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Background: Drug dispensing is a service provided by pharmacists to ensure the supply of medications and other health-related products. However, despite the importance of dispensing services, Public Community Pharmacies (PCP) in Brazil still focus on the control and distribution of medicines and supplies. Thus, this paper aims to evaluate how the pharmacists in charge conduct and the challenges they encounter in dispensing services in PCP. Methods: This is a mixed methods study, with a representative sample of 26 municipalities (whose populations vary between 37,784 and 409,341 inhabitants) in the state of Minas Gerais, Brazil. Data collection took place between April and October 2019 and included interviews and documentary research. Quantitative data analysis was carried out using descriptive statistics and qualitative data was subjected to thematic content analysis. Results: 24 dispensing services were analyzed. The PCP had, on average, two active pharmacists and operated full-time (40 h per week). In relation to dispensing services, the most frequently mentioned steps were checking the adequacy of the prescription received, followed by providing counseling to the user about the medicines, mainly regarding administration, storage and disposal. The results highlighted a need for improvements in terms of infrastructure, workforce and the pharmacist's work process. Conclusion: It is necessary to invest and to design improvement strategies in dispensing services, especially regarding physical infrastructure, human resources and work processes. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) stages 3-4 present a significant clinical challenge due to the absence of a systematic approach to managing associated medication-related problems (MRPs). This lack of a structured framework hinders the timely identification and effective intervention for these complications, potentially compromising patient safety and prognosis. Objective: This study aims to leverage the Delphi method to establish an evaluation index for a rational drug use evaluation system dedicated to CKD patients in stages 3-4. This system will function as a platform for the continuous identification and management of MRPs, ultimately contributing to improved medication safety and patient outcomes. Methods: This research uses the modified Delphi technique to develop an evaluation system for rational drug use in patients with chronic kidney disease. The initial questionnaire was developed by literature review for patients with chronic kidney disease. Twenty-six senior experts formed a panel in order to evaluate items across two Delphi rounds. Consensus was defined as at least 95% agreement (first round) and 85% agreement (second round), agreeing with an average score of at least 4.5 (first round) and 4.0 (second round). Items that fulfill the stipulated criteria are eligible for inclusion in the consensus list. Results: All experts participated in both rounds (100% response rate). Consensus was achieved on three patient-related items in the first round of 34 items. Based on expert feedback, 18 revised items were included in the second round after refining, restructuring, and removing some elements. Following two rounds of consultation, 20 items achieved consensus, encompassing aspects such as drug selection, dosage assessment, treatment duration, prescription and dispensing practices, patient-related factors, and other relevant considerations. Conclusion: This study has successfully identified 20 key evaluation indicators for a rational drug use evaluation system specifically designed for CKD patients in stages 3 and 4. This system will serve as a tool for continuous MRP identification and timely intervention, ultimately enhancing medication safety and patient prognosis. [ABSTRACT FROM AUTHOR]

The National Medicines Policy (NMP) is crucial as it sets the framework for ensuring access to affordable, high-quality medicines and promoting their rational use, which is essential for public health and the efficiency of the healthcare system. This study aims to evaluate the current state of Taiwan's NMP, identify pressing issues for improvement, and establish actionable suggestions through expert consensus to ensure the sustainable provision and use of medications. A modified two-round Delphi technique was employed. The first-round survey identified key issues and suggestions for policy improvement, while the second-round survey evaluated the feasibility and effectiveness of these suggestions. The expert panel, consisting of 50 specialists from pharmacy, medicine, public health, and the pharmaceutical industry, evaluated key issues related to the NMP's efficacy using a 4-point Likert scale. The first-round survey identified 13 key issues in Taiwan's NMP, primarily focusing on the rational use and accessibility of medications. The second-round survey proposed 54 policy improvement suggestions for these issues, of which 20 were considered strong suggestions and 23 were moderate suggestions. The policy recommendations cover medication reimbursement, pharmacy professional services, administration, legislation, and education. The study highlights the urgent need for reforms in Taiwan's NMP, providing specific policy improvement suggestions to ensure high-quality medications and pharmaceutical services while supporting the sustainable operation of Taiwan's NHI system. The study underscores the significance of proactive measures to fortify healthcare sustainability in the face of evolving healthcare landscapes. [ABSTRACT FROM AUTHOR]

The impact of Home Medicines Reviews (HMRs) on long-term health outcomes among individuals receiving long-term in-home aged care services is unknown. To examine associations between HMR provision and hospitalization, long-term care facility (LTCF) entry and mortality among older people receiving long-term in-home aged care services. This retrospective cohort study included individuals aged 65–105 years from three Australian states who accessed in-home aged care services between 2013 and 2017. Using propensity score matching, HMR recipients (n = 1530) were matched to individuals who did not receive an HMR (n = 1530). Associations between HMR provision and outcomes were estimated using multivariable regression models. Over a median of 414 days (interquartile range 217–650) of follow-up, HMR provision was not associated with hospitalizations for unplanned events (subdistribution hazard ratio (sHR) 1.04, 95%CI 0.96–1.14), falls-related hospitalizations (sHR 0.97, 95%CI 0.83–1.13), LTCF entry (sHR 0.97, 95%CI 0.83–1.13), or all-cause mortality (adjusted HR 0.86, 95%CI 0.72–1.01). In a cohort of older people receiving long-term in-home aged care services, no differences in unplanned hospitalizations, falls, LTCF entry or mortality were observed those with HMRs compared to those that did not receive an HMR. • Little is known about long-term outcomes of Home Medicines Reviews in older people. • We examined outcomes associated with medicines review provision in home care services. • Only 4 % of older people accessing home care receive a Home Medicines Review. • No association between medicines reviews and hospitalisations was observed. • No association between medicines reviews and LTCF entry or death was observed. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) represents an important health challenge, despite being preventable and manageable thanks to up-to-date recommendations. In Italy, the pharmaceutical care of COPD patients is still ill-timed and inaccurate. This study aimed to describe the treatment of COPD patients in Italy and possible switches following an exacerbation. Methods: This observational retrospective analysis of Italian administrative healthcare data from the Fondazione Ricerca e Salute (ReS) database identified patients aged ≥ 45 years with COPD in 2019 and 2020. At least 6 years of look-back period and absence of concomitant asthma were required. COPD patients were categorized by treatment (SI–single/MI–multiple inhalers, TT–triple therapy, DT–dual therapy, other respiratory treatments, untreated) at index date (first dispensation during accrual period). Occurrence of moderate/severe exacerbation during one-year preceding index date and treatments during one-year preceding the exacerbation (possible switch) were evaluated. Results: From ~ 4.7 million beneficiaries of the Italian National Health Service in 2019 and 2020, respectively, 105,828 and 103,729 (43 and 41 × 1,000 inhabitants aged ≥ 45 years) were identified as having COPD. Of 2019/2020 patients: 3.4%/5.2% received SI-TT, 20.7%/17.5% MI-TT, 35.9%/38.1% DT, 33.0%/33.1% other treatments, and 7.0%/6.0% were untreated. Males were prevalent and median age was > 73 years for all groups. Of 2019/2020 cohorts, heart failure and coronary artery disease affected 24/20%, 18/17%, and 11%/16% patients with SI-TT, MI-TT, DT, and other treatments, respectively. A previous moderate/severe exacerbation (2019/2020 patients) occurred to 60.5%/56.6%, 39.9%/37.4%, 30.8%/29.2% and 31.9%/29.7% patients treated with SI-TT, MI-TT, DT, and other treatments, respectively. Of 2019/2020 patients experiencing moderate/severe exacerbation: 6.0%/7.0% receiving DT, 5.1%/7.0% receiving other treatments and 4.5%/10.0% untreated, switched to SI-TT; 23.7%/16.9% receiving DT, 21.4%/17.7% receiving other treatments and 15.4%/12.0% untreated, switched to MI-TT. Conclusions: COPD patients receiving TT were older and had more comorbidities, especially cardiovascular diseases, than patients receiving DT or other treatments. The limited number of patients switching after exacerbation suggests that many COPD patients may be inappropriately treated. Ensuring early and adequate treatment, combination of in-hospital and outpatient management, and integration of specialist and primary care is pivotal for the appropriate clinical management of COPD patients. [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) stages 3-4 present a significant clinical challenge due to the absence of a systematic approach to managing associated medication-related problems (MRPs). This lack of a structured framework hinders the timely identification and effective intervention for these complications, potentially compromising patient safety and prognosis. Objective: This study aims to leverage the Delphi method to establish an evaluation index for a rational drug use evaluation system dedicated to CKD patients in stages 3-4. This system will function as a platform for the continuous identification and management of MRPs, ultimately contributing to improved medication safety and patient outcomes. Methods: This research uses the modified Delphi technique to develop an evaluation system for rational drug use in patients with chronic kidney disease. The initial questionnaire was developed by literature review for patients with chronic kidney disease. Twenty-six senior experts formed a panel in order to evaluate items across two Delphi rounds. Consensus was defined as at least 95% agreement (first round) and 85% agreement (second round), agreeing with an average score of at least 4.5 (first round) and 4.0 (second round). Items that fulfill the stipulated criteria are eligible for inclusion in the consensus list. Results: All experts participated in both rounds (100% response rate). Consensus was achieved on three patient-related items in the first round of 34 items. Based on expert feedback, 18 revised items were included in the second round after refining, restructuring, and removing some elements. Following two rounds of consultation, 20 items achieved consensus, encompassing aspects such as drug selection, dosage assessment, treatment duration, prescription and dispensing practices, patient-related factors, and other relevant considerations. Conclusion: This study has successfully identified 20 key evaluation indicators for a rational drug use evaluation system specifically designed for CKD patients in stages 3 and 4. This system will serve as a tool for continuous MRP identification and timely intervention, ultimately enhancing medication safety and patient prognosis. [ABSTRACT FROM AUTHOR]

Case description: Patient (29 years old) with palmo-plantar erythema, goes to the community pharmacy (FC) requesting a cream to treat atopy. Evaluation: The patient accessed the Pharmaceutical Indication Service (SPIF), showing that the manifestations appeared 24 hours after the start of dental treatment with amoxicillin 1g/12h and ibuprofen 600 mg/8h without any concomitant medication. Intervention: After explaining the possible relationship of the symptoms with their medication, patient was derived to the doctor with the referral report completed by SEFAC-eXPERT. Results: The patient went to the emergency where she was treated with intravenous corticosteroid and a prescription for cetirizine 10 mg. The dentist changed the beta-lactam to a macrolide (azithromycin) and the ibuprofen to paracetamol. From the FC, the evolution of the symptoms was monitored, which took 72 hours to disappear. Allergy tests suggested avoiding beta-lactams, cephalosporins, and arylpropionics without being conclusive. Months later, the patient suffered similar symptoms after inhaling a disinfectant spray and the allergy diagnosis was confirmed. Conclusions: The FC identified and immediately referred using SPIF a case of hypersensitivity in a patient susceptible to RNM and the SPIF helps to record the intervention and follow-up, increasing patient safety. [ABSTRACT FROM AUTHOR]

Introduction: To analyze the effect of pharmaceutical intervention on therapeutic adherence, viral load (VL), and CD4 T lymphocyte count in human immunodeficiency virus (HIV) for strengthening the role of the pharmacist in an infectious diseases service. Methods: Retrospective observational study. Data were collected through interviews using the “Assessment of Predictive Factors of Therapeutic Adherence” questionnaire. VL and CD4 parameters were collected f were collected from the patients’ medical records at the hospital. Results: 103 patients were included, 92 % men, mean age 32.30± 10.90 years for the group of patients. After pharmaceutical intervention through strategies to promote adherence: 100 % of patients increased their knowledge of their disease, 62 % increased their knowledge of antiretroviral therapy (ART), 90 % showed tolerance to ART, and 4 % experienced adverse reactions. This was reflected in an increase in the median CD4 T lymphocyte count and a decrease in viral load (undetectable in 72 % of patients), statistically and clinically significant results (p< 0.01). Conclusions: The findings suggest that pharmaceutical intervention in therapeutic adherence to ART has beneficial effects (CD4 and VL) in the analyzed patient group. Further studies are necessary. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco 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.)

Background: The final prescription check is a mandatory but time-consuming process in Dutch community pharmacies. A safer dispensing process may have made the final prescription check obsolete. Objective: To describe the final prescription check in Dutch community pharmacies and explore pharmacists' attitudes towards changing this. Methods: A cross-sectional survey among Dutch community pharmacists. The online questionnaire was based on literature and previous qualitative research, piloted in three pharmacies, and took 10 min to complete. Results were analysed descriptively. Results: A total of 409 pharmacists participated. They saw the final prescription check as an important quality assurance of the dispensing process. Nevertheless, most pharmacists agreed that the final prescription check could be optimized as they thought that the time invested outweighed the benefits. Automation of the dispensing process, only checking selected high-risk prescriptions, and more in-process checks could reduce the need for an extensive final prescription check, rather than delegating the task to assistants. To implement changes, most pharmacists felt current dispensing guidelines needed to be adapted. Conclusion: There was a widespread consensus that optimizing the final prescription check could enhance efficiency and allow more time for person-centred care. Most pharmacists expressed a preference for updated guidelines before implementing such changes. [ABSTRACT FROM AUTHOR]

Background: Ensuring the consistent availability of essential medicines is crucial for effective healthcare systems. However, Ethiopian public health facilities have faced frequent stockouts of crucial medications, highlighting systemic challenges such as inadequate forecasting, prolonged procurement processes, a disjointed distribution system, suboptimal data quality, and a shortage of trained professionals. This study focuses on the Ethiopian Pharmaceutical Supply Services (EPSS), known for its highly unstable and volatile supply chain, aiming to identify risks and mitigation strategies. Methods: Using a mixed-method approach involving surveys and interviews, the research investigates successful and less successful strategies, key success factors, and barriers related to pharmaceutical shortages. Results: Proactive measures such as communication, stock assessment, supervision, and streamlined procurement are emphasized as vital in mitigating disruptions, while reactive strategies like safety stock may lack long-term efficacy. The study highlights the importance of aligning supply chain strategies with product uncertainties, fostering collaboration, and employing flexible designs for resilience. Managerial implications stress the need for responsive structures that integrate data quality, technology, and visibility. Conclusions: This study contributes by exploring proactive and reactive strategies, elucidating key success factors for overcoming shortages in countries with unstable supply chains, and offering actionable steps for enhancing supply chain resilience. Embracing uncertainty and implementing proactive measures can help navigate volatile environments, thereby enhancing competitiveness and sustainability. [ABSTRACT FROM AUTHOR]

Background: Comprehensive medication management (CMM) programs optimize the effectiveness and safety of patients' medication regimens, but CMM may be underutilized. Whether healthcare claims data can identify patients appropriate for CMM is not well-studied. Aim: Determine the face validity of a claims-based algorithm to prioritize patients who likely need CMM. Method: We used claims data to construct patient-level markers of "regimen complexity" and "high-risk for adverse effects," which were combined to define four categories of claims-based CMM-need (very likely, likely, unlikely, very unlikely) among 180 patient records. Three clinicians independently reviewed each record to assess CMM need. We assessed concordance between the claims-based and clinician-review CMM need by calculating percent agreement as well as kappa statistic. Results: Most records identified as 'very likely' (90%) by claims-based markers were identified by clinician-reviewers as needing CMM. Few records within the 'very unlikely' group (5%) were identified by clinician-reviewers as needing CMM. Interrater agreement between CMM-based algorithm and clinician review was moderate in strength (kappa = 0.6, p < 0.001). Conclusion: Claims-based pharmacy measures may offer a valid approach to prioritize patients into CMM-need groups. Further testing of this algorithm is needed prior to implementation in clinic settings. [ABSTRACT FROM AUTHOR]

Background: Clinical pharmacists perform activities to optimise medicines use and prevent patient harm. Historically, clinical pharmacy quality indicators have measured individual activities not linked to patient outcomes. Aim: To determine the proportion of patients who receive a pharmaceutical care bundle (PCB) (consisting of a medication history, medication review, discharge medication list and medicines information on the discharge summary) as well as investigate the relationship between delivery of this PCB and patient outcomes. Method: Pharmaceutical care bundle activities were defined within state-wide (Queensland, Australia) clinical information systems and datasets were linked. An observational study using routinely recorded data was performed at ten participating sites for adult patients who had a non-same day hospital stay. The association between extent of PCB delivery and three patient outcomes were investigated: length of stay (LOS), unplanned readmission, and mortality. Results: In total 283,813 patient hospital stays were evaluated. The delivery of the PCB occurred in 26.9% of patients at the ten participating hospital sites, ranging from 0.6 to 61.2% across sites. Patients with a longer LOS were more likely to receive delivery of the complete PCB (P < 0.001). There was no correlation between PCB and hospital standardised mortality ratio (r = 0.03, p = 0.93). Higher rates of delivery of the PCB were associated with lower rates of unplanned readmission within 30 days (r = − 0.993, p < 0.001). Conclusion: A complete PCB was delivered to 26.9% of patients and was associated with a significantly lower rate of unplanned readmission within 30 days. [ABSTRACT FROM AUTHOR]

Background: Chronic non-cancer pain may affect up to 51% of the general population. Pharmacist interventions have shown promise in enhancing patient safety and outcomes. However, our understanding of the scope of pharmacists' interventions remains incomplete. Aim: Our goal was to characterise pharmacists' interventions for the management of chronic non-cancer pain. Method: Medline, Embase, PsycINFO via Ovid, CINAHL via EBSCO databases and the Cochrane Library were systematically searched. Abstracts and full texts were independently screened by two reviewers. Data were extracted by one reviewer, and validated by the second. Outcomes of studies were charted using the dimensions of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT). Results: Forty-eight reports were included. Interventions ensuring appropriate drug prescription occurred in 37 (79%) studies. Patient education and healthcare professional education were reported in 28 (60%) and 5 (11%) studies, respectively. Therapy monitoring occurred in 17 (36%) studies. Interventions regularly involved interprofessional collaboration. A median of 75% of reported outcome domains improved due to pharmacist interventions, especially patient disposition (adherence), medication safety and satisfaction with therapy. Conclusion: Pharmacists' interventions enhanced the management of chronic non-cancer pain. Underreported outcome domains and interventions, such as medication management, merit further investigation. [ABSTRACT FROM AUTHOR]

Copyright of Angle Health Law Review is the property of Angle Publishing Co., Ltd. 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 Medizinische Klinik: Intensivmedizin & Notfallmedizin is the property of Springer Nature 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.)

Background: The COVID-19 pandemic significantly increased the demand for remote healthcare services delivery, including remote access to medications. This study explored the practices and challenges associated with remote provision of pharmaceutical products and services in Kampala, Uganda. Methods: A cross-sectional study was conducted from July to September 2022, enrolling 174 out of 198 sampled retail pharmacies. Data was collected using a pre-tested questionnaire on remote service provision, platforms used, products offered, delivery methods, and challenges faced. Results: Over 58% of pharmacies provided remote services, primarily through social media (especially WhatsApp) and phone calls. OTCs and POMs were the most commonly dispensed products remotely. Key challenges identified included high internet costs, labor shortages, poor internet quality, and a lack of specific regulations for remote provision of pharmaceutical products and services. Conclusion: The proportion of retail pharmacies providing pharmaceutical products and services remotely is significant in Kampala, but they face challenges that need to be addressed. Regulations are crucial to ensure responsible dispensing practices and rational medicine use. Addressing internet affordability and quality, staffing issues, and delivery logistics is essential for sustainable and effective remote pharmaceutical products and services. [ABSTRACT FROM AUTHOR]

The study examines the influence of pharmaceutical and non-pharmaceutical service quality on prescription redemption decisions and subsequent re-treatment decisions among general outpatients at Pasar Minggu Regional Hospital. The hospital has faced challenges, including a decline in outpatient visits and filled prescriptions, affecting its revenue during the 2022-2023 period. Patient perceptions of the pharmacy services significantly impact their decision to return for further medical care. The research aims to assess both direct and indirect effects of service quality on prescription redemption and retreatment decisions. The study employs a verification approach with a cross-sectional design, using accidental sampling to survey 342 general outpatients between October 2023 and February 2024. Data were analyzed descriptively and inferentially using SEM PLS 3.0, encompassing both outer and inner model analyses through PLS Algorithm, Bootstrapping, and Blindfolding techniques. The findings reveal that the quality of pharmaceutical and non-pharmaceutical services significantly influences the decision to redeem a prescription (P = 0.000). Moreover, non-pharmaceutical service quality and the decision to redeem a prescription significantly affect the decision to re-medicate (P = 0.002 and 0.000, respectively). However, pharmaceutical service quality alone does not positively impact repeat treatment (P = 0.041). Both service variables have a significant indirect effect on retreatment decisions through the mediating role of prescription redemption (P = 0.000). [ABSTRACT FROM AUTHOR]

The aging population, often burdened with multimorbidity and polypharmacy complexities, requires comprehensive care during healthcare transitions. These transitions contribute to increased prescriptions, exacerbating polypharmacy and frailty in older individuals. Medication reconciliation, a preventive strategy, optimizes medication lists through systematic analysis, particularly benefiting older patients grappling with polypharmacy. This practice holds substantial potential in enhancing patient safety during care transitions. Therefore, the aim of this study is to evaluate the discrepancies detected during the practice of medication reconciliation at the admission, discharge, or transfer of older individuals in a ward in Brazil. This is a single-cohort study of patients admitted to an older adult care ward in Brazil, monitored from September 2021 to April 2022. Older individuals hospitalized in the ward, exhibiting the characteristic clinical profile of multimorbidity and polypharmacy, were observed to identify discrepancies in the practice of medication reconciliation conducted as part of pharmaceutical care services. Medication reconciliation was carried out upon admission, discharge from the ward for older adult care, or transfer to other healthcare units. Sixty older individuals were monitored during the study period in the ward. The use of polypharmacy at home was evident in more than 70% of patients, and multimorbidity was present in over 90% of patients. On average, 8.6 discrepancies were identified per patient (± 4.7). Upon admission to the older adult care ward, 501 discrepancies were identified and assessed, decreasing to 200 at the time of hospital discharge or transfer to other units. In total, 48 medication errors were identified in the evaluated prescriptions and ongoing pharmacotherapy. The use of polypharmacy proved to be a contributing factor that increased the identification of discrepancies in medication reconciliation (p < 0.001). Analyzing medication reconciliation discrepancies uncovers intentional and unintentional aspects in prescriptions, with medication quantity, especially in polypharmacy, linked to potential harm. Continuous monitoring proved crucial, significantly enhancing patient safety in the older adult care ward. [ABSTRACT FROM AUTHOR]

Objective To identify new articles that describe services provided by pharmacists during the first year of the COVID-19 pandemic. Methods An update scoping review was conducted in MEDLINE, Embase, Scopus, LILACS, and Google Scholar between 21 May 2020 and 31 May 2021. Study selection and data extraction were performed by two independent authors. DEPICT v. 2 was used to characterize the components of pharmacists' interventions. It was also verified whether the articles evaluated outcomes of care. Key findings A total of 8983 records were identified, of which 120 met the inclusion criteria. The hospital was the workplace of the pharmacist most often described (55%). The majority of articles (73.3%) described the main domains of DEPICT v.2. Pharmacists provided interventions for patients (27.5%), healthcare professionals (25.8%), both (34.2%), individually (84.2%), through face-to-face contact (44.2%), and followed by telephone (41.7%). The main actions included patient counseling (56.7%), drug supply management (42.5%), and drug information for healthcare professionals (40.8%). Less than half of the articles (36.6%) evaluated the dimension "outcomes of care" of the study population. Conclusion Although most of the articles reported the pharmacists' interventions, the description is still not satisfactory. In addition, the majority of articles focused solely on the dimension "process of care". Future research should provide more detailed descriptions of the pharmacists' interventions and assess the effectiveness of their interventions. [ABSTRACT FROM AUTHOR]

Purpose This report describes the step-by-step process that led to expansion of ambulatory care pharmacy services at a newly established internal medicine clinic within a patient-centered medical home in North Carolina. Summary Implementation of clinical pharmacist services at the clinic was led by a postgraduate year 2 (PGY2) pharmacy resident and guided by the 9 steps described in the book Building a Successful Ambulatory Care Practice: A Complete Guide for Pharmacists. After a needs assessment and review of the demographics and insurance status of the clinic's target population, it was determined that pharmacist services would focus on quality measures including diabetes nephropathy screening, diabetes eye examination, blood glucose control in diabetes, discharge medication reconciliation, annual wellness visits, and medication adherence in diabetes, hypercholesterolemia, and hypertension. Clinic appointments were conducted under 3 models: a pharmacist-physician covisit model, a "floor model" of pharmacist consultation on drug information or medication management issues during medical resident sign-out sessions with supervising physicians (medical residents could also see patients along with the pharmacist at a covisit appointment), and a covisit model of stacked physician and pharmacist appointments. The pharmacist's services were expanded from 2 half-day clinic sessions per week initially to 5 or 6 half-day clinic sessions by the end of the residency year. Conclusion By the fourth quarter of the first PGY2 residency year in which ambulatory care pharmacy services were provided in the clinic, the clinical and financial impact of those services justified the addition of a second full-time pharmacist to the clinic team. [ABSTRACT FROM AUTHOR]

Background: Previous evidence underscores the need to assess potential clinical outcomes resulting from pharmaceutical care interventions and to monitor patient's progress to evaluate their clinical evolution, which is crucial for bolstering the relevance of implementing pharmaceutical care in healthcare services. Aims: To conduct an in‐depth analysis of pharmaceutical care practices in a geriatric ward and monitor the clinical outcomes of older people served. Methods: This interventionist study was conducted in the geriatrics ward of a Brazilian university hospital. The research intervention occurred between January and May 2022, with a follow‐up conducted for up to 90 days after patients' hospital discharge. Older patients in the geriatrics ward received pharmaceutical care, including medication reconciliation, medication review, and pharmacotherapeutic follow‐up, aimed at identifying and resolving drug‐related problems (DRPs). The clinical relevance of DRPs and pharmaceutical recommendations was evaluated. Additionally, analyses were conducted on mortality and rehospitalization outcomes in older patients at 30, 60, and 90 days following initial hospital discharge. Results: Of the patients evaluated, a significant 88.3% exhibited at least one DRP (with an average of 2.6 ± 1.9 DRPs per patient), with the majority classified as need/indication problems (38.9%). The acceptance rate of pharmaceutical recommendations was 80.9%, with the majority categorized as very significant relevance (60.4%). DRPs were predominantly of serious clinical relevance (50.9%). In patients whose clinical indicators could be monitored, 95.5% showed some clinical response (in vital signs, laboratory tests and/or clinical status evolution) potentially related to resolved DRPs. Association analysis revealed that a higher number of medications in use before hospitalization correlated with a greater identification of DRPs during hospitalization (p = 0.03). At hospital discharge, 23.6% of patients were no longer using polypharmacy. In total, 16 patients (26.7%) died during the study period. Among patients who did not die during hospitalization (n = 54), 20 patients (37%) experienced rehospitalizations within 90 days following discharge. Conclusion: This study facilitated the consolidation of pharmaceutical care implementation in a geriatric ward. We conducted identification, evaluation, and proposed evidence‐based solutions, as well as monitored cases for outcome analysis. It is anticipated that this methodology will inspire future research and the implementation of pharmaceutical care‐related services. [ABSTRACT FROM AUTHOR]

The implementation of the National Recovery Plan of Ukraine in the field of “Health Care”, namely the restoration of the pharmaceutical sector, improving the population’s access to medicines and their proper use, taking into account the regulatory and legal field harmonized with European legislation, in the context of providing the qualified pharmaceutical care and pharmaceutical services requires application of modern approaches based on evidence-based medicine and implementation in pharmaceutical practice. Patients with cardiovascular diseases, who are provided with medication under the Reimbursement Program and prescriptions from doctors, must be accompanied by pharmaceutical care based on evidence-based medicine to ensure proper use of drugs and rational pharmacotherapy. The aim of the study was to investigate Ukrainian information and scientific databases, scientometric databases, i. e.: Embase, Web of Science, PubMed, and Cochrane Library to identify, generalize, and systematize scientific sources of medical and pharmaceutical data on providing patient-oriented pharmaceutical care to patients with coronary heart disease and predict the future vector of research on the specified topic. Results. The analysis of the main strategies of providing pharmaceutical care to patients with cardiovascular diseases, in particular, coronary heart disease in pharmaceutical practice was carried out; the most researched clusters of providing pharmaceutical care were identified; modern trends and tendencies in the provision of pharmaceutical care to patients with coronary heart disease were summarized. Conclusions. The development of providing qualified pharmaceutical care to patients with cardiovascular diseases is based on the principles of patient-oriented pharmacy and evidence-based medicine, which requires the design and implementation into the pharmaceutical practice of a sustainable conceptual model of providing patient-oriented pharmaceutical care by clinical pharmacists and pharmacists of pharmacy institutions with the expansion of the main roles, respectively the standards of Good Pharmacy Practice.

Abstract Background Drug dispensing is a service provided by pharmacists to ensure the supply of medications and other health-related products. However, despite the importance of dispensing services, Public Community Pharmacies (PCP) in Brazil still focus on the control and distribution of medicines and supplies. Thus, this paper aims to evaluate how the pharmacists in charge conduct and the challenges they encounter in dispensing services in PCP. Methods This is a mixed methods study, with a representative sample of 26 municipalities (whose populations vary between 37,784 and 409,341 inhabitants) in the state of Minas Gerais, Brazil. Data collection took place between April and October 2019 and included interviews and documentary research. Quantitative data analysis was carried out using descriptive statistics and qualitative data was subjected to thematic content analysis. Results 24 dispensing services were analyzed. The PCP had, on average, two active pharmacists and operated full-time (40 h per week). In relation to dispensing services, the most frequently mentioned steps were checking the adequacy of the prescription received, followed by providing counseling to the user about the medicines, mainly regarding administration, storage and disposal. The results highlighted a need for improvements in terms of infrastructure, workforce and the pharmacist’s work process. Conclusion It is necessary to invest and to design improvement strategies in dispensing services, especially regarding physical infrastructure, human resources and work processes.

Abstract Background Chronic obstructive pulmonary disease (COPD) represents an important health challenge, despite being preventable and manageable thanks to up-to-date recommendations. In Italy, the pharmaceutical care of COPD patients is still ill-timed and inaccurate. This study aimed to describe the treatment of COPD patients in Italy and possible switches following an exacerbation. Methods This observational retrospective analysis of Italian administrative healthcare data from the Fondazione Ricerca e Salute (ReS) database identified patients aged ≥ 45 years with COPD in 2019 and 2020. At least 6 years of look-back period and absence of concomitant asthma were required. COPD patients were categorized by treatment (SI–single/MI–multiple inhalers, TT–triple therapy, DT–dual therapy, other respiratory treatments, untreated) at index date (first dispensation during accrual period). Occurrence of moderate/severe exacerbation during one-year preceding index date and treatments during one-year preceding the exacerbation (possible switch) were evaluated. Results From ~ 4.7 million beneficiaries of the Italian National Health Service in 2019 and 2020, respectively, 105,828 and 103,729 (43 and 41 × 1,000 inhabitants aged ≥ 45 years) were identified as having COPD. Of 2019/2020 patients: 3.4%/5.2% received SI-TT, 20.7%/17.5% MI-TT, 35.9%/38.1% DT, 33.0%/33.1% other treatments, and 7.0%/6.0% were untreated. Males were prevalent and median age was > 73 years for all groups. Of 2019/2020 cohorts, heart failure and coronary artery disease affected 24/20%, 18/17%, and 11%/16% patients with SI-TT, MI-TT, DT, and other treatments, respectively. A previous moderate/severe exacerbation (2019/2020 patients) occurred to 60.5%/56.6%, 39.9%/37.4%, 30.8%/29.2% and 31.9%/29.7% patients treated with SI-TT, MI-TT, DT, and other treatments, respectively. Of 2019/2020 patients experiencing moderate/severe exacerbation: 6.0%/7.0% receiving DT, 5.1%/7.0% receiving other treatments and 4.5%/10.0% untreated, switched to SI-TT; 23.7%/16.9% receiving DT, 21.4%/17.7% receiving other treatments and 15.4%/12.0% untreated, switched to MI-TT. Conclusions COPD patients receiving TT were older and had more comorbidities, especially cardiovascular diseases, than patients receiving DT or other treatments. The limited number of patients switching after exacerbation suggests that many COPD patients may be inappropriately treated. Ensuring early and adequate treatment, combination of in-hospital and outpatient management, and integration of specialist and primary care is pivotal for the appropriate clinical management of COPD patients.

The history of global clinical pharmacy can be traced back to the second half of the 20th century. The initiators of the first efforts to disseminate the practice of clinical pharmacists were American pharmacists and American research centers. Not much later, the promotion of clinical pharmacy began on the Old Continent, more specifically in the United Kingdom. To this day the United States and the United Kingdom are role models for clinical pharmacists around the world. Our review aimed to present historical milestones and the current potential of clinical pharmacy services. We investigated articles catalogued in the PubMed database and searched for information on pharmaceutical universities’ and governments’ websites. Based on previous experiences in the USA and UK, pharmacists in other countries are gradually trying to implement their solutions to introduce clinical pharmacy services into the daily healthcare routine. This is facilitated by the increasing need to individualize treatment therapies tailored to the patient’s needs and the overload on health systems which are becoming some of the main arguments for including pharmacists in multidisciplinary teams. Clinical pharmacists’ high aspirations, as well as determination, coupled with the acceptance of the medical community and government, promise to be of rapidly discernible benefit to patients, medical staff and government finances alike. The current situation equally affects Polish clinical pharmacists, who wait for legal conditions and initial acceptance by the clinical community, enabling them to work in hospital units. This raises a question: If not now, then when?

Pharmacists are increasingly involved in patient care. Pharmacy practice research helps them identify the most clinically meaningful interventions. However, the lack of a widely accepted controlled vocabulary in this field hinders the discovery of this literature. To compare the performance of a machine learning model with manual literature searches in identifying potentially relevant publications on the clinical impact of pharmacist interventions. To describe the dataset that was built. An automated PubMed search was performed weekly starting in November 2021. Titles and abstracts were retrieved and independently evaluated by two reviewers to select potentially relevant publications on the clinical impact of pharmacists. A Cohen's kappa score was calculated. Data was collected during an 11-month period to train a machine learning model. It was evaluated prospectively during a 5-month period (predictions were collected without being shown to the reviewers). The performance of the model was compared with manual searches (positive predictive value [PPV] and sensitivity). A transformers-based model was selected. During the prospective evaluation period, 114/1631 (7 %) publications met selection criteria. If the model had been used, 1273/1631 (78 %) would not have needed review. Only 3/114 (3 %) would have been incorrectly excluded. The model showed a PPV of 0.310 and a sensitivity of 0.974. The best manual search showed a PPV of 0.046 and a sensitivity of 0.711. On December 12, 2023, the dataset contained 8607 publications, of which 544 (6 %) met the criteria. The kappa between reviewers was 0.786. The dataset and the model were used to develop a website and a newsletter to share publications (https://impactpharmacy.net). A machine learning model was developed and performs better than manual PubMed searches to identify potentially relevant publications. It represents a considerable workload reduction. This tool can assist pharmacists and other stakeholders in finding evidence that support pharmacists' interventions. • A machine learning model was developed to identify potentially relevant publications • A dataset of publications on the clinical impact of pharmacists is publicly available • This work supports the need to better identify pharmacy practice research publications [ABSTRACT FROM AUTHOR]

Background: Treating multiple myeloma is complex, and providing supportive care through an interdisciplinary approach is essential. Aim: To report and synthesize pharmacists' clinical activities and impact on the care of patients with multiple myeloma. Method: This was a scoping review that followed the PRISMA-ScR reporting recommendations. A search was conducted in PubMed, Embase, Web of Science, Scopus, and LILACS from the inception of the database until January 10th, 2024. Papers that reported pharmacists' clinical activities in the care of patients with multiple myeloma were included. Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2 was used to characterize the pharmacists' clinical activities. The results are presented as a narrative and tabular synthesis. Results: A total of 2885 records were identified, 10 of which met the inclusion criteria. Pharmacists' clinical activities related to 'direct patient care' (n = 8) and 'medication counseling, education, and training' (n = 7) were the most cited. Most were provided for patients (n = 8), by one-on-one contact (n = 9), and through face-to-face communication method (n = 8), with patient counseling being the main action taken by pharmacists (n = 7). Materials that supported pharmacists' actions were cited in five studies. Integrating pharmacists into interdisciplinary teams led to improved process, clinical, humanistic, and economic outcomes. Conclusion: This scoping review emphasizes pharmacists' clinical activities in improving the care of patients with multiple myeloma. There is a need to develop studies with patient-reported outcomes and comprehensive reporting of pharmacists' clinical activities to ensure reproducibility and effective implementation in clinical practice. [ABSTRACT FROM AUTHOR]

Background The Acute Disease Quality Initiative advocates multidisciplinary care for the survivors of acute kidney injury (AKI). The bundled care strategy recognizes the role of pharmacists. However, their specific contributions in this context remain underexplored. Methods This retrospective study examined the efficacy of pharmacist-led post-AKI pharmaceutical care in outpatient settings at a single center. Adults with recent AKI during hospitalization, maintaining an estimated glomerular filtration rate

The expansion of information technologies, particularly during the COVID-19 pandemic, has notably increased the use of remote services, including telehealth. Telepharmacy, a subset of telehealth, offers remote pharmaceutical care services, benefiting patients by providing advice and consultations without the need for physical pharmacy visits. This study aimed to assess public perceptions and awareness of telepharmacy in Malaysia. A cross-sectional study was conducted from Nov 2022 to May 2023, involving 387 Malaysian citizens aged 18 and above. Data collection utilised Google Forms distributed via social medias, covering demographics, technological readiness, awareness, perceptions, and willingness related to telepharmacy. The study demonstrated high digital readiness among respondents, owning smartphones and being adept in utilising various digital features. However, there was a lack of awareness regarding the concept of telepharmacy. Despite predominantly positive perceptions of its potential, only 48.1% of respondents showed willingness to utilise telepharmacy services. While respondents exhibited readiness for digital engagement, there was a notable deficit in understanding telepharmacy. Though perceptions were positive, willingness to embrace telepharmacy was moderate. Addressing the knowledge gap through targeted education initiatives might enhance acceptance. Future research should focus on integrating telepharmacy into healthcare systems considering public preferences, thereby evaluating its actual implementation and outcomes among diverse demographics. [ABSTRACT FROM AUTHOR]

Background: Telepharmacy, utilizing telecommunications to dispense pharmaceutical products and deliver patient care, offers numerous benefits for both the public and pharmacists. Previous research on exploring attitudes and willingness to use telepharmacy services has primarily focused on pharmacists rather than the general population. Aim: This study is aimed at assessing the attitudes and willingness of the United Arab Emirates (UAE) population to utilize telepharmacy services and identifying the factors influencing their inclination to use these services. Methods: In this cross‐sectional study, a survey was distributed using convenience and snowball sampling to individuals aged 18 or older across the UAE through various social media platforms, including Twitter, Facebook, and WhatsApp. The survey domains included sociodemographics, attitudes, and readiness to utilize a telepharmacy service. A binary logistic regression analysis was conducted to investigate the variables associated with participants' willingness to utilize telepharmacy in the future. Results: In total, 963 individuals participated in the study. Participants showed overall positive attitudes towards telepharmacy, with 70.9% believing that telepharmacy saved time and effort. While only 32% of the participants acknowledged that numerous telepharmacy services were available for use in the UAE, most were interested in using telepharmacy services in the future (79.2%). Participants who had higher attitude scores (AOR = 1.147, 95% confidence interval [CI]: 1.11–1.18) and those who had used these services previously (AOR = 3.270, 95% CI: 1.692–6.320) were more interested in using telepharmacy services in the future. Conclusion: Forthcoming healthcare strategies should focus on expanding the availability of telepharmacy services throughout various regions of the country. This expansion will facilitate the broader utilization of these services and ultimately contribute to improved health outcomes. [ABSTRACT FROM AUTHOR]

In the Kingdom of Saudi Arabia, there is an increasing demand for community pharmacists to provide the highest level of clinical knowledge and services. However, evidence regarding Saudi public awareness of the clinical services offered by community pharmacies (CPs) and the barriers to using them is limited. In this cross-sectional study, we used an online questionnaire developed by adapting the Consolidated Framework for Implementation Research. A total of 273 participants completed the survey. Half the participants were generally aware of the availability of some CP services but were not informed about the full range on offer, eg, medication reviews (84%) and online counseling (89%). Most of the participants (69.6%) did not identify differences in the care provided by community pharmacists versus hospital pharmacists (P = 0.02). A commonly reported barrier to using CP services was a general preference for other healthcare professionals to seek pharmaceutical help (85.7%). Many other barriers were also reported, impacting the participants' use of these services. The decision-making authorities should consider improvements to increase patients' awareness and utilization of clinical services and enhance community pharmacists' performance in clinical-oriented pharmaceutical care. [ABSTRACT FROM AUTHOR]

Objective: To describe the resident pharmacist's participation in Shared Medical Appointments (SMA) in palliative care. Methods: The resident pharmacist participated in face-to-face SMA with the attending physician, medical and gerontology students, and a nurse. Key findings: The resident pharmacist supported interdisciplinary discussions and performed pharmaceutical interventions. He helped raise awareness about the effective, safe, and convenient use of medicines, helping improve the quality of life of patients and caregivers. Conclusions: Providing pharmaceutical care to patients in palliative care helped to improve the quality of clinical services offered to these patients, as well as adding value to resident pharmacists' interprofessional practice. [ABSTRACT FROM AUTHOR]

Background: Tolerance and dependence stand out as the most relevant risks observed during benzodiazepine (BZD) treatments. Objectives: To evaluate the degree of dependence of patients on BZD treatments using the Tyrer test; to define a profile of patients at risk of developing BZD dependence; and to discuss the role of the pharmaceutical care offered by the community pharmacy during dispensing. Methods: Prospective cross-sectional descriptive observational study (August 2020–February 2021) involving 127 patients using BZD. They voluntarily answered a questionnaire during the dispensing pharmaceutical care service. The study was evaluated and codified (code: DAA-CLO-2020-01) by the Spanish Agency for Drugs and Health Products (AEMPS), and statistical analysis was performed with SPSS 25.0. Results: 19.05% of patients using BZD were suspected of suffering from BZD tolerance, and 77.88% of all patients were identified as being at a high risk of BZD dependence. The Tyrer test for dependence indicated a mean score of 5.59 out of 13 points. An 18-fold increased risk of developing dependence was detected in the case of coexistence of high anxiety or depression. Conclusions: The community pharmacy, through protocolized care practices and supported by tools such as the Tyrer test, can play a decisive role in the detection, prevention, and resolution of the risks associated with BZD treatments. [ABSTRACT FROM AUTHOR]

Background: Independent prescribing (IP) has not been extensively investigated in community pharmacy (CP). Normalization process theory (NPT) constructs help explain how interventions are integrated into practice and include: 'coherence' (understanding), 'cognitive participation' (what promotes engagement), 'collective action' (integration with existing systems), and 'reflexive monitoring' (evaluation). Aim: To use NPT to investigate the integration of pharmacist IP in CP. Method: NHS Scotland Pharmacy First Plus (PFP) is a community pharmacy IP service. Questionnaire items were developed using the NPT derived Normalisation MeAsure Development (NoMAD) tool for an online survey of all PFP IP pharmacists. Demographic data were analysed descriptively and scale scores (calculated from item scores for the 4 NPT constructs) were used for inferential analysis. Results: There was a 73% (88/120) response rate. Greater than 90% 'strongly agreed'/'agreed' to NoMAD items relating to most NPT constructs. However, responses to 'collective action' items were diverse with more participants answering 'neither agree nor disagree' or 'disagree'. A statistically significant difference in NPT construct scale scores with significant p-values (ranging from p < 0.001 to p = 0.033) was shown on all the NPT constructs for the variable 'On average, how often do you consult with patients under the PFP service?'. Conclusion: This theory-based work offers perspectives on IP integration within CP. Despite its geographic focus this work offers insights relevant to wider contexts on IP integration. It shows 'collective action' focused 'organisation' and 'group process' challenges with a need for further work on staff training, resource availability and utilisation, working relationships, communication and management. [ABSTRACT FROM AUTHOR]

Examining the impact of pharmaceutical services on the clinical management of oncological pain in hospital settings. An integrative review was conducted using the MEDLINE (PubMed) database and grey literature. Thirty-seven studies were retrieved, and after applying eligibility criteria, seven studies were selected. There is a clear trend of benefits from pharmaceutical clinical services in enhancing clinical management of oncological pain in hospitalized patients, as well as revealing financial benefits to hospital institutions. Effective implementation faces challenges, including resistance to opioid use and conservative patterns of medical prescription, affecting the acceptance and efficacy of pharmaceutical interventions. [ABSTRACT FROM AUTHOR]

The aim of training and mentoring activities for vocational pharmaceutical personnel to become people in charge of small traditional medicine businesses are to improve the quality and safety of traditional medicine products as well as improve the technical and managerial skills of vocational pharmaceutical personnel so that they can carry out their role as people in charge effectively. The methods used theoretical presentation sessions, questions/answers and discussions for online training and discussions, FGDs, workshops and case studies for offline mentoring at the Islamic University of Madura which were conducted on 88 students of the diploma three Pharmacy Study Program, Faculty of Health, Islamic University of Madura. The result is community service through training activities and mentoring for pharmaceutical vocational staff to become people in charge of small traditional medicine businesses, receiving an enthusiastic and positive response from the participants present. [ABSTRACT FROM AUTHOR]

Pain is a significant healthcare challenge, impacting millions worldwide. Pharmacists have increasingly taken on expanded roles in managing pain, particularly in primary and ambulatory care contexts. This umbrella review aims to systematically evaluate evidence from published systematic reviews that explore the impact of pharmacist-delivered interventions on clinical, humanistic, and economic outcomes related to pain. A systematic search was conducted across six electronic databases, including Ovid Embase, MEDLINE, CINAHL, Scopus, CENTRAL, APA PsycINFO, and DARE, from inception until June 2023. Prior to inclusion, two independent reviewers assessed study titles and abstracts. Following inclusion, an assessment of the methodological quality of the included studies was conducted. AMSTAR 2 was used to evaluate the methodological quality of the included SRs. From 2055 retrieved titles, 11 systematic reviews were included, with 5 out of 11 being meta-analyses. These SRs encompassed diverse pharmacist-led interventions such as education, medication reviews, and multi-component strategies targeting various facets of pain management. These findings showed favorable clinical outcomes, including reduced pain intensity, improved medication management, enhanced overall physical and mental well-being, and reduced hospitalization durations. Significant pain intensity reductions were found due to pharmacists' interventions, with standardized mean differences (SMDs) ranging from −0.76 to −0.22 across different studies and subgroups. Physical functioning improvements were observed, with SMDs ranging from −0.38 to 1.03. Positive humanistic outcomes were also reported, such as increased healthcare provider confidence, patient satisfaction, and quality of life (QoL). QoL improvements were reported, with SMDs ranging from 0.29 to 1.03. Three systematic reviews examined pharmacist interventions' impact on pain-related economic outcomes, highlighting varying cost implications and the need for robust research methodologies to capture costs and benefits. This umbrella review highlights the effectiveness of pharmacist-delivered interventions in improving clinical, humanistic, and economic outcomes related to pain management. Existing evidence emphasises on the need to integrate pharamacists into multi-disciplinary pain management teams. Further research is needed to investigate innovative care models, such as pharmacist-independent prescribing initiatives within collaborative pain management clinics. • Pharmacists have a vital role in improving pain related outcomes in patients. • Pharmacist-delivered medication review, and patient education, beneficial in managing various types of pain. • Positive outcomes included decreased pain intensity, enhanced quality of life and better medication management. [ABSTRACT FROM AUTHOR]

Objectives There are approximately 5.3 million informal carers in the United Kingdom, many of whom support family in their health despite being unpaid and often unsupported. Many visit pharmacies to collect medicines and look for advice. This work explores informal carer support within community pharmacies (CP). Methods Semi-structured video interviews exploring perspectives on the role of CP in supporting carers were conducted in autumn 2022. The study received institutional ethical approval. Interviews were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic approach. Key findings In total 25 interviews were conducted with 13 carers and 12 pharmacy staff. Three themes were identified: -What support do carers need through CP?—medicines management, navigating services, and carers health and wellbeing. -Barriers to CP better supporting carers—relationships with CP, carer needs, identification as a 'carer'. -Enablers to CP better supporting carers—support is a team effort, and CP as a community 'hub'. Conclusions There is a trusted relationships between carers and pharmacy staff which can contribute to establishing pharmacies as a safe space of support, this includes medicines-specific support and navigating services, but also carer health and wellbeing support. Pharmacy staff may need to reconsider approaches to identifying and supporting carers and not just treating them as an extension of supporting a patient. In making this support accessible, relationships with pharmacy staff are important, as well as embracing CP as a 'community hub', although pharmacy staff may need training and information to facilitate them in this role. [ABSTRACT FROM AUTHOR]

Introduction: Drug therapy-related problems (DTRP) can lead to avoidable negative health consequences, particularly during hospital admissions. This study aimed to assess the frequency, causes, and associated factors of DTRPs, which are detected by clinical pharmacists’ interventions. Methods: This is a prospective cross-sectional study of patients admitted to the medical wards of Fakeeh University Hospital, UAE, over a three-month period from September 2022 to December 2022. The data of patients who were assessed by clinical pharmacists regarding the pretense and causes of DTRPs were collected and analyzed using SPSS version 27.0. Results: 310 patients with the mean age of 33.43 ± 19.98 years were studied (53.9% male). The highest percentage of patients were Asian (31.0%) and Arabs (30.6%). 79 (25.4%) cases had no DTRPs, while 231 (74.6) had DTRPs. The surgical ward had the highest frequency of DTRPs (41.0%). Improper drug selection with 79 cases, drug use without indication with 73 cases, and sub-therapeutic dosage with 26 cases were among the most common causes of DTRPs. Alcohol intake (p= 0.03), food allergy (p = 0.02), age group 31-40 years (p = 0.04), presence of co-morbidities (p = 0.01), family history of diseases (p = 0.02), and admission to the intensive care unit (ICU) (p = 0.01) were amongst the significantly associated factors of DTRPs. The acceptance status for clinical pharmacists’ interventions were complete in 90.0% of cases, partial in 4.1 %, and rejection in 5.9%. Conclusion: The study findings show a high prevalence of DTRPs due to drug/dose selection and drug use without indication. It seems that the participation of clinical pharmacists in multidisciplinary teams together with the presence of closed loop medication management facilitates the detection and correction of DTRPs.

OBJECTIVE: Given the substantial barriers to abortion access in the United States, many clinics now mail patients abortion medications. We examined whether dispensing the medications by mail prolonged time to medication use. STUDY DESIGN: We analyzed data from no-test medication abortions with medication provided either by mail or in a clinic from 11 United States clinics from February 2020 to January 2021. We examined mean number of days from patients first contact with the clinic to mifepristone ingestion, its two-component intervals (first contact to medication dispensing and dispensing to mifepristone ingestion), and pregnancy duration at mifepristone ingestion. We used Poisson regression to compare mean outcomes across three dispensing methods: in-person, mailed from the clinic, and mailed from a mail-order pharmacy. RESULTS: Among the 2600 records, patients took mifepristone on average at 49 days of gestation (95% CI, 47-51) and 7 days (95% CI, 4-10) after first contact. Mean time from first contact to mifepristone ingestion was 6 days when medications were dispensed in-person and 9 days when mailed (p = 0.38). While time from first contact to dispensing was similar across methods (6 days in-person, 5 days mailed, p = 0.77), more time elapsed from dispensing to mifepristone ingestion when medications were mailed (4 days from clinic, 5 days from mail-order pharmacy) versus dispensed in-person (0.3 days, p

Abstract Background Pharmacist clinics offer professional pharmaceutical services that can improve public health outcomes. However, primary healthcare staff in China face various barriers and challenges in implementing such clinics. To identify existing problems and provide recommendations for the implementation of pharmacist clinics, this study aims to assess the knowledge, attitudes, and practices of pharmacist clinics among primary healthcare providers. Methods A cross-sectional survey based on the Knowledge-Attitude-Practice (KAP) model, was conducted in community health centers (CHCs) and private hospitals in Shanghai, China in May, 2023. Descriptive analytics and the Pareto principle were used to multiple-answer questions. Chi-square test, Fisher’s exact test, and binary logistic regression models were employed to identify factors associated with the knowledge, attitudes, and practices of pharmacist clinics. Results A total of 223 primary practitioners participated in the survey. Our study revealed that most of them had limited knowledge (60.1%, n = 134) but a positive attitude (82.9%, n = 185) towards pharmacist clinics, with only 17.0% (n = 38) having implemented them. The primary goal of pharmacist clinics was to provide comprehensive medication guidance (31.5%, n = 200), with medication education (26.3%, n = 202) being the primary service, and special populations (24.5%, n = 153) identified as key recipients. Logistic regression analysis revealed that education, age, occupation, position, work seniority, and institution significantly influenced their perceptions. Practitioners with bachelor’s degrees, for instance, were more likely than those with less education to recognize the importance of pharmacist clinics in medication guidance (aOR: 7.130, 95%CI: 1.809–28.099, p-value = 0.005) and prescription reviews (aOR: 4.675, 95% CI: 1.548–14.112, p-value = 0.006). Additionally, practitioners expressed positive attitudes but low confidence, with only 33.3% (n = 74) feeling confident in implementation. The confidence levels of male practitioners surpassed those of female practitioners (p-value = 0.037), and practitioners from community health centers (CHCs) exhibited higher confidence compared to their counterparts in private hospitals (p-value = 0.008). Joint physician-pharmacist clinics (36.8%, n = 82) through collaboration with medical institutions (52.0%, n = 116) emerged as the favored modality. Daily sessions were preferred (38.5%, n = 86), and both registration and pharmacy service fees were considered appropriate for payment (42.2%, n = 94). The primary challenge identified was high outpatient workload (30.9%, n = 69). Conclusions Although primary healthcare practitioners held positive attitudes towards pharmacist clinics, limited knowledge, low confidence, and high workload contributed to the scarcity of their implementation. Practitioners with diverse sociodemographic characteristics, such as education, age, and institution, showed varying perceptions and practices regarding pharmacist clinics.

Abstract Background Ensuring equal access to medicines and their appropriate and safe use at reasonable costs are core functions of health systems. Despite that, few descriptions of national medicines policies' development processes and implementation strategies have been published. This study aimed to describe the government program-based development of the Rational Pharmacotherapy Action Plan in Finland as a part of the undergoing major health and social service system reform, also covering the implementation of rational pharmacotherapy in the reformed system and processes. Methods The data of this qualitative study consisted of public reports and Steering Group meeting memos related to the development of the national Rational Pharmacotherapy Action Plan that the Ministry of Social Affairs and Health coordinated. Qualitative content analysis applying systems theory and the conceptual framework of integrated services as theoretical frameworks was used as an analysis method. Results The national Rational Pharmacotherapy Action Plan covering 2018–2022 was created in a bottom-up development process involving a wide range of stakeholders. Rational pharmacotherapy was redefined by adding equality as the fifth pillar to complement the previously defined pillars of being effective, safe, high-quality, and cost-effective. The Action Plan formed a normative framework for long-term development, with a vision and principles focusing on people-centeredness, better coordination and management of the medication use processes, the continuity of treatment paths and the flow of patient and medicines information through partnerships, and evidence-informed policies and practices. Conclusion Through intensive stakeholder participation, the bottom-up approach created a national vision and principles of rational pharmacotherapy along with strong commitment to implementing the goals and measures. The concern lies in ensuring the continuity of the Action Plan implementation and achieving a balanced long-term development aligned with the integrated and reformed national social and health services system. The development of the pharmaceutical system has several national and EU-level dependencies requiring political long-term commitment. While the Action Plan differs from the national medicines policy, it forms a good basis for long-term development covering important parts of medicine policy at the micro, meso, and macro levels of the service system.

Background: Assessing customer satisfaction and its determinants are important for evaluating the quality of pharmaceutical services and identifying areas for improvement. Objectives: This study aims to evaluate the level of customer satisfaction and identify key factors associated with it. Methods: A cross-sectional study was conducted in 10 pharmacies located in Yogyakarta, Surakarta, and Magelang cities, involving a total of 1,200 customers. Data was collected using a validated patient satisfaction questionnaire from previous study and analyzed using SPSS 20 software. It was interviewed questionnaire that consists of three domains: sociodemographic characteristics, patient satisfaction, and opinions on service improvement in the community pharmacies. The inclusion criteria were customer who received services at community pharmacies between July and August 2021. Customers who were sick and unable to participate in an interview were eliminated from the study. Results: The average overall satisfaction score obtained was 3.46 (SD ±0.34). The average customer satisfaction scores were as follows: facilities (3.92 ± 0.45), waiting time (3.76 ± 0.59), medicine stocks (3.54 ± 0.61), staff availability (3.25 ± 0.53), and counseling hours (3.18 ± 0.54). Conclusion: Overall, customers are quite satisfied with the community pharmacy services. There is a relationship between age, residence, education level, type of medicine, payment method, and experience in using pharmacy with customer satisfaction level. Community pharmacists should prioritize improving service quality by focusing on enhancing customer counseling and pharmacists’ skills in communication.

ABSTRACTBackground Transition of care (TOC) is associated with an increased risk of medication-related problems. Despite recent advancements in pharmacy practice and research in the Middle East and North Africa (MENA), the characteristics and impact of regional pharmacy-supported TOC interventions remain unclear.This systematic review and meta-analysis aimed to describe pharmacist-supported TOC interventions in the MENA region and evaluate their effectiveness.Methods PubMed, CINAHL, EMBASE, Web of Science, World Health Organization’s International Clinical Trials Registry Platform (ICTRP) were searched from their inception to March 9, 2023, for experimental studies published in English, comparing pharmacist-supported TOC interventions with usual care for adults (age ≥18 years) discharged from the hospital. The risk of bias was evaluated using Cochrane’s risk-of-bias tool for randomised trials (ROB2) and the risk of bias in non-randomised studies of interventions (ROBINS-I) tool for randomised and non-randomised studies respectively. Narrative syntheses and meta-analysis methods were employed depending on the outcomes evaluated.Results Twelve studies (n = 2377 subjects), 10 randomised controlled trials and 2 quasi-experimental studies, were included. Most studies had high or serious risk of bias. The included studies were quite heterogeneous in terms of nature and the delivery of intervention, and assessment of outcome measures. Compared to the usual care group, pharmacist-led TOC interventions contributed to a significant reduction in preventable drug-related (N = 2) and cardiac-related healthcare utilisation (N = 1), a significant reduction in preventable adverse drug events (ADEs) (Odds ratio (OR) 0.34, 95% CI: 0.13-0.94) and an improvement in medication adherence. However, all-cause hospitalisation and medication discrepancies were not significantly reduced.Conclusion Pharmacy-supported TOC interventions may improve patient outcomes in the MENA region. However, considering the limited quality of evidence and the variability in intervention delivery, future well-designed clinical trials are needed.

BackgroundThe effects of climate change are seen with a rise of extreme weather and climate events (EWCEs) which lead to the closures of many healthcare facilities, such as community pharmacies. Pharmacists in community pharmacies are seen as the most accessible healthcare professional to the public and are responsible for the continued delivery of care to patients. However, amid closures due to EWCEs and the emergence of pharmacy deserts, there is decreased access to pharmacies and a disruption of care.ObjectiveIt is important to address the preparedness and accessibility of pharmacies post-EWCEs to guide future research and policy. Additionally, to tackle health disparities that arise due to pharmacy deserts, the populations most affected by a decreased access to pharmacies should be identified. We conducted a scoping review to assess the preparedness and accessibility of pharmacies post-EWCEs and to identify populations most affected by pharmacy deserts.MethodsWe searched PubMed, Embase, and Web of Science from January 1, 2012 to September 30, 2022 and included all English-language, peer-reviewed primary literature that examined the preparedness and accessibility of community pharmacies in the United States post-EWCEs and addressed disparities within pharmacy deserts. Studies meeting these criteria were screened of their titles and abstracts by the first author and discrepancies were resolved with co-authors. We used Covidence for data extraction.ResultsA total of 472 studies were identified (196 duplicates removed) and after screening, 53 studies were assessed for eligibility. The results of included publications (N = 26) showed that pharmacists and pharmacies are not equipped with the necessary emergency protocols which could lead to decreased access of pharmacies in the wake of EWCEs. Pharmacy deserts disproportionately affect residents living in rural, lower income, and Black/African American and Hispanic/Latino neighborhoods. The lack of preparedness of pharmacies post-EWCEs could worsen medication access.ConclusionThis scoping review addresses challenges impacting pharmacies and patients post-EWCEs and within pharmacy deserts. In times of increased need, these challenges implicate the well-being of communities affected by EWCEs by breaking the continuum of care and access to medications. Here we offer suggestions for future research and directions for policy change.