Exploratory research in clinical and social pharmacy最新文献

{"title":"Digital health in pharmacy education: Elective practical course integrating wearable devices and their generated health data","authors":"Florian Kinny ,&nbsp;Sabina Schlottau ,&nbsp;Bushra Ali Sherazi ,&nbsp;Emina Obarcanin ,&nbsp;Stephanie Läer","doi":"10.1016/j.rcsop.2024.100465","DOIUrl":"10.1016/j.rcsop.2024.100465","url":null,"abstract":"<div><p>The widespread adoption of wearable devices (wearables) for monitoring vital signs, including blood pressure and glucose levels, has experienced a considerable surge in recent times. This surge has led to the generation of a substantial amount of health data, accessible to pharmacists during patient consultations as the healthcare sector advances in digitalization. To enhance the digital competencies of future pharmacists required by the rapidly changing digital health landscape, the Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University (HHU) Duesseldorf has developed an innovative elective practical course aimed to bolster pharmacy students' competencies in handling wearables and the health data generated. The three-week practical elective course employed wearables FreeStyle Libre® 3 (Continuous Glucose Monitoring, CGM) and Aktiia (Cuffless Blood Pressure Monitoring). The hands-on activities allowed participants to obtain and interpret wearable-generated health-related data and acquainted them with simulated patient cases. Final-year pharmacy students' subjective assessments before and after the course depicted the increased knowledge and competence regarding analysing wearables data.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000623/pdfft?md5=38755d248ac614e2475f8d27806c6d3d&pid=1-s2.0-S2667276624000623-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412675","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 magnitude and associated factors of unused medications storage practice among households in Jimma city, southwest of Ethiopia: Community-based cross-sectional study","authors":"Andualem Mitiku ,&nbsp;Azmeraw Bekele ,&nbsp;Jafer Siraj ,&nbsp;Gemmechu Hasen","doi":"10.1016/j.rcsop.2024.100459","DOIUrl":"10.1016/j.rcsop.2024.100459","url":null,"abstract":"<div><h3>Background</h3><p>Medicines are kept unused at home for many therapeutic reasons. Conversely, unused medication and subsequent wastage can be attributed to several primary factors such as medication change, death, and non-adherence. This study aimed to assess the magnitude and associated factors of unused medication storage practice among households in Jimma City, southwest Ethiopia.</p></div><div><h3>Methods</h3><p>A community-based cross-sectional study design was conducted among households (<em>n</em> = 397) in Jimma Town from July to August 2021. The data were collected using the pre-tested and interviewer-administered questionnaire. SPSS version 21.0 was used for data analysis. The multivariate logistic regression was used to determine the factors associated with the storage of unused medicine at a 5% level of significance.</p></div><div><h3>Results</h3><p>Out of 397 households that responded, (<em>n</em> = 90, 23%) of households were found to have unused medicine at home. This study showed that the majority of households dispose of unused drugs by burning them (32.2%) and burying them in the ground (29%). Antibiotics were the most (6.3%) unused medicines stored while the anti-diabetics (1.3%) were the least unused drugs stored among households. The presence of family members working in the health sector (AOR: 0.402, 95%, CI: 0.202, 0.800) and family size in households (AOR: 2.325, 95%, CI: 1.045, 5.174) were significantly associated with the magnitude of unused medicine storage.</p></div><div><h3>Conclusion</h3><p>The magnitude and improper disposal of unused medicines storage among households were significant in the study area. Therefore, it is important to educate the community and encourage health professionals to understand their role in problems and solutions.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000568/pdfft?md5=61c855d5269a9ce12950b208387c4a19&pid=1-s2.0-S2667276624000568-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141408186","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":"Compass Rose™ Implementation in a Large Academic Medical Center","authors":"Selina Somani,&nbsp;Shannan Takhar,&nbsp;Derek Miller,&nbsp;Hana Camarillo,&nbsp;Mency Zhu,&nbsp;Kathie Tran","doi":"10.1016/j.rcsop.2024.100462","DOIUrl":"10.1016/j.rcsop.2024.100462","url":null,"abstract":"<div><h3>Background</h3><p>Compass Rose™, a case management tool developed by Epic®, was designed to track various patient coordination tasks, outreaches, and outcomes. This report describes the implementation of Compass Rose™ within an internal health-system specialty pharmacy (HSSP) and changes in care coordination metrics before and after implementation. To the best of our knowledge, this is the first study of its kind to discuss the implementation of Compass Rose™.</p></div><div><h3>Objectives</h3><p>The goals of this study were to describe the implementation process of Compass Rose™ at an internal HSSP and compare staff satisfaction before and after Compass Rose™ as the primary outcome.</p></div><div><h3>Methods</h3><p>This was an Institutional Review Board exempt, retrospective cohort study conducted between June 2022 to December 2022 that assessed staff satisfaction, refill documentation time, prescription turnaround time, and patient satisfaction pre- and post- Compass Rose™ implementation through survey administration, observed time studies, and internal data reports. The process of Compass Rose™ implementation was also described and discussed.</p></div><div><h3>Results</h3><p>24 specialty pharmacy staff members participated in the Compass Rose™ implementation survey. No statistically significant differences were observed in either staff satisfaction (3.96 ± 0.95 versus 3.70 ± 0.69, <em>p</em> = 0.29) or predicted versus actual challenge of implementation (3.67 ± 1.17 versus 3.09 ± 0.96, <em>p</em> = 0.064). There was no significant difference in refill documentation time pre- versus post- Compass Rose™ implementation (4.22 ± 3.15 minutes versus 4.10 ± 2.36 minutes, <em>p</em> = 0.82); however, there was a statistically significant increase in prescription turnaround time post implementation (2.59 ± 2.85 days versus 2.69 ± 2.35 days, <em>p</em> = 0.002).</p></div><div><h3>Conclusion</h3><p>Compass Rose™ implementation had no significant impact on staff satisfaction, patient satisfaction, or overall refill documentation time. Prescription turnaround time increased, which could be due to significant workflow changes with Compass Rose™ or several other contributing factors such as increased prescription volume and training new staff during this period.</p><p>Benefits of Compass Rose™ included standardization of workflow, ability to quantify staff performance and clinical impact, and increased transparency regarding care provided by the specialty pharmacy team.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000593/pdfft?md5=6e8b449af1dab42fd2032b49441ee3fd&pid=1-s2.0-S2667276624000593-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410169","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":"A qualitative study exploring experiences of racial minority stress in pharmacy education and practice","authors":"Arisha Ahmed ,&nbsp;Michael Hagos ,&nbsp;Immer Bhatti ,&nbsp;Nia Cartwright ,&nbsp;Orieoma Chukwu-Etu ,&nbsp;Angela Burini ,&nbsp;Lola Dabiri ,&nbsp;Clare Tolley ,&nbsp;Charlotte Lucy Richardson ,&nbsp;Amandeep Doll ,&nbsp;Tanya Miah ,&nbsp;Adam Pattison Rathbone","doi":"10.1016/j.rcsop.2024.100461","DOIUrl":"https://doi.org/10.1016/j.rcsop.2024.100461","url":null,"abstract":"<div><h3>Background</h3><p>Despite 49.1% of registered pharmacists in the UK being from a Black, Asian and Minority Ethnic (BAME) background, senior management roles within pharmacy are dominated by white males. People from BAME communities may experience minority stress which contributes to a professional attainment gap compared with non-BAME colleagues. Minority stress describes additional stressors, such as unconscious bias, micro-aggression and racial minority stress, experienced by minoritized people to adhere to the social norms of the majority. There is little evidence describing experiences of minority stress in pharmacy practice and education. The aim was to explore experiences of racial minority stress in pharmacy education and practice.</p></div><div><h3>Methods</h3><p>A convenience sample of pharmacy students and pharmacists were recruited via email and social media posts to volunteer to take part in interviews and focus groups. A topic guide was used to explore experiences of unconscious bias, microaggressions and racial minority stress in education and practice. Interviews and focus groups were transcribed verbatim and inductively analysed using thematic analysis underpinned by a phenomenological approach. Ethical approval was granted from Newcastle University (5340/2020, 2430/2593).</p></div><div><h3>Results</h3><p>Forty-five participants were recruited. Six focus groups and sixteen one-to-one semi-structured interviews were conducted. The sample was varied, with 56% (<em>n</em> = 25) students and 33% (<em>n</em> = 15) registered pharmacists from community, hospital, primary care, academia and an additional 11% (<em>n</em> = 5) still in foundation training in these sectors. The sample include diversity of racial identities, including 40% (<em>n</em> = 18) South Asian, 27% (<em>n</em> = 12) White, 15% (<em>n</em> = 7) Black, 7% (<em>n</em> = 3) Chinese and Arab mixed, 2% (n = 1) and 2% (n = 1) Not disclosed. Three themes were identified – Theme 1) Experiences of racial minority stress, Theme 2) Making sense of racial minority stress, and Theme 3) Responding to racial minority stress. Participants characteristics (for example skin colour, dialect, religious dress) made them feel susceptible to judgement, racist comments and microaggressions in education and practice. Participants required time to interpret, understand and make sense of incidents of racial minority stress. Responses to stressors included ‘ignoring ignorance’ and using a ‘professional identity’ to mask feelings. However, malicious comments and actions from other pharmacy staff were responded to differently to experiences from patients. Participants reported poor self-confidence to challenge racist behaviours in the workplace.</p></div><div><h3>Conclusions</h3><p>The aim of this study was to explore experiences of racial minority stress in pharmacy education and practice. This study shows dealing with microaggression, racial minority stress and judgement in pharmacy edu","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000581/pdfft?md5=40dc9f6834bc886451286ab2bab7d743&pid=1-s2.0-S2667276624000581-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141325118","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":"Perceptions of metabolic syndrome management utilization in relation to patient experience and health-related quality of life","authors":"Olajide A. Adekunle ,&nbsp;Jon C. Schommer ,&nbsp;Yun S. Wang ,&nbsp;Ismaeel Yunusa ,&nbsp;Marc L. Fleming ,&nbsp;Enrique Seoane-Vazquez ,&nbsp;Lawrence M. Brown","doi":"10.1016/j.rcsop.2024.100457","DOIUrl":"https://doi.org/10.1016/j.rcsop.2024.100457","url":null,"abstract":"<div><h3>Background</h3><p>One factor for the poor health outcomes among adult people with metabolic syndrome (MetS) is poor utilization of disease management resources, which may be attributable to prior experience with pharmacists (PEwP) and perceptions of disease management resource utilization (PMU). Therefore, understanding patients' experience could be critical to improving their perceptions and promoting health outcomes.</p></div><div><h3>Objectives</h3><p>The study explored the influence of PEwP and PMU on the health-related quality of life (HRQoL) of people with MetS.</p></div><div><h3>Methods</h3><p>Data on perceptions of healthcare, medication, and pharmacy services utilization, PEwP, and HRQoL were collected using validated tools via an electronic survey. Chi-square and ordinal regression tests were used to predict the association between PMU, PEwP, and HRQoL. Also, mediation analysis through Haye's model 4 explored the direct and indirect relationship of PMU and PEwP on HRQoL.</p></div><div><h3>Results</h3><p>A total of 706 completed surveys were collected and used for analyses. On average, respondents reported three comorbidities. Of the respondents, 72.0% had good PEwP, while 32.6% had good PMU. Comparatively, 38.4% of those with good PEwP had good PMU, compared to 17.3% of those with poor PEwP. Also, 47.0% of those with good PMU had good HRQoL compared to 35.3% with poor PMU. The odds of having fair or good PMU were nearly triple (OR = 2.97, p &lt; 0.001) among those with good PEwP compared to those with poor PEwP. Also, respondents with good PMU had 58% (OR = 1.58, p = 0.008) higher odds of having fair or good HRQoL. Analysis through bootstrap indicated a significant relationship (BootCI = −0.072, −0.022) between PEwP and HRQoL via respondents' PMU.</p></div><div><h3>Conclusions</h3><p>MetS individuals with good experience and PMU were more likely to have good HRQoL. Prior experience with pharmacists influenced PMU and indirectly impacted HRQoL. Therefore, pharmacists must consider patients' experience and management utilization perceptions to promote health outcome among people with MetS, while implementing interventions.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000544/pdfft?md5=5aa23a2beb7065ae1359f7cede2c0724&pid=1-s2.0-S2667276624000544-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141243179","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 work life (QWL) of community pharmacists and its association with subjective evaluations of pharmaceutical services","authors":"Yuta Kato ,&nbsp;Takashi Sekiya ,&nbsp;Ryo Ishii ,&nbsp;Yoji Hirako ,&nbsp;Hiroki Satoh ,&nbsp;Hiromichi Kimura","doi":"10.1016/j.rcsop.2024.100458","DOIUrl":"https://doi.org/10.1016/j.rcsop.2024.100458","url":null,"abstract":"<div><h3>Background</h3><p>In Japan, pharmacists' role has drastically changed in recent years. However, previous studies have not performed internal marketing analysis for Japanese community pharmacists so that they improve the quality of work life (QWL) and be satisfied with it. Further, few studies are conducted on Japanese community pharmacists' QWL and its effect on the quality of pharmaceutical services.</p></div><div><h3>Objectives</h3><p>This study aimed to reveal associations between community pharmacists' QWL and their subjective evaluations of pharmaceutical service.</p></div><div><h3>Methods</h3><p>A questionnaire survey was conducted among 2027 pharmacists, with the cooperation of 20 corporations that run pharmacies. The collected data were subjected to multiple regression analysis, using SPSS 29.</p></div><div><h3>Results</h3><p>Standard multiple regression shows that 27.4% of variance in pharmacists' subjective evaluations of their service was explained by QWL and other control variables, such as age, gender, and employee status (<em>p</em> &lt; .001, R² = 0.274). This analysis showed that factors behind pharmacists' QWL, “meaning of existence in the workplace” and “pride in work,” explained pharmacists' subjective evaluations of pharmaceutical service (β = 0.307, <em>p</em> &lt; .001, β = 0.277; p &lt; .001, respectively).</p></div><div><h3>Conclusion</h3><p>This study shows that improving QWL, especially “mental and physical effects on work” and “pride in work,” might contribute to improving community pharmacists' services.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000556/pdfft?md5=088e796d1acd212b5f9796aa18aea120&pid=1-s2.0-S2667276624000556-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141291989","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":"Assessment of the utilization of real-time prescription benefits for patient cost savings within an outpatient setting","authors":"Rachel Reise ,&nbsp;Asinamai M Ndai ,&nbsp;Marvin A Dewar ,&nbsp;Anzeela M Schentrup ,&nbsp;Julia Yang ,&nbsp;Scott Martin Vouri","doi":"10.1016/j.rcsop.2024.100460","DOIUrl":"https://doi.org/10.1016/j.rcsop.2024.100460","url":null,"abstract":"<div><h3>Background</h3><p>This study evaluates the impact of Real-Time Prescription Benefits (RTPB), a tool integrated into electronic health records (EHRs), on patient out-of-pocket costs in an academic institution. RTPB provides prescribers with alternative, less expensive medications based on insurance plans. The primary measure was cost-savings, defined as the difference between the out-of-pocket cost of the prescribed medication and its alternative.</p></div><div><h3>Methods</h3><p>A retrospective analysis of prescriptions from outpatient clinics in a university-based health system was conducted between May 2020 and July 2021. Prescriptions were analyzed at the 2nd level of the Anatomical Therapeutic Chemical (ATC) classification system. Costs were standardized to a 30-day supply. Standardized cost and total cost per prescription, and overall savings for the top 20 medication classes at the 2nd ATC level were calculated. The overall impact of RTPB was estimated based on selecting the least expensive alternative suggested by RTPB.</p></div><div><h3>Results</h3><p>The study found that RTPB information was provided for 22% of prescriptions, with suggested alternatives for 1.26%. Among prescriptions with an alternative selected, the standardized average cost saving was $38.83. The study realized $15,416 in patient total cost savings. If the least expensive RTPB-suggested alternative were chosen for all prescriptions, an estimated $276,386 could have been saved. Psychoanaleptic and psycholeptic medications were the most prescribed with an alternative, with most savings in specialty drugs like anthelmintic and immunostimulant medications.</p></div><div><h3>Conclusion</h3><p>The study highlights the importance of RTPB in reducing patient costs. It reports patient cost-savings with RTPB in prescribing decisions. Future research could explore the impact of RTPB on medication adherence using pharmacy claims data.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266727662400057X/pdfft?md5=81c14271a8579530f13c2865c221d25a&pid=1-s2.0-S266727662400057X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324693","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":"Determining a future policy focus to support antimicrobial stewardship in community pharmacy: A modified Delphi study","authors":"Kathryn Lim ,&nbsp;Elaine Lum ,&nbsp;Anna Olsen ,&nbsp;Lisa Nissen ,&nbsp;Alex Broom ,&nbsp;Holly Seale","doi":"10.1016/j.rcsop.2024.100456","DOIUrl":"10.1016/j.rcsop.2024.100456","url":null,"abstract":"<div><h3>Background</h3><p>Over the past decade, the pharmacy sector's policy, academic and professional spheres have increasingly drawn attention to the opportunities to better leverage the untapped potential of the community pharmacy sector in contributing to global efforts to reduce antimicrobial resistance (AMR). While efforts are in train, progress is slow.</p></div><div><h3>Objective</h3><p>To draw insights from global experts in the field to identify a broad range of potential future policy directions to support community pharmacists' involvement in antimicrobial stewardship (AMS).</p></div><div><h3>Methods</h3><p>A modified Delphi technique, comprising two survey rounds to build consensus amongst global community pharmacy sector stakeholders and opinion leaders. In Round 1, participants rated their level of agreement with 28 statements across the three domains of policy design, implementation design, and monitoring and evaluation. Participants were also invited to contribute feedback in Round 1, which was reflected as new statements (<em>n</em> = 10) in Round 2. In Round 2, participants were asked to re-assess Round 1 statements in view of the group consensus and to rate the new statements.</p></div><div><h3>Results</h3><p>289 participants were invited to participate. 48/289 (17% response rate) completed Round 1, and 25/42 (60% response rate) completed Round 2. Consensus (defined as &gt;70% agreement) was achieved for 79% (<em>n</em> = 30) of the statements across the three domains.</p></div><div><h3>Conclusion</h3><p>Pharmacy sector experts agreed that acknowledging community pharmacists in AMS national action plans is an important component, signalling a recognition of the sector's contribution to whole-of-nation AMS efforts. Implementation components that achieved consensus reflect the profession's evolution to a professional service driven model, particularly in complementary AMS initiatives including infection prevention and control measures. Context-specific adjustments to support implementing these AMS measures will be required, in addition to striking the appropriate balance to support the pace of increased community pharmacists'involvement in AMS with building whole-of-profession buy-in.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000532/pdfft?md5=23a0e0841c47a41cb63b51d7d906affe&pid=1-s2.0-S2667276624000532-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143914","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 network analysis modularity to group health code systems and decrease dimensionality in machine learning models”","authors":"Mohsen Askar ,&nbsp;Lars Småbrekke ,&nbsp;Einar Holsbø ,&nbsp;Lars Ailo Bongo ,&nbsp;Kristian Svendsen","doi":"10.1016/j.rcsop.2024.100463","DOIUrl":"https://doi.org/10.1016/j.rcsop.2024.100463","url":null,"abstract":"<div><h3>Background</h3><p>Machine learning (ML) prediction models in healthcare and pharmacy-related research face challenges with encoding high-dimensional Healthcare Coding Systems (HCSs) such as ICD, ATC, and DRG codes, given the trade-off between reducing model dimensionality and minimizing information loss.</p></div><div><h3>Objectives</h3><p>To investigate using Network Analysis modularity as a method to group HCSs to improve encoding in ML models.</p></div><div><h3>Methods</h3><p>The MIMIC-III dataset was utilized to create a multimorbidity network in which ICD-9 codes are the nodes and the edges are the number of patients sharing the same ICD-9 code pairs. A modularity detection algorithm was applied using different resolution thresholds to generate 6 sets of modules. The impact of four grouping strategies on the performance of predicting 90-day Intensive Care Unit readmissions was assessed. The grouping strategies compared: 1) binary encoding of codes, 2) encoding codes grouped by network modules, 3) grouping codes to the highest level of ICD-9 hierarchy, and 4) grouping using the single-level Clinical Classification Software (CCS). The same methodology was also applied to encode DRG codes but limiting the comparison to a single modularity threshold to binary encoding.</p><p>The performance was assessed using Logistic Regression, Support Vector Machine with a non-linear kernel, and Gradient Boosting Machines algorithms. Accuracy, Precision, Recall, AUC, and F1-score with 95% confidence intervals were reported.</p></div><div><h3>Results</h3><p>Models utilized modularity encoding outperformed ungrouped codes binary encoding models. The accuracy improved across all algorithms ranging from 0.736 to 0.78 for the modularity encoding, to 0.727 to 0.779 for binary encoding. AUC, recall, and precision also improved across almost all algorithms. In comparison with other grouping approaches, modularity encoding generally showed slightly higher performance in AUC, ranging from 0.813 to 0.837, and precision, ranging from 0.752 to 0.782.</p></div><div><h3>Conclusions</h3><p>Modularity encoding enhances the performance of ML models in pharmacy research by effectively reducing dimensionality and retaining necessary information. Across the three algorithms used, models utilizing modularity encoding showed superior or comparable performance to other encoding approaches. Modularity encoding introduces other advantages such as it can be used for both hierarchical and non-hierarchical HCSs, the approach is clinically relevant, and can enhance ML models' clinical interpretation. A Python package has been developed to facilitate the use of the approach for future research.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266727662400060X/pdfft?md5=97bf02f99058457c9ad310ec9e29b460&pid=1-s2.0-S266727662400060X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141324692","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":"Potential for pharmacist prescribing in primary care: A Dutch citizen perspective","authors":"Thomas G.H. Kempen ,&nbsp;Liset van Dijk ,&nbsp;Annemieke Floor-Schreudering ,&nbsp;Aradhana Kohli ,&nbsp;Henk-Frans Kwint ,&nbsp;Laura Schackmann ,&nbsp;Lilian H.D. van Tuyl ,&nbsp;Mette Heringa","doi":"10.1016/j.rcsop.2024.100453","DOIUrl":"10.1016/j.rcsop.2024.100453","url":null,"abstract":"<div><h3>Background</h3><p>Medication prescribing by pharmacists is a task shifting approach to help ensure quality and accessibility of healthcare. In many countries, like the Netherlands, pharmacist prescribing is not legally ensured, and it is unknown what citizens think of its potential introduction.</p></div><div><h3>Objective</h3><p>To investigate citizen perspectives on the potential role of pharmacists in prescribing in primary care.</p></div><div><h3>Methods</h3><p>A Citizen Platform with citizens (&gt;18 years) from the Netherlands was conducted in October 2022. This consisted of a one-day program in which the participants were engaged in interactive assignments and received expert presentations to foster the development of informed opinions. In the final assignment, 3 participant groups designed their ideal future scenario including preconditions regarding the role of the pharmacist in prescribing in primary care. All assignments were recorded, and notes were taken. The researchers then consolidated the 3 scenarios into one version and categorized the preconditions. The Citizen Platform results were summarized and subsequently discussed in 2 online focus groups with other citizens in February 2023 to investigate the perspectives of less informed citizens. Focus group discussions were audio-recorded, transcribed, and thematically analyzed.</p></div><div><h3>Results</h3><p>The Citizen Platform (<em>n</em> = 10) resulted in a shared scenario involving a primary care center where general practitioners (GPs) pharmacists and other healthcare professionals collaborate as a team. In this scenario, pharmacists can modify treatment in certain chronic diseases, manage minor ailments and support GPs with the care for patients with complex needs. Preconditions needed to realize this scenario include having shared medical records, the GP retaining the overview of the care for the patient and additional training for pharmacists. The focus groups (<em>n</em> = 6, in total) yielded 5 themes which acknowledge potential pharmacist prescribing but depict a more skeptical view towards pharmacist prescribing and include several concerns, for example pharmacists' potential conflict of interest.</p></div><div><h3>Conclusions</h3><p>Citizens that are informed about opportunities for pharmacy prescribing are capable of sketching potential scenarios for pharmacist prescribing in a collaborative primary care context. Less informed citizens seem more skeptical towards pharmacist prescribing.</p></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2667276624000507/pdfft?md5=d0800d4854aafc5ea222de321e4ae80b&pid=1-s2.0-S2667276624000507-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141142031","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}