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Pharmacy, Volume 9, Issue 4 (December 2021) – 48 articles

Cover Story (view full-size image): Comprehensive curricular change is a complicated endeavor requiring shared vision, clear processes, strong communication, flexibility, and patience. In this issue, Malone et al. share their experiences with curricular transformation at Monash University, which operates pharmacy training programs based in Melbourne, Australia and in Subang Jaya, Malaysia. While existing curriculum papers have focused on what specific elements were added, enhanced, or deleted, this paper also adds a rich discussion of the processes used to drive decisions. The authors apply a realist perspective to what worked in their situation and how they could have done even better. By sharing these lessons learned, they aim to assist others looking to undertake a transformational health curriculum change.View this paper
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13 pages, 257 KiB  
Article
Patterns and Predictors of Off-Label Drug Prescribing in Psychiatric Practice: A Qualitative Study
by Sadia Shakeel, Shagufta Nesar, Hina Rehman, Khizra Jamil, Imran Ahsan Mallick, Muhammad Shahid Mustafa, Mudassir Anwar and Shazia Jamshed
Pharmacy 2021, 9(4), 203; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040203 - 20 Dec 2021
Cited by 4 | Viewed by 2892
Abstract
Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians’ attitude and knowledge. In this context, the present study was conducted with the [...] Read more.
Off-label drug prescribing (OLDP) must be based on strong scientific evidence to make sure that patients get the optimum therapeutic outcomes. Adherence to the prerequisites is determined by the physicians’ attitude and knowledge. In this context, the present study was conducted with the goal of investigating psychiatrists’ perceptions of the use of OLDP in their clinical practice. A total of 14 psychiatrists were interviewed using a semi-structured interview guide. Thematic content analysis was performed. Data saturation was achieved at the 12th interview. Six major themes and fifteen subthemes emerged from qualitative interviews. Among the major themes were knowledge and concepts about the off-label drugs, attitude and current practice of prescribing off-label drugs, and rationale of prescribing and suggestions for reducing the use of off-label drugs. Almost all of the respondents interviewed provided detailed comments concerning the OLDP concept, depicted an optimistic approach and deemed that OLDP is quite common in psychiatry. Off-label usage of benzodiazepines such as clonazepam, diazepam and lorazepam in mania, depression, and obsessive–compulsive disorder were commonly reported. It was observed that the majority of the respondents did not inform the patients before prescribing off-label drugs. The present findings revealed that respondents had awareness; however, they depicted diverse attitudes towards prescribing off-label drugs. Further education and sensitization in regions with impoverished knowledge would certainly assist in preventing the risks associated with the use of OLDP. Full article
(This article belongs to the Special Issue Qualitative Methods in Pharmacy Research series Ⅱ)
16 pages, 655 KiB  
Article
Interventional, Quasi-Experimental Study of a Chronic Obstructive Pulmonary Disease Education Care Plan for Hospital Discharge
by Letitia N. Warunek, Nicole E. Cieri-Hutcherson, Brian P. Kersten and Amany K. Hassan
Pharmacy 2021, 9(4), 202; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040202 - 16 Dec 2021
Cited by 1 | Viewed by 2209
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity, mortality, and reduced quality of life for patients. Proper use of inhaler devices is critical for effective drug delivery and prevention of COPD progression. The primary endpoint of this study [...] Read more.
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of morbidity, mortality, and reduced quality of life for patients. Proper use of inhaler devices is critical for effective drug delivery and prevention of COPD progression. The primary endpoint of this study was a mean percent increase in correct steps associated with inhaler technique after pharmacist education. The co-primary endpoint was a 25% increase in the proportion of patients correctly identifying the appropriate use of short-acting versus long-acting inhaler types. This was an interventional quasi-experimental study of patients hospitalized at a 491-bed tertiary academic medical center with a COPD exacerbation to assess a pharmacist-led COPD care plan. Eligible patients included general floor, adult patients admitted with a primary diagnosis of COPD exacerbation. The primary investigator recorded initial inhaler technique scores through a paper checklist, and provided education about device types and usage. Patients were reassessed within 48 h to determine if pharmacist education improved inhaler knowledge. A total of 67 patients received the COPD care plan before hospital discharge. At baseline, patients scored a median of 81.8% (67.5–97.0) of steps correct across all inhaler device types. After pharmacist education, patient scores increased to a median of 100% (90.9–100.0) (p < 0.0001). The proportion of patients correctly identifying when to use short-acting versus long-acting inhalers increased from 73.1% to 98.5% (p < 0.0001). Implementation of a pharmacist-led care plan for patients admitted for COPD exacerbation was associated with an increase in correct steps for appropriate inhaler technique and understanding of inhaler device types after pharmacist education. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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11 pages, 224 KiB  
Article
Pharmacists as Personalized Medicine Experts (PRIME): Experiences Implementing Pharmacist-Led Pharmacogenomic Testing in Primary Care Practices
by Miles J. Luke, Nina Krupetsky, Helen Liu, Clara Korenvain, Natalie Crown, Sameera Toenjes, Beth A. Sproule, Micheline Piquette-Miller, Lisa M. Guirguis and Lisa M. McCarthy
Pharmacy 2021, 9(4), 201; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040201 - 16 Dec 2021
Cited by 8 | Viewed by 2547
Abstract
Research exploring the integration of pharmacogenomics (PGx) testing by pharmacists into their primary care practices (including community pharmacies) has focused on the “external” factors that impact practice implementation. In this study, additional “internal” factors, related to the capabilities, opportunities, and motivations of pharmacists [...] Read more.
Research exploring the integration of pharmacogenomics (PGx) testing by pharmacists into their primary care practices (including community pharmacies) has focused on the “external” factors that impact practice implementation. In this study, additional “internal” factors, related to the capabilities, opportunities, and motivations of pharmacists that influence their ability to implement PGx testing, were analyzed. Semi-structured interview data from the Pharmacists as Personalized Medicine Experts (PRIME) study, which examined the barriers and facilitators to implementing PGx testing by pharmacists into primary care practice, were analyzed. Through thematic analysis, using the theoretical domains framework (TDF) domains as deductive codes, the authors identified the most relevant TDF domains and applied the behavioural change wheel (BCW) to generate intervention types to aid in the implementation of PGx testing. Pharmacists described how their professional identities, practice environments, self-confidence, and beliefs in the benefits of PGx impacted their ability to provide a PGx-testing service. Potential interventions to improve the implementation of the PGx service included preparing pharmacists for managing an increased patient load, helping pharmacists navigate the software and technology requirements associated with the PGx service, and streamlining workflows and documentation requirements. As interest in the wide-scale implementation of PGx testing through community pharmacies grows, additional strategies need to address the “internal” factors that influence the ability of pharmacists to integrate testing into their practices. Full article
(This article belongs to the Special Issue Pharmacist-Based Interventions for Health Behavior Change)
7 pages, 431 KiB  
Article
Urban Expansion of the SAFE-Home Opioid Management Education (SAFE-HOME) Naloxone Awareness Initiative for Home Health Workers and Older Adults
by Abigail T. Elmes, Brianna M. McQuade, Michael Koronkowski, Erin Emery-Tiburcio and Jennie B. Jarrett
Pharmacy 2021, 9(4), 200; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040200 - 15 Dec 2021
Viewed by 1951
Abstract
The SAFE-Home Opioid Management Education (SAFE-HOME) Naloxone Awareness pilot program utilized home health workers (HHWs) in rural settings to educate older adults prescribed opioids on naloxone access and use. This work expands the SAFE-HOME program to urban settings to prepare HHWs to educate [...] Read more.
The SAFE-Home Opioid Management Education (SAFE-HOME) Naloxone Awareness pilot program utilized home health workers (HHWs) in rural settings to educate older adults prescribed opioids on naloxone access and use. This work expands the SAFE-HOME program to urban settings to prepare HHWs to educate community-dwelling older adults on opioid risks and life-saving naloxone. This prospective, interventional cohort study evaluated 60-min synchronous, virtual HHW educational training sessions describing opioid risks in older adults, opioid overdose signs and symptoms, and naloxone access and use. Knowledge assessments were conducted pre- and post-intervention via a pre-developed assessment tool in a repeated measure model. Outcomes included change in total opioid and naloxone knowledge, and baseline total and individual opioid and naloxone knowledge. Six educational sessions were held (n = 154). The average pre- and post-education scores were 62.7% (n = 108) and 83.5% (n = 82), respectively (p < 0.001). Of the 69 participants who completed both pre- and post-education assessments, the average change in total score was +19.6% (p < 0.001), opioid knowledge score −0.4% (p = 0.901), and naloxone knowledge score +32.9% (p < 0.001). At baseline, HHWs were knowledgeable on opioid risks, but lacked familiarity with naloxone access and use. Targeting HHWs with opioid and naloxone training positions them to effectively educate at-risk community-dwelling older adults. Full article
(This article belongs to the Special Issue Pharmacist-Based Interventions for Health Behavior Change)
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7 pages, 871 KiB  
Perspective
A Peer Educational Tool to Promote Antimicrobial Stewardship on a University Campus
by Yuman (Yumi) Lee and Nicole Bradley
Pharmacy 2021, 9(4), 199; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040199 - 14 Dec 2021
Cited by 1 | Viewed by 1910
Abstract
Antibiotic resistance is a major public health threat. Patient education on the appropriate use of antibiotics is a key component in combating antimicrobial resistance. The purpose of this study was to analyze the utility of an origami fortune teller as a novel peer [...] Read more.
Antibiotic resistance is a major public health threat. Patient education on the appropriate use of antibiotics is a key component in combating antimicrobial resistance. The purpose of this study was to analyze the utility of an origami fortune teller as a novel peer educational tool in promoting antimicrobial stewardship on a university campus. An origami fortune teller, with various case scenarios to demonstrate key antibiotic principles, was developed and used by peer educators to educate students attending a university wellness fair. The case studies included: antibiotic indications; differentiation between viral vs. bacterial infection; proper use of antibiotics; non-pharmacologic measures to combat infection; and antibiotic resistance. Students were asked to take an assessment pre and post working with the tool. One hundred and forty-three students received education using the novel tool. A significant improvement in the assessment score was observed after education was completed using the novel tool (69.5 vs. 96.6 p ≤ 0.05). Full article
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26 pages, 656 KiB  
Systematic Review
The Secondary Use of Data to Support Medication Safety in the Hospital Setting: A Systematic Review and Narrative Synthesis
by Navila Talib Chaudhry, Bryony Dean Franklin, Salmaan Mohammed and Jonathan Benn
Pharmacy 2021, 9(4), 198; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040198 - 13 Dec 2021
Viewed by 2525
Abstract
Objectives: To conduct a systematic review and narrative synthesis of interventions based on secondary use of data (SUD) from electronic prescribing (EP) and electronic hospital pharmacy (EHP) systems and their effectiveness in secondary care, and to identify factors influencing SUD. Method: The search [...] Read more.
Objectives: To conduct a systematic review and narrative synthesis of interventions based on secondary use of data (SUD) from electronic prescribing (EP) and electronic hospital pharmacy (EHP) systems and their effectiveness in secondary care, and to identify factors influencing SUD. Method: The search strategy had four facets: 1. Electronic databases, 2. Medication safety, 3. Hospitals and quality/safety, and 4. SUD. Searches were conducted within EMBASE, Medline, CINAHL, and International Pharmaceutical Abstracts. Empirical SUD intervention studies that aimed to improve medication safety and/or quality, and any studies providing insight into factors affecting SUD were included. Results: We identified nine quantitative studies of SUD interventions and five qualitative studies. SUD interventions were complex and fell into four categories, with ‘provision of feedback’ the most common. While heterogeneous, the majority of quantitative studies reported positive findings in improving medication safety but little detail was provided on the interventions implemented. The five qualitative studies collectively provide an overview of the SUD process, which typically comprised nine steps from data identification to analysis. Factors influencing the SUD process were electronic systems implementation and level of functionality, knowledge and skills of SUD users, organisational context, and policies around data reuse and security. Discussion and Conclusion: The majority of the SUD interventions were successful in improving medication safety, however, what contributes to this success needs further exploration. From synthesis of research evidence in this review, an integrative framework was developed to describe the processes, mechanisms, and barriers for effective SUD. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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8 pages, 925 KiB  
Article
Prescription Renewal Request Reviews by Student Pharmacists in a Family Medicine Clinic
by Jarred Prudencio and Michelle Kim
Pharmacy 2021, 9(4), 197; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040197 - 12 Dec 2021
Viewed by 2151
Abstract
Prescription renewal requests were reviewed by student pharmacists on advanced pharmacy practice experiences (APPE) at a primary care and family medicine clinic. Student pharmacists reviewed requests and triaged them to the respective primary care provider (PCP), along with any recommendations to optimize the [...] Read more.
Prescription renewal requests were reviewed by student pharmacists on advanced pharmacy practice experiences (APPE) at a primary care and family medicine clinic. Student pharmacists reviewed requests and triaged them to the respective primary care provider (PCP), along with any recommendations to optimize the medication regimen. This study aims to assess the acceptance of these recommendations as well as the student’s perception of this activity as a learning tool. A total of 35 4th-year pharmacy students participated in this activity during APPE rotations from May 2019 to March 2021. A total of 184 recommendations were made, with 128 (70%) being accepted by PCPs. Based on a post-rotation anonymous survey, students reported high levels of agreeance that this activity had a positive impact on their education in a variety of ways. This prescription renewal request review process has been shown to have a positive impact on patient care and clinic workflow while also providing pharmacy students with a helpful educational activity. Full article
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9 pages, 207 KiB  
Article
The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge
by Jaquie Hanley, Maureen Spargo, Joanne Brown and Julie Magee
Pharmacy 2021, 9(4), 196; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040196 - 09 Dec 2021
Cited by 3 | Viewed by 2829
Abstract
The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative [...] Read more.
The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative care pharmacy skills to undertake activities such as the symptom management of patients, appropriate management of medicines, improved access to medicines, advice for other healthcare professionals, and supporting discharge from the hospital. The data collected showed a mean of 6.8 interventions per patient, and that, irrespective of the demand resulting from the COVID-19 pandemic, the palliative care pharmacy team had a role in improving the quality of care for palliative and end-of-life patients. Subsequent data analysis also demonstrated associated cost saving and the potential for the palliative care pharmacy team to reduce the length of stay at the hospital. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
7 pages, 618 KiB  
Article
Impact of a Regional Campus on the Placements of Students at Rural Pharmacy Experiential Sites
by Stephanie Kiser, Elizabeth Ramsaur and Charlene R. Williams
Pharmacy 2021, 9(4), 195; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040195 - 07 Dec 2021
Viewed by 2139
Abstract
Pharmacist shortages in rural communities underscore the need to focus on increasing the pipeline of pharmacists practicing rurally. Experiential placement in rural communities is one method to approach this challenge. Regional pharmacy campuses may facilitate rural experiential placements. The objective of this study [...] Read more.
Pharmacist shortages in rural communities underscore the need to focus on increasing the pipeline of pharmacists practicing rurally. Experiential placement in rural communities is one method to approach this challenge. Regional pharmacy campuses may facilitate rural experiential placements. The objective of this study was to assess the effect of a regional campus on the number of rural experiential placements. This retrospective analysis compared experiential student placements in the five-year periods before and after the addition of a regional school of pharmacy campus. Experiential placements in the designated time periods were compared with respect to numbers of overall pharmacy practice experiences, experiences in rural locations, and rural counties with rotation sites. The average distance to rural sites was also compared. Differences in rural experiential placements were not statistically different. The number of rural counties with pharmacy experiential placements grew from eight to twelve, and driving distance increased. While institution of a regional campus contributed to an increase in the number of rural counties with experiential placements, overall rural experiential placements did not statistically differ versus suburban placements. Additional inquiry into factors that affect rural placement is needed to influence strategies to develop and maintain rural experiential sites and consistently place students at those sites. Full article
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16 pages, 910 KiB  
Article
Prescribing-Assessment Tools for Long-Term Care Pharmacy Practice: Reaching Consensus through a Modified RAND/UCLA Appropriateness Method
by João R. Gonçalves, Betsy L. Sleath, Manuel J. Lopes and Afonso M. Cavaco
Pharmacy 2021, 9(4), 194; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040194 - 03 Dec 2021
Cited by 4 | Viewed by 2653
Abstract
Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a [...] Read more.
Medicines are the most used health technology in Long-Term Care. The prevalence of potentially inappropriate medicines amongst Long-Term Care patients is high. Pharmacists, assisted by prescribing-assessment tools, can play an important role in optimizing medication use at this level of care. Through a modified RAND/UCLA Appropriateness Method, 13 long-term care and hospital pharmacists assessed as ‘appropriate’, ‘uncertain’, or ‘inappropriate’ a collection of commonly used prescribing-assessment tools as to its suitability in assisting pharmacy practice in institutional long-term care settings. A qualitative analysis of written or transcribed comments of participants was pursued to identify relevant characteristics of prescribing-assessment tools and potential hinders in their use. From 24 different tools, pharmacists classified 9 as ‘appropriate’ for pharmacy practice targeted to long-term care patients, while 3 were classified as ‘inappropriate’. The tools feature most appreciated by study participants was the indication of alternatives to potentially inappropriate medication. Lack of time and/or pharmacists and limited access to clinical information seems to be the most relevant hinders for prescribing-assessment tools used in daily practice. Full article
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9 pages, 381 KiB  
Article
Community Pharmacists’ Experiences and Perception about Transitions of Care from Hospital to Home in a Midwestern Metropolis
by Rachel K. Vossen, Yifei Liu and Peggy G. Kuehl
Pharmacy 2021, 9(4), 193; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040193 - 27 Nov 2021
Viewed by 2281
Abstract
Objectives: (1) To describe the experiences of community pharmacists in transitions of care (TOC) from hospital to home in a Midwestern metropolis; and (2) to develop instruments to measure perceived importance of TOC activities. Methods: Survey items were developed, including a six-item instrument [...] Read more.
Objectives: (1) To describe the experiences of community pharmacists in transitions of care (TOC) from hospital to home in a Midwestern metropolis; and (2) to develop instruments to measure perceived importance of TOC activities. Methods: Survey items were developed, including a six-item instrument to capture perceived importance of TOC activities. The items were piloted to examine face validity before dissemination to 310 community pharmacists. Descriptive statistics were reported. Principal component analysis and reliability analysis for the six-item instrument were performed to assess construct validity and Cronbach’s alpha, respectively. Results: The response rate was 37% (n = 118). The majority of community pharmacists estimated that they learned of a patient’s discharge on less than 10% of the occasions. There were 76 cases in which the discharged patients experienced either a prescription- or medication-related problem. For the six-item measurement of perceived importance, one component was yielded and all items loaded on the component with high values, which confirmed construct validity. The Cronbach’s alpha for these six items was 0.941, indicating high reliability. Conclusions: A large communication gap existed for community pharmacists to receive patient discharge information. The six-item instrument to measure perceived importance of TOC activities was valid and reliable. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
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11 pages, 688 KiB  
Commentary
Understanding the Potential for Pharmacy Expertise in Palliative Care: The Value of Stakeholder Engagement in a Theoretically Driven Mapping Process for Research
by Joseph Elyan, Sally-Anne Francis and Sarah Yardley
Pharmacy 2021, 9(4), 192; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040192 - 26 Nov 2021
Cited by 4 | Viewed by 2974
Abstract
Potentially avoidable medication-related harm is an inherent risk in palliative care; medication management accounts for approximately 20% of reported serious incidents in England and Wales. Despite their expertise benefiting patient care, the routine contribution of pharmacists in addressing medication management failures is overlooked. [...] Read more.
Potentially avoidable medication-related harm is an inherent risk in palliative care; medication management accounts for approximately 20% of reported serious incidents in England and Wales. Despite their expertise benefiting patient care, the routine contribution of pharmacists in addressing medication management failures is overlooked. Internationally, specialist pharmacist support for palliative care services remains under-resourced. By understanding experienced practices (‘what happens in the real world’) in palliative care medication management, compared with intended processes (‘what happens on paper’), patient safety issues can be identified and addressed. This commentary demonstrates the value of stakeholder engagement and consultation work carried out to inform a scoping review and empirical study. Our overall goal is to improve medication safety in palliative care. Informal conversations were undertaken with carers and various specialist and non-specialist professionals, including pharmacists. Themes were mapped to five steps: decision-making, prescribing, monitoring and supply, use (administration), and stopping and disposal. A visual representation of stakeholders’ understanding of intended medicines processes was produced. This work has implications for our own and others’ research by highlighting where pharmacy expertise could have a significant additional impact. Evidence is needed to support best practice and implementation, particularly with regard to supporting carers in monitoring and accessing medication, and communication between health professionals across settings. Full article
(This article belongs to the Special Issue The Role of Pharmacists in Palliative and End of Life Care)
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10 pages, 542 KiB  
Article
The Impact of a Pharmacist-Driven Staphylococcus aureus Bacteremia Initiative in a Community Hospital: A Retrospective Cohort Analysis
by Nate J. Berger, Michael E. Wright, Jonathon D. Pouliot, Montgomery W. Green and Deborah K. Armstrong
Pharmacy 2021, 9(4), 191; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040191 - 25 Nov 2021
Cited by 3 | Viewed by 2354
Abstract
Purpose: Staphylococcus aureus is a leading cause of bacteremia with a 30-day mortality of 20%. This study evaluated outcomes after implementation of a pharmacist-driven Staphylococcus aureus bacteremia (SAB) initiative in a community hospital. Methods: This retrospective cohort analysis compared patients admitted with SAB [...] Read more.
Purpose: Staphylococcus aureus is a leading cause of bacteremia with a 30-day mortality of 20%. This study evaluated outcomes after implementation of a pharmacist-driven Staphylococcus aureus bacteremia (SAB) initiative in a community hospital. Methods: This retrospective cohort analysis compared patients admitted with SAB between May 2015 and April 2018 (intervention group) to those admitted between May 2012 and April 2015 (historical control group). Pharmacists were notified of and responded to blood cultures positive for Staphylococcus aureus by contacting provider(s) with a bundle of recommendations. Components of the SAB bundle included prompt source control, selection of appropriate intravenous antibiotics, appropriate duration of therapy, repeat blood cultures, echocardiography, and infectious diseases consult. Demographics (age, gender, and race) were collected at baseline. Primary outcome was in-hospital mortality. Compliance with bundle components was also assessed. Results: Eighty-three patients in the control group and 110 patients in the intervention group were included in this study. Demographics were similar at baseline. In-hospital mortality was lower in the intervention group (3.6% vs. 15.7%; p = 0.0033). Bundle compliance was greater in the intervention group (69.1% vs. 39.8%; p < 0.0001). Conclusions: We observed a significant reduction in in-hospital mortality and increased treatment bundle compliance in the intervention cohort with implementation of a pharmacist-driven SAB initiative. Pharmacists’ participation in the care of SAB patients in the form of recommending adherence to treatment bundle components drastically improved clinical outcomes. Widespread adoption and implementation of similar practice models at other institutions may reduce in-hospital mortality for this relatively common and life-threatening infection. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
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20 pages, 1944 KiB  
Article
Dose Administration Aid Service in Community Pharmacies: Characterization and Impact Assessment
by André Vicente, Beatriz Mónico, Mónica Lourenço and Olga Lourenço
Pharmacy 2021, 9(4), 190; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040190 - 24 Nov 2021
Cited by 3 | Viewed by 3177
Abstract
Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be [...] Read more.
Adherence to therapies is a primary determinant of treatment success. Lack of medication adherence is often associated with medical and psychosocial issues due to complications from underlying conditions and is an enormous waste of medical resources. Dose Administration Aid Service (DAAS) can be seen as part of the solution, allowing individual medicine doses to be organized according to the dosing schedule determined by the patient’s prescriber. The most recent systematic reviews admit the possibility of a positive impact of this service. In line with this background, the study reported in this paper aimed to characterize DAAS implementation in Portugal and understand the perceptions of pharmacists and owners of community pharmacies regarding the impact of DAAS, preferred methodology types, and State contribution. The study was guided by qualitative description methodology and reported using the consolidated criteria for reporting qualitative research (COREQ) checklist. Data were collected through semi-structured interviews with 18 pharmacists and/or owners of community pharmacies. Using qualitative content analysis, we identified categories that revealed that automated weekly methodology is the preferred methodology, because of its easiness of use and lower cost of preparation. However, the investment cost was felt to be too high by the participants considering the number of potential users for implementation in practice. Participants were also unanimous in recognizing that DAAS has a very positive impact in terms of safety and medication adherence, and the majority agreed that it also helped reduce medication waste. Implications of these findings for medication adherence are discussed. Full article
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12 pages, 1215 KiB  
Article
Potentially Inappropriate Medication Prescribing Detected by Computer Algorithm among Older Patients: Results from the MAPT Study
by Arnaud Pagès, Laure Rouch, Nadège Costa, Philippe Cestac, Philipe De Souto Barreto, Yves Rolland, Bruno Vellas, Laurent Molinier, Blandine Juillard-Condat and MAPT/DSA Group
Pharmacy 2021, 9(4), 189; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040189 - 24 Nov 2021
Cited by 3 | Viewed by 3246
Abstract
(1) Background: Some medications may be dangerous for older patients. Potentially inappropriate medication prescribing (PIP) among older patients represents a significant cause of morbidity. The aim of this study was to create an algorithm to detect PIP in a geriatric database (Multidomain Alzheimer [...] Read more.
(1) Background: Some medications may be dangerous for older patients. Potentially inappropriate medication prescribing (PIP) among older patients represents a significant cause of morbidity. The aim of this study was to create an algorithm to detect PIP in a geriatric database (Multidomain Alzheimer Preventive Trial (MAPT) study), and then to assess the algorithm construct validity by comparing the prevalence of PIP and associated factors with literature data. (2) Methods: An algorithm was constructed to detect PIP and was based on different explicit criteria among which the European list of potentially inappropriate medications (EU(7)-PIM), the STOPP and START version 2 tools. For construct validity assessment, logistic mixed-effects model repeated measures analyses were used to identify factors associated with PIP. (3) Results: Prevalence of PIP was 59.0% with the EU(7)-PIM list criteria, 43.2% with the STOPP criteria and 51.3% with the START criteria. Age, polypharmacy, and higher Charlson comorbidity index were associated with PIP. (4) Conclusions: Prevalence of PIP and associated factors are consistent with literature data, supporting the construct validity of our algorithm. This algorithm opens up interesting perspectives both in terms of analysis of very large databases and integration into e-prescribing or pharmaceutical validation software. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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8 pages, 727 KiB  
Article
Parent Attitudes about Childhood Vaccines: Point Prevalence Survey of Vaccine Hesitancy in an Irish Population
by Sarah Marshall, Anne C. Moore, Laura J. Sahm and Aoife Fleming
Pharmacy 2021, 9(4), 188; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040188 - 23 Nov 2021
Cited by 16 | Viewed by 4478
Abstract
Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the [...] Read more.
Understanding parental attitudes to their children’s vaccination is critical to developing and implementing interventions that address parents’ hesitancy and improve vaccine uptake. The Parent Attitudes about Childhood Vaccines (PACV) survey is a validated tool for identifying vaccine hesitancy in parents. We evaluated the rate of vaccine hesitancy and areas of concern regarding childhood vaccinations using an adapted version of the PACV survey, in a convenience sample of parents attending a STEM (Science, Technology, Engineering and Mathematics) outreach event in Ireland, in 2018. A score ≥ 50 identified vaccine hesitant parents. Of 105 parents who completed the survey, the prevalence of vaccine hesitancy was 6.7%, (7/105). Parents had concerns around vaccine side effects (36.2%, n = 38), vaccine safety (20%, n = 21) and the number of vaccines administered (13.3%, n = 14). Parents trusted the vaccine information they received (85.6%, n = 90) and 81.9% (n = 86) believed that the vaccine schedule was good for their child. The findings indicate the presence of vaccine hesitancy in parents in Ireland regarding paediatric vaccines with further research necessary to address parents’ vaccine concerns. Future research should explore further, by qualitative methods, parents’ vaccine concerns. There is also potential to identify vaccine hesitant parents with the PACV survey as a surveillance method in healthcare settings; for example, in community pharmacies, family doctor clinics and out-patient clinics. Full article
(This article belongs to the Special Issue Pharmacist-Based Interventions for Health Behavior Change)
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7 pages, 365 KiB  
Article
Patient Satisfaction with Pharmacist-Provided Health-Related Services in a Primary Care Clinic
by Jacob N. Jordan, Thomas G. Wadsworth, Renee Robinson, Hayli Hruza, Amy Paul and Shanna K. O’Connor
Pharmacy 2021, 9(4), 187; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040187 - 21 Nov 2021
Cited by 4 | Viewed by 2785
Abstract
(1) Background: Patient satisfaction plays an important role in the perceived value, sustained utilization, and coverage of healthcare services by payers and clinics. (2) Methods: A 33-question survey was designed to assess patient satisfaction and perceived value for healthcare services provided by a [...] Read more.
(1) Background: Patient satisfaction plays an important role in the perceived value, sustained utilization, and coverage of healthcare services by payers and clinics. (2) Methods: A 33-question survey was designed to assess patient satisfaction and perceived value for healthcare services provided by a clinical pharmacist in a single primary care facility. It included general items from validated patient satisfaction surveys (i.e., PROMIS®, CAHPS) and pharmacist-specific items identified in selected literature. It was offered to all patients who were presenting for a new, unique visit with the clinical pharmacist at the medical clinic between May 2019 and April 2020. (3) Results: A total of 66 patients agreed to take the survey (RR = 100%), and the responses were overwhelmingly positive. However, men were more likely than women to report higher satisfaction (X2(1, n = 920) = 0.67, p = 0.027), and new patients reported higher satisfaction than existing patients (X2(1, n = 1211) = 1.698, p = 0.037). (4) Conclusions: The findings of this study indicate a high degree of patient satisfaction with pharmacist-provided healthcare services in the primary care setting. Full article
(This article belongs to the Special Issue Pharmacists as Providers of Care)
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8 pages, 703 KiB  
Article
Optimization of Medication Regimens in Patients with Type 2 Diabetes and Clinical Atherosclerotic Cardiovascular Disease
by Jarred Prudencio, Paige Cajudoy and Donald Waddell
Pharmacy 2021, 9(4), 186; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040186 - 17 Nov 2021
Cited by 2 | Viewed by 2472
Abstract
The American Diabetes Association recommends that patients with type II diabetes and atherosclerotic cardiovascular disease be prescribed an SGLT-2 inhibitor or GLP-1 agonist for cardioprotective benefit. This project assessed the use of these medications in this patient population in a rural clinic by [...] Read more.
The American Diabetes Association recommends that patients with type II diabetes and atherosclerotic cardiovascular disease be prescribed an SGLT-2 inhibitor or GLP-1 agonist for cardioprotective benefit. This project assessed the use of these medications in this patient population in a rural clinic by measuring prescribing rates of SGLT-2/GLP-1 therapy before and after pharmacist interventions. Of the 60 patients identified at baseline, 39.39% (13/33) managed by a pharmacist were prescribed SGLT-2/GLP-1 therapy compared to the 14.81% (4/27) who had not seen a pharmacist (p = 0.025). Of the 43 patients that were not on SGLT-2/GLP-1 therapy at baseline, 13 were lost to follow-up and 13 had contraindications. For the 17 remaining patients, pharmacists recommended initiating SGLT-2/GLP-1 therapy and were able to successfully initiate therapy for 9 patients (52.94%). Pharmacist interventions improved the prescription rates from a baseline of 36.17% (17/47) to 55.3% (26/47) (p = 0.002), with SGLT-2/GLP-1 therapy contraindicated in 27.66% (13/47) of patients. This suggests that patients managed by a pharmacist have medication regimens that were optimized at a greater rate and pharmacists can have a positive impact on the appropriate medication usage in this population. Full article
(This article belongs to the Special Issue Medicine Use in Chronic Disease)
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12 pages, 218 KiB  
Article
Evaluation of Student Pharmacists’ Attitudes and Perceptions of Hormonal Contraception Prescribing in Indiana
by J. Henry Papineau, Jenny L. Newlon, Ryan S. Ades, Veronica Vernon, Tracey A. Wilkinson, Lynn M. Thoma and Ashley H. Meredith
Pharmacy 2021, 9(4), 185; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040185 - 12 Nov 2021
Viewed by 2416
Abstract
Community pharmacists’ scope of practice is expanding to include hormonal contraceptive prescribing. Prior to introducing statewide legislation, it is important to assess the perceptions of future pharmacists. A cross-sectional survey was distributed to 651 third- and fourth-year professional students enrolled at three colleges [...] Read more.
Community pharmacists’ scope of practice is expanding to include hormonal contraceptive prescribing. Prior to introducing statewide legislation, it is important to assess the perceptions of future pharmacists. A cross-sectional survey was distributed to 651 third- and fourth-year professional students enrolled at three colleges of pharmacy in Indiana. Data were collected between September and October 2019 to assess students’ attitudes about prescribing hormonal contraceptives, readiness to prescribe, perceived barriers, and desire for additional training. In total, 20.9% (n = 136) students responded. Most (89%, n = 121) believe that pharmacist-prescribed hormonal contraceptives would be beneficial to women in Indiana, and 91% (n = 124) reported interest in providing this service. Liability, personal beliefs, and religious beliefs were the most commonly cited perceived barriers. Most students felt they received adequate teaching on hormonal contraceptive methods (90%, n = 122) and hormonal contraceptive counseling (79%, n = 107); only 5% (n = 7) felt ready to provide the service at the time of survey completion. Student pharmacists in their final two years of pharmacy school are interested in prescribing hormonal contraceptives and believe that this service would be beneficial. This expansion of pharmacy practice would likely be supported by future pharmacists who feel the service could provide benefit to women seeking hormonal contraceptives in Indiana. Full article
11 pages, 1276 KiB  
Article
Physicians’ Opinion Regarding Extended Access to Hormonal Contraception in Switzerland
by Tamara Yous, Samuel Allemann and Monika Lutters
Pharmacy 2021, 9(4), 184; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040184 - 12 Nov 2021
Cited by 2 | Viewed by 2554
Abstract
(1) Background: Access to hormonal contraceptives (HC) strongly differs between countries and varies from over the counter (OTC) to prescription-only availability. This study aimed to identify opinions among physicians in Switzerland regarding extended access to HC. (2) Methods: Web-based survey among [...] Read more.
(1) Background: Access to hormonal contraceptives (HC) strongly differs between countries and varies from over the counter (OTC) to prescription-only availability. This study aimed to identify opinions among physicians in Switzerland regarding extended access to HC. (2) Methods: Web-based survey among physicians (gynecologists, general practitioners, and pediatricians) in Switzerland. (3) Results: Hundred sixty-three physicians, mainly gynecologists, participated in this survey and 147 (90%) were included for analysis. A total of 68% (n = 100) answered that prescription-only status could be extended under certain conditions but physicians were concerned about patients’ safety (97%, n = 142). Moreover, there was concern about insufficient patient education on HC (93%, n = 136) and that women may forego preventive examinations (80%, n = 118). Participants did not support OTC availability (93%, n = 136). Pharmacists prescribing (including initiation of HC) revealed controversial results, but a combined access model (initial prescription from physician and follow-up prescriptions by pharmacists) found acceptance in 70% (n = 103). (4) Conclusions: Participating physicians stated that prescription-only status for HC could be lifted under certain conditions but also some concerns, e.g., patients’ safety or neglection of preventive examinations, were raised. Future research should focus on specific conditions in which extended access to HC could be agreed on. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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12 pages, 644 KiB  
Review
Telepharmacy during COVID-19: A Scoping Review
by Elizabeth J. Unni, Kanchita Patel, Isaac Rex Beazer and Man Hung
Pharmacy 2021, 9(4), 183; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040183 - 11 Nov 2021
Cited by 31 | Viewed by 9235
Abstract
The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges [...] Read more.
The objective of this scoping review is to summarize the implementation of telepharmacy during the surge of COVID-19. This review will focus on answering four questions: During the COVID-19 pandemic, (1) what were the various telepharmacy initiatives implemented? (2) what were the challenges faced when implementing telehealth initiatives? (3) what were the strategies used by pharmacies to overcome the challenges, and (4) what were some of the innovative methods used by pharmacies to implement telepharmacy? A literature search was conducted to include publications post-March 2020 about telepharmacy implementation via PubMed Central database and Google searches. All articles were examined for inclusion or exclusion based on pre-determined criteria. A total of 33 articles were reviewed. The most commonly observed telepharmacy initiatives were virtual consultations, home delivery of medicines and patient education. Limited access to technology and lack of digital access and literacy were major barriers in the implementation of telepharmacy. New protocols were developed by healthcare systems and regulations were relaxed by countries to accommodate telepharmacy. Pharmacies that successfully implemented telepharmacy overcame these challenges through patient and pharmacist education. The review also revealed the steps that can be taken by pharmacy organizations, payers and entrepreneurs in leveraging the convenience of telepharmacy. Full article
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13 pages, 970 KiB  
Article
Medication Utilisation Program, Quality Improvement and Research Pharmacist—Implementation Strategies and Preliminary Findings
by Karen Whitfield, Ian Coombes, Charles Denaro and Peter Donovan
Pharmacy 2021, 9(4), 182; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040182 - 04 Nov 2021
Cited by 1 | Viewed by 4396
Abstract
Judicious use of medicines that considers evidence-based practice, together with cost-effectiveness, is a priority for all health care organisations. We describe an initiative to lead a Medication Utilisation Program, incorporating medication quality improvement and research activities. In August 2020 an advanced pharmacist position [...] Read more.
Judicious use of medicines that considers evidence-based practice, together with cost-effectiveness, is a priority for all health care organisations. We describe an initiative to lead a Medication Utilisation Program, incorporating medication quality improvement and research activities. In August 2020 an advanced pharmacist position was implemented to lead the Program. The purpose was to provide oversight and facilitate initiatives promoting medication optimisation to create sustainable change in practice. A strategic plan was developed with key performance indicators. A governance structure was implemented with relevant reporting mechanisms. Strategic planning and collaboration with medical, nursing and allied health professionals has seen the successful implementation of seven codesigned medication-use evaluations and eight quality improvement projects centred around patient safety, quality and value-based care. Several research studies have been designed with subsequent commencement of pharmacists enrolled in university Research Higher Degree programs. Cost containment initiatives have realised potential savings approximating AUD 250,000. Educational programs included protocol design, ethics approvals and report writing. Key success criteria for a Medication Utilisation Program include dedicated pharmacist resources, structured governance and reporting mechanisms. Alignment of study complexity with staff experience and interdisciplinary collaboration are also critical. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
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7 pages, 221 KiB  
Commentary
An Understanding of the Drivers of Infectious Diseases in the Modern World Can Aid Early Control of Future Pandemics
by Taiwo Opeyemi Aremu, Oluwatosin Esther Oluwole and Kehinde Oluwatosin Adeyinka
Pharmacy 2021, 9(4), 181; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040181 - 03 Nov 2021
Cited by 5 | Viewed by 2693
Abstract
Infectious diseases have been a significant challenge to health and wellbeing from ancient times, with substantial economic implications globally. Despite the advent of technology, infectious diseases continue to affect people of various social statuses and across geographical locations. Understanding some of the drivers [...] Read more.
Infectious diseases have been a significant challenge to health and wellbeing from ancient times, with substantial economic implications globally. Despite the advent of technology, infectious diseases continue to affect people of various social statuses and across geographical locations. Understanding some of the drivers of infectious diseases, antimicrobial resistance, vaccination, and vaccine hesitancy is a step towards thriving in the modern world, achieving fewer morbidities and mortalities, and adequately controlling future pandemics. Pharmacists are strategically placed as healthcare team members to promote early disease control through health education, advocacy, cross-professional and specialty collaboration, communal trust-building, research, and global unity. Not forgetting that infectious diseases in the modern world are about people and science, credible crisis communication during the early phases of disease outbreaks paves the way for well-informed guidance globally. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
11 pages, 276 KiB  
Review
Pharmacists’ Approach to Optimise Safe Medication Use in Paediatric Patients
by Nicole Keuler, Annatjie Bouwer and Renier Coetzee
Pharmacy 2021, 9(4), 180; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040180 - 03 Nov 2021
Cited by 3 | Viewed by 3175
Abstract
Paediatric patients are unique, yet challenging patients to care for by pharmacists. Paediatric medicine use requires special consideration. Pharmacists play an important role in educating and counselling patients, carers, and healthcare workers. Further, pharmacists have the necessary knowledge and skills to optimise safe [...] Read more.
Paediatric patients are unique, yet challenging patients to care for by pharmacists. Paediatric medicine use requires special consideration. Pharmacists play an important role in educating and counselling patients, carers, and healthcare workers. Further, pharmacists have the necessary knowledge and skills to optimise safe medicine use in paediatric patients. This article provides basic principles for safe practices in paediatric medicine by following the nine rights of medication administration. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
9 pages, 498 KiB  
Article
Precision of Medication Therapy Problem Identification and Classification amongst Primary Care Clinic Pharmacists
by Nicholas Cox, Bryce Ashby, Bradly Winter, Gregory Stoddard, Joanne LaFleur, G. Benjamin Berrett and Kyle Turner
Pharmacy 2021, 9(4), 179; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040179 - 03 Nov 2021
Viewed by 2449
Abstract
This study assesses the level of agreement on medication therapy problem (MTP) identification and classification between primary care, ambulatory care pharmacists within a health-system that recently implemented system-wide pharmacist provision of comprehensive medication management (CMM) services. Twenty standardized case vignettes were created and [...] Read more.
This study assesses the level of agreement on medication therapy problem (MTP) identification and classification between primary care, ambulatory care pharmacists within a health-system that recently implemented system-wide pharmacist provision of comprehensive medication management (CMM) services. Twenty standardized case vignettes were created and distributed to pharmacists who reviewed each case and identified and categorized MTPs. Outcomes include the number of MTPs identified, identification (yes/no) of specific MTPs within each case (e.g., need for a statin), and Pharmacy Quality Alliance (PQA) category used when classifying MTPs. The level of agreement on MTP identification/categorization was measured using intraclass correlation coefficient (ICC) and interpreted using the Landis and Koch interpretation scale. “Moderate agreement” was observed for the number of MTPs identified by pharmacists (ICC equal to 0.45; 95% confidence interval [CI]: 0.31 to 0.65). In approximately one-half of opportunities, the pharmacists agreed perfectly on the number of MTPs; in approximately one-third of opportunities, the number of MTPs identified varied by 1; and approximately one-tenth of the time, the number of MTPs varied by 2. In regard to the MTP identification (yes/no) and categorization, percent agreement was ≥73% across all MTPs. The results support the need for further training and education and provide the information necessary to target specific disease states. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
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16 pages, 279 KiB  
Article
Patients, Social Workers, and Pharmacists’ Perceptions of Barriers to Providing HIV Care in Community Pharmacies in the United States
by Adati Tarfa, Kristen Pecanac and Olayinka Shiyanbola
Pharmacy 2021, 9(4), 178; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040178 - 02 Nov 2021
Cited by 4 | Viewed by 3645
Abstract
Retaining people living with HIV (PLWH) in clinical care is a global priority to end the HIV epidemic. Community pharmacies in the United States have structural influences on the success or failure of retention in HIV care by supporting patients’ complex needs. However, [...] Read more.
Retaining people living with HIV (PLWH) in clinical care is a global priority to end the HIV epidemic. Community pharmacies in the United States have structural influences on the success or failure of retention in HIV care by supporting patients’ complex needs. However, to date, barriers to retention in care in the community pharmacy setting have not been examined beyond pharmacy services of medication therapy management. We utilized the patient-centered medical home model to examine the barriers to HIV care in the community pharmacy setting. We utilized semi-structured interviews to collect data from 15 participants: five PLWH, five community pharmacists, and five social workers from a midwestern state. Interview data were transcribed and analyzed using directed content analysis. Four key themes emerged regarding the barriers that impact utilization of community pharmacy services by PLWH: the perception of the role of community pharmacists in HIV care, perceptions of pharmacists’ HIV knowledge, perceptions of pharmacy operation and services, and negative experiences within the community pharmacy space. Participants’ perceptions of solutions for improving HIV care in the community pharmacy focused on improving the relationship between pharmacists and patients, ensuring that the community pharmacy is a private and safe space for patients, and having a diverse pharmacy staff that is equipped to take care of the diverse and marginalized HIV population, such as transgender people. Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
7 pages, 201 KiB  
Communication
Medicines Optimisation for Respiratory Patients: The Establishment of a New Consultant Respiratory Pharmacist Role in Northern Ireland
by Cairine Gormley, Maureen Spargo, Glenda Fleming, Brendan Moore, Michael Scott, Rose Sharkey and Anne Friel
Pharmacy 2021, 9(4), 177; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040177 - 30 Oct 2021
Cited by 3 | Viewed by 3013
Abstract
Medicines optimisation for those with respiratory conditions can have a significant impact on clinical outcomes and substantial efficiency gains for health care. Consultant pharmacists are experts working at the top of their specialism in four main pillars of practice, namely clinical care, leadership, [...] Read more.
Medicines optimisation for those with respiratory conditions can have a significant impact on clinical outcomes and substantial efficiency gains for health care. Consultant pharmacists are experts working at the top of their specialism in four main pillars of practice, namely clinical care, leadership, education and training, and research and development. A consultant respiratory pharmacist has recently been appointed at a large Health and Social Care Trust in Northern Ireland to provide expert care and clinical leadership for the medicines optimisation agenda with regards to respiratory care in Northern Ireland. Alongside clinical practice, leadership, and service development, emphasis will be placed on monitoring and evaluating the work of the consultant respiratory pharmacist with a view to gathering the necessary evidence to support the case for further investment in such consultant pharmacist posts in the region. This short communication article outlines some of the clinical and economic factors associated with the decisions to invest in the consultant pharmacist model of care in Northern Ireland Full article
(This article belongs to the Special Issue Pharmacist Services Ⅱ)
11 pages, 473 KiB  
Article
Healthy People and Interested Students: Medical and Pharmacy Students’ Knowledge and Attitudes Regarding Public Health
by Richard P. Boyd, Trate A. DeVolld, Natalie A. DiPietro Mager and William J. Burke
Pharmacy 2021, 9(4), 176; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040176 - 28 Oct 2021
Viewed by 2773
Abstract
Little is known about health professions students’ awareness and attitudes regarding public health in the United States. Therefore, the purpose of this study was to assess medical and pharmacy students’ knowledge and interest in the Healthy People initiative as well as perceptions of [...] Read more.
Little is known about health professions students’ awareness and attitudes regarding public health in the United States. Therefore, the purpose of this study was to assess medical and pharmacy students’ knowledge and interest in the Healthy People initiative as well as perceptions of public health content in their curricula. An electronic survey was distributed in March 2021 in seven schools across Ohio; participation was incentivized through a USD 5 donation to the Ohio Association of Foodbanks to aid in COVID-19 relief efforts (maximum USD 1000) for each completed survey. A total of 182 medical students and 233 pharmacy students participated (12% response rate). Less than one-third of respondents reported familiarity with Healthy People and correctly identified the latest edition. However, nearly all respondents agreed public health initiatives are valuable to the American healthcare system. Almost all students expressed a desire to practice interprofessionally to attain public health goals. Both medical and pharmacy students recognized core public health topics in their curricula, and nearly 90% wanted more information. These findings indicate that the majority of medical and pharmacy students in Ohio believe public health initiatives to be important, yet knowledge gaps exist regarding Healthy People. This information can guide curricular efforts and inform future studies of health professions students. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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9 pages, 244 KiB  
Article
Linezolid for the Treatment of Urinary Tract Infections Caused by Vancomycin-Resistant Enterococci
by Mary Joyce Wingler, Neel R. Patel, S. Travis King, Jamie L. Wagner, Katie E. Barber and Kayla R. Stover
Pharmacy 2021, 9(4), 175; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040175 - 26 Oct 2021
Cited by 6 | Viewed by 5034
Abstract
Vancomycin-resistant enterococci (VRE) account for a large proportion of hospital-acquired infections. Determining optimal treatment of VRE urinary tract infections (UTIs) is challenging. The purpose of this study was to determine if a difference in efficacy or safety exists between linezolid and non-linezolid treatments [...] Read more.
Vancomycin-resistant enterococci (VRE) account for a large proportion of hospital-acquired infections. Determining optimal treatment of VRE urinary tract infections (UTIs) is challenging. The purpose of this study was to determine if a difference in efficacy or safety exists between linezolid and non-linezolid treatments for VRE UTIs. This retrospective cohort evaluated patients admitted between 1 June 2012–30 November 2017 who were treated for VRE UTI. Patients must have had at least one sign, symptom, or laboratory confirmation of UTI to be included. The primary endpoint of this study was difference in clinical cure between linezolid and non-linezolid treatment options. Secondary endpoints included 30-day recurrence, 30-day infection-related readmission, inpatient mortality, infection-related hospital length of stay (LOS), and time to appropriate therapy. A total of 45 patients (33 linezolid and 12 non-linezolid) were included. Clinical cure occurred in 71.4% linezolid and 58.3% non-linezolid (p = 0.476). No patients had a 30-day infection-related readmission or 30-day recurrence. Of the 45 patients, 6 (13.3%) patients died during admission, and 5 of those deaths were in the linezolid group (p = 1.000). No significant difference was found for clinical cure between linezolid and non-linezolid treatment options for VRE UTIs. Full article
(This article belongs to the Special Issue Improving Antimicrobial Use in Hospitalized Patients)
11 pages, 578 KiB  
Commentary
Ethical Tenets of PRN Medicines Management in Healthcare Settings: A Clinical Perspective
by Mojtaba Vaismoradi, Cathrine Fredriksen Moe, Flores Vizcaya-Moreno and Piret Paal
Pharmacy 2021, 9(4), 174; https://0-doi-org.brum.beds.ac.uk/10.3390/pharmacy9040174 - 22 Oct 2021
Cited by 1 | Viewed by 3841
Abstract
Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on [...] Read more.
Prescription and administration of pro re nata (PRN) medications has remained a poorly discussed area of the international literature regarding ethical tenets influencing this type of medication practice. In this commentary, ethical tenets of PRN medicines management from the clinical perspective based on available international literature and published research have been discussed. Three categories were developed by the authors for summarising review findings as follows: ‘benefiting the patient’, ‘making well-informed decision’, and ‘follow up assessment’ as pre-intervention, through-intervention, and post-intervention aspects, respectively. PRN medicines management is mainly intertwined with the ethical tenets of beneficence, nonmaleficence, dignity, autonomy, justice, informed consent, and error disclosure. It is a dynamic process and needs close collaboration between healthcare professionals especially nurses and patients to prevent unethical practice. Full article
(This article belongs to the Special Issue PRN Medicines Management)
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