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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 31 August 2024 | Viewed by 22034

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Dr. Kevin T. Fuji

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Guest Editor

Department of Pharmacy Practice, School of Pharmacy and Health Professions, Creighton University, Omaha, NE 68178, USA
Interests: pharmacy; health information technology; patient safety; mixed methods; pharmacy informatics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

As medication therapy experts, pharmacists are responsible for ensuring that patients’ medication therapies are safe, appropriate for their health needs, and effective. Adverse drug events and medication errors are a public health concern, with many being preventable in nature through the use of different interventions and strategies by pharmacists. These include, but are not limited to, medication reconciliation, medication therapy management (MTM) services, chronic disease management services (e.g., diabetes, hypertension), medication error reporting, pharmacist integration into interprofessional care teams, and the use of health information technology in practice (e.g., pharmacy-based clinical decision support, barcode systems, electronic prescribing). This Special Issue focuses broadly on the various ways in which pharmacists contribute to medication safety across different care settings (e.g., community pharmacy, hospital, and home care). This includes not just the strategies listed, but also the education of pharmacy students, postgraduate trainees, and practicing pharmacists. It also includes newer strategies such as utilizing pharmacist expertise to engage patients in medication self-management using patient-facing or patient-centered tools and technologies (e.g., patient portals, and mobile health applications). Innovative strategies including pilot efforts with small sample sizes and limited statistical power, or those that are primarily descriptive in nature are also welcome. A particular focus will be placed on submissions describing the translation of known effective strategies for ensuring medication safety to underserved/under-represented patient populations and/or developing countries.

Dr. Kevin T. Fuji
Guest Editor

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Keywords

Medication safety
pharmacy
pharmacy practice
adverse drug events
medication errors
drug-related problems
medication therapy management
patient safety

Published Papers (9 papers)

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13 pages, 3566 KiB

Open AccessArticle

Developing Medication Review Competency in Undergraduate Pharmacy Training: A Self-Assessment by Third-Year Students

by Aleksi Westerholm, Katja Leiman, Annika Kiiski, Marika Pohjanoksa-Mäntylä, Anita Mistry and Marja Airaksinen

Int. J. Environ. Res. Public Health 2023, 20(6), 5079; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20065079 - 14 Mar 2023

Cited by 3 | Viewed by 1930

Abstract

Pharmacists are increasingly involved in medication history taking, medication reconciliation, and review in their daily practice. The objectives of this study were to investigate third-year pharmacy students’ self-assessed competency in medication reviews and gather their feedback for further development of medication review training in their curriculum. The study was conducted as a self-assessment of third-year pharmacy students at the completion of their second three-month internship period in a community pharmacy in 2017–2018. The students were assigned to review medications of a real patient under the supervision of a medication review accredited pharmacist during their internship. The self-assessment was carried out via an e-form, which was created for this study. Recently established national medication review competence recommendations for pharmacists were used as a reference. Students (n = 95, participation rate: 93%) self-assessed their competency as good or very good in 91% (n = 28) of the competency areas listed in the self-assessment. The highest proportion of competencies that were self-assessed as good or very good included using medication risk management databases and evaluating the clinical importance of the information (97%, n = 92). The lowest proportion of competencies was found in applying clinical information from the key laboratory tests to patient care and knowing which laboratory tests are most important to monitor in each condition and medication (36%, n = 34). The students suggested that their pharmacy education should contain more medication review assignments as group work and that an elective course on medication reviews should be compulsory for all pharmacy students. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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14 pages, 1209 KiB

Open AccessArticle

Evaluation of Knowledge, Attitudes, and Practices about Pharmacovigilance among Community Pharmacists in Qassim, Saudi Arabia

by Suhaj Abdulsalim, Maryam Farooqui, Mohammed Salem Alshammari, Meshal Alotaibi, Abdulfattah Alhazmi, Abdulmajeed Alqasomi and Waleed Mohammad Altowayan

Int. J. Environ. Res. Public Health 2023, 20(4), 3548; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20043548 - 17 Feb 2023

Cited by 2 | Viewed by 2312

Abstract

Background: Pharmacovigilance (PV) is an essential activity to detect adverse drug reactions (ADRs) and ensure patient safety. Hence, we aimed to evaluate knowledge, attitudes, and practices (KAP) regarding PV among community pharmacists in Qassim, Saudi Arabia. Methods: A cross-sectional study was conducted by using a validated questionnaire after obtaining ethical approval from the Deanship of Scientific Research, Qassim University. The sample size was calculated based on the total number of pharmacists in the Qassim area by using Raosoft, Inc. Statistical Package for the Social Sciences version 20 was used for data entry and analysis. Ordinal logistic regression was performed to identify the predictors of KAP. A p-value of <0.05 was considered statistically significant. Results: A total of 209 community pharmacists participated in the study; 62.9% of them defined the PV correctly, and 59% of them defined ADRs correctly. However, only 17.2% knew where to report ADRs. Interestingly, the majority of participants (92.9%) reported that it is necessary to report ADRs, and 73.8% of them were willing to report ADRs. A total of 53.8% of the participants identified ADRs during their careers; however, only 21.9% reported ADRs. Barriers discourage ADR reporting; the majority of the participants (85.6%) do not know how to report ADRs. Conclusion: Community pharmacists who participated in the study were knowledgeable about PV, and their attitude towards reporting ADRs was highly positive. However, the number of reported ADRs was low because of the lack of knowledge on how and where to report ADRs. Continuous education and motivation about ADRs reporting and PV are warranted among community pharmacists for the rational use of medications. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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17 pages, 930 KiB

Open AccessArticle

A Pilot Study on Pharmacists’ Knowledge, Attitudes and Practices towards Medication Dysphagia via Asynchronous Online Focus Group Discussion

by Poh Leng Tan, Terence JunHeng Loh and Sui Yung Chan

Int. J. Environ. Res. Public Health 2023, 20(4), 2858; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph20042858 - 06 Feb 2023

Viewed by 1302

Abstract

Medication dysphagia (MD) refers to difficulty swallowing oral medications. To cope, patients may inappropriately modify or skip medications, leading to poorer outcomes. Little is known about healthcare professionals’ (HCPs’) perspectives in managing MD. This study investigated pharmacists’ knowledge, attitudes, and practices (KAP) in caring for patients with MD. An asynchronous online focus group was pilot tested in seven pharmacists, with up to two questions posted daily on an online platform over 15 days. Thematic analysis of the transcripts revealed five interrelated themes: (1) knowledge about MD; (2) management of MD; (3) expectations of patient proactivity; (4) desire for objectivity; (5) professional roles. The findings provided insight into pharmacists’ KAP and may be incorporated into a full-scale study involving various HCPs. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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21 pages, 401 KiB

Open AccessArticle

Why Did I Consult My Pharmacist about Herbal and Dietary Supplements? An Online Survey Amid the COVID-19 Pandemic in Malaysia

by Mohd Shahezwan Abd Wahab, Muhammad Mustaqim Jalani, Khang Wen Goh, Long Chiau Ming and Erwin Martinez Faller

Int. J. Environ. Res. Public Health 2022, 19(17), 10994; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph191710994 - 02 Sep 2022

Cited by 3 | Viewed by 1792

Abstract

Herbal and dietary supplements (HDSs) are frequently obtained from community pharmacies, but community pharmacists (CPs) have been underutilized for information regarding them. This study aimed to determine the prevalence of, factors behind, and reasons for consultation with CPs among HDS consumers in Malaysia. A cross-sectional study using an online survey was conducted among conveniently sampled individuals in Malaysia. Reasons for consultation or non-consultation with CPs about HDSs were sought from the respondents. A logistic regression analysis was conducted to determine the predictors of consultation with CPs. Overall, 40.3% (239/593) of participants consulted CPs about the HDSs that they purchased. The participants were predominantly unmarried (362/588, 61.6%) and belonged to the 18–29 age group (332/593, 56%). The multivariate analysis showed that a suburban residential setting was the only significant predictor for consultation with CPs (adjusted odds ratio = 0.390, 95% CI = 0.260–0.583). Respondents who consulted CPs generally agreed that the CPs were the right people to consult on HDSs (mean = 4.37, SD = 0.73). However, their discussion with CPs regarding HDSs mostly revolved around the benefits and directions for use, but little on the potential risks. Meanwhile, most respondents who did not consult CPs agreed that they had never thought of consulting CPs about their HDS use (mean = 3.45, SD = 1.02). The majority of them referred to the Internet (61.3%, 217/354) and social media (59.9%, 212/354) for information about HDSs. The findings from this study show that more efforts are warranted in encouraging consumers to consult CPs about their HDS use and to enhance their awareness of the roles of CPs in ensuring the safe use of HDSs. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

12 pages, 1185 KiB

Open AccessArticle

Persistence of Adverse Drug Reaction-Related Hospitalization Risk Following Discharge

by Olive Schmid, Bonnie Bereznicki, Gregory Mark Peterson, Jim Stankovich and Luke Bereznicki

Int. J. Environ. Res. Public Health 2022, 19(9), 5585; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19095585 - 04 May 2022

Cited by 2 | Viewed by 2037

Abstract

This retrospective cohort study analyzed the administrative hospital records of 91,500 patients with the aim of assessing adverse drug reaction (ADR)-related hospital admission risk after discharge from ADR and non-ADR-related admission. Patients aged ≥18 years with an acute admission to public hospitals in Tasmania, Australia between 2011 and 2015 were followed until May 2017. The index admissions (n = 91,550) were stratified based on whether they were ADR-related (n = 2843, 3.1%) or non-ADR-related (n = 88,707, 96.9%). Survival analysis assessed the post-index ADR-related admission risk using (1) the full dataset, and (2) a matched subset of patients using a propensity score analysis. Logistic regression was used to identify the risk factors for ADR-related admissions within 90 days of post-index discharge. The patients with an ADR-related index admission were almost five times more likely to experience another ADR-related admission within 90 days (p < 0.001). An increased risk persisted for at least 5 years (p < 0.001), which was substantially longer than previously reported. From the matched subset of patients, the risk of ADR-related admission within 90 and 365 days more than doubled in the patients with an ADR-related index admission (p < 0.0001). These admissions were often attributed to the same drug class as the patients’ index ADR-related admission. Cancer was a major risk factor for ADR-related re-hospitalization within 90 days; other factors included heart failure and increasing age. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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11 pages, 495 KiB

Open AccessArticle

Community Pharmacists’ Perceptions, Barriers, and Willingness for Offering Sexual and Reproductive Health Services

by Ali Mofleh Alshahrani and Mona Y. Alsheikh

Int. J. Environ. Res. Public Health 2021, 18(20), 10735; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182010735 - 13 Oct 2021

Cited by 4 | Viewed by 2102

Abstract

The role of community pharmacists is crucial for promoting health and providing consultation related to sexual and reproductive health. This study measured the perception of community pharmacists in the Kingdom of Saudi Arabia (KSA) towards the provision of counselling services on sex education and reproductive health, including barriers to and proficiency in the delivery of services. A cross-sectional survey was developed and distributed electronically to pharmacists, and responses were analyzed using SPSS version 26. Graphical representations for various opinions on perception, proficiency and barriers were created. More than 80% of pharmacists placed a high value on counselling patients on sex and reproductive health, about 90% counselled their patients very often (74.6%) or often (22.2%), and 3.2% of pharmacists did not counsel patients. Most respondents believed counselling was very important (65.3%) or important (15.1%), with only 19.6% of respondents indicating it was not important. Barriers to offering services included fear from responsibility and liability (M = 4.8), lack of information about patient health (M = 4.7), gender differences (M = 4.7), and lack of social acceptability (M = 4.6). Community pharmacists in KSA possessed positive attitudes, professional education, and willingness to provide counselling to patients on sex education and reproductive health. Apart from the existing barriers that require augmented community pharmacists’ soft skills, clear policies and authorization for offering this type of service are also needed. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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10 pages, 1700 KiB

Open AccessArticle

Development and Validation of a Trigger Tool for Identifying Drug-Related Emergency Department Visits

by Sung-Hee Hwang, Young-Mi Ah, Kwang-Hee Jun, Jae-Woo Jung, Min-Gyu Kang, Hye-Kyung Park, Eui-Kyung Lee, Hye-Kyung Park, Jee-Eun Chung, Sang-Heon Kim and Ju-Yeun Lee

Int. J. Environ. Res. Public Health 2021, 18(16), 8572; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168572 - 13 Aug 2021

Cited by 1 | Viewed by 2273

Abstract

There are various trigger tools for detecting adverse drug events (ADEs), however, a drug-related emergency department (ED) visit trigger tool (DrEDTT) has not yet been developed. We aimed to develop and validate a DrEDTT with a multi-center cohort. In this cross-sectional study, we developed the DrEDTT consisting of 28 triggers through a comprehensive literature review and three phase expert group discussion. Next, we evaluated the performance of the DrEDTT by applying it to relevant medical records retrieved from four hospitals from January 2016 to June 2016. Two experts performed an in-depth chart review of a 25% of random sample of trigger flagged and unflagged ED visits and a true ADE was determined through causality assessment. Among 66,564 patients who visited the ED for reasons other than traffic accident and trauma during the study period, at least one trigger was found in 21,268 (32.0%) patients. A total of 959 true ADE cases (5.8%) were identified from a randomly selected 25% of ED visit cases. The overall positive predictive value was 14.0% (range: 8.3–66.7%). Sensitivity and specificity of DrEDTT were 77.7% and 70.4%, respectively. In conclusion, this newly developed trigger tool might be helpful to detect ADE-related ED visits. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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8 pages, 297 KiB

Open AccessArticle

Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy

by A Jeong Kim, Hayeon Lee, Eun-Jeong Shin, Eun-Jung Cho, Yoon Sook Cho, Hajeong Lee and Ju-Yeun Lee

Int. J. Environ. Res. Public Health 2021, 18(8), 4370; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18084370 - 20 Apr 2021

Cited by 9 | Viewed by 3403

Abstract

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, “missing patient documentation” was the most common, followed by “adverse effect” and “drug not indicated.” The most frequent intervention was “therapy stopped”. In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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17 pages, 662 KiB

Open AccessSystematic Review

Patient-Reported Questionnaires to Identify Adverse Drug Reactions: A Systematic Review

by Renly Lim, Lisa Kalisch Ellett, Elizabeth E. Roughead, Phaik Yeong Cheah and Nashwa Masnoon

Int. J. Environ. Res. Public Health 2021, 18(22), 11877; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211877 - 12 Nov 2021

Cited by 5 | Viewed by 3483 | Correction

Abstract

Background: This systematic review aims to summarise available patient-reported questionnaires to detect adverse drug reactions (ADRs) that can be utilised by healthcare professionals in clinical practice and to summarise the psychometric properties (validity, reliability, and responsiveness) of the questionnaires. Methods: A systematic literature search was conducted using Medline, Pubmed, Embase, and Emcare databases to screen for articles published between January 2000 and July 2020. Data items regarding validity, reliability, and responsiveness were extracted independently by two authors. The methodological quality was assessed using the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) checklist. Results: A total of 1563 unique article titles were identified after removing duplicates. Following shortlisting of relevant articles, 19 patient-reported ADR questionnaires were identified. Questionnaires most commonly focused on mental health medications (42.1%, n = 8), followed by general questionnaires applicable to any medication (21.1%, n = 4). Many questionnaires did not report assessing the validity and reliability of the measurement tool. For example, only 11 questionnaires (58%) mentioned assessing content validity, in addition to criterion or construct testing. Conclusion: This systematic review summarised the available patient-reported questionnaires that can be used in research and clinical practice to identify ADRs. Results of this systematic review highlight the need for more robust validity and reliability testing when developing patient-reported ADR questionnaires. Full article

(This article belongs to the Special Issue Medication Safety and Pharmacy Practice)

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