Journal of Pharmacy Practice and Research最新文献

{"title":"Is medication regimen complexity often overlooked, and what can we do about it?","authors":"J. Simon Bell BPharm (Hons), PhD, Esa Y. H. Chen BPharm, PhD","doi":"10.1002/jppr.70013","DOIUrl":"https://doi.org/10.1002/jppr.70013","url":null,"abstract":"<p>Patients are often identified for referral for medication reviews based on the complexity of their treatment regimen.<span><sup>1</sup></span> 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.<span><sup>2</sup></span> 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.<span><sup>3</sup></span></p><p>In this issue of JPPR, Seth et al. describe an analysis of 196 Home Medicines Reviews (HMRs) in New South Wales, Australia.<span><sup>4</sup></span> 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.<span><sup>5</sup></span> 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.</p><p>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,<span><sup>6</sup></span> 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.<span><sup>3</sup></span></p><p>In contrast to Seth et al.<span><sup>4</sup></span> 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}

{"title":"Effect of dose administration aids on adherence of self-administered medications: a systematic review","authors":"Kanika Chaudhri BMedSci (Hons), MD, PhD,&nbsp;Sonali R. Gnanenthiran MBBS, PhD, FRACP, FCSANZ,&nbsp;Anastasia Williams BSci,&nbsp;Madeleine Kearney BMedSci, MPH,&nbsp;Richard O. Day MB BS (Hons), MD, FRACP,&nbsp;Anthony Rodgers MBChB, DPH, FAFPHM, PhD, FAHMS, GAICD,&nbsp;Emily R. Atkins BSci, PhD","doi":"10.1002/jppr.1962","DOIUrl":"https://doi.org/10.1002/jppr.1962","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Failure to self-administer a medication is the most common reason for non-adherence. Dose administration aids (DAAs) are a simple and common solution to improve unintentional non-adherence for oral tablets. They range from compartmentalised pill boxes and automated medication dispensing devices to blister packs. The aim of this systematic review was to summarise the current literature assessing the impact of DAAs on medication adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data sources</h3>\u0000 \u0000 <p>A search of MEDLINE, Embase, CINAHL, and the Cochrane Library was conducted from the beginning of each database until April 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study selection</h3>\u0000 \u0000 <p>A search strategy and keywords list were developed with a medical research librarian. Two reviewers independently screened studies and extracted data. The primary outcome was to assess the effects of DAAs on medication adherence. The secondary outcome was to evaluate the changes in any health outcomes documented. The study was reported in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analyses (PRISMA) 2020 statement and registered with PROSPERO (Study registration: CRD42018096087).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two randomised controlled trials were included. Median adherence improved within the intervention groups for self-reported (95.5%, range: 88%–100% vs 84.5%, range: 83%–98%) and non-self-reported (88%, range: 54%–100% vs 70%, range: 83%–98%) adherence compared to usual care. However, self-reported adherence was higher in both intervention and control groups than non-self-reported adherence. Measured changes to health outcomes included cardiovascular outcomes, plasma levels, cure rates for malaria, hospital admissions, venous thromboembolism, and anaemia. Even though self-reported adherence levels were high, included studies did not report many statistically significant improvements in health outcomes with DAAs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of DAAs can considerably improve medication adherence, with limited data suggesting positive effects on patient outcomes. Healthcare providers should consider the use of these aids as part of a comprehensive treatment plan for patients who struggle with medication adherence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"90-101"},"PeriodicalIF":1.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1962","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824745","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 structure and implementation of practice-integrated foundational professional development programs for hospital pharmacists: a scoping review","authors":"Yu Ting Sim BPharm,&nbsp;Saravana Kumar BAppSc (PT), GradDip (Digital Learning), MPT (Manip and Sports), PhD,&nbsp;Sally Marotti BPharm, MClinPharm, CGP,&nbsp;Carolyn Murray BAppSc (OT), MaOT, BHlthSc (Hons), PhD","doi":"10.1002/jppr.1964","DOIUrl":"https://doi.org/10.1002/jppr.1964","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Practice-integrated residency programs are one of the most recognised training platforms for early career development across settings, including hospital pharmacy. They embed a structured education and competency framework and preceptor mentoring systems in the workplace.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This review aimed to map the global literature on practice-integrated education and professional development programs for early career hospital pharmacists, with a focus on how the programs were implemented and structured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A search was applied to electronic databases MEDLINE, Ovid Emcare, Embase, ERIC, Scopus, PsycINFO, Cochrane Library, Google Scholar and grey literature sources until 31 December 2023. Search terms were developed in consultation with an academic librarian and using the population, concept and context mnemonic. The scoping review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews and the Joanna Briggs Institute scoping review manual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Forty-seven papers were included from seven countries, with the majority (<i>n</i> = 33) being from the United States of America. Residency program details were mapped against jurisdictions and associated assessment processes, competency training areas, and focused training elements. Findings report similarities and differences of structural, competency frameworks, and locally driven context and requirements.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The demand from early career pharmacists for residency programs remains high, with professional pharmacy organisations providing leadership to grow training positions. The global pharmacy development goals appear to be embedded within the residency programs, but gaps include training in non-direct patient care competencies and research that demonstrates the outcomes from residency training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"16-35"},"PeriodicalIF":1.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1964","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424021","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":"Comparison of closed-system transfer devices to compound cytotoxic medicines in a hospital pharmacy compounding unit","authors":"Evonne Katherine Smith BPharm, GDClinPharm","doi":"10.1002/jppr.1954","DOIUrl":"https://doi.org/10.1002/jppr.1954","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;The use of a closed system transfer device (CSTD) is recommended when compounding hazardous cytotoxic medicines for operator and environmental protection. The hospital pharmacy compounding unit has used the CSTD PhaSeal since 2014. Recent evidence suggests an alternative CSTD, Equashield, may be a suitable alternative.&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;To determine if Equashield provides any advantages financially, in compounding time, rubber bung contamination, cytotoxic medicine surface contamination, staff satisfaction, and work health and safety benefits when compared to PhaSeal.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;CSTD PhaSeal was compared to Equashield by performing a financial cost comparison, time in motion study to compare compounding time, evaluation of product contamination rates and cytotoxic surface contamination levels, work health and safety (WH&amp;S) review and staff satisfaction survey. This project was exempt due to the local policy requirements that constitute research by the Children's Health Queensland Research Ethics Committee (Reference no: EX/23/QCHQ/97690). The justification for this ethics exemption was as follows: the study conformed with the &lt;i&gt;Ethical considerations in quality assurance and evaluation activities&lt;/i&gt; and met local requirements for a quality assurance activity and did not involve any assessment of staff. Informed consent was obtained from all staff via verbal explanation of the project and their voluntary participation. Staff consented via completion of the voluntary survey.&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;The cost to compound using Equashield instead of PhaSeal was increased by AUD $4684 over a 6-month period, with a compounding time saving benefit of approximately 1 min per product. Product contamination by rubber stopper core was 16 per 100,000 products using Equashield. Surface cytotoxic contamination levels remained undetectable before and after the comparison. Staff preferred Equashield and a WH&amp;S product review determined Equashield required less torque and force during use and may reduce repetitive strain injury.&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;Equashield performed better in time to compound, rate of product contamination, staff satisfaction and WH&amp;S assessment. The cost of Equashield was greater; however, Equashield demonstrated benefits over Phaseal in other areas of comparison, which could potentially offset the cost increase. The pharmacy demonstrated Equashield may be a suitable alternative to PhaSea","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"138-145"},"PeriodicalIF":1.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824740","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":"Clinical pharmacy services supporting patient care","authors":"Michael J. Dooley BPharm, GradDipHospPharm, PhD, FSHP","doi":"10.1002/jppr.1968","DOIUrl":"https://doi.org/10.1002/jppr.1968","url":null,"abstract":"&lt;p&gt;In this issue of the &lt;i&gt;Journal of Pharmacy Practice and Research&lt;/i&gt; we have new Clinical Pharmacy Standards for the profession.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; It has been a pleasure to work alongside so many others to help bring this important consensus document together and to have been involved in the earlier versions. The first comprehensive standard of practice for clinical pharmacy was published by the Society of Hospital Pharmacists of Australia in 1996 with updated versions subsequently released in 2005 and 2015.&lt;span&gt;&lt;sup&gt;2-4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;As practice has evolved over time the new &lt;i&gt;Advanced Pharmacy Australia Clinical Pharmacy Standards&lt;/i&gt;&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; have been adapted to incorporate a greater focus on describing the key quality elements for practice as well as focus on person centred care and interdisciplinary practice whilst proving guidance on prioritisation of the clinical pharmacy services.&lt;/p&gt;&lt;p&gt;The accompanying editorial authored by Advanced Pharmacy Australia President Tom Simpson shares his views on the importance of this work and described the Standards as a blueprint for patient care and an ‘instruction manual’ for how to design, implement, and measure the clinical pharmacy services that underpin contemporary medicines management.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Dr Danielle McMullen, the President of the Australian Medical Association, describes the importance of collaboration between professions and the vision to implement innovative models of care safely, to improve patient outcomes and the experience as practitioner.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; This perspective from our medical colleagues is vital as it reinforces one of the key principles in our Standards; that interprofessional collaboration is essential to the delivery of efficient and effective person-centred care.&lt;/p&gt;&lt;p&gt;These Standards provide a framework and guidance for comprehensive and accountable clinical pharmacy services. The underpinning principle is to describe current best practice to support the basic rights of patients when accessing healthcare services, including access, safety, respect, partnership, information, privacy, and the right to give feedback. Comprehensive and accountable clinical pharmacy services are an essential component of contemporary health care. The challenge has been to describe the quality of practice for clinical pharmacy services in Australia, irrespective of service type (private and public hospitals, inpatients, outpatients or community-based services) or location (metropolitan, regional, rural, or remote).&lt;/p&gt;&lt;p&gt;A fundamental component of these Standards has been to provide clear guidance for the pharmacy workforce, which encompasses pharmacists, but also includes pharmacy technicians and assistants who play a pivotal role in the care provided. The scope of practice and role delineation between the professional scope of practice of pharmacists and that of pharmacy technicians and assistants required significant considerat","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 6","pages":"439-440"},"PeriodicalIF":1.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1968","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143252579","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":"Today's advanced is tomorrow's standard","authors":"Tom Simpson BPharm, FANZCAP (Lead&Mgmt), FAdPha","doi":"10.1002/jppr.1967","DOIUrl":"https://doi.org/10.1002/jppr.1967","url":null,"abstract":"&lt;p&gt;Our Society exists because our members collectively seek to ensure that patients receive the greatest benefit possible from the medicines with which they are treated.&lt;/p&gt;&lt;p&gt;This is reflected in the very first sentence of our Constitution: “[t]he overriding purpose of the Society is to improve health outcomes from medicines use within hospitals and/or other healthcare facilities or settings (including the home) where pharmacists, the membership and other health professionals practice, through the use of pharmacist expertise in medicine management”.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;sup&gt;(p1)&lt;/sup&gt;&lt;/p&gt;&lt;p&gt;If this statement is the &lt;i&gt;why&lt;/i&gt;, the &lt;i&gt;Advanced Pharmacy Australia Clinical Pharmacy Standards&lt;/i&gt; are the &lt;i&gt;how&lt;/i&gt;.&lt;/p&gt;&lt;p&gt;The breadth of Advanced Pharmacy Australia's (AdPha's) Clinical Pharmacy Standards spans every element of the Australian health system in which patients, pharmacy practitioners, and medicines intersect and interact. Although it may appear to be a paradox, the Standards are both a foundation and a nexus point.&lt;/p&gt;&lt;p&gt;AdPha's Clinical Pharmacy Standards are a foundation because they are agnostic of care setting. Whether on a ward, in aged care, general practice, or at home, the person receiving care is wrapped in individual patient care activities, which blend into the interprofessional practice that ensures multidisciplinary input into evidence-based decisions. This is depicted in the concentric circles of the &lt;Figure 1: Clinical pharmacy services&gt;.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Surrounding this person-centred care are three enablers: prioritisation to maximise impact; a skilled workforce; and innovation that ensures patients benefit from new approaches to care.&lt;/p&gt;&lt;p&gt;At the same time, the Standards are a nexus. The &lt;Figure 1: Clinical pharmacy standards&gt; shows the principles that wrap around the patient consistently, through all-important transitions of care.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;As well as a blueprint for patient care, the Standards represent an ‘instruction manual’ for how to design, implement, and measure the clinical pharmacy services that underpin contemporary medication management.&lt;/p&gt;&lt;p&gt;It is noteworthy this is achieved with a distinctly Australian flavour, reflecting our health system that is unique in the world. Around four-fifths of the references upon which the Standards are built are Australian, including 25 references to articles published in this journal, AdPha's flagship academic publication.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This reflects the deep expertise of our members and their contribution to evidence of pharmacy impact, nationally and globally.&lt;/p&gt;&lt;p&gt;The maturity of practice they represent is also noteworthy. The 2024 Standards don't only focus on what clinical pharmacy &lt;i&gt;is&lt;/i&gt;, but on the entire supporting system that equips practitioners for the settings in which they practice.&lt;/p&gt;&lt;p&gt;The Standards link deeply with the Australian and New Zealand College of Advanced Pharmacy (ANZCAP), AdPha'","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 6","pages":"441-443"},"PeriodicalIF":1.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1967","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143252580","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":"Driving under the influence of prescribed opioids: a qualitative study of the pharmacist's contribution to road safety","authors":"John Marius Harold Gillett MBBS, FRACGP, FAChPM, MFM, BA (Hons), MLCOM, DMSMed, DipAc, FACRRM,&nbsp;Mark King PhD, MBA, BSc (Hons) (Psych),&nbsp;Julie-Anne Carroll PhD,&nbsp;Melanie White PhD","doi":"10.1002/jppr.1952","DOIUrl":"https://doi.org/10.1002/jppr.1952","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;Australia's 20-year consistent fall in road crash fatalities has stalled. Concerning is the marked increase of prescribed potentially driving-impairing medications (PDIMs), led by opioids, in driver autopsies. Drivers prescribed opioids are often not well advised on cognitive impairment. Pharmacists have a potential role to provide such advice, but their experiences and opinions are generally unreported.&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;To investigate the experiences, perceptions, and opinions of pharmacists dispensing prescribed opioids to patients, particularly what specific advice is given regarding driving safety, and to explore pharmacists' potential future role.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Ten pharmacists in the regional city of Toowoomba, Queensland, consented to semi-structured interviews, conducted between November 2019–November 2021. Interviews were then transcribed and subjected to reflexive thematic analysis to identify themes from the pharmacists' responses. This study is part of a broader project: How do doctors and pharmacists perceive their roles in ensuring safety in driving for both the patient and the general community? Ethical approval was granted by the Queensland University of Technology Research Ethics Committee (Reference no: 1900000374) and the study conforms to Australian &lt;i&gt;National statement on ethical conduct in human research&lt;/i&gt;. Informed consent was obtained from all participants via completion of a written consent form after detailed project information was provided. This occurred at least 5 days after participants were first approached.&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;Three main themes emerged: road safety versus freedom and independence, team approach and communication with general practitioners (GPs), and varying scope of advice on opioid impairment and tolerance. Pharmacists are aware of potential impacts on road safety, yet they are sympathetic towards the independence driving affords. GP communication and a team approach with GPs were the strongest subthemes. Pharmacists gave good information about cognitive impairment without specifically referencing driving. Pharmacists' learning about medications and driving occurred only “on the job.”&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;Pharmacists' current advice to opioid-medicated drivers (OMDs) would benefit from focused opioid upskilling empowering OMDs to make rational drivin","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"129-137"},"PeriodicalIF":1.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1952","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824696","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":"Resilience and strength in healthcare standards","authors":"Dr Danielle McMullen MBBS (Hons), FRACGP, DCH","doi":"10.1002/jppr.1966","DOIUrl":"https://doi.org/10.1002/jppr.1966","url":null,"abstract":"&lt;p&gt;Standards exist at many levels with many objectives in healthcare and are essential to the work we do as health care professionals.&lt;/p&gt;&lt;p&gt;Across professions and in all settings, high-quality, enforceable standards mean that I know my colleagues have at least met basic standards in their training and education, the service I am working in meets required safety standards, and the tools I use have met the relevant standards.&lt;/p&gt;&lt;p&gt;I know from personal experience meeting all accreditation standards in a general practice requires consistent and deliberate effort, but we do this because it upholds patient safety and supports the best outcomes.&lt;/p&gt;&lt;p&gt;The launch of the revised Advanced Pharmacy &lt;i&gt;Australia Clinical Pharmacy Standards&lt;/i&gt;&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; is a positive contribution to our health system and to driving collaboration between professions.&lt;/p&gt;&lt;p&gt;Despite this, the Australian Medical Association (AMA) is deeply concerned standards in healthcare are under threat.&lt;/p&gt;&lt;p&gt;The challenge to standards we currently face is a political one. Australia is suffering serious health workforce pressures which are experienced by the public as delayed access and by health professionals as increased pressure and often expectations to do more with less. Lowering standards to facilitate workforce growth is an appealing solution, but not the right one.&lt;/p&gt;&lt;p&gt;Despite our current workforce shortages, Australia continues to have one of the best health systems in the world. The most recent report from the Commonwealth Fund comparing the health systems of 10 wealthy, developed nations ranked Australia's system as the best overall and the best in health outcomes.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Rigorous standards in safety, accreditation, education, and training contribute to these outcomes.&lt;/p&gt;&lt;p&gt;Australia performed far worse in terms of access, ranking ninth.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The challenge before us as health professionals is to resist lowering standards to improve access. Lowering standards puts positive health outcomes at risk. We have seen this threat to standards proposed as a solution in successive reviews driven largely by the health ministers' meeting. Notably, the recent &lt;i&gt;Independent review of Australia's regulatory settings relating to overseas health practitioners&lt;/i&gt; (known as the ‘Kruk Review’) has proposed lowering English language standards and introducing a new pathway for specialist international medical graduates to register in Australia outside the control of the medical colleges.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;The specialist medical colleges are responsible for ensuring their training programs develop medical professionals who can demonstrate clinical competence and meet patient expectations. The training programs provided by these colleges are comprehensive, involving a strong emphasis on evidence-based medicine, patient safety, and clinical decision-making. Importantly, the programs are designed for the Australian health system ","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 6","pages":"444-445"},"PeriodicalIF":1.0,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1966","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143252581","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":"Factors associated with DPP4i or SGLT2i utilisation: a retrospective cohort study among people with type 2 diabetes mellitus","authors":"Ruth Sim BPharm,&nbsp;Chun Wie Chong PhD,&nbsp;Navin Kumar Loganadan PhD,&nbsp;Noor Lita Adam MBBCh,&nbsp;Zanariah Hussein MBBS,&nbsp;Shaun Wen Huey Lee PhD","doi":"10.1002/jppr.1951","DOIUrl":"https://doi.org/10.1002/jppr.1951","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;Dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium-glucose co-transporter 2 inhibitors (SGLT2i) are increasingly used as glucose-lowering therapies in Malaysia.&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;To examine factors associated with the initiation of DPP4i or SGLT2i among people with type 2 diabetes mellitus (T2DM) in Malaysia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A retrospective cohort study was conducted from 1 January 2012–30 December 2020 in two tertiary Malaysian hospitals. Multivariate logistic regression was used to assess the factors associated with DPP4i or SGLT2i initiation. The impact of treatment initiation on glycaemic control, anthropometric and lipid levels at 6 and 12 months were also measured. Ethical approval was granted by the Malaysian National Medical Research Register (Reference no: NMRR-20-662-52570), the Monash University Human Research Ethics Committee (Reference no: 2020-24900-45575), the Ministry of Health Malaysia Medical Research and Ethics Committee, and the study conforms with the Declaration of Helsinki.&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;This study included 1628 patients. Patients with co-existing dyslipidaemia (odds ratio [OR] 1.34, 95% confidence interval [CI] 1.04–1.73), cardiovascular disease (OR 1.43, 95% CI 1.1–1.87), and microalbuminuria (OR 2.47, 95% CI 1.42–4.3), with ≥5-year history of T2DM (years of T2DM 5–14 OR 1.67, 95% CI1.18–2.38; years of T2DM ≥15 OR 2.07, 95% CI 1.39–3.07), who had a body weight of ≥100 kg (OR 1.75, 95% CI 1.26–2.45), and baseline use of three or more glucose-lowering medicines (OR 2.92, 95% CI 1.74–4.91) had higher odds of being prescribed with SGLT2i. Patients aged ≥65 years old (OR 0.68, 95% CI 0.50–0.93), presented with a family history of diabetes (OR 0.64, 95% CI 0.47–0.89), an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; (eGFR 60–89 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; OR 0.60, 95% CI 0.39–0.90; eGFR ≥90 mL/min/1.73 m&lt;sup&gt;2&lt;/sup&gt; OR 0.55, 95% CI 0.34–0.87), with serum creatinine ≥120 μmol/L (OR 0.31, 95% CI 0.17–0.58), and had baseline usage of sulfonylureas (OR 0.28, 95% CI 0.19–0.4) and insulin (OR 0.5, 95% CI 0.35–0.72) were more likely to receive DPP4i. Glycated haemoglobin of patients receiving these medicines reduced significantly at 6 months (DPP4i: −0.61%, p &lt; 0.001; SGLT2i: −0.66%, p &lt; 0.001) and 12 months (DPP4i: −0.62%, p &lt; 0.001; SGLT2i: −0.74%, p &lt; 0.001).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"117-128"},"PeriodicalIF":1.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1951","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824725","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":"Evaluating the use of glucagon-like peptide-1 receptor agonists in a matched cohort of kidney and liver transplant recipients","authors":"Isabel Baik PharmD,&nbsp;Arin Jantz PharmD, BCPS, BCTXP,&nbsp;Adina Poparad-Stezar PharmD, BCTXP,&nbsp;Deepak Venkat MD,&nbsp;Nadeen Khoury MD,&nbsp;Milagros Samaniego-Picota MD,&nbsp;Humberto C. Gonzalez MD,&nbsp;Mary Grace Fitzmaurice PharmD, BCTXP","doi":"10.1002/jppr.1953","DOIUrl":"https://doi.org/10.1002/jppr.1953","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Diabetes mellitus (DM) and obesity are common among solid organ transplant recipients, but are associated with an increased risk of graft failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are effective for managing both conditions in the general population, there is limited evidence regarding their use among transplant recipients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The effect of GLP-1 RAs on post-transplant glucose control (defined as haemoglobin A1c [HbA1c]) among 37 liver and kidney transplant patients was compared to a control cohort. Secondary outcomes included change in total daily insulin requirements and oral DM agents, estimated glomerular filtration rate (eGFR), weight, and body mass index (BMI). Adverse events attributed to GLP-1 RAs, hypoglycaemia, incidence of pancreatitis, biopsy-proven acute rejection, graft loss, and death were assessed. Ethical approval was granted by the Henry Ford Health Institutional Review Board (Reference no: 15959) and the study conforms with the US Federal Policy for the Protection of Human Subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We observed that patients receiving GLP-1 RAs had a median reduction in HbA1c of 0.5% and reduction in insulin and oral anti-DM agents compared to the control group without GLP-1 RAs. There were statistically significant reductions in both weight and BMI in the GLP-1 RA group. Our observed incidence of adverse events was similar to previous literature. Unlike other smaller studies, a decline in eGFR was observed in the GLP-1 RA group. There were no differences in incidence of biopsy-proven acute rejection, graft loss, or death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>When compared to patients without GLP-1 RA therapy, GLP-1 RAs modestly reduced HbA1c and insulin requirements and statistically reduced weight/BMI review at 6 months. GLP-1 RAs, even if initiated early post-transplant, were seemingly safe and effective. Larger, prospective studies are warranted to evaluate the safety and efficacy of GLP-1 RAs in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"110-116"},"PeriodicalIF":1.0,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824639","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}