Journal of Pharmacy Practice and Research最新文献

{"title":"Missed opportunity: a clinical data linkage study of guideline-directed medical therapy and clinical outcomes of patients discharged with acute coronary syndrome who attended cardiac rehabilitation programs","authors":"Lemlem G. Gebremichael PhD, Alline Beleigoli PhD, Jonathon W. Foote RN, ICU Cert, ACE, Norma B. Bulamu PhD, Joyce S. Ramos PhD, Orathai Suebkinorn RN, MSN, Julie Redfern PhD, Robyn A. Clark PhD, the National Health and Medical Research Council (NHMRC) Country Heart Attack Prevention Project Team","doi":"10.1002/jppr.1923","DOIUrl":"https://doi.org/10.1002/jppr.1923","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Although guidelines recommend guideline-directed medical therapy (GDMT) for patients with acute coronary syndrome (ACS), implementation is limited in clinical practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess the level of GDMT in ACS patients after discharge who attended cardiac rehabilitation (CR) programs and association with clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A cross-sectional study was conducted in 13 rural and 10 metropolitan CR programs via all modes of delivery (face-to-face, telephone, or general practice-hybrid) operating in South Australia, Australia. ACS patients were included if they were ≥18 years of age and were referred and attended CR programs with medication details recorded in their hospital discharge summary. GDMT was assessed according to the Australian clinical guidelines for the management of acute coronary syndromes 2016. Prescription of all the four recommended medication classes was considered optimal. Logistic regression and <i>χ</i><sup>2</sup> test were used for association. Ethical approval was granted by the South Australian Department for Health and Wellbeing Human Research Ethics Committee (Reference No. HREC/15/SAH/63) and the Northern Territory Department of Health Human Research Ethics Committee (Reference No. HREC 2015-2484) which included a waiver of consent per the <i>National Statement on Ethical Conduct in Human Research</i> and the study conforms with the <i>Good Clinical Practice Guidelines</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1229 patients included, 74.6% were male and 41.1% had acute myocardial infarction. Only 39.7% of patients received optimal prescription. Prescription of any three or two medication class combinations occurred for 78.3% and 94.1% of patients, respectively. Optimal GDMT was associated with fewer hospital admissions (odds ratio = 0.647, 95% confidence interval 0.424–0.987, p = 0.043) with no significant gender association. Women were less likely to be prescribed angiotensin converting enzyme inhibitors (p = 0.003), angiotensin receptor blockers (p = 0.007), statins (p = 0.005), and any two (p < 0.001) and three combinations (p = 0.023) of medication classes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>GDMT prescription was suboptimal in patients with ACS before attendance at CR. Primary care and CR clinicians have missed an opportunity to implement best practice guideline recomme","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1923","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142099905","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":"Surface contamination of cytotoxic medicine in preparation and patient care areas in Australian hospitals: a retrospective cross-sectional study","authors":"Vincent Woodward BSc, MPharm, Meghrie Panjarjian BSc, MPharm, Devika Devi MPharm, Jane Hanrahan BSc (Hons), PhD, Michael Soriano BPharm, Matt Roper BMedSc (Hons), BPharm (Hons), Hala Musa BSc (Hons), MS, MPharm, Stephanie Davies BPharm, Peter Samios BPharm, GradDipClinPharm, Michael Teh BPharm, GradDipHospPharm, Peter Barclay BPharm, Clare Naughtin BPharm, Régis Vaillancourt BPharm, PharmD, Carl Nikolaidis BSc, Bryan Pelland BSc, Jonathan Penm BPharm (Hons), GradCertEdStud (Higher Ed), PhD","doi":"10.1002/jppr.1925","DOIUrl":"10.1002/jppr.1925","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cytotoxic medicine contamination of preparation and administration areas of oncology healthcare facilities poses a risk to staff facing repeated low-level exposure over time. The use of closed-system transfer devices (CSTDs) during preparation and administration of cytotoxic products may reduce the levels of contamination. The primary aim was to determine the levels of cytotoxic medicine contamination in preparation and administration areas of hospitals that use CSTDs compared to those that do not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The primary aim was to determine the levels of cytotoxic medicine contamination in preparation and administration areas of hospitals that use CSTDs compared to those that do not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective, cross-sectional study across four Australian hospitals was conducted. Cytotoxic medicine contamination was determined via surface wipe sampling on six specified surfaces. The samples were tested for cyclophosphamide, docetaxel, etoposide, ifosfamide, irinotecan, methotrexate, paclitaxel, pemetrexed, topotecan, and vinblastine. This project was exempt due to the local policy requirements that constitute research by the South Eastern Sydney Local Health District Human Research Ethics Committee (Reference no: ETH01899). The justification for this ethics exemption was as follows: this was a study involving sample testing only and did not include human participants or participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Environmental contamination with cytotoxic medications was observed at all hospitals, regardless of the CSTD used. Of the 24 samples tested, the agent most frequently seen was ifosfamide with 29% (<i>n</i> = 7), followed by cyclophosphamide 13% (<i>n</i> = 3), and methotrexate 8% (<i>n</i> = 2). There was no statistically significant difference between hospitals that used CSTDs compared to hospitals that did not (25% vs 42%, p = 0.67). Contamination was more extensive in preparation areas than administration areas, and was observed on the biological safety cabinets (BSC) worktop, packaging bench, and floor in front of the BSCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All sites had contamination present for cytotoxic medicines. There was no statistically significant difference in the proportion of contaminated surfaces between sites that used CSTDs versus sites where CSTDs were not used. Only ifosfamide contami","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1925","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373029","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":"3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy: what the pharmacist needs to know","authors":"Alexander T. Gallo MPharm, PhD,&nbsp;Paul B. Fitzgerald MBBS, MPM, PhD, FRANZCP","doi":"10.1002/jppr.1921","DOIUrl":"10.1002/jppr.1921","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose of Review</h3>\u0000 \u0000 <p>On 1 July 2023, the Therapeutic Goods Administration approved 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for the treatment of post-traumatic stress disorder (PTSD). Accordingly, the purpose of this review is to provide an overview of MDMA and what pharmacists should know as this treatment emerges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Sources of Information</h3>\u0000 \u0000 <p>EMBASE, MEDLINE, and CINAHL databases were searched to provide an overview narrative synthesis of the literature on MDMA, relevant to pharmacists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>Cytochrome P450 2D6 is involved in the metabolic pathway of MDMA, an enzyme inhibited by a number of drugs used in the pharmacological management of PTSD (e.g. selective serotonin reuptake inhibitors). Co-administration of these drugs with MDMA can lead to increases in plasma MDMA concentrations. Additionally, inhibition of the serotonin transporter can inhibit the uptake of MDMA into the presynaptic terminal, dampening the effects of MDMA and potentially, limiting the effectiveness of MDMA-assisted psychotherapy. Accordingly, these drugs are typically withdrawn prior to treatment with MDMA. While selective serotonin reuptake inhibitor/serotonin noradrenaline reuptake inhibitor drugs with MDMA are unlikely to cause serotonin toxicity, monoamine oxidase inhibitors can. Other drugs, such as caffeine, alcohol, over-the-counter medicines, and complimentary/alternative medicines, can also interact with MDMA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>With a detailed knowledge of the pharmacology of MDMA, pharmacists may play a role in MDMA-assisted psychotherapy by collecting a detailed medication history and assisting clinicians in the withdrawal of interacting medicines.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1921","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108754","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":"Prevention of venous thromboembolism after total hip and knee arthroplasties in Australian hospitals: what are we using?","authors":"Nameer van Oosterom BPharm (Hon), PhD,&nbsp;Michael Barras PhD,&nbsp;Neil Cottrell PhD","doi":"10.1002/jppr.1919","DOIUrl":"10.1002/jppr.1919","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Venous thromboembolism (VTE) is a leading cause of preventable morbidity and mortality, with total hip arthroplasty (THA) and total knee arthroplasty (TKA) at the highest risk. Safe and appropriate thromboprophylaxis is essential. However, investigations into prescribing practices have been limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe current VTE prophylaxis regimens in Australian patients following an elective THA/TKA and compare these regimens to an international standard.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective multisite case series of patients admitted for a THA/TKA in six tertiary hospitals in Queensland, Australia, was conducted over 12 months (1 October 2017–30 September 2018). Patient and medication data were collected following surgery and for 60 days after discharge to determine changes to the patients' thromboprophylaxis regimen. Results were summarised and compared to National Institute for Health and Care Excellence (NICE) guidelines. Ethical approval was granted by the Metro South Human Research Ethics Committee (Reference no: HREC/2018/QMD/46757) and the study conforms to the <i>National Statement on Ethical Conduct in Human Research</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 1011 patients (43.1% THA, 56.9% TKA), and thromboprophylaxis was used in 98.1% of inpatients and in 94.3% of discharge patients for 5.2 (±5.2) and 29.2 (±15.9) days (±standard deviation) respectively. Low-molecular-weight heparins (LMWHs) were the primary drugs for inpatients (71.2%) and aspirin 150 mg for discharge (42.0%), most commonly for 6 weeks (31.8%). Aspirin was used for significantly longer duration than rivaroxaban and LMWH (p &lt; 0.001). A two-staged prophylaxis regimen was implemented, most commonly any anticoagulant as an inpatient; followed by rivaroxaban on discharge (32.7%) or an anticoagulant as an inpatient with aspirin on discharge (26.4%). Overall, adherence to NICE guidelines was low; THA: 8.7%, TKA: 5.9%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>VTE prophylaxis regimens varied considerably, and consequently, adherence to international guidelines was low. There is a need for local, peer-led guidelines to ensure consistent, safe, and effective prophylaxis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1919","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114312","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":"Design and development of the clinical pharmacy key performance indicators dashboard for equity of service provision at regional and rural hospitals in North Queensland, Australia","authors":"Sanja Mirkov BPharm, PGDipPH,&nbsp;Rhondda Jones BSc, BInfTech, PhD,&nbsp;Alexander Ison BPharm,&nbsp;Allan Wilesmith CertIVInfoTech,&nbsp;Jason Black BScPharm (Hons), ClinDipPharm","doi":"10.1002/jppr.1920","DOIUrl":"10.1002/jppr.1920","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;Provision of a Medication Action Plan (MAP) on admission and a Discharge Medication Record (DMR) are associated with reduced medication-related harm.&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 report factors associated with the provision of MAPs and DMRs in rural and regional hospitals in Queensland, Australia.&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 literature search, environmental scan and department consultations were conducted to develop Clinical Pharmacy Key Performance Indicators (cpKPIs) and design a cpKPI dashboard. Two of the five KPIs included in the dashboard, relating to medication action plans on admission and medication records on discharge, were reported for all the hospitals and were included in the study. A retrospective, period-prevalence study was conducted to evaluate the coverage and equity of clinical pharmacy service provision for patients admitted for longer than 24 h. The proportions of patients who received MAPs and DMRs were stratified by age, gender, Indigeneity and hospital type. Statistical analysis used chi-squared tests and logistic regression in R. This project was exempt due to the local policy requirements that constitute research by the Far North Queensland Human Research Ethics Committee (Reference no: EX/2023/QCH/94383-1684QA). The justification for this exemption is as follows: the project was determined to be negligible risk research and involved the use of existing collection of data or records that contain only non-identifiable data about human beings.&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;In total, 13 818 patients (37.9% of admissions) received a MAP and 11 631 patients (32.7% of discharges) received a DMR. The proportion of MAPs and DMRs was significantly higher in rural hospitals than in regional hospitals (MAP 50.6% vs 34.6%, DMR 33.1% vs 31.3%) and for male patients than female patients (MAP 42.2% vs 33.7%, DMR 36.4% vs 29.2%). When stratified by age, First Nations patients received a higher proportion of MAPs and DMRs in each age group, except for age 85 years and over. The proportion of First Nations patients aged 50 years and over who received MAP was lower compared to that for non-Indigenous patients aged 65 years and over (56.3% vs 59.8%), whilst the proportion for DMRs was similar (50.4% vs 49.3%).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The study defined the clinical pharmacy key performance indicators for measuring equity of clinical pharmacy service provision in Australia. When adjusted for a difference in life expectancy, the prop","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140997464","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":"Powered by AI: advancing towards artificial intelligence algorithms in Australian hospital pharmacy","authors":"Nazanin Falconer PhD, FANZCAP (Research),&nbsp;Ian Scott MBBS, FRACP, MHA, MEd,&nbsp;Michael Barras PhD, FANZCAP (Lead&Mgmt, Research)","doi":"10.1002/jppr.1922","DOIUrl":"https://doi.org/10.1002/jppr.1922","url":null,"abstract":"<p>Imagine hospitals where clinicians can quickly and accurately identify patients at risk of medication harm and why. This is what artificial intelligence (AI) promises, and it’s closer than we think.</p><p>While the past decade brought electronic health records (EHRs) and decision support systems, AI-enabled machine learning (ML) prediction models and large language models have emerged, with the potential to greatly assist clinical decision-making and improve patient outcomes. For example, AI can predict optimal doses of pharmacokinetically complex medications<span>¹</span> and identify adverse drug reactions among coded discharge data. These new tools can support busy pharmacists by automating tedious tasks and discerning clinical scenarios warranting pharmacist intervention.</p><p>This editorial highlights considerations relating to AI/ML technologies applied to medicine management in Australian hospitals, drawing insights from local experience in designing and evaluating a ML dosing algorithm for unfractionated heparin (UFH).</p><p>Risk prediction algorithms are common, such as the CHADS-VASc and HAS-BLED scores, developed using conventional statistical (regression) methods. But with the availability of ‘big data’ from EHRs within multiple hospitals, clinician researchers, data scientists, and informaticians can now collaborate to develop more accurate real-time predictive algorithms using AI/ML. Some examples include predicting an individual’s likelihood of a medication-related hospital readmission, suffering a bleed with anticoagulant therapy, or rapid deterioration due to undertreated illness. Detecting and treating these conditions can optimise patient outcomes.</p><p>The ultimate question is whether AI tools enable clinicians to work smarter and more efficiently, save healthcare costs, and render patient care more effective and safe. Machines don’t tire and are not influenced by emotions, and they can learn and process vast amounts of information faster and more accurately than humans. But human oversight and judgement remains crucial in ensuring the appropriate design and use of algorithms and monitoring their performance. Machines exist to augment, not usurp, clinician decision-making, empowering pharmacists to focus more on empathic patient interactions, education, and counselling and fostering interprofessional healthcare delivery; integral care components for which no machine can substitute.</p><p>The future of hospital pharmacy is undeniably intertwined with the evolution of AI, and we should embrace and lead the agenda in using them as supportive tools to enhance our clinical practice.</p><p>The authors declare that they have no conflicts of interest.</p><p>Conceptualisation: NF, IS, MB. Investigation: NF. Writing — original draft: NF, IS, MB. Writing — review and editing: NF, IS, MB.</p><p>Ethical approval was not required for this editorial as it did not contain any human data or participants.</p><p>Not commissioned,","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1922","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140641753","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 in palliative care for pharmacy services","authors":"Josephine To BPharm, MClinPharm, MSHP,&nbsp;Pascale Dettwiller DPharm, MHumBio, BTeach, MSHP,&nbsp;Tony Hall BPharm (Hons), AdvDip (Clin Pharm teaching), DipMedSci (palliative care), FSHP,&nbsp;Jane Lewis BPharm, GCPharmPrac, MClinPharm, GradCertPallCare, MSHP,&nbsp;Maria Vittoria (Vicki) Poulier BPharm, PGDipClinHospPharm, GradDipPallC, MSHP,&nbsp;Penelope Tuffin BPharm, PGDipHospPharm, MPallCare, AdvPracPharm, FANZCAP (PainMgmt, PallCare), AdvPracPharm, AcSHP, MSHP,&nbsp;Robert Wojnar BPharm (Hons), MClinPharm, MSHP,&nbsp;Yee Mellor BPharm, MCncrSc, GPhC, FANZCAP (Generalist, Edu.), MSHP","doi":"10.1002/jppr.1917","DOIUrl":"10.1002/jppr.1917","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140666665","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":"Antibiotics administered as continuous intravenous infusion over 24 hours by elastomeric devices to patients treated at home: a study of infusion efficiency","authors":"Toni Docherty BPharm, PostGradDipComPharm,&nbsp;Michael David PhD, MBiostat, MEd, MEpi, MSc, BSc (Hons), BEd, DipEd,&nbsp;Jennifer Schneider BPharm (Hons), PhD,&nbsp;Gabrielle O'Kane BMed, BSurg (MBBS),&nbsp;Joni Morris Cert IV (Hospital/Health Services Pharmacy Support),&nbsp;Catherine Paavola BNurs,&nbsp;Janelle Sawers BNurs,&nbsp;Deirdre O'Mahony BNurs,&nbsp;Joyce Cooper BPharm, PhD","doi":"10.1002/jppr.1918","DOIUrl":"10.1002/jppr.1918","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Elastomeric infusion devices or ‘Infusors’ are commonly used to administer 24-h continuous intravenous infusions to hospital patients at home, a service which can increase hospital capacity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study sought to determine Infusor efficiency by measuring infusion lengths administered by Infusors to patients in the community setting and reviewing any impacting factors on varying infusion rates, if observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Patients and nurses completed data collection forms daily over a 12-month period. The following information was recorded: time Infusor attached to patient, time Infusor emptied, Infusor ‘empty’ or ‘not empty’ when removed, volume of antibiotic solution remaining, Infusor storage details, antibiotic solution and dose, indication for treatment, and date (season). Statistical analyses was conducted using Stata. Data were analysed using descriptive statistics, including median and range for continuous variables, and frequency counts and percentages for categorical variables. Ethical approval was granted by Northern Sydney Local Health District (NSLHD) Research Office (Reference no: RESP/14/184), the Human Research Ethics Committee (HREC) (Reference no: LNR/14/HAWKE/265) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via a study information leaflet that was provided with the patient questionnaire and patients were informed that their participation in the study was optional. Patients indicated their consent by completing the data collection form for each day of treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A significant number of Infusors (27%) emptied outside the expected infusion duration of 24 h ± 10% (21.6–26.4 h) and Infusors were removed ‘not empty’ when the nurse visited &gt;24 h on 35% of occasions. Infusors were more likely to empty &gt;24 h if they contained piperacillin-tazobactam 13.5 g (predicted probability = 1.0), in winter (predicted probability = 0.83), and in cooler overnight storage locations (predicted probability = 0.64). Infusors were more likely to empty &lt;24 h if they contained vancomycin (predicted probability = 0.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Infusors delivering 24-h continuous intravenous infusions in the home setting may empty at unpredictable times and may","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140686610","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":"Risk of Pseudomonas aeruginosa antimicrobial resistance using time series analysis of antibiotic usage","authors":"Geordan Papacostas BMedSci,&nbsp;Gary D. Grant PhD,&nbsp;Susan Hall PhD","doi":"10.1002/jppr.1911","DOIUrl":"10.1002/jppr.1911","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antimicrobial resistance is emerging as one of the most potentially disastrous threats of the 21st century. <i>Pseudomonas aeruginosa</i> (<i>P. aeruginosa</i>) is a leading resistant pathogen and is clinically significant due to its limited available treatment using antibiotics. Rising resistance of <i>P. aeruginosa</i> is of increasing concern and it is currently listed as one of the top three critically resistant pathogens by the World Health Organization. It is currently known that resistance in <i>P. aeruginosa</i> is significantly linked with the consumption of all antibiotics, making usage surveillance of particular concern.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of the current study was to model current and future antibiotic usage using available prescription data for antipseudomonal antibiotics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A time-series analysis was performed on Pharmaceutical Benefits Scheme/Repatriation Pharmaceutical Benefits Scheme data from January 2000–June 2020 using Facebook Prophet time-series methods in Python 3.9.14 to analyse and forecast trends to 2025. Ethical approval was not required for this research article as it used publicly available data and did not involve human subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The usage of antipseudomonal antibiotics decreased by 14.3% from 2014 to 2020 (95% confidence interval [CI] −30.4% to 2.3%) and is projected to further decrease by 11.7% by 2025 (95% CI −30.6% to 7.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The current study showed a decline in the use of certain antipseudomonal antibiotics in Australia since 2015 and projects that their use will continue to decline. This is likely due to an increased judicious use of these antibiotics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1911","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140373189","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":"Assessing adherence and comprehension of cardiovascular medicines with pharmacist intervention post-acute myocardial infarction: a pilot study","authors":"Samia Goni BPharm, GradCertPharmPrac,&nbsp;Adeline Roussety BPharm, PGDipClinPharm,&nbsp;Marianne Jovanovic BPharm (Hons), GradCertPharmPrac, MPharmPrac","doi":"10.1002/jppr.1898","DOIUrl":"10.1002/jppr.1898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Due to the addition of multiple new medicines following an acute myocardial infarction (MI), medication non-adherence occurs frequently. Medication education can improve adherence, comprehension, and health-related outcomes. There is currently limited literature about individualised pharmacist-led medication education post-hospital discharge following an MI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To assess whether individualised, pharmacist-led education increased patient adherence and comprehension of cardiovascular medicines over a 12-week period following an MI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>All participants completed the Morisky Medication Assessment Scale (MMAS) of self-reported adherence at 1 week and 12 weeks post-hospital discharge. Alongside this, a questionnaire was completed to quantify comprehension of their treatment plan. Participants were randomised to receive individualised pharmacist-led education directed at their medication regimen at 4–6 weeks post-discharge. Data were analysed using paired <i>t</i>-tests and mixed-design analysis of variance (ANOVA). Ethical approval was granted by the Monash Health Human and Research Ethics Committee (Reference no: RES-21-0000234L) and the study conforms to the <i>Australian National Statement on Ethical Conduct in Human Research</i>. Informed consent was obtained from all participants via project information sheets, verbal explanations by recruiting pharmacists with reassurance there would be no difference in standard treatment should patients decline involvement in the project, and written consent forms were completed by all participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 29 participants, 15 (51%) received pharmacist-led education. The intervention group's mean MMAS score increased from 6.7 (moderate adherence) at week 1 to 7.6 (moderate adherence) at week 12 post-hospital discharge (p = 0.009). At 12 weeks, the intervention group demonstrated a statistically significant and greater mean MMAS score compared to the control group (7.6 moderate adherence and 6.9 moderate adherence respectively, p = 0.003). The intervention group's mean comprehension level increased from 58% at 1 week to 90% at 12 weeks (p &lt; 0.05). The intervention group demonstrated a greater mean comprehension level at 12 weeks compared to the control group (90% and 48.21% respectively, p &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study demonstrated that individualised, pharmacist-led education may improve self-reported m","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140379304","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}