International Journal of Clinical Pharmacy最新文献

{"title":"Perspectives of pharmacy staff on provision of self-care and minor ailment education in primary schools: a qualitative study.","authors":"Samira Osman, Vibhu Paudyal, Zahraa Jalal, Christine Hirsch","doi":"10.1007/s11096-024-01753-7","DOIUrl":"10.1007/s11096-024-01753-7","url":null,"abstract":"<p><strong>Background: </strong>Pharmacy professionals, given their health expertise, can play a role in enhancing health education within their communities and among patients. The potential of the pharmacy workforce to enhance health education among primary school children is underexplored.</p><p><strong>Aim: </strong>This study aimed to investigate the perspectives of pharmacy staff on the provision of education regarding self-care and treatment of minor ailments to primary school-aged children and to identify roles that pharmacists could play in this regard.</p><p><strong>Method: </strong>Qualitative semi-structured interviews were conducted online with frontline pharmacy staff in the UK who had patient facing roles with primary school-aged children and parents. Interviews were audio-recorded and transcribed verbatim. Thematic data analysis was applied to the transcripts.</p><p><strong>Results: </strong>A total of 17 participants were recruited. Participants included 12 pharmacists, two pharmacy technicians and three pharmacy dispensers. All participants worked within community, hospital or primary care facilities. Five themes emerged from the data analysis: sources of health knowledge accessed by children and parents; a perceived lack of knowledge regarding self-care and treatments for minor ailments among children and parents; a perceived positive impact of education on self-care; barriers to health education; and the potential role of pharmacy staff in self-care education in schools.</p><p><strong>Conclusion: </strong>Pharmacy staff recognise the value of integrating health education into primary school curricula. A collaborative approach with educational institutions could bridge the gap in knowledge regarding self-care and treatment of minor ailments, and could empower children and reduce unnecessary use of healthcare resources.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300589","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":"Optimizing vancomycin dosing in pediatrics: a machine learning approach to predict trough concentrations in children under four years of age.","authors":"Minghui Yin, Yuelian Jiang, Yawen Yuan, Chensuizi Li, Qian Gao, Hui Lu, Zhiling Li","doi":"10.1007/s11096-024-01745-7","DOIUrl":"10.1007/s11096-024-01745-7","url":null,"abstract":"<p><strong>Background: </strong>Vancomycin trough concentration is closely associated with clinical efficacy and toxicity. Predicting vancomycin trough concentrations in pediatric patients is challenging due to significant inter-individual variability and rapid physiological changes during maturation.</p><p><strong>Aim: </strong>This study aimed to develop a machine learning model to predict vancomycin trough concentrations and determine optimal dosing regimens for pediatric patients < 4 years of age using ML algorithms.</p><p><strong>Method: </strong>A single-center retrospective observational study was conducted from January 2017 to March 2020. Pediatric patients who received intravenous vancomycin and underwent therapeutic drug monitoring were enrolled. Seven ML models [linear regression, gradient boosted decision trees, support vector machine, decision tree, random forest, Bagging, and extreme gradient boosting (XGBoost)] were developed using 31 variables. Performance metrics including R-squared (R²), mean square error (MSE), root mean square error (RMSE), and mean absolute error (MAE) were compared, and important features were ranked.</p><p><strong>Results: </strong>The study included 120 eligible trough concentration measurements from 112 patients. Of these, 84 measurements were used for training and 36 for testing. Among the seven algorithms tested, XGBoost showed the best performance, with a low prediction error and high goodness of fit (MAE = 2.55, RMSE = 4.13, MSE = 17.12, and R² = 0.59). Blood urea nitrogen, serum creatinine, and creatinine clearance rate were identified as the most important predictors of vancomycin trough concentration.</p><p><strong>Conclusion: </strong>An XGBoost ML model was developed to predict vancomycin trough concentrations and aid in drug treatment predictions as a decision-support technology.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300619","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":"Genetic influence of meningioma on cisplatin resistance: a Mendelian randomization analysis.","authors":"Kefu Yu, Ziming Li, Weizhong Shi, Shuxian Yang, Zhigang Zhao, Li Yang","doi":"10.1007/s11096-024-01762-6","DOIUrl":"10.1007/s11096-024-01762-6","url":null,"abstract":"<p><strong>Background: </strong>Although various aspects of cisplatin resistance have been studied, the impact of genetic variations still needs to be explored.</p><p><strong>Aim: </strong>This study aimed to investigate the impact of cisplatin on meningiomas using a two-sample Mendelian randomization (MR) approach, employing genetic variants associated with cisplatin use as instrumental variables.</p><p><strong>Method: </strong>We conducted a two-sample MR analysis using genome-wide association study (GWAS) data. Instrumental variables were derived from single-nucleotide polymorphisms (SNPs) associated with meningioma to estimate the causal relationship with cisplatin resistance. Sensitivity analyses were performed to confirm the findings.</p><p><strong>Results: </strong>Genetic predisposition to meningioma significantly increased the risk of cisplatin resistance (odds ratio (OR): 1.63; 95% confidence interval (CI) 1.44-1.85, P < 0.05). Sensitivity analyses supported the causal link.</p><p><strong>Conclusion: </strong>This MR study suggests that genetic predisposition to meningioma increases susceptibility to cisplatin resistance. Further research is needed to uncover the mechanisms behind these causal effects.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431857","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":"Perceived importance of emotional intelligence for clinical pharmacy practice and suggested improvements: a focus group study of postgraduate pharmacists.","authors":"Dejan Senćanski, Ivana Tadić, Dragana Jocić, Valentina Marinković","doi":"10.1007/s11096-024-01748-4","DOIUrl":"10.1007/s11096-024-01748-4","url":null,"abstract":"<p><strong>Background: </strong>Emotional intelligence (EI) is a critical set of skills that impacts clinical pharmacists' well-being and positively influences high-level patient-centred care. Describing pharmacists' perceptions may support the integration of EI development approaches into their professional development continuum.</p><p><strong>Aim: </strong>The aim of this study was to analyse pharmacists' perceptions of the characteristics of emotionally intelligent clinical pharmacists, the importance of EI in clinical practice, and educational models and approaches to enhancing EI.</p><p><strong>Method: </strong>A qualitative study with a focus group methodology was conducted with pharmacy practitioners using a semi-structured guide grounded in the EI competency framework and existing qualitative research methodology practices. Purposive sampling was conducted until information and meaning saturation occurred. The focus group recordings were transcribed and independently coded by two researchers. The conventional content analysis of qualitative data was applied with the inductive thematic approach at its core.</p><p><strong>Results: </strong>According to the 17 focus group participants, emotionally intelligent clinical pharmacists are perceived as self-confident communicators who control and manage emotions, work well under pressure, and handle every situation effectively. Emotional self-control, self-awareness, awareness of others, tolerance, understanding, and empathy have emerged as key EI competencies required for challenges in clinical practice. EI lectures with reflections from clinical applications, behaviour modelling, and behaviour-changing methods were perceived to be of particular importance for pharmacist education and development programmes.</p><p><strong>Conclusion: </strong>Postgraduate pharmacy practitioners perceived EI competencies as necessary for their professional success and high-quality patient-centred care. They suggested that EI competencies be a focal point in pharmacy professional development programmes.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300620","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":"Measuring the impact of pharmaceutical care bundle delivery on patient outcomes: an observational study.","authors":"Martin Luke Canning, Ross McDougall, Stephanie Yerkovich, Michael Barras, Ian Coombes, Clair Sullivan, Karen Whitfield","doi":"10.1007/s11096-024-01750-w","DOIUrl":"10.1007/s11096-024-01750-w","url":null,"abstract":"<p><strong>Background: </strong>Clinical pharmacists perform activities to optimise medicines use and prevent patient harm. Historically, clinical pharmacy quality indicators have measured individual activities not linked to patient outcomes.</p><p><strong>Aim: </strong>To determine the proportion of patients who receive a pharmaceutical care bundle (PCB) (consisting of a medication history, medication review, discharge medication list and medicines information on the discharge summary) as well as investigate the relationship between delivery of this PCB and patient outcomes.</p><p><strong>Method: </strong>Pharmaceutical care bundle activities were defined within state-wide (Queensland, Australia) clinical information systems and datasets were linked. An observational study using routinely recorded data was performed at ten participating sites for adult patients who had a non-same day hospital stay. The association between extent of PCB delivery and three patient outcomes were investigated: length of stay (LOS), unplanned readmission, and mortality.</p><p><strong>Results: </strong>In total 283,813 patient hospital stays were evaluated. The delivery of the PCB occurred in 26.9% of patients at the ten participating hospital sites, ranging from 0.6 to 61.2% across sites. Patients with a longer LOS were more likely to receive delivery of the complete PCB (P < 0.001). There was no correlation between PCB and hospital standardised mortality ratio (r = 0.03, p = 0.93). Higher rates of delivery of the PCB were associated with lower rates of unplanned readmission within 30 days (r = - 0.993, p < 0.001).</p><p><strong>Conclusion: </strong>A complete PCB was delivered to 26.9% of patients and was associated with a significantly lower rate of unplanned readmission within 30 days.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141156918","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 multicenter retrospective study of antidepressant use in outpatient clinics in China pre- and post-COVID.","authors":"Mengqiang Zhao, Luyao Chang, Jing Yu, Jianxin Wang, Yang Song, Shi Su, Chaoli Chen, Yang Lun, Fangfang Cheng, Yuanyuan Zhao, Chunhua Zhou","doi":"10.1007/s11096-024-01776-0","DOIUrl":"10.1007/s11096-024-01776-0","url":null,"abstract":"<p><strong>Background: </strong>Analyzing antidepressant prescribing in real-world settings can provide clinicians and health policymakers valuable information.</p><p><strong>Aim: </strong>This epidemiological study examined the status and trends in antidepressant prescribing among the Chinese population from July 1, 2017, to June 30, 2022.</p><p><strong>Method: </strong>A retrospective study was conducted in three hospitals. Data were collected 2.5 years before and 2.5 years after the onset of the COVID-19 pandemic. We analyzed the number of patients diagnosed with depression and their corresponding antidepressant prescriptions. Using the chi-square test, stratified analyses were performed to explore the characteristics of these prescriptions in different ages and sexes.</p><p><strong>Results: </strong>The study included 124,355 patients and 400,840 antidepressant prescriptions. We observed fluctuating upward trends in the number of patients and antidepressant prescriptions. Post-COVID-19, the number of patients increased by 37.1% compared to the pre-pandemic period, and the number of antidepressant prescriptions rose by 88.3%. The three most frequently prescribed antidepressants for adolescents were sertraline, citalopram, and escitalopram. Among adults, citalopram, escitalopram, and sertraline were most common, while in older adults, citalopram, escitalopram, and mirtazapine were predominant. Male patients used mirtazapine, venlafaxine, paroxetine, bupropion, fluvoxamine, vortioxetine, and clomipramine more frequently compared to female patients, who were more likely to be prescribed citalopram, flupentixol/melitracen, agomelatine, and fluoxetine. Antidepressant monotherapy represented 76.6% of prescriptions, with the most common combination being antidepressants and anxiolytics.</p><p><strong>Conclusion: </strong>Over the past 5 years, both the number of patients and antidepressant prescriptions have shown upward trends, and the COVID-19 pandemic has impacted prescribing. Understanding the changes in antidepressant prescriptions can identify adherence to national guidelines.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975562","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 Medicines Optimisation Innovation Centre: a dedicated centre driving innovation in medicines optimisation-impact and sustainability.","authors":"A Hogg, M Scott, G Fleming, C Scullin, R Huey, S Martin, N Goodfellow, C Harrison","doi":"10.1007/s11096-024-01775-1","DOIUrl":"10.1007/s11096-024-01775-1","url":null,"abstract":"<p><strong>Background: </strong>Sub-optimal medicines use is a challenge globally, contributing to poorer health outcomes, inefficiencies and waste. The Medicines Optimisation Innovation Centre (MOIC) was established in Northern Ireland by the Department of Health (DH) in 2015 to support implementation of the Medicines Optimisation Quality Framework.</p><p><strong>Aim: </strong>To demonstrate how MOIC informs policy and provides support to commissioners to improve population health and wellbeing.</p><p><strong>Setting: </strong>MOIC is a regional centre with multidisciplinary and multi-sector clinical expertise across Health and Social Care and patient representation.</p><p><strong>Development: </strong>Core funded by DH, MOIC has a robust governance structure and oversight programme board. An annual business plan is agreed with DH. Rigorous processes have been developed for project adoption and working collaboratively with industry.</p><p><strong>Implementation: </strong>MOIC has established partnerships with academia, industry, healthcare and representative organisations across Europe, participating in research and development projects and testing integrated technology solutions. A hosting programme has been established and evaluation and dissemination strategies have been developed.</p><p><strong>Evaluation: </strong>MOIC has established numerous agreements, partnered in three large EU projects and strengthened networks globally with extensive publications and conference presentations. Informing pathway redesign, sustainability and COVID response, MOIC has also assisted in the development of clinical pharmacy services and antimicrobial stewardship in Europe and Africa. Northern Ireland has been recognised as a 4-star European Active and Healthy Ageing Reference Site and the Integrated Medicines Management model as an example of best practice in Central and Eastern Europe.</p><p><strong>Conclusion: </strong>MOIC has demonstrated considerable success and sustainability and is applicable to health systems globally.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748143","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":"Protocols versus practice: unravelling clinical checking variations in community pharmacies in England-a multi-method study.","authors":"Ali Elgebli, Jason Hall, Denham L Phipps","doi":"10.1007/s11096-024-01743-9","DOIUrl":"10.1007/s11096-024-01743-9","url":null,"abstract":"<p><strong>Background: </strong>Standardisation, a widely accepted concept for risk management, entails designing and implementing task-specific operating procedures. In community pharmacies, Standardised Operating Procedures (SOPs) are a mandatory requirement and are recognised as essential for upholding safety and quality.</p><p><strong>Aim: </strong>This study aimed to investigate community pharmacists' (CPs) compliance with SOPs when checking prescriptions, and the reasons for variations between standardised protocols and practice.</p><p><strong>Method: </strong>Eight sets of SOPs underwent hierarchical task analysis (HTA) to generate a normative description of clinical checking execution as per protocols. Subsequently, twelve CPs were engaged in a simulated clinical checking exercise, verbalising their thoughts while checking virtual prescriptions. Transcribed data underwent content analysis, aligned with a descriptive model to uncover engagement patterns, and disparities between SOPs and CPs' practices. Finally, a focus group discussion took place to contextualise the observed variations.</p><p><strong>Results: </strong>HTA aided in constructing a clinical checking model with six primary subtasks and 28 lower subtasks. CPs often omitted subtasks during checks, diverging from prescribed protocols. These deviations, observed in controlled environment, reveal an ingrained aspect within the professional culture of pharmacists, where there may be a tendency not to strictly adhere to protocols, despite variations in work conditions. Contributing factors to this culture include the exercise of professional judgment, reliance on others, and prioritisation of patient preferences.</p><p><strong>Conclusion: </strong>This study highlights ongoing deviations from SOPs during clinical prescription checks in community pharmacies, suggesting a cultural tendency. Future research should delve into risk management strategies for these deviations and address the delicate balance between flexibility and stringent compliance.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186336","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":"Medication Literacy Test for Older Adults: psychometric analysis and standardization of the new instrument.","authors":"Laís Lessa Neiva Pantuzza, Adriano Max Moreira Reis, Stephanie Ferreira Botelho, Ana Luiza Pereira da Rocha, Maria Auxiliadora Parreiras Martins, Mariana Martins Gonzaga do Nascimento, Liliana Batista Vieira, Ronara Camila de Souza Groia Veloso, Elizabeth do Nascimento","doi":"10.1007/s11096-024-01744-8","DOIUrl":"10.1007/s11096-024-01744-8","url":null,"abstract":"<p><strong>Background: </strong>Low medication literacy is prevalent among older adults and is associated with adverse drug events. The Medication Literacy Test for Older Adults (TELUMI) was developed and content validated in a previously published study.</p><p><strong>Aim: </strong>To evaluate the psychometric properties and provide norms for TELUMI scores.</p><p><strong>Method: </strong>This was a cross-sectional methodological study with older adults selected from the community and from two outpatient services. Descriptive item-analysis, exploratory factor analysis (EFA), item response theory (IRT), reliability, and validity analysis with schooling and health literacy were performed to test the psychometric properties of the TELUMI. The classification of the TELUMI scores was performed using percentile norms.</p><p><strong>Results: </strong>A total of 344 participants, with a mean age of 68.7 years (standard deviation = 6.7), were included; most were female (66.6%), black/brown (61.8%), had low schooling level (60.2%) and low income (55.2%). The EFA pointed to the one-dimensional structure of TELUMI. A three-parameter logistic model was adopted for IRT. All items had an adequate difficulty index. One item had discrimination < 0.65, and three items had an unacceptable guessing index (< 0.35) and were excluded. The 29-item version of TELUMI had excellent internal consistency (KR20 = 0.89). There was a positive and strong association between TELUMI scores and health literacy and education level. The scores were classified as inadequate medication literacy (≤ 10.0 points), medium medication literacy (11-20 points), and adequate medication literacy (≥ 21 points).</p><p><strong>Conclusion: </strong>The results suggest that the 29-item version of TELUMI is psychometrically adequate for measuring medication literacy in older adults.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186354","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 avoidance of pharmacist-led deprescribing using STOPPFrail for older adults in nursing homes.","authors":"Eoin Hurley, Stephen Byrne, Elaine Walsh, Tony Foley, Noel Woods, Kieran Dalton","doi":"10.1007/s11096-024-01749-3","DOIUrl":"10.1007/s11096-024-01749-3","url":null,"abstract":"<p><strong>Background: </strong>The Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy (STOPPFrail) criteria aim to reduce inappropriate/unnecessary medications in frail older adults, which should minimise adverse drug events and additional healthcare expenditure. Little is known about the economic outcomes of applying these criteria as an intervention.</p><p><strong>Aim: </strong>To evaluate cost avoidance of pharmacist-led application of STOPPFrail to frail older nursing home residents with limited life expectancy.</p><p><strong>Method: </strong>Pharmacist-identified STOPPFrail-defined potentially inappropriate medications that were deprescribed by patients' general practitioners were assigned a rating by a multidisciplinary panel, i.e. the probability of an adverse drug event occurring if the medication was not deprescribed. The intervention's net cost benefit and cost-benefit ratio were then determined by factoring in adverse drug event cost avoidance (calculated from probability of adverse drug event ratings), direct cost savings (deprescribed medication costs/reimbursement fees), and healthcare professionals' salaries.</p><p><strong>Results: </strong>Of the 176 potentially inappropriate medications deprescribed across 69 patients, 65 (36.9%) were rated as having a medium or high probability of an adverse drug event occurring if not deprescribed. With €27,162 for direct cost savings, €61,336 for adverse drug event cost avoidance, and €2,589 for healthcare professionals' salary costs, there was a net cost benefit of €85,909 overall. The cost-benefit ratio was 33.2 and remained positive in all scenarios in sensitivity analyses.</p><p><strong>Conclusion: </strong>Pharmacist-led application of STOPPFrail to frail older nursing home residents is associated with significant cost avoidance. Wider implementation of pharmacist interventions in frail older nursing home residents should be considered to reduce potentially inappropriate medications and patient harm, alongside substantial cost savings for healthcare systems.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11399282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534420","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}