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Pharmacy, Volume 12, Issue 4 (August 2024) – 33 articles

Cover Story (view full-size image): Most people are not aware that many healthcare outcome statistics in the United States, including prevention of avoidable deaths, are among the worst in high-income countries worldwide. At the nexus of digital health, pharmacy care, and public health, this perspective article describes timely opportunities for retail pharmacies in the US to (1) scale up access to digital health technologies to improve healthcare outcomes and (2) eliminate promotion and sales of health-harming consumer products that increase mortality and morbidity risks. Digital health aisles that support therapies and healthy lifestyles offer win–win solutions for value-based care, the prevention of chronic diseases, and major pharmacy chains looking for innovative ways to better serve patients, caregivers, and healthcare professionals. View this paper
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12 pages, 572 KiB  
Review
Evaluating the Risk–Benefit Profile of Corticosteroid Therapy for COVID-19 Patients: A Scoping Review
by Daniel Hsiang-Te Tsai, Emma Harmon, Jan Goelen, Heather E. Barry, Li-Yang Chen and Yingfen Hsia
Pharmacy 2024, 12(4), 129; https://doi.org/10.3390/pharmacy12040129 - 22 Aug 2024
Viewed by 1969
Abstract
Background: The 2019 coronavirus (COVID-19) outbreak was declared a global pandemic in March 2020. It quickly spread across all continents, causing significant social, environmental, health, and economic impacts. During the pandemic, there has been consideration of repurposing and repositioning of medications, such as [...] Read more.
Background: The 2019 coronavirus (COVID-19) outbreak was declared a global pandemic in March 2020. It quickly spread across all continents, causing significant social, environmental, health, and economic impacts. During the pandemic, there has been consideration of repurposing and repositioning of medications, such as corticosteroids, for the treatment of hospitalised COVID-19 patients. Objective: To assess and summarise corticosteroid regimens used for hospitalised COVID-19 patients, focusing on dosage, route of administration, and clinical outcome from clinical trials. Methods: PubMed and Embase databases and the grey literature were searched to identify randomised controlled trials (RCTs) that evaluated the efficacy of corticosteroids in hospitalised patients with COVID-19 between January 2020 and January 2023. This scoping review was conducted in line with the PRISMA extension for scoping reviews (PRISMA-ScR) checklist. Key findings: A total of 24 RCTs were eligible for inclusion. There was variation in the steroid regimens used for treatment across COVID-19 trials. Despite the heterogeneity of included RCTs, the overall results have shown the benefits of improving lung function and a lower all-cause mortality rate in hospitalised COVID-19 patients treated with systematic corticosteroids. Conclusions: Corticosteroids have proven to be an effective treatment for COVID-19 patients in critical condition. However, comparative effectiveness studies should be conducted to assess the efficacy and safety of optimal corticosteroid treatment at the population level. Moreover, the global burden of long COVID is significant, affecting millions with persistent symptoms and long-term health complications. Thus, it is also necessary to evaluate the optimal steroid regimen for long COVID treatment. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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28 pages, 6053 KiB  
Article
Development and Evaluation of Interprofessional High-Fidelity Simulation Course on Medication Therapy Consultation for German Pharmacy and Medical Students—A Randomized Controlled Study
by Ahmed Reda Sharkas, Bushra Ali Sherazi, Shahzad Ahmad Sayyed, Florian Kinny, Melina Steichert, Holger Schwender and Stephanie Laeer
Pharmacy 2024, 12(4), 128; https://doi.org/10.3390/pharmacy12040128 - 21 Aug 2024
Cited by 2 | Viewed by 2580
Abstract
Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To [...] Read more.
Recently, there has been a remarkable move towards interprofessional collaboration in response to the COVID-19 pandemic and the care of comorbidities. In Germany, there has been a gradual increase in interprofessional learning in medical and pharmacy education, aiming to enhance patient care. To adapt the pharmacy curriculum for collaborative practice between pharmacy and medical students, we developed an immersive interprofessional collaboration course for pharmacy students using adult and pediatric high-fidelity simulators (HFS) to assess and train medication consultation skills. In a randomized controlled trial, we investigated whether interprofessional training between pharmacy and medical students results in differences in pharmacy students’ performance of medication therapy consultation compared to the case of mono-professional training of pharmacy students only. Before and after inter/mono-professional training, each pharmacy student performed an objective structured clinical examination (OSCE) and completed a self-assessment questionnaire. Additionally, an attitude survey towards interprofessional learning was completed by pharmacy and medical students at the end of the training. As expected, interprofessional as well as mono-professional training showed a statistically significant increase in medication consultation skills. Of importance, the performance in the interprofessional training group was significantly better than in the mono-professional group, particularly in drug therapy counselling and consultation behaviors. There was a significant difference between the intervention and control groups in self-assessment scores, and all study participants had positive attitudes toward interprofessional collaboration and training. Therefore, interprofessional training using HFS has been shown to appropriately train pharmacy students for collaborative practice and consultation skills. Full article
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7 pages, 169 KiB  
Communication
Description and Evaluation of a Pharmacy Graduate Health Services Research Methods Course
by David R. Axon
Pharmacy 2024, 12(4), 127; https://doi.org/10.3390/pharmacy12040127 - 21 Aug 2024
Viewed by 884
Abstract
The purpose of this paper is to provide a description and evaluation of a graduate-level Health Services Research Methods course offered at the University of Arizona R. Ken Coit College of Pharmacy. This three-credit, round-table discussion-style course introduces students to fundamental concepts in [...] Read more.
The purpose of this paper is to provide a description and evaluation of a graduate-level Health Services Research Methods course offered at the University of Arizona R. Ken Coit College of Pharmacy. This three-credit, round-table discussion-style course introduces students to fundamental concepts in healthcare study design and teaches them how to design and critique example studies for a variety of commonly encountered study designs. The course is assessed through essay-style examinations, development of a research proposal, and low-stakes weekly assignments. Twenty-seven students have completed the course in the past five years. Feedback from student course surveys was almost unanimously positive, with few meaningful suggestions for improvement. The description and evaluation of a graduate-level Health Services Research Methods course at one institution indicates that students had a largely favorable experience with the course. Considerations for future revisions to the course are discussed alongside other lessons learned. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
17 pages, 724 KiB  
Review
Supporting Patients with Nontuberculous Mycobacterial Pulmonary Disease: Ensuring Best Practice in UK Healthcare Settings
by Toby Capstick, Rhys Hurst, Jennie Keane and Besma Musaddaq
Pharmacy 2024, 12(4), 126; https://doi.org/10.3390/pharmacy12040126 - 21 Aug 2024
Viewed by 1489
Abstract
Nontuberculous mycobacterial pulmonary disease (NTM-PD) results from opportunistic lung infections by mycobacteria other than Mycobacterium tuberculosis or Mycobacterium leprae species. Similar to many other countries, the incidence of NTM-PD in the United Kingdom (UK) is on the rise for reasons that are yet [...] Read more.
Nontuberculous mycobacterial pulmonary disease (NTM-PD) results from opportunistic lung infections by mycobacteria other than Mycobacterium tuberculosis or Mycobacterium leprae species. Similar to many other countries, the incidence of NTM-PD in the United Kingdom (UK) is on the rise for reasons that are yet to be determined. Despite guidelines established by the American Thoracic Society (ATS), the Infectious Diseases Society of America, and the British Thoracic Society, NTM-PD diagnosis and management remain a significant clinical challenge. In this review article, we comprehensively discuss key challenges in NTM-PD diagnosis and management, focusing on the UK healthcare setting. We also propose countermeasures to overcome these challenges and improve the detection and treatment of patients with NTM-PD. Full article
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9 pages, 233 KiB  
Review
Administration of Levetiracetam via Subcutaneous Infusion for Seizure Control in the Palliative Care Setting: A Narrative Review
by Fern Beschi, Rachel Hughes and Jennifer Schneider
Pharmacy 2024, 12(4), 125; https://doi.org/10.3390/pharmacy12040125 - 16 Aug 2024
Viewed by 1758
Abstract
This narrative review aims to summarise the information available on the use of subcutaneous (SC) levetiracetam (LEV) in the adult palliative care setting using clinical texts, databases, journals, and grey literature. A search strategy utilising Embase, Medline CINALH and Cochrane databases, as well [...] Read more.
This narrative review aims to summarise the information available on the use of subcutaneous (SC) levetiracetam (LEV) in the adult palliative care setting using clinical texts, databases, journals, and grey literature. A search strategy utilising Embase, Medline CINALH and Cochrane databases, as well as Google Scholar, was conducted with the mapped search terms “levetiracetam”, “subcutaneous” and “palliative”. LEV intravenous (IV) proprietary products are used subcutaneously, including as continuous subcutaneous infusions (CSCIs), in the adult palliative care setting. The total LEV daily dose ranged from 250 mg to 5000 mg and LEV was administered with various diluents at varying volumes. The data identified a clinical desire to mix LEV with other medications; however, the current evidence on combination compatibility is observational only and drug stability in combinations is lacking. The majority of information in the literature on SC LEV use is based on case reports and retrospective audits. Case reports, whilst at times offering more clinical detail, represent specific circumstances not necessarily applicable to a larger patient cohort. The findings of retrospective audits are limited by the documentation and detail reported at the time of patient care that may not be designed for data collection. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
9 pages, 192 KiB  
Article
Examining Delineated Competencies within Blended Hospital/Health System Pharmacy and General Medicine Advanced Pharmacy Practice Experiences
by Jennifer L. Prisco, Yulia A. Murray, Tewodros Eguale and Jennifer D. Goldman
Pharmacy 2024, 12(4), 124; https://doi.org/10.3390/pharmacy12040124 - 13 Aug 2024
Viewed by 1420
Abstract
In the United States, Doctor of Pharmacy (PharmD) programs are required to provide advanced pharmacy practice experiences (APPEs) in the core inpatient rotation areas of hospital/health system pharmacy and inpatient general medicine patient care. Colleges and Schools of Pharmacy (C/SOPs) nationwide are increasingly [...] Read more.
In the United States, Doctor of Pharmacy (PharmD) programs are required to provide advanced pharmacy practice experiences (APPEs) in the core inpatient rotation areas of hospital/health system pharmacy and inpatient general medicine patient care. Colleges and Schools of Pharmacy (C/SOPs) nationwide are increasingly utilizing blended or longitudinal APPE models to offer experiential opportunities; however, there is a gap in the literature to support programs with delineating rotation-specific competencies when integrating two or more rotations together. Utilizing a survey instrument, PharmD students at two C/SOPs reported their onsite inpatient rotation sub-competency activities achieved within the four competency areas of Hospital/Health Pharmacy Systems, Medication Safety and Quality, Clinical Applications, and Professional Practice, which are listed in Appendix C of the 2016 Accreditation Council for Pharmacy Education Standards Guidance Document. Unpaired two-sample t-tests were performed to compare proportions of sub-competency activity occurrence in the two rotation settings. In total, 168 students reported inpatient activities related to the four competency areas, with 95–100% reporting their involvement in one or more sub-competency opportunities within each area. Of the 26 sub-competencies compared, 73% significantly facilitated the development of competency to a greater extent for one APPE inpatient rotation type over the other (p < 0.05). The findings can be utilized by C/SOPs to support the delineation of rotation-specific competencies when blending inpatient experiential opportunities. Full article
(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)
9 pages, 429 KiB  
Article
Adherence to Cysteamine Therapy Among Patients Diagnosed with Cystinosis in Saudi Arabia: A Prospective Cohort Study
by Reem Algasem, Nedaa Zainy, Essam Alsabban, Hamad Almojalli, Khalid Alhasan, Tariq Ali, Deiter Broering and Hassan Aleid
Pharmacy 2024, 12(4), 123; https://doi.org/10.3390/pharmacy12040123 - 8 Aug 2024
Viewed by 1627
Abstract
Cystinosis is a rare autosomal recessive disorder in which cystine crystals accumulate within the cellular lysosomes, causing damage to multiple organs. Due to challenges with the stringent cysteamine treatment regimen and side effects, adherence is often sub-optimal. This study aimed to assess the [...] Read more.
Cystinosis is a rare autosomal recessive disorder in which cystine crystals accumulate within the cellular lysosomes, causing damage to multiple organs. Due to challenges with the stringent cysteamine treatment regimen and side effects, adherence is often sub-optimal. This study aimed to assess the level of adherence to cysteamine therapy among cystinosis patients in Saudi Arabia and its impact on their quality of life. Electronic medical record data of 39 cystinosis patients from the Department of Nephrology at King Faisal Specialist Hospital and Research Center in Saudi Arabia were reviewed, and 25 patients were included in this study. Out of the 25 patients included in the final analysis, 64% (n = 16) were female. The mean age was 19.04 years. Almost all patients (23/25, 92%) were on oral IR cysteamine therapy, and 52% (13/25) were on topical cysteamine eye drop treatment. Of the 15 patients who responded to the Morisky Medication Adherence Scale-8 (MMAS-8) questionnaire, only 4 (26.7%) were highly adherent to cysteamine therapy. Most of the respondents (7/15, 46.7%) showed a medium level of treatment adherence. Based on the medication possession ratio for oral cysteamine, only 6 out of 23 patients (26.1%) were found to be 96–100% adherent. For the cysteamine eye drops, only 5/13 patients (38.4%) were 76–95% adherent. The 36-Item Short Form Health Survey (SF-36) used to assess patients’ health-related outcomes showed that their quality of life was affected in the domains of ‘social functioning’ and ‘energy/fatigue.’ Despite a small sample size, this study shows sub-optimal adherence to cysteamine treatment in patients from Saudi Arabia. The possible reasons for low treatment adherence could be a high frequency of administration and treatment-related side effects. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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10 pages, 525 KiB  
Article
Medication Reconciliation as Part of Admission Management—A Survey to Improve Drug Therapy Safety in a Urology Department
by Yvonne Remane, Luisa Pfeiffer, Leonie Schuhmann, Annett Huke, Jens-Uwe Stolzenburg and Thilo Bertsche
Pharmacy 2024, 12(4), 122; https://doi.org/10.3390/pharmacy12040122 - 6 Aug 2024
Viewed by 1209
Abstract
Complete medication reconciliation during hospital admission is the rationale for further treatment decisions. A consecutive, controlled intervention study was conducted to assess discrepancies in medication reconciliation performed by nurses of the Urology Department compared to the Best Possible Medication History (BPMH) established by [...] Read more.
Complete medication reconciliation during hospital admission is the rationale for further treatment decisions. A consecutive, controlled intervention study was conducted to assess discrepancies in medication reconciliation performed by nurses of the Urology Department compared to the Best Possible Medication History (BPMH) established by pharmacists. This study included pre-intervention (control group, CG), nursing training as a pharmaceutical intervention, and post-intervention (intervention group, IG) groups. The discrepancies were classified as “Missing” (not recorded but taken), “Added” (additionally recorded) “Strength” (incorrect documented dosage), “Intake” (incorrect intake time/schedule), “Double” (double prescription), and “Others” (no clear assignment). Additionally, high-risk drug subgroup discrepancies were particularly prevalent and were evaluated. Training success was compared concerning discrepancies in the CG and IG. Generally, the percentage of discrepancies per patient found was lower in the IG than in the CG (78.1% vs. 87.5%, significantly). The category most identified was “Missing” (IG, 33.3% vs. CG, 35.2%). Overall, a discrepancy of 7.4% each (discrepancies: IG, 27 vs. CG, 38) was determined for high-risk drugs while “Missing” occurred (77.8% vs. 52.6%, out of 7.4%). Despite nursing training only partially reducing discrepancies, the implementation of medication reconciliation using BPMH by pharmacists could improve the process, especially for high-risk drugs. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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11 pages, 470 KiB  
Article
Student Stress, Coping, and APPE Readiness at Two Public Institutions before and during the Pandemic
by Tram B. Cat, Shareen Y. El-Ibiary and Kelly C. Lee
Pharmacy 2024, 12(4), 121; https://doi.org/10.3390/pharmacy12040121 - 5 Aug 2024
Viewed by 1294
Abstract
The coronavirus disease 2019 (COVID-19) pandemic significantly impacted pharmacy students’ education and well-being. The primary aim of this study was to evaluate the effects of the pandemic on students’ perceived stress by comparing third- and fourth-year students from the pre-pandemic Class of 2019 [...] Read more.
The coronavirus disease 2019 (COVID-19) pandemic significantly impacted pharmacy students’ education and well-being. The primary aim of this study was to evaluate the effects of the pandemic on students’ perceived stress by comparing third- and fourth-year students from the pre-pandemic Class of 2019 with mid-pandemic Class of 2021 at two public institutions. Secondary aims were to evaluate the pandemic effects on students’ academic and professional development skills and practice readiness. The Perceived Stress Scale (PSS) and the Brief Coping Orientation to Problems Experienced (COPE) scale were used to measure student well-being. Students’ self-rated problem-solving, time management, and study skills were used to measure their academic and professional development; practice readiness was measured using students’ self-rated confidence levels. PSS scores were significantly higher in mid-pandemic than pre-pandemic students, and the Brief COPE avoidant coping subscale differed between pre-pandemic and mid-pandemic students. No differences were found in any academic and professional development skills between the pre- and mid-pandemic students, and there were significant improvements in student confidence levels for practice readiness among the mid-pandemic students. In conclusion, the pandemic appeared to affect students’ stress and avoidant coping mechanism but had variable effects on academic and professional development and practice readiness. Full article
(This article belongs to the Special Issue Pharmacy: State of the Art and Perspectives in USA (2nd Edition))
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13 pages, 1013 KiB  
Article
Risk Characterization in Patients Using Benzodiazepines While Providing Pharmaceutical Care Dispensing Service
by Daida Alberto Armas, Verónica Hernández García, Yanira Román Castillo, Juan Ramón Santana Ayala, Franc Capdevila Finestres, Arturo Hardisson de la Torre and Carmen Rubio Armendáriz
Pharmacy 2024, 12(4), 120; https://doi.org/10.3390/pharmacy12040120 - 31 Jul 2024
Cited by 1 | Viewed by 2001
Abstract
Background: Tolerance and dependence stand out as the most relevant risks observed during benzodiazepine (BZD) treatments. Objectives: To evaluate the degree of dependence of patients on BZD treatments using the Tyrer test; to define a profile of patients at risk of developing BZD [...] Read more.
Background: Tolerance and dependence stand out as the most relevant risks observed during benzodiazepine (BZD) treatments. Objectives: To evaluate the degree of dependence of patients on BZD treatments using the Tyrer test; to define a profile of patients at risk of developing BZD dependence; and to discuss the role of the pharmaceutical care offered by the community pharmacy during dispensing. Methods: Prospective cross-sectional descriptive observational study (August 2020–February 2021) involving 127 patients using BZD. They voluntarily answered a questionnaire during the dispensing pharmaceutical care service. The study was evaluated and codified (code: DAA-CLO-2020-01) by the Spanish Agency for Drugs and Health Products (AEMPS), and statistical analysis was performed with SPSS 25.0. Results: 19.05% of patients using BZD were suspected of suffering from BZD tolerance, and 77.88% of all patients were identified as being at a high risk of BZD dependence. The Tyrer test for dependence indicated a mean score of 5.59 out of 13 points. An 18-fold increased risk of developing dependence was detected in the case of coexistence of high anxiety or depression. Conclusions: The community pharmacy, through protocolized care practices and supported by tools such as the Tyrer test, can play a decisive role in the detection, prevention, and resolution of the risks associated with BZD treatments. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
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11 pages, 241 KiB  
Article
Pharmacist-Led Deprescribing of Opioids and Benzodiazepines in Older Adults: Examining Implementation and Perceptions
by Tamera D. Hughes, Elizabeth Sottung, Juliet Nowak and Kimberly A. Sanders
Pharmacy 2024, 12(4), 119; https://doi.org/10.3390/pharmacy12040119 - 30 Jul 2024
Viewed by 1432
Abstract
Background: This study examines the implementation and perceptions of a pharmacist consultant deprescribing program aimed at reducing the risk of falls in older adults using opioids and benzodiazepines. Methods: This qualitative study conducted interviews with healthcare providers. The interviews were conducted from August [...] Read more.
Background: This study examines the implementation and perceptions of a pharmacist consultant deprescribing program aimed at reducing the risk of falls in older adults using opioids and benzodiazepines. Methods: This qualitative study conducted interviews with healthcare providers. The interviews were conducted from August to December 2021 and analyzed using inductive coding techniques. Results: Five participants, predominantly female MDs or PA-Cs from rural clinics, were interviewed. The participants adopted a pharmacist-led deprescribing program due to their heightened awareness of the opioid crisis, dedication to patient safety, and a desire for opioid deprescribing education. Initially, concerns included patient resistance and provider-driven barriers. However, over time, patient attitudes shifted toward greater openness to the program. The providers emphasized several critical needs for the success of the program: guaranteed access to pharmacists, tailored patient education, resources specific to providers, and financial support, including telehealth options. These factors were deemed essential to overcoming initial barriers and ensuring effective implementation. Conclusion: Integrating pharmacists into primary care settings shows promise for deprescribing opioids and benzodiazepines in older adults. Future research should explore telehealth options for patient–pharmacist consultations and expand the application of these findings to other healthcare settings. The study highlights the importance of awareness, patient education, access to resources (pharmacists), and provider support in addressing deprescribing among older adults. Full article
(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
16 pages, 766 KiB  
Article
Analysis of the Justice Component of a JEDI (Justice, Equity, Diversity, and Inclusion) Inventory in a College of Pharmacy
by Chad W. Schulz, Jackson J. Dubas, Allison M. Dering-Anderson, Karen L. Hoff, Adam L. Roskam, Noah A. Kasbohm, Brady W. Holtmeier, Hannah L. Hansen, Kaitlyn L. Stukenholtz, Ashley N. Carron and Lindsey M. Tjards
Pharmacy 2024, 12(4), 118; https://doi.org/10.3390/pharmacy12040118 - 29 Jul 2024
Viewed by 1200
Abstract
At the University of Nebraska Medical Center College of Pharmacy, a longitudinal project is underway to assess how the college is functioning in terms of keeping Justice, Equity, Diversity, and Inclusion (JEDI) at the forefront of the institution. This study is intended to [...] Read more.
At the University of Nebraska Medical Center College of Pharmacy, a longitudinal project is underway to assess how the college is functioning in terms of keeping Justice, Equity, Diversity, and Inclusion (JEDI) at the forefront of the institution. This study is intended to showcase areas of excellence within the college and as a quality improvement exercise to show the institution potential areas in need of improvement. This process was also initiated because such assessments may soon become a requirement for colleges of pharmacy to earn full accreditation. Upon analyzing the Justice component of JEDI and the 32 justice-related ideas that were recommended for exploration and discussion, and further sub-categorized under the terms representation, curriculum and education, policies and procedures, support and resources, and college climate, useful data were discovered. Overall, the information found on representation, policy and procedure, and college climate was difficult to quantify as much of the information was subjective; however, this does not automatically discount this information from being useful. Information relating to curriculum and education was more quantifiable but may be underrepresented. Analyzing information found relating to resources was made possible by identifying readily available support offered at the college for faculty, staff, and students. In identifying these resources, the college was able to take note of any missing support that needed to be implemented to ensure justice was being maintained. This longitudinal process not only allows the college to see areas where they thrive, but it also highlights any shortcomings of the college while providing the institution with information to spark innovative ideas to strengthen and further promote justice. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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12 pages, 568 KiB  
Article
Assessment of Student Pharmacists’ Co-Curricular Professionalization Using an Impact Scale
by Laurie L. Briceland, Megan Veselov and Kelly Bach
Pharmacy 2024, 12(4), 117; https://doi.org/10.3390/pharmacy12040117 - 25 Jul 2024
Viewed by 1113
Abstract
Co-curricular participation is a required component of the pharmacy program. Assessment of co-curricular activities has proven challenging due to lack of manpower to address the workload of reviewing multiple critical reflections. This project documented the professionalization impact of co-curricular involvement and secondarily explored [...] Read more.
Co-curricular participation is a required component of the pharmacy program. Assessment of co-curricular activities has proven challenging due to lack of manpower to address the workload of reviewing multiple critical reflections. This project documented the professionalization impact of co-curricular involvement and secondarily explored the utility of our assessment tool, the Co-curricular Impact Scale (CIS), developed to streamline the assessment process. First- through third-professional-year students (P1, P2, P3) participated in five co-curricular domains: (i) professional development/education; (ii) patient care service; (iii) legislative advocacy; (iv) leadership/service to the pharmacy profession; and (v) healthcare-related community service. For the CIS, 16 questions were developed and mapped to 11 educational outcomes and included assessing the impact of immersing in an authentic learning experience, collaborating with healthcare professionals, and preparing for the pharmacist role. A group of 296 students rated the impact of participation as low, moderate, or significant for five events annually. Based on 717 entries, the two attributes deemed most impactful were: “Activity immersed me in an authentic learning experience” (95% ≥ Moderate Impact) and “Activity improved my self-confidence” (93% ≥ Moderate Impact). P1 students found slightly less impact in co-curricular participation (83.5%) than P2 (88.4%) and P3 (86.8%) counterparts. The CIS proved to be an efficient method to collate impact of co-curricular involvement upon student professionalization. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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21 pages, 1515 KiB  
Article
Deprescribing NSAIDs: The Potential Role of Community Pharmacists
by Delsher Amedi and Parisa Gazerani
Pharmacy 2024, 12(4), 116; https://doi.org/10.3390/pharmacy12040116 - 24 Jul 2024
Cited by 3 | Viewed by 2060
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are largely used for controlling various pain conditions and are widely available in community pharmacies, with and without prescription. Despite their effectiveness, NSAIDs can pose significant risks due to potential side effects and drug interactions, particularly in polypharmacy and [...] Read more.
Non-steroidal anti-inflammatory drugs (NSAIDs) are largely used for controlling various pain conditions and are widely available in community pharmacies, with and without prescription. Despite their effectiveness, NSAIDs can pose significant risks due to potential side effects and drug interactions, particularly in polypharmacy and comorbidity contexts and for vulnerable users. This study investigated whether and how NSAIDs deprescribing can be conducted at the community pharmacy level by assessing pharmacists’ confidence, attitudes, and potential barriers and facilitators. Additionally, we aimed to identify any deprescribing guidelines that pharmacists could use. A literature search and a cross-sectional digital questionnaire targeting community pharmacists in Norway were conducted. Results showed that study participants (N = 73) feel confident in identifying needs for deprescribing NSAIDs but barriers such as time constraints, lack of financial compensation, and communication challenges were noted. Participants reported positive attitudes toward deprescribing but highlighted a need for better guidelines and training. This study highlights a gap in specific guidelines for deprescribing NSAIDs and a potential for enhancing pharmacists’ roles in the deprescribing process, for example, through training and improved financial incentives. Further research is encouraged to develop concrete strategies for an effective implementation where community pharmacists can be involved in the deprescribing of NSAIDs. Full article
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8 pages, 423 KiB  
Article
Impact of a Pharmacist-Led HCV Treatment Program at a Federally Qualified Health Center
by Jerika T. Lam and Sharon Xavioer
Pharmacy 2024, 12(4), 115; https://doi.org/10.3390/pharmacy12040115 - 24 Jul 2024
Viewed by 1311
Abstract
Pharmacists are key players who can help to eliminate the hepatitis C virus (HCV) epidemic in the United States. This pilot retrospective study evaluated the impact of a pharmacist-led HCV treatment program in a federally qualified health center (FQHC) primary care clinic setting. [...] Read more.
Pharmacists are key players who can help to eliminate the hepatitis C virus (HCV) epidemic in the United States. This pilot retrospective study evaluated the impact of a pharmacist-led HCV treatment program in a federally qualified health center (FQHC) primary care clinic setting. The primary outcome was to assess sustained virologic response (SVR) rates 12 weeks after patients were initiated and completed their oral direct acting antiviral (DAA) treatment regimens. Methods: This pilot retrospective study included historical analyses of patients who received DAA treatment in the pharmacist-led HCV treatment program in a FQHC clinic between 1 January 2019 and 31 January 2021. SVR was the primary outcome measure for treatment response. Results: Sixty-seven patients with HCV mono- and HIV co-infection were referred, and 59 patients were initiated on DAA regimens after treatment. Fifty of those who were started on DAA regimens completed their treatment, and 38 achieved SVR (modified intention to treat [mITT] SVR rate of 76%). Conclusion: Our study’s findings demonstrated SVR rates that were comparable with other pharmacist-directed HCV treatment services in the United States despite the impact of the COVID-19 pandemic. Our study included a higher proportion of individuals with HCV/HIV co-infection and of Hispanic ethnicity. Full article
(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
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8 pages, 203 KiB  
Article
The Impact of Motivational Interviewing and MOTIVE Tool Use by Pharmacists on Vaccine Acceptance
by Aleda M. H. Chen, Alea Anthony, Adeola Balogun, Ruth Pereira and Justin W. Cole
Pharmacy 2024, 12(4), 114; https://doi.org/10.3390/pharmacy12040114 - 24 Jul 2024
Viewed by 1744
Abstract
Vaccines have played a significant role in reducing infectious disease burden. However, vaccine hesitancy remains a persistent challenge in public health, including for pharmacists who often interact with patients regarding vaccines. Thus, this study assesses the impact of motivational interviewing (MI) training and [...] Read more.
Vaccines have played a significant role in reducing infectious disease burden. However, vaccine hesitancy remains a persistent challenge in public health, including for pharmacists who often interact with patients regarding vaccines. Thus, this study assesses the impact of motivational interviewing (MI) training and the MI-based vaccine hesitancy discussion tools (MOTIVE) on pharmacists’ management of vaccine hesitancy. Pharmacists in eight Midwestern pharmacy practices who completed MI and MOTIVE training and engaged with vaccine-hesitant patients participated in this study. The pharmacist participants completed post-encounter surveys identifying the vaccine discussed, the tool utilized, and the outcome of the conversation. Descriptive results from 362 encounters indicated that the primary reasons for hesitancy were safety (39%), care coordination (31.5%), and efficacy (30.4%). Post encounter, 35.4% of patients received vaccines, 26% planned to, 25.1% considered it, and 13.5% were uninterested. The findings highlight the importance of patient-centered communication, such as MI, between patients and pharmacists to identify and address reasons for vaccine hesitancy. Pharmacists, equipped with conversation tools such as the MOTIVE tools, may effectively influence vaccine acceptance. Future research should evaluate the utility of MI and the MOTIVE tools in other settings and regions. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
15 pages, 1099 KiB  
Article
Development and Validation of a Tool to Explore Attitudes Towards meDication adHErence Using a Novel Self-Reported QuestionnairE (ADHERE-7)
by Iva Bužančić, Mislav Balen, Dahna Arbanas, Slaven Falamić, Katarina Fehir Šola, Ana Galić Skoko, Mirna Momčilović, Ante Orbanić, Alena Tatarević and Maja Ortner Hadžiabdić
Pharmacy 2024, 12(4), 113; https://doi.org/10.3390/pharmacy12040113 - 18 Jul 2024
Viewed by 2041
Abstract
Despite the availability of various tools for measuring medication adherence, efficiently identifying non-adherence levels and reasons at the point of care remains challenging. Existing tools often lack the ease of use needed for practical clinical application. This study aimed to develop and validate [...] Read more.
Despite the availability of various tools for measuring medication adherence, efficiently identifying non-adherence levels and reasons at the point of care remains challenging. Existing tools often lack the ease of use needed for practical clinical application. This study aimed to develop and validate a user-friendly tool to provide healthcare professionals with a concise yet comprehensive means of identifying adherence behaviors. The methodology consisted of two phases: tool items were first developed using the nominal group technique with healthcare professionals, followed by a cross-sectional pilot study involving community-dwelling adults in Croatia. Validation analysis indicated acceptable face and content validity and satisfactory criterion validity, with Attitudes towards meDication adHErence self-Reported questionnairE (ADHERE-7) scores correlating with both the self-reported five-item Medication Adherence Report Scale (MARS-5 tool) (ρ = 0.765; p < 0.001) and an objective measure of the proportion of days covered (PDC) from pharmacy prescription claims data (G = 0.586; p = 0.015). Construct validity revealed three factors: Aversion, Comfort, and Practical Non-Adherence, with Cronbach’s alpha values of 0.617 for Aversion and 0.714 for Comfort Non-Adherence. The mean total score for ADHERE-7 was 26.27 ± 2.41 (range 17 to 28). This robust validation process confirms the ADHERE-7 tool as a reliable instrument for assessing medication adherence, addressing aversion, comfort, practical issues, and both intentional and unintentional nonadherence. Full article
(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
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11 pages, 189 KiB  
Article
Electronic Logistic Management Information System in Public Health Facilities and Its Implications for the Medicine Supply Chain in Singida District Council, Tanzania
by Anwar Milulu, Stanley Mwita and Namanya Basinda
Pharmacy 2024, 12(4), 112; https://doi.org/10.3390/pharmacy12040112 - 18 Jul 2024
Cited by 1 | Viewed by 2154
Abstract
The effective management of the medicine supply chain is crucial for ensuring the availability of essential medicines and supplies in public health facilities. This study aimed to determine the utilization of the electronic logistic management information system (e-LMIS) in public health facilities and [...] Read more.
The effective management of the medicine supply chain is crucial for ensuring the availability of essential medicines and supplies in public health facilities. This study aimed to determine the utilization of the electronic logistic management information system (e-LMIS) in public health facilities and its implications for the medicine supply chain. A mixed methods approach, combining both quantitative and qualitative data collection methods, was used. The study included 106 healthcare providers from 35 public health facilities in Singida District. Six key informants were interviewed using a qualitative method. Of the 106 participants, 62.3% said they were somehow competent in e-LMIS utilization. In in-depth interviews, respondents underscored the system’s utility for tracking stock levels, procurements, and managing orders. Staff shortages and a lack of customized training were mentioned as major challenges hindering efficiency in managing drug supplies. This study highlighted the positive impact of e-LMIS on various aspects of the medicine supply chain, including the timely submission of orders and enhanced inventory management. Sustained management support and the regular utilization of the e-LMIS system are crucial for building and maintaining competence among healthcare providers, thereby optimizing the medicine supply chain and ultimately improving healthcare delivery. Full article
24 pages, 783 KiB  
Article
Exploring the Role of Community Pharmacists in Pain Management: Enablers and Challenges
by Syed Hassan Mujtaba and Parisa Gazerani
Pharmacy 2024, 12(4), 111; https://doi.org/10.3390/pharmacy12040111 - 18 Jul 2024
Cited by 4 | Viewed by 2910
Abstract
Pain is a common complaint, and the consumption of analgesics is prevalent. Community pharmacists, as primary contact points for patients, can play a crucial role in guiding patients toward rational pharmacotherapy or alternative pain management strategies. However, there are no specific educational curricula [...] Read more.
Pain is a common complaint, and the consumption of analgesics is prevalent. Community pharmacists, as primary contact points for patients, can play a crucial role in guiding patients toward rational pharmacotherapy or alternative pain management strategies. However, there are no specific educational curricula or standard guidelines to support this role, and the perception of this potential role is not well known. We conducted an anonymous online questionnaire among community pharmacists in Norway to assess their knowledge, perspectives, and willingness to engage in pain care. The survey also explored potential facilitators and barriers, and the use of any current guidelines. Seventy-one community pharmacists participated from various regions in Norway. Findings revealed that community pharmacists felt knowledgeable and willing to engage in pain management but anticipated barriers such as time constraints and a lack of standard guidelines. Participants also highlighted the need for better collaboration with other healthcare professionals and continuous professional development to enhance their role. To optimize the role of community pharmacists in pain management, therefore, integrating them into multidisciplinary healthcare teams, minimizing barriers, and providing continuous education and standard guidelines seem essential. This approach can empower community pharmacists and improve pain management outcomes. Full article
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14 pages, 226 KiB  
Article
Questionnaire on the Current Status and Awareness of Palliative Medicine by Community Cooperation Pharmacies
by Keigo Nagatani, Mayu Nakahara, Sachiko Omotani and Michiaki Myotoku
Pharmacy 2024, 12(4), 110; https://doi.org/10.3390/pharmacy12040110 - 16 Jul 2024
Viewed by 1110
Abstract
Community cooperation pharmacies are equipped to prepare narcotics and sterile injectable drugs for palliative medicine at home for cancer pain and end-of-life care; however, to the best of our knowledge, the actual status of the system to provide palliative medicine at home has [...] Read more.
Community cooperation pharmacies are equipped to prepare narcotics and sterile injectable drugs for palliative medicine at home for cancer pain and end-of-life care; however, to the best of our knowledge, the actual status of the system to provide palliative medicine at home has not yet been examined. Therefore, in this study, given that home palliative medicine is one of the accreditation criteria for community cooperation pharmacies, a questionnaire survey was conducted among managing pharmacists engaged in community cooperation pharmacies to investigate the actual status of the system to provide appropriate services, mainly pain management, to patients who need home palliative medicine. An analysis of responses to the questionnaire showed that pharmacists working in community cooperation pharmacies had a high level of understanding of the proper use of rescue doses of medical narcotics and patient guidance. Pharmacists with experience in sterile and injection preparations also had a high level of understanding of palliative medicine. On the other hand, they had a low level of understanding of the WHO method for cancer pain treatment and appropriate suggestions for opioid switching. These results indicate that the creation of learning opportunities, such as training on injectables and prescription designs, for pharmacists in community cooperation pharmacies is one of the measures that may improve their understanding of palliative medicine. Full article
11 pages, 257 KiB  
Article
Factors Determining Quality of Drug Information by Hospital Pharmacies—Results from Five-Year Annual Quality Assessment
by Dorothea Strobach, Ute Chiriac, Sigrun Klausner, Sabine Krebs, Claudia Langebrake, Christiane Querbach, Carolin Schuhmacher, Rickmer Schulte, Simon Wiegrebe and Ute Amann
Pharmacy 2024, 12(4), 109; https://doi.org/10.3390/pharmacy12040109 - 13 Jul 2024
Viewed by 1080
Abstract
Drug information (DI) provided by hospital pharmacies aims to promote rational and safe drug therapy. While quality assessment for this task is recommended, more knowledge on the factors determining the quality is needed. We aimed to evaluate the impacts of different factors on [...] Read more.
Drug information (DI) provided by hospital pharmacies aims to promote rational and safe drug therapy. While quality assessment for this task is recommended, more knowledge on the factors determining the quality is needed. We aimed to evaluate the impacts of different factors on the quality of DI provided by hospital pharmacies to healthcare professionals. Retrospectively, answers on fictitious enquiries about annual DI tests for German hospital pharmacies over five years were evaluated for content-related and structural requirements. Multivariate analysis was performed for the impact of the enquiry complexity, DI organization (specialized DI center; pharmacist responsible per day; DI on top of other routine tasks), and quality measures (second look; experience of answering pharmacist in DI/on ward; use of documentation database). In 2017–2021, 45, 71, 79, 118, and 122 hospital pharmacies participated. The enquiry complexity had a statistically significant impact on the content-related quality, with poor results for a higher complexity (years 2018/2021, OR 0.25/0.04, p < 0.01). The DI centers achieved better results regarding content-related quality than for a pharmacist responsible per day (OR 0.76/p = 0.65) or DI on top of routine tasks (OR 0.35/p = 0.02). The DI centers scored better in structural quality. The second look showed an overall trend of a better content-related and structural quality. In conclusion, specialized DI centers and second looks are recommended as quality-improving measures. Training for answering complex enquiries should be intensified. Full article
26 pages, 20368 KiB  
Article
Developing Medication Reviews to Improve the Aruban Healthcare System: A Mixed-Methods Pilot Study
by Minke L. Copinga, Ellen A. Kok, Anke J. J. van Dam, Anoeska Wever, Adrienne Tromp and Herman J. Woerdenbag
Pharmacy 2024, 12(4), 108; https://doi.org/10.3390/pharmacy12040108 - 12 Jul 2024
Viewed by 1805
Abstract
This study investigated whether and how medication reviews (MRs) conducted by pharmacists and general practitioners (GPs) with patient involvement can be performed on the island of Aruba (Dutch Caribbean). In this mixed-methods pilot study (both qualitative and quantitative), constructive and observational methodologies were [...] Read more.
This study investigated whether and how medication reviews (MRs) conducted by pharmacists and general practitioners (GPs) with patient involvement can be performed on the island of Aruba (Dutch Caribbean). In this mixed-methods pilot study (both qualitative and quantitative), constructive and observational methodologies were combined. Healthcare providers’ and patients’ views on MRs and aspects of Aruban healthcare and culture relevant to MRs were examined. These insights were used to develop a protocol for conducting and implementing MRs in Aruba. Surveys were distributed and semi-structured interviews were held among Aruban community pharmacists and GPs, and a pilot program was created in which MRs were carried out with four Aruban patients and their GPs. According to the included healthcare providers, the main purpose of MRs is to optimize the patient experience and achieve concordance. Even though pharmacists and GPs consider their partnership equal, they have different views as to who should bear which responsibility in the MR process in matters regarding patient selection and follow-up. Common Aruban themes that were mentioned by the healthcare providers and deemed relevant for conducting MRs included behaviour/culture, healthcare, lifestyle, and therapy compliance. Anamnesis should be concise during the MR, and questions about medication storage, concerns, beliefs, and practical problems, as well as checks for limited health literacy, were considered important. In the pilot, at least three to, maximally, eight pharmacotherapy-related problems (PRPs) were detected per MR consultation, such as an incorrect dosage of acetylsalicylic acid, an inappropriate combination tablet for blood pressure regulation, and the absence of important laboratory values. All patients considered their consultation to be positive and of added value. In addition, it was observed that an MR can potentially generate cost savings. The information obtained from the healthcare providers and patients, together with the basic principles for MRs, as applied in the Netherlands, led to a definitive and promising MR format with practical recommendations for community pharmacists in Aruba: in comparison with the Dutch MR approach, GPs and pharmacists in Aruba could collaborate more on patient selection for MRs and their follow-up, because of their specific knowledge regarding the medications patients are taking chronically (pharmacists), and possible low levels of health literacy (GPs). Taking into account the Aruban culture, pharmacists could ask extra questions during MRs, referring to lifestyle (high prevalence of obesity), readability of medication labels (limited literacy), and herbal product use (Latin American culture). GPs and medical specialists sometimes experience miscommunication regarding the prescription of medication, which means that pharmacists must carefully take into account possible duplicate medications or interactions. Full article
(This article belongs to the Special Issue Pharmaceutical Care Services in Pharmacy Practice II)
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24 pages, 2510 KiB  
Perspective
Redesigning Pharmacy to Improve Public Health Outcomes: Expanding Retail Spaces for Digital Therapeutics to Replace Consumer Products That Increase Mortality and Morbidity Risks
by Grzegorz Bulaj, Melissa Coleman, Blake Johansen, Sarah Kraft, Wayne Lam, Katie Phillips and Aarushi Rohaj
Pharmacy 2024, 12(4), 107; https://doi.org/10.3390/pharmacy12040107 - 12 Jul 2024
Viewed by 4267
Abstract
United States healthcare outcomes, including avoidable mortality rates, are among the worst of high-income countries despite the highest healthcare spending per capita. While community pharmacies contribute to chronic disease management and preventive medicine, they also offer consumer products that increase mortality risks and [...] Read more.
United States healthcare outcomes, including avoidable mortality rates, are among the worst of high-income countries despite the highest healthcare spending per capita. While community pharmacies contribute to chronic disease management and preventive medicine, they also offer consumer products that increase mortality risks and the prevalence of cardiovascular diseases, diabetes, cancer, and depression. To resolve these contradictions, our perspective article describes opportunities for major pharmacy chains (e.g., CVS Pharmacy and Walgreens) to introduce digital health aisles dedicated to prescription and over-the-counter digital therapeutics (DTx), together with mobile apps and wearables that support disease self-management, wellness, and well-being. We provide an evidence-based rationale for digital health aisles to replace spaces devoted to sugar-sweetened beverages and other unhealthy commodities (alcohol, tobacco) that may increase risks for premature death. We discuss how digital health aisles can serve as marketing and patient education resources, informing customers about commercially available DTx and other technologies that support healthy lifestyles. Since pharmacy practice requires symbiotic balancing between profit margins and patient-centered, value-based care, replacing health-harming products with health-promoting technologies could positively impact prevention of chronic diseases, as well as the physical and mental health of patients and caregivers who visit neighborhood pharmacies in order to pick up medicines. Full article
(This article belongs to the Special Issue Pharmacy: State of the Art and Perspectives in USA (2nd Edition))
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11 pages, 433 KiB  
Article
How Do Pharmacists Distribute Their Work Time during a Clinical Intervention Trial?—A Time and Motion Study
by Renata Vesela Holis, Renate Elenjord, Elin Christina Lehnbom, Sigrid Andersen, Marie Fagerli, Tine Johnsgård, Birgitte Zahl-Holmstad, Kristian Svendsen, Marit Waaseth, Frode Skjold and Beate Hennie Garcia
Pharmacy 2024, 12(4), 106; https://doi.org/10.3390/pharmacy12040106 - 9 Jul 2024
Cited by 1 | Viewed by 1957
Abstract
Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this [...] Read more.
Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this study was to investigate how clinical pharmacists introduced into the ED interdisciplinary teams distribute their work time. In a time and motion study, we used the Work Observation Method By Activity Timing (WOMBAT) to observe pharmacists in two Norwegian EDs. The pragmatic approach allowed pharmacists to adapt to ED personnel and patient needs. The pharmacists spent 41.8% of their work time on medication-related tasks, especially those linked to medication reconciliation, including documenting medication-related issues (16.2%), reading and retrieving written information (9.6%), and obtaining oral information about medication use from patients (9.5%). The remaining time was spent on non-medication-related tasks (41.8%), and on standby and movement (17.4%). In conclusion, ED pharmacists spent 42% of their work time on medication-related tasks, predominantly medication reconciliation. Their relatively new role in the interdisciplinary team may have limited their broader clinical impact. Relative to other ED healthcare professionals, ED pharmacists’ goal remains to ensure accurate patient medication lists and appropriate medication use. Full article
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9 pages, 224 KiB  
Article
Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma
by Ashley Cid, Alec Patten, Michael A. Beazely and Kelly Grindrod
Pharmacy 2024, 12(4), 105; https://doi.org/10.3390/pharmacy12040105 - 9 Jul 2024
Cited by 1 | Viewed by 1574
Abstract
The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a [...] Read more.
The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach’s α co-efficient were calculated for each version. The term “opioid addiction” was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
20 pages, 724 KiB  
Article
Exploring the Perceptions and Behaviours of UK Prescribers Concerning Novel Lipid-Lowering Agent Prescriptions: A Qualitative Study
by Sarah Baig, Shahrauz Mughal, Yousuf Murad, Mandeep Virdee and Zahraa Jalal
Pharmacy 2024, 12(4), 104; https://doi.org/10.3390/pharmacy12040104 - 3 Jul 2024
Viewed by 1843
Abstract
Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers’, [...] Read more.
Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers’, including doctors, pharmacists, and nurses, on current lipid management for cardiovascular diseases and prescriptions of novel lipid-lowering therapies, and (ii) to explore the challenges and facilitating factors of prescribing novel lipid-lowering therapies through qualitative interviews. Qualitative semi-structured interviews with twelve medical and non-medical prescribers were conducted, around 20–30 min in length. The interviews were audio-recorded and transcribed on an online platform. A thematic analysis was deployed. Four major themes emerged from the analysis: (1) prescribing barriers; (2) prescribing enablers; (3) inter-profession variability; and (4) health literacy. These themes highlighted the contrast between the need for optimal shared decision making and the various constraints in practice. Participants expressed their inexperience with novel lipid-lowering therapies and acknowledged the requirement and importance of these agents for primary cardiovascular disease prevention. Participants recognised confidence and competence as key drivers for prescribing therapies and welcomed further education and training to enhance their skillset. Patients’ misconceptions towards current lipid-lowering therapies contributed to their refusal of newer agents, highlighting a requirement to improve patient education. Targeting communities through awareness campaigns was identified as a viable solution. Full article
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12 pages, 256 KiB  
Perspective
Nutrition’s Role in Quality Healthcare in the United States: Opportunities and Education for Pharmacists to Take a Bite of the Apple and Strengthen Their Skills
by Jeff Cai, Andie Lee Gonzalez and Mary Beth Arensberg
Pharmacy 2024, 12(4), 103; https://doi.org/10.3390/pharmacy12040103 - 29 Jun 2024
Cited by 1 | Viewed by 2183
Abstract
With global chronic disease rates on the rise, diet and nutrition remain pivotal yet under-appreciated aspects of healthcare, including in pharmacy practice. This perspective paper delves into how current United States health policies support nutrition’s role in healthcare and its integration into pharmacy [...] Read more.
With global chronic disease rates on the rise, diet and nutrition remain pivotal yet under-appreciated aspects of healthcare, including in pharmacy practice. This perspective paper delves into how current United States health policies support nutrition’s role in healthcare and its integration into pharmacy practice. The paper also reviews the landscape of nutrition education and training for pharmacists, pharmacy roles in multidisciplinary teams and interprofessional nutrition care, and the opportunities for post-graduate nutrition-focused certification, training, and continuing education. It advocates for a paradigm shift towards greater emphasis on nutrition within pharmacy practice, to improve skills and benefit quality patient nutrition care. Full article
(This article belongs to the Special Issue Pharmacy: State of the Art and Perspectives in USA (2nd Edition))
12 pages, 10419 KiB  
Article
Dynamic Changes in the Distribution of Hydrocodone and Oxycodone in Florida from 2006 to 2021
by Elena Lynn Stains, Akshay C. Patel, Jay P. Solgama, Joseph D. Hagedorn, Kenneth L. McCall and Brian J. Piper
Pharmacy 2024, 12(4), 102; https://doi.org/10.3390/pharmacy12040102 - 28 Jun 2024
Viewed by 1712
Abstract
Background: Florida, which led the country in terms of its number of opioid-prescribing physicians, was unique during the height of the opioid epidemic because of its lax prescribing laws and high number of unregulated pain clinics. Here, we address differences in the distribution [...] Read more.
Background: Florida, which led the country in terms of its number of opioid-prescribing physicians, was unique during the height of the opioid epidemic because of its lax prescribing laws and high number of unregulated pain clinics. Here, we address differences in the distribution rates of oxycodone and hydrocodone across Florida counties during the peak years of the opioid epidemic using an under-utilized database. Methods: The Washington Post and the United States Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) databases provided longitudinal oxycodone and hydrocodone distribution data in grams per county (2006–2014) and state (2006–2021). Grams of oxycodone and hydrocodone were converted into morphine milligram equivalents (MMEs). Results: There was a steep increase in oxycodone from 2006 to 2010, with a subsequent decline. In 2010, the average MME per person across Florida was 729.4, a 120.6% increase from 2006. The three counties with the highest MMEs per person in 2010 were Hillsborough (2271.3), Hernando (1915.3), and Broward (1726.9), and they were significantly (p < 0.05) elevated relative to the average county. Conclusions: The data demonstrated pronounced differences in opioid distribution, particularly oxycodone, between Florida counties during the height of the opioid epidemic. Legislative action taken between 2009 and 2011 aligns with the considerable decline in opioid distribution after 2010. Full article
(This article belongs to the Special Issue Pharmacists’ Role in Reducing Problematic Opioid Use)
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13 pages, 707 KiB  
Article
Adolescent Perspectives on the Pharmacy-Based T-EVER (Teen E-Cigarette and Vaping Educational Resource) and Its Potential Impact on Youth Vaping
by Grace C. Klubertanz, McKennah J. Matulle, Jenny S. Li and Olufunmilola Abraham
Pharmacy 2024, 12(4), 101; https://doi.org/10.3390/pharmacy12040101 - 28 Jun 2024
Cited by 1 | Viewed by 3770
Abstract
Background: While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be [...] Read more.
Background: While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be actively engaged in their health which creates space to educate on vaping in this population segment. Methods: From January to May 2023, 35 adolescents aged 11–18 participated in interviews to assess the investigator-developed Teen E-cigarette and Vaping Educational Resource (T-EVER). All the interviews were recorded and transcribed for independent analysis by two study team members. Results: The participants liked the T-EVER, indicating they were engaged in the content. However, some participants wanted more information. The participants wanted health professionals to educate them on vaping but were worried about the potential barriers facing the implementation in community pharmacy settings. Conclusions: Adolescents want to learn about vaping, but there are limited opportunities to do so. The T-EVER is designed to educate youth about vaping. This tool was well received and has the potential to be used by pharmacists as a vaping prevention and cessation intervention. More research is required to discern the true scope of the pharmacist’s role in using an educational tool to address adolescent vaping. Full article
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10 pages, 864 KiB  
Article
Considering the Possible Role of Pharmacists According to the Presence or Absence of Lifestyle-Related Diseases at the Time of Coronary CT Examination and Trends of Medication Use for These Diseases by Medical Doctors
by Erika Miura-Takahashi, Kohei Tashiro, Yuhei Shiga, Yuto Kawahira, Sara Higashi, Yuki Otsu, Hidetoshi Kamimura and Shin-ichiro Miura
Pharmacy 2024, 12(4), 99; https://doi.org/10.3390/pharmacy12040099 - 27 Jun 2024
Viewed by 1058
Abstract
Background: Because patients often already have coronary artery disease (CAD) at the time of a coronary artery computed tomography angiography (CCTA) examination, we examined the medications prescribed by medical doctors for lifestyle-related diseases and investigated what possible role pharmacists can play in prescribing. [...] Read more.
Background: Because patients often already have coronary artery disease (CAD) at the time of a coronary artery computed tomography angiography (CCTA) examination, we examined the medications prescribed by medical doctors for lifestyle-related diseases and investigated what possible role pharmacists can play in prescribing. Methods: Patients (n = 1357) who underwent CCTA examination were divided into two groups according to the presence or absence of lifestyle-related diseases [hypertension (HTN), dyslipidemia (DL) and diabetes mellitus (DM)], and the relationship between the presence or absence of CAD was examined. Results: The rate of CAD was significantly higher in patients with HTN, DL or DM than in patients without these diseases. The blood pressure in the HTN group was 140 ± 20/79 ± 13 mmHg, the low-density lipoprotein cholesterol value in the DL group was 119 ± 35 mg/dL, and the hemoglobin A1c value in the DM group was 7.0 ± 1.1%, all of which were poorly controlled. Anti-hypertensive drugs were used at low rates in the HTN group, statins were used in 47% and ezetimibe was used in 4% of the DL group, and dipeptidyl peptidase-4 inhibitors were used in 41% of the DM group. Conclusions: Since the rate of CAD (+) was high and control of the three major lifestyle-related diseases was poor, pharmacists should advise medical doctors to use combinations of drugs. Full article
(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
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