Search

The article presents the 2025 American Society of HealthSystem Pharmacists (ASHP) Pharmacy Forecast report which aims to identify and contextualize emerging trends that will influence healthcare, health systems, and the pharmacy profession. Topics discussed include the methods used to develop the 2025 Pharmacy Forecast, contents of the 2025 Pharmacy Forecast, and market pressure on health systems with infusion services.

The article describes the purpose and promise of health system-based research networks with a focus on the medication-use process (MUP). Topics include the pathway for the development of and participation in one such consortium, challenges critical for this initiative to overcome, and an approach that can be taken to conduct research in all domains of the MUP.

Purpose The American Society of Health-System Pharmacists (ASHP) developed the Practice Advancement Initiative 2030 (PAI 2030) to support the continuous improvement of hospital pharmacy services in the United States. Puerto Rico (PR) hospitals' level of compliance with PAI 2030 recommendations is not currently known. The primary objective of this study was to describe the hospital pharmacy scenario in PR in the 5 areas addressed in PAI 2030 recommendations. Summary Through a collaboration between the state affiliate, a school of pharmacy, and ASHP, completion of the PAI 2030 Self-Assessment Tool was promoted among hospital pharmacy directors between August 2022 and March 2023. A total of 18 out of 66 hospitals completed the survey. The results were compared with national data provided by ASHP from 163 US hospitals. Areas where PR hospitals rated high were in PAI 2030 domain A (Pharmacy Technician Role, Education, and Training) and domain E (Pharmacist Leadership in Medication Use and Safety). PR hospitals rate their performance lower in domain A (Patient-Centered Care) and domain B (Pharmacist Role, Education, and Training). Specific focus areas for improvement by PR hospitals include pharmacist participation in medication reconciliation, 24/7 access to advanced clinical pharmacy services, expansion of the pharmacist's scope of practice, and training through the Board of Pharmacy Specialties and residency programs. Conclusion This study illustrates how the PAI 2030 Self-Assessment Tool can be used to benchmark pharmacy services at the state level. We suggest that changes are needed to close the gap between hospital pharmacies working towards optimizing the role of pharmacists in healthcare systems and those still struggling with dedicating staff to well-recognized pharmacist roles and responsibilities. [ABSTRACT FROM AUTHOR]

Background Aim Design Results Conclusion Practice‐integrated residency programs are one of the most recognised training platforms for early career development across settings, including hospital pharmacy. They embed a structured education and competency framework and preceptor mentoring systems in the workplace.This review aimed to map the global literature on practice‐integrated education and professional development programs for early career hospital pharmacists, with a focus on how the programs were implemented and structured.A search was applied to electronic databases MEDLINE, Ovid Emcare, Embase, ERIC, Scopus, PsycINFO, Cochrane Library, Google Scholar and grey literature sources until 31 December 2023. Search terms were developed in consultation with an academic librarian and using the population, concept and context mnemonic. The scoping review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for Scoping Reviews and the Joanna Briggs Institute scoping review manual.Forty‐seven papers were included from seven countries, with the majority (n = 33) being from the United States of America. Residency program details were mapped against jurisdictions and associated assessment processes, competency training areas, and focused training elements. Findings report similarities and differences of structural, competency frameworks, and locally driven context and requirements.The demand from early career pharmacists for residency programs remains high, with professional pharmacy organisations providing leadership to grow training positions. The global pharmacy development goals appear to be embedded within the residency programs, but gaps include training in non‐direct patient care competencies and research that demonstrates the outcomes from residency training. [ABSTRACT FROM AUTHOR]

As the demand for "quick-fixes" and instant gratification intensifies among consumers of the US health care delivery system, health care providers remain essential to ensuring patients receive safe, evidenced-based care. Erectile dysfunction is a common health condition affecting as many as 42% of US men. As such, it is unsurprising that American health care consumers affected by erectile dysfunction (ED) may be tempted by "quick fixes" to ameliorate their symptoms—particularly if such fixes are perceived to be less embarrassing, more accessible, and/or more affordable. Although multiple therapies for the treatment of ED are approved by the US Food and Drug Administration, unregulated and/or counterfeit treatments are abundantly available to health care consumers on the Internet and US retail settings. These unregulated treatments may take the form of over-the-counter supplements or tainted prescription medications from illegal Internet pharmacies. This clinical brief is a call to action for health care professionals to advocate for patient safety, educate patients, and champion evidence-based therapies approved for the treatment of erectile dysfunction. [ABSTRACT FROM AUTHOR]

This essay uses the unpublished casebook kept by the Tuscan surgeon Giovanbattista Nardi to examine the provision of urgent medical care in sixteenth-century Italian hospitals. Most major hospitals on the peninsula maintained separate therapeutic spaces known as medicherie for this purpose. Written in the 1580s while Nardi worked as a staff surgeon at a Florentine civic hospital, this rare surgical casebook provides insight into the types of institutional resources devoted to acute medical problems; the clientele seeking immediate assistance and the situations that brought them there; the treatments used to achieve short-term "cures"; and the clinical experiences of hospital surgeons who served as frontline healers. A close analysis of the seventy-nine cases recorded sheds new light on everyday surgical treatments for conditions ranging from serious head injuries requiring trephination to syphilitic lesions and genital trauma. Casebook entries also reveal Nardi's deep engagement with the composition and use of topical remedies as both practitioner and experimenter. Intended as a memory aid for future reference, the casebook shows material traces of the author's shifting occupational identity as he matured from hospital surgeon to university-trained physician. Viewed through multiple lenses, this richly layered source expands our understanding of both the practice and profession of early modern surgery. [ABSTRACT FROM AUTHOR]

Aims: Computerized decision support systems (CDSSs) aim to prevent adverse drug events. However, these systems generate an overload of alerts that are not always clinically relevant. Anticoagulants are frequently involved in these alerts. The aim of this study was to investigate the efficiency of CDSS alerts on anticoagulants in Dutch hospital pharmacies. Methods: A multicentre, single‐day, cross‐sectional study was conducted using a flashmob design in Dutch hospital pharmacies, which have CDSSs that operate on both a national medication surveillance database and on self‐developed clinical rules. Hospital pharmacists and pharmacy technicians collected data on the number and type of alerts and time needed for assessing these alerts. The primary outcome was the CDSS efficiency on anticoagulants, defined as the percentage of alerts on anticoagulants that led to an intervention. Secondary outcomes where among other CDSSs efficiency related to any medications and the time expenditure. Descriptive data‐analysis was used. Results: Of the 69 hospital pharmacies invited, 42 (61%) participated. The efficiency of CDSS alerts on anticoagulants was 4.0% (interquartile range [IQR] 14.0%) for the national medication surveillance database alerts and 14.3% (IQR 40.0%) for alerts from clinical rules. For any medication, the efficiency was lower: 1.8% (IQR 7.5%) and 13.4% (IQR 21.5%) respectively. The median time for assessing the relevance of all alerts was 2 (IQR 1:21) h/day for pharmacists and 6 (IQR 5:01) h/day for pharmacy technicians. Conclusion: CDSS efficiency is generally low, both for anticoagulants and any medication, while the time investment is high. Optimization of CDSSs is needed. [ABSTRACT FROM AUTHOR]

The article discusses the role of the chief pharmacy officer in eliminating sexual harassment in pharmacy. Topics include role the pharmacy executive in driving change and accountability, a barrier to sexual harassment awareness and reporting, and reason that many incidents of sexual harassment go unreported.

Purpose Two-spirit, lesbian, gay, bisexual, transgender, and queer (2SLGBTQ+) people disproportionally experience health disparities, and hospital pharmacists, given their accessibility and expertise in medication management, are ideally positioned to provide care to this vulnerable population. This study investigated the barriers and facilitators faced by hospital pharmacists when providing care to 2SLGBTQ+ patients, with the goal of informing enhancement of quality care provided to these patients. Methods A mixed-methods triangulation design was utilized, comprising an online survey and qualitative interviews with Canadian hospital pharmacists. The survey used the lens of systemic oppression as a framework and assessed pharmacists' perceptions and knowledge. Survey data were analyzed using descriptive statistics, and interviews were analyzed using thematic analysis. Results A total of 129 individuals participated in the survey, and 15 participants were interviewed. Eleven themes were identified, and findings revealed a complex web of individual, interpersonal, and systemic barriers and facilitators. Pharmacists expressed a lack of proficiency and confidence in discussing 2SLGBTQ+ health topics, further compounded by an apprehension to engage and a fear of causing harm. Pharmacists desired support from their leadership teams and organizations in the form of access to resources, time to engage in training, and workplace environments that encourage discussions about 2SLGBTQ+ health. Conclusion Hospital pharmacists in Canada are willing to provide inclusive care to 2SLGBTQ+ patients but face significant barriers. These findings highlight the need for comprehensive education, supportive workplace cultures, and accessible resources to address health disparities and improve care for 2SLGBTQ+ individuals. [ABSTRACT FROM AUTHOR]

Purpose Integration of pharmacists into the perioperative practice has the potential to improve patients' clinical outcomes. The aim of this systematic review is to systematically investigate the evidence on the roles of pharmacists in perioperative settings and the effects of pharmacist interventions on clinical outcomes and therapy optimization. Methods A protocol-led (CRD42023460812) systematic review was conducted using search of PubMed, Embase, CINAHL and Google Scholar databases. Studies that investigated the roles and impact of pharmacist-led interventions in the perioperative settings on clinical outcomes were included. Data were extracted and quality assessed independently by two reviewers using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and the Crowe Critical Appraisal Tool (CCAT), respectively. Studies were grouped according to the clinical area into 5 sections: (1) pain control and opioid consumption; (2) venous thromboembolism (VTE); (3) surgery-related gastrointestinal complications; (4) postoperative medication management; and (5) total parenteral nutritional. Results Nineteen studies involving a total of 7,168 patients were included; most studies were conducted in gastrointestinal (n = 7) and orthopedics (n = 6) surgical units. Most included studies (n = 14) employed a multicomponent intervention including pharmaceutical care, education, guideline development, drug information services, and recommendations formulation. The processes of developing the implemented interventions and their structures were seldom reported. Positive impacts of pharmacist intervention on clinical outcomes included significant improvement in pain control and reductions in the incidence of VTE, surgery-related stress ulcer, nausea, and vomiting. There is inconsistency in the findings related to medication management (ie, achieving desired therapeutic ranges) and management of chronic conditions (hypertension and type 2 diabetes). Conclusion Whilst there is some evidence of positive impacts of pharmacist intervention on clinical outcomes and optimizing drug therapy, this evidence is generally of low quality and insufficient volume. While this review suggests that pharmacists have essential roles in improving the care of patients undergoing surgery, more research with rigorous designs is required. [ABSTRACT FROM AUTHOR]

The article presents the statement by the American Society of Health-System Pharmacists (ASHP) on the community pharmacist's role in the care continuum. Topics include practice areas where community pharmacies are found, core clinical responsibilities of community pharmacists, and core operations of the community pharmacy that the pharmacist manages or supports.

Background Aim Method Results Conclusion The use of a closed system transfer device (CSTD) is recommended when compounding hazardous cytotoxic medicines for operator and environmental protection. The hospital pharmacy compounding unit has used the CSTD PhaSeal since 2014. Recent evidence suggests an alternative CSTD, Equashield, may be a suitable alternative.To determine if Equashield provides any advantages financially, in compounding time, rubber bung contamination, cytotoxic medicine surface contamination, staff satisfaction, and work health and safety benefits when compared to PhaSeal.CSTD PhaSeal was compared to Equashield by performing a financial cost comparison, time in motion study to compare compounding time, evaluation of product contamination rates and cytotoxic surface contamination levels, work health and safety (WH&S) review and staff satisfaction survey. This project was exempt due to the local policy requirements that constitute research by the Children's Health Queensland Research Ethics Committee (Reference no: EX/23/QCHQ/97690). The justification for this ethics exemption was as follows: the study conformed with the Ethical considerations in quality assurance and evaluation activities and met local requirements for a quality assurance activity and did not involve any assessment of staff. Informed consent was obtained from all staff via verbal explanation of the project and their voluntary participation. Staff consented via completion of the voluntary survey.The cost to compound using Equashield instead of PhaSeal was increased by AUD $4684 over a 6‐month period, with a compounding time saving benefit of approximately 1 min per product. Product contamination by rubber stopper core was 16 per 100,000 products using Equashield. Surface cytotoxic contamination levels remained undetectable before and after the comparison. Staff preferred Equashield and a WH&S product review determined Equashield required less torque and force during use and may reduce repetitive strain injury.Equashield performed better in time to compound, rate of product contamination, staff satisfaction and WH&S assessment. The cost of Equashield was greater; however, Equashield demonstrated benefits over Phaseal in other areas of comparison, which could potentially offset the cost increase. The pharmacy demonstrated Equashield may be a suitable alternative to PhaSeal. [ABSTRACT FROM AUTHOR]

This explorative study investigates the emergence of gray zone markets from search engines amidst the global expansion of online markets. With the analytical approach of infrastructural inversion, we examine how the search infrastructure constructs access to a gray zone market including both authorized online pharmacies and unauthorized vendors. Using Sweden and Google Search as a case, we explore the online presence of three products (vitamin D, paracetamol, and Viagra), through search engine result page analysis, web crawling, and network analysis. Infrastructural inversion unveils the typically invisible mechanisms of search engines, considering user queries, algorithmic priorities, SEO practices, and pharmacy regulations. We find gray zones only emerge in searches for erectile disfunction medicinal products and information, where unauthorized vendors successfully competed for visibility in search engine rankings. A complex web of conditions can steer consumers toward gray zone markets, complicating the access to safe and regulated medicinal products. This can expose individuals to risks associated with unverified medicinal products, but also challenges the integrity of the online health information infrastructure. [ABSTRACT FROM AUTHOR]

Purpose This article identifies, prioritizes, and summarizes published literature on the medication-use process (MUP) from calendar year 2023 that can impact health-system pharmacy daily practice. The MUP is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The MUP is defined in this article as having the following components: prescribing/transcribing, dispensing, administration, and monitoring. Articles evaluating at least one step of the MUP were assessed for their usefulness toward practice improvement. Summary A PubMed search was conducted in January 2024 for calendar year 2023 using targeted Medical Subject Headings keywords and the tables of contents of selected pharmacy journals were searched, providing a total of 5,314 articles. A thorough review identified 40 potentially practice-enhancing articles: 8 for prescribing/transcribing, 15 for dispensing, 6 for administration, and 11 for monitoring. The trends from the articles are briefly summarized, with a mention of the importance within health-system pharmacy. The articles are listed and summarized in tables for further review and evaluation. Conclusion It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article assists in identifying and summarizing the most impactful literature from 2023. Health-system pharmacists have an active role in improving the MUP in their institutions, and awareness of significant published studies can assist in changing practice at the institutional level. [ABSTRACT FROM AUTHOR]

The article highlights the Summit on Artificial Intelligence (AI) in Pharmacy Practice held by the American Society of Health-System Pharmacists (ASHP) on June 9 and 10, 2024 as part of the inaugural ASHP Pharmacy Futures Meeting in Portland, Oregon. Topics include goal of the Summit, key areas highlighted by the ASHP Statement on the Use of Artificial Intelligence in Pharmacy where pharmacists can take the lead, and pharmacy enterprise infrastructure to support AI.

The authors share their experience developing and implementing on-site clinical pharmacy services within a freestanding emergency departments (FSEDs). Topics include pharmacy team structure, medication safety measures unique to the FSED, and collaboration of the FSED pharmacy team with other pharmacy department members.

Purpose To describe the application of the Plan-Do-Study-Act quality improvement framework in the development, implementation, and evaluation of a novel pharmacy practice model in ambulatory oncology. Summary Four iterations of the Plan-Do-Study-Act framework were completed to develop a patient-facing, pharmacist-led ambulatory oncology clinic program. The clinic provided care to patients with prostate cancer on oral anticancer therapy. Metrics were collected throughout all stages of development to inform target processes for improvement. The pharmacist saw 136 patients between July 2019 and January 2023, resulting in 464 total encounters. The pharmacist provided clinical interventions and counseling to patients newly starting on oral anticancer therapy and those established on therapy using a longitudinal model of care. Conclusion Application of the Plan-Do-Study-Act quality improvement framework to a novel pharmacy practice model supported the development, evaluation, and sustainability of a pharmacist-led ambulatory oncology clinic providing care to patients with prostate cancer on oral anticancer therapy. [ABSTRACT FROM AUTHOR]

Purpose Critical care pharmacists (CCPs) are essential members of the multidisciplinary critical care team. Professional activities of the CCP are outlined in a 2020 position paper on critical care pharmacy services. This study looks to characterize CCP perspectives for priorities in optimizing pharmacy practice models and professional activities. Methods This was a cross-sectional survey conducted from July 24 to September 20, 2023. A 41-question survey instrument was developed to assess 7 domains: demographics, CCP resource utilization, patient care, quality improvement, research and scholarship, training and education, and professional development. This voluntary survey was sent to members of the American College of Clinical Pharmacy's Critical Care Practice and Research Network. The survey was open for a total of 6 weeks. Results There was a response rate of 20.7% (332 of 1,605 invitees), with 66.6% of respondents (n = 221) completing at least 90% of the survey questions. Most respondents were clinical specialists (58.2%) and/or practiced at an academic medical center (58.5%). Direct patient care, quality improvement and medication safety, and teaching and precepting were identified as the CCP activities of highest importance to CCPs. The CCP-to-patient ratios considered ideal were 1:11-15 (selected by 49.8% of respondents) and 1:16-20 (33.9% of respondents). The ideal percentage of time dedicated to direct patient care activities, as identified by survey respondents, was 50% (interquartile range, 40-50). Conclusion These findings highlight the professional activities viewed as having the highest priority by CCPs. Future research is needed to define optimal CCP practice models for the delivery of patient care in real-world settings. [ABSTRACT FROM AUTHOR]

The article focuses on the Advanced Pharmacy Australia Clinical Pharmacy Standards, which outline best practices for delivering high-quality, person-centered clinical pharmacy services in Australia. Topics include the principles of safe and effective medicines management, the importance of interprofessional collaboration, and strategies for workforce development and education.

Background: Hospital pharmacy services support quality use of medicines and medication safety through clinical pharmacy activities such as medication reviews and patient education. These activities can be measured and monitored using evidence-based and standardised key performance indicators (KPIs), which highlight the value of pharmacy services. Standardisation of KPIs supports long-term benchmarking and inter- and intra-site comparisons to target key areas for improvement in clinical pharmacy services. Aim: To describe the type and frequency of clinical pharmacy activity across five hospitals within one metropolitan hospital district. Methods: Key Performance Indicator data were collected by pharmacists from five hospital sites at one metropolitan hospital district, in Queensland Australia. Data were collected over one week for the following clinical settings: inpatient, discharge, outpatient clinic, and the dispensary. Data were collected using a manual, paper-based data collection tool previously developed using a co-design process. Results: Across 11,215 inpatient encounters, hospital pharmacy services provided: best possible medication history (BPMH) within 24 h of admission: 69.5%; daily medication chart review: 57.2%; discharge education: 82.7%, discharge reconciliation: 88.2%; and provision of discharge medication record: 82.4%. Across 1,092 outpatient encounters, pharmacists documented BPMH for 33.3% of patients. Pharmacists identified a total of 5,009 drug-related problems (DRPs) across the data collection period, with the rate of identification highest in the outpatient clinic setting (64.8 per 100 patient reviews) followed by discharge (52.6 per 100 patient reviews) and then inpatient (48.1 per 100 patient reviews). Almost 20% of DRPs identified (n = 975) were high risk. Conclusion: Reporting and benchmarking clinical pharmacy activity through standardised KPIs supports opportunities to identify service improvements. Future research should focus on larger scale studies using routinely recorded data to monitor clinical pharmacy KPIs across all care settings. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this paper are to (a) explore stakeholders' opinions regarding Nepal's existing medicines pricing practices/situation and (b) build and present a set of medicines pricing policies for Nepal. Methods: A review of the literature and field visits to community retail pharmacies, hospital pharmacies, wholesalers, and distributor outlets in Kathmandu were conducted to assess the medicines pricing situation. Following the literature review, preliminary meetings with stakeholders and field visits were held and a draft interview guide was prepared. Consultative sessions subsequently were undertaken in Kathmandu, Nepal, in January 2023 with representatives from the Department of Drug Administration, Ministry of Health and Population, Association of Pharmaceutical Producers of Nepal, consumer groups, Transparency International, Medicines Importers Association of Nepal/ Pharmaceutical Distributors Association of Nepal, Nepal Chemist and Druggist Association, and Nepal Pharmaceutical Association. Notes were taken during these meetings regarding issues and concerns raised as well as experiences and recommendations for the future, as outlined in the interview guide. Results: The stakeholders in general stated that they do not have any objection to price regulation; however, they believe such regulation should be subject to periodic review. Both the importers and the Ministry of Health and Population have the view that an independent body/authority should be charged with regulating the prices of medicines. A set of policy options to be considered for use in Nepal include cost-plus pricing, external price referencing, internal reference pricing, and mark-up regulations. Conclusion: Key issues related to pricing were identified and suggest that a set of pricing policies and updated regulations need to be considered to establish changes that are transparent, rational, and acceptable to the related stakeholders. Hence, suggestions made in this paper could be useful to inform a rational and fair pricing structure and to improve access to medicines. [ABSTRACT FROM AUTHOR]

Introduction: Chronic kidney disease (CKD) is a major public health concern in Saudi Arabia. it is pertinent to mention that in the Southwestern region of Saudi Arabia. Hypertension and diabetes mellites are considered the major drivers of CKD. Research has documented worldwide the inappropriate dose adjustments in patients, ranging from 25% to 77%, of drugs requiring dose modifications. Pharmacists are pivotal members of the healthcare team, tasked with addressing issues pertaining to medications. This study aims to unveil pharmacist perspectives on renal dose adjustment in Saudi Arabia an important step in gauging their involvement in promoting healthy behaviours. Method: A cross-sectional study design was conducted from December 2023 to January 2024 among pharmacists working in diverse healthcare settings, including clinical and hospital pharmacies, retail, and community pharmacies who had direct encounters with patients diagnosed with CKD. A validated questionnaire, the Renal Dose Adjustment-13 (RDQ-13) was used for this study. For comparing the knowledge, attitude, and perception scores of pharmacists statistical tests like One-Way ANOVA, and independent t-test; while for factors influencing the knowledge, attitude, and perception scores a multivariate linear regression was performed. The statistical significance level was set at 0.05. Results: A total of 379 pharmacists completed the questionnaire, the knowledge score of pharmacists was 22.06 ± 2.81, while the attitude score was 8.56 ± 2.62 and the practice score was 5.75 ± 2.25. The findings of multivariate linear regression analysis indicated a statistically significant positive association between knowledge score and pharmacist's age while for practice score the findings revealed a statistically negative association between working setting and designation of pharmacists. Conclusion: The pharmacist in Saudi Arabia exhibited a proficient knowledge score of drug dosage adjustment pertinent to renal function while the attitude and practice score was less as compared to the knowledge score. [ABSTRACT FROM AUTHOR]

Background: With the recent Food & Drug Administration (FDA) approval of cellular therapy that requires product manipulation prior to administration in combination with a short stability window, the need was identified for local dose preparation within the pharmacy rather than the off-site stem cell processing laboratory. This approval gave rise to assessment of regulatory standards surrounding cellular therapy, evaluation and revision of current standard operating procedures and policies with formal process validation, assessment of occupational exposure mitigation and safety considerations, and development of staff training and education. Objective: To describe and provide insight into the stepwise process of FACT validation and onboarding of commercially available cellular therapy products that require sterile compounding manipulation within a pharmacy prior to administration. Discussion: A multidisciplinary effort is required to attain FACT certification and implement pharmacist compounding of cellular therapy products. 1 Local preparation within a pharmacy facilitates a sound operational workflow and provides a pathway to perform aseptic manipulations of cellular therapy products safely and efficiently. Conclusion: Safe and successful administration of cellular therapies handled and compounded by pharmacy department staff along with program validation requires a preemptive review utilizing a multidisciplinary approach for process development. This manuscript will provide a foundation based on consistency and transparency in effective cellular therapy sterile compounding and aseptic manipulation, proper handling and disposal procedures, increased communication through creation and optimization of treatment plans and order-sets, standardized medical center staff education, and development of policies and standard operating procedures for the entire health care team. [ABSTRACT FROM AUTHOR]

Purpose This study was designed to evaluate the impact of enterprise inventory optimization (EIO) technology and analytics on pharmacy labor, costs, and medication availability within a large integrated delivery network (IDN). Methods This article describes a mixed-methods, postmarket observational study assessing the impact of a solution of disparate technologies including automated dispensing cabinets (ADCs), centralized pharmacy inventory software, and controlled substance vaults connected by an inventory optimization analytics (IOA) tool. Four study modules were implemented over a 10-month period. The intervention consisted of implementation of the IOA software, linking the disparate automated technologies. Transactional data was collected and aggregated with user perception survey data in both the pre- and postintervention periods. Descriptive and comparative statistical testing was used to assess outcomes. Results A total of 11 facilities with bed counts ranging between 22 and 908 beds were included in this study. At an enterprise level, users were able to complete an average of 2.8 times more periodic automated replenishment (PAR) level changes post intervention, resulting in an estimated enterprise labor avoidance of over 1 full-time equivalent (2,099 labor hours) annually. Despite an enterprise decision to increase ADC inventory on hand from a 3-day supply to a 5-day supply, 5 sites (45%) had a decrease in total inventory, while 9 sites (82%) saw a decrease in ADC inventory costs. Additionally, 7 sites (64%) saw a reduction in the ADC stockout percentage and all 11 sites (100%) saw a decrease in the central pharmacy stockout percentage post intervention. Conclusion Integration and optimization of connected inventory management technology was observed to have positive impacts on improving labor productivity, reducing ADC inventory carrying costs, and increasing medication availability. [ABSTRACT FROM AUTHOR]

Purpose Central line–associated bloodstream infections (CLABSIs) are hospital-acquired, serious complications that greatly affect many vulnerable neonates throughout their hospital stay. This article describes the implementation of a unique practice in which pharmacy primes continuous infusions through medication tubing for neonatal central lines in a cleanroom at Children's Hospital Colorado – Colorado Springs (CHCO-CSH). Summary This institution is a freestanding children's hospital with a level III neonatal intensive care unit (NICU) that opened in April 2019. Since then, the pharmacy department has been priming central line tubing for continuous infusions for all patients in the NICU. Neonates are at increased risk for developing CLABSIs due to their immature immune systems and frequent need for central line placement. With that in mind, the pharmacy department decided to focus efforts on this population. Pharmacists and pharmacy technicians received training on how to properly prime tubing, document when a patient received a new central line, document if a central line was removed, and record when new tubing was due based on a department policy. Conclusion This novel, pharmacy-led priming procedure resulted in a low CLABSI incidence, offering a promising strategy to reduce CLABSIs in a NICU. [ABSTRACT FROM AUTHOR]

One of the main contributing factors of antibiotic resistance is the dispensing of antibiotics without prescription. This study investigated community pharmacists' knowledge, attitudes, and practices in relation to antibiotic dispensing and resistance in United Arab Emirates (UAE). A cross-sectional survey was conducted using validated questionnaire. (40.1%) had an overall positive KAP score. A total of (88%) respondents were aware of the illegality of dispensing antibiotics without a prescription. Only (31%) had good knowledge regarding amoxicillin dosage for upper respiratory tract infection. The primary misconduct found numerous pharmacists prescribing antibiotics without a prescription, even though they were aware that this should never be done. Pharmacists who attended events focused on antibiotic use and resistance were more likely to have good knowledge about antibiotics (Adjusted Odd Ratio (AOR): 1.673; 95%CI: 1.029–2.719; p = 0.038), more likely to have positive attitude (AOR: 1.889; 95%CI: 1.133–3.149; p = 0.015), and more likely to have good practice (AOR: 3.182; 95%CI: 1.541–6.572; p = 0.002). [ABSTRACT FROM AUTHOR]

Background: Chronic myeloid leukaemia (CML) is a haematopoietic stem cell disease characterised by the proliferation of granulocytes and their immature myeloid precursors. The treatments recommended are oral treatments dispensed in the outpatient unit (OU) of the hospital's pharmacy service (PS), where patient-centred pharmaceutical care (PC) is essential to enhance therapeutic adherence, detect drug interactions and create a pharmacist-patient relationship to educate the patient on the main potential toxicities derived from the treatment and warning signs or symptoms requiring immediate attention. Methodology: We present the case of a 55-year-old woman, followed up in consultation by the Haematology Service (HS) since October 2021 for CML in the chronic phase. Results: She started treatment on nilotinib 300 mg every 12 hours. The patient attended OU and was offered PC. After 12 months, nilotinib was well tolerated, but our patient experienced a loss of effectiveness, so HS decided to switch to dasatinib 100 mg daily. After one year of treatment, our patient was presented with symptoms of swelling and dyspnoea on moderate exertion. In January 2024, following a joint Haematology-Pharmacy session, a switch to bosutinib 400 mg daily was decided. After 15 days of treatment, the patient presented without an appointment due to a pruritic generalised rash on the torso, face, and extremities, being diagnosed with leukocytoclastic vasculitis. Conclusion: In conclusion, we describe case reports of a patient who has a lack of effectiveness and ARs in several TKIs and the importance of identifying side effects, through early and close PC, in order for the patient's evolution to be favourable. [ABSTRACT FROM AUTHOR]

Background: Patients continue to face challenges accessing medication for opioid use disorder (MOUD) despite attempts to loosen prescribing restrictions and streamline service provision. Past research has mainly focused on potential barriers surrounding prescribing practices for buprenorphine, but has had limited investigation into the role of pharmacies. Objective: This study investigates the role of both pharmacists and pharmacies in creating or circumventing barriers to accessing buprenorphine for individuals in Georgia seeking medication for opioid use disorder (MOUD). Methods: Semi-structured interviews of pharmacists across 12 access and no access pharmacies were used to create a codebook of 179 discreet statements. The (N = 12) 20–35-minute phone interviews included questions addressing substance use, pharmacy practices, treatment, harm reduction, and psychoeducation. Results: Pharmacists widely agreed that opioid use has caused negative effects on community members (N = 11), that buprenorphine formulation stocking decisions are made based on patient needs (N = 11), and that buprenorphine is relatively easy to stock (N = 10). Additionally, respondents generally stated that buprenorphine is a helpful tool for treating opioid use disorder (OUD) (N = 12) but some reported positive experiences while others reported challenging or negative experiences with patients receiving buprenorphine (N = 7). Finally, few (N = 4) pharmacists agreed that they could benefit from extra training despite many asserting that training is important to inform their own practice (N = 8). Conclusion: Results from respondents generally show that training may be beneficial for pharmacists to develop an enhanced understanding of addiction and treatment. Enhanced effort to stock different formulations or dosages of buprenorphine and develop relationships with prescribers may increase community access. [ABSTRACT FROM AUTHOR]

Scholarly activities are essential for enhancing the pharmacy profession, as well as for personal career development. New practitioner pharmacists in academic or community medical center settings may hesitate to incorporate research into their practice if they feel that they do not have the appropriate resources and guidance. While residency provides structured support for research endeavors, new pharmacists may still find research activities daunting to initiate on their own. Many factors should be considered, including strategies for incorporating research into current roles, collaboration efforts, professional opportunities, and timeline considerations, to help pharmacists effectively implement research early in their careers. This article provides new practitioners with a roadmap to navigate challenges and achieve success when integrating scholarly activities into their practice. [ABSTRACT FROM AUTHOR]

Background: Access to essential medications remains a challenge, especially among socioeconomically disadvantaged populations. In 2021, 18 million U.S. adults struggled to afford prescribed medications, a problem exacerbated by the prevalence of chronic conditions like diabetes, hypertension, and mental health disorders. The 340B Drug Pricing Program has enabled eligible healthcare organizations to purchase drugs at reduced prices, thus enhancing medication accessibility for financially constrained patients. This study explores the impact of the Retail Pharmacy Prescription Assistance Program within a 340B-eligible health system in addressing this issue. Objective: To evaluate the effectiveness of a Retail Pharmacy Prescription Assistance Program in increasing access to essential medications and reducing financial burden for eligible outpatients within a 340B-eligible health system. Methods: This exploratory study was conducted at a 340B-eligible academic medical center and focused on the implementation of the Retail Pharmacy Prescription Assistance Program (RPPA Program). Eligible patients, already enrolled in the health system's financial assistance program, were identified, and assessed for additional eligibility for the RPPA Program, ensuring prescriptions were written by internal providers and that patients did not have access to other financial assistance resources. Data collected included patient demographics, medication history, dispensed prescriptions, out-of-pocket patient savings, and pharmacist interventions. Results: During the study, 156 patients were enrolled. About half (51%; n = 79) did not utilize its services due to reasons such as the absence of active prescriptions, prescriptions from external providers, or existing coverage by the patients' insurance. Of the 563 prescriptions clinically evaluated, 72% (n = 407) were dispensed free of charge to 77 patients, resulting in $13,945 in out-of-pocket patient savings. Of the total prescriptions assessed, 28% (n = 156) were not included on the RPPA Program formulary and were not changed to a RPPA formulary alternative for various reasons, such as a formulary alternative was not available, or the patient opted not to switch to formulary alternatives. Conclusions: The RPPA Program proved effective in reducing financial barriers to accessing essential outpatient medications. While it yielded positive outcomes, the program's benefit was constrained to a limited patient demographic, underscoring the imperative to expand identification and engagement strategies to include a broader patient population. [ABSTRACT FROM AUTHOR]

Background: Integrated pharmacist care into health systems results in significant A1c reduction and improved outcomes in patients with diabetes. However, little is known about the adoption of Health System Specialty Pharmacy (HSSP) chronic disease management (CDM) services within diabetes clinics. Risk stratification is proven to enhance care in various patient populations. Objective: The objective of this study is to describe how the implementation of risk stratification in the HSSP setting results in optimized patient outcomes in diabetes. Method: This is a retrospective descriptive study reporting the results of expanding the HSSP care model to implement risk stratified CDM services for patients with diabetes. A total of 285 patients were enrolled in the HSSP CDM pharmacy services and were stratified into high- or low-risk groups. Results: Eighty-eight patients were stratified as high-risk with an average baseline A1c of 11.47% and a most recent average of 8.84%. The remaining 285 patients were stratified into the low-risk group. Their average baseline A1c was 7.48% and the last recorded average A1c was 7.15%. Patients not enrolled in HSSP CDM services (N = 100) had a lower reduction in average A1c compared to patients enrolled in the program. Conclusion: Patients stratified into high- and low-risk groups had greater reductions in A1c compared to patients who did not use HSSP CDM services. These results showcase the success of risk stratification and demonstrate the impact HSSP has on patients needing CDM services and outlines a strategy to provide the greatest impact in a high-volume patient population. [ABSTRACT FROM AUTHOR]

Background: In the healthcare field, there has been a growing interest in using artificial intelligence (AI)-powered tools to assist healthcare professionals, including pharmacists, in their daily tasks. Objectives: To provide commentary and insight into the potential for generative AI language models such as ChatGPT as a tool for answering practice-based, clinical questions and the challenges that need to be addressed before implementation in pharmacy practice settings. Methods: To assess ChatGPT, pharmacy-based questions were prompted to ChatGPT (Version 3.5; free version) and responses were recorded. Question types included 6 drug information questions, 6 enhanced prompt drug information questions, 5 patient case questions, 5 calculations questions, and 10 drug knowledge questions (e.g., top 200 drugs). After all responses were collected, ChatGPT responses were assessed for appropriateness. Results: ChatGPT responses were generated from 32 questions in 5 categories and evaluated on a total of 44 possible points. Among all ChatGPT responses and categories, the overall score was 21 of 44 points (47.73%). ChatGPT scored higher in pharmacy calculation (100%), drug information (83%), and top 200 drugs (80%) categories and lower in drug information enhanced prompt (33%) and patient case (20%) categories. Conclusion: This study suggests that ChatGPT has limited success as a tool to answer pharmacy-based questions. ChatGPT scored higher in calculation and multiple-choice questions but scored lower in drug information and patient case questions, generating misleading or fictional answers and citations. [ABSTRACT FROM AUTHOR]

Background: Opioid overdoses decrease when communities have access to naloxone. Clinicians play a key role in offering naloxone to high-risk chronic opioid patients. Managed care pharmacists within our health plan noted disproportionate processing for claims of opioid utilizers compared to claims of naloxone prescriptions. Objective: To increase naloxone access and prescribing to members who classify at a dosage with a higher risk for opioid overdose, defined as over 90 morphine milligram equivalents (MME). Methods: Multiple system-wide initiatives were implemented to improve naloxone access. A claims file was pulled monthly to identify members on opioids meeting MME criteria >90 MME per day excluding members with cancer, sickle cell disease, or on hospice. A separate report was then matched to naloxone claims and prescribing percentages calculated. Results: 12 444 utilizing members on opioids were identified from June 2019 prescription claims data. Of these, 131 were on opioids exceeding 90 MME per day, or 1.05% of utilizers, and the percentage of members exceeding 90 MME per day prescribed naloxone was 6.87%. By May 2023, the percentage of opioid utilizers exceeding 90 MME per day decreased to 0.58%. Naloxone prescribing increased to 41.18%. Conclusion: A multi-pronged approach to improve access to naloxone and continued educational efforts by our health plan increased naloxone prescribing in members on opioids exceeding 90 MME per day. [ABSTRACT FROM AUTHOR]

Background: Despite the publication of a European wide competency framework for hospital pharmacy by the European Association of Hospital Pharmacist (EAHP) in 2017, not all countries have adopted and implemented such a framework. Aim: This study aimed to develop and validate a bespoke national hospital pharmacy competency framework for Austria that supports the hospital pharmacy workforce development. Method: A multi-method study was carried out in three phases. (I) A systematic literature review across 48 websites of healthcare-related associations and six scientific databases was conducted, identifying competency frameworks, guidelines and related documents. (II) Extracted behaviour competencies were reviewed for contextual national appropriateness by three researchers prior to mapping against the "Patient Care and Clinical Pharmacy Skills" domain of European Common Training Framework (CTF). (III) Validation of the resultant draft clinical skills competency framework took place by an expert panel (n = 4; Austrian Association of Hospital Pharmacists (AAHP) board members) discussion. Reporting of findings is aligned with the recommendations for reporting Competency Framework Development in health professions (CONFERD-HP guidelines) and the PRISMA 2020 checklist. Results: The systematic review (SR) resulted in 28 frameworks, guidelines and related documents and the identification of 379 behaviour competencies, with nineteen mapped to the "Patient Care and Clinical Pharmacy Skills" domain of the CTF (after removal of duplicates). Expert panel discussion resulted in suggested changes to ensure contextual national appropriateness. Conclusion: This study resulted in the development and validation of the first clinical national pharmacy competency framework for Austria. Future studies should focus on political and practical structures necessary for its successful implementation. [ABSTRACT FROM AUTHOR]

Objective: To explore the association between the implementation of medication safety‐related processes measured with the Medication Safety Self‐Assessment for Long‐Term Care (MSSA‐LTC) tool and medication use in residential aged care facilities (RACFs). Methods: A descriptive cross‐sectional study was conducted in Australian RACFs. Data on facility characteristics, aggregated medication use at the facility level for selected medications commonly associated with a high risk of harm and the MSSA‐LTC were completed by clinical pharmacists providing clinical pharmacy services. The Spearman's correlation test was used to evaluate the association between the MSSA‐LTC score and medication use. A scatter plot between the MSSA‐LTC score and medication use data was generated, and a linear trend line was plotted using the least squares method. Results: Data were collected from 31 RACFs servicing 2986 residents. Most medication safety‐related processes were implemented in Australian RACFs. A higher facility MSSA‐LTC score was associated with a lower proportion of residents with polypharmacy (r = −.48, p =.01) and one or more benzodiazepines (r = −.41, p =.03). In addition, a negative linear trend was observed between the MSSA‐LTC score and the average number of medications per resident, the proportion of residents with one or more anticonvulsants and the proportion of residents using one or more opioid analgesics. Conclusions: This study indicates that implementing medication safety‐related processes may improve medication use in RACFs. [ABSTRACT FROM AUTHOR]

Background: Long COVID remains a significant public health concern. This study investigated risk factors for long COVID in outpatient settings. Methods: A US-based prospective survey study (clinicaltrials.gov NCT05160636) was conducted in 2022 and replicated in 2023. Symptomatic adults testing positive for SARS-CoV-2 at CVS Pharmacies were recruited. CDC-based long COVID symptoms were collected at Week 4, Month 3, and Month 6 following SARS-CoV-2 testing. Logistic regression was used to develop a predictive model for long COVID using data from the 2022 cohort. The model was validated with data from the 2023 cohort. Model performance was evaluated with c-statistics. Results: Patients characteristics were generally similar between the 2022 (N = 328) and 2023 (N = 505) cohorts. The prevalence of long COVID defined as ≥3 symptoms at Month 6 was 35.0% and 18.2%, respectively. The risk factors associated with long COVID were older age, female sex, lack of up-to-date vaccination, number of acute symptoms on the day of SARS-CoV-2 testing, increase in symptoms at Week 1, underlying comorbidities and asthma/chronic lung disease. The c-statistic was 0.79, denoting good predictive power. Conclusions: A predictive model for long COVID was developed for an outpatient setting. This research could help differentiate at-risk groups and target interventions. [ABSTRACT FROM AUTHOR]

Introduction: The provision of palliative care is central to primary health care delivery. In this setting, community pharmacies often act in a medication supply role, yet their broader involvement in supporting people in the last year of life is less well understood. Aim: This study aimed to review the literature on community pharmacies supporting adults with palliative care needs in their last year of life, emphasising challenges to optimising their role and improving equity and service accessibility. Methods: A five-stage scoping review using a comprehensive literature search was conducted using MEDLINE, EMBASE, CINAHL, Web of Science, Scopus, and grey literature up to 30 April 2024. Eligible articles were charted, descriptively analysed, and mapped to a bicultural and holistic health care model, Te Whare Tapa Whā Older Person's Palliative Care model. Results: Twenty-five studies from seven countries were reviewed, revealing that community pharmacies provide a range of services to support people with palliative care needs. The main role of community pharmacies resides in Tinana, the physical health domain of Te Whare Tapa Whā Older Person's Palliative Care model. Challenges experienced by pharmacy staff include communication with palliative care service providers and users, integrating their role into palliative care provision, addressing their educational needs, and managing palliative medication stock. Discussion: The role of community pharmacy in providing palliative care is not widely understood. If the challenges identified in these studies can be addressed, there is potential for community pharmacies to offer a more proactive palliative care approach to their communities. What is already known: Medication management for adults with palliative care needs in the last year of life is complex and challenging. However, there is a limited synthesis of the literature describing the breadth of palliative care services provided by community pharmacies. What this study adds: This review provides evidence that community pharmacies worldwide offer a range of services to support people with palliative care needs and face similar challenges concerning how the public perceives their role in delivering palliative care. A thorough understanding of the role of community pharmacies could enhance care quality, extending benefits to individuals not currently receiving palliative care support in the community. [ABSTRACT FROM AUTHOR]

Introduction: The integration of pharmacists into general practice settings is increasingly common internationally. Within Aotearoa New Zealand, the role has evolved variably in different regions. Recent health policy and professional guidance support further development. Aim: To describe the current status of pharmacists working in primary healthcare settings other than community pharmacy. Methods: An online survey of all pharmacists in Aotearoa New Zealand primary healthcare settings was conducted in 2022, and covered employment, current services, patient consultations, relationships with other health professionals, and service costs and benefits. Descriptive statistical analyses were performed. Results: Responses from 39 pharmacists (~35% response rate) working in primary healthcare practice roles are reported. Most were female (84%), New Zealand European (81%), and 45% had <5 years' experience in this setting. The most common service provided was responding to medicines information queries from other health professionals (87%). Most also offered one or more medicines management services: medicines use review (44%), medicines therapy assessment (62%), and medicines optimisation (69%). One-third were prescribing or repeat prescribing pharmacists; non-prescribers expressed strong interest in future prescribing roles. Most (86%) undertook patient consultations with varied capacity to do more. Key perceived benefits for patients included improved health outcomes and medicines understanding; benefits for the health services included supporting the workloads of busy primary healthcare staff. Discussion: Practice pharmacists have both patient- and practice-facing roles. The proportion with a prescribing qualification has increased over time. There is some capacity for additional consultations, but this requires funding, space and time spent in a service/setting. What is already known: The integration of pharmacist roles into primary health care, including general practice, is growing in Aotearoa New Zealand, with geographical variation. Recent health policy and professional guidance support further development of these roles. What this study adds: There are more pharmacist prescribers in primary health care than there were in 2018, with strong interest in future prescribing roles, yet barriers to further expansion remain. Employers need to ensure that primary healthcare-based pharmacists are well supported in their role by other practice staff and that appropriate infrastructure is in place to facilitate this. [ABSTRACT FROM AUTHOR]

PURPOSE: To describe the impact of an inpatient clinical oncology pharmacy technician program. METHODS: A retrospective study was conducted to observe outcomes in patients discharged from the hematology/oncology or bone marrow transplant (BMT) units at Indiana University Health in the year before (April 1, 2016-March 31, 2017) compared with the year after (April 1, 2018-March 31, 2019) the implementation of expanded technician services. The technician performed admission medication histories and ensured access to discharge medications. RESULTS: There were 1,169 and 1,112 encounters included in the pre- and post-technician cohorts. The median age was lower (54 v 61 years; P <.001), and there was a higher percentage of male patients (62% v 52.3%; P <.001) in the pre- compared with post-technician cohort. There were a higher percentage of oncology (36.4% v 31%; P =.007) and no difference in hematology (37.4% v 40.2%; P =.17) nor BMT encounters (26.3% v 28.8%; P =.18) in the pre- compared with post-technician cohort. The discharge prescription capture rate increased (42.7% v 78.5%; P <.001) from the pre- to post-technician cohort, resulting in a 34.2% increase ($314,639.46 in US dollars [USD]-$422,129.20 USD) in retail pharmacy revenue. More admission medication histories were completed by pharmacy staff (64.4% v 91.9%; P <.001), and there was an increase in the Hospital Consumer Assessment of Healthcare Providers and Systems–derived patient satisfaction results for both hematology/oncology (79% v 88%; P <.001) and BMT units (77% v 84%; P =.02) in the pre- compared with post-technician cohort. There was no difference in rates of unplanned readmissions (16.4% v 18.2%; P =.69) in the pre- compared with post-technician cohort. CONCLUSION: The overall capture rate of discharge prescriptions, revenue for the retail pharmacy, and patient satisfaction scores significantly increased after the implementation of expanded, inpatient clinical pharmacy technician services. [ABSTRACT FROM AUTHOR]

This study explored controlled substance (CS) diversion surveillance practices within hospital pharmacies across the United States. A survey with questions based on published CS diversion risk points was conducted in May 2024. A total of 66 participants from 31 states responded, with 54.5% from single facilities and the remaining from health systems. Most respondents were pharmacy directors, managers, or those in dedicated drug diversion roles. Over 70% have dedicated surveillance teams and use drug diversion software. Results highlight variation in practices, with larger institutions generally showing better compliance. Compliance in procurement and receiving was high for access measures; however, auditing of processes was lower. The lowest procurement compliance was in monitoring periodic automatic replacement (PAR) levels and validating orders with wholesalers. Storage practices showed high compliance in deploying cameras, but low compliance in monitoring them. Dispensing practices had high compliance for restricting CS in automated dispensing cabinets, but low incidence of witness verification during stocking. Waste and disposal practices were well-followed, but training on detecting potential signs of medication tampering was less common. The survey highlights that while strategies to prevent CS diversion exist, their implementation varies. Enhancing monitoring, auditing, and training is essential to strengthen diversion prevention efforts in hospital pharmacies. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this study was to assess the real-world experiences of cleanroom managers and specialists who have designed, installed, and maintained stick-built and/or modular cleanrooms, delineate the advantages and disadvantages of each type of cleanroom, and gather sterile compounding cleanroom design and installation advice and lessons learned. Methods This study was conducted via surveys and semistructured interviews of individuals with cleanroom experience in the previous 5 years. Qualitative analyses were conducted on participants' survey and interview responses to assess their satisfaction with each type of cleanroom and to determine what they perceive to be the pros and cons of each type based on their own experiences. Key lessons learned and advice from these individuals were also extracted from their survey and interview responses. Results Fourteen individuals from 13 US states completed the survey; 12 participated in follow-up interviews. Fifty percent of the participants (n = 7) had installed 5 or more cleanrooms in the previous 5 years and over half (n = 8; 57%) had 7 or more years of cleanroom experience. The average satisfaction scores for each type of cleanroom, on a 1 to 10 scale, was 5.3 for stick-built (n = 11) and 9.3 for modular (n = 4). The pros of stick-built cleanrooms included greater design and material flexibility and lower up-front costs. The pros of modular cleanrooms included the cleanroom experience and expertise of modular vendors, quick and easy installations, guaranteed certification, and high-quality and durable design features and materials. Additionally, modular cleanrooms had fewer long-term maintenance issues, greater long-term flexibility, and lower indirect and long-term costs than stick-built cleanrooms. Key pieces of advice from the participants included the following: do your homework before beginning a cleanroom project; make sure heating, ventilation, and air conditioning system(s) and air handlers are adequate for your needs; and remember that the ultimate purpose of a quality cleanroom is patient safety. Participants also advocated for industry-wide cleanroom standards that go beyond USP regulations. Conclusion The findings of this study confirm many of the purported pros and cons of each type of cleanroom, with further insight gained into the relative quality and costs of each type. Modular cleanrooms were considered by most participants to be a better long-term option, based on quality and lifetime costs, if feasible to install. Study participants also emphasized that designing and installing pharmacy cleanrooms is a complex and time-intensive process that often comes with a steep learning curve. While there are federal and state cleanroom standards available and consultants for hire, a comprehensive resource or manual that could provide guidance, insight, and collective lessons learned on cleanroom design and installation is needed. [ABSTRACT FROM AUTHOR]

The article focuses on ways to manage burnout and resilience in the pharmacy workforce. Topics discussed include the growth in the record levels of burnout among pharmacy professionals, the critical role of pharmacy leadership in driving wellness in the workforce, ways to create a healthy workplace, and organizational strategies to address wellness.

The article presents a speech by Diane B. Ginsburg, associate dean for healthcare partnerships, clinical professor in the division of pharmacy practice and G.D. Searle Endowed Fellow in Pharmacy at The University of Texas at Austin College of Pharmacy, delivered at the Harvey A.K. Whitney Lecture. Topics discussed include her selection as a recipient of the Harvey A.K. Whitney Lecture Award, the purpose of pharmacy, and issues facing the profession.

Background: Drug–drug interactions (DDIs) occur when two or more drugs are administered concomitantly, changing the pharmacokinetics or pharmacodynamics of a drug's characteristics. Despite the advances in health technology, DDIs remain a concern to patient safety. This study aimed to (1) assess the knowledge, attitude, and practice of hospital and community pharmacists toward DDIs in Saudi Arabia and (2) examine factors associated with their practice. Methods: A cross-sectional study was conducted using an online self-administered questionnaire targeting hospital and community pharmacists working in Saudi Arabia. The study questionnaire consisted of five sections: demographics, knowledge, attitude, and practice toward DDIs, as well as pharmacy characteristics. Descriptive statistics were used to summarize the characteristics of participants as count and percentage. Chi-square tests were used to examine associations between practice variables and other independent variables. Results: A total of 131 pharmacists participated in the study. The majority were males (81.7%), aged 26–35 years (64.9%), and worked in community pharmacies (81.7%). Nearly half of the participants reported optimal practice regarding checking drug interactions before dispensing any drug. Factors associated with the practice of checking DDIs were found to be gender, perceived workload, perceived knowledge, and attitude variables. Regarding the practice of asking patients about their prescription and OTC drugs, there were statistically significant differences between hospital and community pharmacists. Conclusions: Our findings on both community and hospital pharmacists in Saudi Arabia reveal that pharmacists' attitudes and perceived knowledge might influence the practice of pharmacists toward DDIs. [ABSTRACT FROM AUTHOR]

Background/Objectives: The rational use of medicines, in accordance with the World Health Organization (WHO) guidelines, is crucial for optimizing healthcare outcomes. This cross-sectional study aimed to evaluate drug prescribing patterns and assess prescription completeness based on the WHO core drug use criteria. A comprehensive analysis was conducted at the University Clinic in the Northern region, Kingdom of Saudi Arabia (KSA). Methods: The study assessed drug prescribing patterns and examined prescription completeness by analyzing various parameters recommended by the WHO core drug use criteria. Results: Upon analyzing the 615 prescriptions, it was observed that each prescription had a mean of 2.56 prescribed drugs. Multiple medicines per prescription were prevalent in 71.4%, whereas polypharmacy was evident in 2.9%. Analgesics were the most frequently prescribed medication, accounting for 50.4% of the prescriptions, followed by supplements (31.7%), decongestants (16.1%), cough syrup (12%), and antihypertensive and diabetes treatments at 17%. Furthermore, antimicrobials were prescribed in 21.5% of the prescriptions. During the evaluation, it was found that 19.8% of the prescriptions were incomplete, lacking important information on dosing, duration, and drugs not suited to the diagnosis. Conclusions: Most of the parameters evaluated in this study were determined to fall outside the range of recommended guidelines criticized by the WHO. As a result, the implementation of efficient intervention programs, such as education initiatives, is recommended to enhance the practice of rational drug use. Contribution: This study highlights the importance of improving prescription indicators at the national level, focusing on both medication prescribing characteristics and prescription quality as a practice. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the prevalence and type of clinical pharmacy services offered within South Carolina Federally Qualified Health Centers (SC FQHCs) and identify existing implementation barriers. Methods: This study was a cross-sectional survey of pharmacists or Chief Medical Officers practicing in SC FQHCs. Organizations were identified utilizing the Health Resources and Services Administration (HRSA) database and were contacted to participate in a telephone survey. An electronic form was created in REDCap® software. Descriptive statistics were used to analyze and evaluate data. Results: Twenty-two SC FQHCs were eligible for the survey, with 16 (72.7%) participating. Of the respondents, 9 (56%) offered at least 1 service. The most common services offered were chronic disease state management, diabetes self-management education and support (DSMES), and tobacco cessation (43.8%, n = 7). The least common services offered were chronic care, Hepatitis C, and HIV management (18.9%, n = 3). The most common barriers to implementation were lack of personnel and provider interest (62.5%, n = 10). The least common barrier was a lack of pharmacist interest or time (25%, n = 4). Conclusion: Pharmacists offered at least 1 clinical service within most SC FQHCs. Barriers were identified that prevented expansion of services and further research is needed to overcome these. [ABSTRACT FROM AUTHOR]

aiman Alruwaili,2 Omar Ahmed Albalawi,2 Fayez Mohammed Alatawi,2 Saleh F Alqifari,1 Ahmed D Alatawi,3 Ahmed Aljabri41Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia; 2Pharm.D Program, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia; 3Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka, Saudi Arabia; 4Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia Correspondence: Palanisamy Amirthalingam, Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, P.O. Box 741, Tabuk, 71491, Saudi Arabia, Email [email protected] Introduction: The adoption of automated drug dispensing systems (ADDS) in hospital pharmacies is a global trend, driven by its potential to reduce dispensing errors, minimize prescription filling time, and ultimately, improve patient care services. However, a significant research gap exists in the field, as a comprehensive assessment of patient satisfaction with ADDS is currently lacking. This study, with its comprehensive approach, aims to fill this gap by comparing patient satisfaction between hospital pharmacies implementing ADDS and traditional drug dispensing systems (TDDS). Patients and Methods: The cross-sectional study was conducted in hospitals adopting ADDS and TDDS. All the outpatients aged 18 or above who visited the pharmacy were included, and severely ill patients were excluded from the study. A 17-item, 5-point Likert scale questionnaire assessed the participant's satisfaction. The questionnaire has four domains: pharmacy administration, dispensing practice, patient education, and dispensing system. Results: The demographics of the study participants were normally distributed between ADDS and TDDS according to chi-square analysis. The mean participant satisfaction was significantly (P< 0.05) higher in ADDS than in TDDS regarding all the items of dispensing practice and dispensing system domains. Three items related to the pharmacy administration domain showed significant participant satisfaction with ADDS. However, the participants' satisfaction showed no significant difference (p=0.176) between ADDS and TDDS in terms of the cleanliness of the pharmacy. Also, the participant's satisfaction between ADDS and TDDS was not statistically significant regarding the pharmacist's explanation of the side effects (p=0.850) and provision of all necessary information to the patient (p=0.061) in the patient education domain. Conclusion: Patient satisfaction was higher in the ADDS participants than in TDDS regarding pharmacy administration, patient education, dispensing practice, and systems. However, pharmacists in ADDS need to be motivated to transfer the advantages of ADDS to patient care, including comprehensive patient education, particularly on side effects. [ABSTRACT FROM AUTHOR]

OBJECTIVE To evaluate factors that influence client selection of a veterinary pharmacy and assess client perception of the impact of online pharmacies on veterinary clinics. METHODS Survey data and satisfaction metrics were compared between online pharmacies, a teaching hospital pharmacy (UW Veterinary Care), and primary care veterinary clinics between March and April 2023. Online pharmacy users were asked about perceived impact of online pharmacies on veterinary clinics. Personal values were correlated with the likelihood of using a pharmacy. RESULTS 158 surveys were analyzed; 32.9% of respondents used an online pharmacy. Of those, 20% used a veterinary-affiliated online pharmacy. Convenience was the value most liked by online pharmacy and primary care clinic users. Online users reported liking price most, whereas veterinary clinic pharmacy users (UW Veterinary Care and primary care clinics) reported liking communication and trust. Online users ranked price as more important, whereas veterinary clinic users ranked personalized experience (caring, explanations, veterinary recommended) as more important. Regardless of pharmacy type, satisfaction scores were high. Most online users perceived a negative impact of online pharmacies on veterinary clinics; this did not change reported usage. CONCLUSIONS Online and veterinary clinic users prioritized different values. Online users prioritized price and veterinary clinic users prioritized personalized experience. Online usage was not influenced by perceived impact. CLINICAL RELEVANCE For veterinary clinics attempting to increase revenue, appealing to these 2 distinct driving values is essential. Offering practice-directed online pharmacies with competitive and transparent pricing could procure online consumers, while maintaining a personalized experience remains important for consumers purchasing prescriptions in-house. [ABSTRACT FROM AUTHOR]

We used human-centered design to explore preferred consumer experiences for obtaining mifepristone for medication abortion care from a pharmacy. We conducted a two-part virtual workshop series with the same 10 participants in March and April of 2022 to initiate the discovery phase of a human-centered design process. Most participants were residents of Illinois and all participants had uteruses and had either sought abortion care or supported someone who had. Co-developed and co-facilitated with a local abortion fund, workshops engaged participants to provide formative data for the development of recommendations for community health center clinicians and pharmacists. A simulated medication abortion care counseling session grounded group activities and discussions that explored the experience of filling a medication abortion prescription at a pharmacy or by mail. Data were analyzed for key themes and recommendations. Qualitative data were collected from the workshops. Data analysis was conducted in three iterative, parallel stages: 1) virtual whiteboard results from both workshops were analyzed deductively through spreadsheets and visualizations; 2) close reading was conducted for workshop transcripts and participant evaluations; and 3) document analysis was used to triangulate data across formats. Data were discussed periodically among the research team until consensus was reached. Five primary categories of questions and preferences emerged from workshop data concerning: logistics, privacy, cost, pharmacist refusal, and follow-up care. Researchers found that participants desired certain questions and concerns to be answered by specific provider types. Participants indicated a desire for further research and opportunities that prioritize lived experience and use storytelling and/or design methods to collect data. Despite existing patient-oriented medication abortion resources, there is a need for patient resources to support pharmacy dispensing, and a corresponding need for clinician and pharmacist resources. These can help in-person and mail-order pharmacy dispensing to be as consumer friendly as possible. [ABSTRACT FROM AUTHOR]