Pharmacy

12 pages, 1410 KiB

Open AccessArticle

SMART Pharmacist—The Impact of Education on Improving Pharmacists’ Participation in Monitoring the Safety of Medicine Use in Montenegro

by Snežana Mugoša, Arijana Meštrović, Veselinka Vukićević, Milanka Žugić and Michael J. Rouse

Pharmacy 2025, 13(2), 57; https://doi.org/10.3390/pharmacy13020057 - 17 Apr 2025

Viewed by 238

Abstract

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their [...] Read more.

Pharmaceutical care as a concept was introduced in Montenegro during the last 10 years. The Pharmaceutical Chamber of Montenegro (PCM) and the Institute for Medicines and Medical Devices (CInMED) conducted SMART Pharmacist Program educational activities for pharmacists as a project to improve their impact on monitoring drug safety. In the period from September 2023 to May 2024, a total of 78 pharmacists participated in the project, of which 53 (68%) submitted valid reports of suspected adverse drug reactions (ADRs). During the project, a total of 302 valid reports were submitted, and the pharmacists’ share in total reporting increased to 74% in 2023 compared to less than 10% in the previous 5 years. The results of this research will be used to make recommendations for further improvement of the pharmacovigilance system, as well as to create plans for continuing education (CE) of other health workers in the area of rational and safe use of medicines. Full article

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11 pages, 191 KiB

Open AccessArticle

Factors Influencing Community Pharmacists’ Participation in Antimicrobial Stewardship: A Qualitative Inquiry

by Tasneem Rizvi, Syed Tabish R. Zaidi, Mackenzie Williams, Angus Thompson and Gregory M. Peterson

Pharmacy 2025, 13(2), 56; https://doi.org/10.3390/pharmacy13020056 - 14 Apr 2025

Viewed by 209

Abstract

Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed [...] Read more.

Very few studies, all employing surveys, have investigated the perceptions of community pharmacists regarding antimicrobial stewardship (AMS). A qualitative inquiry exploring factors affecting community pharmacists’ participation in AMS may assist in the implementation of AMS in the primary care setting. This study aimed to explore the perceived barriers and enablers of community pharmacists’ participation in AMS. One-on-one semi-structured telephone interviews were conducted with a sample of community pharmacists from across Australia. Interviews were transcribed verbatim and analysed using the Framework Analysis method. Twenty community pharmacists (70% female), representing urban, regional, and remote areas of Australia participated in the study. Pharmacists identified a discord between clinical needs of patients and practice policies as the primary source of excessive prescribing and dispensing of antibiotics. The fragmented nature of the primary healthcare system in Australia was seen as limiting information exchange between community pharmacists and general practitioners about antibiotic use, that was encouraging inappropriate and, at times, unsupervised use of antibiotics. The existing community pharmacy funding model in Australia, where individual pharmacists do not benefit from any financial incentives associated with clinical interventions, was also discouraging their participation in AMS. Pharmacists suggested restricting default antibiotic repeat supplies, reducing legal validity of antibiotic prescriptions to less than the current 12 months, and adopting a treatment duration-based approach to antibiotic prescribing instead of the ‘quantity-based’ approach, where the quantity prescribed is linked to the available pack size of the antibiotic. Structural changes in the way antibiotics are prescribed, dispensed, and funded in the Australian primary care setting are urgently needed to discourage their misuse by the public. Modifications to the current funding model for pharmacist-led cognitive services are needed to motivate pharmacists to participate in AMS initiatives. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

14 pages, 591 KiB

Open AccessReview

Heparin-Induced Hyperkalemia Assessment Utilizing the Naranjo Adverse Drug Reaction Probability Scale: A 40-Year Systematic Review

by Divita Singh, Omnia A. E. A. Mesalhy and Michael J. Cawley

Pharmacy 2025, 13(2), 55; https://doi.org/10.3390/pharmacy13020055 - 11 Apr 2025

Viewed by 284

Abstract

Background: Adverse drug reactions have been reported as leading causes of morbidity and mortality. Unfractionated heparin- and low-molecular-weight heparin-induced hyperkalemia are side effects that have been reported in approximately 7 to 8% of heparin-treated patients. Algorithms, assessment tools, and decision aids are needed [...] Read more.

Background: Adverse drug reactions have been reported as leading causes of morbidity and mortality. Unfractionated heparin- and low-molecular-weight heparin-induced hyperkalemia are side effects that have been reported in approximately 7 to 8% of heparin-treated patients. Algorithms, assessment tools, and decision aids are needed to assist in determining the causality of these adverse drug reactions. Aim: The aim of this study was to determine the number of case reports of hyperkalemia resulting from unfractionated heparin or low-molecular-weight heparin use by utilizing the Naranjo Adverse Drug Reaction Probability Scale. Methods: PubMed, International Pharmaceutical Abstracts, and the Cochrane Library were searched for relevant publications. Search terms and Boolean operators, including “hyperkalemia AND heparin”, “hyperkalemia AND low molecular weight heparin”, “heparin AND hypoaldosteronism”, and “low molecular weight heparin AND hypoaldosteronism”, were used. Searches were limited to case reports and human specimens. Results: A total of 29 case reports were identified, incorporating 38 patient cases. Of the 38 patient cases, 5 [4 involving unfractionated heparin and 1 involving low-molecular-weight heparin] (13.2%) utilized the Naranjo Adverse Drug Reaction Probability Scale to identify the possibility of an adverse drug reaction occurring due to exposure to unfractionated or low-molecular-weight heparin as probable. Conclusions: The available evidence suggests that clinicians’ use of the Naranjo Adverse Drug Reaction Probability Scale to determine the potential of hyperkalemia occurring due to exposure to unfractionated heparin and low-molecular-weight heparin is limited. Clinicians should be encouraged to utilize an objective monitoring tool to help standardize assessment of causality for all adverse drug reactions. Full article

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6 pages, 722 KiB

Open AccessArticle

Evaluating Pharmacy Student Perspectives and Attitudes Towards Compliance Aids and Devices Through Health Disparity Simulation

by Bradley Phillips and Jason Powell

Pharmacy 2025, 13(2), 54; https://doi.org/10.3390/pharmacy13020054 - 10 Apr 2025

Viewed by 208

Abstract

Objective: This study intends to evaluate simulated experiences provided to pharmacy students that directly compare the perspective of patients managing chronic disease states through traditional means without compliance aids to those using compliance aids, such as continuous glucose monitors (CGMs) and other devices. [...] Read more.

Objective: This study intends to evaluate simulated experiences provided to pharmacy students that directly compare the perspective of patients managing chronic disease states through traditional means without compliance aids to those using compliance aids, such as continuous glucose monitors (CGMs) and other devices. Methods: This simulation was conducted with third-year pharmacy students enrolled in the ambulatory care elective course at the University of Florida College of Pharmacy. It was designed to simulate a patient responsible for self-administering an array of medications for multiple chronic diseases that the students are likely to encounter during clinical practice. For the first week, students were tasked with adhering to a complex medication schedule from their associated pill bottles without the use of compliance aids (pill organizers, alarms, etc.) and checking their blood glucose twice daily using a traditional glucometer. In the second week, students continued the role of the patient; however, they were provided with compliance aids and encouraged to set alarms and use CGMs. Using a questionnaire developed based on the traditional Likert scale model, the students were able to quantify their experiences in a way that allowed the investigators to observe any changes. Results: Regarding the overall implications of this experience, most participants (>80%) agreed that this project increased their understanding of the value of compliance aids and devices and encouraged them to not only incorporate them into their future patient care plans but also advocate for accessibility to improve health outcomes. Conclusion: Students who completed this experience reported better adherence to chronic disease state control using compliance aids and, in turn, the applicability of the use of compliance aids in managing those with complex medication regimens. This simulation may encourage future pharmacists to incorporate compliance aids with their patients to improve health outcomes. Full article

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30 pages, 6346 KiB

Open AccessArticle

Investigating the Time-Varying Nature of Medication Adherence Predictors: An Experimental Approach Using Andersen’s Behavioral Model of Health Services Use

by Vasco M. Pontinha, Julie A. Patterson, Dave L. Dixon, Norman V. Carroll, D’Arcy Mays, Karen B. Farris and David A. Holdford

Pharmacy 2025, 13(2), 53; https://doi.org/10.3390/pharmacy13020053 - 9 Apr 2025

Viewed by 274

Abstract

Medication adherence is a crucial factor for managing chronic conditions, especially in aging adults. Previous studies have identified predictors of medication adherence. However, current methods fail to capture the time-varying nature of how risk factors can influence adherence behavior. This objective of this [...] Read more.

Medication adherence is a crucial factor for managing chronic conditions, especially in aging adults. Previous studies have identified predictors of medication adherence. However, current methods fail to capture the time-varying nature of how risk factors can influence adherence behavior. This objective of this study was to implement multitrajectory group-based models to compare a time-varying to a time-fixed approach to identifying non-adherence risk factors. The study population comprised 11,068 Medicare beneficiaries aged 65 and older taking select medications for hypertension, high blood cholesterol, and oral diabetes medications, between 2008 and 2016. Time-fixed predictors (e.g., sex, education) were examined using generalized multinomial logistic regression, while time-varying predictors were explored through multitrajectory group-based modeling. Several predisposing, enabling, and need characteristics were identified as risk factors for following at least one non-adherence trajectory. Time-varying predictors displayed an alternative representation of those risk factors, especially depression symptoms. This study highlights the dynamic nature of medication adherence predictors and the utility of multitrajectory modeling. Findings suggest that targeted interventions can be developed by addressing the key time-varying factors affecting adherence. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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11 pages, 1003 KiB

Open AccessArticle

Impact of Removing Race Coefficient from Glomerular Filtration Rate Estimation Equations on Antidiabetics Among Black Patients

by Dhakrit Rungkitwattanakul, Ebony Evans, Ewanna Brown, Kent Patterson Jr., Weerachai Chaijamorn, Taniya Charoensareerat, Sanaa Belrhiti, Uzoamaka Nwaogwugwu and Constance Mere

Pharmacy 2025, 13(2), 52; https://doi.org/10.3390/pharmacy13020052 - 2 Apr 2025

Viewed by 308

Abstract

Background: In 2021, the National Kidney Foundation–American Society of Nephrology (NKF-ASN) recommended the use of the 2021 refit equation without race; however, the effect of the removal is unclear. Our research aimed to examine the implications of antidiabetic dosing and eligibility on the [...] Read more.

Background: In 2021, the National Kidney Foundation–American Society of Nephrology (NKF-ASN) recommended the use of the 2021 refit equation without race; however, the effect of the removal is unclear. Our research aimed to examine the implications of antidiabetic dosing and eligibility on the new 2021 equation among Black patients. Methods: This is a retrospective analysis of patients receiving care at the diabetes treatment center (DTC) of an academic medical center. Estimated glomerular filtration rates (eGFRs) based on serum creatinine were calculated using the 2009 and 2021 CKD-EPI equations. A Monte Carlo simulation was performed to create 10,000 virtual patients. Dosing simulations based on each estimate of kidney function were performed for antidiabetics based on product labeling. The proportion and percentage of patients who were eligible based on the estimates were calculated. Results: The percentages of patients ineligible for metformin based on the estimates from the 2009 and 2021 CKD-EPI equations at the DTC were comparable (8.02% and 8.36%, respectively). In our 10,000 simulated virtual patients, the percentage of ineligibility increased only by 1%. For the GFR cut points of 20 mL/min and 25 mL/min, the rates of ineligibility were similar in our cohort and simulated patients. Conclusions: The exclusion of race from the 2021 CKD-EPI equation may slightly reduce medication eligibility among Black patients. Full article

(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)

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11 pages, 183 KiB

Open AccessArticle

Challenges of Key Performance Indicators and Metrics for Measuring Medical Science Liaison Performance: Insights from a Global Survey

by Samuel Dyer, Cherie Hyder and Jeff Kraemer

Pharmacy 2025, 13(2), 51; https://doi.org/10.3390/pharmacy13020051 - 2 Apr 2025

Viewed by 1380

Abstract

Background: Medical Science Liaisons (MSLs) serve a vital role in facilitating the exchange of scientific knowledge between pharmaceutical companies and health care professionals (HCPs), including pharmacists, ensuring the dissemination of accurate, evidence-based information to support clinical decision-making. Evaluating MSL performance is critical for [...] Read more.

Background: Medical Science Liaisons (MSLs) serve a vital role in facilitating the exchange of scientific knowledge between pharmaceutical companies and health care professionals (HCPs), including pharmacists, ensuring the dissemination of accurate, evidence-based information to support clinical decision-making. Evaluating MSL performance is critical for demonstrating their value, yet defining appropriate key performance indicators (KPIs) remains challenging due to the combination of scientific engagement, relationship-building, and other activities that are difficult to measure. Objective: This study examines the current and perceived ideal use of quantitative and qualitative metrics for MSL performance evaluation, the difficulties in measuring MSL impact, and the perceived effectiveness of existing KPIs. Methods: A global survey of 1023 medical affairs professionals across 63 countries was conducted, gathering data on which KPIs are currently used versus which should be used, the preferred weighting of qualitative vs. quantitative metrics, and opinions on measurement difficulty and KPI effectiveness. Results: The results reveal a strong preference for qualitative metrics (52%) over quantitative metrics (7%), though most organizations primarily use activity-based metrics such as the number of key opinion leader (KOL) engagements (92%). Despite these practices, many respondents believe that MSL KPIs should focus more on impact-based qualitative metrics, such as the quality of KOL/HCP relationships and/or engagements (70%) and the quality of actionable insights gathered (67%). Furthermore, 67% of participants reported it is “difficult” or “very difficult” to measure MSL performance accurately, and only 3% revealed current KPIs and metrics used to measure MSL performance are “very effective”. These findings highlight a disconnect between the way MSLs are evaluated and the value they provide. Conclusions: This study demonstrates the need for a balanced KPI framework that integrates both qualitative and quantitative measures. A more refined performance evaluation system (incorporating stakeholder feedback, insight quality, and strategic impact) can ensure fair assessments and drive MSL effectiveness. Full article

23 pages, 2304 KiB

Open AccessReview

Medication Safety in Saudi Arabia: Evaluating the Current Situation and Identifying the Areas for Improvement

by Anwar A. Alghamdi

Pharmacy 2025, 13(2), 50; https://doi.org/10.3390/pharmacy13020050 - 1 Apr 2025

Viewed by 512

Abstract

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for [...] Read more.

Drug safety is crucial in healthcare, ensuring the secure and effective administration of medications to protect patient welfare. Drug and medication safety is a major concern among Saudi healthcare providers, with numerous studies outlining the incidence of medication errors and the need for enhanced safety standards. This review will examine the existing level of drug-related safety in Saudi Arabia, categorizing the areas for improvement and highlighting concepts to improve safety practices. The overview discusses the history and evolution of pharmaceutical safety procedures, the present regulatory framework, major stakeholders, and the types and origins of prescription errors. It also examines the role of healthcare personnel and the use of technology and patient education in promoting pharmaceutical safety. The data reveal that the rate of pharmaceutical errors in Saudi hospitals is shockingly high, ranging from 13 to 56 per 100 medication orders, highlighting the urgent need for effective medication safety standards. Despite the formation of the Saudi Food and Drug Authority (SFDA) and the National Pharmacovigilance and Drug Safety Centre, issues such as poor understanding among healthcare providers and the need for more effective reporting methods remain a challenge. The evaluation highlights the deficiencies in ongoing education, such as real-world case scenarios and related trainings, inadequate incorporation of skills in assessment methods, and deficiency in standardized protocols for error reporting. To address these gaps, it is proposed to implement structured competency-based training, simulation exercises must be preferred for periodic skill assessments, and a safe reporting culture should be encouraged for the sake of transparency and learning from errors. We recognize the use of technology, such as electronic health records and computerized physician order input systems, as an important technique for improving medication safety. Future directions include creating national guidelines, establishing a centralized pharmaceutical error reporting system, and fostering a safety culture inside healthcare organizations. By addressing these obstacles and capitalizing on the opportunities indicated, we may improve pharmaceutical safety and, ultimately, patient care and outcomes in Saudi Arabia. Full article

(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)

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12 pages, 203 KiB

Open AccessArticle

Is Pharmacy a Friendly Profession for Everyone in the U.S.? A Probe into Gender and Other Income Disparities

by Ioana Popovici and Manuel J. Carvajal

Pharmacy 2025, 13(2), 49; https://doi.org/10.3390/pharmacy13020049 - 26 Mar 2025

Viewed by 213

Abstract

The literature shows that women persistently earn less than men for similar roles and qualifications; yet, pharmacy has been portrayed as an egalitarian profession, with a small gender earnings gap relative to other occupations. There is a lack of recent studies, and some [...] Read more.

The literature shows that women persistently earn less than men for similar roles and qualifications; yet, pharmacy has been portrayed as an egalitarian profession, with a small gender earnings gap relative to other occupations. There is a lack of recent studies, and some evidence suggests a significant gender gap when earnings are estimated separately for male and female pharmacists. This study compared the nature and magnitude of gender income disparities using two alternative methodological procedures and evaluated the evidence for policy implications. The study was based on 2019–2022 American Community Survey (ACS) data collected by the U.S. Census Bureau. The sample consisted of 12,450 pharmacists (61.5% women) ages 25–64 years practicing in the U.S. Ordinary least-squares models calculated pharmacist annual incomes as functions of work input, human-capital, and job-related covariates. Results estimated a gender earnings gap of up to 18.6%. Differences across sociodemographic groups suggested that pharmacy is only friendly to selected segments of the profession. The empirical evidence reported here is expected to be used by healthcare managers and policymakers to inform ongoing discussion regarding the need for policy changes and cultural shifts to promote gender equity. Full article

(This article belongs to the Special Issue Women's Special Issue Series: Pharmacy and Pharmacists)

12 pages, 1258 KiB

Open AccessArticle

Prescription Audit in Outpatient Pharmacy of a Tertiary Care Referral Hospital in Haryana Using World Health Organization/International Network of Rational Use of Drugs (WHO/INRUD) Core Prescribing Indicators: A Step Towards Refining Drug Use and Patient Care

by Nikhil Verma, Shanmugapriya Vinayagam, Niti Mittal, Rakesh Mittal and Neeraj Bansal

Pharmacy 2025, 13(2), 48; https://doi.org/10.3390/pharmacy13020048 - 25 Mar 2025

Viewed by 221

Abstract

Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM). Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from [...] Read more.

Background: The evaluation of internationally comparable indicators of medicine use is important to devise strategies to promote the rational use of medicines (RUM). Methods: A cross-sectional study was conducted in a tertiary care hospital from January to June 2024. Prescriptions were collected from the outpatient pharmacy using systematic random sampling and analyzed for WHO/INRUD core prescribing indicators, index of rational drug prescribing (IRDP) and completeness (general, treatment and prescribers’ details). Results: Out of 844 prescriptions collected, 607 were analyzed. A total of 1837 drugs were prescribed, with a mean (SD) of 3.03 (1.51) drugs per prescription; 1378 (75%) drugs were prescribed as generic names; 125 prescriptions (20.59%) had an antibiotic prescribed; and injectables were given in 7 (1.15%) prescriptions. Of the total 1837 drugs, 1018 (55.4%) were mentioned in the National List of Essential Medicines (NLEM) 2022, while 934 (50.8%) were included in the Haryana state essential medicines list (2013–2014). The IRDP was calculated as 3.86. The mean (SD) completeness score of the prescriptions was 10.33 (0.8) (range 5 to 11). Conclusions: There was a high incidence of polypharmacy, brand name and non-essential drug prescribing, while antibiotic and injection use were in accordance with WHO standards. Full article

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9 pages, 414 KiB

Open AccessBrief Report

Timing of Naldemedine Initiation and Occurrence of Diarrhea in Patients Receiving Strong Opioid Analgesics: A Retrospective Study

by Takuma Matsumoto, Takuya Mura, Tsubasa Wada, Yuki Tsugo, Naoko Mukai, Terutaka Hamaoka, Shuji Horita, Yasushi Semba and Shinichi Watanabe

Pharmacy 2025, 13(2), 47; https://doi.org/10.3390/pharmacy13020047 - 21 Mar 2025

Viewed by 315

Abstract

Naldemedine, a peripherally acting μ-opioid receptor antagonist, is used to treat opioid-induced constipation (OIC). However, it causes diarrhea as an adverse effect. This retrospective study aimed to investigate whether the occurrence of diarrhea was dependent on the timing of naldemedine treatment initiation. Inpatients [...] Read more.

Naldemedine, a peripherally acting μ-opioid receptor antagonist, is used to treat opioid-induced constipation (OIC). However, it causes diarrhea as an adverse effect. This retrospective study aimed to investigate whether the occurrence of diarrhea was dependent on the timing of naldemedine treatment initiation. Inpatients who were initially treated with naldemedine at the Department of Respiratory Medicine, NHO Iwakuni Medical Center, Japan, between 1 December 2017 and 31 March 2021 were included in this study and divided into the simultaneous combination group, in which naldemedine was introduced at the same time as strong opioid analgesics, and the non-simultaneous combination group, in which naldemedine was introduced after the initiation of treatment with strong opioid analgesics. This study included 45 patients, 15 (33.3%) of whom developed diarrhea. Among the patients in the simultaneous combination group and non-simultaneous combination group, diarrhea occurred in 2 (11.1%) and 13 (48.1%) patients, respectively. Multivariate logistic regression analysis revealed that the delayed introduction of naldemedine was significantly associated with the development of diarrhea (odds ratio: 6.68, 95% confidence interval: 1.220–36.700, p = 0.028). Our analysis reveals that the simultaneous administration of naldemedine and oxycodone may prevent the development of diarrhea associated with naldemedine use for OIC. Full article

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18 pages, 745 KiB

Open AccessSystematic Review

Factors and Disparities Influencing Sodium-Glucose Cotransporter 2 Inhibitors and Glucagon-like Peptide 1 Receptor Agonists Initiation in the United States: A Scoping Review of Evidence

by Josiah Moore, Ndidi Iheme, Nicholas S. Rebold, Harriet Kusi, Constance Mere, Uzoamaka Nwaogwugwu, Earl Ettienne, Weerachai Chaijamorn and Dhakrit Rungkitwattanakul

Pharmacy 2025, 13(2), 46; https://doi.org/10.3390/pharmacy13020046 - 19 Mar 2025

Viewed by 441

Abstract

Introduction: Health disparities affecting minority populations and resulting in poorer outcomes for disadvantaged groups have been documented in the literature. Sodium/glucose-cotransporter 2 (SGLT2i) inhibitors and GLP-1 receptor agonists (GLP-1RA) markedly decrease mortality from kidney and cardiovascular events. However, little is known about the [...] Read more.

Introduction: Health disparities affecting minority populations and resulting in poorer outcomes for disadvantaged groups have been documented in the literature. Sodium/glucose-cotransporter 2 (SGLT2i) inhibitors and GLP-1 receptor agonists (GLP-1RA) markedly decrease mortality from kidney and cardiovascular events. However, little is known about the factors and disparities that lead to differences in SGLT2i and GLP-1RA initiation across different ethnic groups. Methods: This scoping review queried databases using key terms related to disparities in the initiation of SGLT2i and GLP-1RA among high-risk populations. Relevant data from eligible studies were extracted, organized, and analyzed thematically to identify key trends and patterns in the literature. Result: Nineteen studies were included in this review. Key risk factors influencing uptake included age, provider type, race, sex, education, comorbidities, insurance, and income, with minority patients consistently showing lower rates of initiation due to systemic barriers and socioeconomic disparities. Patients who were younger, male, had higher education or income levels, and received care from specialists were more likely to use these therapies. Conclusion: The adoption of SGLT2i and GLP-1RA remains suboptimal despite their proven kidney and cardiovascular benefits. Targeted efforts to reduce socioeconomic and racial inequities based on the factors identified should be encouraged. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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11 pages, 191 KiB

Open AccessArticle

A Qualitative Study on Ethics Education at Pharmacy Colleges in Japan Based on a Survey of Ethics Educators

by Etsuko Arita, Yuko Masamura and Rieko Takehira

Pharmacy 2025, 13(2), 45; https://doi.org/10.3390/pharmacy13020045 - 18 Mar 2025

Viewed by 250

Abstract

Background: In pharmacy education in Japan, efforts continue to develop a model for ethics education that fosters high ethical standards and the problem-solving skills essential for medical professionals. This study qualitatively analyzed the attitudes of ethics educators—those who teach ethics classes—to establish [...] Read more.

Background: In pharmacy education in Japan, efforts continue to develop a model for ethics education that fosters high ethical standards and the problem-solving skills essential for medical professionals. This study qualitatively analyzed the attitudes of ethics educators—those who teach ethics classes—to establish a model of ethics education for pharmacy colleges in Japan. Methods: This study analyzed open-ended responses from 32 universities to the question, “What do you think about ethics education provided by faculties of pharmaceutical sciences?” Result: The qualitative analysis revealed that ethics educators at pharmacy colleges in Japan believe in the potential of ethics education to nurture problem-solving skills and logical thinking. However, the educator’s question whether or not the students would be able to apply ethics content in clinical settings as medical professionals. Another issue is that faculties of pharmaceutical sciences lack the staff and expertise to teach ethics. In other words, the educators lack the wherewithal to break the logjam in ethics education through their efforts; hence, they are desperate for an ethics education model. Conclusions: Based on our findings, further research is needed to design strategies that can enhance the quality of pharmacy education in Japan. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

12 pages, 205 KiB

Open AccessArticle

Patterns and Appropriateness of Psychotropic Medications Prescribing in Primary Healthcare in Jordan

by Derar H. Abdel-Qader, Alia Saleh, Abdullah Albassam, Esra’ Taybeh, Nadia Al Mazrouei, Khalid Awad Al-Kubaisi, Rana Ibrahim, Reham Aljalamdeh, Salim Hamadi, Sahar Jaradat and Shorouq Al-Omoush

Pharmacy 2025, 13(2), 44; https://doi.org/10.3390/pharmacy13020044 - 18 Mar 2025

Viewed by 313

Abstract

Background: Although psychotropic medications (PMs) have enormous adverse events and may cause serious harm if administered inappropriately, there is a scarcity of research concerning the patterns and appropriateness of prescribing these medications in primary care in Jordan. This study aimed to investigate the [...] Read more.

Background: Although psychotropic medications (PMs) have enormous adverse events and may cause serious harm if administered inappropriately, there is a scarcity of research concerning the patterns and appropriateness of prescribing these medications in primary care in Jordan. This study aimed to investigate the patterns and appropriateness of PM prescription in primary care, as well as the types and frequency of pharmacist interventions in community pharmacies. Methods: A prospective observational study was conducted in 16 community pharmacies across Jordan. A data reporting sheet was developed, validated, piloted to ensure its applicability, and filled out over 12 weeks (April to June 2023), covering three regions in Jordan. Results: Overall, 426 patients with 469 prescriptions containing 919 PM orders were observed. Among the PMs prescribed, 19.4% were prescribed inappropriately. Among the PMs, 78.7% were dispensed by pharmacists. The inappropriate prescription categories (n = 178) were overprescribing (45, 25.3%), underprescribing (19, 10.7%), inappropriate medication choice (39, 21.9%), inappropriate duration of medication therapy (64, 36.0%), and inappropriate medication dosage (11, 6.2%). The top therapeutic category requested was anti-epileptics (23.9%). Conclusions: This study evaluated the prescribing patterns and appropriateness of PMs in Jordan, revealing notable instances of inappropriate PM prescriptions alongside varied and extensive pharmacist interventions. Full article

9 pages, 584 KiB

Open AccessCase Report

Ekbom Syndrome Management in Elderly Patients: Challenges in Risperidone Titration and Treatment Adherence

by Florina Madalina Mindru, Adrian Gheorghe Bumbu and Darian Faur

Pharmacy 2025, 13(2), 43; https://doi.org/10.3390/pharmacy13020043 - 16 Mar 2025

Viewed by 338

Abstract

Ekbom Syndrome, also known as Delusional Parasitosis (DP), is considered a rare psychiatric condition. Based on diagnostic criteria, it is characterized by the strong belief of being infested with various parasites, as well as the presence of perceptual disturbances, usually tactile and/or visual [...] Read more.

Ekbom Syndrome, also known as Delusional Parasitosis (DP), is considered a rare psychiatric condition. Based on diagnostic criteria, it is characterized by the strong belief of being infested with various parasites, as well as the presence of perceptual disturbances, usually tactile and/or visual hallucinations. The syndrome can manifest idiopathically or in connection with other medical conditions and substance use. Diagnosis is challenging, as patients tend to pursue dermatological care initially. This case report describes an 81-year-old female diagnosed with Ekbom Syndrome, presenting with severe anxiety, insomnia, and persistent delusions of infestation. Initial treatment with low-dose Risperidone (2 mg/day) was ineffective, requiring a dose escalation to 4 mg/day. However, the patient’s nonadherence to follow-up limited the assessment of long-term outcomes. This case highlights key clinical challenges in elderly patients, particularly dose titration, treatment response, and adherence issues. Comparative analysis with prior case reports suggests that higher doses of Risperidone (3–6 mg/day) may be required for symptom remission, but long-term outcomes remain uncertain. Additionally, nonadherence remains a major barrier, underscoring the need for structured monitoring and caregiver involvement. These findings offer insights into antipsychotic strategies for Ekbom Syndrome, highlighting individualized pharmacotherapy, long-term follow-up, and adherence support in elderly patients. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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14 pages, 514 KiB

Open AccessArticle

Long-Term Impact of Sustained Knowledge, Confidence, and Clinical Application Following a First-Year Student Pharmacist Diabetes Self-Care Education Program

by Candis M. Morello and Eduardo S. Fricovsky

Pharmacy 2025, 13(2), 42; https://doi.org/10.3390/pharmacy13020042 - 11 Mar 2025

Viewed by 525

Abstract

With diabetes reaching epidemic proportions globally, it is imperative to increase the number of providers equipped to screen, educate, and help patients achieve glycemic control. This study evaluated the long-term results of student pharmacists attending a first-year Diabetes Self-Care Education Program (DSEP) by [...] Read more.

With diabetes reaching epidemic proportions globally, it is imperative to increase the number of providers equipped to screen, educate, and help patients achieve glycemic control. This study evaluated the long-term results of student pharmacists attending a first-year Diabetes Self-Care Education Program (DSEP) by measuring knowledge retention, confidence, and clinical applicability of skills learned over time. The DSEP, integrated into the early pharmacy curriculum, is a 9-h training program made up of interactive lectures, glucose monitoring assignments, and active-learning workshops. Following DSEP training, two cohorts of first-year student pharmacists were surveyed annually for 3 and 5 years to assess knowledge retention, confidence, and clinical use of the DSEP content in their practice sites. By the year 1 follow-up survey, the response rate from the pre-survey period for cohort 1 was 88% and 78% for cohort 2; over time, the response rate decreased. For the long-term follow-up surveys, cohort 1 (5 years) and cohort 2 (3 years) demonstrated overall significantly improved sustained knowledge of diabetes (48% higher average test score, p < 0.001), perceived confidence, and clinical ability (over 60% and 76% increases from baseline, p < 0.001). Within 12 months of completing the DSEP, about two-thirds of students applied their training to assist patients with diabetes and their caregivers. Long-term, participants in both cohorts reported educating and screening over 22,000 patients with diabetes and caregivers in multiple clinical settings over 3 years and 5 years, respectively, following DSEP training. The positive impact of improved knowledge, confidence, and clinical applicability of the DSEP training obtained by student pharmacists was sustained for 3 or more years, impacting thousands of patients with diabetes and caregivers. Considering the growing global diabetes epidemic, pharmacy schools around the world should consider implementing an early DSEP program. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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22 pages, 817 KiB

Open AccessArticle

Clinical and Operational Applications of Artificial Intelligence and Machine Learning in Pharmacy: A Narrative Review of Real-World Applications

by Maree Donna Simpson and Haider Saddam Qasim

Pharmacy 2025, 13(2), 41; https://doi.org/10.3390/pharmacy13020041 - 7 Mar 2025

Viewed by 1492

Abstract

Over the past five years, the application of artificial intelligence (AI) including its significant subset, machine learning (ML), has significantly advanced pharmaceutical procedures in community pharmacies, hospital pharmacies, and pharmaceutical industry settings. Numerous notable healthcare institutions, such as Johns Hopkins University, Cleveland Clinic, [...] Read more.

Over the past five years, the application of artificial intelligence (AI) including its significant subset, machine learning (ML), has significantly advanced pharmaceutical procedures in community pharmacies, hospital pharmacies, and pharmaceutical industry settings. Numerous notable healthcare institutions, such as Johns Hopkins University, Cleveland Clinic, and Mayo Clinic, have demonstrated measurable advancements in the use of artificial intelligence in healthcare delivery. Community pharmacies have seen a 40% increase in drug adherence and a 55% reduction in missed prescription refills since implementing artificial intelligence (AI) technologies. According to reports, hospital implementations have reduced prescription distribution errors by up to 75% and enhanced the detection of adverse medication reactions by up to 65%. Numerous businesses, such as Atomwise and Insilico Medicine, assert that they have made noteworthy progress in the creation of AI-based medical therapies. Emerging technologies like federated learning and quantum computing have the potential to boost the prediction of protein–drug interactions by up to 300%, despite challenges including high implementation costs and regulatory compliance. The significance of upholding patient-centred care while encouraging technology innovation is emphasised in this review. Full article

(This article belongs to the Special Issue The AI Revolution in Pharmacy Practice and Education)

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21 pages, 958 KiB

Open AccessArticle

Methadone and Buprenorphine as Medication for Addiction Treatment Diversely Affect Inflammation and Craving Depending on Their Doses

by Christonikos Leventelis, Aristidis S. Veskoukis, Andrea Paola Rojas Gil, Panagiotis Papadopoulos, Maria Garderi, Asimina Angeli, Antzouletta Kampitsi and Maria Tsironi

Pharmacy 2025, 13(2), 40; https://doi.org/10.3390/pharmacy13020040 - 6 Mar 2025

Viewed by 584

Abstract

Buprenorphine and methadone are widely used as medication for addiction treatment (MAT) in patients with opioid use disorders. However, there is no compelling evidence of their impact on the immune–endocrine response. Therefore, the aim of this study was to examine the effects of [...] Read more.

Buprenorphine and methadone are widely used as medication for addiction treatment (MAT) in patients with opioid use disorders. However, there is no compelling evidence of their impact on the immune–endocrine response. Therefore, the aim of this study was to examine the effects of the aforementioned medications on craving and on biomarkers of inflammation and cortisol, approaching the dose issue concurrently. Sixty-six patients (thirty-four under methadone and thirty-two under buprenorphine) who had just entered a MAT program and were stabilized with the suitable administered doses after a two-week process were divided into four groups based on medication dose (i.e., methadone high dose, buprenorphine high dose, methadone medium dose, and buprenorphine medium dose). The heroin craving questionnaire for craving assessment was completed, and the blood biomarkers were measured on Days 1 and 180. According to the results, high doses of both medications were accompanied by low levels of craving, cortisol, and inflammation on Day 1, and no alterations were observed on Day 180. On the contrary, medium doses reduced the tested psychosocial and biochemical parameters in terms of time, indicating a positive action for the patients. Concludingly, modifications in MAT doses are needed soon after the stabilization process to prevent inflammation and avoid relapse, thus helping opioid-addicted patients toward rehabilitation. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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16 pages, 233 KiB

Open AccessArticle

Impact of Reproductive Health Education Seminars on College Students’ Contraception and Safe Sex Knowledge and Behaviors

by Marisa Marcath, Kayla Craig and Mary Beth O’Connell

Pharmacy 2025, 13(2), 39; https://doi.org/10.3390/pharmacy13020039 - 3 Mar 2025

Viewed by 796

Abstract

In the United States, 41.6% of all pregnancies are unintended. This disproportionately affects women 20 to 24 years old. The high rate of unintended pregnancy among college students is associated with a lack of or incomplete formal education on reproductive health in grade [...] Read more.

In the United States, 41.6% of all pregnancies are unintended. This disproportionately affects women 20 to 24 years old. The high rate of unintended pregnancy among college students is associated with a lack of or incomplete formal education on reproductive health in grade and high school. The purpose of this study was to evaluate the outcomes of health education seminars designed to reduce reproductive health knowledge gaps among college-aged students and increase their safe sex behavior (health protection/prevention). Student pharmacists offered eighteen one-hour health education programs on fertility, contraception, and emergency contraception to college student attendees via live and Zoom-based presentations. Pre- and post-program quizzes, a post-program performance evaluation, and a post-program behavior change survey were completed anonymously. The response rate was 94.8% (n = 153 attendees). Post-program quiz scores (84%) were significantly higher than pre-program quiz scores (56%, p ≤ 0.001). The greatest increases in knowledge were about sperm survival, correct condom use, and fertility windows. The two-month follow-up survey responses revealed more confidence with birth control decisions, increased awareness of emergency contraception items, increased safe sex behaviors, and increased condom usage. Students reported that the seminars were helpful for preventing future unintended pregnancies. Reproductive health knowledge gaps can be minimized, and some self-reported safe sex behaviors can be improved with health education programs implemented at a university. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

8 pages, 183 KiB

Open AccessProject Report

Hospital Clinicians’ Knowledge of and Opportunity and Motivation for Prescribing Short Antibiotic Courses for Common Infections

by Michael Wilcock, Dan Hearsey, Mandy Slatter and Neil Powell

Pharmacy 2025, 13(2), 38; https://doi.org/10.3390/pharmacy13020038 - 1 Mar 2025

Viewed by 837

Abstract

Short-course antibiotic therapies for common infections treated in hospital are supported by national guidelines. Hospital clinicians’ knowledge of the course length recommendations for the management of common infections has not been fully explored. This study aims to assess doctors’ knowledge of and explores [...] Read more.

Short-course antibiotic therapies for common infections treated in hospital are supported by national guidelines. Hospital clinicians’ knowledge of the course length recommendations for the management of common infections has not been fully explored. This study aims to assess doctors’ knowledge of and explores their opportunity and motivation for prescribing short-course therapy. A survey was emailed to all prescribers working in adult medical specialties in two hospitals in England. The survey responses from both hospitals were pooled before analysis. One hundred and sixty-five responses were provided. Knowledge of the recommended short course lengths was high overall, except for severe community-acquired/hospital-acquired pneumonia (CAP/HAP), with only 44% of respondents opting for shorter-course therapy. The majority did not believe longer courses were more effective than shorter courses. We identified a gap in prescriber knowledge for appropriate antibiotic course lengths for severe CAP/HAP. Addressing this gap may contribute to antimicrobial stewardship efforts to reduce course lengths in line with national guidelines. Full article

26 pages, 3885 KiB

Open AccessArticle

Pharmaceutical Public Health: A Mixed-Methods Study Exploring Pharmacy Professionals’ Advanced Roles in Public Health, Including the Barriers and Enablers

by Diane Ashiru-Oredope, Roeann Osman, Adeola H. Ayeni, Eleanor J. Harvey, Maria Nasim, Emma Wright, Christina Narh, Uju Okereke, Tasmin Harrison, Christopher Garland, Cecilia Pyper, Andrew Evans and Marion Bennie

Pharmacy 2025, 13(2), 37; https://doi.org/10.3390/pharmacy13020037 - 1 Mar 2025

Viewed by 1078

Abstract

Background: In the UK and globally, pharmacy professionals (pharmacists and pharmacy technicians) contribute to the delivery of local and national public or population health interventions. The existing literature on pharmaceutical public health predominantly focuses on micro-level activities, primarily describing community pharmacies delivering public [...] Read more.

Background: In the UK and globally, pharmacy professionals (pharmacists and pharmacy technicians) contribute to the delivery of local and national public or population health interventions. The existing literature on pharmaceutical public health predominantly focuses on micro-level activities, primarily describing community pharmacies delivering public health interventions to individuals. There is little-known evidence on pharmacy professionals’ involvement in delivering public health interventions at meso- (e.g., organisational) and macro (national/policy) levels, nor to what extent pharmacy professionals have specialist/advanced roles within public health practice. This study specifically explored pharmacy professionals’ specialist/advanced roles within public health as well as the opportunities and barriers to career development. The analyses of this mixed-methods study makes a series of important recommendations for future action. Methods: This study included two independent cross-sectional electronic surveys for pharmacy professionals and public health professionals, a call for evidence, and two workshops to develop recommendations. Results: Pharmacy professionals (n = 128) and public health professionals (n = 54) across the UK participated in the surveys. Most of the Pharmacy Professionals respondents were female (70%), pharmacists (85%), working in primary (33%) or secondary (25%) care settings, mainly based in England (75%), and most (63%) lacked formal public health qualifications although they were involved in a diverse range of public health interventions. The public health professionals were mostly females (67%), practicing in England (58%). Both professional groups identified opportunities and barriers to pharmacy professionals’ involvement in public health. Almost half of the public health professionals respondents (44%) stated that they had a pharmacy professional working as part of their current public health teams. Eighty-seven percent of public health professional respondents (45/52) agreed that having pharmacists or pharmacy technicians specialising in public health would be beneficial or very beneficial. Most of the documents, reports, and case histories provided through the call for evidence were unpublished. The workshops generated 94 recommendation statements, highlighting collaboration and the need to acknowledge pharmacy professionals’ contributions to public health. Conclusion: The recommendations for strategic action at meso- and macro-levels included three main themes: adopting a national strategic approach to pharmaceutical public health, including improving commissioning; formalising pharmaceutical public health workforce development; and promoting further evidence-based pharmaceutical public health research and development. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in UK)

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19 pages, 932 KiB

Open AccessArticle

Blueprint for Constructing an AI-Based Patient Simulation to Enhance the Integration of Foundational and Clinical Sciences in Didactic Immunology in a US Doctor of Pharmacy Program: A Step-by-Step Prompt Engineering and Coding Toolkit

by Ashim Malhotra, Micah Buller, Kunal Modi, Karim Pajazetovic and Dayanjan S. Wijesinghe

Pharmacy 2025, 13(2), 36; https://doi.org/10.3390/pharmacy13020036 - 1 Mar 2025

Viewed by 749

Abstract

While pharmacy education successfully employs various methodologies including case-based learning and simulated patient interactions, providing consistent, individualized guidance at scale remains challenging in team-based learning environments. Artificial intelligence (AI) offers potential solutions through automated facilitation, but its possible utility in pharmacy education remains [...] Read more.

While pharmacy education successfully employs various methodologies including case-based learning and simulated patient interactions, providing consistent, individualized guidance at scale remains challenging in team-based learning environments. Artificial intelligence (AI) offers potential solutions through automated facilitation, but its possible utility in pharmacy education remains unexplored. We developed and evaluated an AI-guided patient case discussion simulation to enhance learners’ ability to integrate foundational science knowledge with clinical decision-making in a didactic immunology course in a US PharmD program. We utilized a large language model programmed with specific educational protocols and rubrics. Here, we present the step-by-step prompt engineering protocol as a toolkit. The system was structured around three core components in an immunology team-based learning activity: (1) symptomatology analysis, (2) laboratory test interpretation, and (3) pharmacist role definition and PPCP. Performance evaluation was conducted using a comprehensive rubric assessing multiple clinical reasoning and pharmaceutical knowledge domains. The standardized evaluation rubric showed reliable assessment across key competencies including condition identification (30% weighting), laboratory test interpretation (40% weighting), and pharmacist role understanding (30% weighting). Our AI patient simulator offers a scalable solution for standardizing clinical case discussions while maintaining individualized learning experiences. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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14 pages, 849 KiB

Open AccessArticle

Integration of Teaching of Digital Health-Driven Medical Devices in Pharmacy Education

by Yasi Mojab, Eunjoo H. Pacifici, Terrence F. Graham, Rory E. Kim and Steven W. Chen

Pharmacy 2025, 13(2), 35; https://doi.org/10.3390/pharmacy13020035 - 1 Mar 2025

Viewed by 614

Abstract

As medical devices become integral to modern healthcare, it is essential to prepare future pharmacists to counsel patients on device use and emerging therapeutic technologies. This study evaluates the impact of hands-on medical device training on pharmacy students at the University of Southern [...] Read more.

As medical devices become integral to modern healthcare, it is essential to prepare future pharmacists to counsel patients on device use and emerging therapeutic technologies. This study evaluates the impact of hands-on medical device training on pharmacy students at the University of Southern California (USC) Mann School of Pharmacy and Pharmaceutical Sciences, focusing on the level of comfort in counseling patients and retention of device-related information. Utilizing an active learning framework, this study provides insights into how experiential learning methods using medical devices enhance pharmacy students’ readiness for clinical practice. The results demonstrated significant improvement in levels of student comfort with counseling and information retention. The implementation of a hands-on training module has the potential to be adapted and applied to other courses or programs. The findings highlight the importance of integrating practical training within the pharmacy curriculum to better prepare graduates for effective patient education and support. Full article

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27 pages, 1353 KiB

Open AccessReview

Disparities in Postoperative Pain Management: A Scoping Review of Prescription Practices and Social Determinants of Health

by Aidan Snell, Diana Lobaina, Sebastian Densley, Elijah Moothedan, Julianne Baker, Lama Al Abdul Razzak, Alexandra Garcia, Shane Skibba, Ayden Dunn, Tiffany Follin, Maria Mejia, Panagiota Kitsantas and Lea Sacca

Pharmacy 2025, 13(2), 34; https://doi.org/10.3390/pharmacy13020034 - 24 Feb 2025

Cited by 1 | Viewed by 847

Abstract

Background: Opioid analgesic therapy has been traditionally used for pain management; however, the variability in patient characteristics, complexity in evaluating pain, availability of treatment within facilities, and U.S. physicians overprescribing opioids have contributed to the current opioid epidemic. Despite large research efforts [...] Read more.

Background: Opioid analgesic therapy has been traditionally used for pain management; however, the variability in patient characteristics, complexity in evaluating pain, availability of treatment within facilities, and U.S. physicians overprescribing opioids have contributed to the current opioid epidemic. Despite large research efforts investigating the patterns of postsurgical pain management and influencing factors, it remains unclear how these overall trends vary across the varying sizes and available resources of academic hospitals, community hospitals, and outpatient surgery centers. The primary aim of this scoping review was to examine the patterns of contemporary postoperative pain management across healthcare settings, including academic medical centers, community hospitals, and outpatient surgery centers. Specifically, this study investigates how prescription practices for opioids, NSAIDs, and acetaminophen are influenced by patient demographics, including sex, race, gender, insurance status, and other social determinants of health (SDoH), to inform equitable and patient-centered pain management strategies. Methods: This study utilized The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and was used as a reference checklist. The Arksey and O’Malley methodological framework was used to guide the review process. To ensure comprehensive coverage, searches were conducted across three major databases: PubMed, Embase, and Cochrane Library. Results: A total of 43 eligible studies were retained for analysis. The highest reported Healthy People 2030 category was Social and community context (n = 39), while the highest reported category of SDoH was age (n = 36). A total of 34 articles listed sex and age as SDoH. Additional SDoH examined were race/ethnicity (n = 17), insurance (n = 7), employment (n = 1), education (n = 4), and income (n = 1). This review suggests that there are significant gaps in the implementation of institution-specific, patient-centered, and equitable pain management strategies, particularly in academic hospitals, which our findings show have the highest rates of opioid and NSAID prescriptions (n = 26) compared to outpatient surgical centers (n = 8). Findings from our review of the literature demonstrated that while academic hospitals often adopt enhanced recovery protocols aimed at reducing opioid dependence, these protocols can fail to address the diverse needs of at-risk populations, such as those with chronic substance use, low socioeconomic status, or racial and ethnic minorities. Conclusions: Findings from this review are expected to have implications for informing both organizational-specific and nationwide policy recommendations, potentially leading to more personalized and equitable pain management strategies across different healthcare settings. These include guidelines for clinicians on addressing various aspects of postoperative pain management, including preoperative education, perioperative pain management planning, use of different pharmacological and nonpharmacological modalities, organizational policies, and transition to outpatient care. Full article

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7 pages, 706 KiB

Open AccessArticle

Association Between Reporting Antimicrobial Use and Clostridioides difficile Standardized Infection Ratios in South Carolina Hospitals

by Maya Abo-Hamzy, Kayla Antosz, Sarah E. Battle, Pamela Bailey, Hana R. Winders, P. Brandon Bookstaver and Majdi N. Al-Hasan

Pharmacy 2025, 13(2), 33; https://doi.org/10.3390/pharmacy13020033 - 22 Feb 2025

Viewed by 434

Abstract

The Centers for Disease Control and Prevention have been encouraging hospitals in the United States to report antimicrobial use (AU) to the National Healthcare Safety Network (NHSN). This retrospective cohort study examines the association between reporting AU and the Clostridioides difficile infection (CDI) [...] Read more.

The Centers for Disease Control and Prevention have been encouraging hospitals in the United States to report antimicrobial use (AU) to the National Healthcare Safety Network (NHSN). This retrospective cohort study examines the association between reporting AU and the Clostridioides difficile infection (CDI) standardized infection ratio (SIR) in South Carolina hospitals. Student’s t-test was used to examine the mean difference in the change in CDI SIRs from 2017 to 2021 between hospitals reporting AU for ≥3 years and those reporting AU for <3 years during the study period. Among 65 hospitals in South Carolina, 43 reported AU for <3 years, and 22 reported AU for ≥3 years. There was significantly greater decline in the CDI SIR from 2017 to 2021 in hospitals reporting AU for ≥3 years compared to those reporting AU for <3 years (mean difference of the change in the CDI SIR −0.33 [95% CI −0.57, −0.06]; p = 0.016). The results of a steeper decline in the CDI SIR in hospitals consistently reporting AU during the majority of the study period compared to other hospitals encourages hospitals to report AU to the NHSN and promotes antimicrobial stewardship efforts at the state and national level. Full article

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11 pages, 522 KiB

Open AccessArticle

Distinct Regional Pattern of Sedative Psychotropic Drug Use in South Tyrol: A Comparison with National Trends in Italy

by Christian J. Wiedermann, Katia Sangermano, Pasqualina Marino, Dietmar Ausserhofer, Adolf Engl and Giuliano Piccoliori

Pharmacy 2025, 13(2), 32; https://doi.org/10.3390/pharmacy13020032 - 21 Feb 2025

Viewed by 420

Abstract

This study investigated regional variations in the use of sedative psychotropic medications, often prescribed for insomnia, by comparing Italy and the culturally distinct Autonomous Province of Bolzano, South Tyrol. Using daily defined dose (DDD) data per 1000 inhabitants per day, benzodiazepines, Z-drugs, sedative [...] Read more.

This study investigated regional variations in the use of sedative psychotropic medications, often prescribed for insomnia, by comparing Italy and the culturally distinct Autonomous Province of Bolzano, South Tyrol. Using daily defined dose (DDD) data per 1000 inhabitants per day, benzodiazepines, Z-drugs, sedative antidepressants, and melatonin consumption from 2019 to 2023 were examined. The findings indicate a notably lower utilization of benzodiazepines in South Tyrol compared to the national Italian average, alongside a significant increase in sedative antidepressant use, particularly mirtazapine. These disparities likely stem from regional prescribing preferences influenced by cultural, linguistic, and healthcare system factors. While Z-drug consumption remained comparable across regions, melatonin use exhibited a gradual upward trend, albeit less pronounced in South Tyrol. These insights emphasize the necessity for region-specific strategies in optimizing insomnia treatment, balancing pharmacological approaches with non-pharmacological alternatives such as cognitive behavioral therapy for insomnia. Understanding these prescribing trends can inform healthcare policies aimed at reducing long-term sedative use while enhancing patient-centered care in sleep medicine. Full article

(This article belongs to the Topic Optimization of Drug Utilization and Medication Adherence)

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12 pages, 3796 KiB

Open AccessCommentary

Student Use of Digital Patient Cases May Improve Performance in a Pharmacy Cardiovascular Therapeutics Course

by Paul J. Wong, Noam Morningstar-Kywi, Rory E. Kim and Tien M. H. Ng

Pharmacy 2025, 13(2), 31; https://doi.org/10.3390/pharmacy13020031 - 21 Feb 2025

Viewed by 413

Abstract

The use of digital patient cases (eCases) is associated with student-perceived improvements in learning. However, novel instructional tools must demonstrate measurable student benefits to justify ongoing use. This research sought to identify the impact of digital patient cases (eCases) on student performance in [...] Read more.

The use of digital patient cases (eCases) is associated with student-perceived improvements in learning. However, novel instructional tools must demonstrate measurable student benefits to justify ongoing use. This research sought to identify the impact of digital patient cases (eCases) on student performance in a PharmD cardiovascular course. Optional eCases for hypertension (HTN), venous thromboembolism (VTE), and acute heart failure (AHF) were incorporated into the course. Performance on the exams and course overall was compared between student cohorts based on eCase use. Aggregated data were analyzed by year. Additional analysis was performed for scores on exam items related to eCase content. From 2020 to 2022, a total of 322/562 students (57.3%) used any eCase. While there were no differences in 2020 and 2021, eCase users in 2022 had significantly higher course (83.6% vs. 79.7%, p = 0.002) and final exam scores (75.0% vs. 67.7%, p < 0.001) compared with non-users. VTE eCase users had higher scores on VTE exam items compared to non-users, but only in 2021. AHF eCase users received higher scores on AHF exam items compared to non-users in 2021 and 2022. Among certain cohorts, student eCase use was associated with improved performance, and the use of certain eCases showed differences in content-specific performance. The eCase is a promising instructional tool that warrants further investigation to determine best design elements for maximal effectiveness. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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Pharmacy, Volume 13, Issue 2 (April 2025) – 27 articles

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