN, Alrawi SFF, El-Enany R, Mohamed Ibrahim MI, Hadi MA. Impact of pharmacist-supported transition of care services in the Middle East and North Africa: a systematic review and meta-analysis. J Pharm Policy Pract 2024; 17:2323099. [PMID: 38476501 PMCID: PMC10930094 DOI: 10.1080/20523211.2024.2323099] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Abstract
Background Transition of care (TOC) is associated with an increased risk of medication-related problems. Despite recent advancements in pharmacy practice and research in the Middle East and North Africa (MENA), the characteristics and impact of regional pharmacy-supported TOC interventions remain unclear.This systematic review and meta-analysis aimed to describe pharmacist-supported TOC interventions in the MENA region and evaluate their effectiveness. Methods PubMed, CINAHL, EMBASE, Web of Science, World Health Organization's International Clinical Trials Registry Platform (ICTRP) were searched from their inception to March 9, 2023, for experimental studies published in English, comparing pharmacist-supported TOC interventions with usual care for adults (age ≥18 years) discharged from the hospital. The risk of bias was evaluated using Cochrane's risk-of-bias tool for randomised trials (ROB2) and the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for randomised and non-randomised studies respectively. Narrative syntheses and meta-analysis methods were employed depending on the outcomes evaluated. Results Twelve studies (n = 2377 subjects), 10 randomised controlled trials and 2 quasi-experimental studies, were included. Most studies had high or serious risk of bias. The included studies were quite heterogeneous in terms of nature and the delivery of intervention, and assessment of outcome measures. Compared to the usual care group, pharmacist-led TOC interventions contributed to a significant reduction in preventable drug-related (N = 2) and cardiac-related healthcare utilisation (N = 1), a significant reduction in preventable adverse drug events (ADEs) (Odds ratio (OR) 0.34, 95% CI: 0.13-0.94) and an improvement in medication adherence. However, all-cause hospitalisation and medication discrepancies were not significantly reduced. Conclusion Pharmacy-supported TOC interventions may improve patient outcomes in the MENA region. However, considering the limited quality of evidence and the variability in intervention delivery, future well-designed clinical trials are needed.
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Affiliation(s)
| | | | - Rasha El-Enany
- Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Muhammad Abdul Hadi
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Augusti JV, Silva SN. Management of pharmaceutical services in the fight against COVID-19 in universal public health systems: a rapid review. Int J Pharm Pract 2024; 32:109-119. [PMID: 38233348 DOI: 10.1093/ijpp/riad093] [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: 06/22/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024]
Abstract
INTRODUCTION The coronavirus disease 2019 (COVID-19) pandemic brought new challenges and lessons were learnt for health services. In the field of pharmaceutical care, several interventions have been proposed to optimize and expand the response capacity of services. OBJECTIVE To identify and characterize interventions performed in the management of pharmaceutical services during the COVID-19 pandemic in universal public health systems. METHODS A rapid literature review was conducted and registered in PROSPERO (CRD42022360902). Systematic searches in the MEDLINE (PubMed), Embase, and Virtual Health Library databases were conducted to identify interventions and practices adopted for the management of pharmaceutical care during the COVID-19 pandemic. RESULTS Thirteen articles reporting interventions developed in six countries were included. The interventions were summarized under three major themes: actions for continuous access to medicines, logistical measures for acquisition and storage, and organizational strategies. Telepharmacy services stand out as a typical action adopted in different services, which highlights the use and consolidation of digital technologies in these services. Strategies for process management were described and focused on the reorganization of the internal service of pharmacies, flow of services, and people management. CONCLUSIONS Many interventions were developed during the pandemic, some of which have already been incorporated into routine service delivery. Although the studies did not measure the effect of each intervention, the strategies developed are a source of information for the future delivery of care. Studies should be conducted to evaluate the potential of similar interventions in other health emergency contexts.
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Affiliation(s)
- Júlia Vasconcellos Augusti
- Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627 Pampulha, 31270-90 Belo Horizonte, Minas Gerais, Brazil
| | - Sarah Nascimento Silva
- Fundação Oswaldo Cruz, Instituto Rene Rachou, Núcleo de Avaliação de Tecnologias em Saúde, Av. Augusto de Lima, 1715 Barro Preto, 30190-002 Belo Horizonte, Minas Gerais, Brazil
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Venancio RGDS, Magliano EDS, Barreto EDG. Analysis of pharmaceutical interventions in chemotherapy prescriptions of adult and pediatric patients at an oncology reference institute. J Oncol Pharm Pract 2024:10781552241230630. [PMID: 38444258 DOI: 10.1177/10781552241230630] [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] [Indexed: 03/07/2024]
Abstract
Chemotherapy, one of the primary cancer treatments, has a high risk of causing significant harm in cases of its misuse. Pharmaceutical intervention is one of the strategies used to prevent medication errors from reaching the patient by identifying drug-related problems or other discrepancies related to patient data or medical progress. The primary objective of this study was to analyze the profile of the pharmaceutical intervention made in chemotherapy prescriptions for adult and pediatric patients in order to measure its impact on patient safety. A retrospective cross-sectional and observational study was conducted at a reference center for cancer treatment in Rio de Janeiro, Brazil. Pharmaceutical interventions performed in chemotherapy prescriptions from January to October 2022 were quantified, classified, and analyzed by their type, most common medicine, and acceptability. From the patients treated in the period, 220 (14.8%) adults and 64 (23.4%) children and teenagers received at least one pharmaceutical intervention. The most common types for adults were dose adjustments: overdose (22.5%) and underdose (22.5%). However, in pediatry, incompleteness of supporting drug protocol (22.1%) was the most registered. The most common medicines involved in pharmaceutical intervention were carboplatin (for adults) and electrolytes/hydration (for pediatric patients). Pharmaceutical intervention acceptability by prescriptors was very similar, reaching 80.4% for adults and 77.9% for pediatrics. The pharmaceutical intervention profile was quite distinct by virtue of the singularities of each population. The pharmacists' role was shown to be paramount in intercepting medication errors in the prescription of chemotherapy protocols, contributing to patient safety.
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Richardson CL, Edwards K, Lunny J, Lindsey L. A qualitative exploration of the barriers and enablers to supporting informal and familial carers within community pharmacies. Int J Pharm Pract 2024:riae005. [PMID: 38394367 DOI: 10.1093/ijpp/riae005] [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: 06/15/2023] [Accepted: 01/31/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES There are approximately 5.3 million informal carers in the United Kingdom, many of whom support family in their health despite being unpaid and often unsupported. Many visit pharmacies to collect medicines and look for advice. This work explores informal carer support within community pharmacies (CP). METHODS Semi-structured video interviews exploring perspectives on the role of CP in supporting carers were conducted in autumn 2022. The study received institutional ethical approval. Interviews were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic approach. KEY FINDINGS In total 25 interviews were conducted with 13 carers and 12 pharmacy staff. Three themes were identified:-What support do carers need through CP?-medicines management, navigating services, and carers health and wellbeing.-Barriers to CP better supporting carers-relationships with CP, carer needs, identification as a 'carer'.-Enablers to CP better supporting carers-support is a team effort, and CP as a community 'hub'. CONCLUSIONS There is a trusted relationships between carers and pharmacy staff which can contribute to establishing pharmacies as a safe space of support, this includes medicines-specific support and navigating services, but also carer health and wellbeing support. Pharmacy staff may need to reconsider approaches to identifying and supporting carers and not just treating them as an extension of supporting a patient. In making this support accessible, relationships with pharmacy staff are important, as well as embracing CP as a 'community hub', although pharmacy staff may need training and information to facilitate them in this role.
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Affiliation(s)
| | - Katherine Edwards
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, NE1 7RU, United Kingdom
| | - Judith Lunny
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, NE1 7RU, United Kingdom
| | - Laura Lindsey
- School of Pharmacy, Faculty of Medical Sciences, Newcastle University, NE1 7RU, United Kingdom
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Robberechts A, Brumer M, Garcia-Cardenas V, Dupotey NM, Steurbaut S, De Meyer GRY, De Loof H. Medication Review: What's in a Name and What Is It about? Pharmacy (Basel) 2024; 12:39. [PMID: 38392946 PMCID: PMC10892708 DOI: 10.3390/pharmacy12010039] [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: 01/17/2024] [Revised: 02/09/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Medication review is a multifaceted service aimed at optimizing the use of medicines and enhancing the health outcomes of patients. Due to its complexity, it is crucial to clearly describe the service, its variants, and its components to avoid confusion and ensure a better understanding of medication review among healthcare providers. AIM This study aims to bring clarity to the origins, definitions, abbreviations, and types of medication reviews, together with the primary criteria that delineate key features of this service. METHOD A narrative review approach was employed to clarify the diverse terminology associated with "medication review" services. Relevant references were initially identified through searches on PubMed and Google Scholar, complementing the existing literature known to the authors. RESULTS The study uncovers a complicated and sometimes convoluted history of "medication review" in different regions around the world. The initial optimization of medicine use had an economic purpose before evolving subsequently into a more patient-oriented approach. A selection of abbreviations, definitions, and types were outlined to enhance the understanding of the service. CONCLUSIONS The study underscores the urgent need for comprehensive information and standardization regarding the content and quality of the services, collectively referred to as "medication review".
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Affiliation(s)
- Anneleen Robberechts
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; (M.B.); (G.R.Y.D.M.); (H.D.L.)
- Meduplace, Royal Pharmacists Association of Antwerp (KAVA), 2018 Antwerp, Belgium
- Centre for Pharmaceutical Research, Research Group of Clinical Pharmacology and Clinical Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium;
| | - Maja Brumer
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; (M.B.); (G.R.Y.D.M.); (H.D.L.)
| | | | | | - Stephane Steurbaut
- Centre for Pharmaceutical Research, Research Group of Clinical Pharmacology and Clinical Pharmacy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Jette, Belgium;
- Department of Hospital Pharmacy, UZ Brussel, Laarbeeklaan 101, 1090 Jette, Belgium
| | - Guido R. Y. De Meyer
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; (M.B.); (G.R.Y.D.M.); (H.D.L.)
| | - Hans De Loof
- Laboratory of Physiopharmacology, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium; (M.B.); (G.R.Y.D.M.); (H.D.L.)
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Henman MC, Ravera S, Lery FX. Council of Europe Resolution on the Implementation of Pharmaceutical Care-A Step Forward in Enhancing the Appropriate Use of Medicines and Patient-Centred Care. Healthcare (Basel) 2024; 12:232. [PMID: 38255119 PMCID: PMC10815874 DOI: 10.3390/healthcare12020232] [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: 12/01/2023] [Revised: 01/03/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
Pharmaceutical care was proposed to address morbidity and mortality associated with medicine-related problems. It utilises the pharmacist's expertise in medicines, their relationship with the patient and cooperation with other healthcare professionals to optimise the use of medicines. The European Directorate for the Quality of Medicines & HealthCare (EDQM), part of the Council of Europe, found significant variation in the acceptance of pharmaceutical care and in the implementation of pharmaceutical care in Europe. A multidisciplinary group was established to draft a statement of principles and recommendations concerning pharmaceutical care. Through face-to-face meetings, circulation of draft texts and informal consultation with stakeholders, the group produced a resolution. On 11 March 2020, the resolution was adopted by the Committee of Ministers of the Council of Europe. It explains pharmaceutical care and illustrates pharmacists' contribution to medicine optimisation in different care settings. Pharmaceutical care's value to health services and its place in health policy were emphasised by addressing the risks and harms from suboptimal use of medicines. Pharmaceutical care can improve medicine use, promote rational use of healthcare resources and reduce inequalities in healthcare by realigning the roles and responsibilities of pharmacists and healthcare professionals. EDQM will promote and advocate for the implementation of pharmaceutical care by enacting practice Resolution CM/Res(2020)3.
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Affiliation(s)
- Martin C. Henman
- School of Pharmacy and Pharmaceutical Sciences, Trinity College, D02 PN40 Dublin, Ireland
| | - Silvia Ravera
- European Directorate for the Quality of Medicines and HealthCare (EDQM), Council of Europe, F-67081 Strasbourg, France; (S.R.); (F.-X.L.)
| | - Francois-Xavier Lery
- European Directorate for the Quality of Medicines and HealthCare (EDQM), Council of Europe, F-67081 Strasbourg, France; (S.R.); (F.-X.L.)
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Gutenschwager DW, Patel A, Soyad AT, Patel S, Szandzik EG, Kelly B, Smith ZR. Provision of ambrisentan from a health-system specialty pharmacy affiliated with a pulmonary hypertension Center of Comprehensive Care. Am J Health Syst Pharm 2024; 81:66-73. [PMID: 37611180 DOI: 10.1093/ajhp/zxad191] [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: 08/19/2023] [Indexed: 08/25/2023] Open
Abstract
PURPOSE This descriptive report describes the process used to obtain access to providing ambrisentan from a health-system specialty pharmacy (HSSP) affiliated with a pulmonary hypertension Center of Comprehensive Care, develop a pulmonary arterial hypertension (PAH) care team at the HSSP, and characterize medication adherence and access metrics. SUMMARY PAH is a rare disease treated with several specialty medications requiring intensive monitoring. Historically, specialty medications used to treat PAH have been provided by only select specialty pharmacies due to restricted drug distribution channels. It is recommended that patients with PAH receive their care at centers with expertise in the diagnosis and management of this disorder, but the HSSPs at these expert centers are unable to provide specialty PAH medications. The current care model for PAH leads to patients receiving their medical and pharmaceutical care from separate entities. This descriptive report describes a multidisciplinary team's approach to gaining access to providing ambrisentan and developing a disease state care team within an established HSSP. After implementing this service, specialty pharmacy metrics were assessed, including proportion of days covered (PDC), time to first fill, patient contact rate, Risk Evaluation and Mitigation Strategy (REMS) program compliance, time to prior authorization (PA) approval, rate of optimal adherence (PDC of >80%), and PA renewal rate, to demonstrate a proof-of-concept HSSP model for PAH. In this model, the HSSP was able to demonstrate high-quality specialty pharmacy metrics with regard to medication adherence, medication access, and REMS program compliance. CONCLUSION The development of a PAH care team to provide ambrisentan at an existing HSSP was associated with high adherence rates, efficient and reliable medication access, and REMS program compliance.
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Affiliation(s)
| | - Anand Patel
- Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
| | - Amanda T Soyad
- Clinical Pharmacy Services, Pharmacy Advantage, Rochester Hills, MI, USA
| | - Sweta Patel
- Clinical Pharmacy Services, Pharmacy Advantage, Rochester Hills, MI, USA
| | | | - Bryan Kelly
- Department of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Zachary R Smith
- Department of Pharmacy, Henry Ford Hospital, Detroit, MI, USA
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Barros JC, Silva SN. Use of Psychotropic Drugs during the COVID-19 pandemic in Minas Gerais, Brazil. Rev Bras Epidemiol 2023; 26:e230059. [PMID: 38088718 PMCID: PMC10715318 DOI: 10.1590/1980-549720230059] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE To describe the profile of dispensation of mental health drugs by analyzing trends in use before and during the COVID-19 pandemic within the Unified Health System (Sistema Único de Saúde [SUS]). METHODS Pharmacoepidemiological study based on the retrospective analysis of records regarding the dispensation of psychotropic medicines in the SUS database in the state of Minas Gerais between 2018 and 2021, considering the periods before (2018-2019) and during the COVID-19 pandemic (2020-2021). A database with the records of dispensation of municipalities was created, and the consistency of releases was verified using the Analysis of Variance (ANOVA) test. Medicine consumption was measured in a defined daily dose (DDD) per 1,000 inhabitants/day for SUS, and the difference between periods was evaluated using Student's t-test. RESULTS During the COVID-19 pandemic, there was an increase in the consumption of psychotropic drugs in SUS-MG. The most consumed medicines were fluoxetine hydrochloride, diazepam and phenobarbital sodium (DDD=5.89; 3.42; 2.49) in the Basic Pharmaceutical Services Component(CBAF), and olanzapine, risperidone and quetiapine hemifumarate (DDD=0.80; 0.47; 0.38) in the Specialized Pharmaceutical Services Component (CEAF). The highest percentage increase in consumption was attributed to clonazepam (75.37%) and lithium carbonate (35.35%), in CBAF, and levetiracetam (3,000.00%) and memantine hydrochloride (340.0%) in CEAF. CONCLUSION The change in the psychotropic drug dispensation profile during the COVID-19 pandemic highlights the need to produce more studies to complete, confirm or rule out this profile and monitor the use of psychotropic drugs by the population in the post-pandemic context.
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Affiliation(s)
| | - Sarah Nascimento Silva
- Fundação Oswaldo Cruz, Instituto René Rachou, Health Technology Assessment Unit – Belo Horizonte (MG), Brazil
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12
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Yehualaw A, Tafere C, Demsie DG, Feyisa K, Bahiru B, Kefale B, Berihun M, Yilma Z. Determinants t of patient satisfaction with pharmacy services at Felege Hiwot comprehensive specialized hospital, Bahir Dar, Ethiopia. Ann Med Surg (Lond) 2023; 85:5885-5891. [PMID: 38098594 PMCID: PMC10718396 DOI: 10.1097/ms9.0000000000001161] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/02/2023] [Indexed: 12/17/2023] Open
Abstract
Background Patients have explicit desire for quality services when they visit health institutions. Patient satisfaction is a primary means of measuring the effectiveness of healthcare delivery. However, inadequate discovery of their needs may result in patient dissatisfaction. Patients who are satisfied with pharmaceutical care are likely to adherence, seeking for medical attentions and take medications properly. Providing better access to quality pharmacies is a way to improve patient satisfaction with healthcare services. Study objective The study was aimed to assess patient satisfaction with pharmacy services at Felege Hiwot Comprehensive Specialized Hospital (FHCSH). Methods and materials An institution-based cross-sectional study design was conducted at FHCSH from 1 May 2021 to 30 October 2021. Data were collected by interview with structured questionnaires. Then the data were coded, entered, and then analyzed by SPSS version 23. The association between predictors and outcome was measured using bivariate logistic regression. Result In this study, 384 study participants were included. Majority of the participants were males (55.37%, N=227). The overall satisfaction score of the participants of this study was 65.37%. In our study, clients showed greater satisfaction towards pharmacists' commitment to correct myths (92%), pharmacist availability (88.78), and cleanliness (87.8%). Multivariate analysis indicated physical restriction [adjusted odds ratio (AOR)=6:95%; 95% CI (2.98, 25.9)] and rural residence [AOR=2.43; 95% CI (1.71, 9.6)] had significant association with pharmacy service dissatisfaction. Among the quality pharmacy service indicators, counselling on how medications work [AOR=9; 95% CI (1.48, 8.85)], keeping to dosage regimen [AOR=7.3; 95% CI (5.49, 11.06)], and advice on the current medical condition had greater odds of client dissatisfaction. Conclusion The findings of the current study showed that patients' satisfaction towards outpatient pharmacy services provided by FHCSH is very low as it is indicated in their perception towards revealing written information about medication use, medication availability, medication storage, and instructions about medication side effects.
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Affiliation(s)
| | - Chernet Tafere
- Department of Pharmacy, Bahir Dar University, College of Medicine and Health Sciences, Bahir Dar, Ethiopia
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13
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Cole JA, Gonçalves-Bradley DC, Alqahtani M, Barry HE, Cadogan C, Rankin A, Patterson SM, Kerse N, Cardwell CR, Ryan C, Hughes C. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev 2023; 10:CD008165. [PMID: 37818791 PMCID: PMC10565901 DOI: 10.1002/14651858.cd008165.pub5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
BACKGROUND Inappropriate polypharmacy is a particular concern in older people and is associated with negative health outcomes. Choosing the best interventions to improve appropriate polypharmacy is a priority, so that many medicines may be used to achieve better clinical outcomes for patients. This is the third update of this Cochrane Review. OBJECTIVES To assess the effects of interventions, alone or in combination, in improving the appropriate use of polypharmacy and reducing medication-related problems in older people. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL and two trials registers up until 13 January 2021, together with handsearching of reference lists to identify additional studies. We ran updated searches in February 2023 and have added potentially eligible studies to 'Characteristics of studies awaiting classification'. SELECTION CRITERIA For this update, we included randomised trials only. Eligible studies described interventions affecting prescribing aimed at improving appropriate polypharmacy (four or more medicines) in people aged 65 years and older, which used a validated tool to assess prescribing appropriateness. These tools can be classified as either implicit tools (judgement-based/based on expert professional judgement) or explicit tools (criterion-based, comprising lists of drugs to be avoided in older people). DATA COLLECTION AND ANALYSIS Four review authors independently reviewed abstracts of eligible studies, and two authors extracted data and assessed the risk of bias of the included studies. We pooled study-specific estimates, and used a random-effects model to yield summary estimates of effect and 95% confidence intervals (CIs). We assessed the overall certainty of evidence for each outcome using the GRADE approach. MAIN RESULTS We identified 38 studies, which includes an additional 10 in this update. The included studies consisted of 24 randomised trials and 14 cluster-randomised trials. Thirty-six studies examined complex, multi-faceted interventions of pharmaceutical care (i.e. the responsible provision of medicines to improve patients' outcomes), in a variety of settings. Interventions were delivered by healthcare professionals such as general physicians, pharmacists, nurses and geriatricians, and most were conducted in high-income countries. Assessments using the Cochrane risk of bias tool found that there was a high and/or unclear risk of bias across a number of domains. Based on the GRADE approach, the overall certainty of evidence for each pooled outcome ranged from low to very low. It is uncertain whether pharmaceutical care improves medication appropriateness (as measured by an implicit tool) (mean difference (MD) -5.66, 95% confidence interval (CI) -9.26 to -2.06; I2 = 97%; 8 studies, 947 participants; very low-certainty evidence). It is uncertain whether pharmaceutical care reduces the number of potentially inappropriate medications (PIMs) (standardised mean difference (SMD) -0.19, 95% CI -0.34 to -0.05; I2 = 67%; 9 studies, 2404 participants; very low-certainty evidence). It is uncertain whether pharmaceutical care reduces the proportion of patients with one or more PIM (risk ratio (RR) 0.81, 95% CI 0.68 to 0.98; I2 = 84%; 13 studies, 4534 participants; very low-certainty evidence). Pharmaceutical care may slightly reduce the number of potential prescribing omissions (PPOs) (SMD -0.48, 95% CI -1.05 to 0.09; I2 = 92%; 3 studies, 691 participants; low-certainty evidence), however it must be noted that this effect estimate is based on only three studies, which had serious limitations in terms of risk of bias. Likewise, it is uncertain whether pharmaceutical care reduces the proportion of patients with one or more PPO (RR 0.50, 95% CI 0.27 to 0.91; I2 = 95%; 7 studies, 2765 participants; very low-certainty evidence). Pharmaceutical care may make little or no difference to hospital admissions (data not pooled; 14 studies, 4797 participants; low-certainty evidence). Pharmaceutical care may make little or no difference to quality of life (data not pooled; 16 studies, 7458 participants; low-certainty evidence). Medication-related problems were reported in 10 studies (6740 participants) using different terms (e.g. adverse drug reactions, drug-drug interactions). No consistent intervention effect on medication-related problems was noted across studies. This also applied to studies examining adherence to medication (nine studies, 3848 participants). AUTHORS' CONCLUSIONS It is unclear whether interventions to improve appropriate polypharmacy resulted in clinically significant improvement. Since the last update of this review in 2018, there appears to have been an increase in the number of studies seeking to address potential prescribing omissions and more interventions being delivered by multidisciplinary teams.
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Affiliation(s)
- Judith A Cole
- Clinical Trial Service Unit, University of Oxford, Oxford, UK
| | | | | | | | - Cathal Cadogan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Audrey Rankin
- School of Pharmacy, Queen's University Belfast, Belfast, UK
| | | | - Ngaire Kerse
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | - Chris R Cardwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Cristin Ryan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Carmel Hughes
- School of Pharmacy, Queen's University Belfast, Belfast, UK
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Mill D, Johnson JL, Corre L, Lee K, D'Lima D, Clifford R, Seubert L, Salter SM, Page AT. Use of a reference text by pharmacists, intern pharmacists and pharmacy students: a national cross-sectional survey. Int J Pharm Pract 2023; 31:548-557. [PMID: 37454279 DOI: 10.1093/ijpp/riad047] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Reference texts assist pharmacists by addressing knowledge gaps and enabling evidence-based decisions when providing patient care. It is unknown whether reference text utilisation patterns differ between pharmacists, intern pharmacists and pharmacy students. To describe and compare the self-reported use and perceptions of a reference text, namely the national formulary, by pharmacists, intern pharmacists and pharmacy students. METHODS Registered pharmacists, intern pharmacists and pharmacy students living in Australia were surveyed in July 2020. The survey was electronic and self-administered. Questions considered self-reported use of a specific reference text in the preceding 12 months. KEY FINDINGS There were 554 eligible responses out of 774 who commenced the survey: 430 (78%) pharmacists, 45 (8%) intern pharmacists and 79 (14%) pharmacy students. Most participants (529/554, 96%) reported historical use of the text, though pharmacists were significantly less likely than intern pharmacists and students to use it frequently (52/422, 12% versus 16/43, 37% versus 23/76, 30%, P < 0.001). Pharmacists (44%, 177/404) reported using the text as a tool to resolve a situation when providing a service or patient care (177/404, 44%) or as a teaching resource (150/404, 38%). In contrast, intern pharmacists and students most commonly use these to familiarise themselves with the contents (30/43, 70%; 46/76, 61%) or update their knowledge (34/43, 79%; 53/76, 70%). CONCLUSIONS Access and use patterns varied significantly across career stages. A broader understanding of the use of reference texts may help develop interventions to optimise the content and usability. Varying usage patterns across the groups may inform the tailoring of texts for future use.
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Affiliation(s)
- Deanna Mill
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Jacinta L Johnson
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
- UniSA Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Lauren Corre
- SA Pharmacy, SA Health, Adelaide, South Australia, Australia
| | - Kenneth Lee
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Danielle D'Lima
- Department of Clinical, Educational and Health Psychology, Centre for Behaviour Change, University College London, London, UK
| | - Rhonda Clifford
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Liza Seubert
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Sandra M Salter
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
| | - Amy Theresa Page
- School of Allied Health, University of Western Australia, Perth, Western Australia, Australia
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P P, S P, M S, L A. Bridging the Gaps in Promoting Pharmaceutical Services for Visually Impaired Persons in Public Hospitals, in Bangkok: Pharmacists' Perspectives. Hosp Top 2023:1-8. [PMID: 37671850 DOI: 10.1080/00185868.2023.2252990] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
This cross-sectional study aimed to explore the perceptions and performances of hospital pharmacists in providing services for people with visual impairment. This study surveyed 150 hospital pharmacists at all levels in public hospitals in Bangkok, Thailand. The results demonstrate that hospitals faced challenges in translating the principles of the Convention Rights of People with Disabilities into hospital policy guidelines and service plans. Due to lack of policy endorsement, pharmacists were left unsupported for critical resources, such as facilities, budgets, staff, and materials to provide services quality. The hospital management and disability cultural competency were facilitating factors that promoted equitable care for vulnerable groups.
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Affiliation(s)
- Phongpunpisand P
- Department of Pharmacy, Chulabhorn Royal Academy, Bangkok, Thailand
- Social, Economic and Administrative Pharmacy (SEAP) Graduate Program, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Pumtong S
- Department of Pharmacy, Chulabhorn Royal Academy, Bangkok, Thailand
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Sunantiwat M
- Department of Pharmacy, Chulabhorn Royal Academy, Bangkok, Thailand
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Anuratphanich L
- Department of Pharmacy, Chulabhorn Royal Academy, Bangkok, Thailand
- Social and Administrative Pharmacy Excellence Research (SAPER) Unit, Department of Pharmacy, Mahidol University, Bangkok, Thailand
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16
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Mega TP, da Silva RM. Expenditure of biological drugs for rheumatoid arthritis treatment in the Brazilian public health system. Rev Saude Publica 2023; 57:41. [PMID: 37556663 PMCID: PMC10355319 DOI: 10.11606/s1518-8787.2023057004280] [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: 10/06/2021] [Accepted: 08/18/2022] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE This work aims to analyze the quantity and expenses related to biological drugs used for the treatment of rheumatoid arthritis (RA) in outpatient public care within the Brazilian Unified Health System (SUS). METHODS It is a cross-sectional descriptive study based on secondary data from a historical series, referring to the purchase, volume, and the number of patients treated with different biological drugs (infliximabe, etanercept, adalimumab, rituximab, abatacept, tocilizumab, golimumab, and certolizumab pegol) for RA treatment in outpatient care from 2012 to 2017. The data were extracted from the SUS Outpatient Information System database-SIA/SUS and included ten drugs used for RA treatment. The study assessed the quantity and expenditure of these drugs, the number of RA patients treated, and the expenditure by RA subtypes. The National Broad Consumer Price Index was used to adjust the expenditures for December 2017. RESULTS The Ministry of Health allocated approximately $500 million to provide about 2 million units of biological drugs for RA patients from 2012 to 2017. The supply of adalimumab 40 mg and etanercept 50 mg accounted for 68.3% of the total expenditure. The subtypes "other rheumatoid arthritis with rheumatoid factor" (ICD-10 M05.8), "rheumatoid arthritis without rheumatoid factor" (ICD-10 M06.0), and "Felty's syndrome" (M05. 0) represented 84.5% of the total expenditures. The proportion of patients treated with biological drugs increased by 33.0%. There was a significant 83.0% increase in the number of patients using biological drugs compared to the overall number of RA patients treated during the study period. CONCLUSIONS The results obtained allow us to draw a more recent profile of expenditure on RA treatment and indicate trends in the use of biological drugs for this condition, generating data that can support management decisions in public health policies.
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Affiliation(s)
- Tacila Pires Mega
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sergio AroucaPrograma de Pós-Graduação em Saúde PúblicaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Programa de Pós-Graduação em Saúde Pública. Rio de Janeiro, RJ, Brasil
| | - Rondineli Mendes da Silva
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sergio AroucaDepartamento de Política de Medicamentos e Assistência FarmacêuticaRio de JaneiroRJBrasil Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Departamento de Política de Medicamentos e Assistência Farmacêutica. Rio de Janeiro, RJ, Brasil
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17
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Du Z, Jiang Y, Lu R, Zhou Q, Pan Y, Shen Y, Zhu H. Practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals during COVID-19 pandemic in Wuxi, China. Front Psychiatry 2023; 14:1195298. [PMID: 37547208 PMCID: PMC10397508 DOI: 10.3389/fpsyt.2023.1195298] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/30/2023] [Indexed: 08/08/2023] Open
Abstract
Objective To study the practice of pharmaceutical services in internet-based psychiatric hospitals, and to analyze the prescriptions to ensure the safety and efficacy of internet-based medication in Wuxi, China. Methods All 1,259 internet-based prescriptions from our hospital in 2022 were collected, and data on patients' age, gender, diagnosis, medications used, medication types, dosage forms, rationality of medication use, and reasons for irrationality were analyzed through descriptive statistics. Results In the electronic prescriptions of internet-based psychiatric hospitals, females accounted for the majority (64.50%), with a female-to-male ratio of 1.82:1. Middle-aged and young adults accounted for the majority of patients (57.50%). There were 47 diagnosed diseases involved, with 89 types of medications used and 1,938prescriptions issued. Among them, there were 78 types of western medicine with 1,876 prescriptions (96.80%), and 11 types of traditional Chinese medicine with 62 prescriptions (3.20%). The main medications used were anti-anxiety and antidepressant medications (44.94%) and psychiatric medications (42.21%). The dosage forms were all oral, with tablets (78.53%), capsules (17.54%), and solution preparations (2.17%) being the top three in frequency. According to the prescription review results, the initial pass rate of internet-based system review was 64.26%. After intervention by the internet-based system and manual review by pharmacist reviewers, the final pass rate of internet-based prescriptions reached 99.76%. Conclusion The practice of pharmaceutical services and prescription analysis in internet-based psychiatric hospitals could significantly improve medication rationality, which fills the research gap in this field. In addition, it promotes the transformation of pharmaceutical service models.
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Dabidian A, Obarcanin E, Ali Sherazi B, Schlottau S, Schwender H, Laeer S. Impact of a Digital Tool on Pharmacy Students' Ability to Perform Medication Reviews: A Randomized Controlled Trial. Healthcare (Basel) 2023; 11:1968. [PMID: 37444802 DOI: 10.3390/healthcare11131968] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/29/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
Digital Medication Review Tools (DMRTs) are increasingly important in pharmacy practice. To ensure that young pharmacists are sufficiently competent to perform medication reviews after graduation, the introduction of DMRTs teaching in academic education is necessary. The aim of our study was to demonstrate the effect of DMRTs use on pharmacy students' performance when conducting a medication review (MR) in a randomized controlled pre-post design. Forty-one pharmacy students were asked to complete a MR within 60 min, followed by a 10-min consultation with (intervention group) and without a DMRT (control group). The MR performance was subdivided into four categories: communication skills, subjective and objective patient data, assessment, and plan. Performance was assessed using objective structured clinical examinations (OSCEs) and analytical checklists. With the use of DMRTs, the overall performance was improved by 17.0% compared to the control group (p < 0.01). Improvement through DMRTs was seen in the subcategories "Assessment" and "Plan". Furthermore, pharmacy students liked using DMRTs and felt more confident overall. Our study results demonstrate that DMRTs improve the performance of MRs, hence DMRTs should become an integral part of pharmacy curriculum. Consequently, digitally enabled pharmacists using DMRTs will be better prepared for their professional careers in pharmacy practice.
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Affiliation(s)
- Armin Dabidian
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Emina Obarcanin
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
- Department of Pharmacy, National University Singapore, 18 Science Drive 4, Singapore 117559, Singapore
| | - Bushra Ali Sherazi
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
- Institute of Pharmacy, Faculty of Pharmaceutical and Allied Health Sciences, Lahore College for Women University, Lahore 54000, Pakistan
| | - Sabina Schlottau
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Holger Schwender
- Mathematical Institute, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
| | - Stephanie Laeer
- Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University Duesseldorf, Universitaetsstrasse 1, 40225 Duesseldorf, Germany
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19
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Barrett R. A cross-sectional study on substandard and falsified medicines (fake or counterfeit drugs) in UK pharmacies during the COVID-19 pandemic. Expert Opin Drug Saf 2023; 22:1289-1299. [PMID: 36374122 DOI: 10.1080/14740338.2023.2147922] [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: 07/18/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Failure of the Falsified Medicines Directive (FMD) in the UK could mean that substandard and falsified medicines (SFs) enter the supply chain. Does this risk patients' health? Readiness to implement FMD, and prevalence of SFs vs. regulator detection were assessed. RESEARCH DESIGN AND METHODS A total of 12,040 primary care pharmacies across England were invited (April 2021-March 2022). Respondent postcodes were used to extract deprivation scores. Information request was placed with the medicine's agency. Survey findings were used to calculate probability and power of a simulated trial. RESULTS A total of 208 participants responded: Of the seven who identified SFs, all but one reported it; 61% were ready to implement FMD, 74.1% had adequate resources, 54.8% expected improved patient safety, and 17.8% had ever reported SFs. SFs were prevalent in deprived areas. Bayesian simulation shows 438 (p = 0.030) incidences with a 3% probability of SFs prevalence. The agency identified 15,238 SFs units in the supply chain (2019 and 2020). Results are credible, reliable, and generalisable, with corroborated longitudinal persistence. CONCLUSIONS FMD or equivalent processes need to be urgently reinstated. Deprived children may be more affected. Pharmacists are worried about liability. All health consultations should assess safety, and effectiveness of medicines. Findings should inform policy, systems planning, surveillance, and evaluations.
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Affiliation(s)
- Ravina Barrett
- Pharmacy Practice, School of Applied Sciences, Cockcroft Building, University of Brighton, Brighton, UK
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Abstract
INTRODUCTION Telepharmacy has the potential to enhance pharmacy services in oncology care, especially in remote areas. This scoping review explored the range, critical benefits and barriers of using telepharmacy services in oncology care. METHODS The scoping review followed the Arksey and O'Malley's five-stage framework to identify available evidence. PubMed, CINAHL, Embase, PsycINFO, Ovid MEDLINE and Scopus databases were searched for original research published between 2010 and 2020. The five dimensions of the Alberta Quality Matrix for Health were used to analyse reported outcomes. RESULTS Eligible articles (n = 21) were analysed. Telepharmacy in oncology care was used for follow-up, monitoring and counselling, intravenous chemotherapy and sterile compounding, expanding availability of pharmacy services, and remote education. Telepharmacy obtained high acceptability among cancer patients (n = 5) and healthcare professionals (n = 5), and increased accessibility of pharmaceutical services to underserved cancer populations (n = 2). Commonly cited effectiveness and safety outcomes were improved patient adherence (n = 5), increased pharmacy services (n = 3) and early identification of medication-related problems (n = 5). Telepharmacy improved efficiency in staffing and workload (n = 3), and increased cost savings (n = 3). A shortage of resources (n = 5), technical problems (n = 4) and prolonged turnaround time (n = 4), safety concerns (n = 2) and patient willingness to pay (n = 1) were identified barriers to implementing telepharmacy in oncology care. DISCUSSION Despite evidence pointing to the advantages and opportunities for expanding oncology pharmacy services through telepharmacy, certain challenges remain. Further research is needed to investigate safety concerns and patient willingness to pay for telepharmacy services.
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Affiliation(s)
- Anh Thu Vo
- Faculty of Medicine, Memorial University of Newfoundland, Canada
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21
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Steiner JF, Powers JD, Malone A, Lyons J, Olson K, Paolino AR, Steiner CA. Hypertension care during the COVID-19 pandemic in an integrated health care system. J Clin Hypertens (Greenwich) 2023; 25:315-325. [PMID: 36919191 PMCID: PMC10085815 DOI: 10.1111/jch.14641] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 12/13/2022] [Revised: 01/06/2023] [Accepted: 01/24/2023] [Indexed: 03/16/2023]
Abstract
Retention in hypertension care, medication adherence, and blood pressure (BP) may have been affected by the COVID-19 pandemic. In a retrospective cohort study of 64 766 individuals with treated hypertension from an integrated health care system, we compared hypertension care during the year pre-COVID-19 (March 2019-February 2020) and the first year of COVID-19 (March 2020-February 2021). Retention in hypertension care was defined as receiving clinical BP measurements during COVID-19. Medication adherence was measured using prescription refills. Clinical care was assessed by in-person and virtual visits and changes in systolic and diastolic BP. The cohort had a mean age of 67.8 (12.2) years, 51.2% were women, and 73.5% were White. In 60 757 individuals with BP measurements pre-COVID-19, 16618 (27.4%) had no BP measurements during COVID-19. Medication adherence declined from 86.0% to 80.8% (p < .001). In-person primary care visits decreased from 2.7 (2.7) to 1.4 (1.9) per year, while virtual contacts increased from 9.5 (12.2) to 11.2 (14.2) per year (both p < .001). Among individuals with BP measurements, mean (SD) systolic BP was 126.5 mm Hg (11.8) pre-COVID-19 and 127.3 mm Hg (12.6) during COVID-19 (p = .14). Mean diastolic BP was 73.5 mm Hg (8.5) pre-COVID-19 and 73.5 mm Hg (8.7) during COVID-19 (p = .77). Even in this integrated health care system, many individuals did not receive clinical BP monitoring during COVID-19. Most individuals who remained in care maintained pre-COVID BP. Targeted outreach may be necessary to restore care continuity and hypertension control at the population level.
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Affiliation(s)
- John F Steiner
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA.,Colorado Permanente Medical Group, Denver, Colorado, USA
| | - J David Powers
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Allen Malone
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Jason Lyons
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Kari Olson
- Pharmacy Department, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Andrea R Paolino
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA
| | - Claudia A Steiner
- Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado, USA.,Colorado Permanente Medical Group, Denver, Colorado, USA
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Zanetti MOB, Rodrigues JPV, Varallo FR, Cunha RLG, Simões BP, Pereira LRL. Can pharmacotherapeutic follow-up after allogeneic hematopoietic stem cell transplantation improve medication compliance? J Oncol Pharm Pract 2023; 29:348-357. [PMID: 35038928 DOI: 10.1177/10781552211073469] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Allogeneic Hematopoietic Stem Cell Transplantation (allo-HSCT) is currently one of the most effective therapies in onco-hematology. For the treatment of the disease and prevention of such complications, a complex pharmacotherapeutic regimen is employed. Non-compliance is prevalent among adolescents and young adults with chronic hematological diseases, being reported by up to 50% of the patients. OBJECTIVE To evaluate the results of pharmacotherapeutic follow-up on medication compliance and on the knowledge about pharmacotherapy of patients who underwent allo-HSCT. METHODS A single-arm, open-label and non-randomized intervention study developed in an allo-HSCT outpatient clinic. The participants attended pharmaceutical consultations and had their knowledge about pharmacotherapy and medication compliance measured by MedTake and Brief Medication Questionnaire (BMQ), respectively. RESULTS A total of 27 patients attended pharmaceutical consultations (4.81 consultations/patient; SD = 1.80). There was an improvement in medication compliance and in knowledge between the first and last consultations (p < 0.05). In the final consultation, 70.37% of the patients showed compliance, with a knowledge rate of 98.35% (SD = 3.63). Non-compliant individuals presented a greater tendency to hospital readmissions. There was no relationship between medication compliance and sociodemographic variables, graft-versus-host disease, and knowledge about pharmacotherapy. CONCLUSIONS Pharmacotherapeutic follow-up contributed to improving medication compliance. Knowledge about pharmacotherapy alone does not translate into behaviors, which corroborates the complexity of the biopsychosocial factors associated with medication compliance.
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Affiliation(s)
- Maria Olívia Barboza Zanetti
- Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirao Preto - University of Sao Paulo, Ribeirao Preto, Brazil
| | - João Paulo Vilela Rodrigues
- Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirao Preto - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Fabiana Rossi Varallo
- Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirao Preto - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Renato Luiz Guerrino Cunha
- Department of Internal Medicine, Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Belinda Pinto Simões
- Department of Internal Medicine, Ribeirao Preto Medical School - University of Sao Paulo, Ribeirao Preto, Brazil
| | - Leonardo Régis Leira Pereira
- Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirao Preto - University of Sao Paulo, Ribeirao Preto, Brazil
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dos Santos RLB, Osorio-de-Castro CGS, Sobreira-da-Silva MJ, Pepe VLE. First use of antineoplastic agents in women with breast cancer in the state of Rio de Janeiro, Brazil. Front Pharmacol 2023; 14:1069505. [PMID: 36814497 PMCID: PMC9939900 DOI: 10.3389/fphar.2023.1069505] [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: 10/14/2022] [Accepted: 01/23/2023] [Indexed: 02/08/2023] Open
Abstract
Context: Breast cancer is the most common cancer, except for non-melanoma skin cancer, among women in Brazil and worldwide. Breast cancer treatment involves surgery, radiotherapy and chemotherapy, which is used in 70% of patients. This study analyzes the utilization of antineoplastic agents among women undergoing their first round of chemotherapy in Brazil's public health system (SUS) in the state of Rio de Janeiro. Methods: Data from the SUS Outpatient Information System's authorizations for high-complexity outpatient procedures (APACs) billed between January 2013 and December 2019 were extracted, and three datasets were created: all type 1 and type 2 APACs (including all chemotherapy procedures performed); all type 1 APACs; and first type 1 APACs (containing data only for the first round of breast cancer chemotherapy). Names of antineoplastic agents were standardized to enable the subsequent classification of therapy regimens, mitigating limitations related to data quality. Absolute and relative frequencies were used to describe sociodemographic, clinical and treatment characteristics, therapy regimen and supportive drugs. Results: We analyzed 23,232 records of women undergoing their first round of chemotherapy. There was a progressive increase in the number of procedures over time. Women were predominantly white, lived in the capital and close to the treatment center. Most had stage 3 cancer at diagnosis (50.51%) and a significant proportion had regional lymph node invasion (37.9%). The most commonly used chemotherapy regimens were TAC (docetaxel, doxorubicine, cyclophosphamide) (21.05%) and and cyclophosphamide (17.71%), followed by tamoxifen (15.65%) and anastrozole (12.94%). Supportive drugs were prescribed to 386 women and zoledronic acid was predominant (59.58%). Conclusion: The findings point to important bottlenecks and possible inequities in access to treatment and medicine utilization for breast cancer patients in Brazil. Efforts to improve breast cancer treatment and prevention should not only focus on interventions at the individual level but address the disease as a public health problem. The study focused on women undergoing their first round of treatment, providing valuable insight into patient and treatment characteristics to inform policy decisions.
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Affiliation(s)
- Ranailla Lima Bandeira dos Santos
- Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Brazil,*Correspondence: Ranailla Lima Bandeira dos Santos,
| | - Claudia Garcia Serpa Osorio-de-Castro
- Department of Pharmaceutical Policies and Pharmaceutical Services, Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Vera Lúcia Edais Pepe
- Department of Health Planning and Administration, Sergio Arouca National School of Public Health/Oswaldo Cruz Foundation, Rio de Janeiro, Rio de Janeiro, Brazil
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Martin Y, Cabral G, Salazar Zaffaroni MF, Armando P. [Design, implementation and evaluation of a service for Medication compliance aids (MCAs) in an institutional Pharmacy in the city of Córdoba]. Rev Fac Cien Med Univ Nac Cordoba 2022; 79:310-7. [PMID: 36542585 DOI: 10.31053/1853.0605.v79.n4.35951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/19/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction The Pharmaceutical Service (PS) for the provision of Medication compliance aids (MCAs) consists of reconditioning and unifying, in a protocolized manner and in multi-compartment devices, the medications used by a patient, ordering them according to their dosage guideline. The objective was to design, implement and evaluate an PS of MCAs in an institutional pharmacy in the city of Córdoba. Methods Observational, descriptive and longitudinal study. A Standard Operating Procedure (SOP) was developed from for PS of MCAs and applied to a sample of 20 patients. Adherence was analyzed by: tablet count and Morisky-Green test. A validated service satisfaction questionnaire was applied and a cost analysis was performed considering the initial investment and the times involved. Results A 98.0% adherence was obtained by counting the tablets and by the Morisky-Green test: 5.0% at the start of the service and 55.0% at 3 months. The patients expressed in the satisfaction questionnaire: 90.0% very satisfied and 10.0% satisfied. Regarding the cost analysis, the initial investment was USD 1,670.44. A value of US $ 4.29 was calculated for the first interview, and the monthly cost of preparation ranged from US $ 16.02, for 7-30 weekly takings, to US $ 28.73 for more than 121 takings. Conclusion It was possible to develop and implement an SOP for the PS of SPD, with significant improvements in adherence. A high degree of patient satisfaction was observed and were obtained minimal operating costs to achieve sustainability.
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Rendrayani F, Alfian SD, Wahyudin W, Puspitasari IM. Pharmacists' Knowledge, Attitude, and Practice of Medication Therapy Management: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10122513. [PMID: 36554036 PMCID: PMC9778396 DOI: 10.3390/healthcare10122513] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Understanding pharmacists' knowledge, attitudes, and practices (KAP) and their perceptions of challenges, barriers, and facilitators towards medication therapy management (MTM) provision are vital in informing the design and implementation of successful service delivery. Thus, this review examined pharmacists' knowledge, attitudes, and practices, and their perceived challenges, barriers, and facilitators to MTM services provision, globally. A systematic search was conducted on 1-31 August 2022 to identify relevant studies on PubMed and EBSCO, supplemented with a bibliographic and a particular hand search. We focused on original research in quantitative survey form with the key concepts of "medication therapy management", "pharmacists", and "knowledge, attitude, practice". We assessed the reporting quality using the Checklist for Reporting of Survey Studies (CROSS). Results are reported narratively and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. From 237 articles identified, 17 studies met the eligibility criteria. Of the included studies, five reported that pharmacists had a considerable level of knowledge, seven suggested a positive attitude among pharmacists, and five revealed that pharmacists had been practicing some MTM elements. Factors associated with pharmacists' KAP may include age, educational degree, additional qualification, income, years of practice, practice setting, and experience in patient care service. The challenges toward MTM provision were related to the pharmacist-patient and pharmacist-physician relationship. Insufficient time, staff, compensation, and training were the barriers, while patients' willingness to participate and educational background were the facilitators of MTM provision. These findings of studies on KAP could help develop an MTM program and design an intervention to improve program effectiveness. Further research focusing on other quantitative and qualitative studies of KAP is needed to obtain a comprehensive approach to MTM provision.
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Affiliation(s)
- Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Sofa Dewi Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Wawan Wahyudin
- Ciloto Health Training Centre, Ministry of Health Republic of Indonesia, Cianjur 43253, West Java, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Correspondence:
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Resende LC, do Nascimento MMG, Barbosa MM, Rezende CDP, Pantuzza LLN, Reis EA. Instruments to Measure Patient Satisfaction with Comprehensive Medication Management Services: A Scoping Review Protocol. Pharmacy (Basel) 2022; 10:pharmacy10060151. [PMID: 36412827 PMCID: PMC9680282 DOI: 10.3390/pharmacy10060151] [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: 09/23/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
Comprehensive medication management (CMM) is the service offered within the clinical practice of pharmaceutical care, which has the objective to optimize pharmacotherapeutic outcomes. Patient satisfaction is a multidimensional construct that points to the quality of the health services offered and the degree to which the patients' expectations and needs are met. The evaluation of the level of patient satisfaction is a key indicator to support decisions and to improve the quality of the service provided. This study aims to describe the protocol for a scoping review to map the instruments to measure patient satisfaction with CMM services and compare them according to their development characteristics and the applicability of patient-reported outcome measures. The literature search will be conducted using the scoping review methodology, proposed by the Joanna Briggs Institute and the PRISMA Extension for Scoping Reviews (PRISMA-ScR) method. The results will be presented in two sessions: (1) description of the search strategy; and (2) the characteristics of the satisfaction instruments, number of items and questions related to the conceptual model, content validity, construct validity, reliability, score/interpretation, and respondent burden. This review will shed light on the available satisfaction measurement instruments, allowing existing gaps to be identified for future research.
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Lara-Júnior CR, Ahouagi AEDO, Pinto IVL, Braga DG, Andrade TR, Ramalho-de-Oliveira D, do Nascimento MMG. Implementation and Effectiveness of a Pharmacotherapeutic Follow-Up Service for People with Tuberculosis in Primary Healthcare. Int J Environ Res Public Health 2022; 19:14552. [PMID: 36361432 PMCID: PMC9655657 DOI: 10.3390/ijerph192114552] [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] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 10/28/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
Tuberculosis (TB) is a disease of great relevance, responsible for 1.5 million deaths worldwide. Therefore, actions to control TB are necessary, and pharmacists may play an important role, especially in primary healthcare (PHC), where the diagnosis and management of this infection occurs. In a large Brazilian city, pharmacotherapeutic follow-up in PHC has been offered by pharmacists to people with TB since 2018. The objective of this study was to evaluate the implementation and effectiveness of this service though a longitudinal type 1 effectiveness-implementation hybrid study. Data were collected from January 2018 to February 2020 in the pharmaceutical services system. The service indicators were described and effectiveness was evaluated using Poisson regression analysis to compare the incidence of cure among patients using and not using the service. The service was performed in 148 PHC units by 82 pharmacists. Of the total of 1076 treatments, 721 were followed up by pharmacists, and TB was cured more frequently in these cases (90.4% attended vs. 73.5% unattended). The adjusted hazard ratio of cure among patients enrolled in the pharmacotherapeutic follow-up service was 2.71 (2.04-3.61; p < 0.001). Pharmacotherapeutic follow-up for people with TB significantly increased the incidence of cure and should be encouraged.
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Affiliation(s)
- Célio Rezende Lara-Júnior
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | | | | | | | | | - Djenane Ramalho-de-Oliveira
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
| | - Mariana Martins Gonzaga do Nascimento
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
- Pharmaceutical Products Department, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, MG, Brazil
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Ji W, Xiao R, Wu B, Han S, Duan J, Meng Z, Yang M, Wang C. Evaluation of the effect of pharmaceutical care during inpatient treatment in a department of neurology: A retrospective study. Medicine (Baltimore) 2022; 101:e30984. [PMID: 36254058 PMCID: PMC9575809 DOI: 10.1097/md.0000000000030984] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Common drug-related problems during neurology inpatient treatment can affect expected health results. Some interventions need to be implemented to reduce DRPs. To explore the effect of care from clinical pharmacists during inpatient treatment. Inpatients treated in the department of neurology in the Second Hospital of Shanxi Medical University between January 1 to December 31, 2019, were retrospectively included. Those who received care from the clinical pharmacist service were assigned to the pharma-care group while the other patients were assigned to the control group. From the perspective of drugs, the two groups were compared in terms of types, antimicrobial use, and key monitoring of drug use. From the perspective of patients, the two groups were compared in terms of length of stay, hospital cost, drug cost and proportion. Propensity score matching was used to balance the baseline characteristics. A total of 2684 patients were included 554 in the pharma-care group and 2130 in the control group with a median of 9 days (range, 3-30 days) hospital stay. The groups showed no significant difference in age or gender. Length of stay, the proportion of drug cost, number of adverse events, cost of antibacterial agents, use of a single antibacterial agent, and use of three or more different antibacterial agents were similar between the groups. Medicine expenses cost more in the pharma-care group. The cost and types of intensive monitoring drugs were similar, but Defined Daily Doses were lower in the control group. While clinical pharmacists may play a positive role in the pharmaceutical care of inpatients, in this study the benefits were not obvious. This may be because of the small number of clinical pharmacists in the department of neurology with narrow coverage.
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Affiliation(s)
- Wen Ji
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Ruowei Xiao
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Bei Wu
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Sheng Han
- International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Jinju Duan
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhiqiang Meng
- Department of Pharmacy, Second Hospital of Shanxi Medical University, Taiyuan, China
| | | | - Chen Wang
- Department of Pharmacy, Shanxi Eye Hospital, Taiyuan, China
- *Correspondence: Chen Wang, Department of Pharmacy, Shanxi Eye Hospital, Taiyuan, Shanxi, China (e-mail: )
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Campbell NL, Pitts C, Corvari C, Kaehr E, Alamer K, Chand P, Nanagas K, Callahan CM, Boustani MA. Deprescribing anticholinergics in primary care older adults: Experience from two models and impact on a continuous measure of exposure. J Am Coll Clin Pharm 2022; 5:1039-1047. [PMID: 36620097 PMCID: PMC9796793 DOI: 10.1002/jac5.1682] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 01/11/2023]
Abstract
Background Deprescribing interventions delivered through the electronic medical record have not significantly reduced the use of high-risk anticholinergics in prior trials. Pharmacists have been identified as ideal practitioners to conduct deprescribing; however, little experience beyond collaborative consult models has been published. Objective To evaluate the impact of two pilot pharmacist-based advanced practice models nested within primary care. Methods Pilot studies of a collaborative clinic-based pharmacist deprescribing intervention and a telephone-based pharmacist deprescribing intervention were conducted. Patients receiving the clinic-based pharmacy model were aged 55 years and older and referred for deprescribing at a specialty clinic. Patients receiving the telephone-based pharmacy model were aged 65 years and older and called by a clinical pharmacist for deprescribing without referral. Deprescribing was defined as a discontinuation or dose reduction reported either in clinical records or through self-reporting. Results The 18 patients receiving clinic-based deprescribing had a mean age of 68 years and 78% were female. Among 24 medications deemed eligible for deprescribing, 23 (96%) were deprescribed. The clinic-based deprescribing model resulted in a 93% reduction in median annualized total standardized dose (TSD), 56% lowered their annualized exposure below a cognitive risk threshold, and 4 (17%) of medications were represcribed within 6 months. The 24 patients receiving telephone-based deprescribing had a mean age of 73 years and 92% were female. Among 24 medications deemed eligible for deprescribing, 12 (50%) were deprescribed. There was no change in the median annualized TSD, the annualized TSD was lowered below a cognitive risk threshold in 46%, and no medications were represcribed within 6 months. Few withdrawal symptoms or adverse events were reported in both groups. Conclusions Pharmacist-based deprescribing successfully reduced exposure to high-risk anticholinergics in primary care older adults, yet further work is needed to understand the impact on clinical outcomes.
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Affiliation(s)
- Noll L. Campbell
- Department of Pharmacy PracticePurdue University College of PharmacyWest LafayetteIndianaUSA
- Indiana University Center for Aging Research, Regenstrief Institute, Inc.IndianapolisIndianaUSA
- Center for Health Innovation and Implementation ScienceIndiana University School of MedicineIndianapolisIndianaUSA
- Sandra Eskenazi Center for Brain Care InnovationEskenazi HealthIndianapolisIndianaUSA
| | | | - Claire Corvari
- Department of PharmacyFranciscan HealthIndianapolisIndianaUSA
| | - Ellen Kaehr
- Sandra Eskenazi Center for Brain Care InnovationEskenazi HealthIndianapolisIndianaUSA
- Department of MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | - Khalid Alamer
- Department of Pharmacy PracticePurdue University College of PharmacyWest LafayetteIndianaUSA
| | - Parveen Chand
- Ascenscion St. Vincent North RegionEvansvilleIndianaUSA
| | - Kristine Nanagas
- Ascenscion St. Vincent North RegionEvansvilleIndianaUSA
- Department of MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | - Christopher M. Callahan
- Indiana University Center for Aging Research, Regenstrief Institute, Inc.IndianapolisIndianaUSA
- Center for Health Innovation and Implementation ScienceIndiana University School of MedicineIndianapolisIndianaUSA
- Sandra Eskenazi Center for Brain Care InnovationEskenazi HealthIndianapolisIndianaUSA
- Department of MedicineIndiana University School of MedicineIndianapolisIndianaUSA
| | - Malaz A. Boustani
- Indiana University Center for Aging Research, Regenstrief Institute, Inc.IndianapolisIndianaUSA
- Center for Health Innovation and Implementation ScienceIndiana University School of MedicineIndianapolisIndianaUSA
- Sandra Eskenazi Center for Brain Care InnovationEskenazi HealthIndianapolisIndianaUSA
- Department of MedicineIndiana University School of MedicineIndianapolisIndianaUSA
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Laborne-e-Valle MEP, Ahouagi AEDO, Braga DG, Pinto IVL, Lara-Júnior CR, Ferreira SG, Blunk PDFF, Reis AMM, Reis EA, Ramalho-de-Oliveira D, do Nascimento MMG. Assessment of Pharmaceutical Services for Smoking Cessation: An Effectiveness-Implementation Hybrid Study. Int J Environ Res Public Health 2022; 19:ijerph191912305. [PMID: 36231605 PMCID: PMC9566807 DOI: 10.3390/ijerph191912305] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 05/28/2023]
Abstract
Smoking is the main preventable cause of illness and early death worldwide. Thus, it is better to promote smoking cessation than to treat tobacco-related diseases. The objective of this study was to assess the implementation and effectiveness of smoking cessation pharmaceutical services offered in primary health care (PHC) in a large Brazilian city through a type 1 effectiveness-implementation hybrid study. The services were offered through individual or group approaches (Jan/2018-Dec/2019). The service indicators were described and the incidence of cessation in the services was evaluated. Factors associated with cessation were assessed by Poisson regression analysis. The services were offered in most PHC centers (61.2%) and by most pharmacists (81.3%). In total, 170 individual (9.7%) and 1591 group (90.3%) approaches occurred, leading to cessation in 39.4% (n = 67) and 44.8% (n = 712) of these, respectively. The use of nicotine plus antidepressants (RR = 1.30; 95%CI = 1.08-1.57; p = 0.006) and the number of sessions with pharmacists (RR = 1.21; 95%CI = 1.19-1.23; p < 0.001) were positively associated with cessation; a very high level of dependence was negatively associated (RR = 0.77; 95%CI = 0.67-0.89; p = 0.001). The smoking cessation services were effective and should be encouraged.
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Affiliation(s)
| | | | | | | | - Célio Rezende Lara-Júnior
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
- Belo Horizonte Municipality, Belo Horizonte 30130-003, Minas Gerais, Brazil
| | - Sabrina Gonçalves Ferreira
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Paula de Fátima Fernandes Blunk
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Adriano Max Moreira Reis
- Pharmaceutical Products Department, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Edna Afonso Reis
- Statistics Department, Exact Sciences Institute, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Djenane Ramalho-de-Oliveira
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
| | - Mariana Martins Gonzaga do Nascimento
- Center for Pharmaceutical Care Studies, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
- Pharmaceutical Products Department, College of Pharmacy, Federal University of Minas Gerais, Belo Horizonte 31270-901, Minas Gerais, Brazil
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Gong Y, Chen Q, Zhang Y. The Role of the Clinical Pharmacist on the Health Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD). Int J Chron Obstruct Pulmon Dis 2022; 17:1863-1870. [PMID: 35996393 PMCID: PMC9391938 DOI: 10.2147/copd.s370532] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022] Open
Abstract
Background Clinical pharmacists play a significant role in clinical practice, but their work in the clinical pathway (CP) of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) remains undefined. Methods This prospective study included patients who met the discharge criteria during hospitalization at the department of respiratory medicine of the Second Affiliated Hospital of Fujian Medical University from March to December 2017 (no pharmacists involved) and from March 2018 to January 2019 (pharmacists involved). The adverse drug reaction (ADR) reporting rate, the average DDD number of antibacterial drugs, the per capita cost of pharmaceutical services, and the benefit-cost ratio (B/C) were analyzed. Results and Discussion Eighty participants were enrolled during the traditional period and eighty-five participants during the clinical pharmacist period. The average hospital stays (9.2±0.4 vs 10.7±0.6 days, P=0.032), the total cost of hospitalization expenses (¥ 14,058±826 vs ¥ 18,765±1434, P=0.004), the total cost of drugs (¥ 5717±449 vs ¥ 8002±755, P=0.004), and cost of antimicrobial drugs (¥ 3639±379 vs ¥ 5636±641, P=0.007) were all lower in the clinical pharmacist group than in the traditional group. The B/C was 10.38 and 5.05 in the total cost of hospitalization expenses and the total cost of drugs, respectively. The clinical pharmacists’ participation was independently associated with the total cost of hospitalization expenses (β=−0.201, 95% confidence interval: −0.390, −0.055, P=0.010). What is New and Conclusion The participation of the clinical pharmacist in implementing an AECOPD CP significantly reduces patients’ hospitalization days, the total cost of hospitalization expenses, and antibiotic use and improves the B/C of AECOPD management. The clinical pharmacists’ participation was independently associated with the total hospitalization expenses.
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Affiliation(s)
- Yanqing Gong
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China.,Department of Pharmacy, Gaoxin Branch of the First Affiliated Hospital of Nanchang University, Nanchang, People's Republic of China
| | - Qiying Chen
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China
| | - Yin Zhang
- Department of Pharmacy, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, People's Republic of China
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Mauricio C, Andrea SO, Daniel SH, Pedro A. Effectiveness of a continuing education program of drugs with fiscalized substance to improve pharmacy staff competencies: A multicenter, cluster-randomized controlled trial. Pharm Pract (Granada) 2022; 20:2632. [PMID: 36733513 PMCID: PMC9851815 DOI: 10.18549/pharmpract.2022.3.2632] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/06/2022] [Indexed: 02/05/2023] Open
Abstract
Background Drugs with fiscalized substances without a correct prescription may lead to undesirable side effects. Pharmacy staff needs to improve their competencies (knowledge, skills, and attitudes) to contribute to providing ambulatory pharmacy services and minimizing medication errors. Continuing education programs (CEP) could favor access to relevant and quality information on health promotion, disease prevention, and the rational use of drugs. Objective To evaluate the effectiveness of a continuing education program to improve pharmacy staff competencies to enhance the use of drugs with fiscalized substances. Methods A multicenter, prospective, parallel-group, cluster-randomized, controlled clinical trial was conducted in drugstores and pharmacies in Colombia (ambulatory retail establishments). The intervention group (IG) received a CEP: a web-based social networking site, a virtual course, a dispensing information system, and face-to-face training. The control group (CG) received general written material on the correct use of drugs. We measured pharmacy staff's skills, attitudes, and knowledge self-reported scores, and the simulated patient technique was used to assess the participant skills and attitudes in real practice. We used a questionnaire designed for this study, which was evaluated by a group of experts and piloted and showed a Cronbach's alpha of 0.96. Results Three hundred five drugstores and pharmacies were enrolled in two groups: IG (n = 153) and CG (n = 152). Out of the 750 potential participants, 88% (n=659) agreed to participate. The pharmacy staff's skills, attitudes, and knowledge self-reported scores post-intervention were higher than baseline in both groups; however, the IG had statistically significantly higher scores than the CG. Post-intervention, the self-efficacy skills and attitudes in the IG improved by 88% (22 of 25) and in six of the seven assessed knowledge components (p<0.001). However, the dispensing criteria evaluated with simulated patient methodology showed no statistically significant differences between groups in the pharmacy staff's skills and attitudes in real practice. Conclusions Providing a continuing education program using different educational strategies improved the pharmacy staff's competencies (assessed knowledge and self-reported skills and attitudes) to enhance the use of drugs with fiscalized substances. However, there were no improvements in skills and attitudes in real practice. These findings could show that pharmacy staff needs additional and continuous training/sustainability.
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Affiliation(s)
- Ceballos Mauricio
- Research Group on Pharmaceutical Promotion and Prevention, Research Group on Pharmacy Regency Technology. University of Antioquia, Medellin, Colombia.
| | - Salazar-Ospina Andrea
- Research Group on Pharmaceutical Promotion and Prevention, Research Group on Pharmacy Regency Technology. University of Antioquia, Medellin, Colombia.
| | | | - Amariles Pedro
- Research Group on Pharmaceutical Promotion and Prevention. University of Antioquia, Medellin, Colombia; Pharmaceutical Care Research Group, Faculty of Pharmacy, University of Granada, Granada, Spain.
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Sluggett JK, Caughey GE, Air T, Moldovan M, Lang C, Martin G, Carter SR, Jackson S, Stafford AC, Wesselingh SL, Inacio MC. Provision of a comprehensive medicines review is associated with lower mortality risk for residents of aged care facilities: a retrospective cohort study. Age Ageing 2022; 51:6632479. [PMID: 35794851 PMCID: PMC9259960 DOI: 10.1093/ageing/afac149] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 05/12/2022] [Indexed: 01/05/2023] Open
Abstract
Background no studies have examined the impact of residential medication management review (RMMR, a 24-year government subsidised comprehensive medicines review program) in Australian residential aged care facilities (RACFs) on hospitalisation or mortality. Objective to examine associations between RMMR provision in the 6–12 months after RACF entry and the 12-month risk of hospitalisation and mortality among older Australians in RACFs. Design retrospective cohort study. Subjects individuals aged 65–105 years taking at least one medicine, who entered an RACF in three Australian states between 1 January 2012 and 31 December 2015 and spent at least 6 months in the RACF (n = 57,719). Methods Cox regression models estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for associations between RMMR provision and mortality. Adjusted subdistribution hazard ratios were estimated for associations between RMMR provision and next (i) emergency department (ED) presentation or unplanned hospitalisation or (ii) fall-related ED presentation or hospitalisation. Results there were 12,603 (21.8%) individuals who received an RMMR within 6–12 months of RACF entry, of whom 22.2% (95%CI 21.4–22.9) died during follow-up, compared with 23.3% (95%CI 22.9–23.7) of unexposed individuals. RMMR provision was associated with a lower risk of death due to any cause over 12-months (aHR 0.96, 95%CI 0.91–0.99), but was not associated with ED presentations or hospitalisations for unplanned events or falls. Conclusions provision of an RMMR in the 6–12 months after RACF entry is associated with a 4.4% lower mortality risk over 12-months but was not associated with changes in hospitalisations for unplanned events or falls.
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Affiliation(s)
- Janet K Sluggett
- Address correspondence to: Janet K. Sluggett, UniSA Allied Health and Human Performance, University of South Australia, GPO Box 2471, Adelaide South Australia 5001, Australia.
| | - Gillian E Caughey
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Tracy Air
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Max Moldovan
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- Biometry Hub, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Urrbrae, South Australia, Australia
| | - Catherine Lang
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Grant Martin
- Australian Association of Consultant Pharmacy, Fyshwick, Australian Capital Territory, Australia
| | - Stephen R Carter
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Shane Jackson
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Andrew C Stafford
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Steve L Wesselingh
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Maria C Inacio
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Zhang L, Ren XY, Huang HX, Huang YM, Huang L, Chen XP, Chen Y, Wang C, Xiao J. Development of the Practice of Pharmaceutical Care for Cancer Pain Management in Outpatient Clinics Using the Delphi Method. Front Pharmacol 2022; 13:840560. [PMID: 35721109 PMCID: PMC9201566 DOI: 10.3389/fphar.2022.840560] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background: There exists no broad agreement of experts on the practice of pharmaceutical care for cancer pain management in outpatient clinics. Objectives: This study aimed to use the Delphi consensus process to provide expert recommendations on the practice of cancer pain management in outpatient clinics from the point of view of pharmaceutical care in clinical practice and future clinical trials. Methods: A comprehensive literature review was conducted to draft the initial practice. In this process, 30-40 senior experts from various provinces in China were invited to rank the items of practice during the two Delphi consultations. The definitions of consensus included a combination with an average score of ≥4, the percentage of experts rating the scores at >4 points, and the coefficient of variation of the scores. Results: The expert panel comprised 18 pharmacists, 3 anesthesiologists, 6 oncologists, and 9 nurses. As a result of a comprehensive review, 33 items were initially formed. Among them, the consensus was reached for 27 items after the first Delphi round. The other six items and a total of five items for supplementation entered the second round, among which consensus was reached for eight items and three items were excluded. Expert consensus was achieved on 35 items after two rounds of consultation, which involved the collection of patient basic information, comprehensive pain assessment, breakthrough or neuropathic pain assessment, analgesic treatment evaluation, out-of-hospital follow-up, medical records, and evidence-based documents for reference. Conclusion: The final list of 35 items could be used to develop the practice of pharmaceutical care for cancer pain management in outpatient clinics in China. The practice may aid in the standardization of pharmaceutical care for pain, relieve pain to the greatest extent possible, and enhance the level of pain management in China.
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Affiliation(s)
- Lu Zhang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xia-Yang Ren
- Department of Pharmacy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hang-Xing Huang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ya-Min Huang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Ling Huang
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
| | - Xiao-Ping Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Yao Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, China
| | - Chen Wang
- Department of Pharmacy, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jian Xiao
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, China.,Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, China
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Wen Y, Zhao M, Fu S, Gu Z, Chen W, Zhao Q, Shu W, Tao X, Zhang F. Pharmaceutical services based on therapeutic care pathway for kidney transplantation from donors of infants and young children: a single-center experience. Transl Pediatr 2022; 11:834-847. [PMID: 35800269 PMCID: PMC9253932 DOI: 10.21037/tp-21-515] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 02/11/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The pharmaceutical services based on therapeutic care pathway for kidney transplantation from infants and young children (age <3 years, weight <15 kg) to pediatric recipients can detect and resolve medication-related problems. In this paper, we report our experience on pharmaceutical services based on therapeutic care pathway to evaluate the therapeutic effects and assess the feasibility of perioperative treatment protocols. METHODS We performed a retrospective study of 12 recipients who received their graft from infants and young children, between September 2011 and December 2013 at our institution. As providers of pharmaceutical services, the clinical pharmacists collected and reviewed the clinical data from all patients, including the clinical characteristics, outcome indices, and follow-up dates. A three-step-protocol of pharmaceutical services including clinician's application, pharmacist consultation, and ongoing direct pharmaceutical care and follow-up was used through the entire length of patient's admission, hospitalization, and discharge. This protocol was developed and refined based on the guidelines for transplant perioperative treatment and experiences of the clinical pharmacists to standardize the workflow, and improve the medical treatment and quality of life of patients. RESULTS There was no acute rejection, graft loss, or death in 10 recipients after transplantation, and another 2 received nephrectomy due to dysfunction. Postoperative follow-up of the patients who received the pharmaceutical services from the clinical pharmacist showed an effectiveness in managing medication-related complications, patient-related factors, and an improvement of the outcomes. CONCLUSIONS The three-step protocol of pharmaceutical services for pharmaceutical care and individual dosing regimen sponsored by pharmacists facilitated access to personalized therapies for children undergoing kidney transplantation in our hospital.
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Affiliation(s)
- Yan Wen
- Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Mengpei Zhao
- Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Shangxi Fu
- Department of Organ Transplantation, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Zhichun Gu
- Department of Pharmacy, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wansheng Chen
- Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Qing Zhao
- Department of Pharmacy, Zhabei Central Hospital of Jing'an District, Shanghai, China
| | - Wei Shu
- Department of Pharmacy, Zhabei Central Hospital of Jing'an District, Shanghai, China
| | - Xia Tao
- Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Feng Zhang
- Department of Pharmacy, Changzheng Hospital, Naval Medical University, Shanghai, China
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36
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Mendes SJ, Farisco M, Leite SN, Storpirtis S. A broad view of pharmaceutical services in multidisciplinary teams of public Primary Healthcare Centers: a mixed methods study in a large city in Brazil. Prim Health Care Res Dev 2022; 23:e31. [PMID: 35593129 DOI: 10.1017/S1463423622000160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM This study aims to describe how the pharmaceutical services are performed in Primary Healthcare Centers of the Brazilian Public Health System in a large city. Background: There is extensive international discussion about the role of pharmacists in health care teams, particularly in Primary Health Care (PHC). However, in Brazil, there is still no consensus on what services the pharmacist should perform in multidisciplinary teams in PHC. METHODS This study used mixed methods research, and it was conducted with 200 pharmacists who work in PHC Centers of the public health system in São Paulo. The study was conducted using a focus group and an online survey, and qualitative and quantitative data were obtained. FINDINGS The analysis of the data from the focus group showed two central themes: (i) pharmaceutical services go beyond medicines and (ii) the contributions of the pharmacist to a multidisciplinary team work in PHC. The survey explored 29 services provided by pharmacists, 7 of which were provided daily. It is important to emphasize that pharmacists do not differentiate the relevance attributed to services considered clinical from those that are managerial or more related to access to medicines. This is an opportunity to develop their teamwork skills. Hence, it is necessary to consolidate the professional identity of the pharmacist and to organize their work processes in a multidisciplinary team. PHC is a space that allows a wide development of pharmaceutical services.
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37
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Franco J, de Souza RN, Lima TDM, Moriel P, Visacri MB. Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review. J Oncol Pharm Pract 2022; 28:664-685. [PMID: 35019805 DOI: 10.1177/10781552211073470] [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] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We conducted this scoping review to map and summarize scientific evidence on the role of clinical pharmacists in the palliative care of adults and elderly patients with cancer. DATA SOURCES A literature search was performed in MEDLINE, PubMed Central, Embase, Web of Science, Scopus, and BVS/BIREME for studies published until November 22nd, 2020. Studies that reported work experiences adopted by clinical pharmacists in the palliative care of adults and elderly patients with cancer were included. Two independent authors performed study selection and data extraction. Any disagreements were resolved by discussion with the third and fourth authors. The pharmacist interventions identified in the included studies were described based on key domains in the DEPICT v.2. DATA SUMMARY A total of 586 records were identified, of which 14 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n = 5) and Canada (n = 5) and described the workplace of the pharmacist in clinic/ambulatory (n = 10). Clinical pharmacists performed several activities and provided services, highlighting medication review (n = 12), patient and caregivers education (n = 12), medication histories and-or medication reconciliation (n = 6). The pharmacist interventions were mostly conducted for patients/caregivers (n = 13), by one-on-one contact (n = 14), and by face-to-face (n = 13). Pharmacists were responsible mainly for change or suggestion for change in therapy (n = 12) and patient counselling (n = 12). Pharmacist interventions were well accepted by the clinical team. Overall, studies showed that pharmacists, within an interdisciplinary team, had significant impacts on measured outcomes. CONCLUSIONS In recent years, there have been advances in the role of the pharmacist in palliative care of patients with cancer and there are great opportunities in this field. They play an important role in managing cancer pain and other symptoms, as well as resolving drug related problems. We encourage more research to be carried out to strengthen this field and to benefit patients with advanced cancer with higher quality of life.
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Affiliation(s)
- Julia Franco
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Rafael N de Souza
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Tácio de M Lima
- Department of Pharmaceutical Sciences, 67825Federal Rural University of Rio de Janeiro, Seropédica, RJ, Brazil
| | - Patricia Moriel
- Faculty of Pharmaceutical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Marília B Visacri
- School of Medical Sciences, University of Campinas, Campinas, SP, Brazil
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Amin S, Polley S, DeFrates S, Finnes H, Kinsman K, MacDonald E, Dean L, DeWitt L, Harvey C, Johnston S, Leung TV, Moll EA, Neill GPO, Redic KA, Park SF. National Comprehensive Cancer Network investigational drug service consensus recommendations. Am J Health Syst Pharm 2021; 79:486-491. [PMID: 34849539 DOI: 10.1093/ajhp/zxab455] [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: 11/13/2022] Open
Abstract
In an effort to expedite the publication of articles , AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time.
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Affiliation(s)
- Sapna Amin
- Division of Pharmacy, MD Anderson Cancer Center, Houston, TX, USA
| | - Stephen Polley
- The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | - Sean DeFrates
- Department of Pharmacy, Northwestern Memorial Hospital, Chicago, IL, USA
| | - Heidi Finnes
- Department of Pharmacy, Mayo Clinic, Rochester, MN, USA
| | - Katharine Kinsman
- University of Washington Medical Center/Seattle Cancer Care Alliance, Seattle, WA, USA
| | - Elyse MacDonald
- Department of Pharmacy Services, Stanford Health Care, Palo Alto, CA, USA
| | - Latanya Dean
- Stanford Health Care, Department of Pharmacy Services, Palo Alto, CA, USA
| | - Lorri DeWitt
- Barnes Jewish Hospital Investigational Drug Service, St. Louis, MO, USA
| | | | | | | | - Emily A Moll
- Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI, USA
| | - Gerald P O' Neill
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kimberly A Redic
- Department of Pharmacy Services, Michigan Medicine, Ann Arbor, MI, USA
| | - Sharon F Park
- National Comprehensive Cancer Network, Plymouth Meeting, PA, USA
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Papineau JH, Newlon JL, Ades RS, Vernon V, Wilkinson TA, Thoma LM, Meredith AH. Evaluation of Student Pharmacists' Attitudes and Perceptions of Hormonal Contraception Prescribing in Indiana. Pharmacy (Basel) 2021; 9:185. [PMID: 34842821 DOI: 10.3390/pharmacy9040185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/05/2021] [Accepted: 11/10/2021] [Indexed: 11/30/2022] Open
Abstract
Community pharmacists’ scope of practice is expanding to include hormonal contraceptive prescribing. Prior to introducing statewide legislation, it is important to assess the perceptions of future pharmacists. A cross-sectional survey was distributed to 651 third- and fourth-year professional students enrolled at three colleges of pharmacy in Indiana. Data were collected between September and October 2019 to assess students’ attitudes about prescribing hormonal contraceptives, readiness to prescribe, perceived barriers, and desire for additional training. In total, 20.9% (n = 136) students responded. Most (89%, n = 121) believe that pharmacist-prescribed hormonal contraceptives would be beneficial to women in Indiana, and 91% (n = 124) reported interest in providing this service. Liability, personal beliefs, and religious beliefs were the most commonly cited perceived barriers. Most students felt they received adequate teaching on hormonal contraceptive methods (90%, n = 122) and hormonal contraceptive counseling (79%, n = 107); only 5% (n = 7) felt ready to provide the service at the time of survey completion. Student pharmacists in their final two years of pharmacy school are interested in prescribing hormonal contraceptives and believe that this service would be beneficial. This expansion of pharmacy practice would likely be supported by future pharmacists who feel the service could provide benefit to women seeking hormonal contraceptives in Indiana.
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Barral M, Martin J, Carre E, Janoly-Dumenil A, Ranchon F, Parat S, Rioufol C, Goutelle S, Bourguignon L, Novais T, Doh S, Malatray M, Chaudier P, Gauthier J, Pivot C, Mouchoux C, Hoegy D. How a Patient Personalised Clinical Pharmacy Programme Can Secure Therapeutic Care in an Orthogeriatric Care Pathway (5P Project)? Clin Interv Aging 2021; 16:1857-1867. [PMID: 34707352 PMCID: PMC8544550 DOI: 10.2147/cia.s325035] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023] Open
Abstract
Background A new model was developed for integrating a personalised clinical pharmacy programme (5P project) into the orthogeriatric care pathway. Objective To secure the therapeutic care of orthogeriatric patients. Design and Setting Prospective descriptive study in a multisite teaching hospital from June 2019 to January 2020. Subjects Patients aged ≥75 years admitted for hip fracture. Methods A prescription review was performed for all patients at inclusion. Other clinical pharmacy activities (additional prescription review, pharmaceutical interviews, medication reconciliation) were dedicated to “high-risk” patients. Potential medication errors (ME), either pharmaceutical interventions (PI) or unintentional discrepancies (UID), were recorded. The potential clinical impact of PI was evaluated by a pluriprofessional expert panel using a validated tool. Results In the 455 patients included, 955 potential ME were detected, that is ≥1 potential ME for 324/455 (71%) patients. In acute care, 561 PI were formulated during prescription review for 440/455 (97%) patients and 348/561 (62%) were accepted by physicians. Medication reconciliation was performed for 213 patients, 316 UID were identified. In rehabilitation units, a second prescription review was performed for 112/122 (92%) “high-risk” patients, leading to 61 PI. The clinical impact was evaluated for 519/622 (83%) PI. A consensus was obtained for 310/519 (60%) PI: 147/310 (47%) were rated as having minor clinical impact, 138/310 (45%) moderate, 22/310 (7%) major, 2/310 (0.6%) vital, and 1/310 (0.3%) null. Conclusion The 5P project secured the orthogeriatric care pathway by detecting a great number of potential ME, including PI mostly considered as having a significant clinical impact.
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Affiliation(s)
| | - Julie Martin
- Pharmacie, Hospices Civils de Lyon, Lyon, France
| | - Emmanuelle Carre
- Pharmacie Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Audrey Janoly-Dumenil
- Pharmacie Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,6-EA 4129 P2S Parcours Santé Systémique- Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
| | - Florence Ranchon
- Pharmacie Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,EA3738, CICLY Centre pour l'Innovation en cancérologie de Lyon, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
| | - Stéphanie Parat
- Pharmacie Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Catherine Rioufol
- Pharmacie Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,EA3738, CICLY Centre pour l'Innovation en cancérologie de Lyon, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
| | - Sylvain Goutelle
- Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie Hôpital Pierre Garraud, Hospices Civils de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Villeurbanne, France
| | - Laurent Bourguignon
- Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie Hôpital Pierre Garraud, Hospices Civils de Lyon, Lyon, France.,CNRS, UMR 5558, Laboratoire de Biométrie et Biologie Évolutive, Villeurbanne, France
| | - Teddy Novais
- Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.,Université Claude Bernard Lyon 1, Research on Healthcare Performance (RESHAPE), INSERM U1290, Lyon, France
| | - Sebastien Doh
- Service de Gériatrie Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Matthieu Malatray
- Service de Chirurgie Orthopédique Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Philippe Chaudier
- Service de Chirurgie Orthopédique Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Jerome Gauthier
- Service d'anesthésie et réanimation Hôpital Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Christine Pivot
- Pharmacie Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | - Christelle Mouchoux
- Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,Pharmacie Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France.,Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, Lyon, France
| | - Delphine Hoegy
- Pharmacie, Hospices Civils de Lyon, Lyon, France.,Institut des Sciences Pharmaceutiques et Biologiques, Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France.,6-EA 4129 P2S Parcours Santé Systémique- Univ Claude Bernard Lyon 1, Univ Lyon 1, Lyon, France
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Ghibu S, Juncan AM, Rus LL, Frum A, Dobrea CM, Chiş AA, Gligor FG, Morgovan C. The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:9776. [PMID: 34574698 PMCID: PMC8468206 DOI: 10.3390/ijerph18189776] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022]
Abstract
Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population's access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies' activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities' decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic.
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Affiliation(s)
- Steliana Ghibu
- Department of Pharmacology, Physiology and Pathophysiology, Faculty of Pharmacy, “Iuliu Haţieganu” University of Medicine and Pharmacy, 6A Louis Pasteur Street, 400349 Cluj-Napoca, Romania;
| | - Anca Maria Juncan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Luca Liviu Rus
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Adina Frum
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Carmen Maximiliana Dobrea
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Adriana Aurelia Chiş
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Felicia Gabriela Gligor
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
| | - Claudiu Morgovan
- Preclinical Department, Faculty of Medicine, “Lucian Blaga” University of Sibiu, 2A Lucian Blaga St., 550169 Sibiu, Romania; (A.M.J.); (L.L.R.); (A.F.); (C.M.D.); (F.G.G.); (C.M.)
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Cerbin-Koczorowska M, Przymuszala P, Zielinska-Tomczak L, Wawrzyniak E, Marciniak R. Is there a time and place for health education in chain pharmacies? Perspectives of Polish community pharmacists. Health Soc Care Community 2021; 29:e56-e66. [PMID: 33247859 DOI: 10.1111/hsc.13242] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 09/22/2020] [Accepted: 11/01/2020] [Indexed: 06/12/2023]
Abstract
Pharmaceutical practice has evolved significantly from the provision of drugs to a more patient-centred model. However, the ownership structure of pharmacies may impact the level of cognitive services provided by them. The discrepancy may be observed between pharmacists' opinions on how involved they should get and their actual involvement in health promotion and disease prevention. Given the growing market share of pharmacy chains in Europe, this study aimed to investigate the attitudes of pharmacists employed in them towards their role as health educators. It applies Ajzen's theory of planned behaviour to examine pharmacists' perspectives with the use of semi-structured in-depth interviews. A total of 10 semi-structured face-to-face interviews were conducted in May 2017 among Polish pharmacists employed in chains. Obtained results showed that respondents welcomed the possibility of providing health education, but simultaneously they seek physicians' and patients' acceptance for undertaking this task. Competency gaps and unfavourable working conditions may also decrease pharmacists' intention to serve as health educators. Including the role of a health educator to the scope of the pharmacists' practice requires a precise definition of their competencies and responsibilities together with additional training aimed to fill potential gaps in their qualifications. The pharmacists' image as a health educator should also be widely communicated to patients and other healthcare professionals.
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Affiliation(s)
| | - Piotr Przymuszala
- Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Ryszard Marciniak
- Department of Medical Education, Poznan University of Medical Sciences, Poznan, Poland
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Zuckerman AD, DeClercq J, Choi L, Cowgill N, McCarthy K, Lounsbery B, Shah R, Kehasse A, Thomas K, Sokos L, Stutsky M, Young J, Carter J, Lach M, Wise K, Thomas TT, Ortega M, Lee J, Lewis K, Dura J, Gazda NP, Gerzenshtein L, Canfield S. Adherence to self-administered biologic disease-modifying antirheumatic drugs across health-system specialty pharmacies. Am J Health Syst Pharm 2021; 78:2142-2150. [PMID: 34407179 PMCID: PMC8385960 DOI: 10.1093/ajhp/zxab342] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose Adherence to self-administered biologic disease-modifying antirheumatic drugs (bDMARDs) is necessary for therapeutic benefit. Health-system specialty pharmacies (HSSPs) have reported high adherence rates across several disease states; however, adherence outcomes in rheumatoid arthritis (RA) populations have not yet been established. Methods We performed a multisite retrospective cohort study including patients with RA and 3 or more documented dispenses of bDMARDs from January through December 2018. Pharmacy claims were used to calculate proportion of days covered (PDC). Electronic health records of patients with a PDC of <0.8 were reviewed to identify reasons for gaps in pharmacy claims (true nonadherence or appropriate treatment holds). Outcomes included median PDC across sites, reasons for treatment gaps in patients with a PDC of <0.8, and the impact of adjusting PDC when accounting for appropriate therapy gaps. Results There were 29,994 prescriptions for 3,530 patients across 20 sites. The patient cohort was mostly female (75%), with a median age of 55 years (interquartile range [IQR], 42-63 years). The original(ie, prereview) median PDC was 0.94 (IQR, 0.83-0.99). Upon review, 327 patients had no appropriate treatment gaps identified, 6 patients were excluded due to multiple unquantifiable appropriate gaps, and 420 patients had an adjustment in the PDC denominator due to appropriate treatment gaps (43 instances of days’ supply adjusted based on discordant days’ supply information between prescriptions and physician administration instructions, 11 instances of missing fills added, and 421 instances of clinically appropriate treatment gaps). The final median PDC after accounting for appropriate gaps in therapy was 0.95 (IQR, 0.87-0.99). Conclusion This large, multisite retrospective cohort study was the first to demonstrate adherence rates across several HSSPs and provided novel insights into rates and reasons for appropriate gaps in therapy.
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Affiliation(s)
| | - Josh DeClercq
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leena Choi
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Nicole Cowgill
- CHS Specialty Pharmacy Service at Atrium Health, Charlotte, NC, USA
| | - Kate McCarthy
- Specialty Pharmacy, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Rushabh Shah
- UK Specialty Pharmacy and Infusion Services, University of Kentucky, Lexington, KY, USA
| | | | - Karen Thomas
- Pharmacy Ambulatory Clinical Care Center, University of Utah Health, Salt Lake City, UT, USA
| | - Louis Sokos
- West Virginia University Health System, Morgantown, WV, USA
| | - Martha Stutsky
- Specialty and Retail Pharmacy Services, Yale New Haven Health System, New Haven, CT, USA
| | - Jennifer Young
- Specialty Pharmacy Services, Wake Forest Baptist Health, Winston-Salem, NC, USA
| | | | - Monika Lach
- University of Chicago Medicine, Chicago, IL, USA
| | - Kelly Wise
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Toby T Thomas
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jinkyu Lee
- Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Kate Lewis
- Froedtert & the Medical College of Wisconsin, Milwaukee, WI, USA
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Francisco DB, Dal Paz K, Didone TVN. Patient Factors Associated with Pharmaceutical Interventions for Inpatients at a Brazilian Teaching Hospital. Can J Hosp Pharm 2021; 74:211-218. [PMID: 34248161 DOI: 10.4212/cjhp.v74i3.3148] [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: 11/10/2022]
Abstract
Background Pharmaceutical interventions aim to correct or prevent a drug-related problem (DRP) that might lead to negative clinical consequences and increase health care costs. Objective To identify variables associated with the provision of pharmaceutical interventions by clinical pharmacists during hospitalization. Methods In this retrospective cohort study, adult inpatients of the medical ward of the University Hospital of the University of São Paulo in São Paulo, Brazil, were followed from admission to discharge. Logistic regression models were used to evaluate the association between occurrence of at least 1 pharmaceutical intervention and the following baseline characteristics: sex, age, Charlson comorbidity index, renal failure, electrolyte imbalance, hemoglobin, platelet count, and use of a nasoenteric tube, as well as the number, second-level Anatomical Therapeutic Chemical (ATC) code, and administration route of prescribed medications. Results A total of 148 patients were included in the study, of whom 75 (50.7%) were men. The mean age was 62.8 (95% confidence interval [CI] 59.9-65.8) years, and the mean length of the hospital stay was 10.7 (95% CI 8.4-13.1) days. Analgesics (ATC code N02), the most common type of medication, were prescribed to 144 (97.3%) of the patients. Pharmaceutical interventions were performed for only 49 (33.1%) of the patients. One out of every 4 of these interventions was intended to obtain information not provided in the prescription, to allow the prescription to be completed and dispensing to proceed. According to the multivariate analysis, the odds ratio (OR) of occurrence of at least 1 pharmaceutical intervention increased for patients with electrolyte imbalance (OR 2.68, 95% CI 1.09-6.63; p = 0.033), patients using 5 to 8 medications (OR 8.73, 95% CI 1.07-71.36; p = 0.043), patients using 9 or more medications (OR 10.39, 95% CI 1.28-84.05; p = 0.028), and patients using at least 1 systemic antibacterial (ATC code J01; OR 2.76, 95% CI 1.30-5.84; p = 0.008). Conclusions The findings of this study could allow the identification, at the time of admission and possibly before the occurrence of a DRP, of patients at higher risk of requiring a pharmaceutical intervention later during their hospital stay. To optimize patient care, clinical pharmacists should closely follow inpatients with electrolyte imbalance, polypharmacy, and/or use of systemic antibacterials.
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Affiliation(s)
- Debora Bernardes Francisco
- , BPharm, is a Resident with the Clinical Pharmacy Residency Program, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Karine Dal Paz
- , BPharm, MSc, is a Pharmacist and Head of the Clinical Pharmacy Service, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Thiago Vinicius Nadaleto Didone
- , BPharm, MSc, is a PhD student with the Department of Clinical and Experimental Oncology, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil
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Islam N, Rafferty A, Michalets EL. Impact of a Meds to Beds Program on Re-presentation Rates in Medical and Surgical Patients at a Community Hospital. HCA Healthc J Med 2021; 2:215-222. [PMID: 37427004 PMCID: PMC10324832 DOI: 10.36518/2689-0216.1174] [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] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background While the benefits of bundled transitions of care services are understood, only a limited number of studies have analyzed the impact of a stand-alone bedside medication delivery service on repeat hospital encounters, and those published have reported mixed results. Methods A retrospective analysis was conducted in medical and surgical patients at a large community hospital. Adult patients discharged from either the cardiology, medicine, pulmonary, orthopedic/spine surgery, or women's surgery unit and prescribed at least one new prescription upon discharge to home between September 2015 and March 2018 were included. The primary objective was to compare unplanned 30-day re-presentation rates in patients who received Meds to Beds services to those who did not. The secondary objective was to compare 30-day re-presentation rates by patient type. Re-presentation was defined as an inpatient admission, emergency department visit, or observational encounter for any diagnosis within the six-hospital health system. Chi-square and logistic regression tests were used to assess statistical significance, and the study was powered to detect a difference in the primary objective. Results A total of 45,546 patients were included. Of those, 4,286 received Meds to Beds services (Intervention Group, IG) while 41,260 patients did not (Control Group, CG). Overall 30-day re-presentation rate was not statistically different (15% IG versus 15.3% CG, OR 1.0; 95% CI 0.9-1.1; p = 0.76). However, the 30-day re-presentation rate was statistically lower for women's surgery (12.8% IG versus 15.6%, CG p = 0.03, NNT 36) and orthopedics/spine surgery patients (7.3% IG versus 10.2% CG, p < 0.01, NNT 34). Conclusions While there was no statistically significant differences in overall 30-day re-presentation rates, there were significant reductions in two surgical patient subgroups. Avoidance of re-presentations and generation of prescription revenue outweighed program costs.
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Barrett R, Aldamkhi H. An Evaluation of the Knowledge and Perceptions of Pharmacy Staff and Pre-Registration Students of E-Cigarettes Use: A Systematic Review. Tob Use Insights 2021; 14:1179173X211016867. [PMID: 34188579 PMCID: PMC8209790 DOI: 10.1177/1179173x211016867] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 04/17/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pharmacy staff are a trusted source of advice on the safe and appropriate use of medicines and devices. Retail pharmacies deliver smoking cessation services and sell e-cigarettes in the UK. This review asks 'what knowledge, experience and ability do staff have to support e-cigarette users to quit smoking'. METHODS A systematic literature search was undertaken drawn on predefined eligibility criteria and a comprehensive search strategy following the PRISMA guideline. Eligible papers reported survey-research published in English from 2015 to 2020. PubMed, Google Scholar, OVID, EMBASE and MEDLINE Databases were searched. No restrictions on study design or language were applied. Two reviewers independently screened for inclusion/exclusion and then extracted the relevant information from the articles for synthesis. RESULTS Of 12 potentially eligible full-text studies, 1 was a duplicate, 7 were excluded as per eligibility criteria. Four papers were finally included in this literature review. Two studies indicated that pharmacy staff are less confident in giving advice on e-cigarette use. Knowledge on the adverse effects of e-cigarettes compared to traditional smoking cessation aids remain unclear. In one study, 42% of community pharmacists did not believe that e-cigarettes could be used for smoking cessation. Three studies identified need for specific regulations and professional support. The overall certainty of the evidence is 'low' or 'very low', with moderate levels of bias. CONCLUSION Pharmacists may be well placed to implement e-cigarette smoking cessation interventions, but most practitioners lacked knowledge and ability to support these customers citing unclear risk of harm. Pharmacists felt secure in recommending traditional cessation tools. Further regulation, guidelines and training is needed. Findings may be less generalizable in countries where e-cigarettes are banned. Their extent of knowledge, experience and ability to support users of e-cigarettes within their community to quit smoking is lacking.
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Affiliation(s)
- Ravina Barrett
- School of Pharmacy and Biomolecular Sciences, Cockcroft Building, University of Brighton, UK
- Visiting Researcher in Pharmacy Practice, School of Pharmacy and Biomedical Sciences, University of Portsmouth, UK
| | - Hajar Aldamkhi
- School of Pharmacy and Biomolecular Sciences, Cockcroft Building, University of Brighton, UK
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Barbosa MM, Moreira TA, Nascimento RC, Nascimento MM, Acurcio FA, Godman B, Guerra AA, Alvares-Teodoro J. Access to medicines in the Brazilian Unified Health System's primary health care: assessment of a public policy. J Comp Eff Res 2021; 10:869-879. [PMID: 34032143 DOI: 10.2217/cer-2021-0026] [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: 11/21/2022] Open
Abstract
In 2008, the Programa Rede Farmácia de Minas (RFM, literally translated: 'Minas Gerais Pharmacy Network' program) was created as a strategy to expand access to medicines. Aim: Measure access to medicines in public pharmacies through comparison between municipalities that joined or not the RFM. Materials & methods: Cross-sectional, evaluative study, gathering information from a representative sample of the municipalities in Minas Gerais between July 2014 and May 2015. The Poisson regression results were obtained by calculating the prevalence ratios. Results: Adequate access to medicines in Minas Gerais was 69.9%, being 75.8% in municipalities with and 69.2% without the RFM. The municipalities with the RFM showed statistically higher percentages in the Availability, Adequacy/Accommodation, and Acceptability dimensions. Conclusion: RFM appears an efficient strategy for promoting access to medicines.
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Affiliation(s)
- Mariana M Barbosa
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Thais A Moreira
- School of Medicine, Postgraduate Program in Public Health Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Renata Crm Nascimento
- School of Pharmacy, Department of Pharmacy, Federal University of Ouro Preto, Ouro Preto, Brazil
| | - Mariana Mg Nascimento
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Francisco A Acurcio
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Brian Godman
- Strathclyde Institute of Pharmacy & Biomedical Sciences, University of Strathclyde, Glasgow, G4 0RE, UK.,Health Economics Centre, University of Liverpool Management School, Liverpool, UK.,Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, SE-141 86, Stockholm, Sweden.,School of Pharmacy, Sefako Makgatho Health Sciences University, Garankuwa, Pretoria, South Africa
| | - Augusto A Guerra
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Juliana Alvares-Teodoro
- School of Pharmacy, Postgraduate Program in Medicines & Pharmaceutical Services, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Ebbens MM, Gombert-Handoko KB, Wesselink EJ, van den Bemt PMLA. The Effect of Medication Reconciliation via a Patient Portal on Medication Discrepancies: A Randomized Noninferiority Study. J Am Med Dir Assoc 2021; 22:2553-2558.e1. [PMID: 33905738 DOI: 10.1016/j.jamda.2021.03.022] [Citation(s) in RCA: 3] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/08/2021] [Accepted: 03/20/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Medication reconciliation has become standard care to prevent medication transfer errors. However, this process is time-consuming but could be more efficient when patients are engaged in medication reconciliation via a patient portal. OBJECTIVES To explore whether medication reconciliation by the patient via a patient portal is noninferior to medication reconciliation by a pharmacy technician. DESIGN (INCLUDING INTERVENTION) Open randomized controlled noninferiority trial. Patients were randomized between medication reconciliation via a patient portal (intervention) or medication reconciliation by a pharmacy technician at the preoperative screening (usual care). SETTING AND PARTICIPANTS Patients scheduled for elective surgery using at least 1 chronic medication were included. MEASURES The primary endpoint was the number of medication discrepancies compared to the electronic nationwide medication record system (NMRS). For the secondary endpoint, time investment of the pharmacy technician for the medication reconciliation interview and patient satisfaction were studied. Noninferiority was analyzed with an independent t test, and the margin was set at 20%. RESULTS A total of 499 patients were included. The patient portal group contained 241 patients; the usual care group contained 258 patients. The number of medication discrepancies was 2.6 ± 2.5 in the patient portal group and 2.8 ± 2.7 in the usual care group. This was not statistically different and within the predefined noninferiority margin. Patients were satisfied with the use of the patient portal tool. Also, the use of the portal can save on average 6.8 minutes per patient compared with usual care. CONCLUSIONS AND IMPLICATIONS Medication reconciliation using a patient portal is noninferior to medication reconciliation by a pharmacy technician with respect to medication discrepancies, and saves time in the medication reconciliation process. Future studies should focus on identifying patient characteristics for successful implementation of patient portal medication reconciliation.
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Affiliation(s)
- Marieke M Ebbens
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands; Department of Hospital Pharmacy, St Jansdal Hospital, Harderwijk, the Netherlands; Department of Hospital Pharmacy, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands.
| | - Kim B Gombert-Handoko
- Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands
| | - Elsbeth J Wesselink
- Department of Clinical Pharmacy, Zaans Medical Centre, Zaandam, the Netherlands
| | - Patricia M L A van den Bemt
- Department of Hospital Pharmacy, Erasmus MC, Erasmus University Medical Center, Rotterdam, the Netherlands; Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Feemster AA, Augustino M, Duncan R, Khandoobhai A, Rowcliffe M. Use of failure modes and effects analysis to mitigate potential risks prior to implementation of an intravenous compounding technology. Am J Health Syst Pharm 2021; 78:1323-1329. [PMID: 33889932 PMCID: PMC8083204 DOI: 10.1093/ajhp/zxab179] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The purpose of this study was to identify potential failure points in a new chemotherapy preparation technology and to implement changes that prevent or minimize the consequences of those failures before they occur using the failure modes and effects analysis (FMEA) approach. Methods An FMEA was conducted by a team of medication safety pharmacists, oncology pharmacists and technicians, leadership from informatics, investigational drug, and medication safety services, and representatives from the technology vendor. Failure modes were scored using both Risk Priority Number (RPN) and Risk Hazard Index (RHI) scores. Results The chemotherapy preparation workflow was defined in a 41-step process with 16 failure modes. The RPN and RHI scores were identical for each failure mode because all failure modes were considered detectable. Five failure modes, all attributable to user error, were deemed to pose the highest risk. Mitigation strategies and system changes were identified for 2 failure modes, with subsequent system modifications resulting in reduced risk. Conclusion The FMEA was a useful tool for risk mitigation and workflow optimization prior to implementation of an intravenous compounding technology. The process of conducting this study served as a collaborative and proactive approach to reducing the potential for medication errors upon adoption of new technology into the chemotherapy preparation process.
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Affiliation(s)
- Agnes Ann Feemster
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD.,Department of Pharmacy Practice, School of Pharmacy, University of Maryland, Baltimore, MD, USA
| | | | - Rosemary Duncan
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD
| | | | - Meghan Rowcliffe
- Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD
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Machado FLDS, Dos Santos DMDSS, Lopes LC. Strategies to Approach Medicines Litigation: An Action Research Study in Brazil. Front Pharmacol 2021; 12:612426. [PMID: 33967753 PMCID: PMC8100662 DOI: 10.3389/fphar.2021.612426] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/16/2021] [Indexed: 11/15/2022] Open
Abstract
Background: In the last decades, litigation has been increasingly used to access medicines in Brazil. This phenomenon has led to the development of diverse strategies to reduce its negative impact on the organization of pharmaceutical services. In spite of that, managers still face difficulties dealing with lawsuits. Objective: This study aims to report the planning and implementation of strategies to approach medicines litigation in a municipality located in the southeast region of Brazil. Methods: Mixed methods were employed through an action research cycle. A network coordination team included researchers from university and municipal managers. The scenario analysis comprised the characterization of pharmaceutical services and the profile of medicines lawsuits. Afterward, strategies were planned to deal with the central problem identified. The action plan involved educational outreach visits and distribution of printed materials for health professionals, evaluated through opinion survey. Group conversations were conducted with the users of the public health system, followed by thematic analysis of reports. Results: The characterization of pharmaceutical services in the municipality revealed that treatments supplied were in accordance with the National Medicines Policy. In addition, a sector was implemented to attend demands for non-incorporated medicines. In spite of the services available, the characterization of lawsuits indicated that the main claimants were users of the public health system, requiring non-incorporated medicines, with therapeutic alternatives available. Thus, educational outreach visits were held in 14 health units (23 physicians in total). Everyone who answered the evaluation declared that they were very satisfied with the approach. Group conversations with the users of the health system reached 227 participants in total. In regard to users’ perception about pharmaceutical services, thematic analysis of reports identified three main categories including aspects related to medicines provided, users assisted, and quality of service. Conclusion: The study described the first cycle of an action research project to develop strategies to approach medicines litigation at the municipal level. The application of educational outreach visits for health professionals and group conversations with health system users is a promising approach to improve access to information about pharmaceutical services in Brazil.
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Affiliation(s)
| | | | - Luciane Cruz Lopes
- Pharmaceutical Sciences Graduate Course, University of Sorocaba, UNISO, Sorocaba, Brazil
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