Journal of Pharmacy Practice and Research最新文献

{"title":"Advanced Pharmacy Australia general medicine standards: paving the way for multidisciplinary care and collaboration","authors":"Ak Kar Aung BMedSci, MBBS, FRACP, MPHTM, Michelle Downie MBCHB, FRACP, Leigh-anne Shannon BA, MAICD, 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><sup>1</sup></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, Marianne Jovanovic BPharm (Hons), GradCertPharmPrac, MPharmPrac, FANZCAP (Edu., Gen Med.), FAdPha, Sarah McPhee BPharm (Hons), GradCertPharmPrac, AdPhaM, Abigail Pinto BPharm (Hons), GradCertPharmPrac, AdPhaM, Erica Y. Tong BPharm (Hons), MClinPharm, PhD, CHIA, FAIDH, FSHP, 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":"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":"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}

{"title":"Therapeutic drug monitoring and pharmacogenomic guided perhexiline therapy in kidney failure requiring haemodialysis: a case study","authors":"Harry Ashton BPharm,&nbsp;Hemant Kulkarni DM, FRACP","doi":"10.1002/jppr.70003","DOIUrl":"https://doi.org/10.1002/jppr.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ischaemic heart disease is a leading cause of morbidity and mortality in haemodialysis patients, yet conventional therapies are often precluded due to increased perioperative risk and medication contraindications. Perhexiline, an antianginal agent, is contraindicated in renal impairment. Research has suggested therapy in kidney failure may be safe, but these studies excluded patients requiring haemodialysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We describe a novel case of safe and effective long-term perhexiline therapy in a patient requiring haemodialysis, with treatment guided by therapeutic drug monitoring and interpreted in the context of pharmacogenomic screening.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical Details</h3>\u0000 \u0000 <p>A male patient, aged 84 years, with an intermediate cytochrome P450 2D6 (CYP2D6) metaboliser phenotype, kidney failure (requiring haemodialysis) and ischaemic heart disease (quintuple coronary artery bypass grafting in 1999 with multiple occluded grafts), and intolerant of conventional antianginal therapy received perhexiline 50 mg, twice daily, for refractory symptomatic ischaemic heart disease for the past three years. [Correction added on 28 April 2025, after first online publication: Some text has been corrected in this section].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>Perhexiline and metabolite levels remained within therapeutic range before and after dialysis, and clearance by haemodialysis was negligible. Pharmacogenomic screening and hydroxyperhexiline/perhexiline ratios were consistent with an intermediate CYP2D6 metaboliser phenotype. Therapy in this patient was effective with no adverse events identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This case, combined with existing literature, challenges the contraindication of perhexiline in kidney failure. Perhexiline's unique ability to relieve ischaemic symptoms without inducing intolerable blood pressure reduction makes it a therapy of interest in this patient population. Further studies are needed to definitively establish its long-term safety and efficacy in the kidney failure population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"244-247"},"PeriodicalIF":1.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551279","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":"Questionnaire to assess immunosuppressant knowledge among kidney transplant recipients: item generation and content validation","authors":"Nik Aisyah Najwa Nik Mustaffa Shapri MClinPharm,&nbsp;Nurul Syazfeeza Samsudin MClinPharm,&nbsp;Mohd Shahezwan Abd Wahab PhD,&nbsp;Norkasihan Ibrahim PhD","doi":"10.1002/jppr.1973","DOIUrl":"https://doi.org/10.1002/jppr.1973","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several questionnaires are available to evaluate immunosuppressant knowledge among kidney transplant recipients (KTRs). However, most contain a mixture of questions about different aspects of health management before and after kidney transplantation and do not specifically assess immunosuppressant knowledge.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to generate preliminary items for a questionnaire to assess immunosuppressant knowledge among KTRs, validate the items, and translate the items into Malay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Preliminary items were generated from domains and subdomains identified through a review of previous questionnaires. Then, the item content was validated in a three-round Delphi study by an expert panel of 11 renal pharmacists. The experts rated the relevance of the items and provided feedback on their comprehensibility and comprehensiveness. Items that attained ≥75% expert agreement on their relevance were considered relevant. Finally, the relevant items were translated into Malay through a forward–backward translation process by three external translators and two researchers. Ethical approval was granted by the Universiti Teknologi MARA Research Ethics Committee (Reference no: REC (PH)PG/027/2022) and the study conforms with the Declaration of Helsinki. Participants were approached electronically, and informed consent was obtained from all participants via distribution of a project information sheet, explaining their participation was voluntary and a gift card would be provided as an incentive upon completion of all three rounds of the Delphi study and completion of a written consent form.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 24 preliminary items were generated. In Round 1 of the Delphi study, four items needed revision, and nine new items were suggested for Round 2 (<i>n</i> = 13). In Round 2, only five of the 13 items were carried forward to Round 3. In the final round, only one of the five items was relevant. The final experts' revision produced 27 items. A Malay-language questionnaire equivalent to the English version was produced.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A content-validated questionnaire consisting of 27 items in English and Malay was produced. This questionnaire serves as a reliable tool to identify immunosuppressant knowledge gaps and evaluate the impacts of educational interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"234-243"},"PeriodicalIF":1.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144550919","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":"Every-other-day iron supplementation in male veterans with iron deficiency anaemia","authors":"Chadwick K. Mellen Pharm D,&nbsp;Emily Q. Nguyen PharmD,&nbsp;Joseph P. Rindone PharmD","doi":"10.1002/jppr.1972","DOIUrl":"https://doi.org/10.1002/jppr.1972","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;Iron deficiency anaemia (IDA) is prevalent in the male veteran population and requires iron replacement. Current data on alternate-day dosing for oral iron supplementation in IDA has focused on younger women.&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 evaluate the effectiveness and safety of every-other-day (EOD) iron supplementation compared to daily dosing in men with IDA.&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;This was a retrospective chart review which included American male veterans, aged 18 years or older, who had been diagnosed with IDA. To be included, patients required a haemoglobin (Hb) value &gt;7 g/dL (70 g/L) but &lt;13 g/dL (130 g/L) prior to initiation of oral ferrous sulfate and completed at least 60 days of oral ferrous sulfate therapy between January 2017–July 2021. The primary objective was to evaluate the change in Hb lab values after at least 60 days of oral ferrous sulfate 325 mg regardless of dosage regimen (twice daily [BID], daily [QD], or EOD). The secondary objectives were to evaluate changes in haematocrit, ferritin, iron saturation, and iron levels. In addition, we evaluated the rate of gastrointestinal adverse events for the previously listed dosing of ferrous sulfate. This project was exempt due to the local policy requirements that constitute research by the Southern Arizona VA Health Care System Institutional Review Board (11 February 2022, Vice Chair). The justification for this exemption was as follows: the study only included data and analysis involving the use of identifiable health information for the purposes of research. The data collection and use of the data was covered under Health Insurance Portability and Accountability Act (HIPAA) and for which a waiver of HIPPA authorisation was approved.&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;Eighteen patients were randomly selected for each dosing group. An increase in Hb (± standard deviation) of 16 g/L ± 13 in the EOD dosing, 17 g/L ± 17 in the QD group, and 21 g/L ± 22 in the BID group. There was no statistical difference in change in Hb when the EOD group was compared to the QD or BID groups. There were also no statistical differences noted in the change of haematocrit, ferritin, iron level, or iron saturation between groups. The discontinuation rate in the EOD group was lower than those of the QD or BID groups (5.6%, 11.2%, and 11.7% respectively), though they were not statistically different.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;EOD dosing was comparable in efficacy to daily dosing in older men wi","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"211-215"},"PeriodicalIF":1.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551226","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":"Trends in the uptake of clinical support pharmacy technician roles in Australian hospitals from 2016 to 2022: a cross-sectional survey","authors":"Brett J. Anderson BPharm (Hons), GradCertPharmPrac, FANZCAP (Lead&Mgmt, Research),&nbsp;Simone E. Taylor PharmD (BPharm), GradCertClinicalResearchMethods, FSHP, FANZCAP (EmergMed, Research),&nbsp;Joanne Travaglia BSocStuds (Hons), MEd, PhD,&nbsp;Rachelle L. Catanzariti BMedsci, BBus, MPharm, PhD,&nbsp;Lisa Pont BSc, BPharm, MSc (Epidemiology), PhD, FSHP, FANZCAP (GeriMed, Edu)","doi":"10.1002/jppr.1958","DOIUrl":"https://doi.org/10.1002/jppr.1958","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>A 2016 Australian hospital pharmacy technician workforce survey reported that pharmacy technicians seldom perform clinical support roles. Subsequently, the Society of Hospital Pharmacists of Australia extended their endorsement of pharmacy technicians performing clinical roles in the <i>Standard of practice for pharmacy technicians to support clinical pharmacy services</i> published in 2019. It is unknown if the roles undertaken by hospital pharmacy technicians have since evolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare and contrast trends in the uptake of hospital pharmacy technician roles between 2016–2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>An electronic questionnaire comprising 97 questions was circulated to Australian hospital pharmacy departments in 2022 and the results were compared to those obtained from the 2016 questionnaire. Hospital pharmacy technicians' clinical support roles were categorised as ‘clinical tasks’ (<i>n</i> = 15) or ‘technical tasks’ (<i>n</i> = 34). Ethical approval was granted by the University of Technology Sydney Human Research Ethics Committee (Reference no: ETH21-6732) and the study conforms with the <i>National statement on ethical conduct in human research</i>. Informed consent was obtained from all participants via project information distributed to potential participants via email, indicating their participation would be voluntary and anonymous. Participants provided their consent by completing the questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Responses were received from 54 of 273 pharmacy departments (response rate 20%) in 2022 compared to 154 responses from 308 pharmacy departments (response rate 50%) in 2016. Hospital pharmacy technicians performed a median of 0.5 ‘clinical tasks’ (interquartile range [IQR] 0–1.25) in 2022 and 1 ‘clinical tasks’ (IQR 0–3) in 2016. In contrast, hospital pharmacy technicians performed a median of 7 (IQR 3–12) and 8 (IQR 3–12) ‘technical tasks’ in 2022 and 2016, respectively. No significant changes were identified in the prevalence of hospital pharmacy technicians undertaking clinical tasks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite publication of professional practice standards endorsing clinical roles for pharmacy technicians, clinical roles are still seldom performed. Interventions are required to address the barriers limiting the expansion of hospital pharmacy technician roles.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"193-203"},"PeriodicalIF":1.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551285","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":"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 effectiveness of oral and sublingual ketamine in pain management: a systematic review and meta-analysis","authors":"Stephanie Elizabeth Harris MBBS (Hons),&nbsp;Jeremy Szmerling BPharm (Hons), ANZCAP-Reg (PainMgmt, Steward),&nbsp;Diarna Abbott BNurs, GCertAdNurs (Periop),&nbsp;Enwu Liu BSc, BMed, MSc, PhD,&nbsp;John Oldroyd BSc, MPH, PhD","doi":"10.1002/jppr.1969","DOIUrl":"https://doi.org/10.1002/jppr.1969","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this study was to undertake a systematic review and meta-analysis to determine the effectiveness of oral and sublingual ketamine in pain management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>A systematic search was conducted utilising four databases: MEDLINE, CINAHL, Embase, and Web of Science.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Selection</h3>\u0000 \u0000 <p>The study included randomised controlled trials investigating the use of oral or sublingual ketamine in the management of pain in inpatient or outpatient settings compared to any alternative oral or sublingual comparator, including placebo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one studies were included for systematic review, all assessing oral ketamine, including one comparing oral to sublingual ketamine. Of these, 12 studies evaluated oral ketamine in procedural pain, with 10 studies finding oral ketamine significantly better than the comparator at reducing procedural pain. Two studies focused on oral ketamine in postoperative pain, both finding oral ketamine reduced the requirement for additional analgesia compared to placebo. Five studies investigated oral ketamine in chronic pain with heterogenous results. Of the remaining two studies, one compared various doses of oral ketamine and the other compared oral to sublingual ketamine.</p>\u0000 \u0000 <p>Fifteen studies were included for meta-analysis. Among them, seven studies compared oral ketamine to placebo and found oral ketamine was superior to placebo in reducing pain (p &lt; 0.01). Eight studies compared oral ketamine to other oral medications such as methadone, codeine, midazolam, and dexmedetomidine and showed no significant benefit of oral ketamine in reducing pain (p = 0.18).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results suggest oral ketamine is an effective analgesic in the procedural setting.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 3","pages":"170-185"},"PeriodicalIF":1.0,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1969","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551344","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}