Journal of Pharmacy Practice and Research最新文献

{"title":"Correction to “Advanced Pharmacy Australia general medicine standards: paving the way for multidisciplinary care and collaboration”","authors":"","doi":"10.1002/jppr.70036","DOIUrl":"https://doi.org/10.1002/jppr.70036","url":null,"abstract":"<p>Aung AK, Downie M, Shannon L, Johnson DF. Advanced Pharmacy Australia general medicine standards: paving the way for multidisciplinary care and collaboration. <i>J Pharm Pract Res</i> 2025; <b>55</b>: 167–169.</p><p>In the above article, the first author's name was spelled incorrectly. It should be corrected from ‘Ak Kar Aung’ to ‘Ar Kar Aung’.</p><p>The name has been amended in the online article.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":""},"PeriodicalIF":1.0,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918717","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":"Advanced Pharmacy Australia general medicine standards: paving the way for multidisciplinary care and collaboration","authors":"Ak Kar Aung BMedSci, MBBS, FRACP, MPHTM,&nbsp;Michelle Downie MBCHB, FRACP,&nbsp;Leigh-anne Shannon BA, MAICD,&nbsp;Douglas F. Johnson MBBS (Hons), BComm, PhD, DTM&H, GChPOM, FRACP","doi":"10.1002/jppr.70032","DOIUrl":"https://doi.org/10.1002/jppr.70032","url":null,"abstract":"<p>General Medicine is the largest provider of acute inpatient care in Victoria, and possibly also in the wider Australia and Aotearoa New Zealand.<span>¹</span> Clinicians in General Medicine, including pharmacists, are trained to care for patients who are often elderly and frail, with multiple comorbidities, undifferentiated problems, and complex physiological and psychosocial needs. General Medicine services also care for vulnerable and marginalised patient populations, such as First Nations peoples, people experiencing homelessness, migrant and refugee populations, and people who inject drugs. General Medicine is also frequently involved in the care of perioperative patients, especially for those whose surgical issues are managed non-operatively, and patients who are pregnant with medical issues.</p><p>Management of general medical patients poses unique challenges. The specialty requires both breadth and depth of knowledge, concerning every organ system and their intricate interactions, and yet, the available best practice evidence-based guidelines are often single organ focused and may not directly apply to general medical patients. This is because patients who have competing comorbidities and are often not included due to highly selective exclusion criteria in major clinical trials. Patient presentations in General Medicine can range widely from being undifferentiated and acutely unwell, to management of stable chronic diseases which impact their lifestyle. There are also added layers of patient complexity such as cognitive, functional, and psychosocial issues which impact on access to care, medicine compliance, and health literacy. Additionally, certain considerations must be given in the management paradigm of some patient groups, for instance, prioritising and optimising quality of life for patients with advanced age and comorbidities, minimising medication adverse effects and related harm and reducing polypharmacy through deprescribing, while ensuring adherence to essential and critical medications. The care delivered must be of high quality and high value, not only based on the best available evidence, but also be holistic and patient-centred to tailor individual needs, circumstances, psychosocial, and physiological vulnerabilities. All clinicians in General Medicine have the obligation to minimise and eliminate low-value care options, that will not make any difference to patient outcomes, and may in fact result in harm, with significant associated economic and environmental costs.</p><p>From the systems perspectives, anecdotally, the models of care in General Medicine have been rapidly changing over the last two decades to meet the increasing service demands and to alleviate bed access pressures. While designed to improve patient flow through the hospital systems, evolving models that institute transitions through different care teams at different phases of the patient's journey, such as acute medical units/streaming teams ","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"167-169"},"PeriodicalIF":1.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550987","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":"Advanced Pharmacy Australia general medicine standards","authors":"Paul Firman BPharm, MPharmPrac, PhD, FANZCAP (Generalist), FAdPha,&nbsp;Marianne Jovanovic BPharm (Hons), GradCertPharmPrac, MPharmPrac, FANZCAP (Edu., Gen Med.), FAdPha,&nbsp;Sarah McPhee BPharm (Hons), GradCertPharmPrac, AdPhaM,&nbsp;Abigail Pinto BPharm (Hons), GradCertPharmPrac, AdPhaM,&nbsp;Erica Y. Tong BPharm (Hons), MClinPharm, PhD, CHIA, FAIDH, FSHP,&nbsp;Yee Mellor BPharm, MCncrSc, FANZCAP (Generalist, Edu.), AdPhaM","doi":"10.1002/jppr.70024","DOIUrl":"https://doi.org/10.1002/jppr.70024","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"254-267"},"PeriodicalIF":1.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of electronic clinical progress notes for measuring clinical pharmacy performance","authors":"Huri Balikubiri BPharm (Hons),&nbsp;Anna Kemp-Casey BA (Hons), PhD,&nbsp;Andre Q. Andrade MD, PhD,&nbsp;Richard Marotti BPharm, MMgtStudies (Administration), MSHP,&nbsp;Michael Bakker BPharm, FANZCAP (Informtcs), CHIA, FAdPha,&nbsp;Julian Soriano BPharm,&nbsp;Elizabeth E. Roughead BPharm, GradDipHealthProm, MAppSc, PhD","doi":"10.1002/jppr.70022","DOIUrl":"https://doi.org/10.1002/jppr.70022","url":null,"abstract":"<p>Hospital-based clinical pharmacy services improve patient outcomes, reduce medication-related problems, and lower the cost of medication therapy. Measuring the provision of clinical pharmacy services and related outcomes is essential to ensuring quality. Historically, clinical pharmacy performance measurement relied on manual reporting of performance measures, which was time-consuming. This study validated the use of counts of clinical progress notes, stored in hospital electronic medical records (EMRs), as measures of clinical pharmacy service provision. EMR-generated progress notes completed by pharmacy staff for a random sample of 300 adults admitted to three Australian hospitals between May–November 2021 were manually audited. The audit identified the type of progress notes completed, as indicated by their title, and the type of clinical pharmacy services documented. To determine the validity of using counts of these progress notes to indicate the completion of clinical pharmacy services, sensitivity, specificity, and positive predictive value were calculated using the manual audit as a gold standard. A total of 861 progress notes were audited. Progress notes titled PMM (which is short for Pharmacy Medication Management) Medication History, PMM Medication Review, and PMM Discharge Medications demonstrated high specificity and positive predictive values (&gt;98%) for clinical pharmacy services at admission, during the inpatient stay, and at discharge, respectively, with sensitivities of 98%, 90%, and 89%. Counts of EMR-generated clinical pharmacy progress notes accurately measured service provision and can be used as reliable performance measures. Hospitals using EMR-generated clinical progress notes may apply a similar approach to derive accurate and efficient clinical performance measures. Ethical approval was granted by the Central Adelaide Local Health Network Human Research Ethics Committee (Reference no: 16357) and the University of South Australia Human Research Ethics Committee (Reference no: 205782) and the study conforms with the Australian <i>National statement on ethical conduct in human research</i>.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":"342-347"},"PeriodicalIF":1.0,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918772","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":"Renal clinical pharmacy services and outcomes for patients on dialysis: a scoping review","authors":"Rebecca Livori BPharm (Hons), GradCertPharmPrac, GradCertHlthSysMgmt, MSc (RenalMedicine), FANZCAP (Neph, MedSafety), MAdPha,&nbsp;Catherine Shaji BPharm (Hons)/MPharm, MAdPha,&nbsp;Dao Gia Nguyen Tran BPharm (Hons)/MPharm, MAdPha,&nbsp;Carla Scuderi BPharm, MClinPharm, PhD, FANZCAP (Neph, Lead&Mgt), FAdPha,&nbsp;Renee Dimond BPharm (Hons), MClinPharm, GradCertEdDes, FANZCAP (Paeds, Edu), MAdPha,&nbsp;Adam Livori BAppSci (NucMed), BPharm (Hons), MClinPharm, FCSANZ, FANZCAP (Cardiol, Res), FAdPha","doi":"10.1002/jppr.70006","DOIUrl":"https://doi.org/10.1002/jppr.70006","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;People with end-stage kidney disease receiving dialysis in any form commonly experience symptoms associated with their reduced renal function and dialysis treatment, often requiring complex medication therapy to manage. Pharmacists are ideally placed as medicines experts to contribute alongside the multidisciplinary team in optimising patient care. However, specialty dialysis clinical pharmacist roles are beginning to emerge, and few studies have been conducted evaluating the impact of clinical pharmacists in dialysis services.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review aimed to identify and evaluate clinical pharmacy services implemented, and outcomes measured, for patients receiving haemodialysis or peritoneal dialysis in the hospital or home setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies published in English, with participants aged over 18 years receiving any chronic dialysis and involving clinical pharmacist services were included. Studies were excluded if they included only medication supply services or only included patients receiving continuous renal replacement therapy.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Thirty-five studies, published 1997–2024, detailing 17 unique pharmacist interventions for patients receiving dialysis were identified and measured using 17 different outcomes. In the 25 studies, the most common pharmacist interventions included specialist pharmacist medication review (&lt;i&gt;n&lt;/i&gt; = 29), pharmacist inclusion in the multidisciplinary team (&lt;i&gt;n&lt;/i&gt; = 22), extended pharmacist consultation (&lt;i&gt;n&lt;/i&gt; = 20), and targeted adherence counselling (&lt;i&gt;n&lt;/i&gt; = 18). The outcomes measured were categorised into three broad themes: therapy-effectiveness, patient-centred, and health-system measures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The interventions detailed in the included studies highlight an opportunity to extend the scope of pharmacist activities in providing dialysis services in Australia. This expansion would be in line with the ongoing reviews of scope of practice for health professionals and the broader trend of expanding the clinical pharmacist's role. The variability of detail provided in the studies limits transparency and transferability to different dialysis contexts and may imp","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":"271-286"},"PeriodicalIF":1.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918777","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":"Development and pilot evaluation of an insulin prescribing online resource for adult patients","authors":"Sivarubini Mugunthan BMedSt, MD,&nbsp;Katherine Griffin MBBS, FRACP,&nbsp;Laetitia Hattingh BPharm, MPharm, GCertAppLaw, PhD","doi":"10.1002/jppr.70012","DOIUrl":"https://doi.org/10.1002/jppr.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prescribing is a complex task and high-risk area in clinical practice. The safe prescribing of insulin is an essential skill for doctors. The introduction of the integrated electronic medical record (ieMR) system added a new layer of complexity in prescribing insulin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To develop an insulin prescribing online resource for adult patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Mixed methodology was used for this study conducted between August 2020–July 2021. Phase 1 involved qualitative data collection via stakeholder interviews which informed phase 2, the creation of the online resource. The final phase, phase 3, involved piloting the usefulness of the online tool via a pre- and post-tool survey to determine any change in their knowledge and confidence. Ethical approval was granted by the Gold Coast Hospital and Health Service Human Research Ethics Committee (Reference no: LNR/2021/QGC/73635) and the study conforms with the Australian <i>National statement on ethical conduct in human research</i>. Informed consent was obtained from all participants via distribution of a project information sheet, completion of a written consent form for interview participants, and completion of the anonymous and voluntary pre- and post-tool surveys for survey respondents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The semi-structured interviews with ten stakeholders identified four key issues with insulin prescribing: (1) uncertainty around correct terminology, (2) ambiguity of different prescribing pathways, (3) frequency of dose checks, and (4) action when a dose is missed. Based on these findings, an online resource that was user-friendly and complemented current resources was constructed. The pre- and post-tool surveys (<i>n</i> = 8) used in the pilot evaluation of the online tool demonstrated a statistically significant improvement for seven of 12 responses highlighting enhanced prescribers' confidence in accessing the existing resources as well as navigating and prescribing insulin through the ieMR system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The practical online resource was easy to navigate and increased doctors' confidence to prescribe insulin through an electronic platform. Application of this tool has potential to reduce insulin prescribing errors, an important aspect of patient safety.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":"287-295"},"PeriodicalIF":1.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918715","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":"Getting the full picture: what are the enablers and barriers to a rural pharmacy workforce for employers and employees? A critical review of literature from 2002–2022","authors":"Zikai He MPhil, MPharm, BPharm,&nbsp;Lisa Bourke PhD","doi":"10.1002/jppr.70007","DOIUrl":"https://doi.org/10.1002/jppr.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose of review</h3>\u0000 \u0000 <p>Geographical maldistribution of pharmacists to regional and rural areas in Australia is well documented in a similar fashion to other health professions. This narrative review aimed to identify the enablers and barriers to staff recruitment and retention and ascertain the extent of evidence in the literature from the perspective of prospective employers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Sources of information</h3>\u0000 \u0000 <p>A comprehensive literature search was undertaken for peer reviewed, English language articles published from 2002–2022 using non-Medical Subject Headings (MeSH) terms including ‘rural’, ‘remote’, ‘pharmacy’, ‘pharmacist’, ‘employer’, ‘manager’, ‘workforce’ and ‘practice’, with pharmacy-specific filters applied using databases MEDLINE/EBSCOhost, PudMed, Scopus, ScienceDirect, and DOAJ (Directory of Open Access Journals). The themes identified were tabulated and analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key findings</h3>\u0000 \u0000 <p>A large number of themes were identified, and much of the literature focused on the perspectives of employees. The most commonly identified themes in the 12 studies included ‘rural origin or background/initial training’, ‘professional relationship with other health professionals’, and ‘lifestyle/lifestyle enabled by cost of housing and living’. Some previously highly regarded predictors such as ‘rural origin’ were less common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Recent studies suggest that positive experiences during rural clinical placements and initial employment after undergraduate study are likely to be statistically impactful. Only few themes were shared between employees and employers. The existing literature is heavily skewed towards the views of prospective employees, while relatively little regarding the views of employers. Further, original research from an employer's point of view, especially with regards to the challenges they face and any incentives they offer in attracting a pharmacist workforce to rural and regional areas, is needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"186-192"},"PeriodicalIF":1.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70007","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550975","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":"Partnered pharmacist medication charting of the fractured neck of femur clinical care pathway at hospital admission","authors":"Megan Denton-Brown BPharm, FANZCAP (PeriopMed, Surg),&nbsp;Sharon Selvanayakam BPharm, FANZCAP (Edu, Surg),&nbsp;Jane La MClinPharm,&nbsp;Susan Liew MBBS (Hons), FRACS (orth)","doi":"10.1002/jppr.70001","DOIUrl":"https://doi.org/10.1002/jppr.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neck of femur (NOF) fractures are associated with significant morbidity and mortality. Fractured NOF clinical care pathways (CCPs) standardise care; however, the impact of Partnered Pharmacist Medication Charting (PPMC) in this context remains unexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate pharmacist involvement through PPMC on the proportion of patients initiated on the electronic medical record (EMR) integrated Fractured NOF CCP, at hospital admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective, pre- and post-intervention study was conducted in the orthopaedic unit of a tertiary-referral health service. Patients ≥65 years with a primary minimal trauma NOF fracture were included. In the intervention, the Fractured NOF CCP could be initiated through PPMC, in addition to usual care. The primary outcome of the study was the proportion of patients initiated on the CCP and secondary outcomes included the proportion of PPMC initiated CCPs and the time to CCP initiation. Ethical approval was granted by the Alfred Hospital Research and Ethics Committee (Reference no: 779/20) and the study conforms to the Australian <i>National statement on ethical conduct in human research</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 127 patients pre-intervention (January–August 2020) and 149 patients post-intervention (January–August 2021) were included. Fractured NOF CCP initiation increased post-intervention (<i>n</i> = 20, 15.7% vs <i>n</i> = 83, 55.7%, p &lt; 0.0001). Emergency department initiation of the CCP was similar (<i>n</i> = 20, 15.7% vs <i>n</i> = 23, 15.4%, p = 0.94); and median (interquartile range [IQR]) time to initiation increased (0.9 h, IQR 0.4–1.9 h vs 3.9 h, IQR 2.0–6.3 h, p = 0.001). Post-intervention, 60 additional patients were initiated on the CCP through ward care components; median time to initiation was 16.4 h, IQR 11.8–20.6 h, and 61 (73.5%) patients were initiated on the CCP via PPMC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pharmacist involvement through PPMC significantly increased the proportion of patients initiated on the Fractured NOF CCP at hospital admission. The delay in initiation post-intervention requires further exploration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":"311-318"},"PeriodicalIF":1.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-risk psychotropic medication use and delirium screening in older patients undergoing planned surgical procedures","authors":"Sally B. Marotti BPharm,&nbsp;Sona E. Shaji BPharm,&nbsp;Alanna Maguire BPharm,&nbsp;Angela Lovas-Tiong BPharm,&nbsp;Gizat M. Kassie BPharm, PhD,&nbsp;Anita Taylor MSc,&nbsp;Peter J. Smitham PhD, FRCS (Tr & Orth), FRACS,&nbsp;Lisa M. Kalisch Ellett BPharm, PhD","doi":"10.1002/jppr.70004","DOIUrl":"https://doi.org/10.1002/jppr.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A number of commonly used psychotropic medicines increase the risk of postoperative delirium. In some cases, these medicines could be safely tapered or held prior to planned surgery, which may reduce the incidence of postoperative delirium. However, the frequency with which patients use these medicines prior to planned surgery is unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To determine the prevalence of opioid analgesic, antidepressant, gabapentinoid, and benzodiazepine use prior to planned surgery, the prevalence of delirium screening before and after planned surgery, and the incidence of postoperative delirium in older patients using high-risk medicines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We conducted a retrospective analysis of electronic medical records (EMRs) from four acute-care hospitals. Patients aged 65 years or older who underwent planned surgery over a 2-week period were included. Data relating to patient age, gender, type of surgical procedure, length of surgery, type of anaesthesia, medications on admission, and 4AT delirium tests were extracted from the EMRs. This project was exempt due to the local policy requirements that constitute research by the Central Adelaide Local Health Network (CALHN) Human Research Ethics Committee (Reference no: CALHN19857). The justification for this ethics exemption was as follows: the project complies with the National Health and Medical Research Council's <i>National statement on ethical conduct in human research</i>, met local requirements for an audit activity, and presented no foreseeable risk of patient harm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 158 participants with a median age of 75 years, of whom 41% were taking a medicine associated with increased risk of postoperative delirium prior to their planned surgical admission; 21% were taking an antidepressant, 15% an opioid analgesic, 13% a benzodiazepine, and 6% a gabapentinoid at the time of admission. In addition, 80% of participants had a 4AT test prior to surgery, and 61% received at least one 4AT test after surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among the older patients undergoing planned surgery, 41% used a medicine associated with increased risk of postoperative delirium, and not all older patients received delirium screening prior to or after surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 4","pages":"319-326"},"PeriodicalIF":1.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144918771","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":"Is medication regimen complexity often overlooked, and what can we do about it?","authors":"J. Simon Bell BPharm (Hons), PhD,&nbsp;Esa Y. H. Chen BPharm, PhD","doi":"10.1002/jppr.70013","DOIUrl":"https://doi.org/10.1002/jppr.70013","url":null,"abstract":"&lt;p&gt;Patients are often identified for referral for medication reviews based on the complexity of their treatment regimen.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Regimen complexity can arise due to the number of mediations, formulations, administration timings, and special instructions for medication use. Regimen complexity has been associated with non-adherence, hospitalisations, and medication errors.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Patients with three or more medical conditions, who experience difficultly self-administering specific formulations (e.g. inhalers, eye drops, transdermal patches) or who have other difficulty self-managing their medication regimen are thought to benefit from medication review.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In this issue of JPPR, Seth et al. describe an analysis of 196 Home Medicines Reviews (HMRs) in New South Wales, Australia.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Seth et al. report that patients had similar median Medication Regimen Complexity Index (MRCI) scores before (28.5) and after (29.0) HMR, even when assuming that all pharmacists' recommendations were implemented. These findings were consistent with an earlier study of 285 recipients of Residential Medication Management Reviews (RMMRs) by Pouranayatihosseinabad et al.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; There are some considerations when interpreting the results of these two studies. First, the HMRs and RMMRs were performed by just two pharmacists and one RMMR service provider, respectively meaning that generalisability may be limited. Second, it is unclear whether the general practitioners who initiated these HMRs and RMMRs specified regimen complexity as a reason for referral. The stated purposes of the HMR and RMMR programs are broad and regimen simplification is not explicitly stated. Nevertheless, the lack of apparent impact on MRCI scores (the most widely used method for quantifying regimen complexity) will cause readers to question whether opportunities to simplify complex medication regimens are overlooked when conducting medication reviews.&lt;/p&gt;&lt;p&gt;Seth et al. correctly argue that not all clinically important HMR recommendations reduce regimen complexity. Medication review often includes a range of activities, including taking a best possible medication history and conducting an individualised assessment of the benefits and risks of each medication. The HMRs analysed by Seth et al. also involved recommending additional medications, patient education, lifestyle advice and referral to other health care professional, which may increase the complexity of treatment regimens even as patients better understand their medications. Previous research suggests HMR recipients have a mean of 3.6 medication-related problems each,&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; and so it is unrealistic to expect all aspects of medication management be addressed in a standard HMR or RMMR of 45–60 min duration and the corresponding follow ups.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In contrast to Seth et al.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; and Pour","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"87-89"},"PeriodicalIF":1.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824736","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}