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Journal of the American Pharmacists... 2023Long-acting injectable antipsychotic (LAIA) medications offer an effective treatment option for patients with serious mental illness. Despite demonstrated clinical...
BACKGROUND
Long-acting injectable antipsychotic (LAIA) medications offer an effective treatment option for patients with serious mental illness. Despite demonstrated clinical safety and efficacy as well as increased adherence and less frequent administration compared with daily oral regimens, LAIAs remain underutilized in clinical practice. With legislation allowing pharmacists to administer injectable medications in 48 U.S. states, community pharmacies are uniquely positioned to serve as an access point for patients with serious mental illnesses to receive LAIA injections.
OBJECTIVE
This study aimed to conduct a systematic review of the health and economic benefits and costs of community pharmacist administration of LAIA medications.
METHODS
A systematic search of the literature published from January 1996 to April 2022 was conducted across 3 databases (Embase, PubMed, and Scopus Plus). Publications describing pharmacist administration of LAIA medications in outpatient settings were included. Publications that examined the use of LAIAs but did not involve a pharmacist administering the medication were excluded.
RESULTS
Of 2261 publications reviewed, we identified 8 publications (4 articles and 4 abstracts) that met our inclusion criteria, of which only 7 included results. Four studies reported high medication adherence achieved by patients receiving pharmacist-administered LAIAs. Two publications surveyed patient satisfaction with pharmacist administration of LAIAs in community pharmacy settings. One study found pharmacists' mixed attitudes regarding LAIA administration and time and safety barriers to offering the service.
CONCLUSION
We found very little evidence on the impact of pharmacist administration of LAIAs on patient outcomes. This review highlights the need to generate greater evidence on the health and economic benefits as well as financial models for pharmacists to administer LAIA medications in outpatient and community pharmacy settings. Such evidence could support more community pharmacists to offer LAIA medications and contribute to the shift toward value-based care.
Topics: Humans; Pharmacists; Antipsychotic Agents; Injections; Treatment Outcome; Patient Satisfaction; Community Pharmacy Services
PubMed: 36740528
DOI: 10.1016/j.japh.2022.08.006 -
Pharmacy Practice 2022The people who use complementary medicines (CMs) believe that these medicines are safe and harmless. They could easily access CMs like herbal or traditional medicines in...
BACKGROUND
The people who use complementary medicines (CMs) believe that these medicines are safe and harmless. They could easily access CMs like herbal or traditional medicines in community pharmacies. Therefore, community pharmacists are important professionals in advising the safe choices of CMs and providing evidence-based information for customers to decrease adverse effects of CMs.
OBJECTIVES
To systematically review knowledge, attitude, and practices of community pharmacists about CMs, and the factors associated with CM practices of dispensing, recommending and counseling patients, and answering the patients' queries.
METHOD
An electronic search was performed with four databases: PubMed, Scopus, SpringerLink and ScienceDirect, from 1990 to 19th May 2022. The inclusion criteria were studies 1) about knowledge, attitude, and/or practices of community pharmacists about CMs, 2) written in English, 3) conducted with quantitative methods, and 4) able to retrieve full text.
RESULTS
Twenty-three studies were included in this systematic review. Some studies showed that less than half of the pharmacists asked or counselled about CMs to their patients and answered the patients' queries about CMs. Only 20% of the pharmacists did report CM side-effects. Training or education about CMs was a common factor associated with the CM practice of dispensing, recommending, counseling, and answering the patients' queries about CMs. CMs recommended most by community pharmacists were vitamins & minerals, food or dietary supplements, fish oil and probiotics. The most common dispensed CMs were vitamins & minerals, herbs, food or dietary supplements, fish oil and essential oils. Lacks of reliable information sources and scientific evidence were common barriers for the CM practices. Being less expensive than conventional medicines motivated the pharmacists to recommend and discuss about CMs. The community pharmacists that participated in included studies suggested strengthening CM trainings and highlight the pharmacist role in CM therapy.
CONCLUSION
A high percentage of community pharmacists did dispense CMs to their patients, while a low percentage of the pharmacists did report CM side effects. Pharmacists were most comfortable recommending and responding the patients' CM queries. Training or education about CMs associated with CM dispensing, recommending, discussing, and answering the patients' queries about CMs was recommended.
PubMed: 36733509
DOI: 10.18549/PharmPract.2022.3.2697 -
BMC Health Services Research Jan 2023Community pharmacists actively engage in managing the health of local residents, but the COVID-19 pandemic has necessitated rapid adaptations in practice activities. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Community pharmacists actively engage in managing the health of local residents, but the COVID-19 pandemic has necessitated rapid adaptations in practice activities.
OBJECTIVES
We sought to identify the specific adaptations in practice and the expanded roles of community pharmacists in response to the COVID-19 pandemic.
METHODS
We conducted a systematic review of published studies reporting the tasks of pharmacists in community pharmacies or who were involved in pharmacy practices addressing the pandemic. Two investigators independently searched PubMed (December 2019-January 2022) for eligible articles. We conducted a meta-analysis to measure the frequencies of practical activities by pharmacists in response to COVID-19.
RESULTS
We identified 30 eligible studies. Meta-analysis of these studies found that the most commonly reported adaptation in pharmacist practice activities was modifying hygiene behaviors, including regular cleaning and disinfection (81.89%), followed by maintaining social distance from staff and clients (76.37%). Educating clients on COVID-19 was reported by 22 studies (72.54%). Telemedicine and home delivery services were provided to clients by 49.03 and 41.98% of pharmacists, respectively.
CONCLUSIONS
The roles of community pharmacists in public health activities have adapted and expanded in response to COVID-19, notably by incorporating public health education activities.
Topics: Humans; COVID-19; Pharmacists; Pandemics; Community Pharmacy Services; Professional Role
PubMed: 36691043
DOI: 10.1186/s12913-023-09071-w -
International Journal of Clinical... Apr 2023Recent legal changes in Germany entitle patients on multiple medications to receive a medication review (MR). However, the provision of MRs is not mandatory and pharmacy...
BACKGROUND
Recent legal changes in Germany entitle patients on multiple medications to receive a medication review (MR). However, the provision of MRs is not mandatory and pharmacy owners decide whether to implement this service in their pharmacies.
AIM
To determine pharmacy owners' attitudes towards MRs, explore their experiences with MR implementation and examine their perceptions of barriers and facilitators towards implementation of MRs in community pharmacies.
METHOD
Pharmacy owners were invited to participate in semi-structured interviews. Purposive sampling was used with selection criteria being MR-implementation stage, and geographical location of the pharmacy. The topic guide was based on a systematic review and the Framework for Implementation of Services in Pharmacy (FISpH). Interviews were recorded, transcribed verbatim and coded directly against the FISpH.
RESULTS
Twenty-one pharmacy owners were interviewed. Despite participants' consistent positive attitude towards MRs, most believed that providing MRs on an economically viable basis would be challenging. Several practical suggestions emerged which would enable community pharmacies a smoother implementation of MRs. Suggestions included employing 'change facilitators', who visit and support implementing pharmacies; national awareness campaigns targeting patients and health professionals; reducing bureaucracy; continuing professional development; involving technicians in some MR-tasks; and offering an additional incentive to lower the initial implementation threshold.
CONCLUSION
This research identified numerous factors that are likely to increase owners' and managers' support to the idea of MRs. This may be of interest to any country planning implementation of MRs.
Topics: Humans; Pharmacies; Community Pharmacy Services; Medication Review; Pharmacists; Pharmacy; Qualitative Research; Professional Role; Attitude of Health Personnel
PubMed: 36639520
DOI: 10.1007/s11096-022-01524-2 -
Peritoneal Dialysis International :... May 2023Peritoneal dialysis (PD)-associated peritonitis remains a severe complication of PD. Although peritonitis due to . is rare, the treatment recommendations and outcomes... (Review)
Review
Peritoneal dialysis (PD)-associated peritonitis remains a severe complication of PD. Although peritonitis due to . is rare, the treatment recommendations and outcomes are uncertain. Our study aims to review (1) published literature on peritonitis caused by and (2) reported cases of peritonitis due to in patients on PD in Australia and New Zealand. A literature search of PubMed, Scopus, Embase and Google Scholar for articles published between January 1949 and February 2022 was conducted. To be eligible, articles had to describe antibiotic therapy and treatment outcomes in all PD patients for peritonitis caused by or . Data from the Australia and New Zealand Dialysis and Transplant (ANZDATA) registry of PD patients who developed peritonitis due to between July 2011 and May 2020 were also reviewed. A total of 12 articles and 28 episodes were identified from the literature search and ANZDATA registry analysis, respectively. Over 60% of the peritonitis cases due to were from the species (8/12 and 17/28, respectively), while was the second most commonly identified species in both the literature search and the ANZDATA registry analysis (4/12 and 5/28, respectively). A majority 8 (66.7%) of the articles in the literature search employed a combination antibiotic regimen, while the remaining 4 (33.3%) used a single antibiotic regimen. In contrast, most of the episodes, 22 (78.6%) described in the ANZDATA registry analysis, employed a single antibiotic regimen, and only 6 (21.4%) episodes were treated with a combination antibiotic regimen. The duration of antibiotic therapy ranged from 2 to 3 weeks in the literature search, and 1 to 3 weeks in the ANZDATA registry. While no deaths within 30 days of developing peritonitis were reported, catheter removal was reported in three (25%) and two (7.1%) episodes in both the literature search and the ANZDATA registry analysis, respectively, of which the majority occurred in patients treated for ≤2 weeks. PD-associated peritonitis due to is uncommon and associated with relatively good outcomes. Antibiotic treatment for 3 weeks is associated with better outcomes.
Topics: Humans; Peritoneal Dialysis; Anti-Bacterial Agents; Treatment Outcome; Peritonitis; Registries; Multicenter Studies as Topic
PubMed: 36475560
DOI: 10.1177/08968608221140227 -
Research in Social & Administrative... Apr 2023The process of drug dispensing in hospital pharmacies (HPs) is one of the essential steps in health care, but presents high complexity due to the diversity of... (Review)
Review
BACKGROUND
The process of drug dispensing in hospital pharmacies (HPs) is one of the essential steps in health care, but presents high complexity due to the diversity of professionals and clinical conditions of patients. Therefore, the use of quality management tools may be an important strategy to improve patient safety and to achieve institutional goals, including user satisfaction and reduction of costs.
OBJECTIVE
This scoping review sought to describe quality management tools applied to drug dispensing in HPs; quality indicators used and results obtained.
METHODS
This scoping review was developed according to the Cochrane methodology and reported according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA), being registered at Open Science Framework (https://doi.org/10.17605/OSF.IO/KP3AJ). The searches were performed in electronic databases Medline, Cochrane Library, Embase, CINAHL and Lilacs, with no limit of date or language. Studies on quality management tools applied to drug dispensing in HPs were assessed for eligibility, extracted and compiled in a narrative form.
RESULTS
From the 1318 studies identified, 11 were eligible for this review. The quality management tools more frequently reported were those related to the definition of root cause (n = 4; 36%), e.g. DMAIC (Define, Measure, Analyze, Improve and Control) and the cause and effect diagram; tools for risk management, such as FMEA (Failure Mode and Effect Analysis) and its variations (n = 4; 36%); and tools related to the LSS (LEAN Six Sigma) principles (n = 3; 27%). The quality indicators used to monitor the results were, mainly, work team satisfaction, time spent performing activities and reduction of errors and costs.
CONCLUSIONS
The use of quality management tools showed a tendency to improve the indicators of the drug dispensing process in HPs, such as increase in work team satisfaction, reduction of time spent performing activities, errors and costs, improving the quality of services.
Topics: Humans; Pharmacy Service, Hospital; Delivery of Health Care; Patient Safety
PubMed: 36473787
DOI: 10.1016/j.sapharm.2022.11.008 -
Travel Medicine and Infectious Disease 2023Pharmacists have an important role in providing travel health services and medications to travelers. However, given the limited literature on this topic, the aim of this... (Review)
Review
BACKGROUND AND AIM
Pharmacists have an important role in providing travel health services and medications to travelers. However, given the limited literature on this topic, the aim of this study is to systematically review the types and outcomes of pharmacist-managed travel health services.
METHODS
A comprehensive literature search was performed in four electronic databases, namely Scopus, Web of Science, PubMed and ProQuest to identify studies published in English from 1999 to July 2022. The inclusion criteria included the studies that reported an experience of providing dedicated travel health services by pharmacists and reported the outcomes and/or evaluation of these travel health services.
RESULTS
Nine studies were identified from the literature and included in the review. The pharmacists have provided a wide range of general and specialized travel health services including pre-travel risk assessment, routine and travel-related vaccination service, prescribing or recommending medications for travel-related illnesses, counseling and travel health advice. Overall, 94-100% of the patients were satisfied or very satisfied with pharmacist-managed travel health services. In addition, a good acceptance rate of pharmacist recommendations for vaccines and travel-related mediations was reported with most studies reporting an overall acceptance rate of ≥75% (acceptance rate range: 48%-94.2%). In addition, high rates of acceptance of other nonpharmacological advices were noted.
CONCLUSION
Pharmacists with training in travel medicine have successfully provided a wide range of general and specialized travel health services. Most travelers were highly satisfied with the pharmacy-based travel health services and accepted the pharmacist recommendations.
Topics: Humans; Travel; Travel-Related Illness; Pharmacists; Pharmacies; Pharmaceutical Services
PubMed: 36400319
DOI: 10.1016/j.tmaid.2022.102494 -
Archives of Disease in Childhood Jan 2023Childhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.
OBJECTIVE
Childhood obesity can affect drug disposition and efficacy of ibuprofen. The primary objective was to assess efficacy of ibuprofen in obese children.
DESIGN
A systematic review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Studies were identified from 12 databases. Two independent reviewers evaluated studies against the inclusion criteria and assessed for methodological quality.
SETTING
Any clinical setting.
PATIENTS
Patients under 18 years who were overweight/obese.
INTERVENTIONS
Patients taking ibuprofen for any indication, dose or regimen.
MAIN OUTCOME MEASURES
The efficacy and tolerability of ibuprofen treatment in obese children and presence of any adverse drug reactions.
RESULTS
Searches identified 1305 studies. Four studies met inclusion criteria: three retrospective cohort studies (n=583, median age: 6 years, range: 1-18 years; n=200, median age: 11 years, range: 3-18 years; n=358 median age: 3.1 years, range: 1.2-8.5 years, respectively) and one case study. Each study differed in their method of dosing ibuprofen (weight-based, age-based and adjusted body weight dosing). Various doses were used: 5 mg/kg every 6 hours, 400 mg three times a day, 120 mg/dose and a dose calculated using adjusted body weight. One study reported efficacy (obese n=189, non-obese, n=394), where adequate pain control was achieved using 5 mg/kg. The other three studies did not determine if efficacy differed between obese and non-obese children.One study described adverse effects. An increased risk of bleeding with ibuprofen was noted but did not differentiate between obese and non-obese children.
CONCLUSION
There are little published data to guide clinicians prescribing ibuprofen in obese children.
PROSPERO REGISTRATION NUMBER
CRD42021213500.
Topics: Child; Humans; Adolescent; Child, Preschool; Ibuprofen; Retrospective Studies; Pediatric Obesity; Overweight
PubMed: 36385006
DOI: 10.1136/archdischild-2022-324652 -
Pharmacy (Basel, Switzerland) Sep 2022As the last step in the care pathway, pharmacies can significantly impact a patient's medication adherence and the success of treatment. The potential impact of... (Review)
Review
As the last step in the care pathway, pharmacies can significantly impact a patient's medication adherence and the success of treatment. The potential impact of patient's pharmacy choice on their medication adherence has yet to be established. This study aims to review the impact a pharmacies ownership model, either independent or chain, has on its users' medication adherence. As a generalisation, independent pharmacies offer a more personal service and chain pharmacies offer medications at lower prices. A keyword search of EMBASE and MEDLINE databases in March 2022 identified 410 studies, of which 5 were deemed to meet our inclusion criteria. The studies mostly took place in North America, measured medication adherence using pharmacy records over a 12-month period. This review was unable to substantiate a difference in the rate of medication adherence between the users of independent and chain pharmacies. However, those with a lower income, greater medication burden, and increased age appeared to use an independent pharmacy more than a chain pharmacy and to have greater medication adherence when doing so. Establishing the differences in service provision between types of pharmacies and why people choose a pharmacy to frequent should be a focus of future research.
PubMed: 36287445
DOI: 10.3390/pharmacy10050124 -
PloS One 2022The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The beneficial effect of the dietary practice is significant reduction in the risk of developing diabetes related complication. Dietary practice among type 2 diabetes is not well-implemented in Ethiopia. Up to now, in the nation, several primary observational studies have been done on dietary adherence level and its determinants among type 2 diabetes. However, a comprehensive review that would have a lot of strong evidence for designing intervention is lacking. So, this review with a meta-analysis was conducted to bridge this gap.
METHODS
A systematic review of an observational study is conducted following the PRISMA checklist. Three reviewers have been searched and extracted from the World Health Organization- Hinari portal (SCOPUS, African Index Medicus, and African Journals Online databases), PubMed, Google Scholar and EMBASE. Articles' quality was assessed using the Newcastle-Ottawa Scale by two independent reviewers, and only studies with low and moderate risk were included in the final analysis. The review presented the pooled proportion dietary adherence among type2 diabetes and the odds ratios of risk factors favor to dietary adherence after checking for heterogeneity and publication bias. The review has been registered in PROSPERO with protocol number CRD42020149475.
RESULTS
We included 19 primary studies (with 6, 308 participants) in this meta-analysis. The pooled proportion of dietary adherence in the type 2 diabetes population was 41.05% (95% CI: 34.86-47.24, I2 = 93.1%). Educational level (Pooled Odds Ratio (POR): 3.29; 95%CI: 1.41-5.16; I2 = 91.1%), monthly income (POR: 2.50; 95%CI: 1.41-3.52; I2 = 0.0%), and who had dietary knowledge (POR: 2.19; 95%CI: 1.59-2.79; I2 = 0.0%) were statistically significant factors of dietary adherence.
CONCLUSION
The overall pooled proportion of dietary adherence among type 2 diabetes in Ethiopia was below half. Further works would be needed to improve dietary adherence in the type 2 diabetes population. So, factors that were identified might help to revise the plan set by the country, and further research might be required to health facility fidelity and dietary education according to diabetes recommended dietary guideline.
Topics: Diabetes Mellitus, Type 2; Diet; Ethiopia; Humans; Income; Observational Studies as Topic; Prevalence
PubMed: 36215272
DOI: 10.1371/journal.pone.0271378