Pharmacy

9 pages, 560 KiB

Open AccessArticle

Evaluating the Efficiency and Staff Satisfaction of the Point-of-Care IV Activated System Versus Traditional Piggyback in Administering IV Antibiotics at a Saudi Tertiary Hospital

by Khaled Elshammaa, Abubakr A. Yousif, Abdullah Alshammari, Mohammed Alnuhait, Abdulmalik S. Alotaibi, Mahmoud E. Elrggal and Mohamed Hassan Elnaem

Pharmacy 2024, 12(5), 158; https://doi.org/10.3390/pharmacy12050158 - 21 Oct 2024

Viewed by 950

Abstract

Background: This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Methods: Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed [...] Read more.

Background: This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Methods: Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. Results: The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. Conclusions: The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system. Full article

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

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19 pages, 700 KiB

Open AccessReview

A Review of Survey Instruments and Pharmacy Student Outcomes for Stress, Burnout, Depression and Anxiety

by Kelly C. Lee, Austin Yan, Tram B. Cat and Shareen Y. El-Ibiary

Pharmacy 2024, 12(5), 157; https://doi.org/10.3390/pharmacy12050157 - 18 Oct 2024

Viewed by 1084

Abstract

While the need to measure burnout, stress and mental health among pharmacy students has been emphasized in the literature, there is limited information on which validated scales should be used. The objective of this scoping review was to identify published studies that used [...] Read more.

While the need to measure burnout, stress and mental health among pharmacy students has been emphasized in the literature, there is limited information on which validated scales should be used. The objective of this scoping review was to identify published studies that used validated scales for burnout, stress and mental health among pharmacy students to provide recommendations for implementation at schools/colleges of pharmacy. Thirty-two out of 153 articles published in the United States from 1 January 2000 to 30 September 2022 were included and categorized into studies measuring stress (20), burnout (4) and depression/anxiety (8). The most common validated scales used to assess stress and burnout among pharmacy students were the Perceived Stress Scale (PSS) and the Maslach Burnout Inventory and the Oldenburg Burnout Inventory, respectively. For mental health, anxiety was most commonly investigated using a variety of scales such as the Generalized Anxiety Disorder-7; the Patient Health Questionnaire, 9-item was used to measure depression in two studies. Validity, ease of use, cost and generalizability are important considerations for selecting a scale. The PSS has been studied extensively in pharmacy students and has been correlated with other well-being domains. Studies that measured burnout and mental health (specifically, depression and anxiety) have less published evidence among pharmacy students. Full article

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10 pages, 797 KiB

Open AccessArticle

Pharmacist-Prescribed Hormonal Contraception: A Survey of Perceptions of Georgia Community Pharmacists and Non-Community Pharmacists

by Rebecca H. Stone, Megha D. Patel and Lara L. Beene

Pharmacy 2024, 12(5), 156; https://doi.org/10.3390/pharmacy12050156 - 18 Oct 2024

Viewed by 709

Abstract

Pharmacist-prescribed hormonal contraception (HC) is supported by a majority of pharmacists and pharmacy students; however, few studies have evaluated perceptions of non-community pharmacists, or differences in geographic areas. The primary objective of this study is to assess differences between community and non-community pharmacists [...] Read more.

Pharmacist-prescribed hormonal contraception (HC) is supported by a majority of pharmacists and pharmacy students; however, few studies have evaluated perceptions of non-community pharmacists, or differences in geographic areas. The primary objective of this study is to assess differences between community and non-community pharmacists in perceptions of pharmacist-prescribing HC in Georgia, a state that does not currently permit this practice. Secondary objectives include assessment of community pharmacist interest in prescribing HC, and differences in perceptions between pharmacists in metropolitan and nonmetropolitan areas. A survey was emailed in early 2022 to 2592 Georgia pharmacists, with Likert questions assessing interest, perceptions, comfort, and perceived barriers regarding pharmacist-prescribed HC. Chi square testing identified differences between groups. The completed survey response rate was 11.8%. Regardless of practice site, a majority agreed that pharmacists are well trained to prescribe HC (community 61.8% vs. non-community 68.1%, p = 0.25) and provision of HC services is within pharmacists’ scope (community 73.6% vs. non-community 74.2%, p = 0.90). Overall, metropolitan and nonmetropolitan community pharmacist perceptions were similar; however, more metropolitan pharmacists believed pharmacists are well trained to prescribe HC (66.7% vs. 48.7%, p = 0.049) and that it is within their scope of practice (78.1% vs. 61.5%, p = 0.045). In summary, the majority of pharmacists, regardless of practice type, believe that pharmacists are prepared to prescribe HC and that it is a part of pharmacists’ professional scope of practice. Full article

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

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33 pages, 681 KiB

Open AccessArticle

Pharmacists’ Professional Satisfaction and Challenges: A Netnographic Analysis of Reddit and Facebook Discussions

by Marius Călin Cherecheș, Hajnal Finta, Răzvan Mihai Prisada and Aura Rusu

Pharmacy 2024, 12(5), 155; https://doi.org/10.3390/pharmacy12050155 - 12 Oct 2024

Viewed by 2347

Abstract

Pharmacists, essential healthcare providers, face significant challenges in professional satisfaction and well-being. This study investigates the factors influencing pharmacists’ professional satisfaction, mainly focusing on workload, organizational support, job autonomy, work–life balance, and resilience against burnout. Data were collected from relevant online forums on [...] Read more.

Pharmacists, essential healthcare providers, face significant challenges in professional satisfaction and well-being. This study investigates the factors influencing pharmacists’ professional satisfaction, mainly focusing on workload, organizational support, job autonomy, work–life balance, and resilience against burnout. Data were collected from relevant online forums on Facebook and Reddit using a netnographic methodology. The data were anonymized and thematically coded to identify key themes from 23 conversation threads, primarily involving or concerning Romanian pharmacists. The analysis revealed several critical issues: widespread dissatisfaction with salaries, challenges in professional recognition, and the demanding nature of university education. Additional themes included economic and financial insights, global trends and technological impacts, personal experiences and satisfaction, professional growth and education, regulatory and market environment, and workplace dynamics. Findings indicate these factors significantly impact pharmacists’ job satisfaction and overall well-being. The study concludes that addressing these issues through targeted interventions, such as policy reforms, educational updates, and enhanced organizational support, can improve the professional lives of pharmacists, thereby enhancing their contributions to healthcare outcomes. Full article

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

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13 pages, 1645 KiB

Open AccessArticle

Development of a Theoretical Continuous Glucose Monitoring Module for Pharmacy Students: Preparing Pharmacists for the Future

by Florian Kinny, Bushra Ali Sherazi, Armin Dabidian, Stephanie Laeer and Emina Obarcanin

Pharmacy 2024, 12(5), 154; https://doi.org/10.3390/pharmacy12050154 - 8 Oct 2024

Viewed by 1395

Abstract

To enhance the digital competencies of pharmacy students, the Institute of Clinical Pharmacy and Pharmacotherapy at Heinrich-Heine University Duesseldorf developed and evaluated a theoretical module on digital health and data analysis. This innovative module integrated a continuous glucose-monitoring (CGM) wearable device into teaching, [...] Read more.

To enhance the digital competencies of pharmacy students, the Institute of Clinical Pharmacy and Pharmacotherapy at Heinrich-Heine University Duesseldorf developed and evaluated a theoretical module on digital health and data analysis. This innovative module integrated a continuous glucose-monitoring (CGM) wearable device into teaching, providing students with in-depth practical experience and a 2.5 h seminar on digital health and CGM systems. Students’ knowledge of CGM and self-assessment of their CGM competencies were assessed in a pre-post manner. Additionally, students’ satisfaction with the module and their perceptions of the future integration of digital health training and the role of wearables in pharmacy practice were also assessed after the module. A total of 39 final-year pharmacy students completed the module conducted in June 2024 as part of the clinical pharmacy seminar. In total, 32 students completed the pre- and post-knowledge tests and self-assessment questionnaires. Both the knowledge and the students’ self-assessment of CGM-related skills after the module increased significantly (p < 0.05). Students expanded their knowledge regarding digital health solutions, in particular the CGM systems, and increased their self-reported competence in CGM-related skills. With this module, an important foundation was laid, as this is the first theoretical module including the essentials of CGM digital health tools for pharmacy students in Germany. Full article

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

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9 pages, 454 KiB

Open AccessArticle

Discrepancy between Subjective and Objective Measurements for the Evaluation of Medication Adherence—A Cross-Sectional Study in Patients with Cardiovascular Diseases

by Motoyasu Miyazaki, Hitomi Hirata, Satoko Takaki, Momoko Misaki, Yukako Mori, Kaoko Tokura, Natsuki Sato, Akio Nakashima, Atsuko Yanagida, Isa Okajima, Hidenori Urata and Osamu Imakyure

Pharmacy 2024, 12(5), 153; https://doi.org/10.3390/pharmacy12050153 - 6 Oct 2024

Viewed by 968

Abstract

Medication adherence is important for the appropriate drug-based treatment in patients with chronic diseases, especially those with cardiovascular diseases (CVDs). The purpose of the present study was to evaluate medication adherence among patients with CVDs using subjective and objective measurements. We enrolled outpatients [...] Read more.

Medication adherence is important for the appropriate drug-based treatment in patients with chronic diseases, especially those with cardiovascular diseases (CVDs). The purpose of the present study was to evaluate medication adherence among patients with CVDs using subjective and objective measurements. We enrolled outpatients who visited Fukuoka University Chikushi Hospital from June to December 2022. As a subjective measurement, we used a self-reported questionnaire developed by Ueno et al., which consists of 12 questionnaire items grouped into the following four domains: medication compliance (subjective compliance), collaboration with health care providers (collaboration), willingness to access and use information about medication (willingness), and acceptance to take medication and how taking medication fits a patient’s lifestyle (acceptance). The pill counting method was used as an objective measurement to calculate the medication adherence rate; Poor Adherence was defined as a medication adherence rate of <100%. Ninety-four patients were analyzed. No statistically significant differences were observed between the patients in the Good and Poor Adherence groups classified by pill counting, an objective indicator; in the subjective evaluation index Ueno scale scores of subjective compliance, collaboration, willingness, and acceptance domains; and in the total score. A multivariate analysis revealed that obesity (odds ratio, 3.527; 95% confidence interval, 1.387–9.423; p = 0.008) was an independent factor associated with Poor Adherence. In conclusion, we found a discrepancy between subjective and objective measurements for the evaluation of medication adherence. Furthermore, obesity was an independent factor associated with poor medication adherence assessed by the pill counting method; thus, patients with CVD and obesity require a careful follow-up. Full article

(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)

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21 pages, 451 KiB

Open AccessReview

Clinical Outcomes of Benzodiazepine Prescribing for People Receiving Opioid Agonist Treatment: A Systematic Review of the Evidence

by Catriona Matheson, Chris Vucic, Josh Dumbrell, Roy Robertson, Trina Ritchie, Clare Duncan, Karthigayan Kessavalou, Caroline Woolston and Joe Schofield

Pharmacy 2024, 12(5), 152; https://doi.org/10.3390/pharmacy12050152 - 4 Oct 2024

Viewed by 1296

Abstract

Many countries are experiencing an increased use of unregulated benzodiazepines in combination with opioids and other drugs, which contributes to drug-related harm. This descriptive review identifies and synthesises the outcomes of studies co-prescribing benzodiazepines and opioids. A systematic review was undertaken in Medline, [...] Read more.

Many countries are experiencing an increased use of unregulated benzodiazepines in combination with opioids and other drugs, which contributes to drug-related harm. This descriptive review identifies and synthesises the outcomes of studies co-prescribing benzodiazepines and opioids. A systematic review was undertaken in Medline, CINAHL, PsychInfo, Embase, and the Cochrane databases covering publications from 1 January 1991 to 18 November 2021. Inclusion criteria were peer reviewed, English language studies of adults prescribed opioid agonist treatment (OAT) and a concurrent benzodiazepine, and reporting outcome data. Of the 4370 titles screened, 18 papers were included. The main outcomes identified covered all-cause mortality (ACM) (n = 5); overdose death (n = 3); retention in treatment (n = 7); and hospitalisation/emergency department encounters (n = 2). Other outcomes included QTc interval, cognitive function, illicit drug use, and mental health. The prescription of benzodiazepines alongside OAT increased the ACM by 75–90%, while evidence on overdose death was less robust but indicative of increased risk (40–334%). There was an indicative positive effect on treatment retention, with increased retention in those prescribed a benzodiazepine with OAT compared to those not prescribed or taking non-prescribed benzodiazepines. In conclusion, methodologically robust epidemiological studies found increased ACM and overdose death but possibly improved retention. However confounders (e.g., psychiatric comorbidity) exist, so a trial is recommended. Full article

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11 pages, 235 KiB

Open AccessArticle

The Impact of the Clinical Pharmacist-Led Diabetes Education on the Knowledge and Attitude of Individuals with Type II Diabetes Mellitus: An Interventional Study

by Safaa Badi, Sara Zainelabdein Suliman, Rayan Almahdi, Mohammed A. Aldomah, Habab Khalid Elkheir, Mohamed Izham Mohamed Ibrahim and Mohamed H. Ahmed

Pharmacy 2024, 12(5), 151; https://doi.org/10.3390/pharmacy12050151 - 29 Sep 2024

Viewed by 1068

Abstract

Background: Diabetes mellitus is a complex condition to manage. Patients with a greater understanding and knowledge of their condition might achieve better glycemic control than others. This study aimed to evaluate the impact of clinical pharmacist-led diabetes education on the knowledge and attitude [...] Read more.

Background: Diabetes mellitus is a complex condition to manage. Patients with a greater understanding and knowledge of their condition might achieve better glycemic control than others. This study aimed to evaluate the impact of clinical pharmacist-led diabetes education on the knowledge and attitude of individuals with type II diabetes mellitus (T2DM). Methods: This study was a quasi-experimental study which was conducted at a diabetes clinic in Khartoum, Sudan. The study population was adult individuals with T2DM who attended the diabetes clinic. The estimated sample size was 182 participants. The participants were selected randomly by a simple random sampling method. The knowledge and attitudes of the participants were assessed at baseline and at the end of the study after 12 months. The intervention was carried out through educational materials about diabetes and medications for its treatment. Results: The majority of the participants were females. The mean age was 54.5 (±10) years. Most participants had a family history of diabetes (69.2%). The mean knowledge score after the intervention was increased by 1.4 (±0.1) from baseline, p value (<0.001), while the mean attitude score was increased by 1.7 (±0.2) from baseline, p value (<0.001). At baseline, 14.8% of the participants had a high level of knowledge and 18.7% had a negative attitude, while after intervention for 12 months, 28.5% of them had a high level of knowledge and 16.8% had a negative attitude (p values < 0.001, 0.032, respectively). Conclusions: The knowledge of and attitudes towards diabetes differed significantly as a result of the educational program provided by the clinical pharmacist. Full article

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

11 pages, 1639 KiB

Open AccessArticle

Study on the Consumption of Non-Steroidal Anti-Inflammatory Drugs and Antibiotics by the Brazilian Adult Population: A Cohort Study

by Douglas Araujo Pedrolongo, Fernanda Teixeira Sagioneti, Giovana Maria Weckwerth, Gabriela Moraes Oliveira, Carlos Ferreira Santos and Adriana Maria Calvo

Pharmacy 2024, 12(5), 150; https://doi.org/10.3390/pharmacy12050150 - 29 Sep 2024

Viewed by 1053

Abstract

Self-medication without a medical or dental prescription is an action that leads to a significant problems associated with the overuse of medication in Brazil. The inappropriate use of antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) leads to problems related to microbial agent resistance and [...] Read more.

Self-medication without a medical or dental prescription is an action that leads to a significant problems associated with the overuse of medication in Brazil. The inappropriate use of antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) leads to problems related to microbial agent resistance and gastrointestinal complications. The purpose of this study was to elucidate the patterns of antibiotic and NSAIDs consumption among the adult population of Brazil. The questionnaire was answered by 400 people residing in Brazil who had access to the link in the year 2023. The findings showed that approximately 89.5% of the volunteers had used NSAIDs, and 32.2% had used antibiotics whether or not these medications had been prescribed by doctors or dentists. It was noted that a large proportion of the adverse effects reported by the volunteers involved symptoms related to gastrointestinal complaints. There was a high prevalence of NSAIDs consumption in the studied population, which is consistent with the high frequency of risk of adverse reactions caused by these drugs, particularly in the gastrointestinal tract. In relation to antibiotics, it was observed that the non-prescription consumption of these medications by the population was considered high, reaching one-third of the total number of volunteers who consumed such medications. Full article

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13 pages, 260 KiB

Open AccessArticle

Off-Label Pediatric Medication Prescribing and Dispensing: Awareness and Attitudes among Community Pharmacists: A Questionnaire-Based Study

by Carmen-Maria Jîtcă, George Jîtcă and Imre Silvia

Pharmacy 2024, 12(5), 149; https://doi.org/10.3390/pharmacy12050149 - 27 Sep 2024

Viewed by 828

Abstract

Off-label practice in pediatrics requires relentless engagement from all the health professionals involved. Community pharmacists are the last ones in the prescribing–dispensing chain; therefore, they have the key responsibility of verifying the correctness of a treatment. A cross-sectional study was conducted for assessing [...] Read more.

Off-label practice in pediatrics requires relentless engagement from all the health professionals involved. Community pharmacists are the last ones in the prescribing–dispensing chain; therefore, they have the key responsibility of verifying the correctness of a treatment. A cross-sectional study was conducted for assessing the awareness and views of Romanian community pharmacists, regarding off-label drugs in the pediatric population, through a 28-item questionnaire comprising five sections of different topics (general knowledge, frequency of prescribing and dispensing off-label medication, views, and attitudes). The sample size was 236 questionnaires with a response rate of 41.11%. A statistical analysis of the obtained data was performed with GraphPad Prism v.9. The results indicate that 55.1% of the community pharmacists have a good general knowledge and awareness regarding the off-label practice, although the legal frame is unclear. The responses highlight a high frequency of prescribing and request of medication for respiratory conditions (45.3%) and antibiotics (23.5%), with a concerning gap regarding the adverse events related to the off-label treatments (56.7%). A very small percentage of pharmacists (7.1%) contact a fellow healthcare professional when encountering an off-label prescription. In conclusion, in addition to the pharmacist’s conduct towards the best interest of the patient, there is a clear need to improve the doctor–pharmacist collaboration in order to make an off-label treatment successful. Full article

15 pages, 1171 KiB

Open AccessSystematic Review

Effects of Pharmacist-Led Interventions Regarding Adult Patients with Type 2 Diabetes Mellitus in Mexico: A Systematic Review

by Dulce D. Blanco-Vega, Alfonso Reyes-López, Jessica L. Vargas-Neri and Frida I. Osnaya-Valencia

Pharmacy 2024, 12(5), 148; https://doi.org/10.3390/pharmacy12050148 - 27 Sep 2024

Viewed by 1799

Abstract

In Mexico, type 2 diabetes mellitus (T2DM) is a serious public health concern. As experts in drug therapy, pharmacists are essential additions to multidisciplinary diabetes patient care teams. There have been no systematic reviews or meta-analyses performed on pharmacist-led interventions (PIs) in Mexico; [...] Read more.

In Mexico, type 2 diabetes mellitus (T2DM) is a serious public health concern. As experts in drug therapy, pharmacists are essential additions to multidisciplinary diabetes patient care teams. There have been no systematic reviews or meta-analyses performed on pharmacist-led interventions (PIs) in Mexico; therefore, the impact of PIs on patients remains poorly explored. An electronic search of the PubMed, SciELO and BVS databases and certain institutional repositories was conducted in English and Spanish through 24 August 2021 with a subsequent update through June 2024. A total of 1302 potentially relevant studies were identified in the initial search, of which nine met the eligibility criteria and were included in this systematic review. The results suggest that PIs, such as pharmacotherapeutic follow-up and patient education, may have positive effects on outcomes in Mexican patients with T2DM. PIs led to significant reductions in glycosylated hemoglobin, fasting blood glucose, triglycerides, total cholesterol, LDL cholesterol and arterial blood pressure levels, general reductions in body mass index and negative outcomes associated with medication, as well as significant improvements in therapeutic adherence and patient knowledge in the intervention group during follow-up periods of 3–12 months. Further well-designed research, including controlled studies with adequate sample sizes and standardized tools, is essential to fully understand the effects of PIs regarding patients with T2DM in Mexico. Full article

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8 pages, 365 KiB

Open AccessArticle

Efficacy of Ciprofloxacin in Treating Gram-Negative Infections: Does Obesity Matter?

by Sultan Alotaibi, Nader Damfu, Ahmed Alnefaie, Abdullah Alqurashi, Sami Althagafi, Aown Alotaibi, Musim Alotaibi and Abdullah Alsuwat

Pharmacy 2024, 12(5), 147; https://doi.org/10.3390/pharmacy12050147 - 26 Sep 2024

Viewed by 913

Abstract

Background: Obesity is considered a health issue associated with increased morbidity and a risk factor for multiple conditions, such as type 2 diabetes, cardiovascular diseases and infections. It may affect the pharmacokinetics and pharmacodynamics of many drugs, including antimicrobials like ciprofloxacin. Regrettably, data [...] Read more.

Background: Obesity is considered a health issue associated with increased morbidity and a risk factor for multiple conditions, such as type 2 diabetes, cardiovascular diseases and infections. It may affect the pharmacokinetics and pharmacodynamics of many drugs, including antimicrobials like ciprofloxacin. Regrettably, data on ciprofloxacin’s efficacy in obese patients remain scarce. This study aims to evaluate the impact of obesity on the efficacy of ciprofloxacin in treating Gram-negative bacterial infections. Methods: A retrospective multicenter cohort study was conducted in two tertiary hospitals in Saudi Arabia. Adult patients (≥18 years) treated with ciprofloxacin for confirmed Gram-negative infection between January 2017 and April 2023 were included. Patients were excluded if they received ciprofloxacin empirically, had inadequate source control within 72 h, or had missing weight and height information at ciprofloxacin initiation. The primary outcome was clinical cure, defined as the resolution of the clinical infection manifestations without additional therapeutic management by the end of treatment. Other secondary and safety outcomes were also assessed. Results: A total of 99 patients were included, divided into obese (n = 42) and non-obese (n = 57) groups. The obese group had a significantly lower median age (50 years) compared to the non-obese group (64 years) (p = 0.002). The obese group had fewer male patients (38.10% vs. 68.42%; p = 0.004), higher body weight (90 (81–97) vs. 63 (55–70) days; p < 0.001), and lower height (158 (155–165) vs. 165 (158–172) days; p = 0.008) compared to non-obese. Urinary tract infection was the most common type, with Escherichia coli being the most common isolate. The median hospital length of stay was shorter in the obese group than in the non-obese group (1 vs. 3 days, p = 0.007). There were no significant differences in clinical cure rates between obese (85.71%) and non-obese (85.96%) patients (p = 1). No significant differences were observed in terms of in-hospital mortality, 30-day mortality, or 60-day infection recurrence rates between the two groups. Microbiological eradication was not achieved in the obese group, whereas a 10.53% eradication rate was observed in the non-obese group (p = 0.037). However, the majority of the patients had indeterminate eradication. The incidence of adverse drug reactions (ADRs) was lower in the obese group (4.76%) compared to the non-obese group (17.54%, p = 0.066). Conclusions: Treatment with ciprofloxacin in obese patients has similar efficacy and safety outcomes compared to non-obese patients with infections due to Gram-negative pathogens. Full article

(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)

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12 pages, 243 KiB

Open AccessCommentary

Future Healthcare Workers and Ecopharmacovigilance: Where Do We Stand?

by Toni Durdov, Ana Šešelja Perišin, Nikolina Škaro, Josipa Bukić, Dario Leskur, Darko Modun, Joško Božić, Marjeta Grgas and Doris Rušić

Pharmacy 2024, 12(5), 146; https://doi.org/10.3390/pharmacy12050146 - 26 Sep 2024

Viewed by 827

Abstract

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 [...] Read more.

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

11 pages, 254 KiB

Open AccessArticle

Relationship between Pharmacists’ Emotional Intelligence and Job Performance: A Cross-Sectional Study in Saudi Arabia

by Yasser S. Almogbel, Muath A. Alsalloum, Rubiaan S. Almadi, Abdulaziz A. Almazyad, Yusuf M. Garwan and Razan A. Alregaibah

Pharmacy 2024, 12(5), 145; https://doi.org/10.3390/pharmacy12050145 - 25 Sep 2024

Viewed by 1071

Abstract

Pharmacists’ job performance is crucial for improving pharmacy services. The purpose of this study was to evaluate the association of emotional intelligence with the job performance of pharmacists in Saudi Arabia. Using social media platforms, we disseminated an online questionnaire to pharmacists licensed [...] Read more.

Pharmacists’ job performance is crucial for improving pharmacy services. The purpose of this study was to evaluate the association of emotional intelligence with the job performance of pharmacists in Saudi Arabia. Using social media platforms, we disseminated an online questionnaire to pharmacists licensed to practice in Saudi Arabia between June and July 2022. The questionnaire was filled out by 352 pharmacists. The majority of the participants were women (60.5%) and working as community pharmacists (55.7%). On self-reported emotional intelligence and job performance scales, the respondents scored an average of 5.5 ± 0.9 (out of 7) and 4.0 ± 0.6 (out of 5), respectively. Multiple linear regression analyses revealed that emotional intelligence had a significant relationship with job performance (β = 0.43, p < 0.001). In conclusion, the findings indicated that emotional intelligence may influence the job performance of pharmacists in Saudi Arabia. As the primary objective of every organization is to accomplish the best possible performance, prioritizing emotional intelligence is important. Further research is needed to identify the impact of emotional intelligence on work performance, which could potentially enhance clinical outcomes for patients. Full article

11 pages, 513 KiB

Open AccessReview

A Review of Studies on HIV Pre-Exposure Prophylaxis in Community Pharmacies in States with Restrictive Pharmacist Prescription Authority in the United States

by Hongmei Wang, Dominique Guinn, Xavier Roshitha Ramisetty, Thomas P. Giordano and Ivy O. Poon

Pharmacy 2024, 12(5), 144; https://doi.org/10.3390/pharmacy12050144 - 24 Sep 2024

Viewed by 1087

Abstract

Community pharmacies have unparalleled potential to increase access to pre-exposure prophylaxis medications (PrEP) for HIV prevention; however, only 17 out of 50 states in the United States have statewide authority for pharmacists to provide PrEP at community pharmacies. Few studies have reported on [...] Read more.

Community pharmacies have unparalleled potential to increase access to pre-exposure prophylaxis medications (PrEP) for HIV prevention; however, only 17 out of 50 states in the United States have statewide authority for pharmacists to provide PrEP at community pharmacies. Few studies have reported on how pharmacists overcome the legislative barrier and provide PrEP services in restrictive pharmacy prescription states. The objective of this article is to identify the existing primary literature describing pharmacist PrEP services in the community in states with restrictive prescription authority. Methods: A systemic literature review was conducted to identify the primary literature that involved community pharmacy service and PrEP conducted in states that do not have expanded pharmacist prescriptive authority between 2000 to 2024. Results: Ten publications were identified, describing nine studies, including four interview and survey studies, three intervention reports, and two ongoing clinical trials. None of these studies have a control group. Most pharmacists provide PrEP services in the community through a collaborative practice agreement with a primary care provider. Conclusions: Future clinical studies with randomized controlled designs are required to test novel strategies in the education and implementation of pharmacy-led PrEP services in a community pharmacy setting to increase PrEP access. Full article

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13 pages, 1383 KiB

Open AccessArticle

“I Solemnly Swear”: A Comparative Study of Codes of Professional Ethics amongst Pharmacists from Culturally Diverse European Countries

by Raquel Raimundo and Afonso Cavaco

Pharmacy 2024, 12(5), 143; https://doi.org/10.3390/pharmacy12050143 - 24 Sep 2024

Viewed by 911

Abstract

Ethical practice is a universal concern for healthcare professionals, independent of their social, cultural, or religious background. This study aimed to assess and categorise statements published in codes of ethics for pharmacists from three diverse societies within the wider European area. The study [...] Read more.

Ethical practice is a universal concern for healthcare professionals, independent of their social, cultural, or religious background. This study aimed to assess and categorise statements published in codes of ethics for pharmacists from three diverse societies within the wider European area. The study followed a qualitative exploratory and triangular design, comparing the leading professional and ethical statements between three geographically apart countries (Portugal, Lithuania, and Turkey) and using the International Pharmaceutical Federation Code of Ethics proposal as a gold standard. Common core values such as honesty, integrity, and professional autonomy were identified across the countries’ codes, suggesting that shared recognised core values underpin pharmacists’ practice and policies in culturally diverse settings. None of the codes fully correspond to the framework the International Pharmaceutical Federation proposed. The analysis elicited significant inconsistencies between the codes for analogous practice models within the same continent. Further studies are needed to gain a more profound and comprehensive understanding of the underlying reasons for these discrepancies so that ethical weaknesses can be improved and harmonisation towards best-practice principles can benefit patients and healthcare systems. Full article

(This article belongs to the Special Issue Professional Ethics in Pharmacy: Exploring Contemporary Challenges and Future Directions)

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17 pages, 571 KiB

Open AccessReview

Antibiotic Treatment of Infections Caused by AmpC-Producing Enterobacterales

by Gianpiero Tebano, Irene Zaghi, Monica Cricca and Francesco Cristini

Pharmacy 2024, 12(5), 142; https://doi.org/10.3390/pharmacy12050142 - 21 Sep 2024

Viewed by 1720

Abstract

AmpC enzymes are a class of beta-lactamases produced by Gram-negative bacteria, including several Enterobacterales. When produced in sufficient amounts, AmpCs can hydrolyze third-generation cephalosporins (3GCs) and piperacillin/tazobactam, causing resistance. In Enterobacterales, the AmpC gene can be chromosomal- or plasmid-encoded. Some species, particularly Enterobacter [...] Read more.

AmpC enzymes are a class of beta-lactamases produced by Gram-negative bacteria, including several Enterobacterales. When produced in sufficient amounts, AmpCs can hydrolyze third-generation cephalosporins (3GCs) and piperacillin/tazobactam, causing resistance. In Enterobacterales, the AmpC gene can be chromosomal- or plasmid-encoded. Some species, particularly Enterobacter cloacae complex, Klebsiella aerogenes, and Citrobacter freundii, harbor an inducible chromosomal AmpC gene. The expression of this gene can be derepressed during treatment with a beta-lactam, leading to AmpC overproduction and the consequent emergence of resistance to 3GCs and piperacillin/tazobactam during treatment. Because of this phenomenon, the use of carbapenems or cefepime is considered a safer option when treating these pathogens. However, many areas of uncertainty persist, including the risk of derepression related to each beta-lactam; the role of piperacillin/tazobactam compared to cefepime; the best option for severe or difficult-to-treat cases, such as high-inoculum infections (e.g., ventilator-associated pneumonia and undrainable abscesses); the role of de-escalation once clinical stability is obtained; and the best treatment for species with a lower risk of derepression during treatment (e.g., Serratia marcescens and Morganella morganii). The aim of this review is to collate the most relevant information about the microbiological properties of and therapeutic approach to AmpC-producing Enterobacterales in order to inform daily clinical practice. Full article

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12 pages, 2054 KiB

Open AccessArticle

Improving the Monitoring and Management of Clozapine-Induced Gastrointestinal Hypomotility (CIGH) in Community Mental Health Services: A Quality Improvement Approach

by Balazs Adam and Osama Ayad

Pharmacy 2024, 12(5), 141; https://doi.org/10.3390/pharmacy12050141 - 13 Sep 2024

Viewed by 1709

Abstract

Clozapine is the only approved antipsychotic for refractory schizophrenia to date. It can cause a range of serious and fatal adverse effects, including Clozapine-Induced Gastrointestinal Hypomotility (CIGH). While guidance is readily available to help manage CIGH effectively in hospital inpatients, practical recommendations applicable [...] Read more.

Clozapine is the only approved antipsychotic for refractory schizophrenia to date. It can cause a range of serious and fatal adverse effects, including Clozapine-Induced Gastrointestinal Hypomotility (CIGH). While guidance is readily available to help manage CIGH effectively in hospital inpatients, practical recommendations applicable to the community (outpatient) setting are lacking. This project set out to improve the prevention, detection and management of CIGH in psychiatric outpatients. An initial baseline audit followed by quality improvement work was undertaken in a busy support worker-run community clozapine clinic focusing on, education and training, risk assessments and clinical documentation. The project was registered and managed using the Life QI web-based platform, where a set of primary and secondary drivers were defined and change ideas were executed. Qualitative and quantitative data were collected over a three-month period, demonstrating a significant improvement in clinical documentation (up from 36% to 99%). 23% of enhanced risk assessments resulted in treatment recommendations, modifiable risk factors were proactively discussed in 53% of clinic appointments and 65% of patients were provided with additional written information on CIGH. It was evident from staff and our patient feedback that further efforts would be required to continue to raise awareness about harms of unmanaged constipation among this client group. Future approaches may include enhanced collaborative efforts with primary care, and improving the skill mix in existing clozapine clinics, which could include the utilisation of mental health pharmacists. Full article

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

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14 pages, 246 KiB

Open AccessArticle

Perceived Needs, Barriers, and Challenges to Continuing Professional Development (CPD): A Qualitative Exploration among Hospital Pharmacists

by Sundus Aldakhil, Sana Majdi Baqar, Bashayr Alosaimi, Rafal Almuzirie, Maryam Farooqui, Saud Alsahali and Yasser Almogbel

Pharmacy 2024, 12(5), 140; https://doi.org/10.3390/pharmacy12050140 - 12 Sep 2024

Viewed by 1356

Abstract

Continuing professional development (CPD) is an essential tool for healthcare professionals to remain up-to-date with the latest advancements in their field. In Saudi Arabia, pharmacists are officially registered healthcare professionals by the Saudi Commission for Health Specialties (SCFHS). To uphold their licensure, they [...] Read more.

Continuing professional development (CPD) is an essential tool for healthcare professionals to remain up-to-date with the latest advancements in their field. In Saudi Arabia, pharmacists are officially registered healthcare professionals by the Saudi Commission for Health Specialties (SCFHS). To uphold their licensure, they must complete 40 h of CPD every two years. This qualitative study aimed to explore hospital pharmacists’ perceptions, barriers, and challenges of CPD, as well as their recommendations for improving CPD activities. A qualitative descriptive approach with semi-structured face-to-face interviews was employed. Using purposive sampling, 12 hospital pharmacists were interviewed. The recorded data were transcribed and analyzed using thematic analysis. Pharmacists generally showed positive perceptions of CPD, recognizing its importance for their professional development and the provision of high-quality patient care. However, some pharmacists expressed dissatisfaction with the current system. Several barriers to participation such as heavy workloads, lack of time, and limited financial support were highlighted. The primary motivations for engaging in CPD included fulfilling regulatory requirements. Workshops were the most beneficial CPD activities among others. Additionally, importance of more specialized, practice-oriented programs was highlighted. The study provides valuable insights into the needs and challenges faced by hospital pharmacists in Saudi Arabia regarding CPD. The insights gained can inform theory, policy, and practice relating to pharmacists’ CPD at both professional and governmental levels. Full article

9 pages, 208 KiB

Open AccessPerspective

Leveraging Community Pharmacies to Address Social Needs: A Promising Practice to Improve Healthcare Quality

by Tony Kuo, Noel C. Barragan and Steven Chen

Pharmacy 2024, 12(5), 139; https://doi.org/10.3390/pharmacy12050139 - 11 Sep 2024

Viewed by 1055

Abstract

Emerging research suggests that chronic conditions such as cardiovascular disease, diabetes, and asthma are often mediated by adverse social conditions that complicate their management. These conditions include circumstances such as lack of affordable housing, food insecurity, barriers to safe and reliable transportation, structural [...] Read more.

Emerging research suggests that chronic conditions such as cardiovascular disease, diabetes, and asthma are often mediated by adverse social conditions that complicate their management. These conditions include circumstances such as lack of affordable housing, food insecurity, barriers to safe and reliable transportation, structural racism, and unequal access to healthcare or higher education. Although health systems cannot independently solve these problems, their infrastructure, funding resources, and well-trained workforce can be realigned to better address social needs created by them. For example, community pharmacies and the professionals they employ can be utilized and are well-positioned to deliver balanced, individualized clinical services, with a focus on the whole person. Because they have deep roots and presence in the community, especially in under-resourced neighborhoods, community pharmacies (independent and chain) represent local entities that community members recognize and trust. In this article, we provide case examples from California, United States, to illustrate and explore how community pharmacies can be leveraged to address patient social needs as part of their core responsibilities and overall strategy to improve healthcare quality. Full article

12 pages, 739 KiB

Open AccessArticle

An Internationally Derived Process of Healthcare Professionals’ Proactive Deprescribing Steps and Constituent Activities

by Sion Scott, Natalie Buac and Debi Bhattacharya

Pharmacy 2024, 12(5), 138; https://doi.org/10.3390/pharmacy12050138 - 9 Sep 2024

Viewed by 1127

Abstract

Proactive deprescribing is the process of tapering or stopping a medicine before harm occurs. This study aimed to specify and validate, with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process [...] Read more.

Proactive deprescribing is the process of tapering or stopping a medicine before harm occurs. This study aimed to specify and validate, with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process framework of steps which we populated with literature-derived activities required to be undertaken by healthcare professionals. We distributed a survey to healthcare professionals internationally, requesting for each activity the frequency of its occurrence in practice and whether it was important. Extended response questions investigated barriers and enablers to deprescribing. The 263 survey respondents were from 25 countries. A proactive deprescribing process was developed comprising four steps: (1) identify a patient for potential stop of a medicine, (2) evaluate a patient for potential stop of a medicine, (3) stop a medicine(s), and (4) monitor after a medicine has been stopped, and 17 activities. All activities were considered important by ≥70% of respondents. Nine activities required healthcare professionals to undertake in direct partnership with the patient and/or caregiver, of which seven were only sometimes undertaken. Deprescribing interventions should include a focus on addressing the barriers and enablers of healthcare professionals undertaking the activities that require direct partnership with the patient and/or caregiver. Full article

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13 pages, 223 KiB

Open AccessArticle

Exploring Barriers Faced by Community Pharmacists in Serving Patients with Disabilities in Saudi Arabia: Recommendations for Enhancing Healthcare Provisions

by Aisha F. Badr

Pharmacy 2024, 12(5), 137; https://doi.org/10.3390/pharmacy12050137 - 9 Sep 2024

Viewed by 1749

Abstract

While several studies have explored the barriers to accessing community pharmacies for individuals with physical, hearing, visual, and learning disabilities, most have focused on the perspectives of disabled individuals. Therefore, this study aimed to examine the barriers faced by community pharmacists when serving [...] Read more.

While several studies have explored the barriers to accessing community pharmacies for individuals with physical, hearing, visual, and learning disabilities, most have focused on the perspectives of disabled individuals. Therefore, this study aimed to examine the barriers faced by community pharmacists when serving individuals with physical, visual, and hearing disabilities in Saudi Arabia, with the goal of recommending ways to enhance future healthcare provisions. Methods: A mixed-methods cross-sectional phenomenological study was conducted among community pharmacists in Saudi Arabia between March and April 2022. Both closed- and open-ended questions were utilized to identify themes related to community pharmacists’ barriers and experiences when providing care to individuals with disabilities. Results: A total of 40 community pharmacists participated in this study. Among them, 57.5% reported encountering difficulties when caring for patients with disabilities, with 65% indicating a lack of specialized services at their respective community pharmacies. Three major themes emerged from the findings: the need for pharmacist training and awareness, technology-guided methods for overcoming communication barriers, and improving overall pharmacy accessibility. Conclusion: This study reveals a significant gap in the provision of services for patients with disabilities in Saudi Arabia. Addressing physical accessibility, providing targeted training, and leveraging technology can enhance care delivery and promote inclusivity. Further research is warranted to assess the effectiveness of technological solutions and the integration of artificial intelligence in improving communication and patient-centered care for individuals with disabilities. Full article

(This article belongs to the Special Issue Pharmacy Workflow Optimization: Strategies for Enhancing Efficiency and Patient Satisfaction)

7 pages, 172 KiB

Open AccessCommentary

Drug Shortage and Ethical Issues: Integrating Multidisciplinary Perspectives with a Shared Ethical Framework

by Maya C. Wai

Pharmacy 2024, 12(5), 136; https://doi.org/10.3390/pharmacy12050136 - 6 Sep 2024

Cited by 1 | Viewed by 1314

Abstract

Drug shortages can cause ethical dilemmas when no systematic, equitable allocation, or utilization schema is in place. During the COVID-19 pandemic, an ethical framework outlining moral values was proposed as way to approach allocating limited resources to patients. In addition to an ethical [...] Read more.

Drug shortages can cause ethical dilemmas when no systematic, equitable allocation, or utilization schema is in place. During the COVID-19 pandemic, an ethical framework outlining moral values was proposed as way to approach allocating limited resources to patients. In addition to an ethical perspective, it is prudent to consider costs. Examining existing economic frameworks and combining them with an ethical perspective may provide a practical, systematic process for decision makers when allocating drugs in short supply. Drug shortages continue to impact multiple areas across different subspecialties of medicine due to multiple factors, including limited manufacturers, regulatory issues, and costs. All of these factors make it difficult to anticipate and manage drug shortages effectively, but developing a combined framework may reduce some of the ethical and equitable ambiguity with regards to patient care. Full article

(This article belongs to the Special Issue Professional Ethics in Pharmacy: Exploring Contemporary Challenges and Future Directions)

11 pages, 586 KiB

Open AccessArticle

The Dispensing Error Rate in an App-Based, Semaglutide-Supported Weight-Loss Service: A Retrospective Cohort Study

by Louis Talay and Matt Vickers

Pharmacy 2024, 12(5), 135; https://doi.org/10.3390/pharmacy12050135 - 3 Sep 2024

Cited by 2 | Viewed by 1273

Abstract

Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, the degree to which DWLSs compromise patient safety through the dispensation of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications [...] Read more.

Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, the degree to which DWLSs compromise patient safety through the dispensation of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications is unknown. This study retrospectively analysed the rate at which patients reported GLP-1 RA dispensing errors from patient-selected and partner pharmacies of Australia’s largest DWLS provider over a six-month period. The analysis found that 99 (0.35%) of the 28,165 dispensed semaglutide orders contained an error. Incorrect dose (58.6%) and unreasonable medication expiry window (21.2%) were the two most common error types. Most errors (84.9%) were deemed to have been of medium urgency, with 11.1% being considered high-urgency errors. Incorrect doses (45.5%) and supplies of the wrong medication (36.3%) comprised most errors reported in high-urgency cases. Female patients reported more dispensing errors than male patients (0.41% vs. 0.12%, p < 0.001). Similarly, reported dispensing error rates were highest among patients aged 18 to 29 years (0.6%) and 30 to 39 years (0.5%). This research provides preliminary evidence that GLP-1 RA dispensing errors within comprehensive Australian DWLSs are relatively low. Full article

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

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15 pages, 455 KiB

Open AccessArticle

An Evaluation of Oral Anticoagulant Safety Indicators by England’s Community Pharmacies

by Sejal Parekh, Lingqian Xu and Carina Livingstone

Pharmacy 2024, 12(5), 134; https://doi.org/10.3390/pharmacy12050134 - 29 Aug 2024

Viewed by 2584

Abstract

Background: Anticoagulants are life-saving medicines that can prevent strokes for patients diagnosed with atrial fibrillation (AF) as well as treating patients with venous thromboembolism (VTE), but when used incorrectly, they are frequently associated with patient harm. Aim: To evaluate the impact of community [...] Read more.

Background: Anticoagulants are life-saving medicines that can prevent strokes for patients diagnosed with atrial fibrillation (AF) as well as treating patients with venous thromboembolism (VTE), but when used incorrectly, they are frequently associated with patient harm. Aim: To evaluate the impact of community pharmacy teams on optimising patient knowledge and awareness and improving medication safety from the use of anticoagulants. Methods: Two national audits, consisting of 17 questions assessing and improving patients’ understanding of anticoagulant therapy, identifying high-risk patients, and contacting prescribers when clinically appropriate were incentivised for England’s community pharmacies in 2021–2022 and 2023–2024 using the Pharmacy Quality Scheme (PQS) commissioned by NHS England. Results: Approximately 11,000 community pharmacies audited just under a quarter of a million patients in total, whilst making almost 150,000 interventions for patients taking oral anticoagulants, i.e., identifying and addressing medication issues which could increase the risk of bleeding/harm. Out of the 111,195 patients audited in 2021–2022, only 24,545 (23%) patients were prescribed vitamin K antagonists. The remaining patients were prescribed direct oral anticoagulants (DOACs). By 2023–2024, this decreased to 17,043 (16%) patients. Most patients knew that they were prescribed an anticoagulant (95.6%, 106,255 in 2021–2022 and 96.5%, 101,006 in 2023–2024, p < 0.001). Discussion: The audits resulted in a statistically significant increase in patients with a standard yellow anticoagulant alert card, as identified in audit 2 (73,901 66.5% in 2021–2022 to 76,735, 73.3% in 2023–2024, p < 0.001). Furthermore, fewer patients were prescribed concurrent antiplatelets with an anticoagulant (6021; 4.6% in 2021–2022 to 4975; 4% in 2023–2024, p < 0.001). Although there was an increase in the number of patients prescribed NSAIDs with anticoagulants, more of these patients were also prescribed gastroprotection concurrently (927 77.2% in 2021–2022 to 1457 84.1% in 2023–2024, p < 0.05). The majority of patients on warfarin had their blood checked within 12 weeks. Further there was an increase for these patients in the percentage of people prescribed VKAs who knew dietary changes can affect their anticoagulant medicine (16,764 67.4% in 2021–2022 to 12,594 73.9% in 2023–2024 p < 0.001). Conclusions: Community pharmacy teams are well placed in educating and counselling patients on the safe use of anticoagulants and ensuring that all patients are correctly monitored. Full article

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7 pages, 365 KiB

Open AccessArticle

Evaluation of Anti-Xa Target Attainment with Prophylactic Enoxaparin Dosing Regimens for Venous Thromboembolism Prophylaxis in Morbidly Obese Patients

by Andrew Sabers, Emilie Langenhan, Sean N. Avedissian and Brandon Reynolds

Pharmacy 2024, 12(5), 133; https://doi.org/10.3390/pharmacy12050133 - 28 Aug 2024

Viewed by 872

Abstract

Subcutaneous enoxaparin has been shown to reduce the risk of venous thromboembolism (VTE) among hospitalized patients. However, alternative enoxaparin dosing strategies may be necessary in morbid obesity. The objective of this study was to assess the rate of target anti-Xa attainment with three [...] Read more.

Subcutaneous enoxaparin has been shown to reduce the risk of venous thromboembolism (VTE) among hospitalized patients. However, alternative enoxaparin dosing strategies may be necessary in morbid obesity. The objective of this study was to assess the rate of target anti-Xa attainment with three enoxaparin dosing regimens for venous thromboembolism (VTE) prophylaxis in morbidly obese patients. In this retrospective study, anti-Xa target attainment was assessed among adult patients with a body mass index (BMI) ≥ 40 kg/m² receiving enoxaparin 40 mg twice daily (BID), 60 mg BID, or 0.5 mg/kg BID. Univariate and multivariate analyses were conducted. Target anti-Xa levels were defined as a steady-state, peak level of 0.2–0.5 IU/mL. This study included 120 patients with 55 patients receiving 40 mg BID, 44 patients receiving 60 mg BID, and 21 patients receiving 0.5 mg/kg BID. Target anti-Xa levels were achieved in 29.1% of patients in the 40 mg BID arm, 54.5% in the 60 mg BID arm, and 90.5% in the 0.5 mg/kg BID arm. Anti-Xa target attainment was significantly increased in both the 60 mg BID arm (p = 0.01) and the 0.5 mg/kg arm (p < 0.0001), compared to the 40 mg BID arm. In morbidly obese patients, weight-based dosing was associated with a greater attainment of target anti-Xa levels. Further studies are needed to determine the impact of these dosing regimens on clinical outcomes. Full article

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

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18 pages, 1133 KiB

Open AccessArticle

Effective Supply Chain Strategies in Addressing Demand and Supply Uncertainty: A Case Study of Ethiopian Pharmaceutical Supply Services

by Arebu Issa Bilal, Umit Sezer Bititci and Teferi Gedif Fenta

Pharmacy 2024, 12(5), 132; https://doi.org/10.3390/pharmacy12050132 - 28 Aug 2024

Cited by 1 | Viewed by 1848

Abstract

Background: Ensuring the consistent availability of essential medicines is crucial for effective healthcare systems. However, Ethiopian public health facilities have faced frequent stockouts of crucial medications, highlighting systemic challenges such as inadequate forecasting, prolonged procurement processes, a disjointed distribution system, suboptimal data quality, [...] Read more.

Background: Ensuring the consistent availability of essential medicines is crucial for effective healthcare systems. However, Ethiopian public health facilities have faced frequent stockouts of crucial medications, highlighting systemic challenges such as inadequate forecasting, prolonged procurement processes, a disjointed distribution system, suboptimal data quality, and a shortage of trained professionals. This study focuses on the Ethiopian Pharmaceutical Supply Services (EPSS), known for its highly unstable and volatile supply chain, aiming to identify risks and mitigation strategies. Methods: Using a mixed-method approach involving surveys and interviews, the research investigates successful and less successful strategies, key success factors, and barriers related to pharmaceutical shortages. Results: Proactive measures such as communication, stock assessment, supervision, and streamlined procurement are emphasized as vital in mitigating disruptions, while reactive strategies like safety stock may lack long-term efficacy. The study highlights the importance of aligning supply chain strategies with product uncertainties, fostering collaboration, and employing flexible designs for resilience. Managerial implications stress the need for responsive structures that integrate data quality, technology, and visibility. Conclusions: This study contributes by exploring proactive and reactive strategies, elucidating key success factors for overcoming shortages in countries with unstable supply chains, and offering actionable steps for enhancing supply chain resilience. Embracing uncertainty and implementing proactive measures can help navigate volatile environments, thereby enhancing competitiveness and sustainability. Full article

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16 pages, 2478 KiB

Open AccessArticle

What Do Younger and Well-Educated Adults Think about Self-Medication? Results of a Survey during a Public Science Event at Leipzig University

by Ines Gebert, Sabine Hundertmark and Thilo Bertsche

Pharmacy 2024, 12(5), 131; https://doi.org/10.3390/pharmacy12050131 - 23 Aug 2024

Viewed by 1196

Abstract

Background: Consecutive visitors to a public science event at Leipzig University were asked about their opinions/attitudes regarding their personal use of self-medication. Methods: A written questionnaire survey addressed (i) participants’ characteristics, (ii) frequency of self-medication use in the last 12 months, (iii) symptoms/complaints [...] Read more.

Background: Consecutive visitors to a public science event at Leipzig University were asked about their opinions/attitudes regarding their personal use of self-medication. Methods: A written questionnaire survey addressed (i) participants’ characteristics, (ii) frequency of self-medication use in the last 12 months, (iii) symptoms/complaints most frequently considered applicable, (iv) preconditions, (v) limitations, (vi) risks, (vii) fears, (viii) medication information sources, (ix) influencing factors, and (x) reasons for decision making. Results: (i) A total of 189 visitors (median age: 29.0 years; Q25/Q75: 22.0/44.0) participated, of whom 64.0% were female, 38.6% had a university degree, 20.1% were in training, and 14.8% were licensed in a healthcare profession. (ii) A total of 59.3% of participants stated that they had used self-medication regularly in the last 12 months. The most common answers in the respective questions were (iii) headache, 86.2%; (iv) mild complaints/symptoms, 94.7%; (v) duration, 91.6%; (vi) “self-medication may cause adverse drug reactions”, 94.2%; (vii) “developing a habituation effect”, 58.7%; (viii) pharmacists, 93.7%; (ix) “physician’s recommendation”, 89.3%; (x) “intensity of complaints”, 92.6%; and (vi) 61.3% believed that they could choose an appropriate self-medication. Conclusion: Younger and well-educated adults report using self-medication frequently and rate their expertise as high. Healthcare professionals are the preferred source of information. Full article

(This article belongs to the Topic The Promotion and Development of Community Health for Personal Health: Theories and Applications)

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9 pages, 1504 KiB

Open AccessArticle

Enhancing Operational Efficiency and Service Delivery through a Robotic Dispensing System: A Case Study from a Retail Pharmacy in Brazil

by Karen Basile, Monserrat Martínez, Julia D. Lucaci, Claudia Goldblatt and Idal Beer

Pharmacy 2024, 12(5), 130; https://doi.org/10.3390/pharmacy12050130 - 23 Aug 2024

Viewed by 1466

Abstract

Drug dispensing in retail pharmacies typically involves several manual tasks that often lead to inefficiencies and errors. This is the first published quality improvement study in Latin America, specifically in Brazil, investigating the operational impacts of implementing a robotic dispensing system in a [...] Read more.

Drug dispensing in retail pharmacies typically involves several manual tasks that often lead to inefficiencies and errors. This is the first published quality improvement study in Latin America, specifically in Brazil, investigating the operational impacts of implementing a robotic dispensing system in a retail pharmacy. Through observational techniques, we measured the time required for the following pharmacy workflows before and after implementing the robotic dispensing system: customer service, receiving stock, stocking inventory, separation, invoicing, and packaging of online orders for delivery. Time savings were observed across all workflows within the pharmacy, notably in receiving stock and online order separation, which experienced 70% and 75% reductions in total time, respectively. Furthermore, customer service, stocking, invoicing, and packaging of online orders, also saw total time reductions from 36% to 53% after implementation of the robotic dispensing system. This study demonstrates an improvement in the pharmacy’s operational efficiency post-implementation of the robotic dispensing system. These findings highlight the potential for such automated systems to streamline pharmacy operations, improve staff time efficiency, and enhance service delivery. Full article

(This article belongs to the Special Issue Pharmaceutical Care Services in Pharmacy Practice II)

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