Journal of Pharmacy Practice and Research最新文献

{"title":"Stability of extemporaneously prepared clofazimine oral suspensions","authors":"Ellie Ponsonby-Thomas BPharmSc,&nbsp;Charis Lau BPharm,&nbsp;Sherine Tan BPharm,&nbsp;Malinda Salim PhD,&nbsp;Ben J. Boyd PhD","doi":"10.1002/jppr.1893","DOIUrl":"10.1002/jppr.1893","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Clofazimine is recommended as a treatment for tuberculosis in infants. Extemporaneously prepared clofazimine oral suspensions are more appropriate dosage forms for infants than tablets, however no data exist to inform appropriate storage conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To examine the physical and chemical stability of extemporaneously prepared clofazimine oral suspensions and determine appropriate storage conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>An oral suspension of clofazimine 10 mg/mL was prepared by grinding six 100 mg clofazimine tablets to produce a fine powder. Ora-Blend SF (sugar free) was added to make a final volume of 60 mL. Six 10 mL aliquots were placed in amber plastic bottles with plastic bottle caps. Three bottles were stored at room temperature, and three bottles were refrigerated at 4°C. Following shaking, a 1 mL sample was taken from each bottle on days 0, 7, 14, 28, and 60. Samples were assayed using the high-performance liquid chromatography method. The samples were visually examined for colour change and separation at each time point. Stability was defined as the retention of at least 90% of the initial concentration. Ethics approval was not required for this research article as it was a stability study that did not involve human subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The clofazimine content remained &gt;94% of the initial concentration throughout the 60-day period for samples that were kept at room temperature, and slightly &lt;90% (87.4%) for samples that were kept refrigerated at 4°C. No separation or colour change was noted throughout the 60-day period for both preparations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Extemporaneously prepared suspensions of clofazimine in Ora-Blend SF were chemically stable for at least 60 days when stored at room temperature. Clofazimine degraded slightly more rapidly at 4°C compared to room temperature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139527073","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 challenge of drug prescribing for older people","authors":"David Fonda","doi":"10.1002/jppr.1904","DOIUrl":"https://doi.org/10.1002/jppr.1904","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139627163","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":"Farewell to the Geriatric Therapeutics Review series: the end of the beginning","authors":"R. Elliott","doi":"10.1002/jppr.1900","DOIUrl":"https://doi.org/10.1002/jppr.1900","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138944672","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":"Vitamin B12 deficiency in older people: a practical approach to recognition and management","authors":"Nadia Mouchaileh","doi":"10.1002/jppr.1897","DOIUrl":"https://doi.org/10.1002/jppr.1897","url":null,"abstract":"Vitamin B12 deficiency is common in older people and is linked to anaemia, cognitive decline, and dementia. Clinical presentation is variable, ranging from no symptoms or subtle, non‐specific symptoms, through to serious, irreversible neurological symptoms if left untreated. Although common, it is often under‐recognised, with diagnosis usually occurring on incidental blood test screening. Older people are at increased risk of vitamin B12 deficiency due to insufficient dietary intake, malabsorption associated with aged‐related changes in gastrointestinal function, higher incidence of pernicious anaemia, and chronic use of interfering medications such as metformin and proton‐pump inhibitors. Early detection and treatment in symptomatic deficiency are crucial to prevent irreversible damage. Vitamin B12 intramuscular injection bypasses potential absorption issues and is traditionally the first‐line treatment in older people. However, emerging evidence suggests that high‐dose oral replacement may be as effective. Older people often require lifelong therapy due to the irreversible nature of the underlying cause of deficiency. This review provides an overview of vitamin B12 deficiency and its management in older people.","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139174980","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":"Multidisciplinary care of older adults in the emergency department to influence deprescribing in older adults: a cohort study","authors":"Christopher Reilly BPharm,&nbsp;Elizabeth Buikstra PhD,&nbsp;Edward Strivens MBBS, BSci,&nbsp;Elizabeth Marsden MBBS, PhD,&nbsp;Jarred Brose BNurs,&nbsp;Alison Craswell BNurs, PhD","doi":"10.1002/jppr.1896","DOIUrl":"10.1002/jppr.1896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Inappropriate polypharmacy in older adults is a major health problem associated with poor clinical and health service outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>We aimed to evaluate the effectiveness of a geriatric pharmacist service in the emergency department (ED) identifying potentially inappropriate prescribing (PIP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Between 1 June 2018–31 May 2019, adults ≥70 years of age presenting to ED were reviewed by the Geriatric Emergency Department Intervention (GEDI) pharmacist. The intervention consisted of pharmacist-led medication review using Screening Tool of Older Person’s Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) criteria, patient education on recommendations, an updated medication list, and a letter sent to their general practitioner (GP) electronically. For eligible consenting older adults, telephone calls were made at least 28 days post-discharge to assess the effectiveness of the intervention. A survey with GPs after 6 months determined how recommendations were perceived. Ethics approval was granted by the Metro North Health B Human Research Ethics Committee (reference no: HREC/18QCH/69–1245) and research governance approval was granted by the study site (Cairns Hinterland Hospital and Health Service, reference no: SSA/Q12345/40673). Informed consent was obtained from all participants via a project information sheet and either the completion of a written consent form (patient participants), verbal consent before interview (GP participants), or implied consent via email responses (GP participants). Routinely collected health data obtained for this study were de-identified and data included in the follow-up study was de-identified.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The GEDI pharmacist reviewed 1214 older adults with an average age of 81 years. The median number of prescribed medications was 10 and 36.8% of older adults had STOPP recommendations. When contacted (<i>n</i> = 35), of those enrolled in the follow-up study, 71% had stated their medications changed, 40% reported all STOPP medications had ceased, and 69% had START medications commenced, suggesting the recommendations provided were clinically appropriate and readily accepted by their GPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Integration of a geriatric pharmacist demonstrated ample opportunities to address PIP in targeted olde","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1896","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963663","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":"Fred J Boyd 2023 oration","authors":"M. K. Dunkley","doi":"10.1002/jppr.1899","DOIUrl":"https://doi.org/10.1002/jppr.1899","url":null,"abstract":"","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138965934","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":"Estimation of kidney function for medication dosing in adult patients with chronic kidney disease: a practice update","authors":"Sanja Mirkov BPharm, PGDipPH,&nbsp;Carla Scuderi MClinPharm, BPharm,&nbsp;Jess Lloyd BPharm, GradDipClinPharm,,&nbsp;John Coutsouvelis PhD, MClinPharm, BPharm, FSHP,&nbsp;Shaun O'Connor BPharm, MSHP,&nbsp;Simon Potts BPharm, BSc (Hons),&nbsp;Suzanne Newman BPharm, GradDipHospPharm,&nbsp;Jason Roberts PhD, BPharm (Hons), BAppSc, FSHP, FISAC, FAHMS","doi":"10.1002/jppr.1884","DOIUrl":"10.1002/jppr.1884","url":null,"abstract":"<p>Chronic kidney disease (CKD) is a major health concern with a growing disease burden and inequalities in access to treatments. Glomerular filtration rate (GFR) is accepted as the best overall measure of kidney function and is considered the most important measure for medications cleared by the kidneys. In clinical practice, equations that estimate GFR using validated prediction equations are routinely used. This practice update was developed by a Working Group comprising clinical pharmacists representing the Society of Hospital Pharmacists of Australia (SHPA) Specialty Practice streams of Nephrology, Oncology and haematology, Critical care and Infectious diseases. It is intended to provide practical recommendations for clinical pharmacists who use equations to estimate GFR for medication dosing decisions. The limitations of the various equations in use — such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), the Cockcroft–Gault equation and Modification of Diet in Renal Disease — are summarised and compared to direct measures of kidney function using exogenous markers. The CKD-EPI equation is recommended to be used routinely as a primary measure of kidney function. Dose adjustments should also consider medication-specific, patient-related, and disease-related characteristics. Kidney function and the response to therapy should be continuously assessed by monitoring the signs, symptoms and disease outcomes, the emergence of adverse reactions or medication-induced disorders and use therapeutic drug monitoring (if available) to adjust doses accordingly.</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1884","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136282180","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":"Medication error reporting attitudes and practices in a regional Australian hospital: a qualitative study","authors":"Shady Abdelmaksoud BPharm, MClinPharm,&nbsp;Mohammed S. Salahudeen BPharm, PharmD, PhD, FHEA,&nbsp;Colin M. Curtain BPharm, GradDipComp, PhD","doi":"10.1002/jppr.1887","DOIUrl":"10.1002/jppr.1887","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Medication errors are events that may cause or lead to inappropriate medication use or patient harm. Australians living outside metropolitan areas have poorer health outcomes than those living in urban areas. Medication error reporting (MER) practices vary due to the attitude of healthcare professionals (HCPs). MER can improve patient safety in community and hospital settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To explore HCPs' attitudes, practices, and recommendations towards MER in a regional hospital setting in Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Semistructured interviews were employed to identify the attitudes, practices, and recommendations of HCPs for the best utilisation of medication error reports. The study recruited HCPs (nurses, pharmacists, and doctors) working in all clinical areas from November 2021–February 2022. Interviews were recorded and transcribed via thematic analysis. Ethics approval was obtained from the Goulburn Valley Health (GVH) Human Research Ethics Committee (Reference no: GVH 35/21). Informed consent was obtained from participants via an information sheet and completion of a written consent form.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Interviews with twelve HCPs elucidated four themes: barriers and enablers to reporting, and perceived benefits and recommendations for medication error reports. There was good understanding among regional HCPs about the benefits of MER. Attitudes and practices varied, with nurses reporting more medication errors than doctors, and pharmacists being concerned about the impact of reporting on interprofessional relations. Their recommendations involved standardising medication error definition and improving electronic system education.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite HCPs' understanding of the role of MER, their practices varied. We recommend improved protected time for learning, training with the incident reporting software, education about medication errors, and formalisation of test feedback to clinicians. The implementation of workplace cultural practice changes to improve organisational systems and enhance error reporting without fear of repercussions, and the adoption of additional solutions such as electronic prescribing are also encouraged.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1887","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186215","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":"A case of extrapyramidal side effects due to possible paliperidone: voriconazole interaction","authors":"Louise Beilby BPharm, GradCertPharmPrac,&nbsp;Lucy Arno BPharm (Hons), MHA","doi":"10.1002/jppr.1892","DOIUrl":"10.1002/jppr.1892","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>It is thought that paliperidone, an active metabolite of risperidone, has limited potential for pharmacokinetic drug–drug interactions (DDIs) due to minimal metabolism by cytochrome P450 3A4 (CYP3A4) and cytochrome P450 2D6 (CYP2D6). However, DDIs have been reported and include a theoretical interaction between paliperidone and voriconazole based on interactions between risperidone and strong CYP3A4 inhibitor azoles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the first recorded DDI between paliperidone and voriconazole leading to extrapyramidal side effects (EPSEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Clinical details</h3>\u0000 \u0000 <p>A 34-year-old male presented with febrile neutropenia presumed due to clozapine. Clozapine was ceased and paliperidone commenced with voriconazole added to the patient's empiric piperacillin/tazobactam therapy due to a suspected fungal infection. Two days after starting voriconazole, the patient developed hypertonia and hyperreflexia in all limbs, thought most likely to be antipsychotic induced EPSEs. Paliperidone was withheld and EPSEs resolved.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Outcomes</h3>\u0000 \u0000 <p>The patient had previously tolerated long-term paliperidone at higher doses, prior to transitioning to clozapine. The development of EPSEs occurred two days post azole initiation, indicating a probable paliperidone adverse drug reaction (ADR) due to strong CYP3A4 inhibition by voriconazole. This case appears to be the first documented report of this previous theoretical DDI in practice. Further studies, including therapeutic drug monitoring, are required to confirm findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Paliperidone may be affected by pharmacokinetic drug–drug interactions and patients should be monitored for ADRs when CYP3A4 inhibitors are concomitantly administered.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1892","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135186209","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":"Pharmacists in Australian general practice: Discussion of the findings of an evaluation from 2016 to 2021","authors":"Louise S. Deeks BSc (Hons), PGDip, PGCert,&nbsp;Mark Naunton BPharm (Hons), PhD,&nbsp;Gregory M. Peterson BPharm (Hons), MBA, PhD,&nbsp;Thilini Sudeshika BPharm (Hons), PGDipToxicology, MPhil,&nbsp;Christopher Freeman BPharm, GDipClinPharm, PhD,&nbsp;Ravi Sharma MPharm (Hons), MSc, PGCert,&nbsp;Stacy Leavens BA, MA,&nbsp;Sam Kosari BPharm (Hons), PhD","doi":"10.1002/jppr.1878","DOIUrl":"https://doi.org/10.1002/jppr.1878","url":null,"abstract":"<p>Pharmacists embedded in general practice can improve medicines optimisation and patient safety, but Australia has been slower to adopt and fund this model than other comparable countries. Over the last decade there have been various local programs integrating pharmacists in general practice across Australia. This article summarises the results of an evaluation in Canberra from 2016–2021. Pharmacists predominantly conducted clinical activities, including medication reviews and clinical audits. General practitioner (GP) acceptance and implementation of medication review recommendations was high (75%). General practice pharmacists were able to achieve positive clinical outcomes in asthma and smoking cessation. Surveys and interviews identified that the general practice pharmacist role was welcomed by patients, GPs, and other healthcare professionals. Patient satisfaction was very high, with patients supporting the expansion of this pharmacy service. Collaboration between the pharmacists and other healthcare professionals was high. Some pharmacists left employment in general practice after less than a year. Introducing a clear job description could be beneficial in retaining pharmacists, improving trust and working relationships, and enhancing collaboration. The majority of clinical activities conducted by the pharmacists had the potential to improve patient care and decrease healthcare costs. Apart from healthcare savings, benefit–cost ratios of income generated and costs reduced by pharmacists when compared to salaries suggested that pharmacists may be cost-beneficial in some scenarios. Absence of funding for this model of care remains a barrier to wider adoption in Australia and needs addressing. This study was approved by the University of Canberra Human Research Ethics Committee (Project number: 15–235) and funded under the Primary Health Network Program (Grant number: 25097479).</p>","PeriodicalId":16795,"journal":{"name":"Journal of Pharmacy Practice and Research","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jppr.1878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134803487","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}