Search Results (92)

Cyclin-dependent kinase (CDK)4/6 inhibitors have become a key component of adjuvant treatment for patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2−) early breast cancer who are at high risk of recurrence. The addition of abemaciclib and ribociclib to standard endocrine therapy has demonstrated clinically meaningful improvements in invasive disease-free survival, supported by the monarchE and NATALEE trials, respectively. With expansion of patient eligibility for CDK4/6 inhibitors, multidisciplinary coordination among medical oncologists, surgeons, nurses, pharmacists, and other health care providers is critical to optimizing patient identification, monitoring, and management of adverse events. This expert guidance document provides practical recommendations for implementing adjuvant CDK4/6 inhibitor therapy in routine clinical practice, incorporating insights from multiple specialties and with patient advocacy representation. Key considerations include patient selection based on clinical trial data, treatment duration, dosing schedules, adverse event profiles, monitoring requirements, drug–drug interactions, and patient-specific factors such as tolerability, cost, and quality of life. This guidance aims to support Canadian clinicians in effectively integrating CDK4/6 inhibitors into clinical practice, ensuring optimal patient outcomes through a multidisciplinary and patient-centric approach. Full article

As veganism becomes more popular, the number of vegan pregnant women and children is steadily increasing. During vegan pregnancy and early childhood, there is a high risk for nutrient deficiencies that may impair child development. External factors, such as healthcare advice, social networks, and social environments, that affect the diet of vegan pregnant women, parents, and their children, as well as their approach towards dietary supplementation, have not yet been investigated. Various sources of information, combined with a lack of expertise, sparse food and nutritional health literacy, and qualitatively heterogeneous information provision by medical experts, unsettle vegan pregnant women and parents and affect their dietary choices and potentially the health of their children. The VedieS study aims to investigate potential connections between external influences and associated impacts on a vegan diet and the intake of dietary supplements (DS) of pregnant women and children. Two surveys are being conducted within the study: one targeting 1000 vegan pregnant women and parents, and another targeting 60 experts in each of five healthcare groups: gynecologists, pediatricians, general practitioners, pharmacists, and dietitians. This study is the first to examine how socio-economic, social, and further informational factors influence dietary practices during vegan pregnancy and childhood. It highlights the need for reliable, expert-led guidance, as current information sources are often inconsistent and may put these vulnerable groups at risk. Full article

Background: Since the current increase in antimicrobial resistance globally, parasitic infectious diseases have become a greater public health crisis than ever before and an absolute priority. The Egyptian community pharmacist, as a health care provider and advisor, has a potential role to play in deworming. Objective: To evaluate the outcomes of community pharmacist-led deworming-related counseling services. Methods: A prospective randomized controlled study was conducted in Damanhur, Behera, Egypt. The intervention group received community pharmacy counseling, and the control group received the usual care. Both groups were monitored for 12 months for recurrence evaluation. Results: A total of 173 patients were included, of whom 96 (55.5%) received patient counseling. The types of infection included Oxyuris (44.5%), Entamoeba histolytica (28.9%), Ascaris (8.7%), Entamoeba Cyst (8.7%), Giardiasis (4.6%), Schistosomiasis (2.9%), and pinworm (1.7%). A total of 119 participants (68.8%) reported a need for dose repetition. Personal hygiene practices were reported by 71 participants (41%). Recurrence of infection was observed in 101 cases (58.4%). Patient counseling was significantly associated with lower recurrence rates and higher rates of personal hygiene application (p < 0.001). Multivariate logistic regression analysis revealed that patient counseling and personal hygiene measures were the only significant predictors of infection recurrence rate. Conclusions: Community pharmacists’ deworming-related counseling had positive behavioral and clinical outcomes. Full article

As artificial intelligence (AI) becomes increasingly utilized to perform tasks requiring human intelligence, patients who are pregnant may turn to AI for advice on over-the-counter (OTC) medications. However, medications used in pregnancy may pose profound safety concerns limited by data availability. This study focuses on a chatbot’s ability to accurately provide information regarding OTC medications as it relates to patients that are pregnant. A prospective, descriptive design was used to compare the responses generated by the Chat Generative Pre-Trained Transformer 3.5 (ChatGPT-3.5) to the information provided by UpToDate^®. Eighty-seven of the top pharmacist-recommended OTC drugs in the United States (U.S.) as identified by Pharmacy Times were assessed for safe use in pregnancy using ChatGPT-3.5. A piloted, standard prompt was input into ChatGPT-3.5, and the responses were recorded. Two groups independently rated the responses compared to UpToDate on their correctness, completeness, and safety using a 5-point Likert scale. After independent evaluations, the groups discussed the findings to reach a consensus, with a third independent investigator giving final ratings. For correctness, the median score was 5 (interquartile range [IQR]: 5–5). For completeness, the median score was 4 (IQR: 4–5). For safety, the median score was 5 (IQR: 5–5). Despite high overall scores, the safety errors in 9% of the evaluations (n = 8), including omissions that pose a risk of serious complications, currently renders the chatbot an unsafe standalone resource for this purpose. Full article

Advances in pharmaceutical technology have positioned 3D printing and bioprinting as promising tools for developing personalized drug therapies. These innovations may redefine compounding practices by enabling precise, patient-specific drug formulations. Evaluating pharmacists’ readiness to adopt such technologies is therefore becoming increasingly important. Aim: The aim of this study is to investigate pharmacists’ knowledge, attitudes, and perceived barriers regarding the application of 3D printing and bioprinting technologies, as well as their perspectives on the regulation and implementation of these technologies in the context of personalized pharmacy. Materials and Methods: A custom-designed questionnaire was developed for the purposes of this pilot study, based on a review of the existing literature and informed by expert consultation to ensure conceptual relevance and clarity. The survey was conducted between September and December 2024. The data collection instrument comprises three main sections: (1) sociodemographic and professional characteristics, (2) knowledge regarding the applications of 3D printing and bioprinting in pharmacy, and (3) attitudes toward the regulatory framework and implementation of these technologies. Results: A total of 353 respondents participated, and 65.5% of them (n = 231) correctly distinguished between the concepts of “3D printing” and “bioprinting.” More than 25% (n = 88) were uncertain, and 8.5% (n = 30) were unable to differentiate between the two. Regarding the perceived benefits of personalized pharmacy, 83% (n = 293) of participants identified “the creation of personalized medications tailored to individual needs” as the main advantage, while 66% (n = 233) highlighted the “optimization of drug concentration to enhance therapeutic efficacy and minimize toxicity and adverse effects.” Approximately 60% (n = 210) of the pharmacists surveyed believed that the introduction of 3D-bioprinted pharmaceuticals would have a positive impact on the on-site preparation of customized drug formulations in community and hospital pharmacies. Lack of regulatory guidance and unresolved ethical concerns were identified as primary barriers. Notably, over 40% (n = 142) of respondents expressed concern that patients could be subjected to treatment approaches resembling “laboratory experimentation.” Nearly 90% (n = 317) of participants recognized the need for specialized training and expressed a willingness to engage in such educational initiatives. Conclusions: Three-dimensional printing and bioprinting technologies are considered cutting-edge instruments that may contribute to the advancement of pharmaceutical practice and industry, particularly in the field of personalized medicine. However, respondents’ views suggest that successful integration may require improved pharmacist awareness and targeted educational initiatives, along with the development and adaptation of appropriate regulatory frameworks to accommodate these novel technologies in drug design and compounding. Full article

Introduction: Critically ill patients in intensive care units (ICUs) are at high risk of malnutrition, which can result in muscle atrophy, polyneuropathy, increased mortality, or prolonged hospitalizations with complications and higher costs during the recovery period. They often develop ICU-acquired weakness, exacerbated by sepsis, immobilization, and drug treatments, leading to rapid muscle mass loss and long-term complications. Studies indicate that adequate protein and calorie intake can decrease mortality and improve prognosis and recovery. However, optimal implementation remains a critical challenge. Objectives: This narrative review aims to summarize recent advances in nutritional strategies for critically ill patients. It highlights the benefits and limitations of current approaches including enteral (EN) and parenteral nutrition (PN) and examines their impact on clinical outcomes and overall mortality. Additionally, the review explores the emerging role of precision nutrition in critical care using technologies such as metabolomics and artificial intelligence (AI) to provide valuable insights into optimizing nutritional care in critically ill patients. Methods: A comprehensive literature search was conducted to identify recent studies, clinical guidelines, and expert consensus papers on nutritional support for ICU patients. The investigation focused on critical aspects such as the optimal timing for intervention, the route of administration, specific protein and energy targets, and technological innovations to support personalized nutrition, ensuring that each patient receives tailored support based on their unique needs. Results: Guidelines recommend initiating EN or PN nutrition within the first 48 h of admission, using indirect calorimetry (IC) to estimate energy needs, and supplementing protein up to 1.2 g/kg/day after stabilization. IC has gained importance in assessing energy needs but is still underused in the ICU. EN is preferred because it maintains intestinal integrity, reduces the risk of infections, and is recommended within the first 48 h of ICU admission. PN is used when EN is infeasible, but it increases the risk of infection. By integrating metabolomics with transcriptomic and genomic data, we can gain a deeper understanding of the effect of nutrition on cellular homeostasis, facilitating personalized treatments and enhancing the recovery of critically ill patients. Conclusions: AI is becoming increasingly important in monitoring and evaluating artificial nutrition, providing a more accurate and efficient alternative to traditional methods. AI can assist in identifying and managing malnutrition and is effective for estimating caloric and nutrient intake. AI minimizes human error, enables continuous monitoring, and integrates various data sources. The nutritional care of critically ill patients requires collaboration among specialists from diverse fields, including physicians, nutritionists, pharmacists, radiologists, IT experts, and policymakers. Full article

Background/Objective: Patients have historically trusted healthcare providers to be a reliable source of health information. However, with the recent pandemic and subsequent recovery, understanding and developing patients’ trust has become even more important, especially regarding vaccine acceptance. The objective of this work is to explore the current level of trust that rural patients have in their healthcare providers concerning influenza vaccination and related recommendations and its impact on vaccine uptake in a rural county in Washington State. Methods: An anonymous survey was conducted by a survey research center using a random sampling of 3000 addresses for people living in Yakima County in Washington State. Yakima County has a high percentage of people who identify as Hispanic or Latino/a and is a medically underserved area. The survey was designed to evaluate factors influencing the decision to be vaccinated against influenza and the level of trust in information from healthcare providers. Results: Results showed that participants who had been vaccinated against influenza in the previous five years were more likely to trust the advice of their primary care provider (p < 0.001), specialty care provider (p < 0.001), pharmacist (p = 0.02), and nurse (p = 0.002). People who were not vaccinated against influenza in the last five years were statistically more likely to report that a recommendation from a healthcare provider would not make a difference in their decision (p < 0.001). People who were vaccinated were more likely to utilize healthcare providers as a source of information about the influenza vaccine (p < 0.001) and people who were unvaccinated were more likely to use their own personal research as a trusted information source (p = 0.04). Conclusions: Healthcare providers continue to be well regarded and trusted by their patients, especially in rurally located counties, though work still needs to be carried out around influenza vaccination importance messaging. This work identified that all healthcare providers need to work collaboratively to reinforce vaccination guideline recommendations and to both provide education and continue successful access-to-vaccination strategies to promote influenza prevention. Full article

With the enforcement of the Act for Eliminating Discrimination against Persons with Disabilities, the provision of reasonable accommodations in pharmacies has become mandatory in Japan. This study aimed to develop and validate the effectiveness of a training program to improve pharmacists’ ability to assist people with intellectual disabilities. The educational staff of one chain pharmacy company announced the program, and pharmacists at this company were invited to participate in the program. A 90 min online training was conducted with 15 pharmacists. The session included a lecture on reasonable accommodations and small group discussions (SGD). Before and after the training, participants answered an online survey about 1. Their basic attributes (number of years of experience and awareness of reasonable accommodations and constructive dialogue); 2. Their confidence in providing medication guidance to people with intellectual disabilities (10-point scale); and 3. Possible accommodations that could be provided by pharmacies. Training resulted in an increase in the average score for question 2 from 3.93 to 5.87. In addition, an increase in the number of keywords within the free-text descriptions and in the number of co-occurrences within the responses of mentions of possible accommodations in pharmacies was observed. Despite the shortness of the training, it changed the participants’ awareness about accommodations for people with intellectual disabilities. Further study is needed to enhance the content and evaluate changes in practice. Full article

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

Background/Objectives: This study evaluates the perceptions of pharmacists in Romania regarding self-medication, a growing practice with significant implications for public health and sustainable development. The main objective is to analyze the role of pharmacists in managing self-medication and educating the public on rational medication use. Methods: A descriptive and exploratory methodology was employed, using a questionnaire administered to 300 pharmacists from various regions in Romania between March and April 2024. The data analysis included Chi-square tests and linear regression to identify predictive factors. Results: The findings reveal a direct correlation between the frequency of self-medication and the perceived severity of conditions, with self-medication being more common for minor ailments. Experienced pharmacists are less likely to encourage self-medication. Public education on the risks of self-medication significantly reduces the prevalence of this practice. Conclusions: Self-medication, without proper regulation and education, risks becoming unsustainable. Targeted informational campaigns and educational programs tailored to diverse demographic groups are essential. Pharmacists play a critical role in promoting safe and responsible medication use. Full article

In Japan, telepharmacy is becoming increasingly popular due to deregulation triggered by the outbreak of COVID-19. The purpose of this study was to gain an understanding of the actual state of telepharmacy in Japan by interviewing pharmacists who have experience with telepharmacy and describing its advantages and disadvantages, as well as their outlook for its use going forward. The interviews were conducted online using Zoom. Each interview lasted approximately 30 min. Eleven people were interviewed. The advantages mentioned by the pharmacists were classified into three main categories: “Better communication”, “Time savings”, and “Improved safety”. The disadvantages were classified into the following nine categories: “Drug delivery problems”, “Communication failures”, “Ease of use for patients”, “Emotional reactions”, “Pharmacy system”, “Communication issues”, “Healthcare system issues”, “App system issues”, and “Cost”. Many of these factors correspond to the Unified Theory of Acceptance and Use of Technology (UTAUT) constructs presented by Venkatesh, et al. Many of the pharmacists mentioned that the use of telepharmacy is likely to expand further in the future, but that this will require further development of communication technology and the widespread use of systems such as electronic prescriptions. Full article

With the rapid development of the pharmaceutical industry and constant growth of drug usage, ecopharmacovigilance (EPV) has emerged as a way of coping with and minimizing the effects that drugs have on the environment. EPV concerns and describes unwanted effects that the use of a specific drug could have on the environment. The US, EU and Cananda are the improving position of EPV, both in legislation and practice. EPV requires further development as previous studies have shown that neither the general population nor healthcare professionals have enough knowledge about the subject. Improving awareness and knowledge about this topic is a key task for the future of EPV. The main objective was to determine students’ level of knowledge about ecopharmacovigilance and to examine ways of storing and disposing of unused and expired drugs. Students’ knowledge and habits were examined by a previously published survey. The survey contains twenty questions divided into three parts and the possibility of writing an additional note. There was no difference in the level of knowledge between the students of different studies. Also, students who had a family member working as healthcare professional did not show a higher level of knowledge compared to the others. Pharmacy students had a greater intention to educate their environment about EPV when compared to students of the other studies. This is in the line with a previous study which showed that the general public expects that pharmacists and physicians educate them about EPV. Medicine and dental medicine students will become prescribers after finishing their studies, and as such, they should be informed about eco-directed sustainable prescribing (EDSP) as part of an EPV strategy. More than half of the participants reported good adherence to prescribers’ instruction, which decreased the amount of unused drugs. Most of the students found that the drug expiration date was legible, but they did not check it often. In comparison with similar studies, Croatian students had more knowledge and better practices concerning EPV and drug disposal. Structured learning strategies and curriculum implementation for EPV are much needed for further raising awareness about the subject among healthcare professionals and the public. Full article

Background/Objectives: This review summarizes the current knowledge about factors that affect the physical characteristics of urine. It highlights proper urine sample collection and displays factors like diet, hydration status, and medications that can alter urine color, odor, clarity, specific gravity and pH. Results: Urinalysis is a minimally invasive examination of a patient’s health, especially concerning nephrological and endocrinological abnormalities, as well as dietary habits and stimulants used. Certain deviations in appearance, composition or frequency/pain during urination may indicate an ongoing disease process in the body. Based on laboratory results, further medical treatment is determined. The reason for a change in the color of the urine, for its clouding or intense odor may be a disease, as well as the consumption of food, medication, intensive physical exercise or inadequate hydration of the body. Well-standardized procedures for collecting, transporting, preparing and analyzing samples should become the basis for an effective diagnostic strategy in urinalysis. It is worth noting that pharmacists in pharmaceutical care are often the first people to whom a patient turns for health advice and for the interpretation of simple laboratory tests. Acquiring the ability to interpret the results of laboratory tests and the principles of proper sampling for laboratory tests is indispensable in the process of possible counseling and providing reliable answers to patients’ questions. Conclusions: Although urinalysis is not recommended as a routine screening tool for the general population, it can prove to be a valuable source of patient health data in some cases as the data will be useful to physicians and pharmacists to more effectively diagnose and better care for patients. Full article

The introduction of a new vaccine into immunization programs represents a significant advancement in the global effort to combat vaccine-preventable diseases. Data from the World Health Organization support that immunization prevents between 2 and 3 million deaths each year across various diseases, underscoring its pivotal role in global health. The present study aims to assess the knowledge, attitudes, and anticipated vaccination practices among health professionals in Central Greece in response to the potential introduction of new Respiratory Syncytial Virus (RSV) vaccination guidelines by the National Vaccines Committee. Among the 450 health professionals solicited for the study, 219 provided responses, yielding a response rate of approximately 55%. A substantial majority (70.3%) accurately identified the vaccine’s current availability, and 62.1% were aware of the current recommendation for RSV vaccination in pregnant women. In response to whether health professionals support the inclusion of an RSV vaccine in the national vaccination program if it becomes commercially available and is recommended by the Greek National Immunization Program, general practitioners showed the most support, with an average score of 4.86 (95% CI, 4.69–5.00), followed by pediatricians at 4.76 (95% CI, 4.63–4.89), pulmonologists at 4.68 (95% CI, 4.36–5.00), and obstetricians at 4.33 (95% CI, 3.95–4.71). Concerning general opinions on vaccinations, a high level of agreement was noted among the majority of health professionals, excluding nurses. Pharmacists recorded the highest agreement, with a perfect score of 5 (CI, 5.00–5.00), followed closely by pediatricians at 4.99 (CI, 4.97–5.00), GPs at 4.95 (CI, 4.85–5.00), pulmonologists at 4.93 (CI, 4.83–5.00), obstetricians at 4.74 (CI, 4.42–5.00), and nurses at 3.80 (CI, 3.06–4.54). A tailored approach to education is needed to ensure that healthcare professionals can communicate more effectively about RSV risks and vaccination benefits, fostering a proactive stance towards disease prevention and patient care. In essence, our study underscores the importance of knowledge in shaping a compassionate and responsive healthcare environment, ready to meet the challenges of RSV head-on. Full article

With the increasing pipeline of cell and gene therapies (CGTs) and the expected surge in the number of approvals, understanding the market access landscape becomes crucial for timely patient access. This study evaluates the challenges Dutch stakeholders encounter in CGT market access, offering insights for improving time-to-patient access. A traditional literature review was conducted to identify market access challenges and solutions for CGTs. Based on the findings, participants for semi-structured interviews, designed using an interview guide adapted to the Dutch context, were selected to capture diverse perspectives on market access. This review included 124 relevant articles out of 2449, covering several aspects of market access of CGTs. Subsequently, interviews with 16 stakeholders from academia, patient advocacy groups, manufacturers, health insurers, payers, hospital pharmacists, healthcare practitioners, and the Association of Innovative Medicines were conducted. Stakeholders identified challenges and proposed solutions for reimbursement package management, clinical trials, health economics, payment models, and procedural and organisational aspects. Thematic analysis revealed unique country-specific challenges and solutions in the Netherlands. This research provides insights into these challenges and potential solutions, emphasising the need for collaborative efforts among stakeholders to develop practical and multidisciplinary measures to improve the market access landscape for CGTs in the country. Full article