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Abstract Background The measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank. Methods A total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed. Results 56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient’s satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001). Conclusion This study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan.

Abstract Background Allergic rhinitis is a chronic respiratory disorder that significantly impacts patients’ quality of life (QoL) and work performance. Pharmacists are recognized as suitable professionals to provide patient education and pharmaceutical care for managing allergic rhinitis patients. However, local clinical practice guidelines, particularly regarding pharmaceutical care in public healthcare institutions, are lacking. This study protocol outlines a randomized controlled trial (RCT) designed to evaluate the effectiveness of a pharmacist-led educational model (AR-PRISE Model) in managing allergic rhinitis in adult patients compared to standard pharmaceutical care. The AR-PRISE model delivers patient educational material and a pharmaceutical care algorithm. Method This is a 6-month, single-center, prospective, randomized, two-arm, and parallel-group controlled trial. The trial recruits patients attending the otorhinolaryngology clinics of a tertiary referral hospital. Participants are randomized into control or intervention groups in a 1:1 ratio using permuted block randomization. The total number of participants estimated is 154, with each group requiring 77 participants. The control group receives standard pharmaceutical care, while the intervention group receives pharmacist-led education according to the AR-PRISE model. Both groups are assessed for middle turbinate endoscopy findings, disease severity, knowledge level, symptom control, medication adherence, and QoL at baseline and the end-of-study follow-up (day 180 ± 7). Depending on feasibility, intermediate follow-ups are conducted on days 60 ± 7 and 120 ± 7, either virtually or face-to-face. During intermediate follow-ups, participants are assessed for symptom control, medication adherence, and QoL. The intention-to-treat analysis includes all participants assigned to each group. An independent T-test compares the mean difference in knowledge level between the two groups. A two-way repeated measures ANOVA analysis is employed to determine between-group differences for scores of symptom control, adherence rate, and QoL. A P-value

Background: The measurement of patient satisfaction is a vital metric that enhances stakeholders to take proactive steps in improving the quality of healthcare services within medical care systems. This study assessed patient satisfaction receiving pharmaceutical services from primary health care centers in the Palestinian Ministry of Health (PMoH) governorate directorates in the West Bank. Methods: A total of 938 patients, all aged 18 years or older, completed a self-administered questionnaire. The assessment of general satisfaction was based on selected questions. Analyses were conducted to explore demographic characteristics. Mean and standard deviation (S.D.) were reported. Likert method was used to average scale satisfaction. To examine statistically significant differences, Chi-square analysis and binary logistic analysis were employed. Results: 56.8% of the survey respondents were women, 57.2% were 40 years or older, and 63.2% had graduated from high school. The general satisfaction score averaged 4.10 ± 0.77 indicating good satisfaction. Patients were satisfied with interpersonal relationships, with a mean score of 4.19 ± 0.70. However, satisfaction with therapy management was lower, with a mean score of 3.99 ± 0.77 indicating moderate satisfaction. A significant factor can affect patient's satisfaction such as the location of the pharmacy (OR = 1.720, P = 0.012), the waiting area (OR = 1.671, P = 0.002) and the cleanness of pharmacy (OR = 2.307, P = 0.001). Conclusion: This study underlines the main components of patient satisfaction who receive pharmaceutical services in PMoH. It is highly recommended that PMoH must address patient dissatisfaction points in a total quality management plan. [ABSTRACT FROM AUTHOR]

Objective To explore the application effect of the pharmaceutical service model based on the knowledge, attitude and practice (KAP) intervention theory in the whole process management of cancer patients. Methods Clinical data of 60 cancer patients from October 2022 to April 2023 in the People's Hospital at of Xishuangbanna Dai Autonomous Prefecture were collected and divided into the intervention group and the control group with 30 cases in each group by random number table method. The control group was provided with routine diagnosis and treatment guidance by doctors and nurses, and the patients in the intervention group were provided with whole process pharmaceutical service by professional tumor pharmacists based on the intervention theory of knowledge, attitude and practice. After two cycles of intervention, the two groups of patients were compared in terms of unsolved drug-related problems, KAP score level, emotional situation and satisfaction, and the situation of clinical pharmacists providing pharmaceutical service were analyzed. Results After two cycles of intervention, compared with the control group, the incidence of drug-related problems and per capita number of patients in the intervention group were significantly reduced, with statistical significance(P < 0.01), while satisfaction was significantly increased, with statistical significance(P <0.01). KAP scores in the intervention group were higher than those in the control group in all dimensions except the behavioral dimension. The differences were statistically significant(P <0.05). Compared with before intervention, the anxiety and depression scores of patients in the intervention group were also significantly decreased, with statistical significance(P <0.05). Conclusion The whole process pharmaceutical service model based on the KAP intervention theory can reduce the drug-related problems that may occur in the treatment of cancer patients, relieve the tension and anxiety during the treatment process, and thus improve the compliance and satisfaction of patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effect of intelligent information management of narcotic drugs and class Ⅰ psychotropic drugs ( hereinafter referred to as “ anesthetic and psychotropic drugs ”) based on the hospital information system ( HIS) in inpatient pharmacy of the hospital. METHODS: Problems existing in the process of prescription, dispensing, using, recycling of empty ampoule and waste paste of anesthetic and psychotropic drugs in the hospital were collected, and the main causes of existing problems were analyzed by fish-bone diagram. Those causes were summarized from 5 perspectives of equipment, personnel, drugs, system and feedback by PDCA management method. Intelligent information construction was carried out on the main causes that can be intervened. The centralized dispensing time of anesthetic drugs in the operating room, satisfaction degree of the ward to the quality of anesthetic and psychotropic drugs dispensing, management awareness of related medical staff, and number of irregular and irrational prescriptions per month were collected respectively before (from Mar. to May 2021) and after (from Mar. to May 2022) intelligent information management. RESULTS: The efficient management of anesthetic and psychotropic drugs in inpatient pharmacy was obtained through the addition of HIS information function and intelligent drug cabinet, programmed registration of empty ampoule and waste patches and special knowledge online intelligent assessment. Compared with before intelligent information management, the time of centralized dispensing of anesthetic and psychotropic drugs in operating room was shortened by 56. 25% [from (62. 40±3. 86) min to (27. 30±2. 10) min], the satisfaction of the ward on dispensing quality was increased by 5. 98% [from (86. 90±1. 58) % to (92. 10±2. 80) %], the management awareness of related medical staff on anesthetic and psychotropic drugs was increased by 9. 08% [from (87. 00±1. 41) % to ( 94. 90 ± 1. 64) %], and the number of irregular and irrational prescriptions per month was decreased by 42. 08% [from (60. 00±5. 92) prescriptions to (34. 75±5. 76) prescriptions]. CONCLUSIONS: Based on intelligent information management, the management of anesthetic and psychotropic drugs in the hospital is transferred into the fine management mode, which has achieved the double improvement of pharmaceutical care quality and efficiency, improved the medical experience of patients, and ensured the convenience and safety of clinical medication. [ABSTRACT FROM AUTHOR]

Background: In Japan, pharmacists' role has drastically changed in recent years. However, previous studies have not performed internal marketing analysis for Japanese community pharmacists so that they improve the quality of work life (QWL) and be satisfied with it. Further, few studies are conducted on Japanese community pharmacists' QWL and its effect on the quality of pharmaceutical services. Objectives: This study aimed to reveal associations between community pharmacists' QWL and their subjective evaluations of pharmaceutical service. Methods: A questionnaire survey was conducted among 2027 pharmacists, with the cooperation of 20 corporations that run pharmacies. The collected data were subjected to multiple regression analysis, using SPSS 29. Results: Standard multiple regression shows that 27.4% of variance in pharmacists' subjective evaluations of their service was explained by QWL and other control variables, such as age, gender, and employee status (p

Akihiko Akamine,1 Yuya Nagasaki,2 Atsushi Tomizawa,2 Katsuya Otori2,3 1Department of Pharmacy, Doujin Hospital, Okinawa, Japan; 2Department of Pharmacy, Kitasato University Hospital, Kanagawa, Japan; 3Research and Education Center for Clinical Pharmacy, Division of Clinical Pharmacy, Laboratory of Pharmacy Practice and Science 1, Kitasato University School of Pharmacy, Tokyo, JapanCorrespondence: Akihiko Akamine, Department of Pharmacy, Doujin Hospital, 1-37-12 Gusukuma, Urasoe, Okinawa, 901-2133, Japan, Tel +81-98-876-2212, Fax +81-98-874-7034, Email a-aka@kitasato-u.ac.jpPurpose: The risk factors for non-adherence to pharmacist or non-pharmacist explanations of preoperative medication discontinuation are unknown. The primary outcome of this study was to determine whether the final explainer’s occupation was a risk factor for non-adherence. The secondary outcomes were to determine the risk factors for non-adherence after limiting the departments or adjusting for age.Patients and Methods: We retrospectively examined the data (including patient age, sex, prescription medications, comorbidities, presence of roommate, and number of days between receiving explanation and surgery) of 1132 patients on medications that could affect surgery at a Japanese university hospital between April 1, 2017, and March 31, 2020. The primary endpoint was whether the occupation of the last person explaining medication discontinuation to the patient was an independent risk factor for non-adherence (age ≥ 65 years vs < 65 years). Secondary endpoints included subgroup analyses in urological, gastrointestinal, and otolaryngological areas, as well as a sensitivity analysis (age as a continuous variable) to confirm the validity of the primary endpoint results. A multivariate binary logistic regression identified independent non-adherence risk factors.Results: The main analysis showed that discontinuing two or more medications was a risk factor for non-adherence (adjusted odds ratio (AOR): 1.67; 95% confidence interval (CI): 1.13– 2.47; p = 0.01). However, in analyses coordinated by department (urological, gastrointestinal, and otolaryngological), ≥ 65 (versus < 65) years of age was determined as a risk factor for increased nonadherence (AOR: 2.27, 95% CI: 1.11– 4.63; p=0.024). Age-adjusted analysis (continuous variables) showed similar results to the primary endpoint (AOR: 1.68, 95% CI: 1.14– 2.49, p = 0.009).Conclusion: Two or more medications, and not the final explainer’s occupation, were associated with pre-surgery medication non-adherence. To prevent non-adherence, pharmacists and non-pharmacists should educate patients about preoperative medication discontinuation. These findings could help identify high-risk non-adherence patients.Plain Language Summary: At Kitasato University Hospital, pharmacists and non-pharmacists explain before surgery that patients scheduled for surgery should discontinue medications that could affect surgery. However, there are patients who fail to follow these explanations precisely, but the risk factors have not yet been identified. This study examined risk factors for patients who failed to comply with explanations from a pharmacist or non-pharmacist regarding the use of medications that could affect surgery. Risk factors were examined using a statistical method for identifying risk factors by considering patients’ age ≥ 65 (versus < 65) years, sex, the job title that explained the instructions to the patient, number of medications to be discontinued before surgery, and number of days between instructions and surgery as risk factors. Based on pharmacist/non-pharmacist explanations, the statistical analysis revealed that patients taking two or more medications that could affect surgery may be a risk factor for non-adherence to medications that should be discontinued before surgery. To improve medication adherence, pharmacists and non-pharmacists should be aware of the patient’s non-adherence risk factors, repeatedly explain them to the patient, and help the patient understand that failure to comply with the explanation increases surgical cancelation and intraoperative bleeding risks.Keywords: medication adherence, hematologic agents, pharmaceutical service

Objectives: This study aimed to evaluate the effectiveness of workflow redesign (eaST system) on pharmacy waiting time and near-missed events. We also investigated other factors that may potentially affect these study outcomes. Methods: A quasi-experimental (before–after) study design was adopted. Pre-intervention data were collected over 7 months (January–July 2017). Subsequently, the workflow redesign (eaST system) was implemented and the effect of the intervention (August 2017–February 2018) was evaluated. Univariate analysis was used to compare the differences between pre-intervention and post-intervention of pharmacy waiting time and near-missed events. Significant factors affecting study outcomes were analysed using linear regression analysis. Key findings: A total of 210,530 prescriptions were analysed. The eaST system significantly increases the percentage of prescriptions dispensed within 30 min per day (median = 68 (interquartile range (IQR) = 41) vs. median = 93 (IQR = 33), P < 0.001) and reduced the mean percentage of near-missed events (mean = 50.71 (standard deviation (SD) = 23.95) vs. mean = 27.87 (SD = 12.23), P < 0.001). However, the eaST system's effects on related outcomes were conditional on a three-way interaction effect. The eaST system's effects on pharmacy waiting time were influenced by the number of prescriptions received and the number of PhIS server disruptions. Conversely, the eaST system's effects on near-missed events were influenced by the number of pharmacy personnel and number of controlled medications. Conclusions: Overall, the eaST system improved the pharmacy waiting time and reduced near-missed events. [ABSTRACT FROM AUTHOR]

In 2020, pharmacists in Poland received additional authority to prescribe drugs. In this study, we analyzed prescribing after the implementation of this new responsibility. We assessed how the new regulation works in practice and what it means for the healthcare system in the area of access to prescription-only medicines. Data analysis included information on the prescriptions written, the type of substance according to the ATC classification, and data on the prescribing pharmacists. The study used over 2.994 million e-prescriptions written by pharmacists in Poland, which were made available by the e-Health Center. The largest group of drugs prescribed were drugs used in the treatment of cardiovascular diseases, accounting for 25% of all prescribed medications during the time of the analysis. The next prescription groups were for drugs used in gastrointestinal diseases and metabolic disorders, and those acting on the central nervous system, the respiratory system, and the musculoskeletal system. Among pharmaceutical prescriptions, 73% were pharmaceutical prescriptions issued in pharmacies at full price to the patient. The results indicate that pharmacists are eager to use their permission to prescribe drugs in authority situations. Almost three million records showed improved patient access to medicines in the healthcare system (approximately 5% of repeat prescriptions for all patients during the study period). These data confirm the possibility of cooperation between physicians and pharmacists in strengthening the efficiency of the patient healthcare system. An important conclusion from this work is the need to create the possibility for the pharmacist to access the information resources of the implemented Internet Patient Account system, including therapeutic indications for the drugs used. [ABSTRACT FROM AUTHOR]

Starting from drug discovery, through research and development, to clinical trials and FDA approval, artificial intelligence (AI) plays a vital role in planning, developing, assessing modelling, and optimization of product attributes. In recent decades, machine-learning algorithms integrated into artificial neural networks, neuro-fuzzy logic and decision trees have been applied to tremendous domains related to drug formulation development. Optimized formulations were transformed from lab to market based on optimized properties derived from AI Technologies. Research and development in pharmaceutical industry rely upon computer-driven equipment and machine learning technology to extract data, perform simulations, modelling, and optimization to get optimum solutions. Merging AI technologies in various steps of pharmaceutical manufacture is a major challenge due to lack of in-house technologies. In silico studies based on artificial intelligence are widely applied as effective tools to screen the market needs of medications and pharmaceutical services through inspecting scientific literature and prioritizing medicines for specific illnesses or a particular patient. Specialized personnel who excel in scientific and data science with analytical knowledge are essential for transformation to smart manufacturing and offering services. However, privacy, cybersecurity, AI-dependent unemployment, and ownership rights of AI technologies require proper regulations to gain the benefits and minimize the drawbacks.

Over a long history, the pharmacy was developed in close connection with Traditional Mongolian Medicine (TMM) as one part of it. TMM was Mongolia's only available healthcare method before Western medicine was introduced in the 20th century. The pharmaceutical sector, founded in 1923, has played an essential role in the health system of Mongolia over the last hundred years. During the socialist time, the pharmaceutical sector was state-owned, and privatization started in 1990 when Mongolia transitioned from a centrally planned economy to a market economy. Mongolian current pharmaceutical sector is fully privatized except for public hospital pharmacies, and as of the end of 2021, 2822 pharmaceutical facilities were operating in Mongolia. Before the transition to the market economy, the functions of the pharmaceutical sector were mainly focused on the production, supply, compounding, and dispensing of drugs. Still, since 1990, the scope of pharmaceutical care services has changed. The pharmaceutical care service has been transferring from product-oriented to patient-centered care since the mid-1990s. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To establish a rational drug use model of PIVAS and promote the rational drug use in clinical practices by enhancing the quality of prescription review by pharmacists. Methods The PIVAS physician orders received from 2014 to 2021 were extracted through the hospital information management (HIS) system. The types of irrational physician orders were statistically analyzed, the improvements were made by the method of quality control circle (QCC). Results The model of PIVAS rational drug use formed a standardized process. The proficiency of physician order review was improved. From 2014 to 2021, the number and proportion of unreasonable physician orders in PIVAS decreased year by year. Every type of unreasonable physician orders was improved year by year. Conclusion The professional and technical levels of pharmacist for physician order review at our hospital were improved by the model of PIVAS rational drug use. The quality of pharmaceutical service was significantly improved which ensured the safety of patients' medication. [ABSTRACT FROM AUTHOR]

Pharmacies are a component of the healthcare. Pharmaceutical care and pharmaceutical services improve disease control, quality of patients life and reduce of the burden on healthcare. The implementation of pharmaceutical care and pharmaceutical services for patients with diabetes according to the standards of the GPP is relevant for the domestic pharmacy. Therefore, it is advisable to determine the preferences of patients with diabetes because they have their own needs for treatment and control. The purpose of the study was to study the views of patients with diabetes regarding to function of pharmacies, pharmaceutical services and determine their preferences. The survey of patients with diabetes by the questionnaire method was carried out. Relevant questionnaires of 510 patients with type 1 and type 2 diabetes were included in the study. The results of the survey showed that the majority of patients with diabetes would like to be served in a specialized pharmacy that specializes in drugs and medical products for diabetes. On the basis of the study, the preferences of patients with diabetes regarding to the activities of pharmacies were determined: availability of a wide rang of product; loyalty program for special products related to diabetes, additional services and pharmaceutical consultations. The majority of those interviewed noted that they need a pharmacist's consultation on taking medications. This type of service requires training of pharmacists in diabetes in order to provide pharmaceutical care at an appropriate level. Pharmaceutical services which patients with diabetes need were identificated. There are: testing of blood glucose, cholesterol, blood pressure, weight check, calculation of body mass index and interpretation of results. The creation of a «diabetes self-management school» based on pharmacies will improve the availability of education for patients with diabetes. It is necessary to study the demand directly in the area of the pharmacy before introduction this type of service. It is important to implement systematic special events in pharmacies for the World Diabetes Day. Thes is appropriated for the general population, but also for patients with diabetes. From the point of view of patients with diabetes during this event, they are interested in: consultation of an endocrinologist and nutritionist; blood glucose test; test of diabetes risk; information materials about diabetes. The results of the survey can be prospectively used to improve the service of patients with diabetes and provide for their needs.

Copyright of Revista Salud Bosque is the property of Universidad El Bosque and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To construct the auxiliary system of outpatient drug distribution, reduce errors and improve the quality of outpatient pharmaceutical service. Methods The bar code technology was used to independently develop outpatient pharmacy dispensing assistant system. The system design and function are introduced. The practical application effect of the system was evaluated on dispensing errors, efficiency and pharmacist evaluation. Results Based on the special network environment of the hospital, the system integrated the functions of drug check, prescription right management, expiration date management and medication instruction. After using the system, the number of dispensing errors decreased from 84 to 25. The waiting time for patients to receive medicine decreased by 151 seconds. All pharmacists surveyed agreed that auxiliary system was helpful to pharmacists ’ work. Conclusion The system reduced the medication dispensing error in outpatient pharmacy, improved work efficiency and the quality of pharmaceutical care. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the situation of drug consultation in the outpatient drug consultation center of the hospital, and to provide reference for improving the quality of drug consultation service, promoting rational drug use and improving the level of comprehensive pharmaceutical service. METHODS: A total of 45 485 drug consultation records from outpatient drug consultation center of the hospital from 2014 to Jun. 2022 were screened, and the content of consultation questions, consultation methods and composition of counselors were analyzed. RESULTS: Among the 45 485 cases of pharmacy consultation records, there were 34 089 cases (74. 95%) for western medicine consultation, 11 396 cases (25. 05%) for traditional Chinese medicine problems. Among the 39 589 drug consultation records with the gender of the counsellor recorded, 22 357 cases ( 56. 47%) were females and 17 232 cases ( 43. 53%) were males. The consultation method of 45 485 drug consultation records was mainly on-site consultation (37 660 cases, 82. 80%), followed by phone-call consultation ( 7 825 cases, 17. 20%). In terms of the types of consultation questions, professional pharmaceutical questions included usage and dosage, adverse drug reactions, drug interactions, empirical medication, pharmacological effects, guidance of special dosage forms, and medication for special populations. General questions included drug information, medical insurance, medical treatment process and price. CONCLUSIONS: The professional pharmaceutical services provided by pharmacists through the outpatient drug consultation center are conducive to ensuring the medication safety of patients and promoting rational drug use. [ABSTRACT FROM AUTHOR]

In 2020, pharmacists in Poland received additional authority to prescribe drugs. In this study, we analyzed prescribing after the implementation of this new responsibility. We assessed how the new regulation works in practice and what it means for the healthcare system in the area of access to prescription-only medicines. Data analysis included information on the prescriptions written, the type of substance according to the ATC classification, and data on the prescribing pharmacists. The study used over 2.994 million e-prescriptions written by pharmacists in Poland, which were made available by the e-Health Center. The largest group of drugs prescribed were drugs used in the treatment of cardiovascular diseases, accounting for 25% of all prescribed medications during the time of the analysis. The next prescription groups were for drugs used in gastrointestinal diseases and metabolic disorders, and those acting on the central nervous system, the respiratory system, and the musculoskeletal system. Among pharmaceutical prescriptions, 73% were pharmaceutical prescriptions issued in pharmacies at full price to the patient. The results indicate that pharmacists are eager to use their permission to prescribe drugs in authority situations. Almost three million records showed improved patient access to medicines in the healthcare system (approximately 5% of repeat prescriptions for all patients during the study period). These data confirm the possibility of cooperation between physicians and pharmacists in strengthening the efficiency of the patient healthcare system. An important conclusion from this work is the need to create the possibility for the pharmacist to access the information resources of the implemented Internet Patient Account system, including therapeutic indications for the drugs used.

The aim of this study is to evaluate the implementation of a simple, easy-to-use cognitive screening test in the pharmaceutical care of elderly patients (aged 60 years and over) in community pharmacies and to test whether cognitive decline is associated with metabolic syndrome (MetS).

Copyright of International Journal of Health Management Review is the property of International Journal of Health Management Review and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

(1) Background: Pharmacists are often challenged with situations where women are already on hormonal contraceptives (HC) but have no valid prescription. By Swiss law, pharmacists are allowed to supply prescription-only drugs in exceptional situations without a physician's prescription. Because eligibility for HC can change, women at risk for complications, such as serious side effects, need to be identified. We aimed to develop a protocol to assist pharmacists in clarifying and documenting eligibility for HC. (2) Methods: We conducted a survey using the Delphi method to identify relevant clarifications and develop a protocol for pharmacists. Proposed material was created based on the literature and existing toolkits/protocols aimed at verifying eligibility for HC. A multidisciplinary expert panel, consisting of gynecologists and pharmacists, reviewed the proposed material and provided anonymized feedback over two survey cycles. (3) Results: This Delphi survey revealed items essential to the clarification of eligibility for HC in pharmacies for women who are already using it. This resulted in a protocol that maps "best practices" regarding these ad interim supplies of HC given without a prescription in Switzerland. (4) Conclusions: This survey, made using the Delphi method, allowed us to create a protocol for pharmacists that aims to verify and document eligibility for HC in Switzerland, where HC is frequently supplied without a prescription. [ABSTRACT FROM AUTHOR]

Mannitol is used in freeze-dried products as a bulking agent, consistency enhancer, or stabilizer, having the lowest hygroscopicity among the excipients commonly used as consistency agents, therefore it can be used in the formulation of unstable preparations. Lyophilization is a complex method of drying a solution at low temperature and low-pressure that addresses especially thermolabile substances, such as proteins. The end-product is a lyophilized powder, which can be administered parenterally after reconstitution with suitable solvents. The objective of this study was to evaluate freeze-dried products obtained from mannitol solutions of different concentrations. Mannitol solutions of increasing concentrations of 2.5%, 5%, 7.5%, and 10% were prepared by dissolving mannitol in distilled water. The prepared solutions were freeze-dried after a preliminary DSC analysis, in which the thermal phenomena that occurred during lyophilization were identified. Freeze-dried preparations were analyzed by different methods: macroscopic analysis by visual assessment and comparison with data from the literature, texture analysis by which several properties of these preparations were studied (hardness, deformation, mechanical work, adhesive strength, fracture resistance, and the number of fractures), evaluation of reconstitution time and porosity. The mannitol used in the lyophilization process, being partially amorphous, required differential calorimetric analysis to establish its glass transition and to avoid the collapse of the preparations during lyophilization. Finally, NIR spectroscopy was used to predict the characteristics of the freeze-dried powders in a non-invasive manner, without prior sample preparation.

In order to increase the number of vaccinations performed during the COVID-19 pandemic in Poland, a significant change was introduced in the legislation allowing for the vaccination to also be performed in pharmacies. A cross-sectional survey was conducted among those who chose a pharmacy as a vaccination point during the pandemic COVID-19. The aim of the study was to determine the overall level of patient satisfaction with pharmacist-administered vaccination in pharmacies and to examine patient opinions regarding the further expansion of pharmacy services. A patient survey was conducted immediately after vaccination in the period from January to March 2022. A total of 398 questionnaires were completed. The respondents reported high satisfaction with pharmacist-administered vaccinations (94.5%). In addition, the majority of consumers felt safe during the vaccination procedure (98.5%), and 88.4% declared they would come for other vaccinations at the pharmacy. The two main reasons for choosing this vaccination place were easy access regarding location (94.2%) and proposed vaccination hours (95.2%). The participants reported high levels of satisfaction concerning the pre-vaccination interview (91.2%), information level before immunization (91.5%), injection technique (96.7%), adjusting the premises to the service (95%) and general care in pharmacy after with vaccination (87.7%). The majority of respondents supported the future expansion of pharmacist-administered services, although the support rate ranged from 52% to 83% depending on the type of service offered. The majority of patients supported the continuation of ongoing prescriptions, blood pressure and blood glucose measurement services by pharmacists. Our findings indicate that the involvement of pharmacies in vaccination programs and other public health services met high levels of patient acceptance. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Signos is the property of Universidad Santo Tomas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract Background In the Brazilian public health system, primary health care (PHC) is provided by the municipalities and is considered the entry level of the Unified Health System (SUS). Governmental pharmaceutical services (PharmSes) are part of the SUS, including PHC, and are the most significant way in which patients access medicine and services. Considering the diversity of the country, the municipalities have the autonomy to decide how PharmSes are implemented. Even though policies and procedures should be implemented as expected by policy makers and experts, municipality characteristics may interfere with implementation fidelity. Therefore, this study evaluated the degree to which the PharmSes in PHC were delivered as intended in Brazilian municipalities. Methods We analysed data from a secondary database originating from a cross-sectional nationwide study carried out by the Ministry of Health and the World Bank from 2013 to 2015. Data on 465 municipalities and the Federal District were collected from 4939 governmental PharmSes. A rating system comprising 43 indicators was developed and applied to the dataset to obtain the implementation degree (ID) of each PharmSe. Additionally, the IDs of the two PharmSes dimensions and the nine components were measured. Results Overall, the ID of the PharmSes in Brazilian PHC was evaluated as critical. The ID was critical in 81% of the municipalities (n = 369), incipient in 14% (n = 65) and unsatisfactory in 4.8% (n = 22). Regarding the PharmSes dimensions, the ‘medicine management’ (MM) ID was considered critical (Mean = 46%), while the ‘care management’ (CM) ID was incipient (Mean = 22%). In terms of the PharmSes components, the highest ID was achieved by ‘forecasting’ (58%). In contrast, ‘continuing education and counselling’ showed the lowest figure (ID = 11%) in the whole sample, followed by ‘information and communication’ and ‘teamwork’. Conclusions The degree to which PharmSes were implemented was critical (ID

J&eogon;drzej Lewicki,1 Urszula Religioni,2 Piotr Merks3 1Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 2Collegium of Business Administration, Warsaw School of Economics, Warsaw, Poland; 3Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszy&nacute;ski University, Warsaw, PolandCorrespondence: Piotr MerksFaculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, Wóycickiego 1, Warsaw, 01-938, PolandEmail piotrmerks@googlemail.comObjective: Evaluation of the implementation of pharmaceutical services to detect comorbidities in at-risk patients.Methods: This study was carried out in community pharmacies across Poland in 2019 inside the specially designed service “Refer the Patient”. The project was intended for patients with selected chronic diseases. The patients were identified on the basis of their medications (active substances). At-risk patients were referred for prophylactic examinations to detect comorbidities.Results: A total of 78 pharmacies took part in this study and 209 at-risk patients were identified. Out of the patients referred for examinations, 30% had deviant results, and 0.95% were diagnosed with new diseases.Conclusion: Pharmaceutical services supporting screening tests among at-risk patients are highly recommended. Pharmacist intervention allows for early detection of comorbidities and prompt treatment. The pharmaceutical service “Refer the Patient” makes it possible to detect a disease at an early stage. Rapid implementation of treatment can prevent serious health consequences, maintains patient quality of life, and reduce treatment costs.Keywords: pharmaceutical care pilot study, pharmaceutical care, pharmaceutical service, implementation, screening tests, chronic diseases

BackgroundIn China, the pharmacy departments of most hospitals have changed their main focus from drug procurement and distribution to providing pharmaceutical care services. Various regions of China have successively implemented the pilot Chief Pharmacist System (CPS) to help improve pharmaceutical care services and rational drug use in hospitals. This study was designed to explore the perspectives of pharmacists and government officials on CPS, including the advantages and barriers to the successful implementation of CPS.MethodsA qualitative study, based on semi-structured interviews, was conducted from October 1, 2018 to March 1, 2019. The interview data were gathered from 18 pharmacy staff and government representatives working in five distinct regions of China using purposive sampling. A thematic analysis approach and NVivo version 12 Plus was utilized to code and analysis of all interviews.ResultsFive broad themes were identified: the role of the chief pharmacist; their attitudes toward the CPS; the advantages and results of the CPS; the barriers toward CPS; and their suggestions toward CPS. Most of the participants believed that the chief pharmacist played a vital role in a hospital. Under CPS, the hospital pharmacy department pays more attention to prescription review, medication monitoring, and pharmaceutical consultation. However, an insufficient number of pharmacy personnel, unclear authority, and inadequate salaries were the main barriers to the implementation of the CPS.ConclusionThe attitudes of most of the participants were found to be positive toward CPS in China. The CPS can enhance the prestige of the hospital pharmacy department, improve the quality of hospital pharmaceutical care services, and promote rational drug use. Nevertheless, certain barriers highlighted in this study should be addressed promptly.

Objectives. Highlighting the role of pharmacists in Romanian community pharmacies, in order to build rational approaches, and to establish the legal framework for the implementation of the pharmaceutical services. Analysis of activities carried out in community pharmacies in Romania and evaluation of the potential of pharmacists to provide quality pharmaceutical services. Results. Most pharmacists in community pharmacies in Romania provide advice on medicines and other health services, without them being acknowledged or remunerated. The implementation and recognition of the pharmaceutical service is imperative and involves the establishment of unitary, quantifiable quality standards for each service, so as to benefit the patient, the medical staff and the health system. Conclusions. Maximizing the intervention of community pharmacists in optimizing public health, by implementing pharmaceutical services, could reduce health care costs, and relieve medical staff, making it easier to manage current or crisis situations.

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Karolina Bratkowska,1 Urszula Religioni,2 Jerzy Krysiński,1 Piotr Merks1,3 1Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland; 2Collegium of Business Administration, Warsaw School of Economics, Warsaw, Poland; 3Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, PolandCorrespondence: Piotr Merks Email p.merks@uksw.edu.plIntroduction: Patient satisfaction is a key factor in the evaluation of the quality of healthcare services. Measuring patient satisfaction is common in outpatient, specialist, and hospital healthcare, and is also significant in relation to pharmaceutical services. The pharmacy market in Poland has been undergoing transformations for many years. Legal regulations implemented in 2002 resulted in a rapid growth of pharmacy chains and a decrease in the number of independent pharmacies. This situation may have translated into changes in the quality of pharmaceutical services.Objective: The objective of this study was to evaluate patient satisfaction with services provided in independent pharmacies and pharmacy chains in Poland.Patients and Methods: A total of 163 patients using randomly selected community pharmacies in Poland were enrolled in the study. A modified Community Pharmacy Patient Questionnaire (CPPQ) was used.Results: The patients highly valued pharmaceutical services provided in Polish pharmacies. The level of service was slightly higher in pharmacy chains. The lowest-rated area was the provision of information on medications, with independent pharmacies higher-rated in this respect. The patients were open to additional services in pharmacies and supported the development of pharmaceutical care.Conclusion: Independent pharmacies and pharmacy chains ensure a similar level of services for patients in Poland. Pharmacy staff should place a special emphasis on providing patients with comprehensive information on medications. The development of pharmaceutical care in Poland will require appropriate legislative preparation.Keywords: pharmaceutical service, pharmacy, patient satisfaction, pharmaceutical care

Background: Pharmacy Value Added Services (VAS) were introduced in Malaysian public health facilities to facilitate the process of medicine collection. Examples include Drive-through pharmacy, Medicine by Post, SMS Take&Go, Appointment Card and medicine locker, commonly referred to as Medibox. Objectives: To assess the perception of VAS among pharmacy staff, and to compare the time and cost needed to prepare medications for VAS and conventional counter service. Methods: A cross-sectional study was conducted in 17 public health facilities across Kuala Lumpur and Putrajaya from May until September 2020. There were two parts of this study: 1) a survey on the perception of VAS among pharmacy staff, which assessed respondents' experience of handling VAS and their perception towards the services; and 2) a cost analysis to compare the direct cost of preparing refill medications for VAS and conventional counter service, estimated from average salary and direct non-medical cost. Results: 290 respondents answered the survey. Most respondents had a positive opinion about VAS. Lack of storage and insufficient manpower were the top two barriers in VAS utilisation and implementation as perceived by pharmacy staff. The average time (in minutes) needed to prepare one prescription was highest for Medicine by Post service (10.31), followed by Medibox (10.25), Appointment Systems (6.24) and conventional counter service (3.99). Medibox had the highest average cost per prescription (RM5.49), followed by Medicine by Post (RM5.05), Appointment Systems (RM2.89) and conventional counter service (RM1.75). Conclusions: The majority of the respondents involved in this study acknowledged the benefits of VAS to patients, but there were aspects of the services that could be improved. Preparation of patient medication for VAS requires significantly more time and cost than conventional counter service, indicating the need to review and streamline implementation of the services.

The aim of this study is to evaluate the implementation of a simple, easy-to-use cognitive screening test in the pharmaceutical care of elderly patients (aged 60 years and over) in community pharmacies and to test whether cognitive decline is associated with metabolic syndrome (MetS). Current research has reported the increasing prevalence of MetS with age and indicated a link between cardiovascular risk factors and impairment of cognitive functions. We hypothesized that the short cognitive test realised in pharmaceutical care in community pharmacies could help identify risk groups of patients with potential cognitive decline. Because of the increasing pressure on primary care, collaboration between community pharmacists and general practitioners is essential, especially in preventive programmes and regarding chronically ill patients. The study included 222 elderly patients aged 60 years and over reached between February 2018 and February 2019 in 16 community pharmacies in Slovakia. Criteria for the classification of MetS were used, following the International Diabetes Federation Worldwide Definition of MetS (2005) for European populations. Cognitive performance was evaluated using the Slovak version of the Montreal Cognitive Assessment. The scale range of the MoCA test is 0-30 points, and the cut-off for cognitive impairment is = 24 points. Our outcomes show that the presence of metabolic syndrome only slightly contributes to the impairment of cognitive functions of patients receiving routine pharmaceutical care in community pharmacies. Cognitive assessment might be an important tool for identifying risk groups of patients that would benefit from a specific approach within the framework of pharmaceutical care. [ABSTRACT FROM AUTHOR]

Medication error is any preventable incident that may cause harm to the patient or result in inappropriate use of medications when these are under the control of healthcare professionals or the patient, with potential consequences for patients. In Paraguay, chronic respiratory diseases (COPD, asthma, etc.), together with diabetes, cardiovascular problems, and cancer, are responsible for a high morbi-mortality in the country, with an increasing prevalence; therefore, this research aimed to evaluate the prescriptions that were prescribed in the outpatient clinic of a hospital specialized in respiratory diseases and dispensed in the pharmacy through a cross-sectional, retrospective, observational study and a non-probabilistic sampling, by convenience, which consisted of the review of medical prescriptions issued to patients of both sexes who attended the adult outpatient clinic of the National Institute of Respiratory and Environmental Diseases, during the months of September 2015 and 2016. The data were recorded in spreadsheets designed for this purpose, and a total of 4828 prescriptions were analyzed, of which 2421 correspond to the month of September 2015, with a total of 5955 drugs prescribed, and 2407 prescriptions correspond to the month of September 2016, with 6195 drugs prescribed. The most frequent technical prescription errors found in the prescriptions were the illegibility of the prescriptions and theabsence of dosage and indication, being the most frequent errors for September 2015, and the absence of dosage and therapeutic indication (79.76 %) and illegibility of the prescription in September 2016 (87.00 %). Considering the legal requirements, the absence of diagnosis was the prevalent error (Sep-15: 64.19 %; Sep-16:60.08 %). This is why it is important to establish a risk management program in hospitals to implement new technologies that facilitate prescribing. [ABSTRACT FROM AUTHOR]

Objective: To identify the impact of a collaborative pharmaceutical care service (CPCS) on medication safety and establish the impact of the CPCS on patient reported outcomes for Parkinson's disease (PD) patients. Methods: Initially, PD outpatients receiving the CPCS between March 2017 and March 2019 were compared with PD patients receiving standard of care to identify differences in management. Pharmacist interventions data were coded and patients with PD receiving the CPCS were compared with those receiving standard of care to determine differences in medicines prescribed and dosage associated with these. Following this, data of patients receiving CPCS at baseline and 3-months follow-up were collected using a questionnaire consisting of validated measures of two patient-reported outcomes [adherence and quality of life (QoL)]. Mean scores for continuous variables were calculated, with descriptive analysis of categorical variables consisting of frequency counts and percentages. Change in adherence score before and after CPCS was investigated using a Wilcoxon sign rank sum test, spearman correlation analysis was used to correlate the changes in QoL before and after CPCS with the number of interventions, and p < 0.05 indicates that the difference is statistically significant. Results: A total of 331 PD outpatients received CPCS over 490 outpatient visits with an average age of 71.83 (±12.54). Five hundred and forty-five drug related problems were recorded as pharmacist interventions, of which most involved change to dosage (n = 226, 41.47%), adverse drug reactions (n = 135, 24.77%), and change in a medication (n = 102, 18.72%). Compared with those receiving standard of care, patients receiving CPCS were significantly less likely to have been prescribed pramipexole (18.52 versus 23.77%, p < 0.001) and more likely to have been prescribed amantadine (5.40 versus 3.70%, p = 0.02) and selegiline (17.36 versus 11.64%, p < 0.001). Lower dosages of levodopa/benserazide (0.51 ± 0.31 g versus 0.84 ± 0.37 g, p < 0.001), levodopa/carbidopa (0.33 ± 0.23 g versus 0.66 ± 0.47 g, p < 0.001), pramipexole (1.14 ± 1.63 mg versus 1.27 ± 0.69 mg, p = 0.01), and entacapone (130.00 ± 79.76 mg versus 173.09 ± 97.86 mg, p < 0.001) were also recorded. At baseline 119 PD outpatients with an average age of 69.98 (±9.90) were recruited for the longitudinal study. At 3-month follow-up, participants reported improvement in bodily pain subscale (baseline versus 3-months follow-up, 30.04 ± 22.21 versus 23.01 ± 20.98, p = 0.037) and medication adherence (6.19 ± 1.50 versus 6.72 ± 1.73, p = 0.014). Frequency of CPCS use was related to activity of daily living subscale (p = 0.047), the bodily pain subscale (p = 0.026), and medication adherence (p = 0.011). Total score of PDQ-39 was associated with patient education (p = 0.005) and usage and dosage combined with patient education (p = 0.006), while medication adherence score was associated with usage and dosage (p = 0.005). Conclusion: The CPCS was effective in resolving drug-related problems and in improving patients' medication regimens, medication adherence, and QoL through patient education and dosage adjustments. This is the first step in the development and feasibility testing of pharmacy services for PD patients in China. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Assess the quality of pharmaceutical services provided in public pharmacies using results of audits carried out by the Pharmaceutical Inspection. Part 1. General analysis. In Poland, quality supervision and marketing of medicinal products is the task of the State Pharmaceutical Inspection. The main goal of its activities include securing social interests in terms of health and life safety of people using medications purchased, among others in pharmacies. The manuscript proposes a new solution to assess the quality of pharmaceutical services provided in public pharmacies using results of audits carried out by the Pharmaceutical Inspection. Research material consists of data obtained from the Voivodeship Pharmaceutical Inspectorates (WIF) regarding the number of carried out inspections and detected irregularities between January 1, 2015 and June 30, 2016. The research was conducted in 2016, among all 16 Voivodeship Inspectorates. At the request to provide essential information, 12 WIF responded positively, data from the remaining inspectorates was obtained from public information made available on their websites. In 2015, 3988 audits of public pharmacies were carried out. At that time, 13,469 public pharmacies operated in Poland and 134 inspectors were employed. On average one inspector carried out 2.5 audits monthly, which means that a single pharmacy was inspected once in 3.5 years (these calculations do not refer to other entities supervised by this office). The number of inspectors to entities and imposed tasks is insufficient, translating into the frequency of pharmacy’s inspections. This frequency can have a direct impact on the quality of provided services, as each inspection is aimed at eliminating mistakes. A hypothesis can be drawn that the less frequently an entity is audited, especially an entity where irregularities are noted, the easier it is to repeat and consolidate those irregularities to everyday practice. This in turn can lead to providing low quality pharmaceutical services.

Objective: Patients' complain regarding pharmaceutical services at community pharmacies is a fundamental issue as it can directly affect people's service utilization. For the first time in Iran, this survey aimed to investigate the experience of people regarding declare a complaint against the pharmacy sectors as a community-based study. Methods: In this cross-sectional study, over 100 samples based on postal codes were randomly selected from the city of Shiraz in 2017–2018. The data collection instrument was designed in two parts (demographic and social profile which record the complaint experiences against pharmacists, pharmacy services, etc.). The data were analyzed by SPSS. Findings: All 1035 eligible participants had a mean age of 45.54 ± 15.82 years (ranged from 14 to 91). Nearly 70% of the participants were female. Around 81.8% had a family physician coverage, whereas 7.4% of them had no medical insurance coverage. The frequency of complaints from the pharmacies was 35.6%. Nearly 55% of the complaints were related to governmental pharmacies. Homemakers were 1.36 times more likely to have experienced complaints in comparison with their employed female counterparts. Health status had an inverse association with complaints. Those participants who had received prescription medication were about two times more likely to have filed a complaint in comparison with those who received medication without a prescription. In addition, females aged 40–59 and above 60 and unemployed participants were more satisfied with respect to complaint follow-up process. Conclusion: Low level of satisfaction with respect to the complaint process is a concerning issue; hence, strategies are warranted to improve the quality of services provided in the pharmacies.

Objective: To identify the impact of a collaborative pharmaceutical care service (CPCS) on medication safety and establish the impact of the CPCS on patient reported outcomes for Parkinson’s disease (PD) patients.Methods: Initially, PD outpatients receiving the CPCS between March 2017 and March 2019 were compared with PD patients receiving standard of care to identify differences in management. Pharmacist interventions data were coded and patients with PD receiving the CPCS were compared with those receiving standard of care to determine differences in medicines prescribed and dosage associated with these. Following this, data of patients receiving CPCS at baseline and 3-months follow-up were collected using a questionnaire consisting of validated measures of two patient-reported outcomes [adherence and quality of life (QoL)]. Mean scores for continuous variables were calculated, with descriptive analysis of categorical variables consisting of frequency counts and percentages. Change in adherence score before and after CPCS was investigated using a Wilcoxon sign rank sum test, spearman correlation analysis was used to correlate the changes in QoL before and after CPCS with the number of interventions, and p < 0.05 indicates that the difference is statistically significant.Results: A total of 331 PD outpatients received CPCS over 490 outpatient visits with an average age of 71.83 (±12.54). Five hundred and forty-five drug related problems were recorded as pharmacist interventions, of which most involved change to dosage (n = 226, 41.47%), adverse drug reactions (n = 135, 24.77%), and change in a medication (n = 102, 18.72%). Compared with those receiving standard of care, patients receiving CPCS were significantly less likely to have been prescribed pramipexole (18.52 versus 23.77%, p < 0.001) and more likely to have been prescribed amantadine (5.40 versus 3.70%, p = 0.02) and selegiline (17.36 versus 11.64%, p < 0.001). Lower dosages of levodopa/benserazide (0.51 ± 0.31 g versus 0.84 ± 0.37 g, p < 0.001), levodopa/carbidopa (0.33 ± 0.23 g versus 0.66 ± 0.47 g, p < 0.001), pramipexole (1.14 ± 1.63 mg versus 1.27 ± 0.69 mg, p = 0.01), and entacapone (130.00 ± 79.76 mg versus 173.09 ± 97.86 mg, p < 0.001) were also recorded. At baseline 119 PD outpatients with an average age of 69.98 (±9.90) were recruited for the longitudinal study. At 3-month follow-up, participants reported improvement in bodily pain subscale (baseline versus 3-months follow-up, 30.04 ± 22.21 versus 23.01 ± 20.98, p = 0.037) and medication adherence (6.19 ± 1.50 versus 6.72 ± 1.73, p = 0.014). Frequency of CPCS use was related to activity of daily living subscale (p = 0.047), the bodily pain subscale (p = 0.026), and medication adherence (p = 0.011). Total score of PDQ-39 was associated with patient education (p = 0.005) and usage and dosage combined with patient education (p = 0.006), while medication adherence score was associated with usage and dosage (p = 0.005).Conclusion: The CPCS was effective in resolving drug-related problems and in improving patients’ medication regimens, medication adherence, and QoL through patient education and dosage adjustments. This is the first step in the development and feasibility testing of pharmacy services for PD patients in China.

The combination therapy of binimetinib, encorafenib, and cetuximab ("triplet regimen") was approved in Japan in November 2020 for the second-line treatment of BRAF V600E mutation-positive colorectal cancer. In this study, we encountered a patient who developed a liver injury requiring drug withdrawal on day eight of the triplet regimen administration. The protocol for the international phase III study did not specify blood and biochemical tests on day eight. Hepatic failure occurred in 45.9% (222/484) of the patients within three months, but no specific timing of onset was reported. Since it is important to disseminate novel adverse events to the public, we report the results of this study based on a literature review., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Ethics Committee of Hitachi General Hospital issued approval #2021-55. This study was conducted in compliance with the Ethical Guidelines for Medical Research Involving Human Subjects. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: This study was supported by the Academic Subcommittee of Health Care and Pharmaceutical Sciences and partially funded by the Research Support Budget of the Japanese Society of Pharmaceutical Health Care and Sciences. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Aimono et al.)

(1) Background: Pharmacists are often challenged with situations where women are already on hormonal contraceptives (HC) but have no valid prescription. By Swiss law, pharmacists are allowed to supply prescription-only drugs in exceptional situations without a physician’s prescription. Because eligibility for HC can change, women at risk for complications, such as serious side effects, need to be identified. We aimed to develop a protocol to assist pharmacists in clarifying and documenting eligibility for HC. (2) Methods: We conducted a survey using the Delphi method to identify relevant clarifications and develop a protocol for pharmacists. Proposed material was created based on the literature and existing toolkits/protocols aimed at verifying eligibility for HC. A multidisciplinary expert panel, consisting of gynecologists and pharmacists, reviewed the proposed material and provided anonymized feedback over two survey cycles. (3) Results: This Delphi survey revealed items essential to the clarification of eligibility for HC in pharmacies for women who are already using it. This resulted in a protocol that maps “best practices” regarding these ad interim supplies of HC given without a prescription in Switzerland. (4) Conclusions: This survey, made using the Delphi method, allowed us to create a protocol for pharmacists that aims to verify and document eligibility for HC in Switzerland, where HC is frequently supplied without a prescription.

In order to increase the number of vaccinations performed during the COVID-19 pandemic in Poland, a significant change was introduced in the legislation allowing for the vaccination to also be performed in pharmacies. A cross-sectional survey was conducted among those who chose a pharmacy as a vaccination point during the pandemic COVID-19. The aim of the study was to determine the overall level of patient satisfaction with pharmacist-administered vaccination in pharmacies and to examine patient opinions regarding the further expansion of pharmacy services. A patient survey was conducted immediately after vaccination in the period from January to March 2022. A total of 398 questionnaires were completed. The respondents reported high satisfaction with pharmacist-administered vaccinations (94.5%). In addition, the majority of consumers felt safe during the vaccination procedure (98.5%), and 88.4% declared they would come for other vaccinations at the pharmacy. The two main reasons for choosing this vaccination place were easy access regarding location (94.2%) and proposed vaccination hours (95.2%). The participants reported high levels of satisfaction concerning the pre-vaccination interview (91.2%), information level before immunization (91.5%), injection technique (96.7%), adjusting the premises to the service (95%) and general care in pharmacy after with vaccination (87.7%). The majority of respondents supported the future expansion of pharmacist-administered services, although the support rate ranged from 52% to 83% depending on the type of service offered. The majority of patients supported the continuation of ongoing prescriptions, blood pressure and blood glucose measurement services by pharmacists. Our findings indicate that the involvement of pharmacies in vaccination programs and other public health services met high levels of patient acceptance.

Introduction: Drug-related problems (DRPs) are not only detrimental to patients' physical health and quality of life but also lead to a serious waste of health care resources. The condition of DRPs might be more severe for patients in primary health care institutions.Objective: This systematic review aims to comprehensively review the characteristics of DRPs for patients in primary health care institutions, which might help find effective strategies to identify, prevent, and intervene with DRPs in the future.Methods: We searched three English databases (Embase, The Cochrane Library, and PubMed) and four Chinese databases (CNKI, CBM, VIP, and Wanfang). Two of the researchers independently conducted literature screening, quality evaluation, and data extraction. Qualitative and quantitative methods were combined to analyze the data.Results: From the 3,368 articles screened, 27 met the inclusion criteria and were included in this review. The median (inter-quartile range, IQR) of the incidences of DRPs was 70.04% (59%), and the median (IQR) of the average number of DRPs per patient was 3.4 (2.8). The most common type of DRPs was “treatment safety.” The causes of DRPs were mainly in the prescribing section, including “drug selection” and “dose selection”, while patients' poor adherence in the use section was also an important cause of DRPs. Risk factors such as the number of medicines, age, and disease condition were positively associated with the occurrence of DRPs. In addition, the medians (IQR) of the rate of accepted interventions, implemented interventions, and solved DRPs were 78.8% (22.3%), 64.15% (16.85%), and 76.99% (26.09%), respectively.Conclusion: This systematic review showed that the condition of DRPs in primary health care institutions was serious. In pharmaceutical practice, the patients with risk factors of DRPs should be monitored more closely. Pharmacists could play important roles in the identification and intervention of DRPs, and more effective intervention strategies need to be established in the future.

Background: In the Brazilian public health system, primary health care (PHC) is provided by the municipalities and is considered the entry level of the Unified Health System (SUS). Governmental pharmaceutical services (PharmSes) are part of the SUS, including PHC, and are the most significant way in which patients access medicine and services. Considering the diversity of the country, the municipalities have the autonomy to decide how PharmSes are implemented. Even though policies and procedures should be implemented as expected by policy makers and experts, municipality characteristics may interfere with implementation fidelity. Therefore, this study evaluated the degree to which the PharmSes in PHC were delivered as intended in Brazilian municipalities. Methods: We analysed data from a secondary database originating from a cross-sectional nationwide study carried out by the Ministry of Health and the World Bank from 2013 to 2015. Data on 465 municipalities and the Federal District were collected from 4939 governmental PharmSes. A rating system comprising 43 indicators was developed and applied to the dataset to obtain the implementation degree (ID) of each PharmSe. Additionally, the IDs of the two PharmSes dimensions and the nine components were measured. Results: Overall, the ID of the PharmSes in Brazilian PHC was evaluated as critical. The ID was critical in 81% of the municipalities (n = 369), incipient in 14% (n = 65) and unsatisfactory in 4.8% (n = 22). Regarding the PharmSes dimensions, the 'medicine management' (MM) ID was considered critical (Mean = 46%), while the 'care management' (CM) ID was incipient (Mean = 22%). In terms of the PharmSes components, the highest ID was achieved by 'forecasting' (58%). In contrast, 'continuing education and counselling' showed the lowest figure (ID = 11%) in the whole sample, followed by 'information and communication' and 'teamwork'. Conclusions: The degree to which PharmSes were implemented was critical (ID< 50%). This analysis demonstrated that PharmSes were implemented with low fidelity, which may be related to the low availability of medicine in PHC. Although the care management component requires more attention, considering their incipient ID, all components must be reviewed. Municipalities must increase their investment in PharmSes implementation in order to maximize the benefits of these services and guarantee the essential right of access to medicine. [ABSTRACT FROM AUTHOR]

Introduction: Drug-related problems (DRPs) are not only detrimental to patients' physical health and quality of life but also lead to a serious waste of health care resources. The condition of DRPs might be more severe for patients in primary health care institutions. Objective : This systematic review aims to comprehensively review the characteristics of DRPs for patients in primary health care institutions, which might help find effective strategies to identify, prevent, and intervene with DRPs in the future. Methods: We searched three English databases (Embase, The Cochrane Library, and PubMed) and four Chinese databases (CNKI, CBM, VIP, and Wanfang). Two of the researchers independently conducted literature screening, quality evaluation, and data extraction. Qualitative and quantitative methods were combined to analyze the data. Results: From the 3,368 articles screened, 27 met the inclusion criteria and were included in this review. The median (inter-quartile range, IQR) of the incidences of DRPs was 70.04% (59%), and the median (IQR) of the average number of DRPs per patient was 3.4 (2.8). The most common type of DRPs was "treatment safety." The causes of DRPs were mainly in the prescribing section, including "drug selection" and "dose selection", while patients' poor adherence in the use section was also an important cause of DRPs. Risk factors such as the number of medicines, age, and disease condition were positively associated with the occurrence of DRPs. In addition, the medians (IQR) of the rate of accepted interventions, implemented interventions, and solved DRPs were 78.8% (22.3%), 64.15% (16.85%), and 76.99% (26.09%), respectively. Conclusion: This systematic review showed that the condition of DRPs in primary health care institutions was serious. In pharmaceutical practice, the patients with risk factors of DRPs should be monitored more closely. Pharmacists could play important roles in the identification and intervention of DRPs, and more effective intervention strategies need to be established in the future. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to identify the patterns of medication load, its medication burden, coordination of healthcare and patient’s understanding of their conventional cardiac medications and related herbalderived preparations. Methods: The study is a mixed-method both, quantitative and qualitative approach, which involved Filipino elderly patients (n=69) enrolled in the outpatient service of the National Center for Geriatric Health, Manila. Data were gathered through face-to-face surveys and interviews using a semi-structured questionnaire. Descriptive statistics were used during data analysis. Thematic analysis was also used to emphasize patterns in the responses of the participants. Results: Respondents were knowledgeable on the name (86.9%), visual characteristics (78.3%), and indication and administration of their medicine (88.4%). The frequency of their doctor’s information on the possible side effects of the medicines was noted. The almost negligible difference in the proportions of those who asserted during the information dissemination on the medication side effect by their doctors was observed (<10.5%). Association on the age and awareness of any interaction on the drugs they are taking (p=0.032) and an association between the gender and awareness of the doctor/pharmacists about other drugs the patient is taking (p=0.033) were observed. During thematic analysis, elderly respondents were keen on the physician’s advice than that of the pharmacist. This is due to the limited knowledge of elderly patients on the role of pharmacists to conduct medication counseling. Conclusions: The majority of the elderly patients recognized the purpose and extent of medication. It was noted that pharmacists play a limited role in understanding selected Filipino elderly patients on their medication. Lack of communication between the patient and the pharmacist was noted as preliminary findings in the study. Respondents were not yet informed of the responsibility of the pharmacist to provide information regarding their medication. Integration of pharmacists’ care for geriatric health must be strengthened and highly recommended. Supervision by the healthcare professionals, particularly by the pharmacists, must be fully established. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the effects of pharmaceutical service on the correct use, compliance and efficacy of tiotropium bromide powder spray in patients with chronic obstructive pulmonary disease (COPD). METHODS: Totally 105 COPD patients admitted into the 983th Hospital of Joint Logistics Support Forces of PLA from Feb. 2018 to Aug. 2019 were selected as subjects, according to the order of admission and treatment, the patients were divided into two groups via random number table, 52 patients in control group did not receive any intervention, while the 53 patients in research group received pharmaceutical service intervention. The correct rate of use and compliance of tiotropium bromide powder spray were compared between two groups, the efficacy, pulmonary function and modified British medical research council (mMRC) rating were compared between two groups in 12-month follow-up visit. RESULTS:(1) At 6-month and 12-month follow-up visit, the correct rate of use, score of Morisky medication adherence scale-8 (MMAS-8), forced expiratory volume in 1 s (FEV1 ), the ratio of FEV1 and forced vital capacity (FVC) of research group were significantly higher those at 1 month of enrollment, and the mMRC ratings were significantly lower than that at 1 month of enrollment, with statistically significant differences (P < 0. 05). (2) At 12-month follow-up visit, the correct rate of tiotropium bromide powder spray use, MMAS-8 score, FEV1 and FEV1 / FVC of the research group were significantly higher than those at 6-month follow-up visit, and the mMRC rating was significantly lower than that at 6-month follow-up visit, with statistically significant differences (P < 0. 05). (3) At 6-month and 12-month follow-up visit, the correct rate of tiotropium bromide powder spray use, MMAS-8 score, FEV1 and FEV1 / FVC of the research group were significantly higher than those of the control group, and the mMRC rating was significantly lower than that of the control group, with statistically significant differences (P < 0. 05). (4) At 12-month follow-up visit, the overall effective rate of research group was significantly higher than that of the control group, with statistically significant differences (P < 0. 05). CONCLUSIONS: Pharmaceutical service can effectively promote the correct use, compliance and efficacy of tiotropium bromide powder spray in COPD patients, improve patients' pulmonary function and relieve dyspnea. [ABSTRACT FROM AUTHOR]

Starting from drug discovery, through research and development, to clinical trials and FDA approval, artificial intelligence (AI) plays a vital role in planning, developing, assessing modelling, and optimization of product attributes. In recent decades, machine-learning algorithms integrated into artificial neural networks, neuro-fuzzy logic and decision trees have been applied to tremendous domains related to drug formulation development. Optimized formulations were transformed from lab to market based on optimized properties derived from AI Technologies. Research and development in pharmaceutical industry rely upon computer-driven equipment and machine learning technology to extract data, perform simulations, modelling, and optimization to get optimum solutions. Merging AI technologies in various steps of pharmaceutical manufacture is a major challenge due to lack of in-house technologies. In silico studies based on artificial intelligence are widely applied as effective tools to screen the market needs of medications and pharmaceutical services through inspecting scientific literature and prioritizing medicines for specific illnesses or a particular patient. Specialized personnel who excel in scientific and data science with analytical knowledge are essential for transformation to smart manufacturing and offering services. However, privacy, cybersecurity, AI-dependent unemployment, and ownership rights of AI technologies require proper regulations to gain the benefits and minimize the drawbacks. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the new needs and characteristics of patients for pharmaceutical service under the new medical reform situation, so as to provide guidance for the transformation of pharmaceutical service. METHODS: A questionnaire survey related to pharmacy service was performed for outpatients in the hospital from Jan. to Feb. 2021. A total of 300 questionnaires were distributed, and 276 valid questionnaires ( 276 patients) were recovered. RESULTS: Among the 276 patients who participated in the questionnaire survey, 58. 33% of patients (161 cases) needed to take 3 or more drugs at the same time; 44. 57% of patients (123 cases) expected to obtain pharmacy consultation and science popularization through on-site consultation, and 35. 87% of patients ( 99 cases) chose WeChat platform; the most concerned drug-related issues was adverse drug reactions and cautions; 79. 35% of patients (219 cases) considered that it was necessary to perform pharmaceutical science popularization; 30. 43% of patients (84 cases) missed drugs frequently; 89. 86% of patients (248 cases) wished to receive medication reminder before medication. CONCLUSIONS: Most outpatients want access to pharmaceutical service, under the new medical reform situation, the development of pharmaceutical service should be closely integrated with digital means such as the internet, and carry out individualized pharmaceutical service based on patients’ requirements. [ABSTRACT FROM AUTHOR]

Objective: The majority of patients who receive antihypertensive treatment do not achieve adequate blood pressure (BP) outcomes. Adherence to antihypertensive therapy contributes to adequate control of BP and is a substantial reason for therapeutic success. This study aims to evaluate the role of clinical pharmacists in improving patient adherence to pharmacological treatment and in improving BP outcomes. Methods: A pre- and postpharmaceutical care interventional study was provided to hypertensive patients in the Cardiovascular Health Program of the Family Health Community Hospital in rural Coelemu, Chile. Patients received pharmaceutical care in three individualized sessions over 6 months. Written educational materials including basic information on high BP were provided to each patient in every session using easy-to-understand language. BP was measured at the beginning and end of each session using an electronic tensiometer, and patients reported their adherence to therapy using indirect, self-reported measures. Findings: Over the study period, patients experienced average decreases in systolic and diastolic BP of 7.68 mmHg (P < 0.001) and 2.91 mmHg (P < 0.001), respectively. Patient adherence to medication, according to self-reported measures, increased from 22% to 60% over the study period. Conclusion: Pharmaceutical care, including education about hypertension, healthy lifestyle habits, and adherence, was associated with improved adherence to antihypertensive drug treatment and control of BP in hypertensive patients at a rural hospital in Chile.