Hospital Pharmacy最新文献

{"title":"Comment on \"Assessment of Automation Models in Hospital Pharmacy: Systematic Review of Technologies, Practices, and Clinical Impacts\".","authors":"K Lakshmi Kala, Puneet Sudan","doi":"10.1177/00185787261435535","DOIUrl":"10.1177/00185787261435535","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435535"},"PeriodicalIF":0.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13086758/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of an Integrated Clinical Decision Support System and Clinical Pharmacist-Led Interventions in Domperidone Prescribing: A 10-Year Interrupted Time Series Study.","authors":"Nguyen Thi Thu Phuong, Dao Thuy Duong, Tran Van Anh, Nguyen Duc Long, Le Duc Anh, Hoang Van Dung, Tran Thi Ngan","doi":"10.1177/00185787261433442","DOIUrl":"https://doi.org/10.1177/00185787261433442","url":null,"abstract":"<p><strong>Background: </strong>Domperidone is widely prescribed for gastrointestinal motility disorders and nausea-vomiting but is associated with serious cardiac adverse events, leading to regulatory restrictions on its indications, dosage, and duration. However, passive regulatory notifications alone often fail to translate into safer real-world prescribing practices.</p><p><strong>Objectives: </strong>To evaluate the long-term real-world effectiveness of an integrated prescribing clinical decision support system (CDSS) combined with clinical pharmacist-led interventions in improving the safety and appropriateness of domperidone prescribing.</p><p><strong>Methods: </strong>A 10-year interrupted time series (ITS) study was conducted including all 51 437 inpatient and outpatient domperidone prescriptions issued between June 2015 and December 2025 at a large tertiary hospital in Vietnam. Sequential interventions were implemented: real-time CDSS alerts for contraindicated drug-drug interactions and daily maximum dose exceedance combined with pharmacist-led audit-feedback targeting dose errors (April 2021), updating the interaction database and pharmacist-led audit-feedback interventions targeting drug-drug interactions (January 2022), and pharmacist-led educational and audit-feedback interventions targeting treatment duration (September 2023). Monthly prescribing error rates were analyzed using segmented quasi-binomial regression with Newey-West robust standard errors.</p><p><strong>Results: </strong>Prior to intervention, prescribing errors exhibited significant increasing baseline trends for contraindicated drug-drug interactions and maximum daily dose exceedance, whereas prolonged treatment duration errors showed a gradual but significant decreasing trend (<i>P</i> < .001). CDSS implementation alone was associated with a transient increase in contraindicated drug-drug interactions, followed by a significant reversal in trend. Subsequent pharmacist-led active monitoring resulted in a marked and clinically meaningful reduction in contraindicated interaction errors (trend change OR 0.810; 95% CI 0.766-0.857; <i>P</i> < .001) and a 93% crude risk reduction (RR 0.07; 95% CI 0.05-0.09). For maximum daily dose exceedance, the integrated intervention produced an immediate 72% reduction (OR 0.279; 95% CI 0.128-0.609; <i>P</i> = .001) and near-complete reduction of overdose errors (RR 0.003; 95% CI 0.001-0.008). A pharmacist-led educational and audit-feedback intervention produced an immediate 94.5% reduction in prolonged treatment duration errors (OR 0.055; 95% CI 0.018-0.168; <i>P</i> < .001).</p><p><strong>Conclusions: </strong>Passive regulatory restrictions alone were insufficient to improve domperidone prescribing safety. An integrated CDSS and clinical pharmacist-led intervention model achieved rapid, clinically meaningful, and durable reductions in major prescribing errors and provides an adaptable, evidence-based framework for medication safety ","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261433442"},"PeriodicalIF":0.7,"publicationDate":"2026-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13076465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147689937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Internal Medicine Clinical Pharmacy Specialists at an Academic Medical Center.","authors":"Katarzyna Blair, Melissa Kocek, Tiffany King, Monika Hornung","doi":"10.1177/00185787261419034","DOIUrl":"10.1177/00185787261419034","url":null,"abstract":"<p><strong>Introduction: </strong>In 2024, the American College of Clinical Pharmacy (ACCP) completed a nationwide survey to describe the practice of internal medicine clinical pharmacy specialists (IMCPS). IMCPS were asked to report clinical interventions, rates of intervention acceptance, and the significance of those interventions. However, this study did not provide any description of cost avoidance (CA) provided through IMCPS interventions. The PHARM-CRIT trial identified that for each critical care pharmacist hired, there was a CA of about $3 to 9 per $1 spent on pharmacist salary. Similarly, the PHARM-EM study found there was a CA of $1 to 10 per $1 spent on an emergency medicine pharmacist. There is limited data on the cost benefits specific to IMCPS. This study aims to identify the impact of IMCPS at an academic medical center, specifically evaluating the CA provided.</p><p><strong>Objectives: </strong>The primary outcome of this study is the mean number of interventions per IMCPS per 8-hour shift and total CA generated.</p><p><strong>Methods: </strong>This prospective observational study included interventions related to adverse drug event prevention, resource utilization, hands-on care, drug information, and protocol implementation completed by IMCPS. Intervention severity was assessed utilizing the Medication Error Index. Intervention CA was estimated using CA described in the study by Hammond et al. The primary outcome of this study is the mean number of interventions per IMCPS per 8-hour shift and total CA generated. Secondary outcomes include the number of interventions completed, type of intervention completed, severity of intervention, time spent per intervention, average CA per intervention and mean CA per IMCPS.</p><p><strong>Results: </strong>Over a 28-day period, eight IM clinical pharmacy specialists completed 1,826 interventions. The average number of interventions completed by a pharmacist was 228 (IQR: 115-270) which equates to 12.26 interventions per 8-hour shift worked. The total CA for 28 days was $785,772.86 which equates to $10,215,047.24 per year. Per intervention completed by a pharmacist, $430.32 of cost was avoided. For every dollar spent on an IM clinical pharmacy specialist's salary, $9.29 was avoided.</p><p><strong>Conclusion: </strong>IMCPS provided significant CA and medication error prevention, specifically in areas of adverse drug event prevention and resource utilization.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261419034"},"PeriodicalIF":0.9,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147672856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"Impact of a Pharmacist Driven Penicillin Allergy De-labeling Protocol on Rates of Reported Allergy in the Intensive Care Unit\".","authors":"Diksha Verma, Sudhir Gupta","doi":"10.1177/00185787261435514","DOIUrl":"10.1177/00185787261435514","url":null,"abstract":"","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435514"},"PeriodicalIF":0.9,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Feasibility Assessment of EldenCare: A Geriatric Clinical Decision Support System Pilot Study.","authors":"Jehath Syed, Sri Harsha Chalasani, Pratibha Pereira, Ajay Sharma, Vikram Patil, Madhan Ramesh, Col Melanahalli Dayananda, Suresh Kumar Polumuri, Nipun Bhaskar Tank, Thirthala Leesha Pallavi, Thandu Deepa, Ganesh Ghule","doi":"10.1177/00185787261426945","DOIUrl":"10.1177/00185787261426945","url":null,"abstract":"<p><strong>Background: </strong>Medication safety is a critical concern in geriatric care, with high rates of polypharmacy and potentially inappropriate medications among older adult patients in India. The EldenCare application was developed as a digital clinical decision support tool to address these challenges through evidence-based screening and collaborative medication management.</p><p><strong>Objective: </strong>To evaluate the reliability and feasibility of the EldenCare system in supporting safe medication practices among older adults.</p><p><strong>Methods: </strong>This prospective observational study was conducted over 10 days with 22 healthcare professionals and 15 simulated patient profiles. Reliability assessment included the validation of automated clinical calculations (creatinine clearance and glomerular filtration rate) and the evaluation of drug-related problem (DRP) detection. Feasibility was measured using the System Usability Scale (SUS), AttrakDiff Mini questionnaire, and Technology Acceptance Model. A companion mobile application was also evaluated by 15 Android users based on 11 key features.</p><p><strong>Results: </strong>The EldenCare system received positive usability ratings (SUS: 72.82 ± 9.83) and high acceptance scores (perceived usefulness: 5.86 ± 0.65; perceived ease of use: 6.02 ± 0.60) from healthcare professionals, with no significant differences between physicians and clinical pharmacists (<i>P</i> > .05). However, significant technical limitations were identified: (1) none of the 25 test cases for clinical calculations fell within the acceptable ±2% error margin; (2) DRP detection showed inadequate accuracy across all categories (53.42% overall, range: 61.64% to 76.02%, all below the predetermined 95% threshold); and (3) the patient mobile application's medication and appointment reminder notifications failed after 3 days.</p><p><strong>Conclusion: </strong>EldenCare shows promising potential through high user acceptance but requires substantial technical refinement before clinical implementation. Future development should focus on algorithm accuracy, medication database mapping, and notification reliability to enhance medication safety in older adults.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261426945"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice and Determinants of Spontaneous Adverse Drug Reaction Reporting Among Healthcare Professionals: A Multicenter Cross-Sectional Study in Vietnam.","authors":"Suol Thanh Pham, Thang Nguyen, Khoi Tran Nhat Bui, Phung Thi Tuyet Tran, Vu Thien Nguyen, Yen-Hao Tran","doi":"10.1177/00185787261425847","DOIUrl":"10.1177/00185787261425847","url":null,"abstract":"<p><strong>Background: </strong>Spontaneous adverse drug reaction (ADR) reporting is a cornerstone of pharmacovigilance but remains underutilized globally and in Vietnam. Evidence on healthcare professionals' knowledge of ADR reporting procedures and related determinants is essential to inform system-level improvements.</p><p><strong>Objectives: </strong>To assess ADR-reporting procedure knowledge (practice-related knowledge) among healthcare professionals (HCPs) and to identify associated factors, perceived barriers, and support needs in public hospitals.</p><p><strong>Methods: </strong>A multicenter cross-sectional survey was conducted among 372 HCPs (nurses/midwives, 67.6%; physicians, 22.7%; pharmacists, 9.6%) across 3 public hospitals. A structured instrument assessed 5 scored procedural items: ADR detection, appropriate receiving unit, reporting timelines, access to reporting forms, and minimum required fields. Attainment of ADR-reporting procedure knowledge was defined as ≥4 of 5 correct items (≥80%). Chi-square tests and logistic regression analyses examined associations with age, sex, tenure, profession, and prior pharmacovigilance training.</p><p><strong>Results: </strong>Overall, 47.8% of respondents achieved the predefined attainment threshold (hospital range 32.5%-59.9%). Correct response rates were high for identifying the appropriate receiving unit (83.3%), reporting timelines (83.1%), and access to forms (79.6%), but lower for ADR detection (46.5%) and identification of minimum required fields (54.6%). Although 82.8% of HCPs reported having encountered suspected ADRs, only 14.9% had ever submitted an ADR report. In multivariable analysis, profession remained the only independent predictor of attainment (pharmacists vs nurses/midwives: OR 2.50, 95% CI 1.10-5.69; physicians vs nurses/midwives: OR 1.92, 95% CI 1.11-3.33). Commonly reported barriers included difficulty identifying suspected drugs (80.1%), grading severity (54.3%), and form complexity (30.1%). The most frequently requested supports were peer assistance (95.4%), feedback after submission (93.3%), and targeted training (89.2%).</p><p><strong>Conclusions: </strong>ADR-reporting procedure knowledge among HCPs was suboptimal, with profession-related disparities and specific gaps in ADR detection and documentation of minimum required fields. These findings underscore the need for system-level approaches that support clinical recognition, role-tailored collaboration, and feedback-enabled reporting processes to strengthen hospital pharmacovigilance.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261425847"},"PeriodicalIF":0.9,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13050374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Safety and Effectiveness of Two Nomograms for the Management of Diabetic Ketoacidosis.","authors":"Meghan Dhak, Amina Ammar, Christopher Giuliano","doi":"10.1177/00185787261435482","DOIUrl":"10.1177/00185787261435482","url":null,"abstract":"<p><strong>Background: </strong>No standardized nomogram has been established to reduce hypoglycemia events while optimizing clinical outcomes for patients with diabetic ketoacidosis (DKA).</p><p><strong>Objective: </strong>To evaluate the safety and effectiveness of two DKA nomograms.</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective cohort study in adult patients (≥18 years) treated with IV insulin for DKA. Cohorts were categorized based on the insulin nomogram utilized: Standard Incremental Nomogram with Glucose-Level Evaluation (SINGLE) and Multiple Algorithm Nomogram using Insulin Change and Rate Estimate (MULTIPLE). Patients were excluded if they were experiencing pregnancy, euglycemic DKA, or hyperosmolar hyperglycemic state. The primary outcome was hypoglycemic events (BG < 70 mg/dL). Secondary outcomes included time to DKA resolution and DKA recurrence.</p><p><strong>Results: </strong>A total of 234 patients were included (SINGLE n = 117, MULTIPLE n = 117). Hypoglycemia occurred in eight patients in the MULTIPLE group (6.8%) versus 25 patients in the SINGLE group (21.4%) (<i>P</i>< 0.01) after controlling for confounders, hypoglycemia remained highest in the SINGLE cohort versus the MULTIPLE cohort (OR 3.0 [95% CI 1.2-7.2], <i>P</i> < 0.01). After controlling for confounders, hypoglycemia remained highest in the SINGLE cohort versus the MULTIPLE cohort (OR 3.0 [95% CI 1.2-7.2], <i>P</i> < 0.01). Significant differences were not observed between the two nomograms in time to DKA resolution (16.4 hours [IQR 10.2-28.3] vs 16.1 [IQR 10.0-22.8], <i>P</i> = 0.19), recurrence rates (11.1% vs 15.4%, <i>P</i> = 0.34) or ICU LOS (<i>P</i> = 0.06).</p><p><strong>Conclusion: </strong>The MULTIPLE nomogram had fewer hypoglycemia events with no difference in time to DKA resolution. Additional studies are needed to evaluate varying nomograms to determine the optimal approach.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435482"},"PeriodicalIF":0.9,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13046695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147622795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of Electronic Missing Medication Requests to Identify Medication-Use System Vulnerabilities and Interprofessional Workflow Targets.","authors":"Thomas S Achey, Brittany Goco","doi":"10.1177/00185787261435487","DOIUrl":"10.1177/00185787261435487","url":null,"abstract":"<p><strong>Purpose: </strong>Missing medication requests (MMRs) are common in inpatient care and may represent both medication distribution-system vulnerabilities and uncertainty-driven communication. This quality improvement study characterized electronic health record (EHR)-generated MMRs to identify where requests originated, when they occurred, and why they were submitted, to inform actionable intervention targets.</p><p><strong>Methods: </strong>This IRB-exempt, retrospective quality improvement initiative reviewed MMRs submitted from inpatient nursing units to the inpatient pharmacy during a 30-day period (September 2020) at a 258-bed community teaching hospital. Messages were summarized by nursing unit, hour of day, and day of week, and categorized using a structured operational schema to identify dominant drivers and priorities. A limited post-implementation assessment tracked aggregate message volume to evaluate directional change after targeted workflow interventions.</p><p><strong>Results: </strong>A total of 13 915 MMRs were submitted during the study period (mean 464/day; approximately 20/hour; ~1 message every 3 minutes). Requests clustered in higher-acuity areas and peaked around nursing shift-change and medication administration rhythms (approximately 0800 and 2000). The most frequent categories were continuous infusion redispense (4189; 30.1%), request for dose despite initial dispense (1712; 12.3%), and inability to locate a cart-fill item (1488; 10.7%). Patterns including redundant messages and requests sent soon after dispensing suggested limited visibility into medication status and opportunities to improve transparency and workflow expectations. Following implementation of targeted workflow changes, aggregate message volume decreased by 14.7% (median 11 870; IQR, 11 726-12 045), representing a median reduction of 2045 messages (IQR, 1870-2189) from baseline.</p><p><strong>Conclusion: </strong>High-volume MMRs can serve as a practical diagnostic signal of medication-use system vulnerabilities and communication workarounds. Characterizing MMRs by location, timing, and request type can help health systems prioritize targeted interventions, including infusion standardization, automated dispensing cabinet optimization, workflow alignment to predictable demand peaks, and EHR-based tracking tools.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261435487"},"PeriodicalIF":0.9,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicochemical Stability of the Rituximab Biosimilar ABP 798 in Intravenous Bags Following Preparation and Storage.","authors":"Jeremy Gastwirt, Jeff Brown, David Lai, Golnaz Kamalinia, Monica Goss","doi":"10.1177/00185787261424835","DOIUrl":"10.1177/00185787261424835","url":null,"abstract":"<p><strong>Introduction: </strong>ABP 798 (rituximab-arrx, RIABNI^®) is a biosimilar to rituximab available as a sterile, preservative-free solution (10 mg/mL) in a single-use vial for intravenous (IV) infusion. The purpose of this study was to assess the physicochemical stability of ABP 798 after dilution with 0.9% (w/v) saline or 5% (w/v) dextrose.</p><p><strong>Methods: </strong>Two experimental arms designated \"preliminary hold\" and \"optimized storage condition\" were assessed. For both arms, ABP 798 was diluted to 1 and 4 mg/mL with sterile 0.9% (w/v) saline or 5% (w/v) dextrose in IV bags. For the preliminary hold assessment, the IV bags were kept at 2°C to 8°C for up to 30 days, followed by storage at 30°C for 24 hours (h), and then infusion at ambient temperature. For the optimized storage condition assessment, the IV bags were kept at 2°C to 8°C for up to 30 days (saline-diluted) or up to 24 hours (dextrose-diluted), followed by storage at 30°C (saline-diluted) or 25°C (dextrose-diluted) for 24 hours and infusion at two different infusion rates. Samples collected at different time points were evaluated for various product quality attributes.</p><p><strong>Results: </strong>Saline-diluted ABP 798 was physicochemically stable after 30 days of storage at 2°C to 8°C followed by storage at 30°C for 24 hours, and then infusion, as determined by the absence of changes to quality attributes. Degradation was observed in dextrose-diluted ABP 798 after 30 days of storage at 2°C to 8°C followed by 24 hours storage at 30°C. Dextrose-diluted ABP 798 remained physicochemically stable after 24 hours storage at 2°C to 8°C followed by 24 hours at 25°C.</p><p><strong>Conclusions: </strong>These results indicate that ABP 798 remains chemically and physically stable when diluted in IV bags with 0.9% (w/v) saline stored at 2°C to 8°C for 30 days or 5% (w/v) dextrose stored at 2°C to 8°C for 1 day. Overall, these findings provide strong evidence supporting the chemical and physical stability of ABP 798 under the tested conditions. It is essential for the end-user to ensure the overall quality of the prepared admixture by strictly adhering to the product's packaging insert instructions.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261424835"},"PeriodicalIF":0.9,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147591452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Telepharmacy in Post Ischemic Stroke Patients: A Randomized Controlled Trial.","authors":"Arworn Chaemkiri, Thutcha Thienpanja, Teeraporn Sadira Supapaan, Nonglek Kunawaradisai","doi":"10.1177/00185787261423000","DOIUrl":"10.1177/00185787261423000","url":null,"abstract":"<p><strong>Purpose: </strong>To compare pharmacist-led telepharmacy with standard pharmaceutical care on stroke and medication knowledge, medication adherence, and clinical outcomes (blood pressure [BP], low-density lipoprotein cholesterol [LDL-C], and glycated hemoglobin [HbA1c]) in patients with post-ischemic stroke; and to characterize medication-related problems (MRPs) and their severity in the telepharmacy arm.</p><p><strong>Methods: </strong>In a randomized controlled trial, 126 hospitalized adults with ischemic stroke were assigned 1:1 to receive either standard pharmaceutical care alone or standard care plus structured telepharmacy follow-ups at 1 week, 1, and 2 months post-discharge (n = 63/arm). Outcomes were assessed using validated tools, including knowledge questionnaires; the Medication Adherence Scale for Thais (MAST); the Pharmaceutical Care Network Europe (PCNE); classification v9.1; and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) severity index.</p><p><strong>Results: </strong>Compared with controls, telepharmacy improved post-discharge knowledge (11.75 ± 2.38 vs 9.79 ± 2.43; <i>P</i> < .001) and adherence (MAST 37.00 ± 3.45 vs 33.26 ± 3.76; <i>P</i> < .001). BP target attainment (<130/80 mmHg) was higher with telepharmacy (52.4% vs 30.2%; <i>P</i> = .011). Follow-up BP favored telepharmacy: systolic Δ -3.67 mmHg (95% CI -6.79 to -0.55; <i>P</i> = .041) and diastolic Δ -3.11 mmHg (95% CI -5.99 to -0.23; <i>P</i> = .040). Between-group differences were not significant for LDL-C or HbA1c. In the telepharmacy arm, 76 MRPs were identified; the most frequent problem was unnecessary drug treatment (38.16%), commonly due to patients' decision to use unnecessary drugs (28.93%). Patient counseling was the commonest intervention (40.00%); 83.64% were fully implemented and 92.10% of MRPs were completely resolved. An ~36.84% of MRPs were NCC MERP level E.</p><p><strong>Conclusions: </strong>Telepharmacy improved knowledge, medication adherence, and BP control after ischemic stroke, and enabled effective identification and resolution of MRPs. These findings support incorporating pharmacist-led telepharmacy into post-discharge transitional care pathways. The trial was retrospectively registered (TCTR20250401004). https://www.thaiclinicaltrials.org/show/TCTR20250401004.</p>","PeriodicalId":13002,"journal":{"name":"Hospital Pharmacy","volume":" ","pages":"00185787261423000"},"PeriodicalIF":0.9,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}