International Journal of Clinical Pharmacy最新文献

{"title":"Polypharmacy and medication regimen complexity in transfusion-dependent thalassaemia patients: a cross- sectional study.","authors":"Geok Ying Chun, Sharon Shi Min Ng, Farida Islahudin, Veena Selvaratnam, Nurul Ain Mohd Tahir","doi":"10.1007/s11096-024-01716-y","DOIUrl":"10.1007/s11096-024-01716-y","url":null,"abstract":"<p><strong>Background: </strong>Medication burden and complexity have been longstanding problems in chronically ill patients. However, more data are needed on the extent and impact of medication burden and complexity in the transfusion-dependent thalassaemia population.</p><p><strong>Aim: </strong>The aim of this study was to determine the characteristics of medication complexity and polypharmacy and determine their relationship with drug-related problems (DRP) and control of iron overload in transfusion-dependent thalassaemia patients.</p><p><strong>Method: </strong>Data were derived from a cross-sectional observational study on characteristics of DRPs conducted at a Malaysian tertiary hospital. The medication regimen complexity index (MRCI) was determined using a validated tool, and polypharmacy was defined as the chronic use of five or more medications. The receiver operating characteristic curve analysis was used to determine the optimal cut-off value for MRCI, and logistic regression analysis was conducted.</p><p><strong>Results: </strong>The study enrolled 200 adult patients. The MRCI cut-off point was proposed to be 17.5 (Area Under Curve  =  0.722; sensitivity of 73.3% and specificity of 62.0%). Approximately 73% and 64.5% of the patients had polypharmacy and high MRCI, respectively. Findings indicated that DRP was a full mediator in the association between MRCI and iron overload.</p><p><strong>Conclusion: </strong>Transfusion-dependent thalassaemia patients have high MRCI and suboptimal control of iron overload conditions in the presence of DRPs. Thus, future interventions should consider MRCI and DRP as factors in serum iron control.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140326613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional survey of viral hepatitis education within pharmacy curricula in the United States.","authors":"Michelle T Martin, Aileen N Pham, Jessica S Wagner","doi":"10.1007/s11096-023-01691-w","DOIUrl":"10.1007/s11096-023-01691-w","url":null,"abstract":"<p><strong>Background: </strong>The Viral Hepatitis National Strategic Plan emphasizes the importance of a collaborative provider workforce trained in hepatitis prevention and treatment to eliminate viral hepatitis in the United States by 2030. Although pharmacists play a key role in hepatitis management, literature lacks documentation of the amount of viral hepatitis education provided to pharmacy students.</p><p><strong>Aim: </strong>Our study goal was to describe viral hepatitis education provided at United States pharmacy schools.</p><p><strong>Method: </strong>In this cross-sectional survey study, investigators developed a 19-item Qualtrics questionnaire, sent questionnaire links to curricula content experts at 140 accredited pharmacy colleges/schools in May-June 2022, and allotted 28 days for completion. Questions assessed the viral hepatitis instruction provided to students and hepatitis instructors' training/experience. We used descriptive statistics for analysis.</p><p><strong>Results: </strong>Forty-eight pharmacy institutions across 29 states/territories responded; 44% had 50-99 students/class, and 58% used lecture and discussion to provide required hepatitis education. Students received more lecture (average = 3.4 h, range 0.8-1.6 h/hepatitis topic) than discussion (average = 1.7 h, range 0.6-0.9 h/hepatitis topic), with the most time spent on hepatitis C, followed by hepatitis B virus. Respondents reported 93% of their instructors had post-graduate training/certifications and 67% worked in clinical settings with hepatitis patients.</p><p><strong>Conclusion: </strong>Survey results demonstrate variability in hepatitis education across United States pharmacy curricula. Data offer stakeholders in hepatitis elimination efforts knowledge about the viral hepatitis education provided to Doctor of Pharmacy students. Future directions include consideration of implementation of minimum hepatitis education standards to further support work toward national hepatitis elimination.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139729564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the future: precision pharmacovigilance in the era of personalized medicine.","authors":"Lurdes Silva, Teresa Pacheco, Emília Araújo, Rita J Duarte, Inês Ribeiro-Vaz, Renato Ferreira-da-Silva","doi":"10.1007/s11096-024-01709-x","DOIUrl":"10.1007/s11096-024-01709-x","url":null,"abstract":"<p><p>In the era of personalized medicine, pharmacovigilance faces new challenges and opportunities, demanding a shift from traditional approaches. This article delves into the evolving landscape of drug safety monitoring in the context of personalized treatments. We aim to provide a succinct reflection on the intersection of tailored therapeutic strategies and vigilant pharmacovigilance practices. We discuss the integration of pharmacogenetics in enhancing drug safety, illustrating how genetic profiling aids in predicting drug responses and adverse reactions. Emphasizing the importance of phase IV-post-marketing surveillance, we explore the limitations of pre-marketing trials and the necessity for a comprehensive approach to drug safety. The article discusses the pivotal role of pharmacogenetics in pre-exposure risk management and the redefinition of pharmacoepidemiological methods for post-exposure surveillance. We highlight the significance of integrating patient-specific genetic profiles in creating personalized medication leaflets and the use of advanced computational methods in data analysis. Additionally, we examine the ethical, privacy, and data security challenges inherent in precision medicine, emphasizing their implications for patient consent and data management.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11133017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139982909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Whole blood thiamine, intravenous thiamine supplementation and delirium occurrence in the intensive care unit: retrospective cohort analyses.","authors":"Muhammad A Mumin, Cathrine A McKenzie, Valerie J Page, Daniel Hadfield, Leanne M Aitken, Fraser Hanks, Emma Cunningham, Bronagh Blackwood, Edwin Van Dellen, Arjen J C Slooter, Michael P W Grocott, Daniel F McAuley, Peter E Spronk","doi":"10.1007/s11096-023-01690-x","DOIUrl":"10.1007/s11096-023-01690-x","url":null,"abstract":"<p><strong>Background: </strong>Thiamine di-phosphate is an essential cofactor in glucose metabolism, glutamate transformation and acetylcholinesterase activity, pathways associated with delirium occurrence. We hypothesised that a deficiency in whole blood thiamine and intravenous thiamine supplementation could impact delirium occurrence.</p><p><strong>Aim: </strong>To establish whether a deficiency in whole blood thiamine and/or intravenous thiamine supplementation within 72 h of intensive care admission is associated with delirium occurrence.</p><p><strong>Method: </strong>The first dataset was secondary analysis of a previous study in an intensive care unit in the Netherlands, reported in 2017. The second dataset contained consecutive intensive care admissions 2 years before (period 1: October 2014 to October 2016) and after (period 2: April 2017 to April 2019) routine thiamine supplementation was introduced within 72 h of admission. Delirium was defined as a positive Confusion Assessment Method-Intensive Care Unit score(s) in 24 h.</p><p><strong>Results: </strong>Analysis of the first dataset (n = 57) using logistic regression showed no relationship between delirium and sepsis or whole blood thiamine, but a significant association with age (p = 0.014). In the second dataset (n = 3074), 15.1% received IV thiamine in period 1 and 62.6% during period 2. Hierarchical regression analysis reported reduction in delirium occurrence in the second period; this did not reach statistical significance, OR = 0.81 (95% CI 0.652-1.002); p = 0.052.</p><p><strong>Conclusion: </strong>No relationship was detected between whole blood thiamine and delirium occurrence on admission, at 24 and 48 h. It remains unclear whether routine intravenous thiamine supplementation during intensive care admission impacts delirium occurrence. Further prospective randomised clinical trials are needed.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139706679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of community pharmacists and pharmacies in physical activity promotion: an interdisciplinary e-Delphi study.","authors":"Rúben Viegas, Mara Pereira Guerreiro, Filipa Duarte-Ramos, Romeu Mendes, Filipa Alves da Costa","doi":"10.1007/s11096-024-01731-z","DOIUrl":"https://doi.org/10.1007/s11096-024-01731-z","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140655335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraclass comparison of inhaled corticosteroids for the risk of pneumonia in chronic obstructive pulmonary airway disorder: a network meta-analysis and meta-regression.","authors":"K. Sridharan, G. Sivaramakrishnan","doi":"10.1007/s11096-024-01736-8","DOIUrl":"https://doi.org/10.1007/s11096-024-01736-8","url":null,"abstract":"","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140655366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of fruquintinib in Chinese patients with refractory metastatic colorectal cancer","authors":"Zijia Huang, Lingyan Zhou, Hanrui Zheng, Mei Zhan","doi":"10.1007/s11096-024-01721-1","DOIUrl":"https://doi.org/10.1007/s11096-024-01721-1","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Colorectal cancer is a significant health concern worldwide, with metastatic CRC (mCRC) presenting a particularly challenging prognosis. The FRESCO-2 trial highlighted the potential of fruquintinib in heavily pretreated mCRC patients.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>Given the recent changes in drug pricing in China and the evolving mCRC treatments, this study aimed to evaluate the cost-effectiveness of fruquintinib in the context of current Chinese healthcare standards.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>This study utilized data from the FRESCO-2 trial, incorporating a partitioned-survival model to simulate three health states: Progression-Free Survival, Progressive Disease, and death. Costs and utility values were derived from published literature and the FRESCO-2 trial. Sensitivity analyses were conducted to assess the robustness of the base-case result and to understand the impact of various parameters on the ICER.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>The base-case analysis revealed a total cost of $11,089.05 for the fruquintinib group and $5,374.48 for the placebo group. The overall QALYs were higher in the fruquintinib group (0.61 QALYs) compared to the placebo group (0.43 QALYs). The ICER was calculated to be $31,747.67 per QALY. Sensitivity analyses identified the utility of progression-free survival, the cost of fruquintinib, and the costs of best supportive care as significant determinants of ICER.</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Fruquintinib emerges as a promising therapeutic option for refractory mCRC. However, its cost-effectiveness depends on selected willingness-to-pay (WTP) threshold. While the drug’s ICER surpasses the WTP based on China's 2022 GDP per capita, it remains below the threshold set at three times the national GDP.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delabeling of allergy to beta-lactam antibiotics in hospitalized patients: a prospective study evaluating cost savings","authors":"Miriam Sobrino-García, Francisco J. Muñoz-Bellido, Esther Moreno-Rodilla, Rita Martín-Muñoz, Aránzazu García-Iglesias, Ignacio Dávila","doi":"10.1007/s11096-024-01737-7","DOIUrl":"https://doi.org/10.1007/s11096-024-01737-7","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Patients with a penicillin allergy label are at risk of an associated increase in adverse antibiotic events and hospitalization costs.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>We aimed to study the economic savings derived from the correct diagnosis and delabeling inpatients with suspected beta-lactam allergy, considering the acquisition cost of antimicrobials prescribed during a patient's hospital stay.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>We prospectively evaluated patients admitted to the University Hospital of Salamanca who had been labeled as allergic to beta-lactams and performed a delabeling study. Subsequently, cost differences between antibiotics administered before and after the allergy study and those derived from those patients who received alternative antibiotics during admission and those who switched to beta-lactams after the allergy study were calculated.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>One hundred seventy-seven inpatients labeled as allergic to beta-lactams underwent a delabeling study; 34 (19.2%) were confirmed to have allergy to beta-lactams. Of the total number of patients, 136 (76.8%) received antibiotics during their hospitalization, involving a mean (SD) cost of €203.07 (318.42) and a median (IQR) cost of €88.97 (48.86–233.56). After delabeling in 85 (62.5%) patients, the antibiotic treatment was changed to beta-lactams. In this group of patients, the mean cost (SD) decreased from €188.91 (351.09) before the change to 91.31 (136.07) afterward, and the median cost (IQR) decreased from €72.92 (45.82–211.99) to €19.24 (11.66–168). The reduction was significant compared to the median cost of patients whose treatment was not changed to beta-lactams (p&lt;0.001).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Delabeling hospitalized patients represents a cost-saving measure for treating patients labeled as allergic to beta-lactams.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140630899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical impact of an individualised clinical pharmacy programme into the memory care pathway of older people: an observational study","authors":"Teddy Novais, Elsa Reallon, Julie Martin, Marine Barral, Pierre Krolak-Salmon, Marie-Hélène Coste, Hanane Zenagui, Antoine Garnier-Crussard, Delphine Hoegy, Christelle Mouchoux","doi":"10.1007/s11096-024-01723-z","DOIUrl":"https://doi.org/10.1007/s11096-024-01723-z","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>In older patients, medication exposure [i.e. polypharmacy, potentially inappropriate medications (PIMs), medications with anticholinergic and/or sedative properties] is a modifiable risk factor associated with cognitive iatrogenic risk and dementia.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>To assess the potential clinical impact of the implementation of an individualised clinical pharmacy programme at the initiation of the Memory care pathway in older patients with a cognitive complaint.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>This prospective observational study included older patients with high-risk of adverse drug event (HR) admitted in a French geriatric university hospital to explore the cognitive complaint or the cognitive disorder between January and November 2021. Drug-related problems (DRPs) were identified during a medication review performed in HR patients, and pharmaceutical interventions (PIs) notified in the patient’s hospitalisation report were collected. The clinical impact of PIs was assessed by an expert panel (geriatricians and clinical pharmacists) using the Clinical, Economic, and Organisational (CLEO) tool.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Overall, 326 patients were eligible and 207 (63.5%) were considered as HR patients. Among HR patients, 88.9% (n = 184) were treated using at least 5 medications (polypharmacy), and 36.7% (n = 76) received at least one PIM with cognitive iatrogenic risk. During the medication review, 490 PIs were provided and their clinical impact was rated as minor for 57.3% (n = 281), moderate for 26.7% (n = 131), and major for 2.5% (n = 12).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>The integration of clinical pharmacist secured the Memory care pathway of older patients with a cognitive complaint by identifying an important number of DRPs and PIMs with potential cognitive iatrogenic risk.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140627433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the impact of anticholinergic burden on urinary independence: insights from a post-stroke cohort of older adults","authors":"Ayaka Matsumoto, Yoshihiro Yoshimura, Fumihiko Nagano, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Aomi Kuzuhara, Kota Hori, Takenori Hamada, Kouki Yoneda, Kenichiro Maekawa","doi":"10.1007/s11096-024-01725-x","DOIUrl":"https://doi.org/10.1007/s11096-024-01725-x","url":null,"abstract":"<h3 data-test=\"abstract-sub-heading\">Background</h3><p>Anticholinergic burden is associated with adverse events in the older adults. However, there is a lack of evidence regarding its effect on urinary independence in stroke patients.</p><h3 data-test=\"abstract-sub-heading\">Aim</h3><p>This study examined the association between increased anticholinergic burden during hospitalization and urinary independence in post-stroke patients undergoing rehabilitation.</p><h3 data-test=\"abstract-sub-heading\">Method</h3><p>This observational cross-sectional study included stroke patients admitted to a post-acute rehabilitation hospital between 2020 and 2022 who were not independently urinating. The degree of urinary independence was assessed using the Functional Independence Measure-Bladder (FIM-Bladder), a subscale of the motor domain of the FIM, and urinary independence was defined as FIM-Bladder ≥ 6. Anticholinergic burden was assessed using the anticholinergic risk scale (ARS), and changes in ARS during hospitalization were calculated by subtracting the value at admission from the value at discharge. The study outcome was urinary independence at discharge. Logistic regression analysis was used to examine whether change in ARS score was independently associated with the outcome. Statistical significance was set at <i>P</i> &lt; 0.05.</p><h3 data-test=\"abstract-sub-heading\">Results</h3><p>Of the 573 patients enrolled, 312 patients (mean age 77.5 years, 51.9% male) were included in the analysis. ARS increased during hospitalization in 57 patients (18.3%). Change in ARS score was independently associated with urinary independence (odds ratio: 0.432, 95% confidence interval: 0.247–0.756, <i>P</i> = 0.003).</p><h3 data-test=\"abstract-sub-heading\">Conclusion</h3><p>Increased anticholinergic burden in post-stroke patients who require assistance with urination is significantly associated with less independent urination. Anticholinergic agents may need to be introduced cautiously in patients who require assistance with urination.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140627416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}