Integrated Pharmacy Research and Practice最新文献

{"title":"Impact of Pharmacist Interventions on Health Outcomes of Patients with Type 2 Diabetes Mellitus in the Middle East: A Systematic Review.","authors":"Hussain T Bakhsh","doi":"10.2147/IPRP.S515197","DOIUrl":"https://doi.org/10.2147/IPRP.S515197","url":null,"abstract":"<p><p>This systematic review aimed to evaluate the association between pharmacists' interventions and health outcomes of patients with type 2 Diabetes Mellitus (DM) in the Middle East. A comprehensive database search was conducted in July 2024 using the electronic databases of PubMed, MEDLINE, Embase, Cochrane Library, Web of Science and Scopus. The search strategy involved the following keywords: \"Impact\", \"Effect\", \"Pharmacist\", \"Pharmacy services\", \"Pharmaceutical Care\", \"Intervention\", \"Type 2 diabetes mellitus\", \"diabetes\", and \"Middle East\". Articles published in the English language between January 2010 and July 2024 related to the research question were included. The data extracted from the included papers were summarized using narrative data synthesis. Twelve articles were selected from 536 retrieved articles, with most studies conducted in hospitals (n = 10) and randomized clinical trials (n = 8). The quality of studies was evaluated using the Cochrane risk of bias tool for RCTs and the Newcastle-Ottawa Scale for non-randomized studies to ensure transparent evaluation of the study quality. Narrative synthesis was employed to address variations in study design, outcomes, and biases. Pharmacist interventions reported included patient education (n = 11), counseling (n = 5), drug therapy initiation (n = 5), and dosage adjustment (n = 5). Studies reported significant reductions in glycosylated (HbA1c) (range: 1.4-1.78%) and fasting blood glucose levels (FBG) (range: 2.3-53 mg/dL), decreased systolic and diastolic blood pressure (range: 4.65-14.9 mmHg), body mass index (BMI) (range: 1-2.44 kg/m2), cholesterol, triglycerides, and total cholesterol, and improved medication adherence, self-care activities, and knowledge of diabetes management. In this review, pharmacist interventions reported were associated with improved clinical and humanistic outcomes among type 2 DM patients in the Middle-East. Therefore, collaborative care models involving pharmacists and other healthcare practitioners in the management of type 2 DM should be considered by health policymakers in the region.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"85-98"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019748","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":"Validation of a Scorecard of Quality and Activity Indicators for Telepharmacy Pharmaceutical Care Services in Spanish Hospitals.","authors":"Luis Margusino-Framiñán, Olatz Ibarra-Barrueta, Irene Mangues-Bafalluy, Emilio Monte-Boquet, Patricia Sanmartín-Fenollera, Amparo Talens-Bolós, Ramón Morillo-Verdugo","doi":"10.2147/IPRP.S498218","DOIUrl":"https://doi.org/10.2147/IPRP.S498218","url":null,"abstract":"<p><strong>Purpose: </strong>Telepharmacy must be monitored within a quality management system in order to guarantee the efficiency, safety and quality of the activities it encompasses. The Spanish Society of Hospital Pharmacy has proposed the first scorecard of quality and activity indicators for Telepharmacy (TIS). The objective of this project is to validate this TIS for its implementation in hospital pharmacy services.</p><p><strong>Material and methods: </strong>The project was developed in 4 phases: elaboration of the validation questionnaire/validation criteria; selection of hospitals where the study will be carried out; completion of the validation questionnaire by the selected hospitals; analysis of the results, a proposal of conclusions, and preparation of the final document. The validation criteria were performed using the RAND/UCLA methodology for each of the 5 TIS characteristics: holistic, practical, quantitative, usability, and continuous improvement. Characteristics were considered validated when the median was found to be within the score range 5-9 and at least 2/3 (66.66%) of the respondents scored in the range containing the median.</p><p><strong>Results: </strong>Forty-four hospitals were included and the responses related to TIS characteristics were: holistic=8.2 and 98.5% of responses >5; practical=7.9 and 98.9% of responses >5; quantitative=7.9 and 98.6% of responses >5; usability=6.9 and 87.37% of responses >5; continuous improvement= 7.9 and 100% of responses >5.</p><p><strong>Discussion: </strong>TIS has been validated for use in hospital pharmacy services and its tools and supporting documents are very useful and comprehensive. Hospital informatics systems are needed to allow efficient extraction of the data necessary to obtain the TIS indices.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"73-83"},"PeriodicalIF":2.1,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054058","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":"Molecular Pharmacology of Glucagon-Like Peptide 1-Based Therapies in the Management of Type Two Diabetes Mellitus and Obesity.","authors":"Abdullah M Alzahrani, Ghada A Alshobragi, Abdullah M Alshehri, Majed S Alzahrani, Hasan A Alshehri, Rami M Alzhrani, Samah Basudan, Ayed A Alkatheeri, Salman A Almutairi, Yahya A Alzahrani","doi":"10.2147/IPRP.S503501","DOIUrl":"https://doi.org/10.2147/IPRP.S503501","url":null,"abstract":"<p><strong>Background: </strong>The global increase in type 2 diabetes mellitus (DM2) and obesity presents a significant public health challenge, as these interconnected conditions contribute to severe complications, including cardiovascular disease, stroke, and certain cancers. The incretin system, particularly glucagon-like peptide-1 (GLP-1), has emerged as a promising therapeutic target due to its role in glycemic control and weight management.</p><p><strong>Objective: </strong>This review explores the molecular pharmacology of GLP-1 and its receptor agonists, evaluating their therapeutic efficacy in managing DM2 and obesity.</p><p><strong>Methods: </strong>A comprehensive literature review was conducted, analyzing recent advancements in GLP-1-based therapies, their mechanisms of action, and their clinical applications. The review also highlights the pharmacokinetic modifications developed to enhance the stability and efficacy of GLP-1 receptor agonists.</p><p><strong>Results: </strong>GLP-1 receptor agonists have demonstrated significant benefits in improving glycemic control, reducing body weight, and addressing metabolic complications. Novel therapeutic approaches, including dual and triple incretin receptor agonists, are showing enhanced efficacy in both diabetes and obesity management. However, challenges remain in optimizing treatment outcomes, addressing patient variability, and improving long-term adherence.</p><p><strong>Conclusion: </strong>GLP-1-based therapies have revolutionized the management of DM2 and obesity. Continued research is essential to refine these treatments, overcome existing limitations, and develop personalized approaches to maximize patient outcomes.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"59-72"},"PeriodicalIF":2.1,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144019751","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":"Factors Affecting Data Quality and Reporting Rates for Real-Time ARV Stock Status (RASS) in the West Acholi Sub-Region, Uganda: A Mixed Methods Cross-Sectional Study.","authors":"Ignatius Ankwatsa, Herbert Bush Aguma, Fredrick Atwiine, Rajab Kalidi","doi":"10.2147/IPRP.S514648","DOIUrl":"10.2147/IPRP.S514648","url":null,"abstract":"<p><strong>Background: </strong>\"The World Health Organization aims for universal HIV control by 2030, requiring robust healthcare infrastructure and efficient supply chain management\". In Uganda, a functional real-time ARV Stock Status (RASS) monitoring system and dashboard was developed to provide real-time intelligent data and reliable and accurate information on antiretroviral drugs and other HIV commodities. This integrates data from different information systems for timely decision-making and supports evidence-based ARV commodities supply chain management solutions. This study aimed to identify the factors influencing the quality and reporting rate for Real-Time ARV Stock Status (RASS) weekly reporting in public health facilities in the West Acholi sub-region of Uganda.</p><p><strong>Methods: </strong>A mixed-methods cross-sectional study was conducted in six public health facilities of the West Acholi sub-region. Quantitative data involved a review of 312 reports for the reporting rate. The available 180 RASS reports were reviewed for data quality; supplemental qualitative data was gathered through key informant interviews with 11 healthcare workers and stakeholders. Quantitative data was then cleaned using EPI data, and all the variables were coded and analyzed using SPSS version 21. The tables were then computed using the analyzed data from the software, and the pie charts were constructed using the Excel 2019 version. Thematic analysis was done for the key informant qualitative interviews.</p><p><strong>Results: </strong>Analysis of RASS reports revealed a mixed level of quality, with only 40 reports (22%) categorized as good quality. The overall reporting rate was slightly more than half, with only 180 reports (57.7%) of the expected reports. Key factors influencing data quality were infrastructural limitations, such as unreliable internet, lack of proper equipment, and staff transfers. Lack of training on RASS and limited leadership support were documented to influence the data quality and RASS reporting rate.</p><p><strong>Conclusion: </strong>The quality of RASS reports could have been better than the national set targets. The reporting rate was slightly above average but far below the national set targets. Several factors affecting both the reporting rate and quality of reports were cited. These include staff attitude, knowledge gap, Staff transfers, poor internet connectivity, and lack of internet data bundles.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"45-57"},"PeriodicalIF":2.1,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11929515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693927","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 ChatGPT as a Tool in Pharmacy Practice: A Cross-Sectional Exploration Among Pharmacists in Saudi Arabia.","authors":"Abdulrahman Alghitran, Hind M AlOsaimi, Ahmad Albuluwi, Emad Omar Almalki, Abdullah Zohair Aldowayan, Rakan Alharthi, Jawad Mohammed Qattan, Fahd Alghamdi, Mohammed AlHalabi, Nawaf Ayed Almalki, Abdulaziz Alharthi, Asma Alshammari, Muhammad Kanan","doi":"10.2147/IPRP.S500689","DOIUrl":"10.2147/IPRP.S500689","url":null,"abstract":"<p><strong>Purpose: </strong>Artificial Intelligence (AI), especially ChatGPT, is rapidly assimilating into healthcare, providing significant advantages in pharmacy practice, such as improved clinical decision-making, patient counselling, and drug information management. The adoption of AI tools is heavily contingent upon pharmacy practitioners' knowledge, attitudes, and practices (KAP). This study sought to evaluate the knowledge and practices of pharmacists in Saudi Arabia concerning the utilization of ChatGPT in their daily activities.</p><p><strong>Patients and methods: </strong>A cross-sectional study was performed from May 2023 to July 2024 including pharmacists in Riyadh, Saudi Arabia. An online pre-validated KAP questionnaire was disseminated, collecting data on demographics, knowledge, attitudes, and practices about ChatGPT. Descriptive statistics and regression analyses were conducted using SPSS.</p><p><strong>Results: </strong>Of 1022 respondents, 78.7% were familiar with AI in pharmacy, while 90.1% correctly identified ChatGPT as an advanced AI chatbot. Positive attitudes towards ChatGPT were reported by 64.1% of pharmacists, although only 24.3% used AI tools regularly. Significant predictors of positive attitudes and practices included academic/research roles (β=0.7, p=0.005) and 6-10 years of experience (β=0.9, p=0.05). Ethical concerns were raised by 64% of respondents, and 92% reported a lack of formal training.</p><p><strong>Conclusion: </strong>While the majority of pharmacists held positive attitudes toward ChatGPT, practical implementation remains limited due to ethical concerns and inadequate training. Addressing these barriers is essential for successful AI integration in pharmacy, supporting Saudi Arabia's Vision 2030 initiative.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"31-43"},"PeriodicalIF":2.1,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693930","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":"Disposal Practices of Leftover Medicines Among University of Rwanda Undergraduate Students.","authors":"Jean Claude Hategekimana, Fabien Niyonsenga, Aphrodis Ntabwoba, Jean Baptiste Niyombabazi, Amon Nsengimana","doi":"10.2147/IPRP.S499431","DOIUrl":"10.2147/IPRP.S499431","url":null,"abstract":"<p><strong>Background: </strong>University students typically use prescribed or non-prescribed medications, often resulting in the accumulation of leftover medications. Hence, understanding their disposal practices is crucial, as improper disposal contribute to significant public health and environmental risks.</p><p><strong>Objective: </strong>This study intended to assess the disposal practices of leftover medications among undergraduate students at the University of Rwanda, as well as the factors influencing these practices.</p><p><strong>Methods: </strong>The participants were randomly selected for this cross-sectional study. Data were collected using a self-administered questionnaire, and responses were entered into Microsoft Excel for cleaning. The cleaned data were imported into the Statistical Package for Social Sciences (SPSS) version 25.0 for analysis. Using SPSS, Inferential statistics, notably Pearson's chi-square test, was used to determine variables associated with the disposal practices, with a p-value <0.05 considered significant.</p><p><strong>Results: </strong>Out of 378 students, 66.1% had leftover medications, with 21.2% keeping them for future use. Just 7.1% returned them to pharmacies, while 92.9% resorted to improper disposal practices, with the main methods being discarding them in the toilet (36.3%) and household rubbish (24.6%). Key reasons cited by 81.2% were that neither a drug take-back system was introduced on campus nor were disposal procedures communicated. Gender (<i>x</i> ²=9.735, p-value=0.046), level of study (<i>x</i> ²=8.331, p-value˂001), and college (<i>x</i> ²=9.735, p-value=0.046),and lack of training (<i>x</i> ²=35.66, p-value˂001), and lack of understanding about a drug take-back system (<i>x</i> ²=36.72, p-value˂001) were significantly associated with improper disposal practices.</p><p><strong>Conclusion: </strong>Leftover medications and improper disposal practices were prevalent, mostly caused by lack of awareness about proper disposal practices. This underscores the need to raise public awareness.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"17-29"},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587634","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":"Developing a Prototype Machine Learning Model to Predict Quality of Life Measures in People Living With HIV.","authors":"Gabriel Mercadal-Orfila, Joaquin Serrano López de Las Hazas, Melchor Riera-Jaume, Salvador Herrera-Perez","doi":"10.2147/IPRP.S492422","DOIUrl":"10.2147/IPRP.S492422","url":null,"abstract":"<p><strong>Background: </strong>In the realm of Evidence-Based Medicine, introduced by Gordon Guyatt in the early 1990s, the integration of machine learning technologies marks a significant advancement towards more objective, evidence-driven healthcare. Evidence-Based Medicine principles focus on using the best available scientific evidence for clinical decision-making, enhancing healthcare quality and consistency by integrating this evidence with clinician expertise and patient values. Patient-Reported Outcome Measures (PROMs) and Patient-Reported Experience Measures (PREMs) have become essential in evaluating the broader impacts of treatments, especially for chronic conditions like HIV, reflecting patient health and well-being comprehensively.</p><p><strong>Purpose: </strong>The study aims to leverage Machine Learning (ML) technologies to predict health outcomes from PROMs/PREMs data, focusing on people living with HIV.</p><p><strong>Patients and methods: </strong>Our research utilizes a ML Random Forest Regression to analyze PROMs/PREMs data collected from over 1200 people living with HIV through the NAVETA telemedicine system.</p><p><strong>Results: </strong>The findings demonstrate the potential of ML algorithms to provide precise and consistent predictions of health outcomes, indicating high reliability and effectiveness in clinical settings. Notably, our ALGOPROMIA ML model achieved the highest predictive accuracy for questionnaires such as MOS30 VIH (Adj. <i>R²</i> = 0.984), ESTAR (Adj. <i>R²</i> = 0.963), and BERGER (Adj. <i>R²</i> = 0.936). Moderate performance was observed for the P3CEQ (Adj. <i>R²</i> = 0.753) and TSQM (Adj. <i>R²</i> = 0.698), reflecting variability in model accuracy across instruments. Additionally, the model demonstrated strong reliability in maintaining standardized prediction errors below 0.2 for most instruments, with probabilities of achieving this threshold being 96.43% for WHOQoL HIV Bref and 88.44% for ESTAR, while lower probabilities were observed for TSQM (44%) and WRFQ (51%).</p><p><strong>Conclusion: </strong>The results from our machine learning algorithms are promising for predicting PROMs and PREMs in AIDS settings. This work highlights how integrating ML technologies can enhance clinical pharmaceutical decision-making and support personalized treatment strategies within a multidisciplinary integration framework. Furthermore, leveraging platforms like NAVETA for deploying these models presents a scalable approach to implementation, fostering patient-centered, value-based care.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"14 ","pages":"1-16"},"PeriodicalIF":2.1,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11766232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053744","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":"Expanding HIV Self-Test Kits via Community Pharmacies in Rwanda Has Improved Availability, but Affordability Remains an Issue.","authors":"Amon Nsengimana, Emmanuel Biracyaza, Augustin Manirakiza, Yvette Nsekonziza, Emmanuel Niyonsenga, Frederic Ntirenganya, Théoneste Umumararungu","doi":"10.2147/IPRP.S489143","DOIUrl":"10.2147/IPRP.S489143","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization (WHO) recommends HIV self-testing (HIVST) to complement the existing HIV testing services. Pursuant to this, Rwanda approved the over-the-counter sale of Oral Quick HIV self-tests in community pharmacies, facilitating home testing and addressing accessibility issues. However, the availability and affordability of HIVSTs in these settings remains unexplored. Hence, this study determined the availability and affordability of HIVST kits in Community Pharmacies across Rwanda.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among 220 licensed community pharmacists between February and May 2023. Tools standardized by WHO and Health Action International (HAI) were used to evaluate the affordability of HIVST kits. An ANOVA followed by a post-hoc test examined significant price differences across regions. Bivariate and multivariate logistic regression analyses were used to identify the factors associated with the availability of HIVST kits.</p><p><strong>Results: </strong>The availability was 76%, with 53% being finger-stick tests. Pharmacies owned by pharmacists were almost twice as likely to have HIVST available (AOR=1.858; 95%: 1.280-2.629, p=0.007) than their counterparts. Pharmacies in Kigali were more likely to stock HIVST (AOR=3.549; 95%: 1.283-9.814, p=0.015) than in other regions. Pharmacies experiencing frequent requests for HIVST were more likely to have HIVST available (AOR=0.22; 95%: 0.07-0.66, p<0.001) than those with fewer requests. Both oral quick and finger-stick HIVST were priced beyond the affordability of low-income earners. Moreover, significant price differences for Oral Quick HIVST (F=11.349; p<0.001) were observed across regions, with Kigali's prices significantly differing from those in the southern (p<0.001) and western Provinces (p=0.004).</p><p><strong>Conclusion: </strong>HIVSTs are not economically priced for the lowest-paid workers, with variations in availability and prices across the country. Policymakers should apply subsidies or price regulation strategies to make HIVST more affordable, ensuring equitable access to all regions and income levels.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"13 ","pages":"243-257"},"PeriodicalIF":2.1,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11668063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142886288","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":"Antibiotic Dispensing Practices Among Community Retail Pharmacies and Registered Drugstores: Results from a Simulated Client Study in Lilongwe, Malawi.","authors":"Adriano Focus Lubanga, Akim Nelson Bwanali, Watipaso Kamanga, Bernard Sindani Kathewera, Tumaini John Makole, Samuel L Mpinganjira, Steward Mudenda, Collins Mitambo, Yechan Cho, Daniel Yeum, Jonathan Sukhee Chung, Jooheon Park, Thomas Nyirenda","doi":"10.2147/IPRP.S487530","DOIUrl":"10.2147/IPRP.S487530","url":null,"abstract":"<p><strong>Introduction: </strong>Antimicrobial resistance (AMR) is largely driven by the inappropriate use of antibiotics. This has been attributed to the non-prescription sale of antibiotics in retail drug outlets. Despite the rising number of retail drug outlets in Malawi, the practice of drug dispensing in private pharmacies has not been evaluated. This study therefore assessed the prevalence of non-prescription sales of antibiotics in retail drug outlets in Lilongwe, Malawi.</p><p><strong>Methods: </strong>A community-based simulated client cross-sectional study was conducted in Lilongwe, Malawi from December 2023 to February 2024 using mystery shopping. Data were analyzed using IBM SPSS software version 29 using both descriptive and Analytical statistics. We computed simple proportions and conducted a hypotheses test using Chi-Square to test for Significance.</p><p><strong>Results: </strong>Antibiotic dispensing practices were surveyed in 51 retail drug outlets comprising 36 retail pharmacies and 15 drugstores. 35.3% (n=18) of the drug outlets had drug dispensing done by pharmacists, 13.7% (n=7) by pharmacy technicians, 21.5% (n=11) by pharmacy assistants and 25.5% (n=15) by drug dispensers who had no pharmacy-related training. The rate of non-prescription sales of antibiotics ranged between 53% for acute diarrhoea and 92% for upper respiratory tract infections. Amoxicillin was the most dispensed antibiotic across all case scenarios. Over 50% of dispensed antibiotics were done upon recommendation of the drug dispensers in the absence of a doctor's prescription. Furthermore, for all the dispensed antibiotics across all case scenarios, no advice was given for finishing a full course of the antibiotics.</p><p><strong>Conclusion: </strong>This study found high rates of over-the-counter dispensing of antibiotics, which call for urgent and comprehensive regulatory measures to control antibiotic consumption in an urban part of Malawi that risks increased AMR. These could range from enacting stringent antibiotic dispensing policies to deploying digital systems to monitor prescription practices and community education on rational antibiotic use.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"13 ","pages":"229-242"},"PeriodicalIF":2.1,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773543","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":"Unlicensed \"Special\" Medicines: Using the Pillar Integration Model to Understand Stakeholder Perspectives Across Care Settings.","authors":"Alesha Wale, Efi Mantzourani","doi":"10.2147/IPRP.S477087","DOIUrl":"https://doi.org/10.2147/IPRP.S477087","url":null,"abstract":"<p><strong>Background: </strong>The use of unlicensed medicines has been associated with safety concerns, availability and accessibility issues, and lack of integrated care across care settings.</p><p><strong>Objective: </strong>To understand the interaction between the views and experiences of those who prescribe, those who supply and those who receive unlicensed \"special\" medicines, so that factors affecting the patient journey and successful treatment can be identified and used to inform areas for change.</p><p><strong>Methods: </strong>A qualitative, phenomenological approach was adopted, with semi-structured interviews with prescribers, community pharmacy staff and patients. A combination of stratified, purposive, snowball and convenience sampling was used to identify participants. Interviews were analysed using reflexive thematic analysis and the findings were integrated using an adapted model of the Pillar Integration Process.</p><p><strong>Results: </strong>Three pillars were constructed after synthesising results from interviews with patients (n=4), prescribers (n=5) and pharmacy staff (n=6): the awareness of licensing status; perceptions of patient care and acceptability of unlicensed medicine use; and challenges associated with the accessibility of unlicensed medicines. The varying levels of awareness when unlicensed medicines are prescribed and the varying perceptions of responsibility and acceptability of the use of unlicensed medicines help to explain the challenges faced by participants across the patient journey, Challenges identified included understanding what unlicensed medicines are, awareness of the licensing status when unlicensed medicines are prescribed, managing care across care settings to ensure the patient is effectively treated and ensuring continuity of care for patients in the community.</p><p><strong>Conclusion: </strong>The results highlight a clear need for more integrated care and support for prescribers to reduce the chances of delays between care settings, and more patient-centred care to ensure that any delays when accessing medicines do not lead to treatment disruption for the patient. The new national guidelines informed by findings of this study can support policy-makers across the globe.</p>","PeriodicalId":45655,"journal":{"name":"Integrated Pharmacy Research and Practice","volume":"13 ","pages":"209-228"},"PeriodicalIF":2.1,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11608544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773406","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}