Pharmacy最新文献

{"title":"Leveraging Community Pharmacies to Address Social Needs: A Promising Practice to Improve Healthcare Quality.","authors":"Tony Kuo, Noel C Barragan, Steven Chen","doi":"10.3390/pharmacy12050139","DOIUrl":"10.3390/pharmacy12050139","url":null,"abstract":"<p><p>Emerging research suggests that chronic conditions such as cardiovascular disease, diabetes, and asthma are often mediated by adverse social conditions that complicate their management. These conditions include circumstances such as lack of affordable housing, food insecurity, barriers to safe and reliable transportation, structural racism, and unequal access to healthcare or higher education. Although health systems cannot independently solve these problems, their infrastructure, funding resources, and well-trained workforce can be realigned to better address social needs created by them. For example, community pharmacies and the professionals they employ can be utilized and are well-positioned to deliver balanced, individualized clinical services, with a focus on the whole person. Because they have deep roots and presence in the community, especially in under-resourced neighborhoods, community pharmacies (independent and chain) represent local entities that community members recognize and trust. In this article, we provide case examples from California, United States, to illustrate and explore how community pharmacies can be leveraged to address patient social needs as part of their core responsibilities and overall strategy to improve healthcare quality.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297088","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":"An Internationally Derived Process of Healthcare Professionals' Proactive Deprescribing Steps and Constituent Activities.","authors":"Sion Scott, Natalie Buac, Debi Bhattacharya","doi":"10.3390/pharmacy12050138","DOIUrl":"10.3390/pharmacy12050138","url":null,"abstract":"<p><p>Proactive deprescribing is the process of tapering or stopping a medicine before harm occurs. This study aimed to specify and validate, with an international sample of healthcare professionals, a proactive deprescribing process of steps and constituent activities. We developed a proactive deprescribing process framework of steps which we populated with literature-derived activities required to be undertaken by healthcare professionals. We distributed a survey to healthcare professionals internationally, requesting for each activity the frequency of its occurrence in practice and whether it was important. Extended response questions investigated barriers and enablers to deprescribing. The 263 survey respondents were from 25 countries. A proactive deprescribing process was developed comprising four steps: (1) identify a patient for potential stop of a medicine, (2) evaluate a patient for potential stop of a medicine, (3) stop a medicine(s), and (4) monitor after a medicine has been stopped, and 17 activities. All activities were considered important by ≥70% of respondents. Nine activities required healthcare professionals to undertake in direct partnership with the patient and/or caregiver, of which seven were only sometimes undertaken. Deprescribing interventions should include a focus on addressing the barriers and enablers of healthcare professionals undertaking the activities that require direct partnership with the patient and/or caregiver.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297080","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":"Exploring Barriers Faced by Community Pharmacists in Serving Patients with Disabilities in Saudi Arabia: Recommendations for Enhancing Healthcare Provisions.","authors":"Aisha F Badr","doi":"10.3390/pharmacy12050137","DOIUrl":"10.3390/pharmacy12050137","url":null,"abstract":"<p><p>While several studies have explored the barriers to accessing community pharmacies for individuals with physical, hearing, visual, and learning disabilities, most have focused on the perspectives of disabled individuals. Therefore, this study aimed to examine the barriers faced by community pharmacists when serving individuals with physical, visual, and hearing disabilities in Saudi Arabia, with the goal of recommending ways to enhance future healthcare provisions.</p><p><strong>Methods: </strong>A mixed-methods cross-sectional phenomenological study was conducted among community pharmacists in Saudi Arabia between March and April 2022. Both closed- and open-ended questions were utilized to identify themes related to community pharmacists' barriers and experiences when providing care to individuals with disabilities.</p><p><strong>Results: </strong>A total of 40 community pharmacists participated in this study. Among them, 57.5% reported encountering difficulties when caring for patients with disabilities, with 65% indicating a lack of specialized services at their respective community pharmacies. Three major themes emerged from the findings: the need for pharmacist training and awareness, technology-guided methods for overcoming communication barriers, and improving overall pharmacy accessibility.</p><p><strong>Conclusion: </strong>This study reveals a significant gap in the provision of services for patients with disabilities in Saudi Arabia. Addressing physical accessibility, providing targeted training, and leveraging technology can enhance care delivery and promote inclusivity. Further research is warranted to assess the effectiveness of technological solutions and the integration of artificial intelligence in improving communication and patient-centered care for individuals with disabilities.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297086","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":"Drug Shortage and Ethical Issues: Integrating Multidisciplinary Perspectives with a Shared Ethical Framework.","authors":"Maya C Wai","doi":"10.3390/pharmacy12050136","DOIUrl":"10.3390/pharmacy12050136","url":null,"abstract":"<p><p>Drug shortages can cause ethical dilemmas when no systematic, equitable allocation, or utilization schema is in place. During the COVID-19 pandemic, an ethical framework outlining moral values was proposed as way to approach allocating limited resources to patients. In addition to an ethical perspective, it is prudent to consider costs. Examining existing economic frameworks and combining them with an ethical perspective may provide a practical, systematic process for decision makers when allocating drugs in short supply. Drug shortages continue to impact multiple areas across different subspecialties of medicine due to multiple factors, including limited manufacturers, regulatory issues, and costs. All of these factors make it difficult to anticipate and manage drug shortages effectively, but developing a combined framework may reduce some of the ethical and equitable ambiguity with regards to patient care.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297082","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 Dispensing Error Rate in an App-Based, Semaglutide-Supported Weight-Loss Service: A Retrospective Cohort Study.","authors":"Louis Talay, Matt Vickers","doi":"10.3390/pharmacy12050135","DOIUrl":"10.3390/pharmacy12050135","url":null,"abstract":"<p><p>Digital weight-loss services (DWLSs) combining pharmacotherapy and health coaching have the potential to make a major contribution to the global struggle against obesity. However, the degree to which DWLSs compromise patient safety through the dispensation of Glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications is unknown. This study retrospectively analysed the rate at which patients reported GLP-1 RA dispensing errors from patient-selected and partner pharmacies of Australia's largest DWLS provider over a six-month period. The analysis found that 99 (0.35%) of the 28,165 dispensed semaglutide orders contained an error. Incorrect dose (58.6%) and unreasonable medication expiry window (21.2%) were the two most common error types. Most errors (84.9%) were deemed to have been of medium urgency, with 11.1% being considered high-urgency errors. Incorrect doses (45.5%) and supplies of the wrong medication (36.3%) comprised most errors reported in high-urgency cases. Female patients reported more dispensing errors than male patients (0.41% vs. 0.12%, <i>p</i> < 0.001). Similarly, reported dispensing error rates were highest among patients aged 18 to 29 years (0.6%) and 30 to 39 years (0.5%). This research provides preliminary evidence that GLP-1 RA dispensing errors within comprehensive Australian DWLSs are relatively low.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297090","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":"An Evaluation of Oral Anticoagulant Safety Indicators by England's Community Pharmacies.","authors":"Sejal Parekh, Lingqian Xu, Carina Livingstone","doi":"10.3390/pharmacy12050134","DOIUrl":"10.3390/pharmacy12050134","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulants are life-saving medicines that can prevent strokes for patients diagnosed with atrial fibrillation (AF) as well as treating patients with venous thromboembolism (VTE), but when used incorrectly, they are frequently associated with patient harm.</p><p><strong>Aim: </strong>To evaluate the impact of community pharmacy teams on optimising patient knowledge and awareness and improving medication safety from the use of anticoagulants.</p><p><strong>Methods: </strong>Two national audits, consisting of 17 questions assessing and improving patients' understanding of anticoagulant therapy, identifying high-risk patients, and contacting prescribers when clinically appropriate were incentivised for England's community pharmacies in 2021-2022 and 2023-2024 using the Pharmacy Quality Scheme (PQS) commissioned by NHS England.</p><p><strong>Results: </strong>Approximately 11,000 community pharmacies audited just under a quarter of a million patients in total, whilst making almost 150,000 interventions for patients taking oral anticoagulants, i.e., identifying and addressing medication issues which could increase the risk of bleeding/harm. Out of the 111,195 patients audited in 2021-2022, only 24,545 (23%) patients were prescribed vitamin K antagonists. The remaining patients were prescribed direct oral anticoagulants (DOACs). By 2023-2024, this decreased to 17,043 (16%) patients. Most patients knew that they were prescribed an anticoagulant (95.6%, 106,255 in 2021-2022 and 96.5%, 101,006 in 2023-2024, <i>p</i> < 0.001).</p><p><strong>Discussion: </strong>The audits resulted in a statistically significant increase in patients with a standard yellow anticoagulant alert card, as identified in audit 2 (73,901 66.5% in 2021-2022 to 76,735, 73.3% in 2023-2024, <i>p</i> < 0.001). Furthermore, fewer patients were prescribed concurrent antiplatelets with an anticoagulant (6021; 4.6% in 2021-2022 to 4975; 4% in 2023-2024, <i>p</i> < 0.001). Although there was an increase in the number of patients prescribed NSAIDs with anticoagulants, more of these patients were also prescribed gastroprotection concurrently (927 77.2% in 2021-2022 to 1457 84.1% in 2023-2024, <i>p</i> < 0.05). The majority of patients on warfarin had their blood checked within 12 weeks. Further there was an increase for these patients in the percentage of people prescribed VKAs who knew dietary changes can affect their anticoagulant medicine (16,764 67.4% in 2021-2022 to 12,594 73.9% in 2023-2024 <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Community pharmacy teams are well placed in educating and counselling patients on the safe use of anticoagulants and ensuring that all patients are correctly monitored.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297079","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 Anti-Xa Target Attainment with Prophylactic Enoxaparin Dosing Regimens for Venous Thromboembolism Prophylaxis in Morbidly Obese Patients.","authors":"Andrew Sabers, Emilie Langenhan, Sean N Avedissian, Brandon Reynolds","doi":"10.3390/pharmacy12050133","DOIUrl":"10.3390/pharmacy12050133","url":null,"abstract":"<p><p>Subcutaneous enoxaparin has been shown to reduce the risk of venous thromboembolism (VTE) among hospitalized patients. However, alternative enoxaparin dosing strategies may be necessary in morbid obesity. The objective of this study was to assess the rate of target anti-Xa attainment with three enoxaparin dosing regimens for venous thromboembolism (VTE) prophylaxis in morbidly obese patients. In this retrospective study, anti-Xa target attainment was assessed among adult patients with a body mass index (BMI) ≥ 40 kg/m² receiving enoxaparin 40 mg twice daily (BID), 60 mg BID, or 0.5 mg/kg BID. Univariate and multivariate analyses were conducted. Target anti-Xa levels were defined as a steady-state, peak level of 0.2-0.5 IU/mL. This study included 120 patients with 55 patients receiving 40 mg BID, 44 patients receiving 60 mg BID, and 21 patients receiving 0.5 mg/kg BID. Target anti-Xa levels were achieved in 29.1% of patients in the 40 mg BID arm, 54.5% in the 60 mg BID arm, and 90.5% in the 0.5 mg/kg BID arm. Anti-Xa target attainment was significantly increased in both the 60 mg BID arm (<i>p</i> = 0.01) and the 0.5 mg/kg arm (<i>p</i> < 0.0001), compared to the 40 mg BID arm. In morbidly obese patients, weight-based dosing was associated with a greater attainment of target anti-Xa levels. Further studies are needed to determine the impact of these dosing regimens on clinical outcomes.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297085","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":"Effective Supply Chain Strategies in Addressing Demand and Supply Uncertainty: A Case Study of Ethiopian Pharmaceutical Supply Services.","authors":"Arebu Issa Bilal, Umit Sezer Bititci, Teferi Gedif Fenta","doi":"10.3390/pharmacy12050132","DOIUrl":"10.3390/pharmacy12050132","url":null,"abstract":"<p><strong>Background: </strong>Ensuring the consistent availability of essential medicines is crucial for effective healthcare systems. However, Ethiopian public health facilities have faced frequent stockouts of crucial medications, highlighting systemic challenges such as inadequate forecasting, prolonged procurement processes, a disjointed distribution system, suboptimal data quality, and a shortage of trained professionals. This study focuses on the Ethiopian Pharmaceutical Supply Services (EPSS), known for its highly unstable and volatile supply chain, aiming to identify risks and mitigation strategies.</p><p><strong>Methods: </strong>Using a mixed-method approach involving surveys and interviews, the research investigates successful and less successful strategies, key success factors, and barriers related to pharmaceutical shortages.</p><p><strong>Results: </strong>Proactive measures such as communication, stock assessment, supervision, and streamlined procurement are emphasized as vital in mitigating disruptions, while reactive strategies like safety stock may lack long-term efficacy. The study highlights the importance of aligning supply chain strategies with product uncertainties, fostering collaboration, and employing flexible designs for resilience. Managerial implications stress the need for responsive structures that integrate data quality, technology, and visibility.</p><p><strong>Conclusions: </strong>This study contributes by exploring proactive and reactive strategies, elucidating key success factors for overcoming shortages in countries with unstable supply chains, and offering actionable steps for enhancing supply chain resilience. Embracing uncertainty and implementing proactive measures can help navigate volatile environments, thereby enhancing competitiveness and sustainability.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297083","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":"Enhancing Operational Efficiency and Service Delivery through a Robotic Dispensing System: A Case Study from a Retail Pharmacy in Brazil.","authors":"Karen Basile, Monserrat Martínez, Julia D Lucaci, Claudia Goldblatt, Idal Beer","doi":"10.3390/pharmacy12050130","DOIUrl":"10.3390/pharmacy12050130","url":null,"abstract":"<p><p>Drug dispensing in retail pharmacies typically involves several manual tasks that often lead to inefficiencies and errors. This is the first published quality improvement study in Latin America, specifically in Brazil, investigating the operational impacts of implementing a robotic dispensing system in a retail pharmacy. Through observational techniques, we measured the time required for the following pharmacy workflows before and after implementing the robotic dispensing system: customer service, receiving stock, stocking inventory, separation, invoicing, and packaging of online orders for delivery. Time savings were observed across all workflows within the pharmacy, notably in receiving stock and online order separation, which experienced 70% and 75% reductions in total time, respectively. Furthermore, customer service, stocking, invoicing, and packaging of online orders, also saw total time reductions from 36% to 53% after implementation of the robotic dispensing system. This study demonstrates an improvement in the pharmacy's operational efficiency post-implementation of the robotic dispensing system. These findings highlight the potential for such automated systems to streamline pharmacy operations, improve staff time efficiency, and enhance service delivery.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297084","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":"What Do Younger and Well-Educated Adults Think about Self-Medication? Results of a Survey during a Public Science Event at Leipzig University.","authors":"Ines Gebert, Sabine Hundertmark, Thilo Bertsche","doi":"10.3390/pharmacy12050131","DOIUrl":"10.3390/pharmacy12050131","url":null,"abstract":"<p><strong>Background: </strong>Consecutive visitors to a public science event at Leipzig University were asked about their opinions/attitudes regarding their personal use of self-medication.</p><p><strong>Methods: </strong>A written questionnaire survey addressed (i) participants' characteristics, (ii) frequency of self-medication use in the last 12 months, (iii) symptoms/complaints most frequently considered applicable, (iv) preconditions, (v) limitations, (vi) risks, (vii) fears, (viii) medication information sources, (ix) influencing factors, and (x) reasons for decision making.</p><p><strong>Results: </strong>(i) A total of 189 visitors (median age: 29.0 years; Q25/Q75: 22.0/44.0) participated, of whom 64.0% were female, 38.6% had a university degree, 20.1% were in training, and 14.8% were licensed in a healthcare profession. (ii) A total of 59.3% of participants stated that they had used self-medication regularly in the last 12 months. The most common answers in the respective questions were (iii) headache, 86.2%; (iv) mild complaints/symptoms, 94.7%; (v) duration, 91.6%; (vi) \"self-medication may cause adverse drug reactions\", 94.2%; (vii) \"developing a habituation effect\", 58.7%; (viii) pharmacists, 93.7%; (ix) \"physician's recommendation\", 89.3%; (x) \"intensity of complaints\", 92.6%; and (vi) 61.3% believed that they could choose an appropriate self-medication.</p><p><strong>Conclusion: </strong>Younger and well-educated adults report using self-medication frequently and rate their expertise as high. Healthcare professionals are the preferred source of information.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":null,"pages":null},"PeriodicalIF":2.0,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297091","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}