Pharmacy: Journal of Pharmacy Education and Practice最新文献

{"title":"Deprescribing of Medicines in Care Homes—A Five-Year Evaluation of Primary Care Pharmacist Practices","authors":"Ana Alves, S. Green, D. James","doi":"10.3390/pharmacy7030105","DOIUrl":"https://doi.org/10.3390/pharmacy7030105","url":null,"abstract":"(1) Background: This project evaluates the outcomes of a novel pharmacy-led model of deprescribing unnecessary medications for care home patients. A feasibility study was conducted in 2015 to explore exposure to inappropriate polypharmacy in patients residing in care homes over a one-year timescale. The aim of this study was to present the results of this ongoing service evaluation over a five-year period. (2) Methods: Data collection and risk assessment tools developed during the feasibility study were used to measure the prevalence, nature, and impact of deprescribing interventions by primary care pharmacists over a five-year period. A random sample of approximately 5% of safety interventions were screened twice yearly by the pharmacist leads as part of standard practice. (3) Results: Over a period of five years there were 23,955 interventions (mean 2.3 per patient) reported from the 10,405 patient reviews undertaken. Deprescribing accounted for 53% of total estimated financial drug savings, equating to £431,493; and 16.1% of all interventions were related to safety. (4) Conclusions: Medication reviews in care homes, undertaken by primary care pharmacists who are linked to GP practices, generate a wide range of interventions commonly involving deprescribing, which contributes significantly to the continuous optimisation of the prescribing and monitoring of medicines.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88669182","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":"Adverse Drug Reactions in Norway: A Systematic Review","authors":"M. Vaismoradi, Patricia A Logan, S. Jordan, Hege Sletvold","doi":"10.3390/pharmacy7030102","DOIUrl":"https://doi.org/10.3390/pharmacy7030102","url":null,"abstract":"Prescription medicines aim to relieve patients’ suffering but they can be associated with adverse side effects or adverse drug reactions (ADRs). ADRs are an important cause of hospital admissions and a financial burden on healthcare systems across the globe. There is little integrative and collective knowledge on ADR reporting and monitoring in the Norwegian healthcare system. Accordingly, this systematic review aims to investigate the current trends in ADR reporting, monitoring, and handling in the Norwegian healthcare system and describe related interventions. Appropriate keywords, with regard to ADRs in both English and Norwegian languages, were used to retrieve articles published from 2010 to 2019. Six articles met the inclusion criteria. The findings offer a comprehensive picture of ADR reporting and monitoring in the Norwegian healthcare system. Psychotropic medicines were most commonly implicated by patients, while professionals most commonly reported ADRs associated with anticoagulants. The current ADR systems were compiled with the involvement of both patients and healthcare providers to record all types of drugs and ADRs of various severities, and aimed at improving ADR tracking. However, there is a need to improve current initiatives in terms of feedback and quality, and more studies are needed to explore how ADR profiles, and the associated vigilance, can improve the safety of medicines management in Norway.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76298091","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":"Reduction in Use of Risperidone for Dementia in Australia Following Changed Guidelines","authors":"L. K. Kalisch Ellett, Anna K Moffat, Svetla Gadzhanova, N. Pratt, J. Apajee, M. Woodward, E. Roughead","doi":"10.3390/pharmacy7030100","DOIUrl":"https://doi.org/10.3390/pharmacy7030100","url":null,"abstract":"Background: Risperidone is the only antipsychotic approved in Australia for the management of the behavioural and psychological symptoms of dementia (BPSD). In June 2015, the Australian Government Therapeutic Goods Administration (TGA) amended the indication to restrict use in BPSD to patients with Alzheimer’s dementia for a maximum twelve-week duration. We aimed to determine whether the rate and duration of risperidone use for BPSD decreased following the regulatory changes. Methods: we conducted a study using the Australian Government Department of Veterans’ Affairs administrative claims data and Pharmaceutical Benefits Scheme (PBS) 10% sample data. We included people aged 65 years or older and compared the rate and duration of risperidone use before and after the TGA labelling changes. Results: There was a sustained decrease in the trend of risperidone use for BPSD following the TGA labelling changes, with a monthly decrease of 1.7% in the aged care population, 0.5% in the community living population and 1.5% in the general older Australian population. Overall, in the 24 months post the TGA changes the reduction in the rate of use of risperidone ranged from 20% to 28% lower than compared to what the rate would have been without the TGA changes. The median duration of use of risperidone in aged-care residents decreased from 338 days in the year prior to the TGA labelling changes, to 240 days per person in the year after the changes. Conclusion: The TGA labelling changes were associated with a significant reduction in the rate of use of risperidone for BPSD in veterans living in both the aged care and community settings, and in the general older Australian population. The labelling changes were also associated with a reduced duration of risperidone use in aged care residents, although for most people the duration of use still exceeded the recommended 12-week maximum duration.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74441630","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":"Applying Contemporary Management Principles to Implementing and Evaluating Value-Added Pharmacist Services","authors":"S. Desselle, L. Moczygemba, A. Coe, Karl Hess, D. Zgarrick","doi":"10.3390/pharmacy7030099","DOIUrl":"https://doi.org/10.3390/pharmacy7030099","url":null,"abstract":"Value-added pharmacy services encompass traditional and emerging services provided by pharmacists to individual and entire populations of persons increasingly under the auspices of a public health mandate. The success of value-added pharmacy services is enhanced when they are carried out and assessed using appropriate theory-based paradigms. Many of the more important management theories for pharmacy services consider the “servicescape” of these services recognizing the uniqueness of each patient and service encounter that vary based upon health needs and myriad other factors. In addition, implementation science principles help ensure the financial viability and sustainability of these services. This commentary reviews some of the foundational management theories and provides a number of examples of these theories that have been applied successfully resulting in a greater prevalence and scope of value-added services being offered.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"249 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80666426","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":"Quinolone Allergy","authors":"Edoabasi U. McGee, Essie Samuel, Bernadett Boronea, Nakoasha Dillard, Madison N Milby, S. Lewis","doi":"10.3390/pharmacy7030097","DOIUrl":"https://doi.org/10.3390/pharmacy7030097","url":null,"abstract":"Quinolones are the second most common antibiotic class associated with drug-induced allergic reactions, but data on quinolone allergy are scarce. This review article discusses the available evidence on quinolone allergy, including prevalence, risk factors, diagnosis, clinical manifestations, cross-reactivity, and management of allergic reactions. Although the incidence of quinolone allergy is still lower than beta-lactams, it has been increasingly reported in recent decades, most likely from its expanded use and the introduction of moxifloxacin. Thorough patient history remains essential in the evaluation of quinolone allergy. Many diagnostic tools have been investigated, but skin tests can yield false-positive results and in vitro tests have not been validated. The drug provocation test is considered the test of choice to confirm a quinolone allergy but is not without risk. Evidence regarding cross-reactivity among the quinolones is limited and conflicting. Quinolone allergy can be manifested either as an immediate or delayed reaction, but is not uniform across the class, with moxifloxacin posing the highest risk of anaphylaxis. Quinolone should be discontinued when an allergic reaction occurs and avoided in future scenarios, but desensitization may be warranted if no alternatives are available.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88922029","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":"Pharmacist Outlooks on Prescribing Hormonal Contraception Following Statewide Scope of Practice Expansion","authors":"S. Rafie, E. Richards, Samantha Rafie, S. Landau, Tracey A. Wilkinson","doi":"10.3390/pharmacy7030096","DOIUrl":"https://doi.org/10.3390/pharmacy7030096","url":null,"abstract":"In an effort to increase access to contraception, the pharmacist scope of practice is being expanded to allow prescribing. While this is being accomplished in the United States by a variety of models, legislation that allows pharmacists to prescribe hormonal contraception under a statewide protocol is the most common. This study was designed to explore the outlooks of pharmacists regarding prescribing contraception in the period following the first state legislation and prior to statewide protocol development and availability. A qualitative study of community pharmacists in California using structured phone interviews explored their opinions regarding access to contraception in pharmacies and outlooks regarding prescribing. Data were analyzed using an inductive approach to identify themes. Among the thirty participants, the majority worked in a chain pharmacy. Themes were identified in five overarching domains: Pharmacist barriers, system barriers, patient issues, safety concerns, and pharmacist role. Most were unfamiliar with the new law, yet were interested in expanding access for patient benefit despite foreseeing challenges with implementing the service in community pharmacies. Barriers will need to be addressed and requisite training disseminated widely to facilitate successful implementation and thus improve access on a broad scale. Further research following protocol implementation is needed to understand service implementation, as well as patient utilization and satisfaction.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86074434","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":"Managing Medical Emergencies in Hungarian Pharmacies","authors":"P. Felkai, Zsolt Iván","doi":"10.3390/pharmacy7030095","DOIUrl":"https://doi.org/10.3390/pharmacy7030095","url":null,"abstract":"To amass a body of knowledge for managing emergency situations in pharmacies, we surveyed the occurrence and nature of medical problems in Hungarian pharmacies. The occurrence of real or suspected emergencies in pharmacies was markedly different and varied from 1–52 per year, with five cases per year on average. The most frequent problems were bleeding (69%) and dizziness (55%), but other more serious problems (allergic reaction (32%), collapse (23%), and chest pain (25%)) also occurred. Sometimes more than one symptom was reported by a patient. People appear to consider pharmacies to be an appropriate site for receiving first aid for minor ailments, including common medical problems (e.g., fever (12%)). Unfortunately, the range of interventions was very limited because of local legal regulations and the lack of appropriate guidelines for emergencies in pharmacies. The most frequent interventions were wound treatment, control of bleeding (78%), alleviation of anxiety (68%), and providing patients with a glass of water (55%). Very often, more than one intervention was reported for the same case. Whereas 76.3% of pharmacists provided interventions only for adults, 21% of pharmacists provided interventions for all types of patients (adults, co-workers in pharmacies, and children). Pharmacists appeared to be reluctant to treat children, owing to the special issues related to pediatrics. This poor range of intervention should encourage responsible officials to develop guidelines for pharmacists to ensure pharmacists’ familiarity with the appropriate interventions in emergency situations. Such knowledge could also provide a good basis for preparing pharmacists to perform vaccinations in the future. The pharmacists had a positive attitude toward providing first aid, and 88% of respondents requested more postgraduate education on medical first aid issues.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80762148","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":"Balancing Assessment with “In-Service Practical Training”: A Case Report on Collaborative Curriculum Design for Delivery in the Practice Setting","authors":"Cicely Roche, M. Flood, M. Lynch, L. Sahm","doi":"10.3390/pharmacy7030093","DOIUrl":"https://doi.org/10.3390/pharmacy7030093","url":null,"abstract":"Three Higher Education Institutions (HEIs) in Ireland are accredited to provide education and training, successful completion of which, entitles one to register as a pharmacist with the Pharmaceutical Society of Ireland (PSI). Legislation (2014) mandated that these HEIs replace their existing structure (four-year degree followed by a one-year internship), with a five-year ‘integrated Master’s programme’. Integration includes ‘in-service practical training’ (placement) at the beginning of Year 4 (four months), and the end of Year 5 (eight months). Year 4 placements do not have to be ‘patient-facing’. Students receive a Bachelor’s degree at the end of Year 4. The Affiliation for Pharmacy Practice Experiential Learning (APPEL), established by the HEIs, manages student placements, training establishments, preceptor training, the preceptors’ competency assessment process, and the virtual learning environment (VLE) that enables delivery of co-developed online modules aligned with placements in Years 4 and 5. This case report aims to describe the process by which this integration has taken place across and within these HEIs and the challenges faced by educators, students, preceptors, and other stakeholders along the way.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76538232","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":"Reinforcement of the Framework for Experiential Education in Healthcare in Serbia: Post-Implementation Project Review within Pharmacy Education","authors":"M. Odalović, J. Parojčić, D. Vasiljević, Danijela Đukić - Ćosić, L. Tasić","doi":"10.3390/pharmacy7030092","DOIUrl":"https://doi.org/10.3390/pharmacy7030092","url":null,"abstract":"Background: The Erasmus+ project “Reinforcement of the Framework for Experiential Education in Healthcare in Serbia” (ReFEEHS) has been undertaken with the aim to: (i) reinforce and modernize experiential education (ExEd) in the health sciences curricula, (ii) introduce interprofessional education (IPE), and (iii) promote teaching competency development of academic staff and teacher practitioners/clinician educators. The aim of this paper is a post-implementation review of the project activities and outcomes with the emphasis on the impact and sustainability in pharmacy education. Methods: Project Logical framework matrix has been employed as planning, monitoring and evaluation tool which summarizes the main project objectives, project outcomes, relevant activities, indicators of progress, sources of verification, assumptions and risks. Results: The key project outcomes are: (i) update of competency-based curricula and development of quality assurance framework for students professional practice placements; (ii) development and introduction of interprofessional teaching and learning activities through joint curriculum delivery; and (iii) development and implementation of Teaching Certificate in Health Professions Education (TCinHPE) study program. The short-term impact of project activities and outcomes has been assessed based on the feedback received from relevant stakeholders, as well as self-evaluation of participants enrolled in new/updated curricula. Sustainability of project results is necessary in order to achieve long-term impact envisioned as increased level of professional competency of health science students; increased level of teaching competency of academic staff and teacher practitioners; improved patient healthcare and harmonisation with the EU practice and policies. Conclusions: The project outcomes contributed to building capacity at the Serbian universities involved in terms of collaboration between the healthcare professions and, in curriculum and academic staff development. It is expected that improved curricula will positively impact professional competency development of pharmacy students, graduates employability and increased workforce mobility. Meeting the quality standards of the European Higher Education Area will contribute to visibility of Serbian universities and their internationalisation, which is one of the strategic aims of improvement.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80039260","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":"Feasibility of a Coordinated Human Papillomavirus (HPV) Vaccination Program between a Medical Clinic and a Community Pharmacy","authors":"W. Doucette, Kelly Kent, Laura E. Seegmiller, R. McDonough, William Evans","doi":"10.3390/pharmacy7030091","DOIUrl":"https://doi.org/10.3390/pharmacy7030091","url":null,"abstract":"Human papillomavirus (HPV) vaccination coverage could be enhanced by community pharmacies working with medical clinics to coordinate completion of the HPV vaccination series. The objective for this study was to assess the feasibility of a coordinated model of HPV vaccine delivery in which a clinic gives the first dose and refers patients to a partnering community pharmacy to receive subsequent doses. A medical clinic-community pharmacy team was established in a Midwestern state to develop and operate a coordinated care model for HPV vaccinations. Under the coordinated model, the clinic identified patients needing HPV vaccination(s), administered the first dose and described the option to complete the vaccination series at the pharmacy. Interested patients then had an information sheet faxed and electronic prescriptions sent to the pharmacy. The pharmacy contacted the patients to schedule administration of 2nd and 3rd doses of the HPV vaccine. Over a 12-month period, 51 patients were referred to the pharmacy by the clinic. Of these, 23 patients received a total of 25 vaccinations. Clinic and pharmacy personnel mostly rated the coordinated program favorably. An initial study of a coordinated HPV vaccination program between a medical clinic and a community pharmacy supported patients getting HPV vaccinations.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85434751","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}