Editor’s Choice Articles

Editor’s Choice articles are based on recommendations by the scientific editors of MDPI journals from around the world. Editors select a small number of articles recently published in the journal that they believe will be particularly interesting to readers, or important in the respective research area. The aim is to provide a snapshot of some of the most exciting work published in the various research areas of the journal.

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14 pages, 280 KiB  
Review
Interventions to Expand Community Pharmacists’ Scope of Practice
by Zaynah Zureen Ali, Helen Skouteris, Stephanie Pirotta, Safeera Yasmeen Hussainy, Yi Ling Low, Danielle Mazza and Anisa Rojanapenkul Assifi
Pharmacy 2024, 12(3), 95; https://doi.org/10.3390/pharmacy12030095 - 19 Jun 2024
Cited by 3 | Viewed by 2964
Abstract
Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed [...] Read more.
Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed a scoping review to identify randomised controlled trials (RCTs), published worldwide from 2013 to 2024, which focused on interventions designed to expand pharmacists’ scope of practice in the community. The review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews. To address the aim of this scoping review, the included RCTs were mapped to themes influenced by the Professional Practice Standards 2023 as developed by the Pharmaceutical Society of Australia: medication management, collaborative care and medication adherence. Results: Twelve studies demonstrated the potential to expand community pharmacists’ scope of practice. Two RCTs resulted in no effect of the intervention. One RCT (conducted in Italy) led to an actual change to community pharmacists’ scope of practice, with a statistically significant improvement in the proportion of patients with controlled asthma. Conclusions: On the whole, this scoping review synthesised the findings of peer-reviewed RCT studies that revealed expanding community pharmacists’ scope of practice may result in improved patient outcomes, a reduced burden for the healthcare system, and greater productivity. Full article
12 pages, 864 KiB  
Article
Using Team-Based Learning to Teach Pharmacology within the Medical Curriculum
by Nora L. D. Luitjes, Gisela J. van der Velden and Rahul Pandit
Pharmacy 2024, 12(3), 91; https://doi.org/10.3390/pharmacy12030091 - 12 Jun 2024
Cited by 4 | Viewed by 2434
Abstract
The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation [...] Read more.
The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation highlighted students’ appreciation for pharmacology teaching, but students admitted to attending these teaching moments unprepared, resulting in passive learning. To address this, team-based learning (TBL) was implemented to facilitate learning through interaction, critical thinking, problem solving and reflection through six steps, from superficial to deeper cognitive learning. This study, conducted over two academic years, assessed students’ perception and performance regarding TBL. Analysis of a digital questionnaire using a 5-point Likert scale showed high student satisfaction with TBL as a teaching methodology. However, confidence in pharmacology knowledge following TBL was moderate. TBL attendees outperformed non-attendees in pharmacology-related exam questions, indicating that TBL has a positive impact on student performance. We conclude that TBL is an engaging and effective method for pharmacology education, positively influencing student learning and performance. This method could be broadly applied for teaching pharmacology within the medical curriculum or other biomedical programs. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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12 pages, 522 KiB  
Article
The Role of a Clinical Pharmacist in the Identification of Potentially Inadequate Drugs Prescribed to the Geriatric Population in Low-Resource Settings Using the Beers Criteria: A Pilot Study
by Tijana Kovačević, Maja Savić Davidović, Vedrana Barišić, Emir Fazlić, Siniša Miljković, Vlado Djajić, Branislava Miljković and Peđa Kovačević
Pharmacy 2024, 12(3), 84; https://doi.org/10.3390/pharmacy12030084 - 28 May 2024
Cited by 4 | Viewed by 2318
Abstract
Population aging is a global phenomenon. Each country in the world faces an increased number of older persons in the total population. With aging, a high prevalence of multiple chronic diseases occurs, leading to the use of complex therapeutic regimens and often to [...] Read more.
Population aging is a global phenomenon. Each country in the world faces an increased number of older persons in the total population. With aging, a high prevalence of multiple chronic diseases occurs, leading to the use of complex therapeutic regimens and often to polypharmacy. Potentially inappropriate medication (PIM) is a medicine prescribed to a patient for whom the risks outweigh the benefits. Today, several tools are used to evaluate the use of pharmacotherapy in older adults, one of them is the 2019 AGS Beers Criteria. In this prospective, pilot study, we aimed to investigate if the number of PIMs in elderly patients would be significantly reduced if a clinical pharmacist performed a pharmacotherapy review. The study included 66 patients over 65 years of age who were hospitalized at the 1200-bed university hospital. The intervention was conducted by a clinical pharmacist who reviewed the patients’ pharmacotherapy and provided written suggestions to physicians. The pharmacotherapy was again reviewed at the patients’ discharge from the hospital. A total number of 204 PIMs were identified in the pharmacotherapy of the study population. At discharge, the number of PIMs decreased to 67. A total of 67% of the pharmacist’s suggestions were accepted by the physicians. The pharmacist’s intervention led to significant decrease in the number of PIMs on patients’ discharge letters. Full article
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11 pages, 233 KiB  
Article
Views of the Pharmacists’ Role in HPV Vaccinations: A Qualitative Study in Tennessee
by Alina Cernasev, Kenneth C. Hohmeier, Oluwafemifola Oyedeji, Kristina W. Kintziger and Tracy M. Hagemann
Pharmacy 2024, 12(2), 57; https://doi.org/10.3390/pharmacy12020057 - 28 Mar 2024
Cited by 5 | Viewed by 2628
Abstract
The Human Papillomavirus (HPV) is a frequently occurring sexually transmitted infection in adults and is associated with various cancers that can affect both males and females. Recently, the Advisory Committee on Immunization Practices (ACIP) expanded its recommendations for the HPV vaccine to include [...] Read more.
The Human Papillomavirus (HPV) is a frequently occurring sexually transmitted infection in adults and is associated with various cancers that can affect both males and females. Recently, the Advisory Committee on Immunization Practices (ACIP) expanded its recommendations for the HPV vaccine to include patients aged 27–45 years with shared clinical decision-making. A commonly reported obstacle to receiving the HPV vaccine among adults is a lack of healthcare provider recommendations. Considering the suboptimal HPV vaccine coverage figures and noting that the vast majority of hesitancy research has been conducted among children and adolescents, limited research is available on the adult perception of HPV vaccination in pharmacies. This study focuses on understanding adults’ opinions and perceptions regarding the role of pharmacists in the uptake of the HPV vaccine and awareness of its availability in the pharmacy setting. Methods: After receiving approval from the Institutional Review Board (IRB), the qualitative study was initiated using virtual focus groups (FGs). Concepts from the Transtheoretical Model, the Health Belief Model, and the Social Cognitive Theory guided the study design. The corpus of data was collected in 2021 and 2022 by two researchers, and a third party transcribed the FGs to avoid any biases. The data were analyzed using Braun and Clarke’s Thematic Analysis. Results: Out of 35 subjects that participated in six FGDs, most identified as female, with ages ranging from 18 to 45 years. The following four themes emerged: (1) HPV vaccine awareness; (2) stigmas leading to reduced education and vaccination rates; (3) education preferences; (4) follow-up in vaccination series reminders and preferences. Conclusion: Participants’ views of the HPV vaccine and the ability to receive the vaccine in a pharmacy are influenced by a myriad of factors. Common factors include improved awareness, preferences for educational modalities, avoiding stigmas associated with HPV vaccination, combating gender-focused biases, and preferences for the location of vaccination. These barriers provide opportunities for pharmacists to promote and enhance vaccine uptake. Full article
16 pages, 658 KiB  
Review
Medication Review: What’s in a Name and What Is It about?
by Anneleen Robberechts, Maja Brumer, Victoria Garcia-Cardenas, Niurka M. Dupotey, Stephane Steurbaut, Guido R. Y. De Meyer and Hans De Loof
Pharmacy 2024, 12(1), 39; https://doi.org/10.3390/pharmacy12010039 - 19 Feb 2024
Cited by 8 | Viewed by 7305
Abstract
Background: Medication review is a multifaceted service aimed at optimizing the use of medicines and enhancing the health outcomes of patients. Due to its complexity, it is crucial to clearly describe the service, its variants, and its components to avoid confusion and ensure [...] Read more.
Background: Medication review is a multifaceted service aimed at optimizing the use of medicines and enhancing the health outcomes of patients. Due to its complexity, it is crucial to clearly describe the service, its variants, and its components to avoid confusion and ensure a better understanding of medication review among healthcare providers. Aim: This study aims to bring clarity to the origins, definitions, abbreviations, and types of medication reviews, together with the primary criteria that delineate key features of this service. Method: A narrative review approach was employed to clarify the diverse terminology associated with “medication review” services. Relevant references were initially identified through searches on PubMed and Google Scholar, complementing the existing literature known to the authors. Results: The study uncovers a complicated and sometimes convoluted history of “medication review” in different regions around the world. The initial optimization of medicine use had an economic purpose before evolving subsequently into a more patient-oriented approach. A selection of abbreviations, definitions, and types were outlined to enhance the understanding of the service. Conclusions: The study underscores the urgent need for comprehensive information and standardization regarding the content and quality of the services, collectively referred to as “medication review”. Full article
(This article belongs to the Special Issue Pharmacists: Key Players in a Changing Health Care System)
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12 pages, 470 KiB  
Review
A Review of Olanzapine in the Treatment of Cancer Anorexia-Cachexia Syndrome
by Ivy O. Poon, Veronica Ajewole and Ursula K. Braun
Pharmacy 2024, 12(1), 34; https://doi.org/10.3390/pharmacy12010034 - 17 Feb 2024
Cited by 7 | Viewed by 4124
Abstract
Background: Cancer anorexia-cachexia syndrome (CAS) is a multifactorial condition that is highly prevalent in advanced cancer patients and associated with significant reduction in functional performance, reduction in quality of life, and increased mortality. Currently, no medications are approved for this indication. Recently, the [...] Read more.
Background: Cancer anorexia-cachexia syndrome (CAS) is a multifactorial condition that is highly prevalent in advanced cancer patients and associated with significant reduction in functional performance, reduction in quality of life, and increased mortality. Currently, no medications are approved for this indication. Recently, the American Society of Clinical Oncology (ASCO) released a rapid recommendation suggesting that low-dose olanzapine once daily may be used to treat cancer cachexia. Many questions still exist on how to use olanzapine for this indication in clinical practice. The objective of this review is to identify existing knowledge on the use of olanzapine for CAS. Methods: A comprehensive search was conducted to identify the primary literature that involved olanzapine for anorexia and cachexia in cancer patients between 2000 and 2023. Results: Seven articles were identified and are discussed here, including two randomized double-blinded placebo-controlled studies, one randomized comparative study, two prospective open-label studies, one retrospective chart review, and one case report. Conclusions: Low dose olanzapine (2.5–5 mg once daily) may be useful in the treatment of CAS for increasing appetite, reducing nausea and vomiting, and promoting weight gain. Further large-scale multi-center randomized placebo-controlled studies will be needed to investigate the impact of olanzapine on weight change in CAS patients. Full article
(This article belongs to the Special Issue Medicine Use and Management in Palliative Care)
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13 pages, 3541 KiB  
Review
Review of Leishmaniasis Treatment: Can We See the Forest through the Trees?
by Moshe Shmueli and Shalom Ben-Shimol
Pharmacy 2024, 12(1), 30; https://doi.org/10.3390/pharmacy12010030 - 8 Feb 2024
Cited by 17 | Viewed by 4565
Abstract
There are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medications, or parenteral drugs. [...] Read more.
There are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medications, or parenteral drugs. Leishmaniasis treatment is difficult, with several factors to be considered. First, the efficacy of treatments varies among different species of parasites prevalent in different areas on the globe, with each species having a unique clinical presentation and resistance profile. Furthermore, leishmaniasis is a neglected tropical disease (NTD), resulting in a lack of evidence-based knowledge regarding treatment. Therefore, physicians often rely on case reports or case series studies, in the absence of randomized controlled trials (RCT), to assess treatment efficacy. Second, defining cure, especially in CL and MCL, may be difficult, as death of the parasite can be achieved in most cases, while the aesthetic result (e.g., scars) is hard to predict. This is a result of the biological nature of the disease, often diagnosed late in the course of disease (with possible keloid formation, etc.). Third, physicians must consider treatment ease of use and the safety profile of possible treatments. Thus, topical or oral treatments (for CL) are desirable and promote adherence. Fourth, the cost of the treatment is an important consideration. In this review, we aim to describe the diverse treatment options for different clinical manifestations of leishmaniasis. For each currently available treatment, we will discuss the various considerations mentioned above (efficacy, ease of use, safety, and cost). Full article
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13 pages, 1440 KiB  
Article
Reducing Pharmaceuticals in Water, a New Module Integrated in the Pharmacy Game: Evaluating the Module’s Effects on Students’ Knowledge and Attitudes
by Tanja Fens, Caroline T. A. Moermond, Peter van der Maas, Claudia Dantuma-Wering, Geke H. Lestestuiver, Agata Szperl, Lisette C. M. Schuiling, Eelko Hak and Katja Taxis
Pharmacy 2024, 12(1), 28; https://doi.org/10.3390/pharmacy12010028 - 6 Feb 2024
Cited by 6 | Viewed by 2598
Abstract
Pharmaceutical residues end up in surface waters, impacting drinking water sources and contaminating the aquatic ecosystem. Pharmacists can play a role in reducing pharmaceutical residues, yet this is often not addressed in pharmacy undergraduate education. Therefore, we developed the educational module “Reducing Pharmaceuticals [...] Read more.
Pharmaceutical residues end up in surface waters, impacting drinking water sources and contaminating the aquatic ecosystem. Pharmacists can play a role in reducing pharmaceutical residues, yet this is often not addressed in pharmacy undergraduate education. Therefore, we developed the educational module “Reducing Pharmaceuticals in Water” for pharmacy students; this was integrated in our pharmacy simulation game for third year Master of Pharmacy students at the University of Groningen. In this study, we aim to evaluate the effects of the module on students’ knowledge of pharmaceutical residues in water, to describe students’ experiences in taking the module, and to explore their attitudes towards green pharmacy education in general. This mixed-methods study included quantitative measurements, before and after students took the module (intervention group) and in a control group which did not receive the module. Data were collected between February 2023 and June 2023. Overall, 29 students took the module and 36 students were in the control group. The knowledge score of students in the intervention group (N = 29) increased significantly from 9.3 to 12.9 out of 22 (p < 0.001). The knowledge score of the students in the control group was (8.9 out of 22). Students found the e-learning and the patient cases the most exciting part of this module. Students also recognized the need to including environmental issues in pharmacy education. In conclusion, the module contributes towards improved knowledge and increased awareness of the impact of pharmaceuticals found in water. It represents a promising strategy to strengthen pharmacist’s role in mitigating the amount and the effect of pharmaceuticals on water and the environment in the future. Full article
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14 pages, 523 KiB  
Review
Digital Solutions Available to Be Used by Informal Caregivers, Contributing to Medication Adherence: A Scoping Review
by Margarida Espírito-Santo, Sancha Santos and Maria Dulce Estêvão
Pharmacy 2024, 12(1), 20; https://doi.org/10.3390/pharmacy12010020 - 23 Jan 2024
Cited by 8 | Viewed by 2809
Abstract
Medication adherence is essential for managing chronic diseases and achieving optimal health outcomes. However, this process is often challenging, particularly for patients with complex care needs. Informal caregivers play a pivotal role in supporting medication management, but they may face resource limitations and [...] Read more.
Medication adherence is essential for managing chronic diseases and achieving optimal health outcomes. However, this process is often challenging, particularly for patients with complex care needs. Informal caregivers play a pivotal role in supporting medication management, but they may face resource limitations and a lack of necessary support. Digital health tools offer a promising avenue to enhance medication adherence by providing reminders, education, and remote monitoring capabilities. This scoping review aimed to identify and evaluate digital solutions available to informal caregivers for improving medication adherence. A systematic search of PubMed and Web of Science was conducted using relevant keywords. Four studies were included in the review, examining a variety of digital tools including mobile apps, SMS messaging, and wearable devices. These tools demonstrated efficacy in improving medication adherence, managing disease symptoms, and enhancing quality of life for patients and caregivers. Digital health interventions hold the potential to revolutionize medication adherence among chronic disease patients. By empowering informal caregivers, these tools can bridge the gaps in medication management and contribute to better health outcomes. Further research is warranted to optimize the design, implementation, and evaluation of digital interventions for medication adherence. Full article
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25 pages, 3581 KiB  
Article
Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
by Anthony Mullin, Mark Scott, Giorgia Vaccaro, Giuseppe Floresta, Davide Arillotta, Valeria Catalani, John M. Corkery, Jacqueline L. Stair, Fabrizio Schifano and Amira Guirguis
Pharmacy 2024, 12(1), 13; https://doi.org/10.3390/pharmacy12010013 - 12 Jan 2024
Cited by 8 | Viewed by 7123
Abstract
Introduction: The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam [...] Read more.
Introduction: The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam (F), and pyrazolam (P), available on the drug market for over a decade, comparing the quantitative chemical analyses of tablet samples, purchased from the internet prior to the implementation of the Psychoactive Substances Act UK 2016, with the thematic netnographic analyses of social media content. Method: Drug samples were purchased from the internet in early 2016. The characterisation of all drug batches were performed using UHPLC-MS and supported with 1H NMR. In addition, netnographic studies across the platforms X (formerly Twitter) and Reddit, between 2016–2023, were conducted. The latter was supported by both manual and artificial intelligence (AI)-driven thematic analyses, using numerous.ai and ChatGPT, of social media threads and discussions. Results: UHPLC-MS confirmed the expected drug in every sample, showing remarkable inter/intra batch variability across all batches (E = 13.8 ± 0.6 to 24.7 ± 0.9 mg; F = 4.0 ± 0.2 to 23.5 ± 0.8 mg; P = 5.2 ± 0.2 to 11.5 ± 0.4 mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Thematic analyses showed etizolam dominated social media discussions (59% of all posts), with 24.2% of posts involving sale/purchase and 17.8% detailing new administration trends/poly-drug use scenarios. Artificial intelligence confirmed three of the top five trends identified manually. Conclusions: Purity variability identified across all tested samples emphasises the increased potential health risks associated with DBZD consumption. We propose the global DBZD market is exacerbated by surface web social media discussions, recorded across X and Reddit. Despite the appearance of newer analogues, these three DBZDs remain prevalent and popularised. Reporting themes on harm/effects and new developments in poly-drug use trends, demand for DBZDs continues to grow, despite their potent nature and potential risk to life. It is proposed that greater controls and constant live monitoring of social media user content is warranted to drive active regulation strategies and targeted, effective, harm reduction strategies. Full article
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14 pages, 730 KiB  
Review
Pharmacist-Led Interventions for Medication Adherence in Patients with Chronic Kidney Disease: A Scoping Review
by Luke Calleja, Beverley D. Glass, Alice Cairns and Selina Taylor
Pharmacy 2023, 11(6), 185; https://doi.org/10.3390/pharmacy11060185 - 30 Nov 2023
Cited by 6 | Viewed by 5409
Abstract
Background: Patients with chronic kidney disease (CKD) are routinely prescribed complex medication regimes. Medication reconciliation, medicine reviews, patient counselling and disease state and medication education are all key pharmacist-led interventions, which can improve medication adherence in patients with CKD. Aim: To characterize peer [...] Read more.
Background: Patients with chronic kidney disease (CKD) are routinely prescribed complex medication regimes. Medication reconciliation, medicine reviews, patient counselling and disease state and medication education are all key pharmacist-led interventions, which can improve medication adherence in patients with CKD. Aim: To characterize peer reviewed literature on the role of pharmacists in supporting medication adherence of patients with chronic kidney disease and highlight the impact they might have in the health outcomes for patients. Method: This review was performed in accordance with the Scoping Review Framework outlined in the Joanna Briggs Institute Reviewer’s Guide. Four electronic databases were searched (Medline (Ovid), Emcare, Scopus and Web of Science) for all relevant literature published up until November 2022. A total of 32 studies were reviewed against an exclusion and inclusion criteria, with findings from each study categorized into barriers, interventions, perceptions, financial implications and outcomes. Results: Eight eligible studies were identified, where pharmacists’ interventions including medication reconciliation, medicine reviews, patient counselling and disease state and medication education, were all reported to have a positive effect on medication adherence. Although pharmacy services in chronic kidney disease were acceptable to patients and pharmacists, these services were under-utilized and limited by logistical constraints, including staffing shortages and time limitations. Patient education supplemented with education tools describing disease states and medications was reported to increase patient adherence to medication regimes. Conclusions: Pharmacist-led interventions play an integral role in improving medication adherence in patients with chronic kidney disease, with their inclusion in renal care settings having the potential to improve outcomes for patients. Full article
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15 pages, 663 KiB  
Review
Adult Patients with Difficulty Swallowing Oral Dosage Forms: A Systematic Review of the Quantitative Literature
by Anne Harnett, Stephen Byrne, Jennifer O’Connor, Declan Lyons and Laura J. Sahm
Pharmacy 2023, 11(5), 167; https://doi.org/10.3390/pharmacy11050167 - 19 Oct 2023
Cited by 8 | Viewed by 5304
Abstract
The aim of this systematic review was to identify and critically appraise the available evidence regarding solid oral dosage forms (SODFs), e.g., tablets, and challenges regarding the oral administration of medicine to inpatients in a variety of healthcare settings such as (1) hospitals, [...] Read more.
The aim of this systematic review was to identify and critically appraise the available evidence regarding solid oral dosage forms (SODFs), e.g., tablets, and challenges regarding the oral administration of medicine to inpatients in a variety of healthcare settings such as (1) hospitals, (2) nursing homes and (3) long-term stay units (LTSUs). A literature search was undertaken in September 2021 and repeated in June 2023 in the following databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, The Cochrane Library, PsycINFO and ProQuest. A Microsoft Excel® spreadsheet was devised to collate the following data from each eligible study: study author and year, country, number of participants, title, duration (follow-up period), study design, inclusion and exclusion criteria, method and data collection, relevant outcomes, and key findings. A total of 3023 records were identified, with 12 articles being included in the final systematic review. Seven of the twelve studies reported on the prevalence of difficulties swallowing SODFs, which varied from 10–34.2%. Nine of the twelve studies reported the methods used to manipulate SODFs, with the most reported method being tablet crushing. Given the prevalence of swallowing difficulties and the subsequent crushing of medicines in response to this, it is evident that concerns should be raised regarding the potential for a medication administration error to occur. Full article
(This article belongs to the Special Issue Pharmacy Reviews in 2022)
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17 pages, 1250 KiB  
Review
The Critical Role of Pharmacists in the Clinical Delivery of Pharmacogenetics in the U.S
by Susanne B. Haga
Pharmacy 2023, 11(5), 144; https://doi.org/10.3390/pharmacy11050144 - 10 Sep 2023
Cited by 10 | Viewed by 3848
Abstract
Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The [...] Read more.
Since the rebirth of pharmacogenomics (PGx) in the 1990s and 2000s, with new discoveries of genetic variation underlying adverse drug response and new analytical technologies such as sequencing and microarrays, there has been much interest in the clinical application of PGx testing. The early involvement of pharmacists in clinical studies and the establishment of organizations to support the dissemination of information about PGx variants have naturally resulted in leaders in clinical implementation. This paper presents an overview of the evolving role of pharmacists, and discusses potential challenges and future paths, primarily focused in the U.S. Pharmacists have positioned themselves as leaders in clinical PGx testing, and will prepare the next generation to utilize PGx testing in their scope of practice. Full article
(This article belongs to the Special Issue The Emerging Role of Pharmacists in Pharmacogenomics)
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17 pages, 304 KiB  
Article
Objective Assessment of Adherence and Inhaler Technique among Asthma and COPD Patients in London: A Study in Community Pharmacies Using an Electronic Monitoring Device
by Iman Hesso, Shereen Nabhani-Gebara and Reem Kayyali
Pharmacy 2023, 11(3), 94; https://doi.org/10.3390/pharmacy11030094 - 4 Jun 2023
Cited by 8 | Viewed by 3329
Abstract
Background: The INhaler Compliance Assessment (INCATM) device is an electronic monitoring device (EMD) that assesses both patient’s adherence and inhaler technique (IT). This study aimed, first, to assess the value of using the INCATM device as an objective measure during [...] Read more.
Background: The INhaler Compliance Assessment (INCATM) device is an electronic monitoring device (EMD) that assesses both patient’s adherence and inhaler technique (IT). This study aimed, first, to assess the value of using the INCATM device as an objective measure during medicine use review (MUR) consultations provided by community pharmacists (CPs) on patients’ adherence and IT. Second, we aimed to explore patients’ perceptions about the INCATM device. Methods: A mixed methods approach was used, involving two phases. Phase one was a service evaluation in independent community pharmacies in London with a before-and-after study design. The service included provision of an MUR consultation to asthma and COPD patients using objective feedback about adherence and IT generated with the INCATM device. Descriptive and inferential statistics were performed using SPSS. Phase two involved semi-structured interviews with respiratory patients. Thematic analysis was performed to generate key findings. Main findings: Eighteen patients participated in the study (12 COPD and 6 asthma). The results showed significant improvement in the INCATM actual adherence from 30% to 68% (p = 0.001) and significant reduction in IT error rate from 51% to 12% (p = 0.002) after conducting the service. Analysis of the interviews revealed patients’ positive attitudes in terms of the perceived benefits of the technology and a desire for future use and recommendation for others. Patients had also positive attitudes towards the consultations provided. Conclusion: Embedding an objective measure about adherence and IT during CPs’ consultations showed a significant improvement in patients’ adherence and IT and was accepted by patients as well. Full article
(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)
14 pages, 613 KiB  
Review
Potential Barriers to the Implementation of Computer-Based Simulation in Pharmacy Education: A Systematic Review
by Ahmed M. Gharib, Gregory M. Peterson, Ivan K. Bindoff and Mohammed S. Salahudeen
Pharmacy 2023, 11(3), 86; https://doi.org/10.3390/pharmacy11030086 - 17 May 2023
Cited by 9 | Viewed by 3256
Abstract
Computer-based simulation (CBS) is an interactive pedagogical training method that has seen increased interest, especially in recent years. There is some evidence that CBS in pharmacy education is not as widely adopted compared to other healthcare disciplines. Pharmacy education literature to date has [...] Read more.
Computer-based simulation (CBS) is an interactive pedagogical training method that has seen increased interest, especially in recent years. There is some evidence that CBS in pharmacy education is not as widely adopted compared to other healthcare disciplines. Pharmacy education literature to date has not specifically discussed the potential barriers which may cause this uptake challenge. In this systematic narrative review, we attempted to explore and discuss potential barriers that may impact the integration of CBS in pharmacy practice education and provide our suggestions to overcome them. We searched five major databases and used the AACODS checklist for grey literature assessment. We identified 42 studies and four grey literature reports, published between 1 January 2000 and 31 August 2022, which met the inclusion criteria. Then, the specific approach of Braun and Clarke for thematic analysis was followed. The majority of the included articles were from Europe, North America, and Australasia. Although none of the included articles had a specific focus on barriers to implementation, thematic analysis was used to extract and discuss several potential barriers, such as resistance to change, cost, time, usability of software, meeting accreditation standards, motivating and engaging students, faculty experience, and curriculum constraints. Ad- dressing academic, process, and cultural barriers can be considered the first step in providing guidance for future implementation research for CBS in pharmacy education. The analysis suggests that to effectively overcome any possible barriers to implementing CBS, different stakeholders must engage in careful planning, collaboration, and investment in resources and training. The review indicates that additional research is required to offer evidence-based approach and strategies to prevent overwhelming or disengaging users from either learning or teaching process. It also guides further research into exploring potential barriers in different institutional cultures and regions. Full article
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12 pages, 1125 KiB  
Article
Student Health and Social Care Professionals’ Health Literacy Knowledge: An Exploratory Study
by Helen Wood, Gabrielle Brand, Rhonda Clifford, Sinead Kado, Kenneth Lee and Liza Seubert
Pharmacy 2023, 11(2), 40; https://doi.org/10.3390/pharmacy11020040 - 22 Feb 2023
Cited by 7 | Viewed by 2244
Abstract
Health literacy is essential for shared decision-making and improved health outcomes, and patients with inadequate health literacy often need additional support from health and social care professionals. Despite global calls for developing tertiary-level health literacy education, the extent of this in Australian health [...] Read more.
Health literacy is essential for shared decision-making and improved health outcomes, and patients with inadequate health literacy often need additional support from health and social care professionals. Despite global calls for developing tertiary-level health literacy education, the extent of this in Australian health and social care professional degrees is unknown. This research explored students’ health literacy knowledge across five health and social care professional disciplines. A web-based questionnaire was disseminated to student health and social care professionals enrolled in one of two Australian universities. Questions explored students’ factual and conceptual health literacy knowledge, and responses were inductively themed and reported descriptively. Of the 90 students who participated, the depth of health literacy knowledge was low. Students frequently identified understanding as components of health literacy; however, most students did not identify health information access, appraisal and use. Additionally, students’ knowledge of helping patients with inadequate health literacy was limited. Adjusting patient education to their health literacy level and evaluating patient understanding was poorly understood. Without a solid understanding of fundamental health literacy principles, newly-graduated health and social care professionals will be poorly equipped to facilitate patients’ health literacy-related challenges in the community. Further exploration of health literacy education is urgently recommended to identify areas for improvement. Full article
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8 pages, 215 KiB  
Review
Considering the Intercultural Development Inventory (IDI) to Assess Intercultural Competence at U.S. Pharmacy Schools
by Diana Tamer, Yifei Liu and Jennifer Santee
Pharmacy 2023, 11(1), 39; https://doi.org/10.3390/pharmacy11010039 - 19 Feb 2023
Cited by 6 | Viewed by 2962
Abstract
Background: U.S. pharmacy schools need to engage in improving intercultural competence among administrators, faculty, staff, and students. The Intercultural Development Inventory (IDI) can be a possible tool to determine the level of intercultural competence. U.S. pharmacy schools need to examine the validity of [...] Read more.
Background: U.S. pharmacy schools need to engage in improving intercultural competence among administrators, faculty, staff, and students. The Intercultural Development Inventory (IDI) can be a possible tool to determine the level of intercultural competence. U.S. pharmacy schools need to examine the validity of the IDI within the context of health professional education prior to using this tool. Objectives: To describe the relationship between the IDI and its underlying theory, identify whether the validity of the IDI has been established within two specific contexts, and discuss the practical issues and implications of using the IDI. Methods: Medline, Embase, and selected health professional education journal websites were searched to identify fully published studies utilizing the IDI within health professional education. Eligibility of articles was determined with a standardized approach. Results: Ten studies were identified by full-text reviews, but none investigated the validity of the IDI. Conclusions: The IDI has been shown to be valid in certain contexts, but its validity has yet to be confirmed within health professional education. U.S. pharmacy schools need to examine practical issues and implications when deciding if the resources required to administer, analyze, and report IDI results are reasonable. Full article
(This article belongs to the Special Issue Pharmacy Reviews in 2022)
9 pages, 369 KiB  
Article
Assessing Learner Engagement and the Impact on Academic Performance within a Virtual Learning Environment
by Suzanne Galal, Deepti Vyas, Martha Ndung’u, Guangyu Wu and Mason Webber
Pharmacy 2023, 11(1), 36; https://doi.org/10.3390/pharmacy11010036 - 15 Feb 2023
Cited by 5 | Viewed by 3276
Abstract
Background: The objective of this pilot study was to examine student engagement with weekly self-paced learning materials in a virtual therapeutics course, and how sub-factors in the Motivated Strategies for Learning Questionnaire (MSLQ) may have influenced academic performance. Methods: Students within a diabetes [...] Read more.
Background: The objective of this pilot study was to examine student engagement with weekly self-paced learning materials in a virtual therapeutics course, and how sub-factors in the Motivated Strategies for Learning Questionnaire (MSLQ) may have influenced academic performance. Methods: Students within a diabetes module of a therapeutics course were provided with weekly asynchronous optional self-directed learning activities. Student submissions, on-time rates, self-reported weekly study time, and exam performance were collected. Students completed the MSLQ at the completion of the study. Data was evaluated using various correlation analyses to determine the predictive ability of the MSLQ and its 5 subscales. Results: In total, 173 students completed the study. Students’ self-efficacy score on the MSLQ subscale and case submission on-time rate have the strongest positive correlation with the exam score, while the test anxiety as reported on the MSLQ test anxiety subscale had the strongest negative correlation with the exam score. Conclusions: Study results proved the MSLQ to be an effective predictive tool in students’ self-regulation skills. Results can be used to develop intentional interventions aimed at improving self-regulation skills while providing opportunities to enhance student learning. Full article
(This article belongs to the Special Issue Women’s Special Issue Series: Pharmacy)
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19 pages, 1078 KiB  
Review
Public Health Interventions Delivered by Pharmacy Professionals in Low- and Middle-Income Countries in Africa: A Systematic Scoping Review
by Begashaw Melaku Gebresillassie, Kelly Howells and Diane Ashiru-Oredope
Pharmacy 2023, 11(1), 24; https://doi.org/10.3390/pharmacy11010024 - 30 Jan 2023
Cited by 7 | Viewed by 3922
Abstract
Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa’s Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore [...] Read more.
Pharmacists and their teams play an important role in providing public health services, however little is known about their level of contribution and the strength of evidence in Africa’s Low- and Middle-Income Countries (LMICs). The purpose of this scoping review was to explore and map the available evidence on pharmacy professional-delivered public health interventions in Africa’s LMICs. Six electronic databases (Medline, Embase, International Pharmaceutical Abstract, PsycInfo, Maternity and Infant Care, and Cochrane database), relevant grey literature sources, key journals focused on African health issues, and libraries of relevant organizations were searched between January 2010 and December 2020. Studies were included if they reported public health interventions delivered by pharmacy professionals (pharmacists or pharmacy technicians) or their teams. The quality of the individual studies was assessed using an adapted grading system. Thirty-nine studies were included in this review. Pharmacy professionals delivered a wide range of public health interventions, with the most common themes being noncommunicable diseases, infectious diseases, sexual and reproductive health, antimicrobial resistance, and other health conditions, e.g., dental health, unused drugs or waste, minor ailments. The majority of the studies were classified as low-quality evidence. They were predominantly feasibility and acceptability studies conducted in a narrow study area, in a small number of LMICs in Africa, resulting in little evidence of service effectiveness, issues of broad generalizability of the findings, and sustainability. The major constraints to service provision were identified as a lack of training, public recognition, and supporting policies. Pharmacy professionals and their teams across LMICs in Africa have attempted to expand their practice in public health. However, the pace of the expansion has been slow and lacks strong evidence for its generalizability and sustainability. Future research is needed to improve the quality of evidence, which will subsequently serve as a foundation for policy reform, allowing pharmacy professionals to make significant contributions to the public health initiatives in the region. Full article
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19 pages, 3627 KiB  
Article
Pharmacists’ Satisfaction with Work and Working Conditions in New Zealand—An Updated Survey and a Comparison to Canada
by Sharon Jessie Lam, Larry D. Lynd and Carlo A. Marra
Pharmacy 2023, 11(1), 21; https://doi.org/10.3390/pharmacy11010021 - 23 Jan 2023
Cited by 5 | Viewed by 3201
Abstract
Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. Aim: To evaluate pharmacists’ perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and [...] Read more.
Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. Aim: To evaluate pharmacists’ perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and compare results with Canadian studies and historic NZ data. Methods: A cross-sectional online survey was distributed to registered pharmacists in NZ. The survey included demographics, work satisfaction, psychological distress, and perceptions of their working conditions (six statements with agreement rated on a 5-point Likert scale). Comparisons were made with surveys from Canada and NZ. Chi-square, t-tests, and non-parametric statistics were used to make comparisons. Results: The response rate was 24.7% (694/2815) with 73.1% practicing in a community pharmacy (45.8% independent, 27.3% chains). Pharmacists disagreed on having adequate time for breaks and tasks, while the majority contemplated leaving the profession and/or not repeating their careers again if given the choice. Working longer hours and processing more prescriptions per day were predictive factors for poorer job satisfaction. More NZ pharmacists perceived their work environment to be conducive to safe and effective primary care (57% vs. 47%, p < 0.001) and reported that they had enough staff (45% vs. 32%, p = 0.002) as compared to Canadian pharmacists. Pharmacists’ job satisfaction and psychological distress have not improved compared to the assessment 20 years prior. Conclusions: NZ pharmacists perceive working conditions to be sub-optimal yet had higher satisfaction than their Canadian counterparts. Work dissatisfaction and psychological distress are high and have not improved over the last two decades. Full article
(This article belongs to the Special Issue Community-Based Pharmacy Practice Quality Improvement and Research)
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19 pages, 964 KiB  
Review
Recent Advances in Sickle-Cell Disease Therapies: A Review of Voxelotor, Crizanlizumab, and L-glutamine
by Michael Migotsky, Molly Beestrum and Sherif M. Badawy
Pharmacy 2022, 10(5), 123; https://doi.org/10.3390/pharmacy10050123 - 26 Sep 2022
Cited by 21 | Viewed by 7392
Abstract
Sickle-cell disease (SCD) is an inherited hemoglobinopathy, causing lifelong complications such as painful vaso-occlusive episodes, acute chest syndrome, stroke, chronic anemia, and end-organ damage, with negative effects on quality of life and life expectancy. Within the last five years, three new treatments have [...] Read more.
Sickle-cell disease (SCD) is an inherited hemoglobinopathy, causing lifelong complications such as painful vaso-occlusive episodes, acute chest syndrome, stroke, chronic anemia, and end-organ damage, with negative effects on quality of life and life expectancy. Within the last five years, three new treatments have been approved: L-glutamine in 2017 and crizanlizumab and voxelotor in 2019. We conducted a literature search of these three medications, and of the 31 articles meeting inclusion criteria, 6 studied L-glutamine, 9 crizanlizumab, and 16 voxelotor. Treatment with L-glutamine was associated with decrease in pain crises, hospitalizations, and time to first and second crises, with a decrease in RBC transfusion rate. Barriers to filling and taking L-glutamine included insurance denial, high deductible, and intolerability, especially abdominal pain. Crizanlizumab was associated with a reduction in pain crises and time to first crisis, with reduction in need for opioid use. Adverse effects of crizanlizumab include headache, nausea, insurance difficulty, and infusion reactions. Voxelotor was associated with increased hemoglobin and decreased markers of hemolysis. Barriers for voxelotor use included insurance denial and side effects such as headache, rash, and diarrhea. These three medications represent exciting new therapies and are generally well-tolerated though price and insurance approval remain potential barriers to access. Other studies are ongoing, particularly in the pediatric population, and more real-world studies are needed. The objective of this article is to evaluate post-approval studies of crizanlizumab, voxelotor, and L-glutamine in SCD, with a focus on real-world efficacy, side effects, and prescribing data. Full article
(This article belongs to the Special Issue Medicine Use in Chronic Disease)
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11 pages, 525 KiB  
Review
Clinical Update on Patient-Controlled Analgesia for Acute Postoperative Pain
by Cyrus Motamed
Pharmacy 2022, 10(1), 22; https://doi.org/10.3390/pharmacy10010022 - 27 Jan 2022
Cited by 22 | Viewed by 16003
Abstract
Patient-controlled analgesia (PCA) is an effective method for controlling acute pain, including postoperative pain in adults and in children from five years of age, pain resulting from labor, trauma, or other medical situations, or chronic and malignant pain. The treatment consists of a [...] Read more.
Patient-controlled analgesia (PCA) is an effective method for controlling acute pain, including postoperative pain in adults and in children from five years of age, pain resulting from labor, trauma, or other medical situations, or chronic and malignant pain. The treatment consists of a mini-computer-controlled infusion pump permitting the administration of on-demand, continuous, or combined doses of analgesic (mainly opioid) variations in response to therapy, which allows pain to be significantly controlled. Intravenous (IV)-PCA minimizes individual pharmacodynamics and pharmacokinetic differences and is widely accepted as a reference method for mild or severe postoperative pain. IV-PCA is the most studied route of PCA; other delivery methods have been extensively reported in the literature. In addition, IV-PCA usually voids the gap between pain sensation and analgesic administration, permitting better recovery and fewer side effects. The most commonly observed complications are nausea and vomiting, pruritus, respiratory depression, sedation, confusion and urinary retention. However, human factors such as pharmacy preparation and device programming can also be involved in the occurrence of these complications, while device failure is much less of an issue. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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12 pages, 644 KiB  
Review
Telepharmacy during COVID-19: A Scoping Review
by Elizabeth J. Unni, Kanchita Patel, Isaac Rex Beazer and Man Hung
Pharmacy 2021, 9(4), 183; https://doi.org/10.3390/pharmacy9040183 - 11 Nov 2021
Cited by 61 | Viewed by 13886
Abstract
The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges [...] Read more.
The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy. Full article
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18 pages, 10922 KiB  
Review
COVID the Catalyst for Evolving Professional Role Identity? A Scoping Review of Global Pharmacists’ Roles and Services as a Response to the COVID-19 Pandemic
by Kaitlyn E. Watson, Theresa J. Schindel, Marina E. Barsoum and Janice Y. Kung
Pharmacy 2021, 9(2), 99; https://doi.org/10.3390/pharmacy9020099 - 4 May 2021
Cited by 42 | Viewed by 10799
Abstract
The COVID-19 pandemic requires a range of healthcare services to meet the needs of society. The objective was to explore what is known about the roles and services performed by frontline pharmacists during the first year of the COVID-19 pandemic. A scoping review [...] Read more.
The COVID-19 pandemic requires a range of healthcare services to meet the needs of society. The objective was to explore what is known about the roles and services performed by frontline pharmacists during the first year of the COVID-19 pandemic. A scoping review was conducted of frontline pharmacists’ roles and services during the first year of the COVID-19 pandemic. A medical librarian conducted comprehensive searches in five bibliographic databases—MEDLINE (via Ovid), Embase (Ovid), CINAHL, Scopus, and Web of Science Core Collection for articles published between December 2019 and December 2020. The initial search retrieved 3269 articles. After removing duplicates, 1196 articles titles and abstracts were screened, 281 full texts were reviewed for eligibility, and 63 articles were included. This scoping review presents a conceptual framework model of the different layers made visible by COVID-19 of pharmacist roles in public health, information, and medication management. It is theorized that there is an invisible layer of change representing evolving professional role identity that may influence permanent role change following the pandemic. Thus, the pharmacy profession needs to build upon the lessons and experiences of this global pandemic and not let the momentum of the visible and invisible changes go to waste. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
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10 pages, 468 KiB  
Article
The Quality of Advice Provided by Pharmacists to Patients Taking Direct Oral Anticoagulants: A Mystery Shopper Study
by Jonathon Ertl, Leanne Chalmers and Luke Bereznicki
Pharmacy 2020, 8(3), 164; https://doi.org/10.3390/pharmacy8030164 - 3 Sep 2020
Cited by 1 | Viewed by 3874
Abstract
Pharmacists report being less confident in their knowledge of direct acting oral anticoagulants (DOACs) than of vitamin K antagonists, which may influence their ability to detect and manage complications arising from DOAC use. In a mystery shopper study, patient agents were sent into [...] Read more.
Pharmacists report being less confident in their knowledge of direct acting oral anticoagulants (DOACs) than of vitamin K antagonists, which may influence their ability to detect and manage complications arising from DOAC use. In a mystery shopper study, patient agents were sent into community pharmacies with symptom or product-related requests related to common complications that might arise during treatment with oral anticoagulants, with each visit being assessed for the preferred outcome. Only 10/41 (24.4%) visits resulted in the preferred outcome. A complete history-taking process, obtaining a medical history, patient characteristics and pharmacist involvement were strong predictors of the preferred outcome being achieved. The preferred outcome was not consistently achieved without pharmacist involvement. The potential for strategies that support comprehensive pharmacist involvement in over-the-counter requests should be considered to ensure the provision of optimal care to patients taking high-risk medications such as DOACs. Full article
(This article belongs to the Special Issue Atrial Fibrillation Management in Pharmacy)
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15 pages, 1046 KiB  
Review
The Role of Hospital and Community Pharmacists in the Management of COVID-19: Towards an Expanded Definition of the Roles, Responsibilities, and Duties of the Pharmacist
by Nicola Luigi Bragazzi, Muhammad Mansour, Alessandro Bonsignore and Rosagemma Ciliberti
Pharmacy 2020, 8(3), 140; https://doi.org/10.3390/pharmacy8030140 - 7 Aug 2020
Cited by 92 | Viewed by 40150
Abstract
Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as “coronavirus disease 2019” (COVID-19). The pathogen was initially named as “2019 novel coronavirus” (2019-nCoV) and [...] Read more.
Since late December 2019, a novel, emerging coronavirus was identified as the infectious agent responsible for a generally mild but sometimes severe and even life-threatening disease, termed as “coronavirus disease 2019” (COVID-19). The pathogen was initially named as “2019 novel coronavirus” (2019-nCoV) and later renamed as “Severe Acute Respiratory Coronavirus type 2” (SARS-CoV-2). COVID-19 quickly spread from the first epicenter, the city of Wuhan, province of Hubei, mainland China, into neighboring countries, and became a global pandemic. As of July 15th 2020, the outbreak is still ongoing, with SARS-CoV-2 affecting 213 countries and territories. The coronavirus has caused a dramatic toll of deaths and imposed a severe burden, both from a societal and economic point of view. COVID-19 has challenged health systems, straining and overwhelming healthcare facilities and settings, including hospital and community pharmacies. On the other hand, COVID-19 has propelled several changes. During the last decades, pharmacy has shifted from being products-based and patient-facing to being services-based and patient-centered. Pharmacies have transitioned from being compounding centers devoted to the manipulation of materia medica to pharmaceutical centers, clinical pharmacies and fully integrated “medical-pharmaceutical networks”, providing a significant range of non-prescribing services. Moreover, roles, duties and responsibilities of pharmacists have paralleled such historical changes and have known a gradual expansion, incorporating new skills and reflecting new societal demands and challenges. The COVID-19 outbreak has unearthed new opportunities for pharmacists: community and hospital pharmacists have, indeed, played a key role during the COVID-19 pandemic, suggesting that a fully integrated, inter-sectoral and inter-professional collaboration is necessary to face crises and public health emergencies. Preliminary, emerging evidence seems to suggest that, probably, a new era in the history of pharmacies (“the post-COVID-19 post-pharmaceutical care era”) has begun, with community pharmacists acquiring more professional standing, being authentic heroes and frontline health workers. Full article
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16 pages, 760 KiB  
Review
A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health
by Philip Crilly and Reem Kayyali
Pharmacy 2020, 8(3), 137; https://doi.org/10.3390/pharmacy8030137 - 4 Aug 2020
Cited by 36 | Viewed by 9071
Abstract
Community pharmacists (CPs) continue to have an important role in improving public health, however, advances in telehealth and digital technology mean that the methods by which they support their customers and patients are changing. The primary aim of this study was to identify [...] Read more.
Community pharmacists (CPs) continue to have an important role in improving public health, however, advances in telehealth and digital technology mean that the methods by which they support their customers and patients are changing. The primary aim of this study was to identify which telehealth and digital technology tools are used by CPs for public health purposes and determine if these have a positive impact on public health outcomes. A systematic review was carried out using databases including PubMed and ScienceDirect, covering a time period from April 2005 until April 2020. The search criteria were the following: randomized controlled trials, published in English, investigating the delivery of public health services by community pharmacists using a telehealth or digital tool. Thirteen studies were included out of 719 initially identified. Nine studies detailed the use of telephone prompts or calls, one study detailed the use of a mobile health application, two studies detailed the use of a remote monitoring device, and one study detailed the use of photo-aging software. Public health topics that were addressed included vaccination uptake (n = 2), smoking cessation (n = 1), hypertension management (n = 2), and medication adherence and counseling (n = 8). More studies are needed to demonstrate whether or not the use of novel technology by CPs can improve public health. Full article
(This article belongs to the Special Issue The Role of Community Pharmacists in Public Health)
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8 pages, 183 KiB  
Case Report
From Pilot to Scale, the 5 Year Growth of a Primary Care Pharmacist Model
by Jordan Spillane and Erika Smith
Pharmacy 2020, 8(3), 132; https://doi.org/10.3390/pharmacy8030132 - 30 Jul 2020
Cited by 1 | Viewed by 2902
Abstract
This case report details the five year journey of implementing, growing and optimizing a primary care pharmacist model in the ambulatory clinic setting within a health system. There is published evidence supporting the numerous benefits of including pharmacists in the primary care medical [...] Read more.
This case report details the five year journey of implementing, growing and optimizing a primary care pharmacist model in the ambulatory clinic setting within a health system. There is published evidence supporting the numerous benefits of including pharmacists in the primary care medical team model. This case report provides information regarding evolution of practice, the pharmacists’ roles, justification and financial models for the pharmacist services, as well as lessons learned and determined conclusions. Full article
(This article belongs to the Special Issue Embedded Pharmacists in Primary Care)
20 pages, 657 KiB  
Article
The Use of a Decision Support System in Swedish Pharmacies to Identify Potential Drug-Related Problems—Effects of a National Intervention Focused on Reviewing Elderly Patients’ Prescriptions
by Tora Hammar, Lina Hellström and Lisa Ericson
Pharmacy 2020, 8(3), 118; https://doi.org/10.3390/pharmacy8030118 - 13 Jul 2020
Cited by 6 | Viewed by 4821
Abstract
In pharmacies in Sweden, a clinical decision support system called Electronic Expert Support (EES) is available to analyse patients’ prescriptions for potential drug-related problems. A nationwide intervention was performed in 2018 among all Swedish pharmacy chains to increase the use of EES among [...] Read more.
In pharmacies in Sweden, a clinical decision support system called Electronic Expert Support (EES) is available to analyse patients’ prescriptions for potential drug-related problems. A nationwide intervention was performed in 2018 among all Swedish pharmacy chains to increase the use of EES among patients 75 years or older. The aim of this research was to study the use of EES in connection with the national intervention in order to describe any effects of the intervention, to understand how pharmacists use EES and to identify any barriers and facilitators for the use of EES by pharmacists for elderly patients. Data on the number and categories of EES analyses, alerts, resolved alerts and active pharmacies was provided by the Swedish eHealth Agency. The effects of the intervention were analysed using interrupted time series regression. A web-based questionnaire comprising 20 questions was sent to 1500 pharmacists randomly selected from all pharmacies in Sweden. The study shows that pharmacists use and appreciate EES and that the national intervention had a clear effect during the week of the intervention and seems to have contributed to a faster increase in pharmacists’ use of EES during the year to follow. The study also identified several issues or barriers for using EES. Full article
(This article belongs to the Special Issue Technology-Enabled Provision of Pharmacy Services)
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17 pages, 3629 KiB  
Article
Association of a Novel Medication Risk Score with Adverse Drug Events and Other Pertinent Outcomes Among Participants of the Programs of All-Inclusive Care for the Elderly
by David L. Bankes, Hubert Jin, Stephanie Finnel, Veronique Michaud, Calvin H. Knowlton, Jacques Turgeon and Alan Stein
Pharmacy 2020, 8(2), 87; https://doi.org/10.3390/pharmacy8020087 - 20 May 2020
Cited by 28 | Viewed by 10634
Abstract
Preventable adverse drug events (ADEs) represent a significant public health challenge for the older adult population, since they are associated with higher medical expenditures and more hospitalizations and emergency department (ED) visits. This study examines whether a novel medication risk prediction tool, the [...] Read more.
Preventable adverse drug events (ADEs) represent a significant public health challenge for the older adult population, since they are associated with higher medical expenditures and more hospitalizations and emergency department (ED) visits. This study examines whether a novel medication risk prediction tool, the MedWise Risk Score™ (MRS), is associated with ADEs and other pertinent outcomes in participants of the Programs of All-Inclusive Care for the Elderly (PACE). Unlike other risk predictors, this tool produces actionable information that pharmacists can easily use to reduce ADE risk. This was a retrospective cross-sectional study that analyzed administrative medical claims data of 1965 PACE participants in 2018. To detect ADEs, we identified all claims that had ADE-related International Classification of Diseases and Health Related Problems, 10th revision (ICD-10) codes. Using logistic and linear regression models, we examined the association between the MRS and a variety of outcomes, including the number of PACE participants with an ADE, total medical expenditures, ED visits, hospitalizations, and hospital length of stay. We found significant associations for every outcome. Specifically, every point increase in the MRS corresponded to an 8.6% increase in the odds of having one or more ADEs per year (OR = 1.086, 95% CI: 1.060, 1.113), $1037 USD in additional annual medical spending (adjusted R2 of 0.739; p < 0.001), 3.2 additional ED visits per 100 participants per year (adjusted R2 of 0.568; p < 0.001), and 2.1 additional hospitalizations per 100 participants per year (adjusted R2 of 0.804; p < 0.001). Therefore, the MRS can risk stratify PACE participants and predict a host of important and relevant outcomes pertaining to medication-related morbidity. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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9 pages, 756 KiB  
Commentary
Rethinking Competence: A Nexus of Educational Models in the Context of Lifelong Learning
by Dalia Bajis, Betty Chaar and Rebekah Moles
Pharmacy 2020, 8(2), 81; https://doi.org/10.3390/pharmacy8020081 - 8 May 2020
Cited by 10 | Viewed by 10209
Abstract
Competency-based education (CBE) “derives a curriculum from an analysis of a prospective or actual role in modern society and attempts to certify students’ progress on the basis of demonstrated performance in some or all aspects of that role”. This paper summarizes pertinent aspects [...] Read more.
Competency-based education (CBE) “derives a curriculum from an analysis of a prospective or actual role in modern society and attempts to certify students’ progress on the basis of demonstrated performance in some or all aspects of that role”. This paper summarizes pertinent aspects of existing CBE models in health professions education; pharmacy education presented as an example. It presents a synthesis of these models to propose a new diagrammatic representation. A conceptual model for competency-based health professions education with a focus on learning and assessment is discussed. It is argued that various elements of CBE converge to holistically portray competency-based learning and assessment as essential in initial education and relevant to practitioners’ continuing professional development, especially in the context and importance of pursing lifelong learning practices. Full article
(This article belongs to the Special Issue Continuing Professional Development in Pharmacy)
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15 pages, 483 KiB  
Review
Screening Tools Used by Clinical Pharmacists to Identify Elderly Patients at Risk of Drug-Related Problems on Hospital Admission: A Systematic Review
by Amanda Brady, Chris E. Curtis and Zahraa Jalal
Pharmacy 2020, 8(2), 64; https://doi.org/10.3390/pharmacy8020064 - 10 Apr 2020
Cited by 11 | Viewed by 5214
Abstract
In recent years, a number of studies have examined tools to identify elderly patients who are at increased risk of drug-related problems (DRPs). There has been interest in developing tools to prioritise patients for clinical pharmacist (CP) review. This systematic review (SR) aimed [...] Read more.
In recent years, a number of studies have examined tools to identify elderly patients who are at increased risk of drug-related problems (DRPs). There has been interest in developing tools to prioritise patients for clinical pharmacist (CP) review. This systematic review (SR) aimed to identify published primary research in this area and critically evaluate the quality of prediction tools to identify elderly patients at increased risk of DRPs and/or likely to need CP intervention. The PubMed, EMBASE, OVID HMIC, Cochrane Library, PsychInfo, CINAHL PLUS, Web of Science and ProQuest databases were searched. Keeping up to date with research and citations, the reference lists of included articles were also searched to identify relevant studies. The studies involved the development, utilisation and/or validation of a prediction tool. The protocol for this SR, CRD42019115673, was registered on PROSPERO. Data were extracted and systematically assessed for quality by considering the four key stages involved in accurate risk prediction models—development, validation, impact and implementation—and following the Checklist for the critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS). Nineteen studies met the inclusion criteria. Variations in study design, participant characteristics and outcomes made meta-analysis unsuitable. The tools varied in complexity. Most studies reported the sensitivity, specificity and/or discriminatory ability of the tool. Only four studies included external validation of the tool(s), namely of the BADRI model and the GerontoNet ADR Risk Score. The BADRI score demonstrated acceptable goodness of fit and good discrimination performance, whilst the GerontoNet ADR Risk Score showed poor reliability in external validation. None of the models met the four key stages required to create a quality risk prediction model. Further research is needed to either refine the tools developed to date or develop new ones that have good performance and have been externally validated before considering the potential impact and implementation of such tools. Full article
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19 pages, 2411 KiB  
Review
Cystatin C: A Primer for Pharmacists
by Hilary R. Teaford, Jason N. Barreto, Kathryn J. Vollmer, Andrew D. Rule and Erin F. Barreto
Pharmacy 2020, 8(1), 35; https://doi.org/10.3390/pharmacy8010035 - 9 Mar 2020
Cited by 35 | Viewed by 11770
Abstract
Pharmacists are at the forefront of dosing and monitoring medications eliminated by or toxic to the kidney. To evaluate the effectiveness and safety of these medications, accurate measurement of kidney function is paramount. The mainstay of kidney assessment for drug dosing and monitoring [...] Read more.
Pharmacists are at the forefront of dosing and monitoring medications eliminated by or toxic to the kidney. To evaluate the effectiveness and safety of these medications, accurate measurement of kidney function is paramount. The mainstay of kidney assessment for drug dosing and monitoring is serum creatinine (SCr)-based estimation equations. Yet, SCr has known limitations including its insensitivity to underlying changes in kidney function and the numerous non-kidney factors that are incompletely accounted for in equations to estimate glomerular filtration rate (eGFR). Serum cystatin C (cysC) is a biomarker that can serve as an adjunct or alternative to SCr to evaluate kidney function for drug dosing. Pharmacists must be educated about the strengths and limitations of cysC prior to applying it to medication management. Not all patient populations have been studied and some evaluations demonstrated large variations in the relationship between cysC and GFR. Use of eGFR equations incorporating cysC should be reserved for drug management in scenarios with demonstrated outcomes, including to improve pharmacodynamic target attainment for antibiotics or reduce drug toxicity. This article provides an overview of cysC, discusses evidence around its use in medication dosing and in special populations, and describes practical considerations for application and implementation. Full article
(This article belongs to the Special Issue Pharmacokinetics of Drugs and Dosing in Kidney Disease)
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8 pages, 413 KiB  
Article
Precision Genomic Practice in Oncology: Pharmacist Role and Experience in an Ambulatory Care Clinic
by Farah Raheem, Pauline Kim, Meagan Grove and Patrick J. Kiel
Pharmacy 2020, 8(1), 32; https://doi.org/10.3390/pharmacy8010032 - 8 Mar 2020
Cited by 5 | Viewed by 5855
Abstract
Recent advancements in molecular testing, the availability of cost-effective technology, and novel approaches to clinical trial design have facilitated the implementation of tumor genome sequencing into standard of care oncology practices. Current models of precision oncology practice include specialized clinics or consultation services [...] Read more.
Recent advancements in molecular testing, the availability of cost-effective technology, and novel approaches to clinical trial design have facilitated the implementation of tumor genome sequencing into standard of care oncology practices. Current models of precision oncology practice include specialized clinics or consultation services based on a molecular tumor board (MTB) approach. MTBs are comprised of interprofessional teams of clinicians and scientists who evaluate tumors at the molecular level to guide patient-specific targeted therapy. The practice of precision oncology utilizing MTB-based models is an emerging approach, transforming precision genomics from a novel concept into clinical practice. This rapid shift in practice from cytotoxic therapy to targeted medicine poses challenges, yet brings exciting opportunities to clinical pharmacists practicing in hematology and oncology. Only a few precision genomics programs in the United States have a strong pharmacy presence with oncology pharmacists serving in leadership roles in research, interpreting genomic sequencing, making treatment recommendations, and facilitating off-label drug procurement. This article describes the experience of the precision medicine clinic at the Indiana University Health Simon Cancer Center, with emphasis on the role of the pharmacist in the precision oncology initiative. Full article
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