International Journal of Clinical Pharmacy最新文献

{"title":"Exploring the impact of baseline platelet count on linezolid-induced thrombocytopenia: a retrospective single-center observation study.","authors":"Yuki Inoue, Hitoshi Kashiwagi, Yuki Sato, Shunsuke Nashimoto, Mitsuru Sugawara, Yoh Takekuma","doi":"10.1007/s11096-024-01810-1","DOIUrl":"10.1007/s11096-024-01810-1","url":null,"abstract":"<p><strong>Background: </strong>Patients treated with linezolid (LZD) frequently develop thrombocytopenia, and previous studies have identified the risk factors for this condition. However, the relationship between the development of LZD-induced thrombocytopenia and baseline platelet count has varied according to different reports.</p><p><strong>Aim: </strong>To explore the relationship between platelet count and the development of LZD-induced thrombocytopenia.</p><p><strong>Method: </strong>Patients who underwent LZD at Hokkaido University Hospital in Japan from September 2008 to March 2023 were included. We collected data on patient characteristics and platelet counts at baseline and during LZD therapy from the electronic medical records. Thrombocytopenia was defined as a decrease in platelet count by 30% or more from baseline, or a platelet level < 100,000/µL.</p><p><strong>Results: </strong>Two hundred and ninety-five patients who received LZD were included in this study, of whom 34.9% developed thrombocytopenia. In the early days of LZD treatment, the thrombocytopenia group showed a nearly 5% decrease in platelet count, while the non-thrombocytopenia group exhibited an increase of over 5%. Additionally, focusing on early onset thrombocytopenia (within 5 days), a baseline platelet count of < 150,000/µL was identified as a risk factor for early thrombocytopenia. Conversely, it was also observed that 24.7% of patients with a baseline platelet count ≥ 150,000/µL still developed early thrombocytopenia.</p><p><strong>Conclusion: </strong>Our findings suggest that while a baseline platelet count of < 150,000/µL is a risk factor for the early onset of thrombocytopenia, vigilant monitoring of platelet counts by clinical pharmacists in the early stages of LZD treatment is essential, regardless of baseline platelet levels.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"90-98"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371771","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":"Translation and validation of the CLEO tool in Vietnamese to assess the significance of pharmacist interventions.","authors":"An Thi-Truong Nguyen, Khanh Hoang-Phuong Nguyen, Hai Ba Le, Hong Tham Pham, Hai Thanh Nguyen, Nga Thi-Bich Nguyen, Phuong Thi-Xuan Dong, Trang Nguyen-Doan Dang, Van Thi-Thuy Pham, Dung Tuan Nguyen, Allenet Benoit, Pierrick Bedouch, Ha Thi Vo","doi":"10.1007/s11096-024-01813-y","DOIUrl":"10.1007/s11096-024-01813-y","url":null,"abstract":"<p><strong>Background: </strong>There is currently no validated tool available for assessing the potential significance of pharmacist interventions in Vietnam.</p><p><strong>Aim: </strong>This study aimed to translate the CLEO tool from French into Vietnamese, validate the Vietnamese version, and demonstrate its feasibility in daily practice.</p><p><strong>Method: </strong>The CLEO tool was translated into Vietnamese (CLEO_VN) using a 5-step process by bilingual experts. A total of 100 scenarios were compiled from clinical cases from nine hospitals evaluated by seven clinical pharmacists to determine inter-rater reliability and 30 out of 100 scenarios were re-evaluated one month later to determine test-retest reliability. Reliability was quantified using the intra-class correlation coefficient (ICC). A 20-item questionnaire on a 7-point Likert scale assessed the tool's appropriateness, acceptability, precision, and feasibility.</p><p><strong>Results: </strong>Inter-rater reliability was good for clinical dimension (ICC_A,1 = 0.71), excellent for economic dimension (ICC_A,1 = 0.86), and fair for organizational/operational dimension (ICC_A,1 = 0.56). Test-retest reliability scores were excellent for clinical (I̅C̅C̅_A,1 = 0.79), excellent for economic (I̅C̅C̅_A,1 = 0.84), and fair for organizational/operational (I̅C̅C̅_A,1 = 0.56). The tool was rated as appropriate (mean = 5.86; SD = 1.03), acceptable (mean = 5.19; SD = 1.12), precise (mean = 5.71; SD = 1.17), and feasible (mean = 5.05; SD = 1.24). The maximum time required to evaluate an intervention was three minutes.</p><p><strong>Conclusion: </strong>The CLEO_VN tool was successfully translated and validated for reliability, appropriateness, acceptability, precision, and feasibility. It will be suitable to evaluate the value of clinical pharmacy interventions.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"119-127"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371773","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 of tislelizumab versus sorafenib as first-line treatment for unresectable hepatocellular carcinoma: a comparative analysis in China, the United States and Europe.","authors":"Yuyang Sun, Kai Xu, Hongting Yao, Jingxuan Wei, Baolong Ding, Xiaodan Qian, Dan Su, Jinhong Gong, Jingjing Shang, Lingli Zhang, Xin Li","doi":"10.1007/s11096-024-01824-9","DOIUrl":"10.1007/s11096-024-01824-9","url":null,"abstract":"<p><strong>Background: </strong>Tislelizumab has emerged as a promising therapy for unresectable hepatocellular carcinoma (uHCC), although its economic viability across different healthcare systems remains uncertain.</p><p><strong>Aim: </strong>This study compared the cost-effectiveness of tislelizumab versus sorafenib as a first-line treatment for uHCC from the perspectives of the healthcare systems of China, the United States and Europe.</p><p><strong>Method: </strong>A partitioned survival model was developed using data from the RATIONALE-301 trial. Costs and utilities were sourced from local healthcare charges, publicly available databases, and published literature. Total costs, quality-adjusted life years, and incremental cost-effectiveness ratios (ICERs) were assessed. Price simulations were conducted to identify cost-effective pricing within established willingness-to-pay (WTP) thresholds. Sensitivity and scenario analyses were performed to test the robustness of the model.</p><p><strong>Results: </strong>Tislelizumab (priced at $1587.45/100 mg) was cost-effective in the US at a WTP threshold of $150,000, with an ICER of $108,812.52. In Europe, tislelizumab was cost-effective at a WTP threshold of $100,000, with an ICER of $94,880.40. For $186.18/100 mg in China, tislelizumab was cost-effective with an ICER of $14,206.80. Price simulation analyses showed that in the US, tislelizumab was favored when priced below $1438.30/100 mg at a $100,000 WTP threshold and below $2284.56/100 mg at a $150,000 WTP threshold. In Europe, it was favored below $1661.82/100 mg and $2501.93/100 mg for the same thresholds. In China, tislelizumab was cost-effective at a WTP threshold of $38,184 when priced below $582.11/100 mg.</p><p><strong>Conclusion: </strong>Tislelizumab presents a cost-effective first-line treatment option for uHCC, potentially supporting its broader adoption in health policy. Future research should focus on long-term efficacy and real-world data to further validate these findings.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"196-209"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709071","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":"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":"166-177"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","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":"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":"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":"46-52"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","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":"Medicine communication from hospital to residential aged care facilities: a cross-sectional survey of aged care facility staff.","authors":"Sarah Browning, Rachael A Raleigh, H Laetitia Hattingh","doi":"10.1007/s11096-024-01801-2","DOIUrl":"10.1007/s11096-024-01801-2","url":null,"abstract":"<p><strong>Background: </strong>Continuity of medicines management can be compromised when older people are transferred between hospital and residential aged care facilities.</p><p><strong>Aim: </strong>This study explored medicines management practices at facilities during patients' transfer of care from hospital, and staff experiences with medicines information handover from hospitals.</p><p><strong>Method: </strong>An electronic cross-sectional questionnaire sent to all residential aged care facilities within a metropolitan region in Australia, in February 2022. The questionnaire comprised 23 questions covering facilities' profiles, medicines management practices, and medicines management at transfer of care from 2 public hospitals.</p><p><strong>Results: </strong>Of 53 listed facilities, 31 [58.5%] responded. Facilities varied in size ranging between < 50 and up to 200 beds. Twenty-seven [87.1%] facilities offered more than one level of care. Of those 27 facilities, 26 [96.3%] offered dementia care, and 23 [85.2%] offered palliative care. Six (19.4%) solely used hardcopy medication charts. Handover from hospitals to manage patients' medicines at transfer was inconsistent with only 15 [48.4%] reporting consistently receiving appropriate documentation.</p><p><strong>Conclusion: </strong>Residential aged care facilities varied in size and level of care. Diverse processes exist for medicines management. There is inconsistency in information received when residents transfer from hospital to facilities, potentially compromising patient safety.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"218-223"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346079","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 effect of clinical pharmacist-led pharmaceutical care services on medication adherence, clinical outcomes and quality of life in patients with stroke: a randomised controlled trial.","authors":"Kayhan Nuri Cengiz, Ipek Midi, Mesut Sancar","doi":"10.1007/s11096-024-01811-0","DOIUrl":"10.1007/s11096-024-01811-0","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a major cause of morbidity and mortality worldwide. Pharmaceutical care services play a significant role in managing the risk factors associated with stroke.</p><p><strong>Aim: </strong>This study aimed to examine the effects of a one-year pharmaceutical care programme on medication adherence, quality of life and clinical outcomes of patients with stroke.</p><p><strong>Method: </strong>This study was conducted as a randomised controlled trial at the neurology clinic of a university hospital in Türkiye. Patients were randomly assigned to either an intervention group or usual care group (IG vs UCG). A simple randomization method using computer-based random numbers was used to assign participants in a 1:1 ratio. The IG received pharmaceutical care including medication reconciliation, medication review and patient education in addition to routine health services. The medication adherence, quality of life and clinical parameters of the patients were evaluated at the beginning and the end of the 12th month.</p><p><strong>Results: </strong>This study included 193 patients (89 and 104 patients in the IG and the UCG, respectively; mean age: 60.1 years), of whom 67.4% were male. At the one-year follow-up evaluation, the percentage of adherent patients (86.5% vs 47.1%, p < 0.001) and the total Stroke-Specific Quality of Life score (184.9 vs 166.0, p < 0.001) were higher in the IG than in the UCG. The stroke recurrence rate at the one-year follow-up (2.2% vs 10.6%, p = 0.044) was lower in the IG than in the UCG.</p><p><strong>Conclusion: </strong>Pharmaceutical care services improved the medication adherence, quality of life and clinical outcomes of patients with stroke.</p><p><strong>The clinical trial registration: </strong>ClinicalTrials.gov Identifier: NCT06129318; Study Registration Date: 13 November 2023.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":"99-106"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142464597","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":"157-165"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742330/pdf/","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":"OA","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":"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":"187-195"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","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":"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":"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":"178-186"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11741990/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}