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BACKGROUND: Medication reviews aim to support patients who take medicines, and they are often led by pharmacists. There are different types of medication reviews undertaken in various settings. Previous research undertaken in 2015 found mixed evidence that medication reviews in community settings improve clinical outcomes, but further work needs to be undertaken to establish their impact on patient-orientated and economic outcomes. AIM: This scoping review aims to explore the extent and range of systematic reviews of medication reviews conducted by pharmacists, the nature of the intervention, the evidence for effectiveness, and reported research gaps. METHOD: Systematic reviews were included irrespective of participants, settings or outcomes and were excluded if pharmacists did not lead the delivery of the included interventions. Data extracted included the design of included studies, population, setting, main results, description of interventions, and future research recommendations. RESULTS: We identified twenty-four systematic reviews that reported that medication review interventions were diverse, and their nature was often poorly described. Two high-quality reviews reported that there was evidence of no effect on mortality; of these one reported an improvement in medicines-related problems (all studies reported an increase of identified problems), and another a reduction in hospital readmissions (Risk ratio 0.93 [95% CI 0.89, 0.98]). Other lower-quality reviews reported evidence supporting intervention effectiveness for some clinical outcomes (odds ratio: achieving diabetes control = 3.11 95% prediction intervals (PI), 1.48-6.52, achieving blood pressure target = 2.73, 95% PI, 1.05-7.083.50). CONCLUSION: There is mixed evidence of effectiveness for medication reviews across settings and patient populations. There is limited data about the implementation of medication reviews, therefore is difficult to ascertain which components of the intervention lead to improved outcomes. As medication reviews are widely implemented in practice, further research should explore the nature of the interventions, linking the components of these to outcomes.
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Farmacéuticos , Humanos , Revisiones Sistemáticas como AsuntoRESUMEN
To evaluate the extent to which pharmacies in Hetauda Sub-metropolitan City, Nepal adhere to the recommended practices outlined in the good pharmacy practice guidelines formulated by International Pharmaceutical Federation and draft developed by Nepal Pharmacy Council. Good Pharmacy Practice evaluates the safety, effectiveness, availability, and accessibility of medicines, ensuring their correct usage which is essential component of community pharmacies. Data was collected by visiting community pharmacies throughout Hetauda sub-metropolitan city. The questionnaire includes 38 questions under 9 sections: premises, personnel, quality policy, services, documentation, procurement, storage, prescription handling, and dispensing. Frequencies and percentages were used to represent all categorical variables, while mean ± standard deviation (SD) was used to represent continuous variables. To determine relationships between categorical data, the Pearson Chi-square test (χ²) was utilized with a significance level set at P < .05. Using SPSS Version 23, the quantitative data were analyzed. The findings indicated an overall compliance rate of 56.21% with the GPP indicators. The lowest adherence was observed in relation to the quality policy (11.02%), whereas the highest was obtained on the procurement process (86.6%). With regard to the qualifications of the pharmacy in charge, only 16.3% of the pharmacies had a pharmacist holding a bachelor's degree, while 32.6% employed an assistant pharmacist with a diploma degree. A significant association was found between the qualification of pharmacy in charge with availability of computer (P = .010), safe and effective procurement (P = .036), keeping narcotics drugs in lock and key system (P = .002) and maintaining records of narcotics (P = .020). Our findings reveal that community pharmacists in Hetauda Sub-metropolitan city, Nepal do not meet the standards set by International Pharmaceutical Federation and the Good Pharmacy Practice guidelines formulated by the Nepal Pharmacy Council.
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Servicios Comunitarios de Farmacia , Humanos , Estudios Transversales , Nepal , Servicios Comunitarios de Farmacia/normas , Adhesión a Directriz , Encuestas y Cuestionarios , Farmacias/normas , Masculino , Femenino , Farmacéuticos/estadística & datos numéricosRESUMEN
BACKGROUND: Antibiotics are widely used in the pediatric population, and their inappropriate use contributes to antibiotic resistance, which is a growing concern in developing countries. Therefore, this national cross-sectional study aimed to assess community pharmacists' knowledge, attitudes and practices regarding appropriate antibiotic use and dosing in pediatric patients and to explore the barriers to such use in Palestine. METHODS: A questionnaire-based survey was conducted among community pharmacists on the West Bank, Palestine, from September 2022 to March 2023. The survey assessed the pharmacists' sociodemographic characteristics; knowledge, practices, and attitudes toward antibiotic use; and understanding of antibiotic dosing. The data were analyzed using descriptive statistics, and the factors affecting pharmacists' knowledge were evaluated. RESULTS: The study included 301 community pharmacists, with an average age of 30.06 years, who were primarily female (75.1%). The majority of the pharmacists (80.1%) correctly believed that antibiotics are effective against bacterial infections. However, 18.3% believed that antibiotics are effective against viruses. While 61.8% knew that antibiotics kill germs, 32.0% were unaware that not all antibiotics require refrigeration. Furthermore, 67.8% were aware that antibiotics do not speed up recovery from diarrhea. Over 99% of the participants recognized that antibiotic resistance developed due to various resistant mechanisms. The majority (78.7%) believed that each infection needed a different antibiotic. Pharmacists demonstrated reasonable knowledge of antibiotic dosing in case scenarios. Knowledge was positively correlated with years of experience (P = 0.001). CONCLUSIONS: This study revealed that community pharmacy professionals have a good understanding of antibiotic usage in pediatric patients. The findings suggest that professional expertise and quality training improve healthcare services. However, the results may not be universally applicable, as identifying knowledge gaps is necessary to help with the development of focused interventions. Therefore, ongoing educational initiatives, awareness campaigns and antibiotic stewardship programs are recommended.
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Antibacterianos , Conocimientos, Actitudes y Práctica en Salud , Farmacéuticos , Humanos , Femenino , Masculino , Antibacterianos/uso terapéutico , Estudios Transversales , Adulto , Medio Oriente , Encuestas y Cuestionarios , Farmacorresistencia Microbiana , Pautas de la Práctica Farmacéutica , Niño , Servicios Comunitarios de Farmacia , Persona de Mediana Edad , Farmacorresistencia BacterianaRESUMEN
BACKGROUND: Patients' satisfaction with their treatment directly impacts the control of their diabetes. Quality of life is crucial for patients with diabetes mellitus to maintain long-term health and minimize complications. The current study aimed to evaluate the impact of diabetes education on quality of life (QoL) and treatment satisfaction of patients with type 2 diabetes mellitus. METHODS: The current study was a randomized controlled trial. Patients with type 2 diabetes who were attending the diabetes clinic for 1 year were recruited. The overall sample in this study was 364 participants; 182 controls 182 cases. The interventional and control group participants were assigned randomly by simple random sampling technique. Controls were managed per usual care while cases were managed per usual care plus education done by the researcher. Pre-structured standardized questionnaires were used to collect the data. Data were processed and analyzed by using SPSS; version 28. RESULTS: More than three-fourth of the participants; 76.4% were females. The average (±SD) age of the cases was 54.5 (±10) years, while was 56 (±9.8) years for controls. The overall median (IQR) years of DM diagnosis for all participants was 8 (4-14) years. The results showed a statistically significant difference between the mean satisfaction score from baseline to 12 months in the cases compared the controls (P < .001). Furthermore, there are statistically insignificant differences between the changes of mean overall QoL score from baseline to 12 months among the 2 groups. CONCLUSION: The education provided improved self-reported treatment-satisfaction among individuals with diabetes .A statistically insignificant differences in QoL between the 2 groups compared to baseline have been shown at the study end.The trial registration number is PACTR202311766174946 which was registered by pan African clinical trials registry, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26928.
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Diabetes Mellitus Tipo 2 , Educación del Paciente como Asunto , Satisfacción del Paciente , Farmacéuticos , Calidad de Vida , Humanos , Diabetes Mellitus Tipo 2/terapia , Femenino , Masculino , Persona de Mediana Edad , Sudán , Educación del Paciente como Asunto/métodos , Adulto , Método Doble Ciego , Encuestas y Cuestionarios , AncianoRESUMEN
OBJECTIVE: Diabetes-related care makes up approximately 24% of outpatient clinic visits. Therefore, confidence and understanding of diabetes management is necessary for family medicine residents. METHODS: We developed a combined lecture and simulation lab curriculum utilizing a registered nurse and pharmacist to deliver education to 20 family medicine learners. Pre and post surveys of the educational material were completed in 2 sections including one gauging medical knowledge and a second part gauging level of comfort. RESULTS: Of the learners who participated, fourteen completed the pre-post surveys. Most (53%) respondents improved their scores, while 20% scored the same 27% scored worse. The overall average score increased 57% to 70% and improvement was statistically significant (P < .05). All learners improved confidence by at least 1 point. CONCLUSION: An interprofessional team utilizing a lecture curriculum focusing on providing education on effective prescribing, medication safety profiles, and resource availability, showed improvement in confidence but mixed knowledge benefit. Further modifications to the curriculum may yield further educational gains.
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Curriculum , Diabetes Mellitus , Medicina Familiar y Comunitaria , Internado y Residencia , Humanos , Medicina Familiar y Comunitaria/educación , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/terapia , Relaciones Interprofesionales , Grupo de Atención al Paciente , Competencia Clínica , Administración del Tratamiento Farmacológico/educación , Farmacéuticos , Educación InterprofesionalRESUMEN
Excessive and incorrect use of antibiotics contributes to the rise of antimicrobial resistance (AMR). Given that pharmacists act as final checkpoint before antibiotics is handled over to patients, they play a crucial role in promoting proper antibiotic use and ensuring treatment adherence. However, there is often a gap between the patients' needs and perceptions, and what the pharmacists provide. Improving pharmacists' training is essential for enhancing patient-centered care. The aim of this research was to evaluate the suitability of academic detailing (AD) for improving Norwegian pharmacists' knowledge and practice on adherence promoting counseling of antibiotic patients. Key insights from prior qualitative research regarding community pharmacists' position in promoting optimized antibiotic use were incorporated in a tailored AD program. The AD's suitability was evaluated using the validated "Provider Satisfaction with Academic Detailing" (PSAD) and "Detailer Assessment of Visit Effectiveness" (DAVE) instruments. Additionally, participants preferred knowledge updates method were assessed. Eighty-one of 86 visits completed PSAD (94% response rate). Satisfaction summary score for PSAD was 40.03 (of maximum 45) and scale summary score for DAVE 12.45 (of maximum 15). One-sample t-test (P < .001) indicated preference for AD over other knowledge update methods. This study confirmed that AD is a successful knowledge updating tool for improving adherence promoting counseling among Norwegian pharmacists. Future research should align practice change intentions with actions post-AD and evaluate patient impact.
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Antibacterianos , Consejo , Farmacéuticos , Humanos , Noruega , Masculino , Antibacterianos/uso terapéutico , Antibacterianos/administración & dosificación , Femenino , Adulto , Persona de Mediana Edad , Rol Profesional , Conocimientos, Actitudes y Práctica en Salud , Encuestas y CuestionariosRESUMEN
BACKGROUND: Direct oral anticoagulants (DOACs) have complex dosing regimens and are often incorrectly prescribed. We evaluated a nationwide DOAC population management dashboard rollout whose purpose includes pharmacist review and correction of off-label dosing prescriptions. METHODS AND RESULTS: Using data from Veterans Health Affairs, we identified all patients prescribed DOACs for atrial fibrillation or venous thromboembolism between August 2015 and December 2019. Sites were grouped on the basis of the timing of moderate-high usage of the DOAC population management tool dashboard. Effectiveness was defined as the monthly rate of off-label DOAC prescribing and the rate of clinical adverse events (bleeding, composite of stroke or venous thromboembolism). Implementation was evaluated as the percentage of off-label DOAC prescriptions changed within 7 days. Among the 128 652 patients receiving DOAC therapy at 123 centers, between 6.9% and 8.6% had off-label DOAC prescriptions. Adoption of the DOAC population management tool dashboard before July 2018 was associated with a decline in off-label dosing prescriptions (8.7%-7.6%). Only 1 group demonstrated a significant reduction in monthly rates of bleeding following implementation. All sites experienced a reduction in the composite of venous thromboembolism or stroke following dashboard adoption. There was no difference in the implementation outcome of DOAC prescription change within 7 days in any of the adoption groups. CONCLUSIONS: Early adoption of the DOAC population management tool dashboard was associated with decreased rates of off-label DOAC dosing prescription and reduced bleeding. Following adoption of the DOAC population management tool dashboard, all sites experienced reductions in venous thromboembolism and stroke events.
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Fibrilación Atrial , Uso Fuera de lo Indicado , Farmacéuticos , Tromboembolia Venosa , Humanos , Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/complicaciones , Estados Unidos , Tromboembolia Venosa/tratamiento farmacológico , Tromboembolia Venosa/prevención & control , Tromboembolia Venosa/epidemiología , Femenino , Masculino , Anciano , Hemorragia/inducido químicamente , Hemorragia/epidemiología , Accidente Cerebrovascular/prevención & control , Accidente Cerebrovascular/epidemiología , Administración Oral , Anticoagulantes/efectos adversos , Anticoagulantes/administración & dosificación , Anticoagulantes/uso terapéutico , Inhibidores del Factor Xa/efectos adversos , Inhibidores del Factor Xa/uso terapéutico , Inhibidores del Factor Xa/administración & dosificación , Pautas de la Práctica en Medicina/normas , Prescripciones de Medicamentos/estadística & datos numéricos , United States Department of Veterans AffairsRESUMEN
INTRODUCTION: The disorder known as burnout develops as a reaction to the damaging impacts of workplace stress. When occupational stress is poorly managed, it can result in burnout, which has a detrimental impact on workers' performance and emotional and physical well-being. Those who work in the helping profession are the most vulnerable. Pharmacy practitioners are among the most vulnerable groups in the healthcare industry.
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Agotamiento Profesional , Farmacéuticos , Lugar de Trabajo , Humanos , Agotamiento Profesional/psicología , Agotamiento Profesional/epidemiología , Proyectos Piloto , Farmacéuticos/psicología , Lugar de Trabajo/psicología , Masculino , Femenino , Adulto , Persona de Mediana Edad , Encuestas y Cuestionarios , Estrés Laboral/psicología , Condiciones de TrabajoRESUMEN
OBJECTIVE: This study aimed to evaluate pharmacists' attitude and willingness to provide extended community pharmacy services (ECPS), the barriers to ECPS, and the factors associated with attitude and willingness to implement ECPS. METHODS: In this cross-sectional study, a validated, self-administered questionnaire was distributed online to community pharmacists across the United Arab Emirates between September and November 2023. In addition to sociodemographic data, the questionnaire evaluated attitudes toward ECPS, willingness to provide ECPS, and barriers to its implementation. Binary logistic regression was conducted to explore the factors associated with attitude and willingness to implement ECPS. RESULTS: The study included 409 pharmacists. Over half of the participants reported below the median attitude (58.7%) and willingness (59.4%) scores. Female pharmacists had a lower attitude towards ECPS (OR = 0.425, 95%CI: 0.242-0.747). Higher number of daily prescriptions (OR = 1.066, 95%CI: 1.029-1.105) and being a Pharm D graduate (OR = 2.664, 95%CI: 1.439-4.932) were associated with higher willingness to provide ECPS, while an increased number of employed pharmacists (OR = 0.518, 95%CI: 0.397-0.676) was associated with a lower willingness (OR = 0.049, 95%CI: 0.004-0.660). Patients' preoccupation (76.5%), lack of specific training (76.3%), lack of clinical problem-solving skills (74.6%) and lack of a private consultation room (74.6%) were the most commonly reported barriers to ECPS. CONCLUSIONS: Community pharmacists demonstrated unsatisfactory levels of attitude and willingness towards ECPS provision. Therefore, providing training and education programs that enhance pharmacists' perception and willingness to implement ECPS and emphasize improving clinical problem-solving skills, as well as setting up specific private consultation rooms, is deemed necessary. Female pharmacy graduates, pharmacists dispensing fewer daily prescriptions, and those working with a higher number of employed pharmacists should be specifically targeted when implementing these strategies.
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Actitud del Personal de Salud , Servicios Comunitarios de Farmacia , Farmacéuticos , Humanos , Farmacéuticos/psicología , Femenino , Masculino , Adulto , Estudios Transversales , Encuestas y Cuestionarios , Persona de Mediana Edad , Emiratos Árabes UnidosRESUMEN
BACKGROUND: Pre-exposure prophylaxis (PrEP) uptake remains low among people who could benefit, some of whom may prefer alternatives to oral PrEP, such as long-acting injectable pre-exposure prophylaxis (LAI-PrEP). We evaluated the potential for LAI-PrEP provision in pharmacies through a mixed methods study of pharmacists in California, where Senate Bill 159 enables pharmacists to independently provide oral PrEP. METHODS: In 2022-2023, we conducted an online cross-sectional survey of California pharmacists and pharmacy students (n = 919) and in-depth interviews with pharmacists (n = 30), both of which included modules assessing attitudes about PrEP provision. Using log-binomial regression, we estimated prevalence ratios (PRs) comparing survey participants' willingness to provide LAI-PrEP by pharmacy- and individual-level characteristics. Qualitative interview data were analyzed using Rapid Qualitative Analysis to identify factors that may affect pharmacists' provision of LAI-PrEP. RESULTS: Half of the survey participants (53%) indicated that they would be willing to administer LAI-PrEP using gluteal injection in their pharmacy. Willingness was higher among participants who worked in pharmacies that provided vaccinations or other injections (56% vs. 46%; PR: 1.2; 95% confidence interval: 1.0-1.4) and/or oral PrEP under Senate Bill 159 (65% vs. 51%; PR: 1.3; 95% confidence interval: 1.1-1.5) than among participants whose pharmacies did not. Interviewed participants reported barriers to LAI-PrEP provision, including the need for increased training and staffing, a private room for gluteal injections, better medication access, and payment for services. CONCLUSION: Pharmacies offer a promising setting for increased LAI-PrEP access. However, pharmacists may require additional training, resources, and policy changes to make implementation feasible.
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Infecciones por VIH , Farmacéuticos , Profilaxis Pre-Exposición , Humanos , California , Profilaxis Pre-Exposición/métodos , Masculino , Femenino , Infecciones por VIH/prevención & control , Estudios Transversales , Adulto , Fármacos Anti-VIH/administración & dosificación , Fármacos Anti-VIH/uso terapéutico , Persona de Mediana Edad , Encuestas y Cuestionarios , Actitud del Personal de Salud , Inyecciones , Adulto JovenRESUMEN
OBJECTIVE: The COVID-19 pandemic resulted in health care workers experiencing temporary or permanent changes in employment due to layoffs, quits, and postpandemic increased job demand. Analyzing the association of the COVID-19 pandemic with employment changes and results of changes for practicing pharmacists and understanding the associations with demographic and work-related factors could inform practice, policy, and educational programs. This study aimed to explore the frequency, characteristics, and results of employment status changes (ESCs) experienced by pharmacists practicing pharmacy in March 2020 (ie, the start of the COVID-19 pandemic). METHODS: A descriptive, cross-sectional survey research design was used to collect data from a random sample of 93,990 licensed pharmacists in the United States. The study team developed an online survey questionnaire designed to assess the impacts of the COVID-19 pandemic on pharmacists' work and work-life. The survey items used for this study related to ESCs, work-life characteristics, work characteristics in March 2020 and 2022, and demographic variables. A total of 4947 usable responses were received between November 2022 and January 2023. RESULTS: Overall, 36.4% of respondents reported experiencing an ESC and approximately 70% of those reporting an ESC reported experiencing just 1 ECS. Overall, 39.5% of respondents who experienced an ESC stopped working (ie, were unemployed) pursuant to an ESC. Respondents who experienced an ESC reported significantly lower levels of work exhaustion and interprofessional disengagement and significantly higher levels of professional fulfillment in their current employment than respondents that did not experience an ESC. CONCLUSION: The overall increase in demand for workers in the health care sector appeared to provide opportunities for pharmacists, especially pharmacists with 1 to 10 years of experience, to change their employment situation, resulting in better work-life characteristics. Given projections of a pharmacist shortage, research, policy, and educational programs could determine the best practices to improve work settings and the work-life characteristics of practicing pharmacists to improve the health of the current pharmacist workforce.
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COVID-19 , Empleo , Farmacéuticos , Humanos , COVID-19/epidemiología , Farmacéuticos/estadística & datos numéricos , Estudios Transversales , Femenino , Adulto , Empleo/estadística & datos numéricos , Masculino , Encuestas y Cuestionarios , Persona de Mediana Edad , Estados Unidos/epidemiología , PandemiasRESUMEN
Pertussis vaccination is recommended during pregnancy to protect the baby. Pertussis vaccination was initially free to pregnant people through general practice and hospitals in New Zealand, but uptake was suboptimal. In one district funding of maternal pertussis vaccination was widened to community pharmacies in 2016. Eighteen months later promotion to pharmacies, midwives and pregnant people took place. In 2020 and 2021, COVID-19 lockdowns occurred. AIM: To explore the effects of promotion and COVID-19 lockdowns on uptake of funded maternal pertussis vaccination in pharmacy, and awareness, use and opinions of promotional elements. METHODS: Five years of pharmacy claims data were analysed and 12 pharmacists, 18 people eligible/recently eligible for maternal pertussis vaccination and 11 midwives were interviewed. RESULTS: Provision of maternal pertussis vaccination increased during and after promotion. Qualitative data showed that pharmacists valued phone calls with information about maternal pertussis vaccination and recommendations for increasing uptake. Prompted by these calls, some pharmacists contacted midwives to inform them of funded maternal pertussis vaccination in the pharmacy (which midwives appreciated) and recommended pertussis vaccination to pregnant clients. Pharmacy staff reportedly were motivated to recommend this vaccination by being informed about it and having posters displayed in the pharmacy. Pregnant people valued healthcare professionals' conversations about maternal pertussis vaccination, but appeared to be uninfluenced by posters and promotional social media posts about this vaccination. During COVID-19, maternal pertussis uptake in pharmacies increased 31% March to May 2020 (before and during the first COVID-19 lockdown) versus the same time the previous year, then declined. CONCLUSION: Promotion appeared to have a sustained effect on uptake of maternal pertussis vaccination in pharmacies. Pregnant people were most influenced by discussions with healthcare professionals. Pharmacists and pharmacy staff increased proactivity with maternal vaccinations after promotion to them. Promotion may need to be repeated over time.
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COVID-19 , Vacuna contra la Tos Ferina , Farmacéuticos , Vacunación , Tos Ferina , Humanos , COVID-19/prevención & control , COVID-19/epidemiología , Femenino , Embarazo , Tos Ferina/prevención & control , Vacunación/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Farmacias , Adulto , Nueva Zelanda , SARS-CoV-2 , ParteríaRESUMEN
This study aimed to explore physicians' and pharmacists' knowledge, attitudes, and practice (KAP) regarding the prevention and treatment of cardiovascular toxicity associated with cancer treatment. A multicenter cross-sectional study included physicians and pharmacists between April 2023 and June 2023. The study included 918 participants (514 physicians and 404 pharmacists). The average scores of knowledge, attitudes, and practice were 11.6 ± 3.39, 24.7 ± 2.6, and 26.3 ± 6.8 points. Sufficient knowledge was significantly associated with age ≥ 41 years (odds ratio (OR) = 2.745, 95% confidence interval (CI) 1.086-6.941, P = 0.033), male (OR = 2.745, 95% CI 1.150-2.223, P = 0.005), bachelor's degree (OR = 0.084, 95% CI 0.013-0.533, P = 0.009), master's degree and above (OR = 0.096, 95% CI 0.015-0.609, P = 0.013), physician occupation (OR = 7.601, 95% CI 1.337-43.207, P = 0.022), pharmacy department (OR = 18.858, 95% CI 3.245-109.57, P = 0.001), oncology department (OR = 4.304, 95% CI 2.426-7.634, P < 0.001), cardiology department (OR = 3.001, 95% CI 1.387-6.492, P = 0.005), hospitals located in Eastern China (OR = 1.957, 95% CI 1.120-3.418, P = 0.018), and hospitals located in Western China (OR = 3.137, 95% CI 1.783-5.518, P < 0.001). Positive attitudes were significantly associated with a senior professional title (OR = 2.989, 95% CI 1.124-7.954, P = 0.028) and hospitals located in Eastern China (OR = 0.424, 95% CI 0.257-0.698, P = 0.001), Western China (OR = 0.231, 95% CI 0.136-0.394, P < 0.001), and Southern China (OR = 0.341, 95% CI 0.198-0.587, P < 0.001). Proactive practice was significantly associated with male (OR = 1.414, 95% CI 1.029-1.943, P = 0.033), senior professional title (OR = 3.838, 95% CI 1.176-12.524, P = 0.026), oncology department (OR = 3.827, 95% CI 2.336-6.272, P < 0.001), and cardiology department (OR = 2.428, 95% CI 1.263-4.669, P = 0.008). Both physicians and pharmacists had positive attitudes toward the prevention and treatment of cardiovascular toxicity associated with cancer treatment, while their knowledge and practice were not as proactive.
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Conocimientos, Actitudes y Práctica en Salud , Neoplasias , Farmacéuticos , Médicos , Humanos , Masculino , Femenino , Persona de Mediana Edad , Médicos/psicología , Adulto , Estudios Transversales , Neoplasias/tratamiento farmacológico , Enfermedades Cardiovasculares/prevención & control , Antineoplásicos/efectos adversos , Actitud del Personal de Salud , Encuestas y Cuestionarios , Cardiotoxicidad/prevención & control , Cardiotoxicidad/etiologíaRESUMEN
The advances in digital health, including mobile healthcare (mHealth) medication adherence applications (MApps), have been demonstrated to support medication adherence and improve health outcomes. This study aims to evaluate the knowledge and perception of the MApps among pharmacists and pharmacy students. An online cross-sectional survey was conducted among 223 pharmacists and pharmacy students in the Jazan region of Saudi Arabia between 1st and 30th April 2023. The survey collected information about the participants' socio-demographics, knowledge, and perception of the MApps. Among the 223 participants included in the study, 105 (47.1%) were pharmacists and 118 (52.9%) were pharmacy students. Most participants were females (72.6%) and aged 18-30 (70.4%). About half of the participants had poor knowledge of the MApps [pharmacists (48.0%) and students (42.0%)] and mainly encountered Medisafe (18.1%) or Pills (17.0%) MApps, respectively. Pharmacy students showed significantly higher knowledge of MApps (p = 0.048), especially the Pills (p = 0.022) than pharmacists. However, the pharmacists had significantly higher knowledge of MyMeds (p = 0.001) than pharmacy students. Most participants had a positive perception of the usefulness of the MApps (pharmacists, 79.0%; students 80.0%). Notably, over 85% of the participants expressed willingness to know and provide guidance on MApps, with over 50% willing to recommend it to the patients. There was no significant difference in perception between the pharmacists and pharmacy students (p>0.05). In conclusion, the study demonstrates limited knowledge with a positive perception of mHealth medication adherence applications among pharmacists and pharmacy students. Integrating digital adherence tools like the MApps into pharmacy training could significantly improve professional practice mHealth competencies, and optimize healthcare delivery and patient outcomes.
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Conocimientos, Actitudes y Práctica en Salud , Cumplimiento de la Medicación , Farmacéuticos , Estudiantes de Farmacia , Telemedicina , Humanos , Estudiantes de Farmacia/psicología , Femenino , Arabia Saudita , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Farmacéuticos/psicología , Adulto , Estudios Transversales , Adulto Joven , Adolescente , Encuestas y Cuestionarios , Aplicaciones MóvilesAsunto(s)
Isotretinoína , Farmacéuticos , Humanos , Embarazo , Femenino , Irlanda , Farmacéuticos/organización & administración , Isotretinoína/uso terapéutico , Fármacos Dermatológicos/uso terapéutico , Fármacos Dermatológicos/administración & dosificación , Prescripciones de Medicamentos/estadística & datos numéricos , Rol Profesional , Acné Vulgar/tratamiento farmacológico , Complicaciones del Embarazo/prevención & control , Complicaciones del Embarazo/tratamiento farmacológicoRESUMEN
In May 2022, Hyogo Medical University Hospital introduced protocol-based pharmacotherapy management(PBPM), which is jointly planned by doctors and pharmacists, for certain cancer drug therapies. Colorectal cancer patients who underwent outpatient cancer chemotherapy in the Department of Lower Gastrointestinal Surgery from October to December 2021(before the introduction of PBPM)and from May to August 2022(after the introduction of PBPM)were retrospectively studied. The proportion of clinical examinations performed, number of prescription questions, and time taken by pharmacists to solve the prescription questions before and after the introduction of PBPM were compared. Additionally, the number of modifications made in the medical record by pharmacists on behalf of doctors in response to the prescription questions was assessed. The proportion of clinical examinations performed(clinical examinations actually performed/clinical examinations that should have been performed)improved from 93.2%(260/279)before to 98.8%(405/410)after the introduction of PBPM(p<0.001). The number of prescription questions decreased from an average of 64.7(±11.9)per month before to an average of 29.5(±3.4)per month after the introduction of PBPM. The average number of modifications made in the medical record by pharmacists on behalf of the doctors in response to the prescription questions was 25.8(±5.4)per month after the introduction of PBPM. There was no significant difference before and after the introduction of PBPM in regard to the median(interquartile range)time taken by pharmacists to solve the prescription questions (before PBPM: 1.88 minutes per case[1.70-2.28 minutes]; after PBPM: 1.71 minutes per case[1.61-2.06 minutes][p= 0.75]). The increased proportion of clinical examinations performed after the implementation of PBPM may have improved the safety of cancer drug management, and the decreased number of prescription questions is speculated to have led to a reduction in physician workload.
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Antineoplásicos , Médicos , Carga de Trabajo , Humanos , Antineoplásicos/uso terapéutico , Femenino , Masculino , Estudios Retrospectivos , Pacientes Ambulatorios , Anciano , Persona de Mediana Edad , FarmacéuticosRESUMEN
Breast cancer is the leading cause of cancer-related death in women worldwide and the fifth most common cause of cancer death overall. Most women with breast cancer have a good prognosis if the cancer is detected at an early stage and the patients have access to the appropriate treatment and disease management. This study aims to evaluate the impact of pharmacist-led interventions on breast cancer management and health outcomes. A literature review was carried out through the scientific databases PubMed, Scopus, and Web of Science using predefined keywords. Only full-text original articles written in English that investigated the role of the pharmacist in the management of breast cancer were included in the final analysis. No publication date limits were set. A total of 1625 articles were retrieved from the electronic databases, of which 14 met the inclusion criteria. The current scoping review consists of different study types, including randomized controlled trials, cross-sectional studies, pre-post studies, retrospective cohort studies, quality improvement projects, case-control studies, and one pharmacoeconomic study. Pharmacists commonly provided the following interventions: consultations regarding chemotherapy treatment, risk assessment and patient education, adverse drug reactions and drug-drug interactions detection, and adherence assessment. This scoping review highlights the beneficial effects of the involvement of pharmacists in breast cancer management, such as better quality of life, reduced drug interaction risk, greater adherence rates, and improved patient knowledge. This confirms the importance of including the pharmacist in the oncology team caring for patients with breast cancer.
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Neoplasias de la Mama , Farmacéuticos , Humanos , Neoplasias de la Mama/tratamiento farmacológico , FemeninoRESUMEN
OBJECTIVE: To determine the consonance between medical practitioners and clinical pharmacists about antimicrobial resistance and stewardship in their practices. STUDY DESIGN: Descriptive cross-sectional study. Place and Duration of the Study: Department of Pathology and Department of Pharmacology, Jinnah Sindh Medical University, Karachi, Pakistan, from September 2023 to January 2024. METHODOLOGY: Medicinal and Clinical Pharmacy professionals were included in the study through purposive sampling technique. The study employed a methodological approach using a predesigned questionnaire administered through Google Forms, based on a 4-step scale strategy. Through an extensive literature review, item development, expert validation, and pilot testing, the questionnaire aimed to assess medical practitioners' and pharmacists' knowledge and perceptions regarding antibiotic practices and antimicrobial stewardship (AMS). Following a pilot test involving 30 participants and a Cronbach's alpha analysis yielding a value of 0.7 for internal consistency, minor modifications were implemented before dissemination to the participants. The responses were analysed using descriptive statistics, Chi-square test, and Kappa index. RESULTS: Out of the total 200 participants, 130 responded within the stipulated timeframe, resulting in an overall response rate of 65%. Among the respondents, medical practitioners constituted 60% (n = 78), while clinical pharmacists comprised 42% (n = 52) of the total. The general agreement level between medical practitioners and clinical pharmacists was determined to be 0.39, indicating a fair level of concordance between the two cohorts. CONCLUSION: The present investigation emphasised the agreement level between medical practitioners and pharmacists, the two key components of the AMS programme. Nevertheless, a consistent deficiency in knowledge was observed across both cohorts, underscoring the necessity for a heightened level of consensus among the study participants. KEY WORDS: Antimicrobial stewardship, Antimicrobial resistance, Anti-bacterial agents, Pharmacists.
Asunto(s)
Programas de Optimización del Uso de los Antimicrobianos , Farmacéuticos , Humanos , Estudios Transversales , Pakistán , Encuestas y Cuestionarios , Masculino , Femenino , Adulto , Antibacterianos/uso terapéutico , Conocimientos, Actitudes y Práctica en Salud , Médicos , Actitud del Personal de Salud , Persona de Mediana EdadRESUMEN
Pharmacogenetic testing in the United Kingdom's National Health Service (NHS) has historically been reactive in nature, undertaken in the context of single gene-drug relationships in specialist settings. Using a discrete choice experiment we aimed to identify healthcare professional preferences for development of a pharmacogenetic testing service in primary care in the NHS. Respondents, representing two professions groups (general practitioners or pharmacists), completed one of two survey versions, asking them to select their preferred pharmacogenetic testing service in the context of a presentation of low mood or joint pain. Responses from 235 individuals were included. All respondents preferred pharmacogenetic testing over no testing, though preference heterogeneity was identified. Both professional groups, but especially GPs, were highly sensitive to service design, with uptake varying depending on the service offered. This study demonstrates uptake of a pharmacogenetic testing service is impacted by service design and highlights key areas which should be prioritised within future initiatives.