Pharmacy

11 pages, 433 KiB

Open AccessArticle

How Do Pharmacists Distribute Their Work Time during a Clinical Intervention Trial?—A Time and Motion Study

by Renata Vesela Holis, Renate Elenjord, Elin Christina Lehnbom, Sigrid Andersen, Marie Fagerli, Tine Johnsgård, Birgitte Zahl-Holmstad, Kristian Svendsen, Marit Waaseth, Frode Skjold and Beate Hennie Garcia

Pharmacy 2024, 12(4), 106; https://doi.org/10.3390/pharmacy12040106 - 9 Jul 2024

Abstract

Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this [...] Read more.

Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this study was to investigate how clinical pharmacists introduced into the ED interdisciplinary teams distribute their work time. In a time and motion study, we used the Work Observation Method By Activity Timing (WOMBAT) to observe pharmacists in two Norwegian EDs. The pragmatic approach allowed pharmacists to adapt to ED personnel and patient needs. The pharmacists spent 41.8% of their work time on medication-related tasks, especially those linked to medication reconciliation, including documenting medication-related issues (16.2%), reading and retrieving written information (9.6%), and obtaining oral information about medication use from patients (9.5%). The remaining time was spent on non-medication-related tasks (41.8%), and on standby and movement (17.4%). In conclusion, ED pharmacists spent 42% of their work time on medication-related tasks, predominantly medication reconciliation. Their relatively new role in the interdisciplinary team may have limited their broader clinical impact. Relative to other ED healthcare professionals, ED pharmacists’ goal remains to ensure accurate patient medication lists and appropriate medication use. Full article

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9 pages, 224 KiB

Open AccessArticle

Adapting the Opening Minds Stigma Scale for Healthcare Providers to Measure Opioid-Related Stigma

by Ashley Cid, Alec Patten, Michael A. Beazely and Kelly Grindrod

Pharmacy 2024, 12(4), 105; https://doi.org/10.3390/pharmacy12040105 - 9 Jul 2024

Abstract

The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a [...] Read more.

The opioid crisis in Canada continues to cause a devastating number of deaths. Community-based naloxone programs have been identified as one of the solutions for combatting this crisis; however, there are disparities in which pharmacies stock and offer naloxone. Opioid-related stigma is a major barrier for limited naloxone distribution through pharmacies. Therefore, the development of anti-stigma interventions is crucial to improve naloxone distribution in Canada. However, there is no validated tool to specifically measure opioid-related stigma. The Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) is a validated scale used to measure mental illness-related stigma. This study will adapt the OMS-HC by using four different opioid-related terminologies to determine which is the most stigmatizing to use in an opioid-related anti-stigma intervention. Pharmacy students completed four versions of the adapted OMS-HC. The average OMS-HC scores and Cronbach’s α co-efficient were calculated for each version. The term “opioid addiction” was found to be the most stigmatizing term among participants and will be used in the adapted version of the OMS-HC in a future anti-stigma interventions. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

20 pages, 724 KiB

Open AccessArticle

Exploring the Perceptions and Behaviours of UK Prescribers Concerning Novel Lipid-Lowering Agent Prescriptions: A Qualitative Study

by Sarah Baig, Shahrauz Mughal, Yousuf Murad, Mandeep Virdee and Zahraa Jalal

Pharmacy 2024, 12(4), 104; https://doi.org/10.3390/pharmacy12040104 - 3 Jul 2024

Abstract

Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers’, [...] Read more.

Reducing low-density lipoprotein cholesterol levels lowers the risk of atherosclerotic cardiovascular disease. With the current and future portfolios of emerging lipid-lowering therapies included in various national and international guidelines, the objectives of this study were (i) to investigate the perceptions of UK prescribers’, including doctors, pharmacists, and nurses, on current lipid management for cardiovascular diseases and prescriptions of novel lipid-lowering therapies, and (ii) to explore the challenges and facilitating factors of prescribing novel lipid-lowering therapies through qualitative interviews. Qualitative semi-structured interviews with twelve medical and non-medical prescribers were conducted, around 20–30 min in length. The interviews were audio-recorded and transcribed on an online platform. A thematic analysis was deployed. Four major themes emerged from the analysis: (1) prescribing barriers; (2) prescribing enablers; (3) inter-profession variability; and (4) health literacy. These themes highlighted the contrast between the need for optimal shared decision making and the various constraints in practice. Participants expressed their inexperience with novel lipid-lowering therapies and acknowledged the requirement and importance of these agents for primary cardiovascular disease prevention. Participants recognised confidence and competence as key drivers for prescribing therapies and welcomed further education and training to enhance their skillset. Patients’ misconceptions towards current lipid-lowering therapies contributed to their refusal of newer agents, highlighting a requirement to improve patient education. Targeting communities through awareness campaigns was identified as a viable solution. Full article

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12 pages, 256 KiB

Open AccessPerspective

Nutrition’s Role in Quality Healthcare in the United States: Opportunities and Education for Pharmacists to Take a Bite of the Apple and Strengthen Their Skills

by Jeff Cai, Andie Lee Gonzalez and Mary Beth Arensberg

Pharmacy 2024, 12(4), 103; https://doi.org/10.3390/pharmacy12040103 - 29 Jun 2024

Abstract

With global chronic disease rates on the rise, diet and nutrition remain pivotal yet under-appreciated aspects of healthcare, including in pharmacy practice. This perspective paper delves into how current United States health policies support nutrition’s role in healthcare and its integration into pharmacy [...] Read more.

With global chronic disease rates on the rise, diet and nutrition remain pivotal yet under-appreciated aspects of healthcare, including in pharmacy practice. This perspective paper delves into how current United States health policies support nutrition’s role in healthcare and its integration into pharmacy practice. The paper also reviews the landscape of nutrition education and training for pharmacists, pharmacy roles in multidisciplinary teams and interprofessional nutrition care, and the opportunities for post-graduate nutrition-focused certification, training, and continuing education. It advocates for a paradigm shift towards greater emphasis on nutrition within pharmacy practice, to improve skills and benefit quality patient nutrition care. Full article

(This article belongs to the Special Issue Pharmacy: State of the Art and Perspectives in USA (2nd Edition))

14 pages, 10419 KiB

Open AccessArticle

Dynamic Changes in the Distribution of Hydrocodone and Oxycodone in Florida from 2006 to 2021

by Elena Lynn Stains, Akshay C. Patel, Jay P. Solgama, Joseph D. Hagedorn, Kenneth L. McCall and Brian J. Piper

Pharmacy 2024, 12(4), 102; https://doi.org/10.3390/pharmacy12040102 - 28 Jun 2024

Abstract

Background: Florida, which led the country in terms of its number of opioid-prescribing physicians, was unique during the height of the opioid epidemic because of its lax prescribing laws and high number of unregulated pain clinics. Here, we address differences in the distribution [...] Read more.

Background: Florida, which led the country in terms of its number of opioid-prescribing physicians, was unique during the height of the opioid epidemic because of its lax prescribing laws and high number of unregulated pain clinics. Here, we address differences in the distribution rates of oxycodone and hydrocodone across Florida counties during the peak years of the opioid epidemic using an under-utilized database. Methods: The Washington Post and the United States Drug Enforcement Administration’s Automation of Reports and Consolidated Orders System (ARCOS) databases provided longitudinal oxycodone and hydrocodone distribution data in grams per county (2006–2014) and state (2006–2021). Grams of oxycodone and hydrocodone were converted into morphine milligram equivalents (MMEs). Results: There was a steep increase in oxycodone from 2006 to 2010, with a subsequent decline. In 2010, the average MME per person across Florida was 729.4, a 120.6% increase from 2006. The three counties with the highest MMEs per person in 2010 were Hillsborough (2271.3), Hernando (1915.3), and Broward (1726.9), and they were significantly (p < 0.05) elevated relative to the average county. Conclusions: The data demonstrated pronounced differences in opioid distribution, particularly oxycodone, between Florida counties during the height of the opioid epidemic. Legislative action taken between 2009 and 2011 aligns with the considerable decline in opioid distribution after 2010. Full article

(This article belongs to the Special Issue Pharmacists’ Role in Reducing Problematic Opioid Use)

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13 pages, 707 KiB

Open AccessArticle

Adolescent Perspectives on the Pharmacy-Based T-EVER (Teen E-Cigarette and Vaping Educational Resource) and Its Potential Impact on Youth Vaping

by Grace C. Klubertanz, McKennah J. Matulle, Jenny S. Li and Olufunmilola Abraham

Pharmacy 2024, 12(4), 101; https://doi.org/10.3390/pharmacy12040101 - 28 Jun 2024

Abstract

Background: While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be [...] Read more.

Background: While public health efforts have made tobacco smoking near obsolete among adolescents, vaping products are quickly taking their place. With the negative health consequences looming ahead of young vapers, there is a desperate need to curb youth vaping. Adolescents want to be actively engaged in their health which creates space to educate on vaping in this population segment. Methods: From January to May 2023, 35 adolescents aged 11–18 participated in interviews to assess the investigator-developed Teen E-cigarette and Vaping Educational Resource (T-EVER). All the interviews were recorded and transcribed for independent analysis by two study team members. Results: The participants liked the T-EVER, indicating they were engaged in the content. However, some participants wanted more information. The participants wanted health professionals to educate them on vaping but were worried about the potential barriers facing the implementation in community pharmacy settings. Conclusions: Adolescents want to learn about vaping, but there are limited opportunities to do so. The T-EVER is designed to educate youth about vaping. This tool was well received and has the potential to be used by pharmacists as a vaping prevention and cessation intervention. More research is required to discern the true scope of the pharmacist’s role in using an educational tool to address adolescent vaping. Full article

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20 pages, 364 KiB

Open AccessReview

Exploring the Significance of Pharmaceutical Care in Mental Health: A Spotlight on Cannabis

by Claudete da Costa-Oliveira, Michele Lafayette Pereira, Nicole Ferrari de Carvalho, Luiza Aparecida Luna Silvério, Ygor Jessé Ramos and Priscila Gava Mazzola

Pharmacy 2024, 12(4), 100; https://doi.org/10.3390/pharmacy12040100 - 27 Jun 2024

Abstract

Although preliminary evidence suggests Cannabis’s efficacy in symptom control for anxiety and depression—psychiatric disorders that significantly impact mental health—much remains to be understood about its effects on the central nervous system (CNS) and how to optimize treatment for these disorders. This study [...] Read more.

Although preliminary evidence suggests Cannabis’s efficacy in symptom control for anxiety and depression—psychiatric disorders that significantly impact mental health—much remains to be understood about its effects on the central nervous system (CNS) and how to optimize treatment for these disorders. This study aims to conduct a narrative review to evaluate pharmaceutical care in treating symptoms of anxiety and depression alongside Cannabis use, focusing on safety and therapeutic efficacy optimization. We seek to conceptualize anxiety and depression disorders, review evidence on Cannabis use, evaluate the evidence quality, and identify knowledge gaps. Twelve articles were identified, revealing a significant gap in the literature regarding the integration of pharmaceutical care with Cannabis-based therapies, specifically for anxiety and depression. Despite a growing interest in the relationship between Cannabis and mental health, current research is insufficient for a comprehensive understanding. The relationship between Cannabis use and anxiety and depression disorders requires further, more targeted investigations. This study underscores the importance of future research to fill existing gaps, providing informed insights and robust guidelines for the safe and effective use of Cannabis as part of the treatment for anxiety and depression. It is crucial that pharmaceutical care integrates these therapies responsibly to improve the overall well-being of patients. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

10 pages, 864 KiB

Open AccessArticle

Considering the Possible Role of Pharmacists According to the Presence or Absence of Lifestyle-Related Diseases at the Time of Coronary CT Examination and Trends of Medication Use for These Diseases by Medical Doctors

by Erika Miura-Takahashi, Kohei Tashiro, Yuhei Shiga, Yuto Kawahira, Sara Higashi, Yuki Otsu, Hidetoshi Kamimura and Shin-ichiro Miura

Pharmacy 2024, 12(4), 99; https://doi.org/10.3390/pharmacy12040099 - 27 Jun 2024

Abstract

Background: Because patients often already have coronary artery disease (CAD) at the time of a coronary artery computed tomography angiography (CCTA) examination, we examined the medications prescribed by medical doctors for lifestyle-related diseases and investigated what possible role pharmacists can play in prescribing. [...] Read more.

Background: Because patients often already have coronary artery disease (CAD) at the time of a coronary artery computed tomography angiography (CCTA) examination, we examined the medications prescribed by medical doctors for lifestyle-related diseases and investigated what possible role pharmacists can play in prescribing. Methods: Patients (n = 1357) who underwent CCTA examination were divided into two groups according to the presence or absence of lifestyle-related diseases [hypertension (HTN), dyslipidemia (DL) and diabetes mellitus (DM)], and the relationship between the presence or absence of CAD was examined. Results: The rate of CAD was significantly higher in patients with HTN, DL or DM than in patients without these diseases. The blood pressure in the HTN group was 140 ± 20/79 ± 13 mmHg, the low-density lipoprotein cholesterol value in the DL group was 119 ± 35 mg/dL, and the hemoglobin A1c value in the DM group was 7.0 ± 1.1%, all of which were poorly controlled. Anti-hypertensive drugs were used at low rates in the HTN group, statins were used in 47% and ezetimibe was used in 4% of the DL group, and dipeptidyl peptidase-4 inhibitors were used in 41% of the DM group. Conclusions: Since the rate of CAD (+) was high and control of the three major lifestyle-related diseases was poor, pharmacists should advise medical doctors to use combinations of drugs. Full article

(This article belongs to the Special Issue Innovations in Clinical Pharmacy: Towards Optimized Patient Care)

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21 pages, 5487 KiB

Open AccessSystematic Review

Pharmacists’ Willingness to Offer Vaccination Services: A Systematic Review and Meta-Analysis

by Arit Udoh, Desak Ernawati, Ifunanya Ikhile and Asma Yahyouche

Pharmacy 2024, 12(4), 98; https://doi.org/10.3390/pharmacy12040098 - 26 Jun 2024

Abstract

Pharmacy-based vaccination (PBV) services increase coverage and enhance access to lifesaving vaccines. This systematic review assessed the proportion of pharmacists willing to offer PBV services. PubMed/MEDLINE, CINAHL, EMBASE and Scopus electronic databases were searched from inception to identify relevant literature. Google scholar and [...] Read more.

Pharmacy-based vaccination (PBV) services increase coverage and enhance access to lifesaving vaccines. This systematic review assessed the proportion of pharmacists willing to offer PBV services. PubMed/MEDLINE, CINAHL, EMBASE and Scopus electronic databases were searched from inception to identify relevant literature. Google scholar and other sources of grey literature was also searched. The literature findings were synthesized narratively, and via a random-effects meta-analysis. Risk of bias was evaluated using nine quality assessment criteria adapted from the Joanna Briggs Institute checklist for prevalence studies. The review protocol is registered on PROSPERO (REF: CRD42021293692). In total, 967 articles were identified from the literature search. Of this, 34 articles from 19 countries across 5 WHO regions were included in the review. No article from the Western Pacific WHO region was identified. Most of the included studies (n = 21, 61.8%) showed an overall low risk of bias. None showed a high risk of bias. Pooled willingness for PBV services was 69.45% (95% CI: 61.58–76.33; n total pharmacists = 8877), indicating that most pharmacists were willing to offer the service, although nearly a third were not. Pharmacists’ willingness was highest in the Americas (71.49%, 95% CI: 53.32–84.63, n pharmacists = 3842) and lowest in the African region (58.71%, 95% CI: 45.86–70.46, n pharmacists = 1080) although the between-group difference was not statistically significant across the WHO regions (Q = 3.01, df = 4, p < 0.5567). Meta-regression showed no evidence (R² = 0%, p = 0.9871) of the moderating effect of the type of vaccine assessed, PBV service availability, sampling technique and the study risk of bias. These findings show that most pharmacists are willing to offer PBV services; however, strategies that will enhance greater involvement in service provision are needed. Full article

(This article belongs to the Special Issue Pharmacy: State-of-the-Art and Perspectives in UK)

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13 pages, 3009 KiB

Open AccessArticle

Development of an Educational Brochure about Treatment Options for Pregnant Women with Opioid Use Disorders

by Ruth Jeminiwa, Sohyeon Park, Caroline Popielaski, Meghan Gannon, Ronald Myers and Diane J. Abatemarco

Pharmacy 2024, 12(4), 97; https://doi.org/10.3390/pharmacy12040097 - 22 Jun 2024

Abstract

The goal of this study was to describe the development of an educational brochure for pregnant women with opioid use disorders (OUDs) about treatment options. Based on findings from a preliminary review of the literature, we drafted a brochure that addressed the following [...] Read more.

The goal of this study was to describe the development of an educational brochure for pregnant women with opioid use disorders (OUDs) about treatment options. Based on findings from a preliminary review of the literature, we drafted a brochure that addressed the following questions: (1) What are your options (Medication-Assisted Treatment (MAT) versus no treatment)? (2) What are the benefits of MAT? (3) What are the risks of MAT? (4) Can I take buprenorphine or methadone while breastfeeding? (5) Which medication should I choose? Clinicians and doulas (n = 19) who provide care to pregnant women with OUDs were recruited. Semi-structured interviews elicited participants’ feedback on brochure content and their perceptions about brochure use for patient education. Thematic data analyses were performed. Three emergent themes were identified (suggested uses and settings of use, content revisions, and perceptions about the brochure) and used to refine the final brochure. This study provides valuable insights into the desired content of an educational brochure describing treatment options for pregnant women with OUDs from the provider’s standpoint. Research is needed to assess the use of the brochure in shared decision-making conversations with providers about treatment. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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18 pages, 1039 KiB

Open AccessReview

Identifying Pertinent Digital Health Topics to Incorporate into Self-Care Pharmacy Education

by Jason C. Wong, Luiza Hekimyan, Francheska Anne Cruz and Taylor Brower

Pharmacy 2024, 12(3), 96; https://doi.org/10.3390/pharmacy12030096 - 20 Jun 2024

Abstract

The ever-evolving landscape of digital health technology has dramatically enhanced patients’ ability to manage their health through self-care effectively. These advancements have created various categories of self-care products, including medication management, health tracking, and wellness. There is no published research regarding integrating digital [...] Read more.

The ever-evolving landscape of digital health technology has dramatically enhanced patients’ ability to manage their health through self-care effectively. These advancements have created various categories of self-care products, including medication management, health tracking, and wellness. There is no published research regarding integrating digital health into pharmacy self-care courses. This study aims to identify pertinent digital health devices and applications to incorporate into self-care course education. Digital health limitations, challenges incorporating digital health in self-care pharmacy education, and potential solutions are also reviewed. In conducting this research, many resources, including PubMed, APhA, ASHP, fda.gov, and digital.health, were reviewed in March 2024 to gather information on digital health devices and applications. To supplement this, targeted keyword searches were conducted on topics such as “digital health”, “devices”, “applications”, “technology”, and “self-care” across various online platforms. We identified digital health devices and applications suitable for self-care education across eight topics, as follows: screening, insomnia, reproductive disorders, eye disorders, home medical equipment, GI disorders, pediatrics, and respiratory disorders. Among these topics, wellness screening had the most digital health products available. For all other topics, at least three or more products were identified as relevant to self-care curriculum. By equipping students with digital health knowledge, they can effectively apply it in patient care throughout their rotations and future practice. Many digital health products, including telemedicine, electronic health records, mobile health applications, and wearable devices, are ideal for inclusion in pharmacy curriculum as future educational material. Future research is needed to develop the best strategies for incorporating relevant digital health into self-care education and defining the best student-learning strategies. Full article

(This article belongs to the Special Issue Digital Health in Pharmacy Practice and Education)

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14 pages, 280 KiB

Open AccessReview

Interventions to Expand Community Pharmacists’ Scope of Practice

by Zaynah Zureen Ali, Helen Skouteris, Stephanie Pirotta, Safeera Yasmeen Hussainy, Yi Ling Low, Danielle Mazza and Anisa Rojanapenkul Assifi

Pharmacy 2024, 12(3), 95; https://doi.org/10.3390/pharmacy12030095 - 19 Jun 2024

Abstract

Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed [...] Read more.

Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed a scoping review to identify randomised controlled trials (RCTs), published worldwide from 2013 to 2024, which focused on interventions designed to expand pharmacists’ scope of practice in the community. The review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews. To address the aim of this scoping review, the included RCTs were mapped to themes influenced by the Professional Practice Standards 2023 as developed by the Pharmaceutical Society of Australia: medication management, collaborative care and medication adherence. Results: Twelve studies demonstrated the potential to expand community pharmacists’ scope of practice. Two RCTs resulted in no effect of the intervention. One RCT (conducted in Italy) led to an actual change to community pharmacists’ scope of practice, with a statistically significant improvement in the proportion of patients with controlled asthma. Conclusions: On the whole, this scoping review synthesised the findings of peer-reviewed RCT studies that revealed expanding community pharmacists’ scope of practice may result in improved patient outcomes, a reduced burden for the healthcare system, and greater productivity. Full article

10 pages, 554 KiB

Open AccessReview

Examining the Impact of the World Health Organization 2022 Guidelines on Evaluation of Biosimilars for Non-Local Comparators in Biosimilar Studies on Middle East and North Africa Member States

by Michael W. Strand and Jonathan H. Watanabe

Pharmacy 2024, 12(3), 94; https://doi.org/10.3390/pharmacy12030094 - 16 Jun 2024

Abstract

Global support and standardization of regulation for biosimilars approval owes much of its legacy to the World Health Organization (WHO), since the first guidance by the organization on the matter was released in 2009. Since then, and with over a decade of research, [...] Read more.

Global support and standardization of regulation for biosimilars approval owes much of its legacy to the World Health Organization (WHO), since the first guidance by the organization on the matter was released in 2009. Since then, and with over a decade of research, the 2022 revision provides opportunities for time and financial savings to pharmaceutical manufacturers aiming to prove similarity of a potential biosimilar product to some reference product, particularly by clarifying that the use of a non-local reference product as a comparator in certain studies is permissible. This declaration has important implications, particularly in the emerging biological markets of the Middle East and North Africa region, where WHO guidelines have been integral to the regulatory framework of over a dozen countries for more than a decade. This article aims to review the impact of this revision on these countries and relevant policies on non-local comparator usage. Since 2022, this revision has been adopted only in Egypt. Many North African countries are yet to adopt a first draft of the formalized guidance. This analysis revealed that, although many of these countries reference the WHO guidelines, hesitation remains in terms of sourcing comparator products outside the US or European countries. This likely translates to slow regional development and cooperation of functioning, sustainable biosimilars markets. Future studies will be necessary to evaluate the continued development of guidance within these countries and changes in comparator sourcing norms as more time is allowed for their policies to mature and adapt to new standards. Full article

(This article belongs to the Special Issue Pharmacy Reviews in 2022)

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12 pages, 1724 KiB

Open AccessArticle

Excessive Self-Medication with Prescription NSAIDs: A Cross-Sectional Study in Kosovo

by Gentiana Krasniqi, Ilirjeta Qeriqi, Genta Qeriqi, Rajmonda Borovci, Daniela Zenelaj, Fehmi Rrahmani, Manushaqe Kryeziu-Rrahmani and Nderim Kryeziu

Pharmacy 2024, 12(3), 93; https://doi.org/10.3390/pharmacy12030093 - 12 Jun 2024

Abstract

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, fever, and inflammation. Although most are usually classified as prescription-only medicines, in many countries they are frequently purchased for self-medication purposes. This study explores NSAID-usage patterns in Kosovo, aiming for a safer and [...] Read more.

Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, fever, and inflammation. Although most are usually classified as prescription-only medicines, in many countries they are frequently purchased for self-medication purposes. This study explores NSAID-usage patterns in Kosovo, aiming for a safer and more effective medicinal use. The study employed a dual approach to collect data. First, NSAID sales were analyzed in a convenience sample of ten community pharmacies across diverse regions in Kosovo in 2023. Second, data on NSAID-usage patterns and patient awareness were systematically gathered from 410 patients during routine pharmacist–patient interactions. The four most commonly purchased NSAIDs according to sales analysis were diclofenac (33.1%), ketoprofen (27.6%), ibuprofen (17.0%) and nimesulide (12.7%). A significant 74.8% of NSAIDs were bought without prescriptions, particularly among younger adults (20–39 years), who accounted for 82.8% of such purchases. The predominant reason for NSAID use was headache (43.8%). Although many of the patients suffered from occasional (33.7%) or frequent (12.6%) stomachaches and took acid-lowering medicines, the majority (85.9%) could not recall any NSAID adverse reactions. This study exposes widespread self-medication and a significant lack of awareness regarding potential risks of NSAIDs, particularly among young adults. To address these issues, it is critical to improve dispensing practices through increased pharmacist awareness and stricter law enforcement. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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11 pages, 608 KiB

Open AccessOpinion

Decoding Clozapine-Induced Agranulocytosis: Unraveling Interactions and Mitigation Strategies

by Ali Alalawi, Enas Albalawi, Abdullah Aljohani, Abdullah Almutairi, Abdulraouf Alrehili, Areej Albalawi and Ahmed Aldhafiri

Pharmacy 2024, 12(3), 92; https://doi.org/10.3390/pharmacy12030092 - 12 Jun 2024

Abstract

Agranulocytosis represents a severe complication associated with the administration of clozapine. Clozapine is an antipsychotic medication that has demonstrated substantial efficacy in remediating refractory schizophrenia and various other psychiatric disorders. Nonetheless, it is crucial to monitor patients for neutropenia regularly during clozapine therapy. [...] Read more.

Agranulocytosis represents a severe complication associated with the administration of clozapine. Clozapine is an antipsychotic medication that has demonstrated substantial efficacy in remediating refractory schizophrenia and various other psychiatric disorders. Nonetheless, it is crucial to monitor patients for neutropenia regularly during clozapine therapy. Therefore, this article aimed to delve into the prevalence of agranulocytosis during clozapine treatment by scrutinizing the extant literature to discern trends and correlations. This review endeavored to explore factors such as drug interactions, dose-related factors, duration of treatment, and genetic predispositions that could potentially influence the likelihood of patients developing agranulocytosis while undergoing clozapine therapy. Moreover, this review enunciates the ramifications of agranulocytosis on both patients and healthcare providers and meticulously evaluates the strategies to mitigate this risk and ensure optimal patient outcomes. Full article

(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)

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12 pages, 864 KiB

Open AccessArticle

Using Team-Based Learning to Teach Pharmacology within the Medical Curriculum

by Nora L. D. Luitjes, Gisela J. van der Velden and Rahul Pandit

Pharmacy 2024, 12(3), 91; https://doi.org/10.3390/pharmacy12030091 - 12 Jun 2024

Abstract

The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation [...] Read more.

The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation highlighted students’ appreciation for pharmacology teaching, but students admitted to attending these teaching moments unprepared, resulting in passive learning. To address this, team-based learning (TBL) was implemented to facilitate learning through interaction, critical thinking, problem solving and reflection through six steps, from superficial to deeper cognitive learning. This study, conducted over two academic years, assessed students’ perception and performance regarding TBL. Analysis of a digital questionnaire using a 5-point Likert scale showed high student satisfaction with TBL as a teaching methodology. However, confidence in pharmacology knowledge following TBL was moderate. TBL attendees outperformed non-attendees in pharmacology-related exam questions, indicating that TBL has a positive impact on student performance. We conclude that TBL is an engaging and effective method for pharmacology education, positively influencing student learning and performance. This method could be broadly applied for teaching pharmacology within the medical curriculum or other biomedical programs. Full article

(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)

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13 pages, 531 KiB

Open AccessArticle

The Association between Academic Performance and Entry-to-Practice Milestones within a Co-Operative Education PharmD Program

by Ali Syed, Yuying Huang, Joslin Goh, Sarah Moroz, John Pugsley, Nancy M. Waite and Sherilyn K. D. Houle

Pharmacy 2024, 12(3), 90; https://doi.org/10.3390/pharmacy12030090 - 11 Jun 2024

Abstract

Research on associations between student performance in pharmacy programs and entry-to-practice milestones has been limited in Canada and in programs using a co-operative (co-op) education model. Co-op exposes students to a variety of opportunities both within direct patient care roles and in non-traditional [...] Read more.

Research on associations between student performance in pharmacy programs and entry-to-practice milestones has been limited in Canada and in programs using a co-operative (co-op) education model. Co-op exposes students to a variety of opportunities both within direct patient care roles and in non-traditional roles for pharmacists, such as policy, advocacy, insurance, research, and the pharmaceutical industry. The purpose of this research is to analyze associations between student grades and evaluations achieved in the University of Waterloo (UW) Doctor of Pharmacy (PharmD) co-op program and success rates on entry-to-practice milestones, including the Pharmacy Examining Board of Canada (PEBC) Pharmacist Qualifying Examination and performance on final-year clinical rotations. Grades and evaluations from courses, co-op work terms, clinical rotations, and PEBC exam data from three graduating cohorts were obtained. A multiple regression analysis was performed to explore associations between student evaluations and PEBC Pharmacist Qualifying Examination and clinical rotation performance. Holding all other variables constant, grades in anatomy/physiology were negatively correlated with scores on the PEBC Pharmacist Qualifying Examination, while grades in one of the professional practice courses showed a positive relationship with the same examination. Students with higher grades in a problem-based learning capstone therapeutics course, in their first co-op work term, and in the direct patient care co-op work term tended to score higher on clinical rotations. Co-op performance was not significant in predicting PEBC performance. However, complimentary descriptive analysis underscored that students with a co-op rating of good or below were more likely to fail courses, midpoint evaluations, Objective Structured Clinical Examinations (OSCEs), and PEBC measures. Multiple predictors of performance on final-year clinical rotations and the PEBC Pharmacist Qualifying Examination were identified. This predictive model may be utilized to identify students at risk of underperforming and to facilitate early intervention and remediation programs, while also informing curricular revision. Full article

(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)

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12 pages, 441 KiB

Open AccessArticle

Mental Health Evaluation in Community Pharmacies—A Cross-Sectional Study

by Mónica Condinho, Isabel Ramalhinho, Catarina Vaz-Velho and Carlos Sinogas

Pharmacy 2024, 12(3), 89; https://doi.org/10.3390/pharmacy12030089 - 7 Jun 2024

Abstract

Portugal has a high prevalence of anxiety and depression, and community pharmacists are well-placed to identify mental health problems and monitor their treatment. This study aimed to screen undiagnosed people for symptoms of anxiety and depression and to monitor these conditions in diagnosed [...] Read more.

Portugal has a high prevalence of anxiety and depression, and community pharmacists are well-placed to identify mental health problems and monitor their treatment. This study aimed to screen undiagnosed people for symptoms of anxiety and depression and to monitor these conditions in diagnosed patients. We conducted an observational, cross-sectional study of a sample of community pharmacy users. Anxiety and depression symptoms were assessed using the Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Altogether, 591 participants were enrolled between September 2020 and July 2021, 74.9% of whom were female. Of the 477 undiagnosed participants who completed the GAD-7, 87 (18.2%) had moderate or severe anxiety symptoms. Of the 485 participants who completed the PHQ-9, 59 (12.1%) had moderate or severe symptoms of depression. Of the 94 patients diagnosed with anxiety, 37 (39.4%) reported moderate to severe symptoms. Similarly, of the 97 patients with depression, almost half (49.5%) reported moderate to severe symptoms. Anxiety levels were lower among men and among those who reported not taking any medication (p < 0.001). Moderate or severe symptoms of depression were more common among women (p < 0.001), participants with lower education levels (p < 0.005), participants who live alone (p < 0.007), and those taking medication for insomnia (p < 0.001), pain (p < 0.001), anxiety (p < 0.001), and/or depression (p < 0.001). Screening for anxiety and depression revealed that a significant proportion of undiagnosed participants had clinically relevant symptoms of anxiety and depression. However, among participants diagnosed with anxiety and depression, between 40% and 50% were uncontrolled, respectively. These data highlight pharmacists’ role in identifying customers at risk of anxiety and depression as well as the need for better monitoring of those already diagnosed. Full article

(This article belongs to the Section Pharmacy Practice and Practice-Based Research)

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15 pages, 573 KiB

Open AccessArticle

Exposure of Pharmacists and Pharmacy Technicians to Violence in Community Pharmacies in Southeast Europe: Frequency and Ethical Considerations

by Monika Popčević, Tanja Javorina, Miljenko Košiček and Arijana Meštrović

Pharmacy 2024, 12(3), 88; https://doi.org/10.3390/pharmacy12030088 - 4 Jun 2024

Abstract

Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types [...] Read more.

Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types of violence, as well as the common perpetrators that community pharmacy staff in SEE (Southeast Europe) are dealing with. A cross-sectional study was conducted using an online questionnaire created for this purpose. Selected community pharmacies in Croatia, Serbia, Bosnia and Herzegovina, and Montenegro participated in this study. In total, 732 responses were collected from 24 pharmacy chains or independent pharmacies including all community pharmacy staff. More than 80% of pharmacists and pharmacy technicians reported having been exposed to verbal violence at the workplace, while more than 20% of them reported physical and sexual violence in the preceding 12 months. There were no statistically significant differences between pharmacists and pharmacy technicians, gender, age groups, or countries in relation to exposure to physical, verbal, and sexual violence. The most common perpetrators were identified as patients/clients. More than 90% of pharmacy staff reported they did not receive any kind of support from their employer nor any other help after experiencing a robbery. There is a need for a structured approach to addressing violence in pharmacies including organized support for pharmacy staff. Achieving quality patient care, despite dealing with violent individuals or situations daily, is one of the greatest ethical challenges for healthcare providers in community pharmacies to be empowered. Full article

(This article belongs to the Special Issue Professional Ethics in Pharmacy: Exploring Contemporary Challenges and Future Directions)

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