Exploratory research in clinical and social pharmacy最新文献

{"title":"Measuring the impact of automated dispensing cabinets implementation on data and inventory management of human normal immunoglobulin in an acute teaching hospital: A pre- and post- intervention study","authors":"Alice Pinfield,&nbsp;Kit Lai,&nbsp;Shelley Jones","doi":"10.1016/j.rcsop.2024.100516","DOIUrl":"10.1016/j.rcsop.2024.100516","url":null,"abstract":"<div><h3>Background</h3><div>Human Normal Immunoglobulin (HNIg) is a complex plasma-derived blood product used to treat a variety of medical conditions. Global supply problems have increased focus on HNIg stewardship, including mandatory recording of HNIg usage on the National Immunoglobulin Database (NIgD). Local departmental audits identified significant inconsistencies in data uploaded to NIgD. Inventory management issues caused a number of stock losses in the last financial year. A paper-based HNIg batch number recording system was replaced with the use of Automated Dispensing Cabinets (ADCs), which generated an electronic batch number report, with matching fields required for electronic upload to NIgD.</div></div><div><h3>Aim</h3><div>To measure the impact of ADC implementation on the accuracy of data uploaded to NIgD, HNIg stock control and staff time associated with processes of HNIg data and inventory management.</div></div><div><h3>Method</h3><div>Three months of pre- and post-implementation HNIg dispensing data was compared to the data uploaded to the NIgD for discrepancies. Inventory reports were used to identify unexplained stock adjustments. Time and motion methods were used to quantify staff time associated with HNIg activities.</div></div><div><h3>Results</h3><div>Pre-implementation: 20.7 % (3762.5 g/18,217 g) of HNIg by volume (23.7 % of dispensing episodes; 66/279) were inaccurately uploaded or absent on the NIgD and three stock adjustments were made (loss of &gt;£15 k). Post-implementation: 12 % (2325 g/19,347 g) of HNIg by volume (10.8 % of dispensing episodes; 31/286) were inaccurately uploaded or absent on the NIgD and zero stock adjustments were observed; Mean time for dispensing per HNIg prescription reduced from 17 min to 8 min; Time spent uploading data to NIgD per month reduced from 5 h to 1.75 h.</div></div><div><h3>Discussion/Conclusion</h3><div>The use of ADCs improved accuracy of NIgD data upload. Following implementation direct observations have cited unregistered or finished patient episodes, dispensing procedural compliance, and user familiarity with the system as common reasons for incomplete data uploads to NIgD. The new ADC process had consequences of forcing dispensing procedure compliance to improve uploads, whilst reducing dispensing times. It led to improved stock control and removed upload burden from dispensers. ADC stock discrepancy alerts allowed staff to proactively resolve discrepancies in real time. Time taken for additional processes to support management of stocks in ADCs, including monthly stock cycle counts, were important considerations for implementation. The key advantage of using ADC batch number reports is the ability to upload as a single monthly batch without having to manually access individual patient records on the NIgD. It facilitates early identification of failed upload attempts and supports resolution of stock discrepancies.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100516"},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358103","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":"Involving community pharmacies in management of late effects of cancer treatment: Opinions from cancer survivors.","authors":"Nadia Lund Olsen ,&nbsp;Ramune Jacobsen ,&nbsp;Linda Aagaard Thomsen ,&nbsp;Lotte Stig Nørgaard","doi":"10.1016/j.rcsop.2024.100514","DOIUrl":"10.1016/j.rcsop.2024.100514","url":null,"abstract":"<div><h3>Background</h3><div>More than 50 % of cancer survivors experience late effects of cancer (LEC). Current models of follow-up care often prove inadequate, resulting in unresolved LEC. Given the pivotal role of community pharmacists as the most accessible healthcare professionals and the demonstrated benefits of evidence-based pharmacy services on patient centered care, exploring the potential contribution of community pharmacies in managing LEC is relevant.</div></div><div><h3>Objective</h3><div>This study aimed to investigate cancer survivors' needs, preferences, and attitudes regarding pharmacy involvement in managing LEC.</div></div><div><h3>Method</h3><div>The developed questionnaire based on validated instruments underwent a pilot test among cancer survivors at four Danish community pharmacies. In August 2021, the questionnaire was distributed to all 611 cancer survivors of the Danish Cancer Society's cancer patient panel. The resulting quantitative data were subjected to descriptive statistical analysis, while qualitative data underwent a thematic content analysis.</div></div><div><h3>Results</h3><div>Among the 611 panel members, 354 responded to the questionnaire (response rate 58 %). Fatigue was the most frequent LEC experienced by 88 % of respondents. Three out of four (75 %) of respondents expressed dissatisfaction with the level of counseling they had received regarding LEC, and 23 % disclosed not having discussed LEC with a healthcare professional despite feeling the need to do so. Nearly all respondents visited pharmacies annually and used available products to alleviate LEC. Approximately half of respondents expressed a need for counseling on the appropriate use of these products. While nearly half of respondents were receptive to pharmacy-based counseling, concerns regarding discretion and staff knowledge were prevalent.</div></div><div><h3>Conclusion</h3><div>Cancer survivors experience an insufficiency in counseling on LEC and demonstrate an openness towards involving community pharmacies in addressing this gap. However, further investigation is warranted to delineate survivors' specific needs and expectations regarding community pharmacy involvement in LEC management. Additionally, suggestions from survivors underscore the importance of enhancing pharmacy staff knowledge and establishing discreet counseling areas.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100514"},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322986","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":"Prescribers' perspectives: The impact of the controlled substance scheduling system on providing optimal patient care","authors":"Michael R. Barnes ,&nbsp;Yijia Luo ,&nbsp;Jonathon M. Parker ,&nbsp;Brian M. Shepler","doi":"10.1016/j.rcsop.2024.100511","DOIUrl":"10.1016/j.rcsop.2024.100511","url":null,"abstract":"<div><h3>Background</h3><div>In the United States, the scheduling system for controlled substances was established by the Controlled Substance Act of 1970. In 2009, Parker et al. published the study “Physicians' knowledge and attitudes toward scheduling.” Since 2009, the opioid epidemic has gathered national attention from social and scientific perspectives as the number of drug overdose deaths in the United States has nearly tripled.</div></div><div><h3>Objective</h3><div>To follow up on a 2009 survey by Parker, et al. to determine prescribers' knowledge and attitudes regarding the controlled substance scheduling system and assess the impact of the controlled substance scheduling system on providing optimal patient care.</div></div><div><h3>Methods</h3><div>The cross-sectional survey was designed to assess prescribers' attitudes and mailed to 400 randomly selected physicians and 400 randomly selected nurse practitioners.</div></div><div><h3>Results</h3><div>Prescribers across all groups provided consistent responses suggesting an overall lack of understanding of controlled substance regulations, a negative attitude towards the controlled substance scheduling system, and a detrimental effect on providing optimal patient care. Responses from nurse practitioners differed significantly from physicians in 75 % (3 of the 4) questions regarding regulations, suggesting nurse practitioners possess a greater understanding of pharmaceutical regulations. Specialists' responses demonstrated an enhanced level of dissatisfaction regarding the controlled substance scheduling system compared to primary care providers in 75 % (3 of the 4) questions. Questions regarding the impact of the scheduling system on prescribing patterns differed significantly across multiple demographic groups, notably between physicians and nurse practitioners, differences in practice setting, and primary state of practice for 75 % (3 of the 4) questions.</div></div><div><h3>Conclusions</h3><div>The results of this survey confirm the findings of Parker, et al., and further display the need for investigation into how to improve the controlled substance scheduling system in the United States.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100511"},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358104","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":"Assessing the psychometric properties of Connor-Davidson Resilience Scale 25 (CD-RISC 25) in pharmacy students and academics in the Eastern Mediterranean Region","authors":"Mona Almanasef ,&nbsp;Dalia Bajis ,&nbsp;Asmaa Al-Haqan ,&nbsp;Saja Alnahar ,&nbsp;Ian Bates","doi":"10.1016/j.rcsop.2024.100515","DOIUrl":"10.1016/j.rcsop.2024.100515","url":null,"abstract":"<div><h3>Background</h3><div>Resilience is a complex concept that is defined and influenced by the context of individuals, organisations, societies and cultures. The Connor-Davidson Resilience Scale (CD-RISC) is a widely used validated tool to evaluate psychological resilience. CD-RISC is a self-administered scale of twenty-five items, each rated by a 5-point Likert scale. The scale evaluates overall personal resilience through assessing five main resilience-related constructs; personal competence, trust in one's instincts, positive acceptance of change, control and spiritual influences. As per the scale's developers, higher scores reflecting greater level of resilience. This particular tool has not previously been tested with a pharmacy student or academic population sample.</div></div><div><h3>Objective</h3><div>This study aims to assess the factor structure, validity, and reliability of the CD-RISC-25 in a sample of pharmacy students and academics from faculties drawn across the Eastern Mediterranean Region (EMR).</div></div><div><h3>Methods</h3><div>A cross-sectional study was carried out between October 2020 and January 2021 sampling pharmacy students and academics across the EMR who were invited to complete the self-administered CD-RISC 25 questionnaire. Confirmatory factor analysis using principal components analysis with oblique rotation was conducted on sample responses (<em>n</em> = 616). The internal consistency and reliability for each identified factor and from the CD-RISC scale was evaluated by using Cronbach's alpha coefficient.</div></div><div><h3>Results</h3><div>Five factors were isolated accounting for 51.5 % total cumulative model variance. Identification of factors showed high convergence with previous work on the CD-RISC resilience tool. The current study in our sample found a five–factor structure which differed from the original scale reliabilities. This study did identify a five-factor solution with differing item factor loadings. The reliability analysis on the CD-RISC-25 items in our study sample revealed an overall Cronbach Alpha value of 0.89; however, three items showed corrected Item-total correlations of &lt;0.3. Our analysis, in this respondent sample, suggested a re-adjustment of the scale inclusions to improve overall scale stability and performance.</div></div><div><h3>Conclusions</h3><div>The current research findings propose a modified five-factor structure to resilience, with a 22-item unidimensional model of CD-RISC scale.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100515"},"PeriodicalIF":1.8,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142328073","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":"Behavioral factors associated with medication adherence among hypertensive patients using the theoretical domains framework","authors":"Van De Tran ,&nbsp;Thi My Loan Vo ,&nbsp;Quang Loc Duyen Vo ,&nbsp;Minh Trung Nguyen ,&nbsp;Minh Cuong Nguyen ,&nbsp;Rebecca Susan Dewey ,&nbsp;Thi Hai Yen Nguyen","doi":"10.1016/j.rcsop.2024.100510","DOIUrl":"10.1016/j.rcsop.2024.100510","url":null,"abstract":"<div><h3>Background</h3><div>Theoretical exploration of the behavioral factors associated with adherence to medication in hypertensive patients has been limited in previous studies.</div></div><div><h3>Objectives</h3><div>This study aims to understand the associations between demographic and health characteristics and behavioral factors for medication taking, and how these predict medication adherence.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted in hypertensive outpatients, with a sample size of 399 participants. Behavioral factors predicting medication taking, designed to align with the theoretical domains framework, and the medication adherence scale were used. Behavioral factors were determined using principal component analysis, and their associations with demographic and health characteristics and medication adherence were analyzed using non-parametric statistics.</div></div><div><h3>Results</h3><div>Four behavioral factors were identified: (F1) negative emotions and beliefs about capabilities, (F2) beliefs about consequences, (F3) knowledge and skills, and (F4) social support. F1 showed a strongest inverse association with medication adherence (ρ = −0.25; <em>p</em> &lt; 0.01). Significantly higher F1 scores were recorded in hypertensive patients with secondary school or lower education (<em>p</em> &lt; 0.001), income less than 4 million VND (<em>p</em> = 0.03), who were currently smoking (<em>p</em> = 0.018), self-reporting chest pain or discomfort (<em>p</em> &lt; 0.001), and of older age (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Certain demographic and health characteristics were significantly associated with emotions and beliefs about capabilities to take medication, which, in turn, was significantly associated with medication adherence. Future research should design interventions that focus on reassuring patients of the need and of their ability to overcome their worries and sadness and reduce their difficulties in using medications.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100510"},"PeriodicalIF":1.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358102","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":"Montelukast deprescribing in outpatient specialty clinics: A single center cross-sectional study","authors":"David C. Foote ,&nbsp;Jamie L. Miller ,&nbsp;Grant H. Skrepnek ,&nbsp;Stephen Neely ,&nbsp;Kiya Bennett ,&nbsp;Paul M. Boylan","doi":"10.1016/j.rcsop.2024.100509","DOIUrl":"10.1016/j.rcsop.2024.100509","url":null,"abstract":"<div><h3>Objective</h3><p>To identify and evaluate montelukast deprescribing in outpatient specialty clinics.</p></div><div><h3>Methods</h3><p>This was a single-center, retrospective, cross-sectional study conducted at an academic health system in the southern US including 21 specialty clinics. Subjects included adults ≥18 years with an active prescription for montelukast who attended at least one appointment in pulmonology, otolaryngology, or neurology outpatient specialty clinics between January 1, 2021 to December 31, 2022. Patients &lt;18 years and those with diagnoses of uncontrolled asthma or allergic rhinitis were excluded. Outcomes assessed included the frequency and period prevalence of montelukast deprescribing, defined by a documented montelukast discontinuation within the medical record, and evaluation of reasoning for discontinuation mentioned in visit notes.</p></div><div><h3>Results</h3><p>There were 1152 patients who met inclusion criteria. Of these, 43 (3.7 %) experienced a montelukast deprescribing event: 18 (41.9 %) in neurology, 13 (30.2 %) in otolaryngology, and 12 (27.9 %) in pulmonology. Documented reasons for deprescribing were only available for 11 patients (25.6 %); reasons for deprescribing included patient-provider shared decision-making regarding the Black Box Warning [<em>n</em> = 5 (11.6 %)], inadequate treatment response [<em>n</em> = 3 (7.0 %)], suicidal thought development [<em>n</em> = 1 (2.3 %)], adverse drug event [<em>n</em> = 1 (2.3 %)], and pregnancy planning [<em>n</em> = 1 (2.3 %)].</p></div><div><h3>Conclusion</h3><p>Montelukast deprescribing rates were less than 5 % in outpatient specialty clinics. Factors associated with montelukast deprescribing beget further investigation.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100509"},"PeriodicalIF":1.8,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624001069/pdfft?md5=8b6efabe7c4e4834d80a3aa747062844&pid=1-s2.0-S2667276624001069-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274568","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":"Empowering precision medicine: Insights from a national survey on pharmacogenomics knowledge, attitudes, and perceptions among community pharmacists in the UAE","authors":"Ammar Abdulrahman Jairoun ,&nbsp;Sabaa Saleh Al-Hemyari ,&nbsp;Moyad Shahwan ,&nbsp;Mena Al-Ani ,&nbsp;Mustafa Aal Yaseen ,&nbsp;Mahmood H. Al-Aawad ,&nbsp;Ghala Rashid Alnuaimi ,&nbsp;B. Mahalakshmi","doi":"10.1016/j.rcsop.2024.100508","DOIUrl":"10.1016/j.rcsop.2024.100508","url":null,"abstract":"<div><h3>Background</h3><div>Community pharmacists are essential to pharmacogenomics implementation because they can help trainers, clinical advisors, and other medical professionals understand the importance of pharmacogenomics and encourage them to use it in their practice. This study is to evaluate the community pharmacists' understanding, attitudes, and perceptions of pharmacogenomics in the United Arab Emirates (UAE).</div></div><div><h3>Methods</h3><div>Professionals employed at community pharmacies in Abu Dhabi, Dubai, and the Northern Emirates participated in a cross-sectional study design. From July 2023 to February 2024, five pharmacy students in their last year conducted the survey. The study team employed a structured questionnaire to collect data in addition to conducting in-person interviews. The study questionnaire comprised three distinct sections namely, demographic information, knowledge of pharmacogenomics concepts, and perceptions regarding pharmacogenomics.</div></div><div><h3>Results</h3><div>A total of 586 pharmacists enrolled in the study. The average knowledge score regarding pharmacogenomics was 75.1 % with a 95 % confidence interval (CI) of [72.4 %, 77.7 %]. The average attitude score toward pharmacogenomics was 67.5 % with a 95 % CI of [66.3 %, 68.7 %]. Better pharmacogenomics knowledge among several groups: independent pharmacies (OR 1.7; 95 % CI 1.2–2.4), Pharmacists in Charge (OR 1.4; 95 % CI 1.3–2.02), pharmacists with 11–15 years of experience (OR 2.1; 95 % CI 1.4–4.2), graduates from international universities (OR 4.6; 95 % CI 1.6–12.9), and those who received training on pharmacogenomics (OR 11.9; 95 % CI 3.3–14.5). Similarly, better attitude scores were observed among independent pharmacies (OR 1.5; 95 % CI 1.1–2.1), Pharmacists in Charge (OR 1.5; 95 % CI 1.07–2.1), pharmacists with 16–20 years of experience (OR 2.1; 95 % CI 1.16–3.7), graduates regional universities (OR 1.47; 95 % CI 1.05–2.1), and those who received training on pharmacogenomics (OR 4.8; 95 % CI 3.2–7.3).</div></div><div><h3>Conclusion</h3><div>The positive attitudes toward pharmacogenomics that we found in our research indicate that community pharmacists in the United Arab Emirates are beginning to realize the potential advantages of pharmacogenomics in terms of improving patient care. Policies ensuring the privacy and confidentiality of genetic information are also necessary in considering concerns about the availability of genetic test results to insurance companies and potential employers.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100508"},"PeriodicalIF":1.8,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624001057/pdfft?md5=625218b46de6b74959c05f84dba93308&pid=1-s2.0-S2667276624001057-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142311050","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":"Appropriateness of direct oral anticoagulant dosing in patients with atrial fibrillation at a tertiary care hospital in Thailand","authors":"Chayanat Pongsathabordee ,&nbsp;Piyachat Saringkarn ,&nbsp;Kanjana Ratanapornsompong ,&nbsp;Ratiya Rungruang ,&nbsp;Saranporn Srithonrat ,&nbsp;Pimlada Tangkaotong ,&nbsp;Salintip Sena ,&nbsp;Taniya Paiboonvong","doi":"10.1016/j.rcsop.2024.100507","DOIUrl":"10.1016/j.rcsop.2024.100507","url":null,"abstract":"<div><h3>Background</h3><p>Appropriate dosing of direct oral anticoagulants (DOACs) has been associated with clinical efficacy and safety. Several studies have shown that DOAC dosing are often inconsistent with guideline recommendations. Little is known about this issue in Thailand. This study aimed to evaluate the appropriateness of DOAC dosing in Thai hospitalized patients with atrial fibrillation (AF).</p></div><div><h3>Method</h3><p>This was a retrospective descriptive study conducted on hospitalized patients at Rajavithi Hospital, a tertiary care hospital in Thailand. Inpatients diagnosed with AF and treated with DOACs between February 2021 and February 2023 were enrolled in the study. The appropriate dosing of DOACs was assessed according to the recommendation of the 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation (EHRA). Descriptive statistics were used to analyze the data; median (interquartile range) for continuous variables, and numbers and percentages for categorical variables.</p></div><div><h3>Results</h3><p>A total of 120 patients with AF were evaluated for dosing. The patients received rivaroxaban in 47 cases (39.2 %), apixaban in 32 cases (26.7 %), edoxaban in 31 cases (25.8 %), and dabigatran in 10 cases (8.3 %). Most of the patients were elderly, with a median age of 77.5 (68–84) years. Females were predominant (57.5 %). Our findings indicate that the prevalence of appropriate dosing of DOACs was 63.3 %. However, approximately one-third of patients received inappropriate dosing, with 24 (20.0 %) being overdosed, and 20 (16.7 %) being underdosed. The highest overdosing and underdosing rates were seen in dabigatran (90.0 %) and apixaban (21.9 %), respectively.</p></div><div><h3>Conclusion</h3><p>Inappropriate dosing of DOACs according to the 2021 EHRA recommendations was high in 36.7 %, with overdosing mostly occurring in 20.0 %. The high number of inappropriate dosing highlights the need for implementation of optimal strategies to select the appropriate dose of DOACs in Thai hospitalized patients with AF.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100507"},"PeriodicalIF":1.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624001045/pdfft?md5=6fd96cf91344ef68497a458fd9fc328b&pid=1-s2.0-S2667276624001045-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232805","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":"Development of a medication review intervention by seconding a hospital pharmacist to primary care","authors":"Sara Sommer Holst ,&nbsp;Johanne Mølby Hansen ,&nbsp;Susanne Kaae ,&nbsp;Charlotte Vermehren","doi":"10.1016/j.rcsop.2024.100505","DOIUrl":"10.1016/j.rcsop.2024.100505","url":null,"abstract":"<div><h3>Background</h3><div>Medication reviews (MRs) are a well-described initiative that improves health outcomes for polypharmacy patients. However, there is limited knowledge about the performance of medication reviews carried out in general practice especially under the leadership of hospital clinical pharmacists. When developing complex interventions, such as MRs, it is essential to describe the development process to ensure transparency and avoid research waste.</div></div><div><h3>Objective</h3><div>Thus, this study aimed to describe the steps of developing a new MR intervention targeting general practice to ensure transparency and transferability.</div></div><div><h3>Methods</h3><div>A stepwise approach inspired by the Medical Research Council framework was utilised in the process, covering two of the phases, i.e., development and feasibility, divided into four steps: 1) intervention drafting by a literature search, 2) expert opinion, 3) pilot testing in general practice clinics, and 4) evaluation of quantitative MR data.</div></div><div><h3>Results</h3><div>Based on the results from the first three steps, four main themes which influenced the success of the MR intervention were identified: general practitioner resources, patient involvement, implementation difficulties and interdisciplinarity. These themes guided the pilot evaluation in step four.</div></div><div><h3>Conclusion</h3><div>A new feasible, complex MR intervention utilising clinical pharmacists in general practice involving hospital clinical pharmacists in a real-life setting was developed.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100505"},"PeriodicalIF":1.8,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322984","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":"Comparing nursing medication rounds before and after implementation of automated dispensing cabinets: A time and motion study","authors":"Emma Jeffrey ,&nbsp;Áine Walsh ,&nbsp;Joseph Hague ,&nbsp;Kit Lai","doi":"10.1016/j.rcsop.2024.100504","DOIUrl":"10.1016/j.rcsop.2024.100504","url":null,"abstract":"<div><p>Nursing medication administration is an integral, albeit time consuming component of a nursing shift. Automated dispensing cabinets (ADCs) are a medicines management solution designed to improve both efficiency and patient safety. This study aimed to evaluate the time taken to undertake a medication round including the number of locations visited to retrieve medicines, across four different clinical specialties within one hospital. Studies to date have investigated the effect of ADCs on nursing medication rounds centred around one clinical specialty, in hospitals with varying levels of digital maturity. This study adds to the existing body of evidence by investigating multiple clinical specialties where EPMA in use throughout the study period. In this study, prior to ADC implementation nurses retrieved required medicines from shelves in the medication room, mobile medication carts, and patients' own drug (POD) lockers. Post-ADC implementation, medicines were retrieved exclusively from the ADC and POD lockers only. Nurses were observed on each ward completing medication rounds, using the data collection tool designed for this study. Pre-implementation data was collected between February and June 2023, and post-implementation data collected between July and September 2023. There was a statistically significant reduction in the time required for medicines retrieval on the surgical ward only, post- ADC implementation. The time taken to retrieve each medication went from a mean of 98.1 s to 47.2 s (<em>p</em> = 0.0255). When comparing all four specialties as a whole, there was a reduction in the mean time required to issue each medicine preversus post-ADC implementation, from 83.3 s to 62.6 s respectively, however this difference was not shown to be statistically significant. The mean number of locations visited to obtain all required medicines for each patient reduced significantly from 1.73 to 1.04 (<em>p</em> &lt; 0.01). There is potential for improved efficiency as nurses become more familiar with new workflows. It may be of benefit to repeat this study to ascertain whether time savings have been further improved.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100504"},"PeriodicalIF":1.8,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266727662400101X/pdfft?md5=9b813fbcfde8f721de8372b5e9edfa89&pid=1-s2.0-S266727662400101X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172340","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}