Journal of Pharmaceutical Policy and Practice最新文献

{"title":"Balancing acts: exploring work family conflict, psychological flexibility and job performance among Chinese pharmacists.","authors":"Rabia Mahmood, Umbreen Khizar, Maham Imtiaz, Humara Adnan, Tanzila Rehman, Engidaw Abriham Ebabu, Abida Naz, Ali Ahmed Al-Halani","doi":"10.1080/20523211.2025.2450597","DOIUrl":"10.1080/20523211.2025.2450597","url":null,"abstract":"<p><strong>Background: </strong>Pharmacists are key to China's healthcare system, balancing traditional Chinese medicine (TCM) and Western pharmaceuticals. The expanding pharmaceutical industry has increased their workload, contributing to work family conflict, which affects job satisfaction and performance and can lead to burnout. Psychological flexibility may alleviate the negative effects of work family conflict on job performance.</p><p><strong>Method: </strong>This study used a cross-sectional quantitative approach to examine the relationships between work family conflict, psychological flexibility and job performance among 1,359 pharmacists in Shenzhen, China. Online questionnaires assessed work family conflict using the Work and Family Conflict Scale, psychological flexibility using the Acceptance and Action Questionnaire-2 and job performance using the Individual Work Performance Questionnaire.</p><p><strong>Results: </strong>Correlation analyses revealed significant positive associations between work family conflict and psychological flexibility and between psychological flexibility and job performance. Regression analyses showed that work family conflict negatively predicted job performance, while psychological flexibility positively predicted it. Pharmacists in metropolitan areas reported higher psychological flexibility than those in rural areas, but there were no significant differences in job performance. Male pharmacists had higher psychological flexibility and job performance scores than females although the differences were not statistically significant.</p><p><strong>Conclusion: </strong>This study underlines the importance of psychological flexibility in enhancing job performance amid work family conflict. The study suggests implementing stress reduction programmes, mindfulness training and workplace policies such as flexible working hours and childcare services to reduce work family conflict and foster psychological flexibility. Addressing these issues can significantly improve the well-being and job performance of pharmacists in China.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2450597"},"PeriodicalIF":3.3,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11852238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness analysis of a first-line treatment with cadonilimab plus platinum-based chemotherapy with or without bevacizumab for persistent, recurrent, or metastatic cervical cancer in China: COMPASSION-16 trial.","authors":"Yiling Ding, Chunping Wang, Yamin Shu, Jinglin Wang, Qilin Zhang","doi":"10.1080/20523211.2025.2464781","DOIUrl":"10.1080/20523211.2025.2464781","url":null,"abstract":"<p><strong>Background: </strong>The addition of cadonilimab to first-line platinum-based chemotherapy with or without bevacizumab significantly improved progression-free survival (PFS) and overall survival (OS) in patients with persistent, recurrent, or metastatic cervical cancer. However, the economic value of using this novel therapy for this indication is currently unknown. The aim of this study is to evaluate the cost-effectiveness of the addition of cadonilimab to first-line standard chemotherapy for patients with persistent, recurrent, or metastatic cervical cancer from the perspective of Chinese healthcare system.</p><p><strong>Methods: </strong>A partitioned survival model was constructed to compare the cost-effectiveness of cadonilimab versus placebo in patients enrolled in the COMPASSION-16 trial. Cost, life-year, quality-adjusted life-year (QALY), incremental cost-effectiveness ratio (ICER), incremental net health benefit (INHB), and incremental net monetary benefit (INMB) were calculated for 2 treatment strategies. Sensitivity, scenario, and subgroup analyses, and value of information analysis (EVPI) were performed.</p><p><strong>Results: </strong>Cadonilimab provided an additional 1.18 QALYs and $89,528.64 compared with placebo, which resulted in an ICER of $75,944.56/QALY. At the willingness-to-pay threshold of $38,042.49/QALY, INHB was estimated to be -1.17 QALYs, while INMB amounted to -$44,681.55 and EVPI was calculated as $71.40/person. Sensitivity analyses revealed that the model was most sensitive to hazard ratio (HR) for OS and PFS, and the probability of cadonilimab being cost-effective was 0.70%. To achieve cost-effectiveness, the price of cadonilimab must be reduced by approximately 50%. Subgroup analysis found that all subgroups unfavored cadonilimab by varying the HR for OS and PFS. Scenario analyses showed using life-year as effectiveness, altering time horizon and selection of survival analysis did not reverse results.</p><p><strong>Conclusions: </strong>Although the use of cadonilimab resulted in clinical benefit, it was not deemed cost-effective as a first-line therapy for persistent, recurrent, or metastatic cervical cancer in China. Lowering the price of cadonilimab may enhance its cost-effectiveness.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2464781"},"PeriodicalIF":3.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding access to NCD services via community retail pharmacies in LMICs: a systematic review of the literature.","authors":"Arianna Gentilini, Lombe Kasonde, Zaheer-Ud-Din Babar","doi":"10.1080/20523211.2025.2462450","DOIUrl":"10.1080/20523211.2025.2462450","url":null,"abstract":"<p><strong>Background: </strong>Non-communicable diseases (NCDs) pose a significant global health challenge. In LMICs, NCDs are an incresing driver of premature deaths and have substantial economic impacts, particularly on working-age adults. The World Health Organization has identified four priority NCDs - cardiovascular diseases, diabetes, asthma/chronic obstructive pulmonary disease, and cancer - which are included in its Package of Essential Non-Communicable Disease Interventions for low-resource primary care settings. However, a shortage of healthcare professionals further compounds the problem. Pharmacists, who could play a pivotal role in NCD care, remain underutilised.</p><p><strong>Methods: </strong>We conducted a systematic literature review to identify studies on the role of community pharmacies and pharmacists in delivering NCD services in low- and middle-income settings and assessed their risk of bias. Searches were performed in PubMed, MEDLINE via Ovid, and CINAHL from 1990 to 2022, including English, French, or Spanish publications.</p><p><strong>Results: </strong>Out of 1,284 articles, 23 met inclusion criteria, predominantly focusing on diabetes (65%), followed by cardiovascular diseases (22%), cancer (9%), and asthma (4%). Most studies were conducted in Asia (52%), followed by South America (22%) and Africa (13%). Significant improvements were observed in glycaemic control and medication adherence for diabetes, and in blood pressure management and adherence for hypertension. Positive outcomes were also seen in health behaviours for breast cancer, asthma, and cardiovascular disease risk management. Interventions were cost-effective for managing diabetes and hypertension in elderly patients. However, accessibility challenges were noted in vaccination programmes, and concerns about bias were identified, particularly in observational studies.</p><p><strong>Conclusions: </strong>Expanding NCD services through community pharmacies in low and middle-income countries can significantly improve health outcomes. Pharmacists can enhance education, screening, and management for NCDs, leading to better disease control and patient satisfaction. Addressing resource constraints, legal barriers, and disease focus disparities is essential. Adequate training, financial incentives, and collaboration among stakeholders are crucial for integrating pharmacists into NCD care frameworks.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2462450"},"PeriodicalIF":3.3,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home blood pressure during night-time sleep - a feasible treatment target for patients with hypertension: a proof-of-concept randomised controlled trial.","authors":"Eric Kam-Pui Lee, Shuqi Wang, Benjamin Hon-Kei Yip, Esther Yee-Tak Yu, Shuk-Yun Leung, Jinghao Han, Yue-Kwan Choi, Kam-Fai Chow, Wai-Ho Chung, Byran P Yan, Anastasia S Mihailidou, Richard J McManus, Samuel Yeung-Shan Wong","doi":"10.1080/20523211.2025.2463435","DOIUrl":"10.1080/20523211.2025.2463435","url":null,"abstract":"<p><strong>Background: </strong>This trial assessed the feasibility of titrating evening dosing of anti-hypertensive medications based on nighttime home blood pressure measurement (HBPM) readings in primary care for hypertensive (HT) patients.</p><p><strong>Methods: </strong>78 patients with nocturnal HT and stage I daytime HT were randomly assigned in a 1:1 ratio to either nighttime HBPM measurements (intervention group) or daytime HBPM measurements (control group). Nighttime blood pressure (BP) was measured 3x per night for at least two nights over 1 week using an automatic and validated HBPM device. The intervention group and control group aimed to achieve systolic BP <120 mmHg on nocturnal HBPM and systolic BP <135 mmHg on daytime HBPM respectively. All patients were seen every four weeks and followed the same drug titration algorithm.</p><p><strong>Results: </strong>The trial achieved a recruitment rate of 6.5 persons per month and a retention rate of 96.1%. In the intervention group, patients provided ≥6 (considered adequate) and ≥9 nighttime HBPM readings for 77.5% and 63.8% of their follow-ups, respectively. At 6-month, both groups had similar nighttime, 24-hour, and daytime BP on ambulatory BP monitoring, as well as similar numbers of non-dippers and healthcare utilisation. Most patients reported that they learned more from their HBPM nighttime readings and found the intervention well-tolerated.</p><p><strong>Conclusion: </strong>Adjusting evening dosage of anti-HT medications based on nighttime HBPM is a potential and feasible treatment approach for patients with nocturnal HT in primary care. This approach is well-accepted by patients and results in at least non-inferior BP control. Although titrating medications according to nighttime HBPM readings may improve nighttime BP, the small sample size limited statistical significance and the single-centre design restricted generalizability. Additionally, a few patients exhibited fair adherence to nighttime HBPM. Further randomised controlled trials are required to confirm that targeting nocturnal BP should be the primary treatment goal for HT.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2463435"},"PeriodicalIF":3.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834773/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of outpatient dispensing services in Thailand's hospitals: what has been done and where are we heading?","authors":"Trisak Chetsurakarn, Nattapong Khansai, Alisara Sangviroon Sujarit, Osot Nerapusee, Sanguan Lerkiatbundit, Puree Anantachoti","doi":"10.1080/20523211.2025.2463438","DOIUrl":"10.1080/20523211.2025.2463438","url":null,"abstract":"<p><strong>Background: </strong>Outpatient pharmacy dispensing services in Thailand require patients to fill prescriptions at hospital pharmacies for reimbursement.</p><p><strong>Objective: </strong>This study explored hospital outpatient dispensing services in Thailand before, during, and after the COVID-19 pandemic. Characteristics of most frequently used alternative services were described. The study further explored the challenges and enablers associated with continuation of alternative hospital outpatient dispensing services.</p><p><strong>Methods: </strong>This study utilised a telephone survey targeting management-level hospital pharmacists from various hospital types and sizes. A stratified random sample of 305 hospitals was drawn from 1,471 hospitals. Data was collected using a validated semi-structured interview questionnaire between June-October 2022. Descriptive statistics and content analysis were used for data analysis.</p><p><strong>Results: </strong>Data from 189 public hospitals were analysed. Before COVID-19, 38.6% of hospitals implemented at least one type of alternative outpatient dispensing service to reduce overcrowding and waiting times. During the pandemic, 97.4% of hospitals implemented alternative services with drug delivery service being most popular among large hospitals. Primary hospitals utilised other services such as subdistrict hospital network which better suited their contexts. Post-pandemic, many large-sized hospitals planned to continue drug delivery service. Enabling factors included reducing overcrowding and supporting patients, while challenges were workload and patient willingness to pay.</p><p><strong>Conclusion: </strong>The COVID-19 pandemic has redefined outpatient dispensing services in Thailand, making drug delivery a new norm. Hospitals should evaluate current situations and adjust criteria and workflows to sustain these services.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2463438"},"PeriodicalIF":3.3,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11834770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to effective communication in UAE community pharmacies: general public perspectives on enhancing patient-pharmacist interaction and policy development.","authors":"Zelal Kharaba, Ahmad Al-Azayzih, Sayer Al-Azzam, Anan Jarab, Hisham E Hasan, Dania Rahhal, Feras Jirjees, Khalid A Al-Kubaisi, Monia H Aljumah, Faris El-Dahiyat, Sara Meer, Mohammad A Y Alqudah, Mamoon A Aldeyab, Karem H Alzoubi","doi":"10.1080/20523211.2025.2460744","DOIUrl":"10.1080/20523211.2025.2460744","url":null,"abstract":"<p><strong>Background: </strong>Community pharmacies serve as accessible points of care, offering essential services such as medication dispensing, health consultations, vaccinations, and chronic disease management, thereby playing a critical role in the healthcare system. This study aims to identify and evaluate the factors that obstruct general public-pharmacist interactions, providing insights to enhance pharmacy environments.</p><p><strong>Methods: </strong>A total of 406 general publics were surveyed using a validated questionnaire. Statistical analysis was performed with categorical variables presented as frequencies and percentages, and continuous variables as medians with 95% confidence intervals. Binary regression models were used to explore the relationships between sociodemographic characteristics and communication barriers, with a significance level set at <i>p</i> < 0.05 for all analyses.</p><p><strong>Results: </strong>The primary reasons for pharmacy visits were collecting prescription medications (61.58%) and purchasing OTC products (55.17%), while health screenings were less common (9.11%). Barriers to effective communication included crowded environments (61.58%), limited counseling time (45.81%), and lack of privacy (45.07%). Binary logistic regression revealed that participants who visited the pharmacy weekly were 5.5 times more likely to experience high environmental barriers (OR: 5.502, <i>p</i> = 0.002), while interacting with younger pharmacists increased the likelihood of personal barriers (OR: 12.357, <i>p</i> = 0.025). Pharmacy proximity (75.12%) and shorter waiting times (47.29%) were the most influential factors in pharmacy preference, while additional services had minimal impact (20.2%).</p><p><strong>Conclusion: </strong>Effective communication is crucial in community pharmacies for high-quality healthcare. This study identifies key barriers in the UAE and offers insights into targeted interventions to improve communication and public satisfaction.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2460744"},"PeriodicalIF":3.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist prescriber in Italy and possible changes to current legislation: <i>survey</i> of attitudes among pharmacists, family doctors and users.","authors":"Francesca Baratta, Irene Pignata, Lorenzo Ravetto Enri, Paola Brusa","doi":"10.1080/20523211.2025.2456382","DOIUrl":"10.1080/20523211.2025.2456382","url":null,"abstract":"<p><strong>Background: </strong>In many countries in Europe and in the world, pharmacists are allowed to prescribe or modify therapies. In Italy, the only healthcare professions authorised to prescribe are medical doctors and veterinary surgeons. The extension of the duties of the Italian pharmacist to include prescribing would be extremely important considering the challenges the National health system is facing regarding the shortage of healthcare workers.</p><p><strong>Methods: </strong>In this article, we report the findings of a survey on the role of the pharmacist prescriber conducted among pharmacists, family doctors, and pharmacy users in the North-West of Italy. The investigation was conducted by means of interviews carried out, using category-specific questionnaires.</p><p><strong>Results: </strong>Interviews were conducted with 234 pharmacists, 926 users and 9 family doctors. The majority of pharmacists and users would agree to the introduction of the prescribing pharmacist. In return for taking on the increased responsibility, the pharmacists stressed the need for appropriate legal status and additional training. The reasons most commonly indicated by pharmacists for introducing such a service are the ability to respond immediately to a pathology or minor condition, and the prevention of inappropriate self-medication by patients. More than three-quarters of pharmacists and family doctors feel that the most suitable pharmacist prescribing procedure would be that within a clinical management plan. The family doctors, expressed reservations regarding the pharmacist prescriber: the cases in which they were really open to a change were the renewal of a prescription.</p><p><strong>Conclusions: </strong>This study highlights the fact that both pharmacists and pharmacy users tend to be favourable to the introduction of the figure of the pharmacist prescriber in Italy. Many obstacles remain to be overcome but, based on the procedures already experimented in other European countries and worldwide, a route leading to the introduction of the pharmacy prescriber role may be hypothesised.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2456382"},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abuse and misuse of tramadol in patients with non-oncologic pain in a region of Southern Europe.","authors":"M Perelló, K Rio-Aigé, G Cereza, P Rius, F J Pérez-Cano, M Rabanal","doi":"10.1080/20523211.2025.2457406","DOIUrl":"10.1080/20523211.2025.2457406","url":null,"abstract":"<p><strong>Background: </strong>Tramadol can cause dependence even within the recommended dose range. Its use has increased recently, especially in patients with chronic pain, and although a growing body of literature identifies a non-therapeutic use, patterns of misuse of tramadol is so far limited.</p><p><strong>Methods: </strong>Two-year observational and cross-sectional study (January 2020 - December 2021) was conducted in 75 community pharmacies from Catalonia. To estimate the potential abuse and misuse of tramadol by patients visiting community pharmacy, and to establish the demographic characteristics of the tramadol users, a validated questionnaire based on the Finch criteria was designed. A total of 251 cases were registered.</p><p><strong>Results: </strong>Data show that women were more involved (56.6%) and the highest proportion was found in the age interval of 46-65 years (42.6%). The combination of tramadol and paracetamol was reported in 54.6% of the cases and 73.7% corresponded to immediate-release tablets. In 93.6% of the cases, the request was preceded by previous use. Conversely, young men showed a higher non-prescription request for tramadol, reporting acute pain (<i>p</i> < 0.05). These results indicate that there is non-therapeutic use among patients who visit community pharmacies for information on two profiles.</p><p><strong>Conclusion: </strong>This study shows that being an aged woman and suffering from chronic pain seems to involve a risk of generating dependence on tramadol. Likewise, a suspicion of recreational use of tramadol by young people has also been identified. There is a need to investigate how to manage chronic pain, given its complexity and take into account the risk of misuse that may come with tramadol. The involvement of characteristics such as gender as well as the pharmaceutical form in the development of tramadol misuse also needs to be analysed deeply. It is mandatory to evaluate the criteria for prescribing tramadol and initiatives to improve the knowledge of the health professionals and the population.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2457406"},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a pharmacist-led tele-psychiatric clinic in managing drug-related problems.","authors":"Majed Al Shakhori, Savera Arain, Suhaj Abdulsalim, Mohammed Salim Karattuthodi, Marwa Al Dhamen, Shoruq Almutairi, Shabeer Ali Thorakkattil, Dina Alahmdi, Vijayanarayana Kunhikatta, Abdul Sammad AlJishi","doi":"10.1080/20523211.2025.2460038","DOIUrl":"10.1080/20523211.2025.2460038","url":null,"abstract":"<p><strong>Background: </strong>The study aimed to evaluate the effectiveness of telepsychiatry combined with the expertise of psychiatric clinical pharmacists in identifying and addressing drug-related problems (DRPs) associated with psychotropic medications. Additionally, the research assessed physicians' acceptance of pharmacists' recommendations for managing these DRPs.</p><p><strong>Methods: </strong>A cohort retrospective study was conducted at a leading tertiary care hospital in Saudi Arabia spanning from January 2023 to January 2024 in a psychiatry setting. The study comprehensively examined all instances of interventions for DRPs facilitated through patient-initiated telepsychiatry encounters with psychiatric clinical pharmacists. Detailed and meticulously recorded notes from patient chart reviews, documented by the pharmacist in the Electronic Health Record (EHR), during each encounter, were reviewed. These notes provided significant information on psychiatric diagnosis, identified DRPs and the specific interventions and recommendations proposed by the clinical pharmacist to the attending physician. The Krska classification was utilised to classify and analyse the identified DRPs, ensuring a structured and systematic approach to the study's findings.</p><p><strong>Results: </strong>A total of 259 pharmacist interventions were made, and the results revealed a remarkably high acceptance rate of 98.5% among physicians. The most common intervention (16.21%) involved targeted education to improve medication adherence. Additionally, substantial efforts were directed towards rectifying inappropriate dosage regimens, accounting for 13.51% of DRPs resolved by the pharmacist. Noteworthy interventions also encompassed the identification and management of potential or suspected adverse reactions, comprising 12.35% of the interventions, along with interventions addressing concerns regarding potentially ineffective therapy, which constituted 11.59%.</p><p><strong>Conclusion: </strong>The study underscores the critical role of pharmacists in psychiatric care, with high physician acceptance of their interventions. The diverse range of DRPs highlights the need to expand clinical pharmacy services and integrate pharmacists into psychiatric teams. Our findings clearly demonstrate that integrating pharmacists into psychiatric care settings is beneficial. This approach enhances DRP identification and management, ultimately enhancing patient care and treatment outcomes.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2460038"},"PeriodicalIF":3.3,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of thromboembolic events among COVID-19 patients admitted to a single centre intensive care unit (ICU): an epidemiological study from a Malaysian population.","authors":"Nur Farhani Mansor, Izzati Abdul Halim Zaki, Lee Chew Kiok, Eng Kar Seng, Tharmini Ravi, Mohan Pathmanathan, Khang Wen Goh, Long Chiau Ming, Pakhrur Razi, Hanis Hanum Zulkifly","doi":"10.1080/20523211.2024.2449044","DOIUrl":"10.1080/20523211.2024.2449044","url":null,"abstract":"<p><strong>Introduction: </strong>Thromboembolic (TE) complications in COVID-19 patients are rising globally, contributing significantly to mortality, particularly in severe cases. However, their prevalence, characteristics, and impact on mortality in Malaysia remain unclear.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of thromboembolic (TE) events and associated mortality among COVID-19 patients admitted within a single centre intensive care unit (ICU). The proportions of patients with TE events who died, and factors associated with TE events were explored.</p><p><strong>Methods: </strong>In this retrospective cohort study, patients with PCR confirmed SARS-CoV-2 virus and who received thromboprophylaxis within February 2020-2021 were included. TE event is a combination of venous [(deep vein thrombosis (DVT), pulmonary embolism (PE)] and arterial (myocardial infarction (MI), stroke) thromboembolism.</p><p><strong>Results: </strong>Mean (SD) age 56.6 (13.7), 63.5% were male, 61.6% Malays, median (IQR) 7 (3-14) days of ICU stay, 64.2%, 53.2% and 20.9% had underlying hypertension, diabetes and obesity respectively. In total, 240 (44.9%) developed TE event. Significantly higher proportions of COVID-19 patients who developed complications of DVT (2.5% vs. 0.2%; <i>p</i> = 0.013), PE (47.5% vs 34.0%; <i>p</i> = 0.006), stroke (12.3% vs. 1.5; <i>p</i><0.001) and MI (16.4% vs. 4.6%; <i>p</i><0.001) died. Predictors of TE events were age [HR 1.01 (95% CI 1.00-1.02)], obesity [HR 1.98 (95% CI 1.51-2.6)], D-dimer [HR 1.01 (95% CI 1.00-1.01)], and duration of ICU stay [HR 0.98 (95% CI 0.97-0.99)].</p><p><strong>Conclusion: </strong>In severely ill COVID-19 patients, TE complications were common, and patients with DVT, PE, stroke, or MI faced increased mortality, even with thromboprophylaxis. Age, obesity, elevated D-Dimer levels, and longer ICU stays were significant predictors of TE events. Considering these findings, a more aggressive approach, combining thromboprophylaxis with enhanced anti-inflammatory treatments, may be necessary for high-risk COVID-19 ICU patients to reduce TE events and mortality.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2449044"},"PeriodicalIF":3.3,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800336/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}