Pharmacy最新文献

{"title":"Designing Effective Protocol-Based Pharmacotherapy Management: Assessment of the Development Processes and Outcomes in Inflammatory Bowel Disease Care Prescription Management.","authors":"Masatsugu Sato, Shiho Fujita, Masahiko Kimura, Ken Takeuchi, Yukihiro Hamahata, Yoshikazu Matsuda","doi":"10.3390/pharmacy13010017","DOIUrl":"10.3390/pharmacy13010017","url":null,"abstract":"<p><p>Prolonged working hours among physicians in Japan, alongside rising inflammatory bowel disease (IBD) cases, have heightened the need for additional support in IBD care. Protocol-based pharmacotherapy management (PBPM) has emerged as an effective approach that allows pharmacists to assist in prescription management under predefined protocols, potentially reducing physicians' workload. However, the detailed process of formulating PBPMs remains unclear. This study developed effective PBPM protocols by reviewing past provisional prescriptions. Provisional prescriptions made by pharmacists based on verbal instructions from physicians were reviewed to develop new PBPMs at Tsujinaka Hospital, Kashiwanoha. We retrospectively analyzed the PBPM application rate during three months before and after this initiative based on the proportion of prescriptions processed under standard procedure (SP), pharmacist provisional prescribing (PPP), and PBPM (PBPM-P). A total of 1259 prescriptions were retrospectively analyzed in this study. Before the initiative, there were 586 prescriptions (oral/topical, 128; injection, 458); after the initiative, there were 673 prescriptions (oral/topical, 242; injection, 431). The pre-initiative rates for SP, PPP, and PBPM-P were 68.3%, 30.7%, and 1.0%, respectively. Post-initiative, the rates were 48.3%, 26.6%, and 25.1%, respectively. A significant decrease was observed in the proportion of SP and PPP, while PBPM-P showed a significant increase after the initiative. Specifically, the proportion of PBPM-P increased by 24.1 percentage points, reflecting its broader adoption. In terms of safety, the proportion of pharmacists' prescription questions decreased significantly from 3.1% before to 0.3% after the initiative. Additionally, the proportion of prescription changes resulting from these questions decreased significantly, from 1.2% to 0%. The PBPM development process evaluated here could successfully form effective PBPMs, which have the potential to reduce physicians' workload, indicating that the process detailed in this study could be applied to future protocol development.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11860031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493821","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":"Quality-of-Life Assessment and Pharmacokinetic Study in Hemophilia A Patients Undergoing Prophylactic Treatment.","authors":"Nikolaos Kotsiou, Paschalis Evangelidis, Michail Bolios, Konstantinos Tragiannidis, Panagiotis Kalmoukos, Zacharo Ntova, Sofia Chissan, Sofia Vakalopoulou, Eleni Gavriilaki","doi":"10.3390/pharmacy13010016","DOIUrl":"10.3390/pharmacy13010016","url":null,"abstract":"<p><p>This study evaluates the health-related quality of life (HRQoL) among patients with hemophilia A currently undergoing prophylactic treatment at the Hemophilia Center of Northern Greece. Using the Haem-A-QoL questionnaire, we assessed various HRQoL dimensions in a cohort of 29 adult male patients, analyzing the impact of age, disease severity, and treatment regimens. The results revealed that younger patients (18-30 years old) exhibited significantly better overall HRQoL scores (total score of 25.36) compared to older age groups (37.81 for the 31-45 group and 43.71 in the 45+ group), particularly in the physical health (29.16 vs. 48.43 vs. 58.57) and mental well-being domains (25 vs. 37.11 vs. 41.07). Interestingly, moderate hemophilia patients reported lower HRQoL (42.31) than those with severe form (34.85), suggesting unique challenges in managing their condition. The 'Sports/Free Time' domain had the highest scores (65.81), indicating significant limitations in physical activities in the everyday lives of affected individuals. However, better outcomes were observed in the mental dimension (36.09), work/study (34.88), family planning (10.68), and relationships aspects (16.67), where our cohort reported very low scores compared to similar studies, indicating a significantly better quality of life in these domains. These findings highlight the importance of personalized psychosocial support and targeted interventions to address the specific needs of hemophilia patients, particularly in enhancing physical activity opportunities and managing the psychological burden of moderate hemophilia. The study contributes valuable insights into the HRQoL of hemophilia patients and underscores the necessity for tailored approaches to improve patient outcomes across all dimensions of life.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493926","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":"Operational Definitions of Polypharmacy and Their Association with All-Cause Hospitalization Risk: A Conceptual Framework Using Administrative Databases.","authors":"Stefano Scotti, Lorenza Scotti, Federica Galimberti, Sining Xie, Manuela Casula, Elena Olmastroni","doi":"10.3390/pharmacy13010015","DOIUrl":"10.3390/pharmacy13010015","url":null,"abstract":"<p><p>Polypharmacy, defined as the concurrent use of multiple medications, increases the risk of various adverse outcomes. However, the variability in definitions across the literature contributes to substantial heterogeneity. Building on the published literature, this study aimed to identify a set of operational definitions of polypharmacy applicable to administrative databases and to assess their association with all-cause hospitalization. Data from the pharmacy refill and hospitalization databases of the Local Health Unit (LHU) of Bergamo, Lombardy, were analyzed. Patients aged ≥40 with at least one reimbursed drug prescription in 2017 were included. Prescription coverage was evaluated using total defined daily doses (DDDs), and all-cause hospitalizations from January to June 2018 were considered. Definitions explored included (i) the WHO's criterion of ≥5 medications by ATC fourth-level code; (ii) the exclusion of prescriptions usually for short-term treatments; and (iii) drugs with cumulative annual DDD ≥ 60. Approaches were assessed annually, quarterly, and monthly, and logistic regression was used to estimate odds ratios (ORs) for hospitalization risk. Among 431,620 patients, the DDD ≥ 60 definition showed the least variability (20.47-21.16%) and identified an older more complex cohort. All definitions showed a dose-dependent association with hospitalization risk. Different definitions of polypharmacy result in varying prevalence, with DDD ≥ 60 being the most consistent. A patient-centric approach is crucial to assess the appropriateness of polypharmacy.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493877","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":"Impact and Enablers of Pharmacogenetic-Informed Treatment Decisions-A Longitudinal Mixed-Methods Study Exploring the Patient Perspective.","authors":"Anna Bollinger, Melissa Semedo Fortes, Henriette E Meyer Zu Schwabedissen, Kurt E Hersberger, Céline K Stäuble, Samuel S Allemann","doi":"10.3390/pharmacy13010014","DOIUrl":"10.3390/pharmacy13010014","url":null,"abstract":"<p><p>Pharmacogenetic (PGx) testing is a promising approach for optimizing drug therapies. However, there is limited knowledge regarding its real-world utilization and long-term impact in clinical practice. This study assessed how often PGx information informs treatment decisions and evaluated patients' perspectives on its use and non-use, identifying enablers for PGx implementation. A mixed-methods study was conducted with 24 patients with a median of 1 year after PGx testing. Medication and health-related data were collected at enrollment and at the follow-up 1 year later using a semi-structured questionnaire. At the follow-up, 62 medication changes were identified in 18 patients. A median of four medication changes per patient were initiated mainly by medical specialists (58%). PGx information was considered for 15 patients in 39 medication changes (63%). Patient-reported factors contributing to the non-use of PGx information included a lack of knowledge and interest among healthcare professionals (HCPs), structural and administrative barriers, and an over-reliance on patient advocacy. Potential enablers should address targeted PGx education, interprofessional collaboration, awareness among policymakers, and concise recommendations focused on PGx-actionable drugs from testing providers. By implementing these interdependent enablers, PGx can evolve into a long-term, clinically integrated cornerstone of individualized pharmacotherapy.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493917","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":"Using Healthcare Redesign to Identify Medication Management Issues in Parkinson's Disease.","authors":"Susan Williams, Marissa A Iannuzzi, Sarah J Prior","doi":"10.3390/pharmacy13010013","DOIUrl":"10.3390/pharmacy13010013","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is a neurodegenerative disorder that is predominantly controlled through pharmacotherapy. People with PD have highly complex medication regimens that are often poorly managed during hospital admissions. This project aims to understand the issues experienced by patients with PD and healthcare staff that impacted their medication management during their hospital admission at a tertiary metropolitan hospital in New South Wales, Australia.</p><p><strong>Methods: </strong>This project focuses on the mixed-methods diagnostics phase of the healthcare redesign approach to health service improvement, utilising organisational data, online surveys, interviews, and focus groups.</p><p><strong>Results: </strong>The findings from this project highlight key areas to address to improve the medication management of patients with PD admitted to hospital. The organisational data (<i>n</i> = 222) showed that the identification of PD patients, untimely medication reviews, prescribing errors, and untimely medication administration all contributed to poor patient experience. The staff surveys (<i>n</i> = 81) highlighted that a lack of knowledge of PD medications and poor patient identification impacted patient experience. The patient surveys (<i>n</i> = 18) and patient interviews (<i>n</i> = 16) suggested that confidence around medication management and administration timing could be improved.</p><p><strong>Conclusions: </strong>Poor PD medication management in hospital impacts the patient experience and should be improved to ensure better outcomes for patients and the health services.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493739","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 the Benefits, Barriers and Improvement Opportunities in Implementing Automated Dispensing Cabinets: A Qualitative Study.","authors":"Abbas Al Mutair, Alya Elgamri, Kawther Taleb, Batool Mohammed Alhassan, Mohamed Alsalim, Horia Alduriahem, Chandni Saha, Kawthar Alsaleh","doi":"10.3390/pharmacy13010012","DOIUrl":"10.3390/pharmacy13010012","url":null,"abstract":"<p><p>Technology has increasingly influenced the provision of healthcare services by enhancing patient safety, optimising workflows, and improving efficiency. Large healthcare facilities have adopted automated dispensing cabinets (ADCs) as an advanced technological solution. A key gap exists in understanding the ADC implementation experience in different contexts. Therefore, this study seeks to fill this literature gap by exploring key stakeholders' perspectives on the benefits, barriers, and improvement opportunities related to ADCs, offering valuable insights to support their effective integration across various healthcare settings. This qualitative study was conducted in Saudi Arabia. The implementation of ADCs generally has positive outcomes for all staff. The system has brought about enhanced medication tracking, greater time efficiency, along with reduced workload and medication errors. However, there are barriers to their implementation, including changes in workflow and workload distribution, cabinet design, technical medication management challenges, and the need for staff training. To maximise the effectiveness of ADCs, healthcare organisations should focus on improving operational workflows, providing ongoing staff training, and maintaining robust system monitoring. Additionally, manufacturers should focus on advancing technology to further enhance the efficiency and functionality of ADCs.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493916","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' Perspectives on Nicotine Vaping Products (NVPs) for Smoking Cessation in Australia: A Qualitative Analysis.","authors":"David Le, Maya Saba, Habib Bhurawala, Muhammad Aziz Rahman, Smita Shah, Bandana Saini","doi":"10.3390/pharmacy13010011","DOIUrl":"10.3390/pharmacy13010011","url":null,"abstract":"<p><p>Vaping, particularly the use of nicotine vaping products (NVPs), has emerged as a public health concern. The regulatory environment surrounding NVPs in Australia has rapidly evolved, shifting from a prescription-only model to availability through community pharmacies. Pharmacists play a critical role in addressing vaping-related health concerns. This study explores Australian pharmacists' perspectives on their professional roles and the support needed to manage vaping-related enquiries. Qualitative semi-structured interviews were conducted with 25 practicing pharmacists using a topic guide developed from the current literature and team expertise. The interviews were transcribed verbatim and analysed thematically using an inductive approach to identify key themes. Key themes included <i>risk perception</i>, <i>professional vaping health-related services</i>, <i>professional practice</i> and <i>other support-related needs</i>. Pharmacists expressed significant uncertainty about the risks and harms associated with vaping. There was apprehension around the regulatory complexity of supplying NVPs, and participants called for greater education and support, particularly around NVP's place in smoking cessation and potential vaping cessation services. Effective public health messaging and risk communication about vaping are crucial. At the centre of recent legislative changes, pharmacists require training and professional support to address vaping-related scenarios and provide counselling that aligns with individual risk perceptions, ensuring NVP use is clinically appropriate.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493923","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":"Closing Tobacco Treatment Gaps for Rural Populations: The Role of Clinic-Based Pharmacists at a Federally Qualified Health Center.","authors":"Lavinia Salama, Karen Suchanek Hudmon, Leena Myran, Nervana Elkhadragy","doi":"10.3390/pharmacy13010010","DOIUrl":"10.3390/pharmacy13010010","url":null,"abstract":"<p><p>Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients' interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11858977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493812","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":"Ultraviolet C Decontamination Devices in a Hospital Pharmacy: An Evaluation of Their Contribution.","authors":"Clara Baudart, Thomas Briot","doi":"10.3390/pharmacy13010009","DOIUrl":"10.3390/pharmacy13010009","url":null,"abstract":"<p><strong>Purpose: </strong>The COVID-19 pandemic led to a major interest in ultraviolet C (UVC) disinfection devices and accelerated the implementation of UVC devices in healthcare facilities due to their proven efficacy in the inactivation of various pathogens. While UVC technology offers several advantages, some drawbacks remain. This report, drawing on studies, guidelines, and practical experiences related to the use of UVC technology in healthcare settings, examines the efficacy, advantages, and drawbacks of UVC devices, and their applications in aseptic drug-compounding pharmaceutical units.</p><p><strong>Summary: </strong>Studies, guidelines, and practical experiences were selected. UVC technology offers advantages such as rapid disinfection, reduced reliance on chemical agents, minimal waste, and freedom from manual disinfection variability, making it particularly valuable for maintaining aseptic conditions in compounding environments. However, some drawbacks persist, as it is a germ-dependent method and there is currently no standardized method for ensuring effectiveness.</p><p><strong>Conclusions: </strong>This opinion paper highlights the effectiveness of UCV technology in pharmaceutical compounding units, proving that it is a viable alternative to the traditionally used manual and operator-dependent methods. However, there is a need for standardized methods to evaluate UVC devices.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859781/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493949","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":"Integrating Domestic Violence Education into the Pharmacy Curriculum.","authors":"Harjit K Khera, Rita Wardan, Hiu Tek Wu, Andy Ling, Suzanne M Caliph","doi":"10.3390/pharmacy13010008","DOIUrl":"10.3390/pharmacy13010008","url":null,"abstract":"<p><p>Domestic violence (DV) is a pervasive issue with significant implications for public health, yet it remains under-addressed in healthcare systems. Pharmacists, as accessible healthcare providers, are in a unique position to identify and support individuals affected by DV, but training in this area is often lacking in pharmacy education. This study explores the challenges of and opportunities for integrating DV education into the pharmacy curriculum by interviewing twelve pharmacy educators from Monash University. Using semi-structured interviews, data were analyzed thematically to identify key barriers and facilitators. The findings highlight several benefits of integrating DV education, including pharmacists' accessibility to patients and their ability to play a vital role in recognizing and responding to DV. However, challenges such as time constraints, lack of confidence, insufficient training, and perceived limitations on pharmacists' scope of practice were noted. Ethical and legal concerns regarding pharmacists' roles in DV cases were also identified. This study concludes that integrating DV education into pharmacy curricula is essential; however, it requires significant barriers to be overcome, including the need for specialised training and collaboration with DV experts. This study recommends interdisciplinary workshops and greater faculty support to equip future pharmacists with the necessary skills to address DV effectively.</p>","PeriodicalId":30544,"journal":{"name":"Pharmacy","volume":"13 1","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11859440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493920","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}