Journal of Pharmacy Practice and Research最新文献

{"title":"Impact of Home Medicines Review on medication regimen complexity","authors":"Shrey Seth Pharm D,&nbsp;Lipin Lukose Pharm D,&nbsp;Wubshet H. Tesfaye BPharm, MSc, PhD,&nbsp;Sathvik B. Sridhar MPharm, PhD,&nbsp;Girish Thunga BPharm, MPharm, PhD,&nbsp;Ronald L. Castelino BPharm, MPharm, PhD","doi":"10.1002/jppr.1945","DOIUrl":"https://doi.org/10.1002/jppr.1945","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Previous studies on pharmacist-led Home Medicines Review (HMR) have demonstrated positive associations of HMR and clinical outcomes. However, little is known about their impact on medication regimen complexity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Investigate the impact of pharmacist-led HMRs on simplifying medication regimen complexity using the Medication Regimen Complexity Index (MRCI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective cohort study of 196 general practitioners (GPs) initiated HMRs, conducted over a period of 2 years (2020–2022) using two credentialed pharmacists in New South Wales, Australia. MRCI was used to measure the complexity at two separate time points, at baseline and following pharmacists' recommendations (assuming the GPs accepted all of the pharmacists' recommendations provided during the HMRs). The Wilcoxon signed-rank test was used to determine the difference between the scores at baseline and after HMR. Ethical approval was granted by the University of Sydney Human Research Ethics Committee (Reference no: 2022/584) and the study conforms to the Australian <i>National statement on the ethical conduct in human research</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the HMR service, pharmacists made a total of 792 recommendations (mean ± standard deviation [4.04 ± 2.3] per HMR), among which dosage and frequency adjustment, laboratory monitoring, and therapeutic monitoring were the most common, collectively accounting for almost half of the recommendations. The median MRCI score at baseline was 28.5 (interquartile range [IQR] 21.5–37.6) and following pharmacists' recommendations was 29 (IQR 21.9–37.1). The difference between the baseline and post-HMR scores was not statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrates the lack of significant reductions in medication complexity following HMRs as measured by the MRCI. However, these results need to be interpreted with caution as not all interactions with patients lead to a change in the MRCI score. Comprehensive examination of individual medication changes may provide more meaningful and clinically relevant inferences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"102-109"},"PeriodicalIF":1.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist consultations in hospitalised older surgical patients","authors":"Jacinta Lin BA,&nbsp;Sophie James MD,&nbsp;Garry Soo BPharm, MClinPharm,&nbsp;Leanne Kearney RN,&nbsp;Vasi Naganathan MBBS, PhD,&nbsp;Sarah N Hilmer MBBS, PhD,&nbsp;Janani Thillainadesan MBBS, PhD","doi":"10.1002/jppr.1950","DOIUrl":"https://doi.org/10.1002/jppr.1950","url":null,"abstract":"<p>Older adults are at high risk of drug-related problems during hospitalisation for surgery. Pharmacists play a key role in the multidisciplinary health care team to improve the safety and quality use of medicines in hospitals. The aims of this prospective study were to examine the frequency, type, associated factors, and acceptance rates of pharmacist consultations in a cohort of 302 consecutive patients aged ≥65 years admitted to a tertiary vascular surgery unit. Data collected included frequency and type of pharmacist consultations, patient and clinical characteristics, and the rate of acceptance of pharmacist recommendations. There was a total of 299 pharmacist consultations, with 159 (52.6%) patients being reviewed at least once by a pharmacist. Of the 299 pharmacist consultations, the most common reason for consultation was a medication order review (38.8%). Pharmacist consultation was more likely if the patient had an emergency admission (p = 0.045), had admission to intensive care unit during the hospitalisation (p &lt; 0.001), or had a long-stay admission defined as &gt;14 days (p &lt; 0.001). Older age, frailty status, cognitive impairment, polypharmacy, and operative management were not associated with having a pharmacist review. Of these pharmacist consultations, 190 (63.5%) included recommendations for the care team to implement, and 166 (87.4%) of the 190 recommendations were addressed. These findings provide insight into the roles played by hospital pharmacists and suggest an unmet need for proactive pharmacist consultation for older surgical patients with polypharmacy, frailty, and cognitive impairment. Ethical approval was granted by the Sydney Local Health District Human Research Ethics Committee — Concord Hospital (Reference no: CH62/6/2018–170) and the study conforms to 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 2","pages":"154-158"},"PeriodicalIF":1.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1950","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824738","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 Clinical Pharmacy Standards","authors":"Michael Dooley BPharm, GradDipHospPharm, PhD, FANZCAP (Lead&Mgmt), FSHP,&nbsp;Georgia Bennett BPharm (Hons), ANZCAP-Reg (OncHaem), AdPhaM,&nbsp;Tara Clayson-Fisher GCertClinLead, FANZCAP (Lead&Mgmt), FAdPha,&nbsp;Courtney Hill BPharm, ProfHonsClinPharm, GradCertClinicalResdesign, FANZCAP (Lead&Mgmt, Generalist), AdPhaM,&nbsp;Neil Lam BPharm, MMedSci (Drug Dev) BCGP, ANZCAP-Reg. (OncHaem), AdPhaM,&nbsp;Sally Marotti BPharm, MClinPharm, FANZCAP (Edu., Research), FAdPha,&nbsp;Kate O'Hara BMedSci (Hons), MPharm, PhD, FANZCAP (Neonatol., Paeds), AdPhaM,&nbsp;Cassandra Potts BPharm, GradCertChronCondMgt, FANZCAP (Cardiol.), AdPhaM,&nbsp;Brenda Shum BSc (Hons), BPharm, MBA (Health Management), FANZCAP (Lead&Mgmt), GAICD, FAdPha,&nbsp;Erica Tong BPharm (Hons), MClinPharm, PhD, CHIA, FANZCAP (Informatcs, GenMed), FAIDH, FSHP,&nbsp;Susan Trevillian BPharm, PGradDipHospPharm, FANZCAP (Lead&Mgmt, RuralHlth), FAdPha,&nbsp;Nick Sharp-Paul BA, PGDipArts (Edit&Comm),&nbsp;Suzanne Newman BPharm, GradDipHospPharm, ANZCAP-Reg. (Generalist), AdPhaM,&nbsp;Yee Mellor BPharm, MCncrSc, FANZCAP (Edu., Generalist), AdPhaM","doi":"10.1002/jppr.1959","DOIUrl":"https://doi.org/10.1002/jppr.1959","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 6","pages":"446-511"},"PeriodicalIF":1.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143252562","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":"Fibrinogen concentrate use in the operating theatre at a quaternary hospital in Australia","authors":"Kate Elizabeth Doreen Ziser BPharm, GradDipEd, MClinPharm,&nbsp;Madeline Bullock BPharm,&nbsp;Brett Coghill BPharm (Hons),&nbsp;Sarah Al-Kureshy BPharm (Hons),&nbsp;Aaron Nihal MD, BMedSt,&nbsp;Jess Bendeich BNurs","doi":"10.1002/jppr.1947","DOIUrl":"https://doi.org/10.1002/jppr.1947","url":null,"abstract":"<p>At our quaternary teaching hospital in Queensland, Australia, there has been a rapid increase from 2019 to 2022 in the usage of fibrinogen concentrate (FC) in preference to cryoprecipitate for cardiac surgery. FC is indicated for patients having major trauma requiring haemostatic resuscitation, major intraoperative haemorrhage, or liver transplant patients with major intraoperative haemorrhage. These patients must exhibit severe hypofibrinogenaemia, which is assessed using assay cut-offs of thromboelastogram (TEG) (citrated functional fibrinogen [CFF] ≤ 10 mm) or rotational thromboelastometry (ROTEM) (FIBTEM A5 ≤ 8 mm). FC usage over cryoprecipitate for cardiac surgery is an ongoing debate due to advantages such as dose predictability, rapid reconstitution, viral inactivation, and minimal transfusion-related adverse events; however, it is expensive. The aim of this study was to capture prescribing patterns of FC and appropriateness against local guidelines. Retrospective data were analysed, and the practice was compared to hospital guidelines. Data from 52 patients over a 4-year period (2019–2022) showed intraoperative haemorrhage was the leading indication for FC use (65%, <i>n</i> = 34), followed by liver transplantation (27%, <i>n</i> = 14), and major trauma (8%, <i>n</i> = 4). When breaking down the cause of intraoperative haemorrhage, cardiothoracic surgery, both elective (50%, <i>n</i> = 17) and emergency procedures (41%, <i>n</i> = 14), accounted for 91% of all operative bleeding requiring FC. There were 34 (65%) of 52 patients who received a differing dose of FC compared to what was recommended in the hospital guideline, with 50% (<i>n</i> = 17) receiving a higher than recommended dose and 50% (<i>n</i> = 17) receiving lower than recommended doses. This project was exempt due to the local policy requirements that constitute research by the Metro South Human Research Ethics Committee (Reference no: CM2305202303). The justification for this exemption was as follows: the study presented no foreseeable risk of patient harm as it involved evaluation of standard care involved the use of existing non-identifiable patient records.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"79-84"},"PeriodicalIF":1.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1947","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423580","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":"Standard of practice for pharmacy services specialising in transitions of care","authors":"Katie Phillips BPharm (Hons), GradCertPharmPract, FANZCAP (ToC, PrimCare), AcSHP, MPS, AdPhaM,&nbsp;Deirdre Criddle BPharm, GradDipHospPharm, FANZCAP (ToC, GeriMed), AcSHP, FPS, FSHP,&nbsp;Margaret Jordan BPharm, MSc (Res), PhD, FANZCAP (MedsMgmt, PrimCare) AcSHP, FSHP,&nbsp;Elizabeth Manias RN, BPharm, MPharm, PhD, BCGP, MPS, FANZCAP (ToC, GeriMed), AdPhaM,&nbsp;Brigid McInerney BPharm, MClinPharm, FANZCAP (ToC, GeriMed), AcSHP, AdPhaM,&nbsp;Horst Thiele DiplPharm, AdPhaM,&nbsp;Ahmed Zeidan BPharm, GCeH, MClinPharm, BCGP, FANZCAP (ToC, GeriMed), AdPhaM,&nbsp;Yee Mellor BPharm, MCncrSc, FANZCAP (Edu., Generalist), AdPhaM","doi":"10.1002/jppr.1957","DOIUrl":"https://doi.org/10.1002/jppr.1957","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"54 5","pages":"417-435"},"PeriodicalIF":1.0,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664564","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":"The Australian Injectable Drugs Handbook (AIDH): Experience of artificial intelligence translations of non-English product information","authors":"Emma Wong BPharm, GradDipHospPharm, FANZCAP (Emerg),&nbsp;Keli Symons BPharm, AACPA, FANZCAP (GeriMed, PrimCare)","doi":"10.1002/jppr.1946","DOIUrl":"https://doi.org/10.1002/jppr.1946","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In June 2022, the Society of Hospital Pharmacists of Australia (SHPA) Specialty Practice Medicines Information Leadership Committee formally requested an expanded range of imported medicines to be included in the latest edition of the <i>Australian Injectable Drugs Handbook</i> (AIDH), developed and published by SHPA. This request was to aid medication safety and reduce the duplication of work required by tertiary hospital staff when producing local guidance. This study describes the challenges faced by the AIDH editorial team in obtaining information in English for imported medicines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The purpose of this study was to determine whether machine translation is suitable for translating foreign language product information (PI) documents into English.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Three sources (one machine and two human sources) were used to translate the PI provided for five imported medicines from four languages into English. We compared the quality of the translations for obtaining information suitable to inform a medicine administration guideline. Ethical approval was not required for this research article as it involved no experimental investigations on humans and did not involve human participants or cohort comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our study found machine translation and human translations to be very similar in terms of readability and adequacy. Machine translation was found to be more time-saving and cost-effective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results suggest that it may be appropriate for pharmacists to harness the time- and cost-saving benefits of machine translation. However, pharmacists must apply their critical evaluation skills to the information provided regardless of the source of the translation. Information translated from another language relating to the administration of an injectable medicine must be verified against an English language source.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"68-78"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423930","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":"Impact of medicine shortages on Australian pharmacists' professional practice and patient care: a nationwide survey","authors":"Jack Luke Janetzki BPharm (Hons), PhD,&nbsp;Wern Chern Chai BPharm (Hons), PhD,&nbsp;Tien Ngoc Thi Bui BPharm (Hons),&nbsp;Tin Fei Sim BPharm (Hons), PhD,&nbsp;Vijayaprakash Suppiah BSc (Pharmacy) (Hons), PhD","doi":"10.1002/jppr.1949","DOIUrl":"https://doi.org/10.1002/jppr.1949","url":null,"abstract":"<p>Recent medicine shortages in Australia have significantly impacted pharmacists' professional practice. The inability to provide essential medicines to consumers in a timely manner has increased pharmacist workload whilst attempting to maintain quality patient care during and after the COVID-19 pandemic. This study aimed to investigate the impact of medicine shortages on the operational responsibilities of community pharmacists, their ability to deliver health care, and the personal impact on community pharmacists. A nationwide anonymous survey was distributed to Australian community pharmacists via the Qualtrics survey platform between April – September 2023. Of the 142 pharmacists who responded to this survey, 89.5% (<i>n</i> = 127) reported having to purchase medicines from sources other than their regular wholesaler on at least a weekly basis in the last 3 months. The same number reported that they frequently needed to substitute medicines because of ongoing shortages. Most pharmacists (<i>n</i> = 128, 90.1%) reported that their workload had been affected by medicine shortages and that their motivation and engagement with work were frequently affected (<i>n</i> = 79, 55.7%). Pharmacists reported taking on additional administrative responsibilities to ensure access to treatment and health care. Current regulatory restrictions regarding the substitution of medicine dosage forms are often implemented only after community pharmacists are affected by medicine shortages. This survey highlights the need for improved awareness of medicine shortages and timely actions to be taken to ensure pharmacist wellbeing and patient access to health care in the face of medicine shortages. Ethics approval was granted by the University of South Australia Human Research Ethics Committee (Reference no.: 205399) and the study conforms with the Australian <i>National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"146-153"},"PeriodicalIF":1.0,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1949","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824724","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":"Scoping the barriers to influenza and pneumococcal vaccinations from the perspectives of patients with cancer: is there a role for the pharmacist?","authors":"Kristoffer Johnstone BPharm, GDPHTM, MSHP, FANZCAP (OncHaem),&nbsp;John Smithson BNSc, BPharm, PhD,&nbsp;Joyce Cooper PhD, BSc (Pharmacy), GDCLinPharm, GCClinEpi, GCTertiaryTeach, FSHP,&nbsp;Beverley Glass BPharm, BSc (Chemistry), PhD, ARPharmS, FPS","doi":"10.1002/jppr.1940","DOIUrl":"https://doi.org/10.1002/jppr.1940","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Routine immunisation for influenza and pneumococcal disease has the potential to reduce morbidity and mortality in patients with cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This scoping review aims to determine barriers to influenza and pneumococcal vaccinations from the perspective of patients with cancer and to discuss the potential role of the pharmacist in impacting these barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A systematic search of seven databases, including MEDLINE (Ovid), Cochrane Library, Informit (health), PubMed, and CINAHL (complete), from database inception to 6 June 2023 was conducted. Search terms included: 'cancer', 'vaccination', 'influenza', 'pneumococcal', and 'barrier'. Articles published in English that describe barriers to receiving vaccinations from the perspectives of patients with cancers were included. Barriers were thematically analysed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five articles met the inclusion criteria. Barriers identified in the literature were analysed into three key themes: healthcare professionals, patients, and healthcare system barriers. A key healthcare professional barrier was lack of recommendations from the treating oncologist or haematologist. Patient barriers included lack of information about the indication for vaccination as part of patients' cancer treatment and fear of side effects. Access to vaccination services was reported as a healthcare system barrier.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This scoping review highlights the significant barriers to influenza and pneumococcal vaccination according to patients with cancer. Healthcare professionals, patients, and health systems were identified as key barriers. Enablers to improve vaccination rates include patient education, increased healthcare professional vaccine recommendations, and improved access. Although pharmacists have a potential role to play in addressing these barriers, the feasibility and impact of their involvement requires further research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"1-15"},"PeriodicalIF":1.0,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423566","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":"Assessment of enoxaparin-related knowledge, administration technique, and self-reported adherence among women after caesarean section delivery","authors":"Sutha Rajakumar BPharm,&nbsp;Retha Rajah PhD,&nbsp;Nur Alia Razali BPharm,&nbsp;Tan Xin Yan BPharm,&nbsp;Ooi Guat Tee BPharm","doi":"10.1002/jppr.1943","DOIUrl":"https://doi.org/10.1002/jppr.1943","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Venous thromboembolism is among the main causes of maternal morbidity and mortality, with caesarean section (CS) delivery carrying greater risk. Outpatient thromboprophylaxis, such as enoxaparin, is administered subcutaneously and prescribed as an outpatient; raising the issue of medication adherence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to evaluate women's adherence to enoxaparin administration after CS delivery, explore the reasons for non-adherence, and assess the factors associated with patients' adherence to enoxaparin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Women after CS delivery, who had been given enoxaparin at discharge were included in the study. Eligible patients were contacted via telephone at the middle and the end of the enoxaparin treatment. Syringe count determined the main outcome of adherence during direct telephone interviews with the patient. Optimal adherence was defined as all the doses of enoxaparin being administered and suboptimal adherence was at least one dose not administered. Ethical approval was granted by the Malaysian Registry Ethics Committee belonging to National Medical Research Registry (Reference no: NMRR ID-22-02859-P41) and the study conforms with the Declaration of Helsinki. Informed consent was obtained from all participants through completion of written consent forms, after an explanation of the study was provided by investigators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 201 women included, the majority (91.5%) were fully adherent to enoxaparin, while 8.5% missed at least one dose. Most patients administering at home missed the dose due to reporting they were unwell (<i>n</i> = 6), busy (<i>n</i> = 4), or forgot to administer (<i>n</i> = 2). Among missed doses in patients administered in a healthcare setting, all participants (<i>n</i> = 5) forgot to bring their medication to the appointment. Only medication knowledge had a significant association with adherence to enoxaparin administration (p = 0.008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study raised concern about the substantial percentage of patients missing at least one dose of enoxaparin, particularly among patients injecting at home. Initiatives should focus on customised enoxaparin administration counselling and providing educational materials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 1","pages":"61-67"},"PeriodicalIF":1.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143424324","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":"Evaluation of a weight-based process for real-time accurate confirmation of oral liquid controlled drug balances","authors":"Paul Wembridge BPharm (Hons), MClinPharm, FANZCAP (Lead&Mgmt, MedSafety),&nbsp;Linda Ta BPharm (Hons),&nbsp;Meegan Callinan BN, MHPEd, GradCertPallCare,&nbsp;Kayin Chan BPharm,&nbsp;Aliesha-jane Fejgl BN, PostGradNursPrac (Cancer and Palliative Care),&nbsp;Joshua Colaci BPharm (Hons), BSc, GradCertPharmPrac,&nbsp;Mazdak Zamani PharmD, MHM, CHE, FCHSM, FANZCAP (MedsMgmt, MedSafety)","doi":"10.1002/jppr.1955","DOIUrl":"https://doi.org/10.1002/jppr.1955","url":null,"abstract":"<p>To meet legislative requirements in Australia, the balance of controlled drugs (CDs) must be confirmed after completion of each transaction. This is particularly challenging for liquid CD formulations, and over the years, health organisations have implemented various methods of performing this task, including the use of visual aids or conversion of bulk formulations to individual unit doses. These methods have a number of limitations. Therefore, this study aimed to evaluate the accuracy and feasibility of a weight-based method for confirming oral liquid CD balances packed in multidose containers. This study was conducted in a palliative care ward of a metropolitan hospital over a 41-day period. Morphine mixture 5 mg/1 mL transactions and balance checks were confirmed using weight calculations of the product bottle. The weights were then converted to volume using a locally developed electronic application, which was recorded in the relevant CD registers. The acceptable tolerance per transaction (±0.1 mL) was determined prior to commencement based on 80 test transactions. Throughout the trial period, 407 transactions were undertaken, among which there were no CD discrepancies. Nine nurses provided feedback via an anonymous online survey after the trial, mostly reporting that the new method was more accurate. However, participants also reported that it took on average 3 min longer to complete each transaction. In conclusion, utilising a weight-based method of confirming liquid CD balances may present a feasible method of meeting legislative requirements related to the recording and accountability of CDs. This project was exempt due to the local policy requirements that constitute research by the Eastern Health Office of Research and Ethics (Reference no: QA24-100-111698). The justification for this ethics exemption was as follows: the study conformed with the National Health and Medical Research Council (NHMRC) <i>Ethical considerations in quality assurance and evaluation activities</i> and did not directly affect patient care; written consent was not required from participants per local requirements, however staff were provided verbal and written project information and were informed their participation in the survey was voluntary and anonymous.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":"55 2","pages":"159-163"},"PeriodicalIF":1.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1955","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143824739","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}