Special Issue "Health Services Research in the Use of Medicines"

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (30 June 2017)

Special Issue Editor

Guest Editor
Prof. Dr. David Wright

School of Pharmacy, The University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK
Website | E-Mail
Interests: pharmaceutical care of the older person; pharmacy education

Special Issue Information

Dear Colleagues,

I have been asked to guest edit a special edition for the Pharmacy Journal on Health Services Research in the Use of Medicines. As you know, medicines are the main intervention used within western healthcare and are the second largest element within any health services budget after workforce. Consequently it is an important topic which is well researched.

I would very much like this Special Issue to encompass all areas of health services research in the use of medicines from prescribing through to medicines administration and patient related medicines taking behaviours. The setting within which the research takes places adds to the complexity of the subject and is of just as much interest as the intervention being tested. Understanding the barriers and facilitators which exist in different settings with respect to improving the use of medicines is important for intervention success.

Whilst I would be very interested in any current research in the area, I would also welcome literature reviews and thought pieces considering the future of research in the area. Whilst the use of pharmacists as prescribers, pharmacy technicians within medicines optimisation roles, and technology to support information sharing and decision making are obvious future directions for improving medicines use, there may be things on the horizon such as pharmacogenomics which you would like to draw the reader’s attention to.

If you are too busy yourself to make a contribution perhaps you could recommend a colleague either in your workplace or working in the same area as yourself whom you could recommend.

Prof. Dr. David Wright
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 350 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Pharmaceutical care
  • Medicines optimisation
  • Pharmacy workforce
  • Prescribing
  • Polypharmacy
  • Adherence
  • Pharmacogenomics

Published Papers (4 papers)

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Research

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Open AccessFeature PaperArticle Community Pharmacists’ Knowledge Regarding Donepezil Averse Effects and Self-Care Recommendations for Insomnia for Persons with AD
Pharmacy 2017, 5(3), 42; doi:10.3390/pharmacy5030042
Received: 4 July 2017 / Revised: 25 July 2017 / Accepted: 25 July 2017 / Published: 28 July 2017
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Abstract
Alzheimer’s disease (AD) impacts millions of individuals worldwide. Since no cure is currently available, acetylcholinesterase inhibitors are symptomatic therapy. This study assessed community pharmacists’ knowledge regarding donepezil adverse effects (AEs) and self-care recommendations for insomnia management for persons with AD treated with rivastigmine.
[...] Read more.
Alzheimer’s disease (AD) impacts millions of individuals worldwide. Since no cure is currently available, acetylcholinesterase inhibitors are symptomatic therapy. This study assessed community pharmacists’ knowledge regarding donepezil adverse effects (AEs) and self-care recommendations for insomnia management for persons with AD treated with rivastigmine. This is a cross-sectional, standardized telephone survey of community pharmacists (n = 862) in three study areas: West Virginia, North Dakota/South Dakota, and Southern Oregon/Northern California. Pharmacists’ degree, sex, and pharmacists’ AD-related knowledge were assessed. In-stock availability of donepezil and rivastigmine formulations was assessed. Analyses were performed using Stata 10.1. Only 31.4% pharmacists were able to name ≥2 donepezil AEs. Only four donepezil AEs were named by at least 13% of pharmacists: nausea (36.1%), dizziness (25.1%), diarrhea (15.0%), and vomiting (13.9%). All other AEs were named by fewer than 7% of respondents. Only 62.9% of pharmacists (n = 542) provided appropriate recommendations: melatonin (40.3%), referral to physician (22.0%), or sleep hygiene (0.6%). Over 12% of pharmacists (n = 107) provided inappropriate recommendations (anticholinergic agent or valerian root) and 21.5% of pharmacists were unable to provide any recommendation. We identified significant gaps in community pharmacists’ knowledge regarding donepezil AEs and non-prescription insomnia recommendation needing significant improvement to ensure high-quality AD-related care. Full article
(This article belongs to the Special Issue Health Services Research in the Use of Medicines)
Open AccessFeature PaperArticle Defining the Role of the Pharmacy Technician and Identifying Their Future Role in Medicines Optimisation
Pharmacy 2017, 5(3), 40; doi:10.3390/pharmacy5030040
Received: 21 June 2017 / Revised: 11 July 2017 / Accepted: 12 July 2017 / Published: 15 July 2017
PDF Full-text (573 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation.
[...] Read more.
Background: Traditionally, pharmacy technicians have worked alongside pharmacists in community and hospital pharmacy. Changes within pharmacy provide opportunity for role expansion and with no apparent career pathway, there is a need to define the current pharmacy technician role and role in medicines optimisation. Aim: To capture the current roles of pharmacy technicians and identify how their future role will contribute to medicines optimisation. Methods: Following ethical approval and piloting, an online survey to ascertain pharmacy technicians’ views about their roles was undertaken. Recruitment took place in collaboration with the Association of Pharmacy Technicians UK. Data were exported to SPSS, data screened and descriptive statistics produced. Free text responses were analysed and tasks collated into categories reflecting the type of work involved in each task. Results: Responses received were 393 (28%, n = 1380). Results were organised into five groups: i.e., hospital, community, primary care, General Practitioner (GP) practice and other (which included HM Prison Service). Thirty tasks were reported as commonly undertaken in three or more settings and 206 (84.7%, n = 243) pharmacy technicians reported they would like to expand their role. Conclusions: Tasks core to hospital and community pharmacy should be considered for inclusion to initial education standards to reflect current practice. Post qualification, pharmacy technicians indicate a significant desire to expand clinically and managerially allowing pharmacists more time in patient-facing/clinical roles. Full article
(This article belongs to the Special Issue Health Services Research in the Use of Medicines)
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Review

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Open AccessReview Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management—A Narrative Review of Current Practices
Pharmacy 2017, 5(2), 30; doi:10.3390/pharmacy5020030
Received: 9 March 2017 / Revised: 5 May 2017 / Accepted: 26 May 2017 / Published: 1 June 2017
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Abstract
Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED
[...] Read more.
Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED. Full article
(This article belongs to the Special Issue Health Services Research in the Use of Medicines)
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Other

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Open AccessCommentary Safety of People with Intellectual Disabilities in Hospital. What Can the Hospital Pharmacist Do to Improve Quality of Care?
Pharmacy 2017, 5(3), 44; doi:10.3390/pharmacy5030044
Received: 8 June 2017 / Revised: 27 July 2017 / Accepted: 30 July 2017 / Published: 4 August 2017
PDF Full-text (1432 KB) | HTML Full-text | XML Full-text | Supplementary Files
Abstract
People with intellectual disabilities are vulnerable in healthcare environments. They experience health and healthcare inequalities, and when admitted to general hospitals are at a greater risk of patient safety incidents. This is well known in specialist services, but less recognized within primary or
[...] Read more.
People with intellectual disabilities are vulnerable in healthcare environments. They experience health and healthcare inequalities, and when admitted to general hospitals are at a greater risk of patient safety incidents. This is well known in specialist services, but less recognized within primary or secondary healthcare. The most significant barriers to safer and better healthcare appear to include ‘invisibility’ of people with intellectual disabilities within health-care systems, widespread lack of staff understanding of intellectual disability, the vulnerabilities of people with intellectual disabilities, and the reasonable adjustment they may need in order to access health-care services. They may be ‘invisible’ to pharmacists in general hospitals. This article aims to raise awareness among those pharmacists and others providing care and support to people with intellectual disabilities in hospital in relation to how pharmacists can contribute to safety. Medication is the main therapeutic intervention in this population. Research is needed to determine the role of pharmacists in improving health outcomes and reducing health inequalities in this vulnerable population group when they are admitted to general hospitals. Full article
(This article belongs to the Special Issue Health Services Research in the Use of Medicines)
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