International Journal of Clinical Pharmacy最新文献

{"title":"Model-informed precision dosing of vancomycin in clinical practice: an intervention development study.","authors":"Maria Swartling, Anna-Karin Hamberg, Mia Furebring, Thomas Tängdén, Elisabet I Nielsen","doi":"10.1007/s11096-024-01822-x","DOIUrl":"https://doi.org/10.1007/s11096-024-01822-x","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend dosing vancomycin based on the area under the concentration time curve (AUC) to maximise efficacy and minimise the risk of nephrotoxicity. The preferred approach to AUC-guided therapy is to apply model-informed precision dosing (MIPD). However, the adoption in clinical practice has been slow.</p><p><strong>Aim: </strong>We aimed to develop an intervention, including a standardised MIPD workflow and an implementation plan for vancomycin AUC-guided dosing, in a Swedish tertiary hospital.</p><p><strong>Method: </strong>The intervention was developed in a framework-guided process. The design phase included stakeholder feedback (nurses, pharmacists, physicians), local data collection and feasibility testing of intervention components with parallel consideration of implementation aspects. The hypothesised relationships between the different components, implementation strategies and the mechanism of action resulting in expected outcomes were represented by a logic model.</p><p><strong>Results: </strong>The final intervention consisted of a workflow for MIPD, with defined roles and responsibilities, as well as processes for data and information transfer. Details were provided in supportive documents; an instruction on therapeutic drug monitoring (TDM) sampling and documentation for nurses, and a detailed dosing software instruction for MIPD consultants and clinical pharmacists. Activities to facilitate implementation included the development of a local clinical routine for vancomycin dosing, staff training and recurring MIPD rounds.</p><p><strong>Conclusion: </strong>An intervention for MIPD, with an implementation plan for AUC-guided dosing of vancomycin, was developed for a tertiary hospital setting. The process can be used as guidance for other institutions with similar context wishing to initiate MIPD.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603825","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":"Desprescribing antihypertensives in older people in primary care: subgroup analysis of the MINOR randomised clinical trial.","authors":"Igor Matheus Silva, Pablo Maciel Moreira, Alessa Maria Santos, Priscila Ribeiro Castro, Erlan Canguçu Aguiar, Marcio Galvão Oliveira","doi":"10.1007/s11096-024-01805-y","DOIUrl":"https://doi.org/10.1007/s11096-024-01805-y","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy is often required for older adults with hypertension, and excessive treatment is associated with a high risk of adverse reactions, including hypotension.</p><p><strong>Aim: </strong>To evaluate the deprescribing of antihypertensive medications guided by pharmacists using home blood pressure monitoring in older adults with hypotension.</p><p><strong>Method: </strong>A subgroup of older adults with signs or symptoms of hypotension, included in the MINOR clinical trial, was analysed. In the MINOR procedures, each patient was provided with a device to conduct blood pressure measurement at home for 1 week, following which a report was generated and shared with pharmacists (intervention group) or family physicians (control group). In the intervention group, a pharmacist suggested optimising pharmacotherapy; meanwhile, in the control group, a family physician alone determined the necessary treatment adjustments. Differences in mean blood pressure, the patients with symptoms/signs of hypotension, and the antihypertensive medication deprescribing between both groups were analysed.</p><p><strong>Results: </strong>Seventy-two patients were evaluated (35, control group; 37, intervention group). The intervention group showed a significant reduction in medication prescriptions (- 28.6%; P < 0.001), especially beta-blockers (- 74.2%), loop diuretics (- 83.3%), and aldosterone antagonists (- 80%). The mean office blood pressure in the intervention group increased (14.1 mmHg systolic and 6.9 mmHg diastolic), remaining below the target range (140/90 mmHg). The intervention group showed a significantly reduction in hypotensive symptoms than the control group (64.9% vs. 20%) (P < 0.001).</p><p><strong>Conclusion: </strong>The data highlight an important role for pharmacists in optimizing hypertension management in older people. Deprescribing antihypertensives can limit symptomatic hypotension.</p><p><strong>Trial registration: </strong>Registered on ClinicalTrials.gov under number NCT04861727.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582784","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":"Cardiac adverse events associated with statins in myocardial infarction patients: a pharmacovigilance analysis of the FDA Adverse Event Reporting System.","authors":"Chuanhuan Deng, Xiaofang Lin, Dan Ni, Ludong Yuan, Jing Li, Yuxuan Liu, Pengfei Liang, Bimei Jiang","doi":"10.1007/s11096-024-01804-z","DOIUrl":"https://doi.org/10.1007/s11096-024-01804-z","url":null,"abstract":"<p><strong>Background: </strong>Despite the advent of new pharmacotherapies, statins remain a cornerstone in the secondary prevention of myocardial infarction (MI). However, the cardiac adverse events (AEs) linked to statins are not well-documented.</p><p><strong>Aim: </strong>This pharmacovigilance study used data from the FDA Adverse Event Reporting System (FAERS) to investigate the association between statin use and cardiac AEs in MI patients.</p><p><strong>Method: </strong>Reports from the FAERS database (2004-2023) identifying statins as the primary suspect in MI patients were analyzed. The study evaluated seven types of statins: atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin. Disproportionality analysis using four major indices, Reporting Odds Ratio (ROR), Proportional Reporting Ratio (PRR), Bayesian Confidence Propagation Neural Network (BCPNN), and Multi-Item Gamma-Poisson Shrinker (MGPS), was conducted to detect signals of statin-related cardiac AEs.</p><p><strong>Results: </strong>Of the 20,346,289 reports reviewed, 150 identified statins as the primary suspect drug in MI patients. The most common cardiac AEs were recurrent MI (50 reports), acute MI (14 reports), followed by tachycardia (10), angina pectoris (8), coronary artery occlusion (6), cardiac failure (6), and arrhythmia (6). The analysis revealed no significant signals of statin-induced cardiac AEs.</p><p><strong>Conclusion: </strong>The findings confirm that statin use in MI patients does not significantly increase the risk of cardiac adverse effects, supporting their safety profile in this context.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582774","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":"Short-term outcome of personalized theory-based pharmaceutical care service on the medication administration problems of family caregivers: a pre-post intervention study.","authors":"Zehra Betul Kingir Baycar, Mesut Sancar, Pinar Ay, Refik Demirtunc, Cagatay Nuhoglu, Cemile H Misirli, Betul Okuyan","doi":"10.1007/s11096-024-01823-w","DOIUrl":"https://doi.org/10.1007/s11096-024-01823-w","url":null,"abstract":"<p><strong>Background: </strong>Family caregivers face many problems during administration of medications. Pharmacists are reliable and accessible healthcare providers in addressing family caregivers' medication related inquiries in primary care.</p><p><strong>Aim: </strong>This study aimed to evaluate the short-term outcome of a personalized theory-based pharmaceutical care service on the medication administration problems of family caregivers.</p><p><strong>Method: </strong>This pre-post intervention study was carried out among family caregivers at a community pharmacy in Istanbul, Türkiye from May through December 2022. The service was developed by mapping problems using the Theoretical Domains Framework and selecting related behavioural change techniques. The primary outcome was the change in the scores on the Turkish version of the Family Caregiver Medication Administration Hassles Scale (FCMAHS-TR) from baseline to the one-month follow-up assessment. Secondary outcomes were their ability to read health related materials, care burden, and satisfaction.</p><p><strong>Results: </strong>Among family caregivers (n = 100), total score of FCMAHS-TR was significantly reduced after receiving theory based pharmaceutical care service (median [IQR] 23.0 [17.0-27.0] vs 17.0 [10.3-20.0]; p < 0.001). The proportion of family caregivers with high ability to read health related materials was significantly increased (34.0% vs 48.0%; p < 0.05) with non-significant change in the proportion of family caregiver with high burden (97.0% vs 94.0%; p > 0.05). Younger family caregivers had significantly higher scores on the Turkish version of Patient-Oriented Pharmacy Services Questionnaire (PSPSQ) 2.0 when compared with the older ones (≥ 65 y) (p < 0.05).</p><p><strong>Conclusion: </strong>Family caregivers' medication administration problems were reduced after receiving the theory based pharmaceutical care service. Long term impact and national implementation of this service should be assessed in the further studies.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582790","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 suitability of a ward-based clinical pharmacy activity collection tool for ambulatory care practice: a mixed-methods study.","authors":"Izwan Ishak, Caroline Cheng, Lindsay Greenland, Ian Bates","doi":"10.1007/s11096-024-01820-z","DOIUrl":"https://doi.org/10.1007/s11096-024-01820-z","url":null,"abstract":"<p><strong>Background: </strong>At a London-based hospital, a validated ward-based clinical pharmacy activity collection tool has been used to monitor activities of clinical pharmacy teams across all settings, including ambulatory care services. No data confirm its representativeness for the full range of ambulatory clinical pharmacy services, and pharmacists share this concern.</p><p><strong>Aim: </strong>This study aimed to identify the range of clinical pharmacy activities in ambulatory care, assess the suitability of the existing ward-based tool for capturing these activities, and recommend modifications.</p><p><strong>Method: </strong>Non-participant direct observations were conducted to record pharmacists' clinical activities in ambulatory clinics and multidisciplinary meetings. These observations were compared to the existing ward-based tool to identify discrepancies. Semi-structured interviews with eight ambulatory pharmacists were transcribed verbatim and thematically analysed inductively to explore the tool's representativeness of their routine clinical activities.</p><p><strong>Results: </strong>Twenty-nine clinical pharmacy activities were observed in ambulatory services. Only fifteen were captured by the existing tool, with therapy monitoring and recommending therapeutic changes not accurately captured. Pharmacists agreed that the tool was not fully representative and included irrelevant activities. Four common uncaptured activities were multidisciplinary meeting-specific activities, arranging laboratory tests, monitoring patient outcomes, and liaising with community healthcare professionals. This study identified 33 candidate ambulatory clinical pharmacy activities.</p><p><strong>Conclusion: </strong>The existing ward-based tool does not fully capture the full range of ambulatory care clinical pharmacy activities, highlighting the need for an improved tool. Pharmacists recommended including the uncaptured activities. The candidate activities provide a foundation for standardised measurement of relevant ambulatory care activities to enable effective workforce deployment and improve patient outcomes.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568020","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 study of recent patterns of psychotropic medication use in children and adolescents in Ireland.","authors":"Rebecca Parkin, Kathleen Bennett, Fiona Mc Nicholas, John C Hayden","doi":"10.1007/s11096-024-01817-8","DOIUrl":"https://doi.org/10.1007/s11096-024-01817-8","url":null,"abstract":"<p><strong>Background: </strong>There has been a global rise in prescribing of psychotropic medications. Variations in patterns of use, according to age, gender and drug class type, have also been reported.</p><p><strong>Aim: </strong>This study aimed to analyse patterns of psychotropic medication use in Ireland according to age group, gender and drug class type, to determine if variations exist, and identify specific nuances to be addressed in future research.</p><p><strong>Method: </strong>A retrospective, repeated, cross-sectional study of the Irish pharmacy claims database (community setting dispensing data) was conducted. Yearly prevalence of children/adolescents receiving dispensed psychotropic medications was analysed from January 2017 to December 2021, across years, age groups (5-15, 5-11 and 12-15 years), gender and drug class type. All available data were used. Yearly prevalence was the mean number of patients receiving medication per month per 1000 eligible population during a given year. Negative binomial regression was used to examine association of year, age group and gender on prevalence.</p><p><strong>Results: </strong>In the 12-15 years group, prevalence for all selected psychotropic medications in 2021 in males was almost twice that in females (19.92/1000 vs 10.62/1000). In the 5-11 years group, prevalence was three times higher in males than females (7.56/1000 vs 2.49/1000). Overall, there was a higher rate of increase in females and higher usage in older children.</p><p><strong>Conclusion: </strong>This study found variations in psychotropic medication use in children/adolescents, depending on age, gender and drug class type. Further research is needed to determine whether variations have resulted in treatment disparities for certain cohorts.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545314","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":"Predicting survival benefits of immune checkpoint inhibitor therapy in lung cancer patients: a machine learning approach using real-world data.","authors":"Lingyun Pan, Li Mu, Haike Lei, Siwei Miao, Xiaogang Hu, Zongwei Tang, Wanyi Chen, Xiaoxiao Wang","doi":"10.1007/s11096-024-01818-7","DOIUrl":"https://doi.org/10.1007/s11096-024-01818-7","url":null,"abstract":"<p><strong>Background: </strong>Due to the heterogeneity in the effectiveness of immunotherapy for lung cancer, identifying predictors is crucial.</p><p><strong>Aim: </strong>This study aimed to develop a machine learning model to identify predictors of overall survival in lung cancer patients treated with immune checkpoint inhibitors (ICIs).</p><p><strong>Method: </strong>A retrospective analysis was performed on data from 1314 lung cancer patients at the Chongqing University Cancer Hospital from September 2018 to September 2022. We used the random survival forest (RSF) model to identify survival-influencing factors, using backward elimination for variable selection. A Cox proportional hazards (CPH) model was constructed using the most significant predictors. We assessed model performance and generalizability using time-dependent receiver operating characteristics (ROC) and predictive error curves.</p><p><strong>Results: </strong>The RSF model demonstrated better predictive accuracy than the CPH (IBS 0.17 vs. 0.17; C-index 0.91 vs. 0.68), with better discrimination and prediction performance. The influential variables identified included D-dimer, Karnofsky performance status, albumin, surgery, TNM stage, platelet count, and age. The RSF model, which incorporated these variables, achieved area under the curve (AUC) scores of 0.95, 0.94, and 0.98 for 1-, 3-, and 5-year survival predictions, respectively, in the training set. The validation set showed AUCs of 0.94, 0.90, and 0.95, respectively, exceeding the performance of the CPH model.</p><p><strong>Conclusion: </strong>The study successfully developed a machine learning model that accurately predicted the survival benefits of ICI therapy in lung cancer patients, supporting clinical decision-making in lung cancer treatment.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545315","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":"Credentialed pharmacist-led home medicines reviews targeting treatable traits and their impact on health outcomes in people with chronic obstructive pulmonary disease: a pre- and post-intervention study.","authors":"Muhammad Rehan Sarwar, Vanessa Marie McDonald, Michael J Abramson, Sally Wilson, Anne E Holland, Billie Bonevski, Ajay Mahal, Eldho Paul, Brian Meier, Johnson George","doi":"10.1007/s11096-024-01819-6","DOIUrl":"10.1007/s11096-024-01819-6","url":null,"abstract":"<p><strong>Background: </strong>Patients with chronic obstructive pulmonary disease (COPD) should engage in self-management strategies targeting behavioural traits and lifestyle risk-factors for optimal outcomes.</p><p><strong>Aim: </strong>To evaluate the impact of credentialed pharmacist-led home medicines review (HMR) targeting treatable traits (TTs) on health outcomes in COPD in primary care.</p><p><strong>Method: </strong>A pre- and post-intervention study was nested within a cluster-randomised controlled trial. A total of 81 participants with COPD from 21 Australian general practices received an HMR with a credentialed pharmacist targeting TTs. Changes in health outcomes at 6 and 12 months from baseline were assessed.</p><p><strong>Results: </strong>Ten TTs were assessed and targeted during the HMR. At baseline, no-one had a written action plan for managing exacerbations, and medication adherence was sub-optimal in 85% of patients. Additionally, 53% of participants demonstrated inadequate inhaler device technique, while 52% were current smokers. At 6-months follow-up, significant improvements were observed in health-related quality of life (St. George's Respiratory Questionnaire score = 34.6 versus 39.1 at baseline, p = 0.006), health status (COPD Assessment Test score = 12 versus 16, p = 0.002), anxiety (Hospital Anxiety and Depression Scale (HADS)-Anxiety score = 2.0 versus 5.0, p < 0.001), depression (HADS-Depression score = 1.0 versus 5.0, p < 0.001), self-reported smoking (47% versus 51.9%, p = 0.031) and treatment adherence (Tool for Adherence Behaviour Screening score = 12.5 versus 10.0, p = 0.002). At 12-months: health status, anxiety, depression, smoking abstinence and adherence to treatment, continued to show statistically significant improvements compared to baseline measurements.</p><p><strong>Conclusion: </strong>HMRs targeting TTs improved health outcomes in people with COPD. Credentialed pharmacists in primary care can work alongside general practitioners to optimise COPD management.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521820","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":"Adverse drug reactions in older people following hospitalisation: a qualitative exploration of general practitioners' perspectives.","authors":"Justin M Cousins, Bonnie Bereznicki, Nibu Parameswaran Nair, Elizabeth Webber, Colin Curtain","doi":"10.1007/s11096-024-01806-x","DOIUrl":"https://doi.org/10.1007/s11096-024-01806-x","url":null,"abstract":"<p><strong>Background: </strong>Older people have greater comorbidity and medication burden. Adverse drug reactions occur in up to 30% of older people within one month of hospital discharge. General practitioners are key stakeholders in transitions of care from hospital to the community.</p><p><strong>Aim: </strong>The study aimed to explore general practitioner perspectives of adverse drug reactions in older people after hospitalisation, investigating the medication-related issues encountered and possible approaches to reduce the risk.</p><p><strong>Method: </strong>An invitation to participate in the study was sent to general practitioners in Southern Tasmania, Australia. A semi-structured interview occurred in person at their practice or online. The questions covered experiences with managing medication in older people after hospital discharge, challenges and risks involving adverse drug reactions and suggestions to prevent adverse drug reactions. The interviews were transcribed and analysed through thematic analysis.</p><p><strong>Results: </strong>Twelve general practitioners were interviewed, revealing four themes describing challenges, including (i) complex patients and acceptance of risk, (ii) patient confusion and decline in hospital, (iii) time taken to manage older patients and (iv) communication challenges. Three themes describing recommendations were identified, including (i) clear communication on discharge, (ii) patient involvement and (iii) roles for pharmacists.</p><p><strong>Conclusion: </strong>Prevention of adverse drug reactions after hospital discharge may require clear and timely communication to general practitioners, patients and families to be educated and empowered to help manage their own health and risk, and pharmacists to support both patients and general practitioners in managing the risks.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464594","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":"Pharmacists' empathy after a postgraduate course in narrative medicine: an observational study.","authors":"Trine Graabæk, Anders Juhl Rasmussen, Anne-Marie Mai, Charlotte Rossing, Merethe Kirstine Kousgaard Andersen, Ulla Hedegaard","doi":"10.1007/s11096-024-01815-w","DOIUrl":"https://doi.org/10.1007/s11096-024-01815-w","url":null,"abstract":"<p><strong>Background: </strong>Narrative medicine is a recent cross-disciplinary approach which through aesthetic activities such as reading fiction and creative writing aims to encourage empathy, reflection, professionalism, and trustworthiness in the encounter between patients and health care professionals.</p><p><strong>Aim: </strong>The aim of this study was to evaluate changes in level of empathy after a postgraduate course in narrative medicine among pharmacists conducting medication counselling.</p><p><strong>Method: </strong>During 2020-2021, three courses in narrative medicine among pharmacists with the aim to enhance empathy were held in Odense, Denmark. The primary outcome was the pharmacists' self-reported level of empathy before and after the course measured with Jefferson Scale of Empathy (JSE), which is a validated 20 item scale with higher scores indicating higher levels of cognitive empathy.</p><p><strong>Results: </strong>A total of 33 community and hospital pharmacists participated in the three courses. The pharmacists' median age was 41 years, 91% were female, 76% were working in community pharmacy, and 47% were, according to themselves, rare readers. The pharmacists completed the JSE scale before and after the course. A statistically significant increase was found in mean total JSE score from 109.9 ± 17.1 before the course to 115.7 ± 14.6 after the course (p = 0.0362).</p><p><strong>Conclusion: </strong>Following the course in narrative medicine the level of empathy for the pharmacists according to JSE was enhanced. We recommend that future studies also use patient-reported outcomes to explore if the self-experienced enhanced empathy among pharmacists affects the patients' experience of their encounters.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464596","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}