Journal of Pharmaceutical Policy and Practice最新文献

{"title":"Compounded glucagon-like peptide-1 receptor agonists for weight loss: the direct-to-consumer market in Colorado.","authors":"Michael J DiStefano, Mouna Dardouri, Gina D Moore, Joseph J Saseen, Kavita V Nair","doi":"10.1080/20523211.2024.2441220","DOIUrl":"https://doi.org/10.1080/20523211.2024.2441220","url":null,"abstract":"<p><strong>Background: </strong>High prices and other access barriers have contributed to the rise of a market for compounded glucagon-like peptide-1 receptor agonists for weight loss in the United States. This market has not been systematically studied. We conducted a pilot study to assess the prevalence, characteristics, and advertising content of direct-to-consumer providers of compounded glucagon-like peptide-1 products for weight loss in Colorado.</p><p><strong>Methods: </strong>We conducted a cross-sectional study of websites advertising compounded glucagon-like peptide-1 products for weight loss in Colorado. Websites were identified using Google searches focused on census-defined statistical areas. Searches were conducted between March 21 and April 12, 2024. Data collected from websites included physical addresses, business type, highest reported staff credential, advertised glucagon-like peptide-1 products, whether businesses referred to Food and Drug Administration approval when describing products, and whether businesses referred to products as 'generic'.</p><p><strong>Results: </strong>We identified 93 business websites advertising compounded glucagon-like peptide-1 products for weight loss corresponding to 188 physical locations throughout Colorado. Most businesses were self-categorized as medical/health spas (33/93) or weight loss services (26/93). Advertised products included semaglutide (92/93), tirzepatide (40/93), liraglutide (2/93), and retatrutide (1/93). Advertised combination products included B vitamins (8/93), levocarnitine (1/93), mannitol (1/93), BPC-157 (1/93), and glycine (1/93). Seven websites advertised oral formulations. Additionally, 41/93 websites referred to Food and Drug Administration approval in their descriptions of compounded products and 5/93 referred to products as 'generic'.</p><p><strong>Conclusion: </strong>This study identified several instances of unapproved glucagon-like peptide-1 products being compounded and advertised in Colorado. Additionally, 1 product was advertised as compounded with BPC-157, a substance determined by the Food and Drug Administration to be unsafe for compounding. This study also identified numerous examples of misleading claims regarding the regulatory status of compounded glucagon-like peptide-1 products. Regulatory action is needed to ensure the benefits of compounded GLP-1 products outweigh the risks.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2441220"},"PeriodicalIF":3.3,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703442/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950550","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":"Effect of statins and antihyperglycemics on chronic kidney disease in patients with type 2 diabetes mellitus: a retrospective cohort study with a 12-year follow-up.","authors":"Ammar Abdulrahman Jairoun, Chong Chee Ping, Baharudin Ibrahim, Dina Farhan Al Jawamis, Asma Khaled Al Jaberi, Tasnim Dawoud, Khuloud Jamal Mohammed, Faris El-Dahiyat, Moyad Shahwan","doi":"10.1080/20523211.2024.2414293","DOIUrl":"https://doi.org/10.1080/20523211.2024.2414293","url":null,"abstract":"<p><strong>Background: </strong>Chronic Kidney Disease (CKD) represents a significant worldwide health challenge, with far-reaching implications for both patients and healthcare systems. This study aimed to identify the incidence of CKD at stages 3-5, analyzed the impact of statin and other antihyperglycemic interventions, on the CKD progression in individuals with T2DM.</p><p><strong>Methods: </strong>This was a single-center retrospective cohort study based on data derived from electronic medical records (EMR) of UAE populations with diabetes mellitus, registered at outpatient clinics at Tawam Hospital in Al Ain, UAE, between January 2011 and December 2021. T2DM patients aged ≥ 18 years who had serum HbA1c level ≥ 6.5% and using one of the statin therapies were inclusion criteria. Patients with T1DM, who had undergone permanent renal replacement therapy, with under 1 year of follow-up and missing or incomplete data were excluded from the study. The collected data encompassed socio-demographics, detailed medical history, anthropometric measurements, laboratory analyses, clinical parameters, disease characteristics, and medications.</p><p><strong>Results: </strong>Our study included a cohort of 1,003 individuals. We observed 388 subjects developed CKD stages 3-5 across an average monitoring duration of 11.7 years. This resulted in a cumulative incidence of 38.7%, translating to an incidence rate of 38 cases per 1000 person-years. There was a statistically significant difference in the cumulative incidence of CKD stages 3 ± 5 according to statin therapy (<i>P</i> = 0.047). High intensity statin users are more likely to develop a CKD stage 3-5 compared to low/moderate intensity users and to no statin users respectively (44.3% vs 37.9%), (44.3% vs 30.9%). Conversely, the use of Biguanides was associated with a decreased probability of CKD progression (37.9% vs. 52.8%; <i>P</i> = 0.001), whereas Insulin users demonstrated a heightened risk (54.2% vs. 34.1%; <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The findings emphasise the pivotal role of personalised treatment strategies, particularly concerning statin therapy and other medications, in populations at high risk.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2414293"},"PeriodicalIF":3.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950553","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":"Relevance of perioperative fluid dynamics in liver transplantation to acute kidney injury and patient outcomes: a cross-sectional survey.","authors":"Desheng Li, Qinghua Guan, Chuanlin Chen, Bo Sheng, Zhenyu Zhang, Yongfang Hu","doi":"10.1080/20523211.2024.2438225","DOIUrl":"https://doi.org/10.1080/20523211.2024.2438225","url":null,"abstract":"<p><strong>Background: </strong>Fluid administration is a critical component of perioperative management for liver transplant recipients, and excessive fluid infusion can lead to acute kidney injury (AKI) and poor patient outcomes.</p><p><strong>Method: </strong>We conducted a cross-sectional survey on the fluid intake and output of adult liver transplant recipients over a 7-day period. The patients were divided into AKI and non-AKI groups. Multivariate logistic regression analyses were used to evaluate the association between fluid balance (FB) and AKI. A Kaplan-Meier survival analysis was performed to determine the survival of the recipient survival at 180 days.</p><p><strong>Results: </strong>A total of 210 liver transplant recipients were included. The peak FB occurred on the second day after transplantation, which was higher than on the seventh day (0.3 [<i>IQR</i>, -0.2 to 0.8] L vs. -0.4 [<i>IQR</i>, -1.0 to 0.3] L, <i>p</i> < 0.001). The highest incidence of AKI was observed on the second day after transplantation and the lowest on the seventh day (52.4% vs. 15.4%, <i>p</i> < 0.001). Multivariate analysis showed that a cumulative FB > 1 L within the first 2 days postoperatively was an independent risk factor for AKI on the second day after liver transplantation (LT) (<i>OR</i> = 2.66, <i>95</i>% <i>CI</i>, 1.31-5.41, <i>p</i> = 0.007). Survival analysis indicated significant differences in 180-day survival rates among patients with different grades of AKI [94.0% (grade 1) vs. 91.4% (grade 2) vs. 77.8% (grade 3), <i>χ</i> ^<i>2</i>  = 12.93, <i>p</i> < 0.001].</p><p><strong>Conclusion: </strong>There is a significant correlation between post-LT AKI and perioperative FB. Cumulative FB > 1 L in the first 2 days postoperatively is an independent risk factor for AKI on the second day after LT. AKI after LT is associated with a lower 180-day survival rate in patients.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"18 1","pages":"2438225"},"PeriodicalIF":3.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11703520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950475","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":"Beliefs of patients who visited community pharmacies about medicines and supplements, the need for drug therapy and medication adherence - a cross-sectional study.","authors":"Etidal-Mihaela Manoliu-Hamwi, Cristina Gena Dascălu, Cristina Mihaela Ghiciuc, Georgeta Zegan, Elena-Mihaela Cărăușu, Mihaela Moscu, Cătălina Daniela Stan","doi":"10.1080/20523211.2024.2438235","DOIUrl":"10.1080/20523211.2024.2438235","url":null,"abstract":"<p><strong>Background: </strong>Beliefs about medicines, the need for drug therapy and patient willingness can influence medication adherence. The community pharmacist, through his skills as an expert in drug therapy, has the opportunity to promote medication adherence in everyday pharmaceutical practice. This study aims to assess beliefs about medicines and supplements and the need for drug therapy and medication adherence of the patients who visited community pharmacies.</p><p><strong>Methods: </strong>809 patient volunteers answered a 14-item online questionnaire using a 5-point Likert scale. Statistical analysis was done in SPSS 27.0.</p><p><strong>Results: </strong>The validity indices of the questionnaire were acceptable; internal consistency was good; and the factor analysis indicated 3 factors (Eigen values > 1.0). The median scores were 3.33 regarding the beliefs about medicines and supplements; 2.75 regarding the beliefs about the need for therapy; and 2.71 on medication adherence. Beliefs about medicines and supplements, the need for drug therapy, and medication adherence varied according to patients' socio-demographic status, health status, and access to pharmacy services (<i>p </i>≤ 0.05).</p><p><strong>Conclusion: </strong>Patients' beliefs about medicines and supplements were moderate, patients' beliefs about the need for drug therapy were negative and patients' medication adherence was good.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2438235"},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391181","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":"Comparing Beers, STOPP and MALPIP criteria in detecting potentially inappropriate medications, clinical outcomes, and cost impacts among older Malaysians: a cohort study.","authors":"Chee Tao Chang, Huan-Keat Chan, Aie Yen Tan, Siti Fatimah Kamis, Yee Ling Yeo, Muhammad Azuan Azman, Shamini Rama, James Yau Hon Voo, Hoo Seng Tan, Janice Kah Weng Kwan, Xin Yi Ooi, Philip Rajan, Siew Li Teoh, Shaun Wen Huey Lee","doi":"10.1080/20523211.2024.2436896","DOIUrl":"10.1080/20523211.2024.2436896","url":null,"abstract":"<p><p><b>Background:</b> Potentially inappropriate medications (PIMs) are associated with adverse outcomes and higher healthcare costs in older adults. Explicit screening criteria like the Beers Criteria, STOPP criteria, and the Malaysian Potentially Inappropriate Prescribing (MALPIP) criteria served to identify PIMs, but comparative data are scarce. <b>Aim:</b> To evaluate the prevalence of PIMs identified by Beers 2019, STOPP version 2 and MALPIP criteria in Malaysian older adults and examine their predictive ability for adverse outcomes and cost-saving potential. M<b>ethods:</b> A historical cohort study was conducted among older adults aged ≥ 60 years on five or more medications in four Malaysian tertiary hospitals. PIMs were identified using Beers, STOPP, and MALPIP criteria. Sensitivity, specificity and predictive abilities of these criteria were analysed against clinical outcomes. Monthly cost savings were calculated based on hypothetical deprescribing scenarios. <b>Results:</b> Among 1069 patients, the prevalence of PIMs was 89.1% using MALPIP, 51.3% with Beers, and 37.0% with STOPP criteria. A moderate concordance was seen between Beers and STOPP criteria (κ =  0.437), and the lowest agreement was observed between the STOPP and MALPIP (κ =  0.131). STOPP criteria significantly predicted hospital readmissions (<i>p</i> = 0.003), while Beers and MALPIP did not show significant predictive abilities across all outcomes. The most common PIMs identified were proton pump inhibitors (PPIs) and nonsteroidal anti-inflammatory drugs (NSAIDs). Deprescribing scenarios based on these criteria indicated potential monthly cost savings of MYR 4.83 to MYR 44.84 per patient, with the greatest savings associated with MALPIP criteria. <b>Conclusion:</b> MALPIP demonstrated the highest potential for cost savings, the highest sensitivity but the lowest specificity in PIM detection. Context-specific assessments and clinical judgment are crucial in optimising medication safety and efficacy in geriatric pharmacotherapy. Further research is needed to refine PIM criteria to better predict clinical outcomes and balance the benefits and risks of deprescribing in diverse healthcare settings.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2436896"},"PeriodicalIF":3.3,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391104","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":"Benchmarking hospital clinical pharmacy practice using standardised key performance indicators (KPIs).","authors":"Amelia R Cossart, Martin L Canning, Faith R Yong, Christopher R Freeman","doi":"10.1080/20523211.2024.2431181","DOIUrl":"10.1080/20523211.2024.2431181","url":null,"abstract":"<p><p><b>Background:</b> Hospital pharmacy services support quality use of medicines and medication safety through clinical pharmacy activities such as medication reviews and patient education. These activities can be measured and monitored using evidence-based and standardised key performance indicators (KPIs), which highlight the value of pharmacy services. Standardisation of KPIs supports long-term benchmarking and inter- and intra-site comparisons to target key areas for improvement in clinical pharmacy services. <b>Aim:</b> To describe the type and frequency of clinical pharmacy activity across five hospitals within one metropolitan hospital district. <b>Methods:</b> Key Performance Indicator data were collected by pharmacists from five hospital sites at one metropolitan hospital district, in Queensland Australia. Data were collected over one week for the following clinical settings: inpatient, discharge, outpatient clinic, and the dispensary. Data were collected using a manual, paper-based data collection tool previously developed using a co-design process. <b>Results:</b> Across 11,215 inpatient encounters, hospital pharmacy services provided: best possible medication history (BPMH) within 24 h of admission: 69.5%; daily medication chart review: 57.2%; discharge education: 82.7%, discharge reconciliation: 88.2%; and provision of discharge medication record: 82.4%. Across 1,092 outpatient encounters, pharmacists documented BPMH for 33.3% of patients. Pharmacists identified a total of 5,009 drug-related problems (DRPs) across the data collection period, with the rate of identification highest in the outpatient clinic setting (64.8 per 100 patient reviews) followed by discharge (52.6 per 100 patient reviews) and then inpatient (48.1 per 100 patient reviews). Almost 20% of DRPs identified (<i>n </i>= 975) were high risk. <b>Conclusion:</b> Reporting and benchmarking clinical pharmacy activity through standardised KPIs supports opportunities to identify service improvements. Future research should focus on larger scale studies using routinely recorded data to monitor clinical pharmacy KPIs across all care settings.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2431181"},"PeriodicalIF":3.3,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11650437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846910","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":"An exploratory study of the mandate and functions of national pharmaceutical services units: global trends and the cases of Côte d'Ivoire, Kenya, and Nepal.","authors":"Augustina Koduah, Ndinda Kusu, Herodias Ahimon, Andrew Brown, Nancy Njeru, Tom Menge, Mahama Ouattara, Nijan Upadhyay, Madan Kumar Upadhyaya, Melissa Jiha, Robbie Hodgson, Emmanuel Nfor, Francis Aboagye-Nyame, Tamara Hafner","doi":"10.1080/20523211.2024.2430438","DOIUrl":"10.1080/20523211.2024.2430438","url":null,"abstract":"<p><strong>Background: </strong>National pharmaceutical services units (NPSUs) - organisational units within the central government usually responsible for pharmaceutical services and management - have an increasingly narrow mandate. Anecdotal evidence points to an increasing focus, almost exclusively, on logistics management, while pharmaceutical care and policy oversight have become fragmented. This study examined NPSUs' current functions and mandates, and proposed what should be the critical functions and roles of these units going forward.</p><p><strong>Methods: </strong>Using case studies of Côte d'Ivoire, Kenya and Nepal, the study relied on a literature review and in-depth interviews. We triangulated and synthesised the findings to identify NPSUs by level in the health ministry's hierarchy and reporting line, mandate, and function.</p><p><strong>Results: </strong>We identified medicine regulation, procurement and supply chain management, selection and rational use of medicines, and pharmacy practice regulation as four broad sets of functions that NPSUs commonly have as their mandate. A clear position in the Ministry of Health's hierarchical structure, the legal or administrative framework that mandates an NPSU's functions, and national pharmaceutical policies and regulations to guide the pharmaceutical sector are three critical factors for effective functioning. It is essential to have a legislative framework that at a minimum identifies one NPSU as responsible for pharmaceutical policy and governance, serving as the steward for the pharmaceutical system. This role encompasses pharmaceutical system coordination and administrative functions, formulating and implementing policies for organising, managing, financing, regulating, monitoring, and evaluating the pharmaceutical system. As such, we recommend that NPSUs should at a minimum have four broad sets of functions: pharmaceutical policy and governance, medicine regulation, pharmacy practice regulation and procurement and supply chain management.</p><p><strong>Conclusion: </strong>The study substantiates the need for a pharmaceutical policy and governance unit that stewards the pharmaceutical system and is empowered to monitor and evaluate system performance and coordinate efforts for system strengthening.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2430438"},"PeriodicalIF":3.3,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11648141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837217","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":"Screening for substandard and falsified medicines in Nigeria using visual inspection and GPHF-Minilab analysis: lessons learnt for future training of health workers and pharmacy personnel.","authors":"Micha Lächele, Julia Gabel, Nkiru Sunny-Abarikwu, Rita Ezinwanne Ohazulike, Juliet Ngene, Jane Frances Chioke, Lutz Heide","doi":"10.1080/20523211.2024.2432471","DOIUrl":"10.1080/20523211.2024.2432471","url":null,"abstract":"<p><strong>Background: </strong>Substandard and falsified (SF) medicines are a serious threat to public health in low- and middle-income countries (LMICs). Visual inspection of medicines and screening analysis using the Global Pharma Health Fund (GPHF)-Minilab are important in medicine quality surveillance in low-resource settings.</p><p><strong>Methods: </strong>Recently, 260 medicine samples from Nigeria had been investigated for assay and dissolution according to the United States Pharmacopeia (USP). In the present study, these results were compared to the results of the investigation of the same samples by visual inspection and by GPHF-Minilab analysis by local personnel in Nigeria.</p><p><strong>Results: </strong>Visual inspection identified many deficiencies of dosage units and packaging information in SF medicines. All four falsified medicines were readily identifiable, primarily from serious spelling errors in the labelling, and from manufacturer names which could not be verified using internet resources. In GPHF-Minilab disintegration testing, two samples did not disintegrate even after 60 min; both were found to fail USP dissolution testing with extreme deviations. Of the 20 samples which deviated in USP assay analysis by more than 20% from the declared API amount, seven (35%) were detected as non-compliant in TLC analysis. Evaluation by TLC image analysis with a recently developed smartphone application (named TLCyzer) increased sensitivity to 62.5% but led to an unacceptably low specificity (75.2%). Additional training of the local personnel improved the results of both TLC analysis and TLCyzer evaluation. Photographs of the visual deficiencies and of the TLC analysis results of the SF medicines are provided as PowerPoint and PDF slides with this publication, for future training courses of pharmacy staff and health workers in LMICs.</p><p><strong>Conclusion: </strong>Visual inspection, and screening analysis with simple, rapid and inexpensive methods, are important in the surveillance for SF medicines in LMICs. This study provides data on the potential and the limitations of such screenings.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2432471"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812580","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":"Lipid-lowering agent preferences among patients with hypercholesterolemia: a focus group study.","authors":"Hei Hang Edmund Yiu, Kehui Deng, Lydia Wy Fung, Xuxiao Ye, Joseph Edgar Blais, Hung Fat Tse, Martin Chi Sang Wong, Bryan P Yan, William Chi Wai Wong, Xue Li, Carlos King Ho Wong, Chun Ka Wong, Esther W Chan","doi":"10.1080/20523211.2024.2421261","DOIUrl":"10.1080/20523211.2024.2421261","url":null,"abstract":"<p><strong>Background: </strong>Non-adherence to lipid-lowering agents poses significant risks to patients and diminishes treatment effectiveness. Current understanding of patients' preferences regarding the characteristics of these agents is limited. This study aims to qualitatively identify the barriers to lipid-lowering medication adherence and the factors considered by patients with hypercholesterolemia when choosing lipid-lowering agents, and to inform the design of a medication preference study.</p><p><strong>Methods: </strong>Face-to-face focus group interviews were conducted with Cantonese-speaking patients diagnosed with hypercholesterolemia in Hong Kong. Patients were recruited by cardiologists at a university-affiliated hospital using convenience sampling. The interviews consisted of three parts: gathering patients' perceptions of disease and medication, identifying important factors in selecting lipid-lowering agents, and completing the medication preference tasks designed using the Discrete Choice Experiment (DCE) method. Thematic analysis was used to categorise the codes derived from the transcripts into higher-order themes.</p><p><strong>Results: </strong>Twenty patients completed the focus group interviews on the university campus between January and March 2023. Four main themes emerged: medication management issues, patients' medication preferences, structure, and comprehension of preference tasks. Barriers to medication adherence included lack of knowledge, a high pill burden, poor communication with healthcare providers, minimal treatment decision involvement, limited access to medication information, side effects, and forgetfulness. Factors influencing medication choice were treatment regimen (i.e. the route and frequency of administration), effectiveness, side effects, doctors' opinions, drug interactions, and out-of-pocket costs. Despite suggestions for modifying attributes and levels, the medication preference tasks effectively reflected patients' trade-offs.</p><p><strong>Conclusions: </strong>The identified barriers to medication adherence and the factors influencing medication choice highlight the importance of considering patients' perspectives. These insights could assist decision-makers in selecting medications that align with patient preferences, thereby promoting medication adherence. A large-scale DCE preference study will be conducted in Hong Kong to quantify the relative importance of the attributes of lipid-lowering agents.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2421261"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632947/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812303","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":"Long-Term clinical efficacy of liraglutide for type 2 diabetes: real-world evidence and outcomes from Pakistan.","authors":"Muhammad Daoud Butt, Siew Chin Ong, Azra Rafiq, Nighat Batool, Rumana Saifi, Samina Yaseen, Irum Kaukab, Basit Ramzan","doi":"10.1080/20523211.2024.2432462","DOIUrl":"10.1080/20523211.2024.2432462","url":null,"abstract":"<p><strong>Background: </strong>Liraglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated efficacy in improving glycemic control and promoting weight loss in clinical trials. However, real-world data from diverse populations, particularly from South Asia, are limited. The study aims to evaluate the long-term efficacy and safety of liraglutide in a real-world setting among Pakistani patients with type 2 diabetes mellitus (T2DM).</p><p><strong>Methodology: </strong>A retrospective cohort study of 624 patients initiated on liraglutide was conducted. Data were collected at baseline and 6, 12, 18, and 24 months. Primary outcomes were HbA1c and weight changes. Secondary outcomes included fasting plasma glucose, lipid profile, and blood pressure. Statistical analyses were performed using appropriate methods.</p><p><strong>Results: </strong>In study population the mean HbA1c reduction of -1.45 ± 0.67% was observed at 24 months, with 30.6% achieving HbA1c ≤ 7.5%. A rapid and sustained weight loss of -7.51 kg was achieved, with 27.2% experiencing ≥5% weight loss. Additionally, liraglutide led to a significant reduction in LDL cholesterol, with 46.7% of patients achieving a ≥ 10% reduction at 24 months. Liraglutide was well-tolerated, with a low discontinuation rate of 4.6%.</p><p><strong>Conclusion: </strong>Liraglutide demonstrated sustained efficacy and safety in a diverse Pakistani population with T2DM, regardless of baseline characteristics. These findings support the use of liraglutide as an effective treatment option for T2DM in real-world clinical practice.</p>","PeriodicalId":16740,"journal":{"name":"Journal of Pharmaceutical Policy and Practice","volume":"17 1","pages":"2432462"},"PeriodicalIF":3.3,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11619037/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142785019","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}