Journal Description
Pharmacy
Pharmacy
is an international, scientific, peer-reviewed, open access journal dealing with pharmacy education and practice and is published bimonthly online by MDPI.
- Open Access— free for readers, with article processing charges (APC) paid by authors or their institutions.
- High Visibility: indexed within ESCI (Web of Science), PubMed, PMC, Embase, and other databases.
- Rapid Publication: manuscripts are peer-reviewed and a first decision is provided to authors approximately 24.6 days after submission; acceptance to publication is undertaken in 3.6 days (median values for papers published in this journal in the second half of 2023).
- Recognition of Reviewers: Reviewers who provide timely, thorough peer-review reports receive vouchers entitling them to a discount on the APC of their next publication in any MDPI journal, in appreciation of the work done.
Impact Factor:
2.2 (2022);
5-Year Impact Factor:
2.3 (2022)
Latest Articles
Timely, Cheap, or Risk-Free? The Effect of Regulation on the Price and Availability of New Drugs
Pharmacy 2024, 12(2), 50; https://doi.org/10.3390/pharmacy12020050 - 18 Mar 2024
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The high level of regulation of innovative drugs on the market, which is necessary to protect consumers, produces important effects on drug availability and innovation. In public healthcare systems, the need to curb prices comes from expenditure considerations. The aim of price regulation
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The high level of regulation of innovative drugs on the market, which is necessary to protect consumers, produces important effects on drug availability and innovation. In public healthcare systems, the need to curb prices comes from expenditure considerations. The aim of price regulation is to obtain a more equitable allocation of the value of an innovative drug between industries and patients (by reducing prices to make drugs more affordable), but it may also reduce access. (In the listing process, the industry may find it more convenient to limit commercialisation to profitable subgroups of patients.) Furthermore, with the advent of personalised medicine, there is another important dimension that has to be considered, namely, incentives to invest in drug personalisation. In this paper, we review and discuss the impact of different pricing rules on the expenditure and availability of new drugs.
Full article
Open AccessArticle
Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults
by
Vishal Vennu
Pharmacy 2024, 12(2), 49; https://doi.org/10.3390/pharmacy12020049 - 12 Mar 2024
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A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999–2000 and
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A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999–2000 and 2017–2018. The cross-sectional National Health and Nutrition Examination Survey dataset covered ten cycles between 1999–2000 and 2017–2018. All individuals aged ≥18 years were included. The simultaneous use of at least five medications by one person is known as polypharmacy. Multivariable logistic regression showed that there was a statistically significant association between polypharmacy sociodemographic factors (such as age between 45 and 64 (odds ratio [OR] = 3.76; 95% confidence interval [CI] = 3.60–3.92; p < 0.0001) and age of 65 years or above (OR = 3.96; 95% CI = 3.79–4.13; p < 0.0001), especially women (OR = 1.09; 95% CI = 1.06–1.13; p < 0.0001), non-Hispanic blacks (OR = 1.66; 95% CI = 1.51–1.83; p < 0.0001), and veterans (OR = 1.27; 95% CI = 1.22–1.31; p < 0.0001)) and SES (such as being married (OR = 1.14; 95% CI = 1.08–1.19; p = 0.031), widowed, divorced, or separated (OR = 1.21; 95% CI = 1.15–1.26; p < 0.0001), a college graduate or above (OR = 1.21, 95% CI = 1.15–1.27, p < 0.0001), and earning > USD 55,000 per year (OR = 1.86; 95% CI = 1.79–1.93; p < 0.0001)). Individuals aged 45 years and above, women, and non-Hispanic blacks with higher educational levels and yearly incomes were more likely to experience polypharmacy in the US between 1999–2000 and 2017–2018.
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Open AccessReview
A Systematic Review of Naldemedine and Naloxegol for the Treatment of Opioid-Induced Constipation in Cancer Patients
by
Ursula K. Braun, Leanne K. Jackson, Mary A. Garcia and Syed N. Imam
Pharmacy 2024, 12(2), 48; https://doi.org/10.3390/pharmacy12020048 - 06 Mar 2024
Abstract
Background: Opioid-induced constipation (OIC) is a pervasive and distressing side effect of chronic opioid therapy in patients with cancer pain, significantly impacting their quality of life. Peripherally acting μ-opioid receptor antagonists (PAMORAS) were developed for treatment-resistant OIC but most studies were conducted with
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Background: Opioid-induced constipation (OIC) is a pervasive and distressing side effect of chronic opioid therapy in patients with cancer pain, significantly impacting their quality of life. Peripherally acting μ-opioid receptor antagonists (PAMORAS) were developed for treatment-resistant OIC but most studies were conducted with non-cancer patients. Objective: to discuss two oral formulations of PAMORAs, naldemedine and naloxegol, and to review available evidence of the effectiveness of these drugs for OIC in cancer patients. Methods: a comprehensive search to identify primary literature for either naldemedine or naloxegol for OIC in cancer patients. Results: Only three prospective randomized, double-blind, placebo-controlled clinical trials for naldemedine enrolling cancer patients were identified; the results of a subgroup analysis of two of those studies and two non-interventional post marketing surveillance studies of these trials are also reported here. For naloxegol, only two randomized controlled trials were identified; both were unsuccessful in enrolling sufficient patients. An additional four prospective non-interventional observational studies with naloxegol were found that enrolled cancer patients. There were significantly higher rates of responders in the PAMORA groups than in the placebo groups. The most common side effect for both PAMORAs was diarrhea. Limitations: All studies were industry-funded, and given that only three trials were randomized controlled studies, the overall quality of the studies was lacking. Conclusion: Naldemedine or naloxegol appeared safe and useful in the treatment of OIC in cancer patients and may improve their quality of life. Larger-scale randomized placebo-controlled studies of PAMORAs in cancer patients would strengthen existing evidence.
Full article
(This article belongs to the Special Issue Medicine Use and Management in Palliative Care)
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Open AccessReview
Rational Prescribing of Pancreatic Enzymes for Patients with Pancreatic Cancer
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Mary Acelle G. Garcia, Syed Imam, Ursula K. Braun and Leanne K. Jackson
Pharmacy 2024, 12(2), 47; https://doi.org/10.3390/pharmacy12020047 - 06 Mar 2024
Abstract
Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to
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Most patients with pancreatic cancer at some point present with symptoms related to exocrine pancreatic insufficiency (EPI). These include diarrhea, abdominal bloating, indigestion, steatorrhea, weight loss, and anorexia. Even though up to 80% of pancreatic cancer patients eventually present with symptoms related to exocrine pancreatic insufficiency, only 21% are prescribed pancreatic enzyme replacement therapy (PERT). Its effectiveness is also highly dependent on its proper timing of administration, and patients must be thoroughly educated about this. The impact of symptoms of EPI can lead to poorer overall well-being. Pharmacists play a crucial role in properly educating patients on the correct use of pancreatic enzyme replacement therapy. PERT is a key strategy in managing the symptoms of EPI and can improve quality of life, which is a central focus in palliative care. This treatment is profoundly underutilized in the palliative care of these patients. The objective of this review is to discuss the pharmacology, pharmacokinetics, side effects, available evidence of the effectiveness of pancreatic enzyme use for patients with pancreatic cancer, and challenges, along with proposed solutions regarding its use.
Full article
(This article belongs to the Special Issue Medicine Use and Management in Palliative Care)
Open AccessArticle
Decreases and Pronounced Geographic Variability in Antibiotic Prescribing in Medicaid
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Alexia G. Aguilar, Priscilla C. Canals, Maria Tian, Kimberly A. Miller and Brian J. Piper
Pharmacy 2024, 12(2), 46; https://doi.org/10.3390/pharmacy12020046 - 01 Mar 2024
Abstract
Antibiotic resistance is a persistent and growing concern. Our objective was to analyze antibiotic prescribing in the United States (US) in the Medical Expenditure Panel System (MEPS) and to Medicaid patients. We obtained MEPS prescriptions for eight antibiotics from 2013 to 2020. We
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Antibiotic resistance is a persistent and growing concern. Our objective was to analyze antibiotic prescribing in the United States (US) in the Medical Expenditure Panel System (MEPS) and to Medicaid patients. We obtained MEPS prescriptions for eight antibiotics from 2013 to 2020. We extracted prescribing rates per 1000 Medicaid enrollees for two years, 2018 and 2019, for four broad-spectrum (azithromycin, ciprofloxacin, levofloxacin, and moxifloxacin) and four narrow-spectrum (amoxicillin, cephalexin, doxycycline, and trimethoprim-sulfamethoxazole) antibiotics. Antibiotic prescriptions in MEPS decreased from 2013 to 2020 by 38.7%, with a larger decline for the broad (−53.7%) than narrow (−23.5%) spectrum antibiotics. Antibiotic prescriptions in Medicaid decreased by 6.7%. Amoxicillin was the predominant antibiotic, followed by azithromycin, cephalexin, trimethoprim-sulfamethoxazole, doxycycline, ciprofloxacin, levofloxacin, and moxifloxacin. Substantial geographic variation in prescribing existed, with a 2.8-fold difference between the highest (Kentucky = 855/1000) and lowest (Oregon = 299) states. The South prescribed 52.2% more antibiotics (580/1000) than the West (381/1000). There were significant correlations across states (r = 0.81 for azithromycin and amoxicillin). This study identified sizable disparities by geography in the prescribing rates of eight antibiotics with over three-fold state-level differences. Areas with high prescribing rates, particularly for outpatients, may benefit from stewardship programs to reduce potentially unnecessary prescribing.
Full article
(This article belongs to the Special Issue The 10th Anniversary of Pharmacy—Advances in Pharmacy Education and Practice)
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Open AccessArticle
Web Survey of Turkish Pharmacy Students Comparing First and Fifth Years’ Antidepressant Awareness and Stigmatizing Attitudes Regarding Depression and Anxiety
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Nadir Yalçın, Gökçe Gül Özkan, Karel Allegaert, Sertaç Ak and Kutay Demirkan
Pharmacy 2024, 12(2), 45; https://doi.org/10.3390/pharmacy12020045 - 01 Mar 2024
Abstract
The prevalence of depression and anxiety has increased day by day. Prejudice, self-stigma, and public stigma, on the other hand, continue to prevent patients from seeking adequate treatment, particularly in traditional communities. In this web-based, cross-sectional study, both the presence of depression and
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The prevalence of depression and anxiety has increased day by day. Prejudice, self-stigma, and public stigma, on the other hand, continue to prevent patients from seeking adequate treatment, particularly in traditional communities. In this web-based, cross-sectional study, both the presence of depression and anxiety, and the knowledge, attitude, and awareness of first- and fifth (final)-year pharmacy students were examined via an online survey. The aim was to demonstrate the potential impact of public information and five years of pharmacy school on knowledge, attitude, and awareness. Our study population consisted of first- and fifth-year pharmacy students enrolled in one faculty of pharmacy during the spring semester of 2022–2023. The Beck Depression Inventory and Beck Anxiety Scale were utilized to measure the presence of depression and anxiety, while the Depression and Antidepressant Awareness and Knowledge Scale (DAKAS) was applied to assess their knowledge, attitude, and awareness. Fifth-year participants (n = 101) exhibited noticeably fewer stigmatizing attitudes than first-year participants (n = 104) (p < 0.05). There was no statistically significant difference between the mean Beck Depression Inventory and Beck Anxiety scores in first- and fifth-year pharmacy students. Being in the fifth class (OR: 3.690; p = 0.025), being of female gender (OR: 4.653; p < 0.001), and having a relationship with someone who took a psychotropic (OR: 3.060; p = 0.008) were associated with a lower overall stigma score by multiple linear regression analysis. The students’ awareness of antidepressants and familiarity with mental health issues at the end of their pharmacy education were higher and stigmatization behavior was lower than in first-year students. The positive attitudes at the end of their training towards depression will reduce the likelihood of future pharmacists’ patients from being exposed to stigmatization, prevents the formation of an additional stress factor, and likely will improve pharmacy practices.
Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
Open AccessArticle
Influences of Software Changes on Oxycodone Prescribing at an Australian Tertiary Emergency Department: A Retrospective Review
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Giles Barrington, Katherine Davis, Zach Aandahl, Brodie-Anne Hose, Mitchell Arthur and Viet Tran
Pharmacy 2024, 12(2), 44; https://doi.org/10.3390/pharmacy12020044 - 01 Mar 2024
Abstract
Opioid prescribing and dispensing from emergency departments is a noteworthy issue given widespread opioid misuse and diversion in many countries, contributing both physical and economic harm to the population. High patient numbers and the stochastic nature of acute emergency presentations to emergency departments
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Opioid prescribing and dispensing from emergency departments is a noteworthy issue given widespread opioid misuse and diversion in many countries, contributing both physical and economic harm to the population. High patient numbers and the stochastic nature of acute emergency presentations to emergency departments (EDs) introduce challenges for prescribers who are considering opioid stewardship principles. This study investigated the effect of changes to electronic prescribing software on prescriptions with an auto-populated quantity of oxycodone immediate release (IR) from an Australian tertiary emergency department following the implementation of national recommendations for reduced pack sizes. A retrospective review of oxycodone IR prescriptions over two six-month periods between 2019 and 2021 was undertaken, either side of a software adjustment to reduce the default quantities of tablets prescribed from 20 to 10. Patient demographic details were collected, and prescriber years of practice calculated for inclusion in linear mixed effects regression modelling. A reduction in the median number of tablets prescribed per prescription following the software changes (13.5 to 10.0, p < 0.001) with little change in the underlying characteristics of the patient or prescriber populations was observed, as well as an 11.65% reduction in the total number of tablets prescribed. The prescriber’s years of practice, patient age and patient sex were found to influence increased prescription sizes. Reduced quantity of oxycodone tablets prescribed was achieved by alteration of prescribing software prefill parameters, providing further evidence to support systems-based policy interventions to influence health care providers behaviour and to act as a forcing function for prescribers to consider opioid stewardship principles.
Full article
(This article belongs to the Special Issue Pharmacists’ Role in Reducing Problematic Opioid Use)
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Open AccessArticle
Social Prescribing Competence among Community Pharmacists and Pharmacy Students in Norway
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Riyaan Mahamud Gabeyre, Misbah Hussein, Siedra Salih, Salia Amir and Parisa Gazerani
Pharmacy 2024, 12(2), 43; https://doi.org/10.3390/pharmacy12020043 - 01 Mar 2024
Abstract
Background and aim: Social prescribing, which links patients to non-clinical services and involves general physicians, has been gaining traction. Community pharmacists, who are integral to primary healthcare, have untapped potential in social prescribing. This study explores social prescribing competence among Norwegian community pharmacists
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Background and aim: Social prescribing, which links patients to non-clinical services and involves general physicians, has been gaining traction. Community pharmacists, who are integral to primary healthcare, have untapped potential in social prescribing. This study explores social prescribing competence among Norwegian community pharmacists and pharmacy students. Method: A cross-sectional study utilizing an anonymous online questionnaire to collect quantitative data was conducted. Inspired by the limited relevant literature, the questionnaire was constructed, pilot-tested, and distributed in a one-week window within a Facebook group for Norwegian pharmacists. The questionnaire comprised 23 questions categorized into demographic details and competence assessment, covering general knowledge, attitude, and barriers/facilitators related to social prescribing. Statistical analyses were employed to determine the competence of the participants. Results: The online questionnaire collected data from 96 participants, primarily females (79.2%), aged 25–34 (40.6%), who were identified as community pharmacists (49.0%). Most (91.7%) worked in community pharmacies, with 31.3% having over 10 years of experience. Despite positive client relationships (93.8%), statistical analysis revealed no significant associations between competence and variables such as work experience, education, or gender. The custom scoring system yielded an average competence score of 1.98 on a 5-point scale, with attitudes and perceptions of participants scoring 3.82. Overall competence was calculated at 3.4, indicating a moderate level. Conclusions: The findings of this study reveal that the participants had limited knowledge regarding social prescribing, emphasizing the need for education. However, the participants showed strong enthusiasm for competence development. This groundwork paves the way for future investigations centered on pilot-testing strategies to boost social prescribing knowledge and engagement among Norwegian community pharmacists and pharmacy students.
Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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Open AccessArticle
An Assessment of Knowledge, Attitude, and Practice (KAP) of Colorectal Cancer among Community Pharmacists in the Qassim Region of Saudi Arabia
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Mohammed Alshammari, Saleh Al-Maktoum, Abdulrahman Alsharidah, Abubakar Siddique, Mohammed Anaam, Saud Alsahali, Yasser Almogbel and Ali Alkhoshaiban
Pharmacy 2024, 12(2), 42; https://doi.org/10.3390/pharmacy12020042 - 27 Feb 2024
Abstract
Background: The global burden of colorectal cancer remains a major public health issue and one of the leading causes of death worldwide. In Saudi Arabia, it continues to be a health concern. Any delays in diagnosis for any reason may contribute to
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Background: The global burden of colorectal cancer remains a major public health issue and one of the leading causes of death worldwide. In Saudi Arabia, it continues to be a health concern. Any delays in diagnosis for any reason may contribute to advanced complications; therefore, pharmacists’ knowledge and awareness of colorectal cancer are crucial for the welfare of society. Studies of colon cancer-related knowledge, attitude, and practice (KAP) among community pharmacists have not previously been conducted in the Al-Qassim region of Saudi Arabia. In the present study, therefore, we sought to investigate the KAP on colon cancer among pharmacists in Al-Qassim. Methods: This was a prospective, cross-sectional, observational study. A sample of 150 community pharmacists was recruited using a convenience sampling method. A self-administered questionnaire was used to evaluate levels of knowledge and practice. Results: Out of a total of 150 pharmacists, the majority of respondents (60.7%) possessed an adequate level of knowledge. About 50% of participants had heard of the early screening test, and 68.7% knew that colonoscopy is necessary in such scenarios. On the basis of their attitudes, 41.3% of study participants were aware of colon cancer symptoms and risk factors. In practice, however, the majority of pharmacists (81%) did not perform early cancer screenings, while 19% did screen when advised to do so by a physician. Conclusions: Our results indicate that pharmacists in Qassim have an adequate level of knowledge of colon cancer in terms of awareness, assessment, and screening. Since community pharmacists are among the most reliable members of the medical community, a greater awareness of colon cancer among pharmacists may improve public knowledge of the disease.
Full article
Open AccessArticle
Exogenous Melatonin Use in University Students: A Cross-Sectional Survey
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Sulafa T. Alqutub, Faris A. Alzahrani, Abdulrahman S. Hassan, Abdullah H. Alirbidi, Osama A. Alraddadi, Omar A. AlSadah, Mohammad B. Yamani and Mansour Tobaiqy
Pharmacy 2024, 12(2), 41; https://doi.org/10.3390/pharmacy12020041 - 23 Feb 2024
Abstract
To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use,
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To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use, melatonin use in relation to exam periods, perceived safety, and adverse effects was gathered. Of 380 students, ~52% reported using exogenous melatonin for sleep disorders. Most participants reported using melatonin during and after exam periods. Additionally, several (n = 157; 75.4%) believed that its use was safe. The predominant use patterns were daily and as needed, and this study observed a higher rate of use compared with previous studies in Saudi Arabia. The most frequently reported adverse effect was headache (n = 36; 37.5%). A significant number of undergraduate male students in health specialties used melatonin. A high rate of melatonin use was noted during exam periods, which was attributed to sleep deprivation. Additionally, a significant number of students from private universities reported using exogenous melatonin. Melatonin use is common among university students. Future research should use a reliable psychometric measure to test its effect on university students’ sleep quality and quantity.
Full article
(This article belongs to the Topic Drug Utilization and Medication Adherence: Strategies, Technologies and Practices)
Open AccessArticle
Pharmacists’ Attitudes towards Medically Assisted Dying
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Lun Shen Wong, Shane L. Scahill, Emma Barton, Bert Van der Werf, Jessica Boey and Sanyogita (Sanya) Ram
Pharmacy 2024, 12(2), 40; https://doi.org/10.3390/pharmacy12020040 - 20 Feb 2024
Abstract
Aims: We aimed to explore pharmacists’ attitudes and support toward medically assisted dying (MaiD) through the End of Life Choice Act 2019 (EOLC), their willingness to provide services in this area of practice, and the influences on their decisions. Methods: The study was
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Aims: We aimed to explore pharmacists’ attitudes and support toward medically assisted dying (MaiD) through the End of Life Choice Act 2019 (EOLC), their willingness to provide services in this area of practice, and the influences on their decisions. Methods: The study was conducted via an anonymous, online QualtricsTM survey of pharmacists. Registered New Zealand pharmacists who agreed to receive surveys from the two Schools of Pharmacy as part of their Annual Practicing Certificate renewal were invited to participate through an email with a Qualtrics URL link. The survey contained questions regarding demographics, awareness, knowledge, support for, and attitudes and willingness to participate. Results: Of the 335 responses received, 289 were valid and included in the analysis. Most participants supported legally assisted medical dying (58%), almost a third of participants did not support it (29%), and 13% of respondents were unsure. The five primary considerations that participants perceived to be beneficial included support from legislation, respect for patient autonomy, discussions around morality, ending suffering, and preserving dignity. The main concerns were legal, personal bias, palliation, stigmatisation, and vulnerability. Conclusions: The influences on the decision by pharmacists to support and willingness to participate in the provision of services consistent with the EOLC are complex and multifactorial. Diverse factors may influence attitudes, of which religion is the most significant factor in not supporting the Act or willingness to participate. Clarity and standardised guidance to ensure that assisted dying queries are appropriately managed in practice would help to address any potential access issues.
Full article
(This article belongs to the Special Issue Professional Ethics in Pharmacy: Exploring Contemporary Challenges and Future Directions)
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Open AccessReview
Medication Review: What’s in a Name and What Is It about?
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Anneleen Robberechts, Maja Brumer, Victoria Garcia-Cardenas, Niurka M. Dupotey, Stephane Steurbaut, Guido R. Y. De Meyer and Hans De Loof
Pharmacy 2024, 12(1), 39; https://doi.org/10.3390/pharmacy12010039 - 19 Feb 2024
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
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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”.
Full article
(This article belongs to the Special Issue Pharmacists: Key Players in a Changing Health Care System)
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Open AccessCase Report
Two Cases of Vancomycin-Induced Neutropenia
by
Kirsten Ganaja, Sarah Scoular and Staci Hemmer
Pharmacy 2024, 12(1), 38; https://doi.org/10.3390/pharmacy12010038 - 19 Feb 2024
Abstract
(1) Background: The incidence of vancomycin-induced neutropenia in hospitalized patients is estimated to be around 2 to 8 percent Data surrounding vancomycin-induced neutropenia is limited as it is based on a small number of observational case reports. Additionally, it is difficult to provide
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(1) Background: The incidence of vancomycin-induced neutropenia in hospitalized patients is estimated to be around 2 to 8 percent Data surrounding vancomycin-induced neutropenia is limited as it is based on a small number of observational case reports. Additionally, it is difficult to provide generalized conclusions since patient characteristics and indications for treatment vary between reports. (2) Case Reports: We present two cases of vancomycin-induced neutropenia that occurred at our facility; a 50-year-old male who developed neutropenia after treatment with vancomycin for a gluteal abscess and a 51-year-old female who developed neutropenia after treatment with vancomycin for lumbar osteomyelitis. In both cases, neutropenia resolved within 2 days of discontinuation of vancomycin. (3) Conclusions: Vancomycin-induced neutropenia is thought to be a relatively uncommon adverse drug reaction. These two cases of neutropenia likely caused by prolonged exposure to vancomycin occurred at our facility within 3 months of each other. Additional studies are needed to better understand the true incidence of this adverse drug reaction and to identify risk factors that may predispose patients to vancomycin-induced neutropenia.
Full article
(This article belongs to the Special Issue Antimicrobial Adverse Reaction and Drug-Drug Interactions)
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Open AccessArticle
Development of a Prediction Model to Identify the Risk of Clostridioides difficile Infection in Hospitalized Patients Receiving at Least One Dose of Antibiotics
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Abdulrahman Alamri, AlHanoof Bin Abbas, Ekram Al Hassan and Yasser Almogbel
Pharmacy 2024, 12(1), 37; https://doi.org/10.3390/pharmacy12010037 - 19 Feb 2024
Abstract
Objective: This study’s objective was to develop a risk-prediction model to identify hospitalized patients at risk of Clostridioides difficile infection (CDI) who had received at least one dose of systemic antibiotics in a large tertiary hospital. Patients and methods: This was a retrospective
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Objective: This study’s objective was to develop a risk-prediction model to identify hospitalized patients at risk of Clostridioides difficile infection (CDI) who had received at least one dose of systemic antibiotics in a large tertiary hospital. Patients and methods: This was a retrospective case–control study that included patients hospitalized for more than 2 days who received antibiotic therapy during hospitalization. The study included two groups: patients diagnosed with hospital CDI and controls without hospital CDI. Cases were matched 1:3 with assigned controls by age and sex. Descriptive statistics were used to identify the study population by comparing cases with controls. Continuous variables were stated as the means and standard deviations. A multivariate analysis was built to identify the significantly associated covariates between cases and controls for CDI. Results: A total of 364 patients were included and distributed between the two groups. The control group included 273 patients, and the case group included 91 patients. The risk factors for CDI were investigated, with only significant risks identified and included in the risk assessment model: age older than 70 years (p = 0.034), chronic kidney disease (p = 0.043), solid organ transplantation (p = 0.021), and lymphoma or leukemia (p = 0.019). A risk score of ≥2 showed the best sensitivity, specificity, and accuracy of 78.02%, 45.42%, and 78.02, respectively, with an area under the curve of 0.6172. Conclusion: We identified four associated risk factors in the risk-prediction model. The tool showed good discrimination that might help predict, identify, and evaluate hospitalized patients at risk of developing CDI.
Full article
(This article belongs to the Special Issue The 10th Anniversary of Pharmacy—Advances in Pharmacy Education and Practice)
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Open AccessArticle
How Intuitive Is the Administration of Pediatric Emergency Medication Devices for Parents? Objective Observation and Subjective Self-Assessment
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Ruth Melinda Müller, Birthe Herziger, Sarah Jeschke, Martina Patrizia Neininger, Thilo Bertsche and Astrid Bertsche
Pharmacy 2024, 12(1), 36; https://doi.org/10.3390/pharmacy12010036 - 18 Feb 2024
Abstract
Background: to assess the intuitiveness of parents’ administration of pediatric emergency devices (inhalation, rectal, buccal, nasal, and auto-injector). Methods: We invited parents without prior experience to administer the five devices to dummy dolls. We observed whether the parents chose the correct administration route
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Background: to assess the intuitiveness of parents’ administration of pediatric emergency devices (inhalation, rectal, buccal, nasal, and auto-injector). Methods: We invited parents without prior experience to administer the five devices to dummy dolls. We observed whether the parents chose the correct administration route and subsequently performed the correct administration procedures without clinically relevant errors. We interviewed parents for their self-assessment of their own administration performance and willingness to administer devices in actual emergencies. Results: The correct administration route was best for the inhalation device (81/84, 96% of parents) and worst for the intranasal device (25/126, 20%). The correct administration procedures were best for the buccal device (63/98, 64%) and worst for the auto-injector device (0/93, 0%). Their own administration performance was rated to be best by parents for the inhalation device (59/84, 70%) and worst for the auto-injector device (17/93, 18%). The self-assessment of the correct administration overestimated the correct administration procedures for all the devices except the buccal one. Most parents were willing to administer the inhalation device in an emergency (67/94, 79%), while the fewest were willing to administration procedures the auto-injector device (28/93, 30%). Conclusions: Intuitiveness concerning the correct administration route and the subsequent correct administration procedures have to be improved for all the devices examined. The parents mostly overestimated their performance. Willingness to use a device in an actual emergency depended on the device.
Full article
Open AccessSystematic Review
Strategies to Improve Therapeutic Adherence in Polymedicated Patients over 65 Years: A Systematic Review and Meta-Analysis
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Natalia Burgos-Alonso, María Torrecilla, Aitziber Mendiguren, Marta Pérez-Gómez Moreta and Cristina Bruzos-Cidón
Pharmacy 2024, 12(1), 35; https://doi.org/10.3390/pharmacy12010035 - 17 Feb 2024
Abstract
Background: Part of the population over 65 years of age suffer from several pathologies and are therefore polymedicated. In this systematic review and metanalysis, we aimed to determine the efficacy of several strategies developed to improve adherence to pharmacological treatment in polymedicated elderly
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Background: Part of the population over 65 years of age suffer from several pathologies and are therefore polymedicated. In this systematic review and metanalysis, we aimed to determine the efficacy of several strategies developed to improve adherence to pharmacological treatment in polymedicated elderly people. Design: Web Of Science, PubMed and the Cochrane Library were searched until 2 January 2024. In total, 17 of the 1508 articles found evaluated the efficacy of interventions to improve adherence to medication in polymedicated elderly patients. Methodological quality and the risk of bias were rated using the Cochrane risk of bias tool. Open Meta Analyst® software was used to create forest plots of the meta-analysis. Results: In 11 of the 17 studies, an improvement in adherence was observed through the use of different measurement tools and sometimes in combination. The most frequently used strategy was using instructions and counselling, always in combination, in a single strategy used to improve adherence; one involved the use of medication packs and the other patient follow-up. In both cases, the results in improving adherence were positive. Five studies using follow-up interventions via visits and phone calls showed improved adherence on the Morisky Green scale compared to those where usual care was received [OR = 1.900; 95% CI = 1.104–3.270] (p = 0.021). Discussion: There is a high degree of heterogeneity in the studies analyzed, both in the interventions used and in the measurement tools for improving adherence to treatment. Therefore, we cannot make conclusions about the most efficacious strategy to improve medication adherence in polymedicated elderly patients until more evidence of single-intervention strategies is available.
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(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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Open AccessReview
A Review of Olanzapine in the Treatment of Cancer Anorexia-Cachexia Syndrome
by
Ivy O. Poon, Veronica Ajewole and Ursula K. Braun
Pharmacy 2024, 12(1), 34; https://doi.org/10.3390/pharmacy12010034 - 17 Feb 2024
Abstract
Background: Cancer anorexia-cachexia syndrome (CAS) is a multifactorial condition that is highly prevalent in advanced cancer patients and associated with significant reduction in functional performance, reduction in quality of life, and increased mortality. Currently, no medications are approved for this indication. Recently, the
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Background: Cancer anorexia-cachexia syndrome (CAS) is a multifactorial condition that is highly prevalent in advanced cancer patients and associated with significant reduction in functional performance, reduction in quality of life, and increased mortality. Currently, no medications are approved for this indication. Recently, the American Society of Clinical Oncology (ASCO) released a rapid recommendation suggesting that low-dose olanzapine once daily may be used to treat cancer cachexia. Many questions still exist on how to use olanzapine for this indication in clinical practice. The objective of this review is to identify existing knowledge on the use of olanzapine for CAS. Methods: A comprehensive search was conducted to identify the primary literature that involved olanzapine for anorexia and cachexia in cancer patients between 2000 and 2023. Results: Seven articles were identified and are discussed here, including two randomized double-blinded placebo-controlled studies, one randomized comparative study, two prospective open-label studies, one retrospective chart review, and one case report. Conclusions: Low dose olanzapine (2.5–5 mg once daily) may be useful in the treatment of CAS for increasing appetite, reducing nausea and vomiting, and promoting weight gain. Further large-scale multi-center randomized placebo-controlled studies will be needed to investigate the impact of olanzapine on weight change in CAS patients.
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(This article belongs to the Special Issue Medicine Use and Management in Palliative Care)
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Open AccessReview
New Adverse Drug Reaction Signals from 2017 to 2021—Genuine Alerts or False Alarms?
by
Yoon Kong Loke, Katharina Mattishent and Navena Navaneetharaja
Pharmacy 2024, 12(1), 33; https://doi.org/10.3390/pharmacy12010033 - 10 Feb 2024
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Spontaneous adverse events reporting systems are used internationally to flag new or unexpected adverse drug reactions (ADRs). Disproportionality analysis is a recognised technique, but false alarms may arise. We aimed to determine whether these new ADR signals had subsequently been followed-up with detailed
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Spontaneous adverse events reporting systems are used internationally to flag new or unexpected adverse drug reactions (ADRs). Disproportionality analysis is a recognised technique, but false alarms may arise. We aimed to determine whether these new ADR signals had subsequently been followed-up with detailed hypothesis-testing studies. We searched PubMed to identify published studies (years 2017–2021) where the authors reported findings of new ADR signals from disproportionality analyses. We used PubMed and forward citation tracking (Google Scholar) to identify any subsequent confirmatory studies of these ADR signals. We screened 414 titles and abstracts and checked the full-text articles of 57 studies. We found signals for 56 suspected new ADRs from 24 drugs. Google Scholar showed that the ADR studies had been cited a median of seven times (range 0–61). However, none of the suspected new ADRs had undergone detailed evaluation in the citing literature. Similarly, our PubMed search did not find any confirmation studies for the 56 suspected new ADRs. Although many suspected new ADR signals have been identified through disproportionality analysis, most signals have not been further verified as being either genuine ADRs or false alarms. Researchers must focus on follow-up studies for these new signals.
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Open AccessArticle
Enteral Delivery of Pravastatin Sodium Tablets: Effect of Compounding into a Liquid Form and Co-Administration of Enteral Nutrition
by
Serena Logrippo, Roberta Ganzetti, Matteo Sestili, Diego Romano Perinelli, Marco Cespi and Giulia Bonacucina
Pharmacy 2024, 12(1), 32; https://doi.org/10.3390/pharmacy12010032 - 09 Feb 2024
Abstract
Background: Compounding solid oral dosage forms into liquid preparations is a common practice for administering drug therapy to patients with swallowing difficulties. This is particularly relevant for those on enteral nutrition, where factors such as the administration procedure and co-administration of enteral nutrition
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Background: Compounding solid oral dosage forms into liquid preparations is a common practice for administering drug therapy to patients with swallowing difficulties. This is particularly relevant for those on enteral nutrition, where factors such as the administration procedure and co-administration of enteral nutrition play crucial roles in effective drug delivery. Due to the limited studies focused on this practice, the impact of co-administered nutrition remains unclear. Methods: Pravastatin tablets were compounded into two liquid formulations and administered through three independent tubes for ten cycles. The drug amount was quantified upstream and downstream of the tubes both with and without different (fiber content) nutritional boluses. Results: The compounding procedure did not lower the drug amount with respect to the original tablets. However, when the liquid formulation was pumped through the tubes, a statistically significant reduction in the pravastatin administered (between 4.6% and 11.3%) was observed. The co-administration of different nutritional boluses or the compounding procedure did not affect the general results. Conclusions: Pravastatin loss appears unavoidable when administered via the enteral tube. Although, in this case, the loss was of limited clinical relevance, it is important not to underestimate this phenomenon, especially with drugs having a narrow therapeutic index.
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(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
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Collaborative Prescribing Practice in Managing Patients Post-Bariatric Surgery in a Tertiary Centre in Singapore
by
Giat Yeng Khee, Paik Shia Lim, Yoke Ling Chan and Phong Ching Lee
Pharmacy 2024, 12(1), 31; https://doi.org/10.3390/pharmacy12010031 - 08 Feb 2024
Abstract
Background: A collaborative prescribing (CP) practice model, established by the endocrinologists, pharmacists, and advanced practice nurses, aims to provide for the postoperative monitoring and medical and nutritional management of stable patients after bariatric surgery. Method: Under the CP agreement, endocrinologists refer patients who
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Background: A collaborative prescribing (CP) practice model, established by the endocrinologists, pharmacists, and advanced practice nurses, aims to provide for the postoperative monitoring and medical and nutritional management of stable patients after bariatric surgery. Method: Under the CP agreement, endocrinologists refer patients who have undergone bariatric surgery with stable medical conditions to CP practitioners, comprising senior pharmacists and advanced practice nurses. CP practitioners review the patient’s weight loss progress, blood test results and vitals, the sufficiency of micronutrient repletion, adherence to supplements and medications, and chronic disease control. CP practitioners can prescribe and adjust the medications and supplements, in accordance with a clinical evaluation and standard guidance. Patients who require immediate attention due to complications or red flags are referred to the primary endocrinologist for further management. Results: From 5 May 2020 to 30 September 2023, CP practitioners provided 672 consultations. At least 68% and 80% of patients achieved appropriate weight loss post-surgery during the acute and maintenance phases, respectively. Less than 10% of the patients presented with anaemia and iron deficiency, and vitamin B12, folate and vitamin D deficiency. More than 80% of patients achieved a HbA1c of less than 7%. Conclusions: The CP practice framework provides a sustainable and viable model to facilitate optimal outcomes after bariatric surgery.
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(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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