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Pharmacy, Volume 12, Issue 6 (December 2024) – 27 articles

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25 pages, 363 KiB  
Review
Rationale and Logistics of Continuous Infusion Cephalosporin Antibiotics
by Abbie L. Blunier, R. Jake Crocker, Rachel Foster, Stephanie S. May, Caroline E. Powers and P. Brandon Bookstaver
Pharmacy 2024, 12(6), 185; https://doi.org/10.3390/pharmacy12060185 - 5 Dec 2024
Viewed by 535
Abstract
Cephalosporins have traditionally been administered as an intermittent infusion. With the knowledge that cephalosporins demonstrate a time-dependent pharmacodynamic profile, administration via continuous infusion may provide more effective antibiotic exposure for successful therapy. Proposed benefits of administration via continuous infusion include less IV manipulation, [...] Read more.
Cephalosporins have traditionally been administered as an intermittent infusion. With the knowledge that cephalosporins demonstrate a time-dependent pharmacodynamic profile, administration via continuous infusion may provide more effective antibiotic exposure for successful therapy. Proposed benefits of administration via continuous infusion include less IV manipulation, decreased potential for antibiotic resistance, and potential cost savings. The objective of this review was to provide a detailed assessment of available evidence for the use of continuous infusion cephalosporins and practical dosing and administration recommendations. Studies were gathered and assessed for inclusion via a literature search of PubMed and Ovid MEDLINE using mesh terms [“continuous infusion” and “cephalosporin”], “intermittent infusion”, [“intermittent versus continuous” and “cephalosporin”], “continuous infusion cephalosporin”, as well as specific drug names. References from included studies were also evaluated for inclusion. Data which compared the two administration methods (continuous infusion vs. intermittent infusion) were evaluated. Thirty-five studies were analyzed among several cephalosporins with variable delivery. Dosing regimens utilized in the selected studies were assessed with known compatibility and stability data and further summarized. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
10 pages, 468 KiB  
Review
Clinical Pharmacist-Led Collaboration of Multiple Clinical Professions Model Focusing on Continuity of Pharmacotherapy: Japanese Version of the Lund Integrated Medicines Management (LIMM) Model
by Rie Sato, Syuichi Aoshima and Tommy Eriksson
Pharmacy 2024, 12(6), 184; https://doi.org/10.3390/pharmacy12060184 - 5 Dec 2024
Viewed by 652
Abstract
(1) Background: In general, it is known that continuity of care can contribute to an increase in patient satisfaction, reduce health care costs, and improve patient outcomes. A guarantee of continuity in pharmacotherapy is a big challenge facing Japanese health care as a [...] Read more.
(1) Background: In general, it is known that continuity of care can contribute to an increase in patient satisfaction, reduce health care costs, and improve patient outcomes. A guarantee of continuity in pharmacotherapy is a big challenge facing Japanese health care as a system that encourages cooperation/collaboration for pharmacists with other health care professions is currently lacking. (2) Method: This is a narrative review. (3) Results: The Lund Integrated Medicine Management (LIMM) model describes a systematic approach to individuals and was developed in Sweden to optimize pharmacotherapy among elderly inpatients. The aim of the LIMM model is to provide patients with continuous pharmacotherapy at different levels of care. The LIMM model, in which a clinical pharmacist is the catalyst and leads other health care professions in completing the process, has the potential to reduce potentially inappropriate prescriptions, reduce rehospitalization risk, unscheduled hospital revisits due to problems related to medications, reduce total medical expenditure, and provide a comprehensive understanding of patients’ conditions of taking medicine. (4) Conclusions: Introducing a framework such as Sweden’s LIMM model, anchored by clinical pharmacists, could provide a good opportunity to promote collaborations among different health care professionals and improve continuity in pharmacotherapy. Full article
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22 pages, 8986 KiB  
Article
Insights from a National Survey on Controlled Substance Diversion Practices in U.S. Hospital Pharmacies: Opportunities for Enhanced Surveillance and Compliance
by Samantha S. Bastow, Eric P. Borrelli, Julia D. Lucaci, Heather Nelkin, April Graves and Amanda Hays
Pharmacy 2024, 12(6), 183; https://doi.org/10.3390/pharmacy12060183 - 4 Dec 2024
Viewed by 409
Abstract
This study explored controlled substance (CS) diversion surveillance practices within hospital pharmacies across the United States. A survey with questions based on published CS diversion risk points was conducted in May 2024. A total of 66 participants from 31 states responded, with 54.5% [...] Read more.
This study explored controlled substance (CS) diversion surveillance practices within hospital pharmacies across the United States. A survey with questions based on published CS diversion risk points was conducted in May 2024. A total of 66 participants from 31 states responded, with 54.5% from single facilities and the remaining from health systems. Most respondents were pharmacy directors, managers, or those in dedicated drug diversion roles. Over 70% have dedicated surveillance teams and use drug diversion software. Results highlight variation in practices, with larger institutions generally showing better compliance. Compliance in procurement and receiving was high for access measures; however, auditing of processes was lower. The lowest procurement compliance was in monitoring periodic automatic replacement (PAR) levels and validating orders with wholesalers. Storage practices showed high compliance in deploying cameras, but low compliance in monitoring them. Dispensing practices had high compliance for restricting CS in automated dispensing cabinets, but low incidence of witness verification during stocking. Waste and disposal practices were well-followed, but training on detecting potential signs of medication tampering was less common. The survey highlights that while strategies to prevent CS diversion exist, their implementation varies. Enhancing monitoring, auditing, and training is essential to strengthen diversion prevention efforts in hospital pharmacies. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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13 pages, 227 KiB  
Article
Latvian Healthcare Professionals’ Self-Reported Knowledge, Attitudes, and Behaviors Related to Pregnancy Prevention Program Materials for Valproate-Containing Medicines
by Milana Špoģe, Mirdza Kursīte and Elita Poplavska
Pharmacy 2024, 12(6), 182; https://doi.org/10.3390/pharmacy12060182 - 4 Dec 2024
Viewed by 415
Abstract
Background: Valproates are recognized for their significant teratogenic risks, which can lead to physical defects and developmental disorders when used during pregnancy. To mitigate these risks, the Pregnancy Prevention Program (PPP) was developed by European regulators for patients and healthcare professionals (HCPs). Despite [...] Read more.
Background: Valproates are recognized for their significant teratogenic risks, which can lead to physical defects and developmental disorders when used during pregnancy. To mitigate these risks, the Pregnancy Prevention Program (PPP) was developed by European regulators for patients and healthcare professionals (HCPs). Despite the crucial nature of this program, the implementation of the PPP does not appear to be fully effective. This situation highlights the need for a deeper understanding of HCPs’ knowledge, attitudes, and behaviors regarding the PPP. Methods: A cross-sectional study using anonymous electronic questionnaires was conducted. The questionnaires were developed by a board of experts from eight different EU countries and were distributed among prescribers (general practitioners (GPs), neurologists, and psychiatrists) and pharmacists. Descriptive statistics were used to analyze the obtained data on participants’ knowledge, attitudes, and behaviors regarding the prescribing and dispensing of valproate-containing medicines to women of reproductive age, as well as the impact of PPP materials on their work. Results: The study results indicate that while HCPs in Latvia are generally aware of valproate teratogenic risks, significant gaps remain in the implementation of the PPP. A considerable number of both prescribers and pharmacists expressed the belief that they are not responsible for educating patients about the PPP, attributing this responsibility to other specialists. Furthermore, barriers such as a lack of time and accessible materials were identified. Conclusions: The roles and responsibilities of HCPs should be clearly defined to improve adherence to the PPP. Further research is needed to assess prescription and dispensing strategies, as well as HCPs’ attitudes toward the PPP. Additionally, re-evaluating and enhancing the accessibility of PPP materials is essential in effective risk management and better patient care. Full article
(This article belongs to the Special Issue Women's Special Issue Series: Pharmacy and Pharmacists)
13 pages, 2267 KiB  
Article
High-Performance Liquid Chromatography with DAD Detection for the Determination of Cannabinoids in Commercial Veterinary CBD Oil
by Zehra Hajrulai-Musliu, Elizabeta Dimitreska Stojkovikj, Dimitar Gusheski, Dea Musliu and Daniel Velkovski
Pharmacy 2024, 12(6), 181; https://doi.org/10.3390/pharmacy12060181 - 2 Dec 2024
Viewed by 523
Abstract
The study highlights the need for quality control in evaluating medicinal plant products, especially CBD oils, before market release. Due to varying regulatory requirements, product labeling can sometimes be misleading, especially regarding cannabinoid concentrations such as CBD and THC. This research focused on [...] Read more.
The study highlights the need for quality control in evaluating medicinal plant products, especially CBD oils, before market release. Due to varying regulatory requirements, product labeling can sometimes be misleading, especially regarding cannabinoid concentrations such as CBD and THC. This research focused on developing a validated high-performance liquid chromatography (HPLC) method for accurately identifying and quantifying key cannabinoids in Commercial Veterinary CBD Oil. The main compounds identified included Cannabidivarin (CBDV), Cannabidiolic Acid (CBD-A), Cannabigerolic Acid (CBG-A), Cannabigerol (CBG), Cannabidiol (CBD), Tetrahydrocannabivarin (THCV), Cannabinol (CBN), ∆9-Tetrahydrocannabinol (d9-THC) ∆8-Tetrahydrocannabinol (d8-THC), Cannabicyclol (CBL), Cannabichromene (CBC), and Tetrahydrocannabinolic Acid (THCA), determined in line with the International Conference on Harmonization’s (ICH) guidelines. The method was validated for linearity, accuracy, precision, limit of detection (LOD), and limit of quantitation (LOQ). It was determined to be linear, with a correlation coefficient (R²) > 0.999. The LOD and LOQ values calculated from the calibration curve ranged from 0.05 to 0.13 and 0.50 to 0.61 µg/mL, respectively. The method also exhibited acceptable precision, with relative standard deviation values lower than or equal to 2%. The method’s accuracy was assessed through recovery percentages and fell within an acceptable range of 98–102 if the RSD was 2%. This study’s rigorous methodology and comprehensive findings significantly contribute to cannabinoid analysis. This validated protocol was used to analyze cannabinoids in 14 commercial veterinary CBD oil products from the Republic of North Macedonia. The performance parameters demonstrated that the method is reliable for quantitatively measuring cannabinoids in CBD oil. The analysis showed that the cannabinoid levels in the products were consistent with the manufacturers’ declared specifications, with no significant discrepancies in labeling. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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21 pages, 2029 KiB  
Systematic Review
Addition of Bevacizumab to Chemotherapy and Its Impact on Clinical Efficacy in Cervical Cancer: A Systematic Review and Meta-Analysis
by Aleena Shahzad, Anees ur Rehman, Tehnia Naz, Muhammad Fawad Rasool, Alisha Saeed, Saba Rasheed, Sadia Shakeel, Saleh Karamah Al-Tamimi and Rabia Hussain
Pharmacy 2024, 12(6), 180; https://doi.org/10.3390/pharmacy12060180 - 1 Dec 2024
Viewed by 788
Abstract
Background and Objectives: Cervical cancer is the third leading cause of cancer-related mortality in females. One of the most successful therapeutic modalities to date is suppressing vascular endothelial growth factor (VEGF)-mediated angiogenesis. Bevacizumab is a monoclonal antibody that targets VEGF-A. The outcomes [...] Read more.
Background and Objectives: Cervical cancer is the third leading cause of cancer-related mortality in females. One of the most successful therapeutic modalities to date is suppressing vascular endothelial growth factor (VEGF)-mediated angiogenesis. Bevacizumab is a monoclonal antibody that targets VEGF-A. The outcomes for cervical cancer patients treated with bevacizumab in combination with platinum-based chemotherapy have been explored in several studies. This study aimed to assess the impact of bevacizumab on progression-free survival (PFS) and overall survival (OS) in patients with metastatic cervical cancer. Materials and Methods: This systematic review was registered in PROSPERO (CRD42023456755). Following PRISMA guidelines, a comprehensive literature search on PubMed and Google Scholar identified 28 studies meeting the inclusion criteria. The outcomes of interest were PFS and OS. The statistical analysis computed hazard ratios (HRs) with 95% confidence intervals (CIs). The study also included a subgroup analysis by cervical cancer stage. Results: The pooled analysis revealed that bevacizumab-based therapy significantly improved both PFS with HR 0.77 (95% CI: 0.58–0.96; p < 0.01; I2 = 58%) and OS with HR 0.63 (95% CI: 0.45–0.89; p < 0.01; I2 = 41%) in cervical cancer patients. Subgroup analysis by stage of cervical cancer demonstrated better efficacy of bevacizumab in metastatic stage IVB cervical cancer patients indicated by HR for PFS (0.69, 95% CI: 0.54–0.79; p < 0.01) and HR for OS (0.57, 95% CI: 0.46–0.73; p < 0.01). Conclusions: Bevacizumab exhibits a significant increase in PFS and OS, underscoring the efficacy of anti-angiogenesis therapy in cervical cancer, particularly in stage IVB metastatic cervical cancer patients. Full article
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19 pages, 3878 KiB  
Article
Current Situation for Pharmacists in Japanese Veterinary Medicine: Exploring the Pharmaceutical Needs and Challenges of Veterinary Staff to Facilitate Collaborative Veterinary Care
by Taisuke Konno, Hiroyuki Suzuki, Naoto Suzuki, Kouji Okada, Yosuke Nishikawa, Daisuke Kikuchi, Hitoshi Nakamura and Yuriko Murai
Pharmacy 2024, 12(6), 179; https://doi.org/10.3390/pharmacy12060179 - 29 Nov 2024
Viewed by 455
Abstract
While veterinary pharmacy is common overseas, it has yet to gain traction in Japan. To clarify the actual situation in Japan, two surveys were conducted, targeting 4017 facilities (2000 pharmacies/drug stores, 2000 veterinary medical facilities, and 17 university-affiliated veterinary hospitals). We received 324 [...] Read more.
While veterinary pharmacy is common overseas, it has yet to gain traction in Japan. To clarify the actual situation in Japan, two surveys were conducted, targeting 4017 facilities (2000 pharmacies/drug stores, 2000 veterinary medical facilities, and 17 university-affiliated veterinary hospitals). We received 324 responses from pharmacy staff and 217 from veterinary hospital staff. Pharmacists were involved in drug therapy for companion animals either via direct discussion with veterinarians or by referrals for prescriptions from veterinarians (11 respondents). Veterinary staff and pharmacists showed a disparity regarding pharmacists’ involvement in companion animal healthcare. Veterinary staff wanted pharmacists to provide pharmaceutical guidance, perform audits, supply drug information, and prepare drugs. Strong demand (72.2% of the veterinary staff) existed for consultations with pharmacists regarding medication issues. Veterinary medicine has evolved to meet the demand for the advanced care of companion animals. Veterinary staff have diverse and substantial requests for pharmacists. Integrating the expertise of both veterinary staff and pharmacists may facilitate a team-based approach to veterinary medicine and improve the quality of care for companion animals. Tailoring approaches to suit Japan’s unique circumstances and creating a conducive environment for effective communication between pharmacists and veterinary staff are pivotal for advancing veterinary pharmacy in Japan. Full article
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18 pages, 1033 KiB  
Review
A Systematic Review of Controlled Trials: Can Patient Adherence to Antibiotics Be Improved Through Pharmaceutical Communication-Based Interventions?
by Carla Pires
Pharmacy 2024, 12(6), 178; https://doi.org/10.3390/pharmacy12060178 - 26 Nov 2024
Viewed by 326
Abstract
Background: Patient adherence to antibiotics is vital to ensure treatment efficiency. Objective: To evaluate the impact of pharmacist communication-based interventions on patients’ adherence to antibiotics. Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for systematic review (PRISMA) [...] Read more.
Background: Patient adherence to antibiotics is vital to ensure treatment efficiency. Objective: To evaluate the impact of pharmacist communication-based interventions on patients’ adherence to antibiotics. Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for systematic review (PRISMA) checklist and flow diagram. Controlled trials were included. Databases: PubMed, Cochrane Library, SciELO, and Google Scholar. Quality, risk of bias, and confidence in cumulative evidence were evaluated. Results: Twenty-one trials were selected, with better patient adherence for the intervention than the control group. However, statistically significant differences were only found in two-thirds of these trials. The use of educational leaflets, personalized delivery of antibiotics, follow-up measures, and structured counseling were among the most impactful and significant interventions. The fact that community and/or hospital pharmacists were required to intervene in both groups (e.g., intervention vs. control/usual care) may explain that statistically significant differences were not achieved in all trials. Moderate quality issues and/or risk of bias were detected in some of the evaluated trials. The cumulative evidence was classified as high to moderate, which was considered acceptable. Conclusion: It seems that more intense and structured pharmacist interventions can improve patient adherence to antibiotics. Full article
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11 pages, 988 KiB  
Article
The Role of Pharmacists in Minimizing the Risk Inherent in Unbundled Telehealth Services: A 12-Month Retrospective Case Study
by Louis Talay, Matt Vickers and Tiffany Cheng
Pharmacy 2024, 12(6), 177; https://doi.org/10.3390/pharmacy12060177 - 25 Nov 2024
Viewed by 441
Abstract
Pharmacists have often been viewed as the last line of defence against prescription errors in traditional care models. Although a large number of chronic care patients are using telehealth services to increase their access to continuous care, researchers have yet to investigate prescription [...] Read more.
Pharmacists have often been viewed as the last line of defence against prescription errors in traditional care models. Although a large number of chronic care patients are using telehealth services to increase their access to continuous care, researchers have yet to investigate prescription safety in such settings in Australia. The absence of this literature is particularly concerning in the context of the Australian Government’s admission in a 2024 report that the national health system has not adequately addressed the World Health Organization’s ‘Medication without harm’ objective. One of the report’s key findings was that knowledge on digital direct-to-consumer services is insufficient. A defining feature of some of these services is their unbundling of the pharmacy component, which logically increases the risk for prescription errors. This study analyzed the frequency of which the Cloud pharmacy network intercepted prescription errors in an unbundled digital sexual dysfunction service for men. Investigators found that Cloud pharmacists were responsible for intercepting 22 (5.31%) the 414 prescribing errors observed in the Pilot Australia service in 2023, including 12 (8.05%) of the 149 prescription errors for premature ejaculation (PE) patients and 10 (3.77%) of the 265 errors for erectile dysfunction (ED) patients. Seven of the errors intercepted by Cloud pharmacists were of high or medium severity, including four drug contraindications, two cases of inadequate patient history reviews, and one case of inadequate counselling. This study also appears to be the first to provide digital prescribing error rate data in an Australian sexual healthcare setting, observing an error rate of 0.86% from 30,649 ED prescriptions, 1.13% from the 13,154 PE prescriptions, and a total prescription error rate of 0.95% (414 out of 43,792 prescriptions). These findings demonstrate the vital role of pharmacists in intercepting prescribing errors in unbundled telehealth services. Possible implications of these findings include the allocation of additional resources across the pharmacy sector and the establishment of regulatory safety standards for unbundled telehealth services. Full article
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19 pages, 963 KiB  
Article
Cannabidiol Supplements in Romania: Bridging the Gap Between Marketed Claims and Clinical Reality
by Corina Andrei, George Mihai Nitulescu, Georgiana Nitulescu and Anca Zanfirescu
Pharmacy 2024, 12(6), 176; https://doi.org/10.3390/pharmacy12060176 - 25 Nov 2024
Viewed by 485
Abstract
In recent years, the European market, including Romania, has witnessed a significant increase in the promotion of cannabidiol (CBD)-based products, often presented as effective treatments for various health conditions. This study investigates the inconsistencies between the health claims associated with these supplements and [...] Read more.
In recent years, the European market, including Romania, has witnessed a significant increase in the promotion of cannabidiol (CBD)-based products, often presented as effective treatments for various health conditions. This study investigates the inconsistencies between the health claims associated with these supplements and the evidence from clinical trials. To identify products available on the Romanian market, a systematic review of online pharmacies and websites that specialize in selling CBD-based products has been performed. Additionally, a systematic review of clinical trials has been conducted to assess the efficacy of CBD for the specified indications. Our analysis revealed that some claims, such as those related to post-traumatic stress disorder, lack substantial clinical evidence. Moreover, even when clinical support exists, the dosages recommended for the supplements are often significantly lower than those used in trials, raising concerns about their efficacy. These findings highlight the need for stricter regulatory oversight and more transparent communication to ensure that consumer expectations are aligned with scientific evidence, ultimately promoting informed decision-making and consumer safety. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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12 pages, 464 KiB  
Article
Attitudes and Experiences of Patients Regarding Gender-Specific Aspects of Pain Management
by Carolin Alexandra Boldt, Dirk Keiner, Norman Best and Thilo Bertsche
Pharmacy 2024, 12(6), 175; https://doi.org/10.3390/pharmacy12060175 - 22 Nov 2024
Viewed by 427
Abstract
Background: Biological, pharmacological, and socio-cultural aspects influence gender-specific effects in pain management. Methods: Gender-specific aspects of pain management were assessed in a rural outpatient center via semi-structured patient interview: (i) general gender aspects (total population) from 1 = “fully disagree” to 5 = [...] Read more.
Background: Biological, pharmacological, and socio-cultural aspects influence gender-specific effects in pain management. Methods: Gender-specific aspects of pain management were assessed in a rural outpatient center via semi-structured patient interview: (i) general gender aspects (total population) from 1 = “fully disagree” to 5 = “fully agree”; and (ii) individual pain (matched pairs) via numeric analog scale (NAS) from 0 = “no pain” to 10 = “maximum pain”. Patient charts were assessed for pain management (WHO-ladder). Results: In total, 113 patients were enrolled (59.18 [SD: 12.76] years, 46% female, 54% male, 0% diverse), and 42 were matched into female-male pairs. (i) Women and men agreed that men and women should be treated equally despite biological differences (median: 5 [women] vs. 5 [men]; p = 0.789). As a reason for gender-specific aspects, “medication concentration” was reported more frequently by women (p = 0.038) and “no answer” by men (p = 0.014). (ii) Mean value (SD) of pain (NAS) was 4.0 (SD 2.3) for women and 3.3 (SD 2.6) for men (p = 0.215) with a positive correlation between pain management escalation (WHO-ladder) and the pain score (NAS) only in men (r = 0.704, p = 0.001). Women rather reported an influence of adverse drug reactions on treatment contentment than men (p = 0.042). Conclusions: Although patients pleaded for gender-independent equal treatment, gender-specific differences in pain therapy were found. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
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11 pages, 248 KiB  
Article
Assessment of Potential Drug–Drug Interactions of Psycholeptics and Antidepressants in Outpatient Settings
by Iva Marović, Ivana Marinović, Vesna Bačić Vrca and Ivana Samardžić
Pharmacy 2024, 12(6), 174; https://doi.org/10.3390/pharmacy12060174 - 22 Nov 2024
Viewed by 645
Abstract
Mental health is an important segment in preserving overall health and represents a significant public health issue. In modern times, mental health disorders have risen, often requiring complex pharmacotherapy and chronic monitoring. The aim of this research was to determine the prevalence and [...] Read more.
Mental health is an important segment in preserving overall health and represents a significant public health issue. In modern times, mental health disorders have risen, often requiring complex pharmacotherapy and chronic monitoring. The aim of this research was to determine the prevalence and clinical significance of potential psychotropic drug interactions in outpatient settings and compare the differences in potential drug–drug interaction (pDDIs) exposure with age. The psychotropic drugs included antipsychotics—N05A, anxiolytics—N05B, hypnotics and sedatives—N05C, and antidepressants—N06A. This retrospective study analyzed prescribed pharmacotherapy in 492 outpatients who were treated with at least one psychotropic drug. We determined 1.64 prescribed psychotropic drugs per patient and 2.2 pDDIs that involved psychotropic drugs. In total, 2285 pDDIs were recorded, of which almost half (47.6%) were pDDIs with psychotropic drugs. More prescribed psychotropic drugs were found in patients younger than 65 years, and equal exposure to pDDIs of psychotropic drugs (p = 0.5077) was found in both age groups. The most commonly identified psychotropics involved in pDDIs were benzodiazepines, promazine, and zolpidem. The results indicate that psychotropic drug interactions represent important drug-related problems for primary health care. The widespread use of psychotropic drugs and the determined clinical significance of their interactions require pharmacist interventions which can reduce the prevalence of pDDIs and increase patient safety. Full article
8 pages, 548 KiB  
Commentary
Tackling Pharmaceutical Pollution Along the Product Lifecycle: Roles and Responsibilities for Producers, Regulators and Prescribers
by Gillian Parker and Fiona A. Miller
Pharmacy 2024, 12(6), 173; https://doi.org/10.3390/pharmacy12060173 - 22 Nov 2024
Viewed by 589
Abstract
Pharmaceuticals produce considerable environmental harm. The industry’s resource-intensive nature, coupled with high energy costs for manufacturing and transportation, contribute to the “upstream” harms from greenhouse gas emissions and ecosystem pollution, while factors such as overprescription, overuse, and pharmaceutical waste contribute to the “downstream” [...] Read more.
Pharmaceuticals produce considerable environmental harm. The industry’s resource-intensive nature, coupled with high energy costs for manufacturing and transportation, contribute to the “upstream” harms from greenhouse gas emissions and ecosystem pollution, while factors such as overprescription, overuse, and pharmaceutical waste contribute to the “downstream” harms. Effectively addressing pharmaceutical pollution requires an understanding of the key roles and responsibilities along the product lifecycle. In this commentary, we argue that three actors—producers, regulators, and prescribers—have unique and interdependent responsibilities to address these issues. Producers and market access regulators are upstream actors who can manage and mitigate harms by both shifting manufacturing, business practices, and regulatory requirements and producing transparent, robust data on environmental harms. By contrast, prescribers are downstream actors whose capacity to reduce environmental harms arises principally as a “co-benefit” of reducing inappropriate prescribing and overuse. Potentially complicating the prescriber’s role are the calls for prescribers to recommend “environmentally preferable medicines”. These calls continue to increase, even with the sparsity of transparent and robust data on the impact of pharmaceuticals on the environment. Recognizing the interdependencies among actors, we argue that, rather than being ineffectual, these calls draw needed attention to the critical responsibility for upstream actors to prioritize data production, reporting standards and public transparency to facilitate future downstream efforts to tackle pharmaceutical pollution. Full article
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7 pages, 213 KiB  
Article
Evaluating Pharmacists’ Knowledge of Food–Drug Interactions in Croatia: Identifying Gaps and Opportunities
by Josipa Bukić, Doris Rušić, Antonela Turic, Dario Leskur, Toni Durdov, Joško Božić, Martin Kondža, Darko Modun and Ana Šešelja Perišin
Pharmacy 2024, 12(6), 172; https://doi.org/10.3390/pharmacy12060172 - 21 Nov 2024
Viewed by 554
Abstract
Food–drug interactions (FDIs) are pharmacokinetic or pharmacodynamic changes in drug effects caused by the presence of specific foods. To identify and prevent FDIs, pharmacists, alongside other healthcare professionals, should possess a certain level of knowledge. This study aimed to assess knowledge of FDIs [...] Read more.
Food–drug interactions (FDIs) are pharmacokinetic or pharmacodynamic changes in drug effects caused by the presence of specific foods. To identify and prevent FDIs, pharmacists, alongside other healthcare professionals, should possess a certain level of knowledge. This study aimed to assess knowledge of FDIs among Croatian pharmacists. A total of 206 participants were included in this cross-sectional study. The median knowledge score among Croatian pharmacists was 69.44%, with an interquartile range of 19.44. Croatian pharmacists most commonly recognized FDIs involving theophylline, warfarin, and tetracycline, while the lowest rate of correct answers was observed with digoxin interactions. Future studies should evaluate pharmacists’ clinical practice concerning FDIs. Additionally, more research is needed to develop educational programs on this topic, either at the university level or for continuing education. Full article
(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)
17 pages, 319 KiB  
Article
Cardiovascular Diseases and Metabolic Medications in the Lebanese Population: A Post Hoc Analysis from a Nationwide Cross-Sectional Study
by Rony M. Zeenny, Rachel Abdo, Chadia Haddad, Aline Hajj, Rouba Karen Zeidan, Pascale Salameh and Jean Ferrieres
Pharmacy 2024, 12(6), 171; https://doi.org/10.3390/pharmacy12060171 - 20 Nov 2024
Viewed by 543
Abstract
Objective: This study assesses the association of metabolic drugs (specifically hypoglycemic and hypolipemic agents) with cardiovascular diseases (CVD) among the Lebanese population and patients’ subgroups. Methods: A nationwide cross-sectional retrospective study was carried out in Lebanon. The survey collected information on sociodemographic characteristics, [...] Read more.
Objective: This study assesses the association of metabolic drugs (specifically hypoglycemic and hypolipemic agents) with cardiovascular diseases (CVD) among the Lebanese population and patients’ subgroups. Methods: A nationwide cross-sectional retrospective study was carried out in Lebanon. The survey collected information on sociodemographic characteristics, lifestyles, comorbidities, and medication use. Logistic regression models were employed to analyze the data and determine associations between CVD and metabolic drugs. Stratification analyses were performed based on diabetes and dyslipidemia status. Results: The study found significant associations with CVD among the 2048 participants. Higher scores on the Lebanese Mediterranean Diet Score (LMDS; ORa = 1.06), hypertension (ORa = 1.71), diabetes (ORa = 1.75), dyslipidemia (ORa = 1.89), family history of CVD (ORa = 1.58), and smoking (previous: ORa = 1.63, current: ORa = 2.15) were linked to increased CVD odds. Higher income (intermediate: ORa = 0.64, high: ORa = 0.40) was inversely related to it. A subsequent model that included hypoglycemic and lipid-lowering medications yielded similar results. However, neither hypoglycemic nor lipid-lowering medications demonstrated a significant association with CVD risk. A third regression model was conducted by taking the classes of drugs as an independent variable. Also, the result revealed that all the classes of medication were not associated with the risk of CVD. Stratification by diabetes revealed LMDS and hypertension as risk factors in both groups. Among non-diabetic participants, dyslipidemia (ORa = 2.40), current smoking (ORa = 2.28), and higher income (intermediate: ORa = 0.57, high: ORa = 0.62) were linked to CVD. Among people with diabetes, a family history of CVD (ORa = 2.69) increased the CVD odds, while being an employer (ORa = 0.49) lowered it. Stratification by dyslipidemia showed consistent risk factors, and higher LMDS (ORa = 1.07), diabetes (ORa = 2.14), hypertension (ORa = 1.79), and previous smoking (ORa = 1.95) were linked to CVD without dyslipidemia. Being a female (ORa = 0.52) and having a lower income (ORa = 0.40) were associated with lower CVD odds in those with dyslipidemia. Subgroup analyses showed that medications were not significantly associated with CVD odds among patients with diabetes or hyperlipidemia. Conclusions: This study’s findings highlight the importance of addressing modifiable risk factors and socioeconomic factors to reduce the burden of CVD. Targeted interventions and longitudinal research are necessary to optimize preventive strategies and improve the management of CVD in individuals using hypoglycemic and hypolipemic agents in low- and medium-income countries. Full article
15 pages, 277 KiB  
Article
Medication Reconciliation of Patients by Pharmacist at the Time of Admission and Discharge from Adult Nephrology Wards
by Hossein Ahmadi, Yalda Houshmand, Ghanbar Ali Raees-Jalali and Iman Karimzadeh
Pharmacy 2024, 12(6), 170; https://doi.org/10.3390/pharmacy12060170 - 18 Nov 2024
Viewed by 515
Abstract
Purpose: The aim of the present study was to investigate the impact of medication reconciliation by pharmacists at both admission and discharge in hospitalized patients with different kidney diseases. Methods: A prospective study was performed in adult nephrology wards of a teaching referral [...] Read more.
Purpose: The aim of the present study was to investigate the impact of medication reconciliation by pharmacists at both admission and discharge in hospitalized patients with different kidney diseases. Methods: A prospective study was performed in adult nephrology wards of a teaching referral hospital in Iran from September 2020 to March 2021. All patients hospitalized in the nephrology ward for at least 1 day who received the minimum of one medication during their ward stay within the study period were considered eligible. Medication reconciliation was performed by taking a best-possible medication history from eligible patients during the first 24 h of ward admission. Medications were evaluated for possible intentional as well as unintentional discrepancies. Results: Here, 178 patients at admission and 134 patients at discharge were included. The mean numbers of unintentional drug discrepancies for each patient at admission and discharge were 6.13 ± 4.13 and 1.63 ± 1.94, respectively. The mean ± SD numbers of prescribed medications for patients before ward admission detected by the nurse/physician and pharmacist were 6.06 ± 3.53 and 9.22 ± 4.71, respectively (p = 0.0001). The number of unintentional discrepancies at admission and discharge had a significant correlation with the number of drugs used and underlying diseases. The number of unintentional discrepancies at admission was also correlated with patients’ age. The number of comorbidities was significantly associated with the number of unintentional medication discrepancies at both admission and discharge. At the time of ward discharge, all patients were given medication consultations. Conclusions: The rate of reconciliation errors was high in the adult nephrology ward. The active contribution of pharmacists in the process of medication reconciliation can be significantly effective in identifying these errors. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
11 pages, 397 KiB  
Article
A Qualitative Study of Pharmacists’ Perceptions of the Advantages and Disadvantages of Telepharmacy
by Masaki Shoji and Mitsuko Onda
Pharmacy 2024, 12(6), 169; https://doi.org/10.3390/pharmacy12060169 - 16 Nov 2024
Viewed by 592
Abstract
In Japan, telepharmacy is becoming increasingly popular due to deregulation triggered by the outbreak of COVID-19. The purpose of this study was to gain an understanding of the actual state of telepharmacy in Japan by interviewing pharmacists who have experience with telepharmacy and [...] Read more.
In Japan, telepharmacy is becoming increasingly popular due to deregulation triggered by the outbreak of COVID-19. The purpose of this study was to gain an understanding of the actual state of telepharmacy in Japan by interviewing pharmacists who have experience with telepharmacy and describing its advantages and disadvantages, as well as their outlook for its use going forward. The interviews were conducted online using Zoom. Each interview lasted approximately 30 min. Eleven people were interviewed. The advantages mentioned by the pharmacists were classified into three main categories: “Better communication”, “Time savings”, and “Improved safety”. The disadvantages were classified into the following nine categories: “Drug delivery problems”, “Communication failures”, “Ease of use for patients”, “Emotional reactions”, “Pharmacy system”, “Communication issues”, “Healthcare system issues”, “App system issues”, and “Cost”. Many of these factors correspond to the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs presented by Venkatesh, et al. Many of the pharmacists mentioned that the use of telepharmacy is likely to expand further in the future, but that this will require further development of communication technology and the widespread use of systems such as electronic prescriptions. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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17 pages, 3463 KiB  
Article
Potential Adverse Drug Events Identified with Decision Support Algorithms from Janusmed Risk Profile—A Retrospective Population-Based Study in a Swedish Region
by Tora Hammar, Emma Jonsén, Olof Björneld, Ylva Askfors, Marine L. Andersson and Alisa Lincke
Pharmacy 2024, 12(6), 168; https://doi.org/10.3390/pharmacy12060168 - 15 Nov 2024
Viewed by 601
Abstract
Adverse drug events (ADEs) occur frequently and are a common cause of suffering, hospitalizations, or death, and can be caused by harmful combinations of medications. One method used to prevent ADEs is by using clinical decision support systems (CDSSs). Janusmed Risk Profile is [...] Read more.
Adverse drug events (ADEs) occur frequently and are a common cause of suffering, hospitalizations, or death, and can be caused by harmful combinations of medications. One method used to prevent ADEs is by using clinical decision support systems (CDSSs). Janusmed Risk Profile is a CDSS evaluating the risk for nine common or serious ADEs resulting from combined pharmacodynamic effects. The aim of this study was to examine the prevalence of potential ADEs identified using CDSS algorithms from Janusmed Risk Profile. This retrospective, cross-sectional study covered the population of a Swedish region (n = 246,010 inhabitants in year 2020) using data on all medications dispensed and administered. More than 20% of patients had an increased risk of bleeding, constipation, orthostatism, or renal toxicity based on their medications. The proportion of patients with an increased risk varied from 3.5% to almost 30% across the nine categories of ADEs. A higher age was associated with an increased risk of potential ADEs and there were gender differences. A cluster analysis identified groups of patients with an increased risk for several categories of ADEs. This study shows that combinations of medications that could increase the risk of ADEs are common. Future studies should examine how this correlates with observed ADEs. Full article
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14 pages, 572 KiB  
Article
Views from Multinational Pharmaceutical Companies on Allocation of Clinical Trials in Saudi Arabia—Qualitative Study
by Nouf M. Aloudah and Ahmed M. Shaman
Pharmacy 2024, 12(6), 167; https://doi.org/10.3390/pharmacy12060167 - 12 Nov 2024
Viewed by 653
Abstract
Clinical trials conducted by pharmaceutical companies are essential for bridging local research efforts with broader populations, facilitating the transfer of valuable insights and solutions. This study aimed to explore the barriers and facilitators affecting clinical trials in Saudi Arabia from the perspective of [...] Read more.
Clinical trials conducted by pharmaceutical companies are essential for bridging local research efforts with broader populations, facilitating the transfer of valuable insights and solutions. This study aimed to explore the barriers and facilitators affecting clinical trials in Saudi Arabia from the perspective of key personnel within the pharmaceutical industry and Contract Research Organizations (CROs). We conducted in-depth semi-structured interviews with nine participants, which provided a holistic understanding of the intricate dynamics shaping the landscape of clinical trials in the country. The analysis revealed three prominent themes: operational challenges, complexities in navigating approval hurdles, and the unique value proposition for conducting clinical trials in Saudi Arabia. The participants expressed pride in the local infrastructure but acknowledged existing flaws, particularly in regulatory processes that contribute to delays in trial initiation. They emphasized the importance of conducting clinical trials in areas such as diabetes, crowd management during pilgrimages, and rare diseases, which are prevalent in the region. Despite the limited number of clinical trials registered (354 from 2009 to 2020, with only 1% being phase 1 studies), Saudi Arabia’s total pharmaceutical market exceeds SAR 13 billion, positioning it as the largest market in the region. Stakeholders recognized the country’s potential as a research hub, particularly within the Gulf Cooperative Council (GCC) region. However, to attract more trials and enhance the medical research landscape, it is crucial to address the identified barriers, streamline processes, and improve stakeholder alignment. The findings highlight the need for targeted interventions to overcome these challenges and leverage Saudi Arabia’s investments in healthcare infrastructure since its transformation program launched in 2010. By enhancing the regulatory environment and fostering collaboration among stakeholders, Saudi Arabia can solidify its role as a key player in international clinical research. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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13 pages, 1080 KiB  
Article
Drug Shortages in Albania: Pharmacists’ Experiences and Perspectives
by Delina Xhafaj, Sonila Vito and Alban Xhafaj
Pharmacy 2024, 12(6), 166; https://doi.org/10.3390/pharmacy12060166 - 7 Nov 2024
Viewed by 640
Abstract
Drug shortages are a significant global issue, particularly affecting healthcare systems in resource-limited countries such as Albania. Pharmacists play a critical role in managing these shortages, yet little is known about their experiences and perspectives. This study aims to explore pharmacists’ views on [...] Read more.
Drug shortages are a significant global issue, particularly affecting healthcare systems in resource-limited countries such as Albania. Pharmacists play a critical role in managing these shortages, yet little is known about their experiences and perspectives. This study aims to explore pharmacists’ views on the current drug shortages in Albania, identifying the most affected drug classes, and suggesting potential strategies for mitigating these shortages. A cross-sectional survey was conducted with 93 pharmacists across Albania between December 2023 and May 2024. Data were collected using an online questionnaire that addressed the types of drugs experiencing shortages, the causes of these shortages, and pharmacists’ coping strategies. Cardiovascular and central nervous system medications were reported as the most frequently affected, with supply chain disruptions, regulatory hurdles, and low domestic production cited as key contributors. The findings suggest an urgent need for national policy reforms focusing on improving supply chain resilience and boosting the local pharmaceutical production. The pharmacists proposed mitigation strategies, including stricter regulatory oversight, improved communication channels, and increased local production to reduce dependence on imports. These recommendations underscore the study’s contribution to understanding how tailored, pharmacist-informed strategies could strengthen Albania’s healthcare system. Full article
(This article belongs to the Special Issue Women's Special Issue Series: Pharmacy and Pharmacists)
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11 pages, 616 KiB  
Article
Deciphering the Roots of Pharmacists’ Critical Thinking About Pseudoscientific Claims: Insights from a Cross-Sectional Survey
by Tomofumi Watanabe, Mari Matsumoto, Masami Ukawa, Makoto Ohira and Masaru Tsunoda
Pharmacy 2024, 12(6), 165; https://doi.org/10.3390/pharmacy12060165 - 6 Nov 2024
Viewed by 1164
Abstract
The global trend toward self-medication has increased public reliance on over-the-counter treatments and health-related information, contributing to the spread of pseudoscientific claims in healthcare and posing serious public health risks. Pharmacists, as accessible healthcare professionals, play a crucial role in critically evaluating these [...] Read more.
The global trend toward self-medication has increased public reliance on over-the-counter treatments and health-related information, contributing to the spread of pseudoscientific claims in healthcare and posing serious public health risks. Pharmacists, as accessible healthcare professionals, play a crucial role in critically evaluating these claims and providing evidence-based guidance. However, little quantitative research has assessed pharmacists’ critical thinking regarding pseudoscientific claims or the factors influencing them. This study aims to evaluate the demographic factors affecting pharmacists’ critical thinking about pseudoscientific claims. A cross-sectional survey was conducted among pharmacists in hospitals, insurance pharmacies, and drugstores across Japan. The newly developed Pseudoscience Criticism Scale (PCS) measured attitudes toward pseudoscientific claims. Statistical analysis identified factors that form and influence critical thinking. This study revealed two primary dimensions: “Medical Superstitions and Unscientific Treatments” and “Natural Healing Superstitions”. Gender and educational background significantly impacted PCS scores, with male pharmacists and graduates from six-year pharmacy programs exhibiting higher skepticism. These findings underscore the importance of ongoing professional development in pharmacy education to strengthen critical thinking. The PCS is an effective tool for assessing this competency. Enhancing educational efforts is essential to equip pharmacists to effectively counter pseudoscientific claims and improve public health. Full article
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18 pages, 245 KiB  
Article
Assessing the Impact of a Leadership Development Programme for Community Pharmacy Neighbourhood Leads in South East London
by Finlay Royle, Sarah Guard and Ricarda Micallef
Pharmacy 2024, 12(6), 164; https://doi.org/10.3390/pharmacy12060164 - 2 Nov 2024
Viewed by 712
Abstract
Community pharmacists continue to deliver a growing number of services, with an increased need for collaborative work between local teams in community settings. In South East London, the Integrated Care Board and Pharmacy Alliance have invested in the development of community pharmacy neighbourhood [...] Read more.
Community pharmacists continue to deliver a growing number of services, with an increased need for collaborative work between local teams in community settings. In South East London, the Integrated Care Board and Pharmacy Alliance have invested in the development of community pharmacy neighbourhood leads (CPNLs), who represent community pharmacies in a locality and provided a tailored five-session leadership course that ran between November 2023 and March 2024, covering theory and implementation. This study aimed to evaluate the experiences of the CPNLs and other colleagues who participated in the leadership development programme. Participants were asked to complete an evaluation survey after each session, along with individual interviews taking place with those who volunteered. Ethical approval was received. There was a total of 37 participants at the sessions, and 7 participated in an interview. Overall confidence increased throughout the course, with males statistically more confident than females. Relationships with new stakeholders also increased throughout the course. The proposed actions after each session echoed the topics covered, with planning meetings being prioritised. The interviews highlighted new opportunities identified and being acted on, a greater understanding of the role, and an increase in confidence and key relationships. Barriers in the role included time for meetings. Overall, investment in the CPNL role showed that learning from the programme was applied in practice, with an increase in confidence and understanding of the role and improved local relationships. The findings from this study can be used by others to support community pharmacy transformation and integration. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
19 pages, 1616 KiB  
Review
Nexus of Quality Use of Medicines, Pharmacists’ Activities, and the Emergency Department: A Narrative Review
by Tesfay Mehari Atey, Gregory M. Peterson, Mohammed S. Salahudeen and Barbara C. Wimmer
Pharmacy 2024, 12(6), 163; https://doi.org/10.3390/pharmacy12060163 - 1 Nov 2024
Viewed by 992
Abstract
Acute care provided in the hospital’s emergency department (ED) is a key component of the healthcare system that serves as an essential bridge between outpatient and inpatient care. However, due to the emergency-driven nature of presenting problems and the urgency of care required, [...] Read more.
Acute care provided in the hospital’s emergency department (ED) is a key component of the healthcare system that serves as an essential bridge between outpatient and inpatient care. However, due to the emergency-driven nature of presenting problems and the urgency of care required, the ED is more prone to unintended medication regimen changes than other departments. Ensuring quality use of medicines (QUM), defined as “choosing suitable medicines and using them safely and effectively”, remains a challenge in the ED and hence requires special attention. The role of pharmacists in the ED has evolved considerably, transitioning from traditional inventory management to delivering comprehensive clinical pharmacy services, such as medication reconciliation and review. Emerging roles for ED pharmacists now include medication charting and prescribing and active participation in resuscitation efforts. Additionally, ED pharmacists are involved in research and educational initiatives. However, the ED setting is still facing heightened service demands in terms of the number of patients presenting to EDs and longer ED stays. Addressing these challenges necessitates innovation and reform in ED care to effectively manage the complex, rising demand for ED care and to meet government-imposed service quality indicators. An example is redesigning the medication use process, which could necessitate a shift in skill mix or an expansion of the roles of ED pharmacists, particularly in areas such as medication charting and prescribing. Collaborative efforts between pharmacists and physicians have demonstrated positive outcomes and should thus be adopted as the standard practice in improving the quality use of medicines in the ED. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
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12 pages, 3801 KiB  
Article
Impact of a Clinical Decision Support System on the Change over Time in the Anticholinergic Load in Geriatric Patients: The SADP-Antichol Study
by Grégoire Delvallée, Lisa Mondet, Chloé Cornille, Guillaume Deschasse and Aurélie Lenglet
Pharmacy 2024, 12(6), 162; https://doi.org/10.3390/pharmacy12060162 - 30 Oct 2024
Viewed by 582
Abstract
Purpose: Anticholinergic drugs can cause adverse events (AEs) in older adults. Clinical decision support systems (CDSSs) can detect prescriptions with a high anticholinergic load. Our starting hypothesis was that the anticholinergic load could be reduced by combining a CDSS with a strategy for [...] Read more.
Purpose: Anticholinergic drugs can cause adverse events (AEs) in older adults. Clinical decision support systems (CDSSs) can detect prescriptions with a high anticholinergic load. Our starting hypothesis was that the anticholinergic load could be reduced by combining a CDSS with a strategy for generating pharmacist interventions. The objective of the present study was to assess the impact of this combination on the change over time in the anticholinergic load in hospitalized older adults. Methods: This prospective, single-centre study was divided into two 6-week periods. During the interventional period, a pharmacist analyzed the alerts generated by the CDSS for 30 targeted anticholinergic drugs and decided whether to issue a pharmacist intervention. A control period corresponds to standard care. The primary endpoint of the study is the delta of the anticholinergic load between the alert and hospital discharge; the secondary endpoint is the incidence of anticholinergic adverse events (AEs). Results: Of the 144 alerts generated, 87 were considered to be relevant (36 in the interventional period and 51 in the control period). A significant difference was observed between the delta anticholinergic load between the experimental and control periods (1.61 vs. 0.67, p-value = 0.0115). For the targeted drugs (n = 94) over the 87 alerts, 46.8% were for antihistamines and 21.3% were for desloratadine. Of the 36 pharmacist interventions sent by the pharmacist, 19 (52.8%) were accepted. The most deprescribed drug class was the antihistamine class (n = 7), and the most deprescribed drug was amitriptyline (n = 5). Among these 87 patients with alerts, the correlation between the anticholinergic load and the number of AEs was not statistically significant (p = 0.887). The most common AE affecting the peripheral nervous system was constipation (28.6%), and the most common AE affecting the central nervous system was confusion (29.9%). Conclusions: Our results showed that the combination of specific CDSS rules with pharmacist-mediated risk management procedures could further reduce the anticholinergic load in hospitalized older adults, relative to routine care. It remains to be determined whether this reduction in the anticholinergic load has an impact on the incidence of peripheral and central anticholinergic AEs, and thus the health of these patients. Full article
(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)
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14 pages, 1271 KiB  
Review
Pharmacy Education and Clinical Pharmacy Training in France
by Florence Ranchon, Sébastien Chanoine, ANEPC Pedagogical Committee, Antoine Dupuis, Gaël Grimandi, Michel Sève, Stéphane Honoré, Benoît Allenet and Pierrick Bedouch
Pharmacy 2024, 12(6), 161; https://doi.org/10.3390/pharmacy12060161 - 29 Oct 2024
Viewed by 1103
Abstract
Clinical pharmacy education varies widely between European countries, and several major changes have taken place in France. This review aims to describe the current state of pharmacy education in France, focusing on clinical pharmacy. Research into legislative texts on pharmacy education in France [...] Read more.
Clinical pharmacy education varies widely between European countries, and several major changes have taken place in France. This review aims to describe the current state of pharmacy education in France, focusing on clinical pharmacy. Research into legislative texts on pharmacy education in France was conducted based on the national database “legifrance”. A complementary search on clinical pharmacy teaching methods used in France was carried out on the Medline, Embase, Pascal and Francis database for articles published from 2008 to 30 April 2021. Pharmacy studies are taught in universities and last from six to ten years, depending on the student’s chosen options. The scientific curriculum is defined at the national level. Students choose their professional path after the fourth year with specialized courses. Whatever the direction chosen, all students have several internships, including a half-time one-year hospital internship, with patient-centered hospital functions within medical and pharmaceutical teams. The status of clinical pharmacy has been enhanced under French law and regulations, improving clinical pharmacy education, which is now skill-based, in a progressive, active, and dynamic process, with community or hospital pharmacists as university teachers and closer to real-life clinical pharmacy. Teaching is increasingly innovative, and this needs to be shared and reported in the literature. Several important reforms have modernized French pharmacy studies in recent years, conferring a pivotal place for clinical pharmacy. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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9 pages, 454 KiB  
Article
Categorisation of Patients’ Anticholinergic Burden at Admission and Discharge from the Geriatric Ward of Sønderjylland Hospital
by Cecilie Marie Bæk Kehman, Maja Schlünsen and Lene Juel Kjeldsen
Pharmacy 2024, 12(6), 160; https://doi.org/10.3390/pharmacy12060160 - 25 Oct 2024
Viewed by 618
Abstract
Background: High anticholinergic burden is associated with an increased risk of hospitalisation, readmission, and mortality in geriatric patients. The objectives were to develop an updated anticholinergic burden scale for drugs registered in Denmark and to estimate the burden at admission and discharge for [...] Read more.
Background: High anticholinergic burden is associated with an increased risk of hospitalisation, readmission, and mortality in geriatric patients. The objectives were to develop an updated anticholinergic burden scale for drugs registered in Denmark and to estimate the burden at admission and discharge for hospitalised patients at the Geriatric Ward of Sønderjylland Hospital. Methods: The updated scale was developed through a systematic evaluation of the anticholinergic effect for all active pharmaceutical ingredients (APIs) listed on validated burden scales. APIs registered in 2020 and 2021 were evaluated separately for possible anticholinergic effect. The anticholinergic effect of each API was scored from 1 (low) to 3 (high). The scale was applied to medical records for patients hospitalised between October 2021 and March 2022. Results: The scale comprised 87 APIs with anticholinergic effect. We applied the scale on 196 patients aged (median [IQR]) 84 (78–89) years. Of these patients, 75 (38.3%) had a high burden (3) on admission. These patients had significantly higher drug use and higher risk of 30-day readmission but no relationship with length of stay. Overall, the anticholinergic burden was unchanged at discharge for 109 (55.1%) patients. Conclusion: An updated scale for estimation of the anticholinergic burden in geriatric patients was successfully developed, and a high burden among the admitted geriatric patients was found. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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10 pages, 201 KiB  
Article
Pharmaceutical Advertising and Public Perceptions in Saudi Arabia
by Mohammed A. Alnuhait, Hana A. Althobaiti, Meshari H. Alharbi, Raef A. Alahmadi, Yasser E. Althubaiti, Abdulrahman A. Alsaedi, Abdullah S. Alshammari, Mahmoud E. Elrggal, Mohammed A. Alrashed, Mohamed A. Albekery, Abdullah A. Alhifany and Abdulmalik S. Alotaibi
Pharmacy 2024, 12(6), 159; https://doi.org/10.3390/pharmacy12060159 - 23 Oct 2024
Viewed by 1396
Abstract
Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. [...] Read more.
Introduction: As the pharmaceutical advertising landscape evolves with digital advancements, this study examines public awareness and perceptions of medication advertisements in Saudi Arabia. It focuses on the effects of regulatory frameworks and evaluates how they influence public understanding and attitudes toward these advertisements. Method: A cross-sectional study was conducted using an electronic survey in Saudi Arabia in December 2023. The survey was distributed on social media platforms and reached a diverse sample of 440 participants. It covered public perception and attitudes toward drug advertisements, knowledge of regulatory laws, and preferences regarding advertising mediums. Results: Out of the 440 participants in the study, who were primarily employees with bachelor’s degrees, there was a clear awareness of drug advertisements. The average age of the group was 33 years, and a significant portion (71.1%) held a bachelor’s degree, with 51.1% being employed. The findings revealed that 25.5% of participants frequently noticed drug ads, while 22.7% saw them very often. Although many found the ads informative, there were significant concerns about unrealistic expectations and the risk of overmedication; 89.8% believed the ads set unrealistic expectations about the effectiveness of medications. Additionally, 60.7% thought that celebrity endorsements might mislead the audience, and 91.1% felt that ads should provide more detailed information about potential risks and side effects. Regarding preferred advertising platforms, mobile apps and websites were favored (47%), followed closely by social media (46.4%). A striking 93.2% of participants believed that drug ads on social media should be subject to stricter regulations, and 96.4% wanted more proactive monitoring of online advertising. Many also reported using other sources, such as medical review sites, to verify medication information. Conclusions: Pharmaceutical advertising in Saudi Arabia must balance ethical transparency with educational value. The influence of digital platforms underscores the necessity for stricter regulation and accurate information dissemination. A collaborative approach is essential to align advertising practices with public health interests and regulatory standards. Full article
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