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Pharmacy
Volume 12
Issue 3
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Pharmacy, Volume 12, Issue 3 (June 2024) – 24 articles

Cover Story (view full-size image): OTC PPIs in Canada have altered pharmacist treatment options for heartburn. To explore how current scheduling may impact pharmacist treatvment choices, an online survey in Ontario and Québec examined their recommendations for two hypothetical heartburn cases. Approaches varied between cases and provinces. Ontario pharmacists favoured a combination of H2RA + antacid for milder cases, while Québec pharmacists preferred H2RA on its own. Both tended to recommend switching medications or medical referral if symptoms persisted. These findings have sparked debates regarding optimal therapeutic approaches and the impact of drug scheduling on patient care. View this paper
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18 pages, 1039 KiB  
Review
Identifying Pertinent Digital Health Topics to Incorporate into Self-Care Pharmacy Education
by Jason C. Wong, Luiza Hekimyan, Francheska Anne Cruz and Taylor Brower
Pharmacy 2024, 12(3), 96; https://doi.org/10.3390/pharmacy12030096 - 20 Jun 2024
Cited by 1 | Viewed by 1325
Abstract
The ever-evolving landscape of digital health technology has dramatically enhanced patients’ ability to manage their health through self-care effectively. These advancements have created various categories of self-care products, including medication management, health tracking, and wellness. There is no published research regarding integrating digital [...] Read more.
The ever-evolving landscape of digital health technology has dramatically enhanced patients’ ability to manage their health through self-care effectively. These advancements have created various categories of self-care products, including medication management, health tracking, and wellness. There is no published research regarding integrating digital health into pharmacy self-care courses. This study aims to identify pertinent digital health devices and applications to incorporate into self-care course education. Digital health limitations, challenges incorporating digital health in self-care pharmacy education, and potential solutions are also reviewed. In conducting this research, many resources, including PubMed, APhA, ASHP, fda.gov, and digital.health, were reviewed in March 2024 to gather information on digital health devices and applications. To supplement this, targeted keyword searches were conducted on topics such as “digital health”, “devices”, “applications”, “technology”, and “self-care” across various online platforms. We identified digital health devices and applications suitable for self-care education across eight topics, as follows: screening, insomnia, reproductive disorders, eye disorders, home medical equipment, GI disorders, pediatrics, and respiratory disorders. Among these topics, wellness screening had the most digital health products available. For all other topics, at least three or more products were identified as relevant to self-care curriculum. By equipping students with digital health knowledge, they can effectively apply it in patient care throughout their rotations and future practice. Many digital health products, including telemedicine, electronic health records, mobile health applications, and wearable devices, are ideal for inclusion in pharmacy curriculum as future educational material. Future research is needed to develop the best strategies for incorporating relevant digital health into self-care education and defining the best student-learning strategies. Full article
(This article belongs to the Special Issue Digital Health in Pharmacy Practice and Education)
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14 pages, 280 KiB  
Review
Interventions to Expand Community Pharmacists’ Scope of Practice
by Zaynah Zureen Ali, Helen Skouteris, Stephanie Pirotta, Safeera Yasmeen Hussainy, Yi Ling Low, Danielle Mazza and Anisa Rojanapenkul Assifi
Pharmacy 2024, 12(3), 95; https://doi.org/10.3390/pharmacy12030095 - 19 Jun 2024
Cited by 1 | Viewed by 1586
Abstract
Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed [...] Read more.
Background: The role of community pharmacists has evolved beyond the dispensing of medicines. The aim of this scoping review was to describe the interventions that expand the pharmacist’s scope of practice within a community pharmacy setting and assess their effectiveness. Methods: We performed a scoping review to identify randomised controlled trials (RCTs), published worldwide from 2013 to 2024, which focused on interventions designed to expand pharmacists’ scope of practice in the community. The review was undertaken in accordance with the Joanna Briggs Institute methodology for scoping reviews. To address the aim of this scoping review, the included RCTs were mapped to themes influenced by the Professional Practice Standards 2023 as developed by the Pharmaceutical Society of Australia: medication management, collaborative care and medication adherence. Results: Twelve studies demonstrated the potential to expand community pharmacists’ scope of practice. Two RCTs resulted in no effect of the intervention. One RCT (conducted in Italy) led to an actual change to community pharmacists’ scope of practice, with a statistically significant improvement in the proportion of patients with controlled asthma. Conclusions: On the whole, this scoping review synthesised the findings of peer-reviewed RCT studies that revealed expanding community pharmacists’ scope of practice may result in improved patient outcomes, a reduced burden for the healthcare system, and greater productivity. Full article
10 pages, 554 KiB  
Review
Examining the Impact of the World Health Organization 2022 Guidelines on Evaluation of Biosimilars for Non-Local Comparators in Biosimilar Studies on Middle East and North Africa Member States
by Michael W. Strand and Jonathan H. Watanabe
Pharmacy 2024, 12(3), 94; https://doi.org/10.3390/pharmacy12030094 - 16 Jun 2024
Viewed by 1128
Abstract
Global support and standardization of regulation for biosimilars approval owes much of its legacy to the World Health Organization (WHO), since the first guidance by the organization on the matter was released in 2009. Since then, and with over a decade of research, [...] Read more.
Global support and standardization of regulation for biosimilars approval owes much of its legacy to the World Health Organization (WHO), since the first guidance by the organization on the matter was released in 2009. Since then, and with over a decade of research, the 2022 revision provides opportunities for time and financial savings to pharmaceutical manufacturers aiming to prove similarity of a potential biosimilar product to some reference product, particularly by clarifying that the use of a non-local reference product as a comparator in certain studies is permissible. This declaration has important implications, particularly in the emerging biological markets of the Middle East and North Africa region, where WHO guidelines have been integral to the regulatory framework of over a dozen countries for more than a decade. This article aims to review the impact of this revision on these countries and relevant policies on non-local comparator usage. Since 2022, this revision has been adopted only in Egypt. Many North African countries are yet to adopt a first draft of the formalized guidance. This analysis revealed that, although many of these countries reference the WHO guidelines, hesitation remains in terms of sourcing comparator products outside the US or European countries. This likely translates to slow regional development and cooperation of functioning, sustainable biosimilars markets. Future studies will be necessary to evaluate the continued development of guidance within these countries and changes in comparator sourcing norms as more time is allowed for their policies to mature and adapt to new standards. Full article
(This article belongs to the Special Issue Pharmacy Reviews in 2022)
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12 pages, 1724 KiB  
Article
Excessive Self-Medication with Prescription NSAIDs: A Cross-Sectional Study in Kosovo
by Gentiana Krasniqi, Ilirjeta Qeriqi, Genta Qeriqi, Rajmonda Borovci, Daniela Zenelaj, Fehmi Rrahmani, Manushaqe Kryeziu-Rrahmani and Nderim Kryeziu
Pharmacy 2024, 12(3), 93; https://doi.org/10.3390/pharmacy12030093 - 12 Jun 2024
Cited by 1 | Viewed by 1369
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, fever, and inflammation. Although most are usually classified as prescription-only medicines, in many countries they are frequently purchased for self-medication purposes. This study explores NSAID-usage patterns in Kosovo, aiming for a safer and [...] Read more.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to manage pain, fever, and inflammation. Although most are usually classified as prescription-only medicines, in many countries they are frequently purchased for self-medication purposes. This study explores NSAID-usage patterns in Kosovo, aiming for a safer and more effective medicinal use. The study employed a dual approach to collect data. First, NSAID sales were analyzed in a convenience sample of ten community pharmacies across diverse regions in Kosovo in 2023. Second, data on NSAID-usage patterns and patient awareness were systematically gathered from 410 patients during routine pharmacist–patient interactions. The four most commonly purchased NSAIDs according to sales analysis were diclofenac (33.1%), ketoprofen (27.6%), ibuprofen (17.0%) and nimesulide (12.7%). A significant 74.8% of NSAIDs were bought without prescriptions, particularly among younger adults (20–39 years), who accounted for 82.8% of such purchases. The predominant reason for NSAID use was headache (43.8%). Although many of the patients suffered from occasional (33.7%) or frequent (12.6%) stomachaches and took acid-lowering medicines, the majority (85.9%) could not recall any NSAID adverse reactions. This study exposes widespread self-medication and a significant lack of awareness regarding potential risks of NSAIDs, particularly among young adults. To address these issues, it is critical to improve dispensing practices through increased pharmacist awareness and stricter law enforcement. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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11 pages, 608 KiB  
Opinion
Decoding Clozapine-Induced Agranulocytosis: Unraveling Interactions and Mitigation Strategies
by Ali Alalawi, Enas Albalawi, Abdullah Aljohani, Abdullah Almutairi, Abdulraouf Alrehili, Areej Albalawi and Ahmed Aldhafiri
Pharmacy 2024, 12(3), 92; https://doi.org/10.3390/pharmacy12030092 - 12 Jun 2024
Cited by 1 | Viewed by 1481
Abstract
Agranulocytosis represents a severe complication associated with the administration of clozapine. Clozapine is an antipsychotic medication that has demonstrated substantial efficacy in remediating refractory schizophrenia and various other psychiatric disorders. Nonetheless, it is crucial to monitor patients for neutropenia regularly during clozapine therapy. [...] Read more.
Agranulocytosis represents a severe complication associated with the administration of clozapine. Clozapine is an antipsychotic medication that has demonstrated substantial efficacy in remediating refractory schizophrenia and various other psychiatric disorders. Nonetheless, it is crucial to monitor patients for neutropenia regularly during clozapine therapy. Therefore, this article aimed to delve into the prevalence of agranulocytosis during clozapine treatment by scrutinizing the extant literature to discern trends and correlations. This review endeavored to explore factors such as drug interactions, dose-related factors, duration of treatment, and genetic predispositions that could potentially influence the likelihood of patients developing agranulocytosis while undergoing clozapine therapy. Moreover, this review enunciates the ramifications of agranulocytosis on both patients and healthcare providers and meticulously evaluates the strategies to mitigate this risk and ensure optimal patient outcomes. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
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12 pages, 864 KiB  
Article
Using Team-Based Learning to Teach Pharmacology within the Medical Curriculum
by Nora L. D. Luitjes, Gisela J. van der Velden and Rahul Pandit
Pharmacy 2024, 12(3), 91; https://doi.org/10.3390/pharmacy12030091 - 12 Jun 2024
Viewed by 1482
Abstract
The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation [...] Read more.
The primary goal of pharmacology teaching is to prepare medical students to prescribe medications both safely and efficiently. At the Utrecht University Medical School, pharmacology is integrated into the three-year bachelor’s curriculum, primarily through large group sessions with limited interaction. A recent evaluation highlighted students’ appreciation for pharmacology teaching, but students admitted to attending these teaching moments unprepared, resulting in passive learning. To address this, team-based learning (TBL) was implemented to facilitate learning through interaction, critical thinking, problem solving and reflection through six steps, from superficial to deeper cognitive learning. This study, conducted over two academic years, assessed students’ perception and performance regarding TBL. Analysis of a digital questionnaire using a 5-point Likert scale showed high student satisfaction with TBL as a teaching methodology. However, confidence in pharmacology knowledge following TBL was moderate. TBL attendees outperformed non-attendees in pharmacology-related exam questions, indicating that TBL has a positive impact on student performance. We conclude that TBL is an engaging and effective method for pharmacology education, positively influencing student learning and performance. This method could be broadly applied for teaching pharmacology within the medical curriculum or other biomedical programs. Full article
(This article belongs to the Section Pharmacy Education and Student/Practitioner Training)
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13 pages, 531 KiB  
Article
The Association between Academic Performance and Entry-to-Practice Milestones within a Co-Operative Education PharmD Program
by Ali Syed, Yuying Huang, Joslin Goh, Sarah Moroz, John Pugsley, Nancy M. Waite and Sherilyn K. D. Houle
Pharmacy 2024, 12(3), 90; https://doi.org/10.3390/pharmacy12030090 - 11 Jun 2024
Viewed by 1147
Abstract
Research on associations between student performance in pharmacy programs and entry-to-practice milestones has been limited in Canada and in programs using a co-operative (co-op) education model. Co-op exposes students to a variety of opportunities both within direct patient care roles and in non-traditional [...] Read more.
Research on associations between student performance in pharmacy programs and entry-to-practice milestones has been limited in Canada and in programs using a co-operative (co-op) education model. Co-op exposes students to a variety of opportunities both within direct patient care roles and in non-traditional roles for pharmacists, such as policy, advocacy, insurance, research, and the pharmaceutical industry. The purpose of this research is to analyze associations between student grades and evaluations achieved in the University of Waterloo (UW) Doctor of Pharmacy (PharmD) co-op program and success rates on entry-to-practice milestones, including the Pharmacy Examining Board of Canada (PEBC) Pharmacist Qualifying Examination and performance on final-year clinical rotations. Grades and evaluations from courses, co-op work terms, clinical rotations, and PEBC exam data from three graduating cohorts were obtained. A multiple regression analysis was performed to explore associations between student evaluations and PEBC Pharmacist Qualifying Examination and clinical rotation performance. Holding all other variables constant, grades in anatomy/physiology were negatively correlated with scores on the PEBC Pharmacist Qualifying Examination, while grades in one of the professional practice courses showed a positive relationship with the same examination. Students with higher grades in a problem-based learning capstone therapeutics course, in their first co-op work term, and in the direct patient care co-op work term tended to score higher on clinical rotations. Co-op performance was not significant in predicting PEBC performance. However, complimentary descriptive analysis underscored that students with a co-op rating of good or below were more likely to fail courses, midpoint evaluations, Objective Structured Clinical Examinations (OSCEs), and PEBC measures. Multiple predictors of performance on final-year clinical rotations and the PEBC Pharmacist Qualifying Examination were identified. This predictive model may be utilized to identify students at risk of underperforming and to facilitate early intervention and remediation programs, while also informing curricular revision. Full article
(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)
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12 pages, 441 KiB  
Article
Mental Health Evaluation in Community Pharmacies—A Cross-Sectional Study
by Mónica Condinho, Isabel Ramalhinho, Catarina Vaz-Velho and Carlos Sinogas
Pharmacy 2024, 12(3), 89; https://doi.org/10.3390/pharmacy12030089 - 7 Jun 2024
Viewed by 1676
Abstract
Portugal has a high prevalence of anxiety and depression, and community pharmacists are well-placed to identify mental health problems and monitor their treatment. This study aimed to screen undiagnosed people for symptoms of anxiety and depression and to monitor these conditions in diagnosed [...] Read more.
Portugal has a high prevalence of anxiety and depression, and community pharmacists are well-placed to identify mental health problems and monitor their treatment. This study aimed to screen undiagnosed people for symptoms of anxiety and depression and to monitor these conditions in diagnosed patients. We conducted an observational, cross-sectional study of a sample of community pharmacy users. Anxiety and depression symptoms were assessed using the Generalised Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Altogether, 591 participants were enrolled between September 2020 and July 2021, 74.9% of whom were female. Of the 477 undiagnosed participants who completed the GAD-7, 87 (18.2%) had moderate or severe anxiety symptoms. Of the 485 participants who completed the PHQ-9, 59 (12.1%) had moderate or severe symptoms of depression. Of the 94 patients diagnosed with anxiety, 37 (39.4%) reported moderate to severe symptoms. Similarly, of the 97 patients with depression, almost half (49.5%) reported moderate to severe symptoms. Anxiety levels were lower among men and among those who reported not taking any medication (p < 0.001). Moderate or severe symptoms of depression were more common among women (p < 0.001), participants with lower education levels (p < 0.005), participants who live alone (p < 0.007), and those taking medication for insomnia (p < 0.001), pain (p < 0.001), anxiety (p < 0.001), and/or depression (p < 0.001). Screening for anxiety and depression revealed that a significant proportion of undiagnosed participants had clinically relevant symptoms of anxiety and depression. However, among participants diagnosed with anxiety and depression, between 40% and 50% were uncontrolled, respectively. These data highlight pharmacists’ role in identifying customers at risk of anxiety and depression as well as the need for better monitoring of those already diagnosed. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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15 pages, 573 KiB  
Article
Exposure of Pharmacists and Pharmacy Technicians to Violence in Community Pharmacies in Southeast Europe: Frequency and Ethical Considerations
by Monika Popčević, Tanja Javorina, Miljenko Košiček and Arijana Meštrović
Pharmacy 2024, 12(3), 88; https://doi.org/10.3390/pharmacy12030088 - 4 Jun 2024
Viewed by 1171
Abstract
Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types [...] Read more.
Pharmacists and pharmacy technicians working in community pharmacies are exposed to the risk of violence in their workplaces. Studies have shown that workplace violence is affecting their job satisfaction, productivity, and mental health. This study aims to identify the frequency of different types of violence, as well as the common perpetrators that community pharmacy staff in SEE (Southeast Europe) are dealing with. A cross-sectional study was conducted using an online questionnaire created for this purpose. Selected community pharmacies in Croatia, Serbia, Bosnia and Herzegovina, and Montenegro participated in this study. In total, 732 responses were collected from 24 pharmacy chains or independent pharmacies including all community pharmacy staff. More than 80% of pharmacists and pharmacy technicians reported having been exposed to verbal violence at the workplace, while more than 20% of them reported physical and sexual violence in the preceding 12 months. There were no statistically significant differences between pharmacists and pharmacy technicians, gender, age groups, or countries in relation to exposure to physical, verbal, and sexual violence. The most common perpetrators were identified as patients/clients. More than 90% of pharmacy staff reported they did not receive any kind of support from their employer nor any other help after experiencing a robbery. There is a need for a structured approach to addressing violence in pharmacies including organized support for pharmacy staff. Achieving quality patient care, despite dealing with violent individuals or situations daily, is one of the greatest ethical challenges for healthcare providers in community pharmacies to be empowered. Full article
(This article belongs to the Special Issue Professional Ethics in Pharmacy: Exploring Contemporary Challenges and Future Directions)
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9 pages, 512 KiB  
Brief Report
Pharmacists’ Behavioral Changes after Attending a Multi-Prefectural Palliative Care Education Program
by Masahiro Yamada, Mayako Uchida, Masao Hada, Haruka Wakabayashi, Daigo Inma, Shunji Ariyoshi, Hidetoshi Kamimura and Tohru Haraguchi
Pharmacy 2024, 12(3), 87; https://doi.org/10.3390/pharmacy12030087 - 4 Jun 2024
Viewed by 852
Abstract
Central to the pharmacist’s role in palliative care is symptom management through direct participation in patient care and the provision of optimal pharmacotherapy to support patient outcomes. Consequently, palliative care requires extensive knowledge and action for patients with cancer. Therefore, this study aimed [...] Read more.
Central to the pharmacist’s role in palliative care is symptom management through direct participation in patient care and the provision of optimal pharmacotherapy to support patient outcomes. Consequently, palliative care requires extensive knowledge and action for patients with cancer. Therefore, this study aimed to evaluate how pharmacists’ behavior changed after attending a palliative care educational program. We conducted a web-based questionnaire survey examining the behavior of pharmacists regarding palliative care before participating in the program, two months after participating in the program, and eight months after participating in the program to determine their behavior and changes over time. For all questions, scores were higher at two and eight months after attending the program than before attending the program (p < 0.05). In addition, no significant difference was observed between two and eight months after attending the program for any question (p = 0.504–1.000). The knowledge gained from the educational program was used to repeatedly intervene with patients with cancer in order to address the various symptoms they experienced and maintain their behavior. The proven effectiveness of this program serves as a stepping stone for nationwide rollout across Japan’s 47 prefectures. Full article
(This article belongs to the Collection Oncology Pharmacy Education)
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19 pages, 1084 KiB  
Article
Challenges and the Way Forward in Demand-Forecasting Practices within the Ethiopian Public Pharmaceutical Supply Chain
by Arebu Issa Bilal, Umit Sezer Bititci and Teferi Gedif Fenta
Pharmacy 2024, 12(3), 86; https://doi.org/10.3390/pharmacy12030086 - 31 May 2024
Cited by 1 | Viewed by 1518
Abstract
This study delves into the challenges of pharmaceutical forecasting within the Ethiopian public pharmaceutical supply chain, which is vital for ensuring medicine availability and optimizing healthcare delivery. t It aims to identify and analyze key hindrances to pharmaceutical forecasting in Ethiopia, employing qualitative [...] Read more.
This study delves into the challenges of pharmaceutical forecasting within the Ethiopian public pharmaceutical supply chain, which is vital for ensuring medicine availability and optimizing healthcare delivery. t It aims to identify and analyze key hindrances to pharmaceutical forecasting in Ethiopia, employing qualitative analysis through semi-structured interviews with stakeholders. Thematic analysis using NVIVO 14 software reveals challenges including finance-related constraints, workforce shortages, and data quality issues. Financial challenges arise from funding uncertainties, causing delayed procurement and stockouts. Workforce shortages hinder accurate forecasting, while data quality issues result from incomplete and untimely reporting. Recommendations include prioritizing healthcare financing, investing in workforce development, and improving data quality through technological advancements and enhanced coordination among stakeholders. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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11 pages, 430 KiB  
Article
COVID-19 Vaccine Hesitancy among Parents of Children Younger than 12 Years: Experience from a Tertiary Outpatient Clinic
by Moataz Mohamed Hassan, Laila Al Yazidi, Nagi Elsidig, Mohamed Al Falahi, Najah Salmi, Yahya Al-Jaffari, Labiba Al-Amri, Huyam Zeiidan and Ibrahim Al-Zakwani
Pharmacy 2024, 12(3), 85; https://doi.org/10.3390/pharmacy12030085 - 31 May 2024
Viewed by 924
Abstract
This study explored parents’ attitudes towards vaccinating their children against COVID-19 and the rate of vaccine hesitancy in Oman. A cross-sectional, online, self-administered questionnaire, previously validated and administered between June 2021 and May 2022, was used. The questionnaire consisted of nine items. Parents [...] Read more.
This study explored parents’ attitudes towards vaccinating their children against COVID-19 and the rate of vaccine hesitancy in Oman. A cross-sectional, online, self-administered questionnaire, previously validated and administered between June 2021 and May 2022, was used. The questionnaire consisted of nine items. Parents of children younger than 12 years were eligible for participation. A total of 384 participants, including 207 males (54%), completed the questionnaire, resulting in an 86% response rate (384/447). The results showed that 69% of participants were hesitant to vaccinate their children aged 1–11 years. In parents of children aged 1–4 years, vaccination status was significantly associated with vaccine hesitancy (odds ratio [OR], 0.116; 95% confidence interval [CI], 0.044–0.306; p = 0.001). Furthermore, after multivariable analysis, compared to the fathers, mothers were significantly less likely to be associated with vaccine hesitancy (OR, 0.451; 95% CI, 0.240–0.848; p = 0.013). Full article
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12 pages, 522 KiB  
Article
The Role of a Clinical Pharmacist in the Identification of Potentially Inadequate Drugs Prescribed to the Geriatric Population in Low-Resource Settings Using the Beers Criteria: A Pilot Study
by Tijana Kovačević, Maja Savić Davidović, Vedrana Barišić, Emir Fazlić, Siniša Miljković, Vlado Djajić, Branislava Miljković and Peđa Kovačević
Pharmacy 2024, 12(3), 84; https://doi.org/10.3390/pharmacy12030084 - 28 May 2024
Viewed by 1408
Abstract
Population aging is a global phenomenon. Each country in the world faces an increased number of older persons in the total population. With aging, a high prevalence of multiple chronic diseases occurs, leading to the use of complex therapeutic regimens and often to [...] Read more.
Population aging is a global phenomenon. Each country in the world faces an increased number of older persons in the total population. With aging, a high prevalence of multiple chronic diseases occurs, leading to the use of complex therapeutic regimens and often to polypharmacy. Potentially inappropriate medication (PIM) is a medicine prescribed to a patient for whom the risks outweigh the benefits. Today, several tools are used to evaluate the use of pharmacotherapy in older adults, one of them is the 2019 AGS Beers Criteria. In this prospective, pilot study, we aimed to investigate if the number of PIMs in elderly patients would be significantly reduced if a clinical pharmacist performed a pharmacotherapy review. The study included 66 patients over 65 years of age who were hospitalized at the 1200-bed university hospital. The intervention was conducted by a clinical pharmacist who reviewed the patients’ pharmacotherapy and provided written suggestions to physicians. The pharmacotherapy was again reviewed at the patients’ discharge from the hospital. A total number of 204 PIMs were identified in the pharmacotherapy of the study population. At discharge, the number of PIMs decreased to 67. A total of 67% of the pharmacist’s suggestions were accepted by the physicians. The pharmacist’s intervention led to significant decrease in the number of PIMs on patients’ discharge letters. Full article
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20 pages, 490 KiB  
Article
Associations between Diabetes-Specific Medication Regimen Complexity and Cardiometabolic Outcomes among Underserved Non-Hispanic Black Adults Living with Type 2 Diabetes Mellitus
by Cheryl Wisseh, Edward Adinkrah, Linda Opara, Sheila Melone, Emem Udott, Mohsen Bazargan and Magda Shaheen
Pharmacy 2024, 12(3), 83; https://doi.org/10.3390/pharmacy12030083 - 26 May 2024
Viewed by 1227
Abstract
Type 2 diabetes mellitus (T2DM) management and glycemic control in underserved non-Hispanic Black adults presents with multifaceted challenges: balancing the optimal complexity of antihyperglycemic medications prescribed, limited medication access due to socioeconomic status, medication nonadherence, and high prevalence of cardiometabolic comorbidities. This single-center, [...] Read more.
Type 2 diabetes mellitus (T2DM) management and glycemic control in underserved non-Hispanic Black adults presents with multifaceted challenges: balancing the optimal complexity of antihyperglycemic medications prescribed, limited medication access due to socioeconomic status, medication nonadherence, and high prevalence of cardiometabolic comorbidities. This single-center, cross-sectional, retrospective chart analysis evaluated the association of Medication Regimen Complexity (MRC) with cardiometabolic outcomes (glycemic, atherogenic cholesterol, and blood pressure control) among non-Hispanic Black adults with type 2 diabetes. Utilizing 470 independent patient electronic health records, MRC and other covariates were examined to determine their associations with cardiometabolic outcomes. Chi-square tests of independence and multiple logistic regression were performed to identify associations between MRC and cardiometabolic outcomes. Our findings indicate significant negative and positive associations between MRC and glycemic control and atherogenic cholesterol control, respectively. However, there were no associations between MRC and blood pressure control. As diabetes MRC was shown to be associated with poor glycemic control and improved atherogenic cholesterol control, there is a critical need to standardize interdisciplinary diabetes care to include pharmacists and to develop more insurance policy interventions that increase access to newer, efficacious diabetes medications for historically marginalized populations. Full article
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9 pages, 529 KiB  
Opinion
Empowering Pharmacists: Strategies for Addressing the Opioid Crisis through a Public Health Lens
by Tamera D. Hughes, Juliet Nowak, Elizabeth Sottung, Amira Mustafa and Geetha Lingechetty
Pharmacy 2024, 12(3), 82; https://doi.org/10.3390/pharmacy12030082 - 23 May 2024
Viewed by 1844
Abstract
Background: The opioid crisis in the US is a severe public health issue, prompting pharmacists to adopt various strategies for prevention, harm reduction, treatment, and recovery. Despite progress, barriers persist. Results: This commentary examines five determinants of public health in relation to pharmacist-led [...] Read more.
Background: The opioid crisis in the US is a severe public health issue, prompting pharmacists to adopt various strategies for prevention, harm reduction, treatment, and recovery. Despite progress, barriers persist. Results: This commentary examines five determinants of public health in relation to pharmacist-led interventions for the opioid crisis: individual behavior, social factors, policymaking, health service accessibility, and biological/genetic considerations. Pharmacists can influence individual behavior through education and support, address social determinants like stigma, advocate for policy changes, ensure health service accessibility, and personalize opioid prescriptions based on biological factors. Conclusion: Pharmacists play a crucial role in addressing the opioid crisis by navigating these determinants. Pharmacists’ engagement is essential for reducing opioid-related harms and improving public health outcomes through advocacy, service provision, and education. Full article
(This article belongs to the Special Issue Pharmacists’ Role in Reducing Problematic Opioid Use)
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11 pages, 244 KiB  
Article
Treatment of Heartburn: A Survey of Ontario and Québec Community Pharmacists
by Nardine R. Nakhla, Sherilyn K. D. Houle and Jeffrey G. Taylor
Pharmacy 2024, 12(3), 81; https://doi.org/10.3390/pharmacy12030081 - 22 May 2024
Viewed by 1287
Abstract
The shift of proton pump inhibitors (PPIs) from prescription to nonprescription (nonRx) status in Canada has altered pharmacist treatment options for heartburn. This report examines pharmacist approaches to therapy based on case severity; pharmacist confidence and consult duration were also explored. A 2022 [...] Read more.
The shift of proton pump inhibitors (PPIs) from prescription to nonprescription (nonRx) status in Canada has altered pharmacist treatment options for heartburn. This report examines pharmacist approaches to therapy based on case severity; pharmacist confidence and consult duration were also explored. A 2022 online survey gathered data from Ontario and Québec pharmacists regarding their therapeutic approaches for two hypothetical heartburn cases. A total of 715 pharmacists participated, with most having 1–10 years of experience. In Ontario, common choices for the milder case included a solo histamine-2 receptor antagonist (H2RA) (21.2%), combination H2RA + antacid (29.4%), and nonRx PPI (22.3%). For the more severe case, common choices for Québec were switches to nonRx H2RA (22.1%), combination H2RA + antacid (13.4%), a nonRx PPI (24.9%), or prescription PPI (22.5%). Pharmacists often recommended switching medications or referring patients with recurring symptoms after seven days. The approaches varied significantly between cases and provinces. The Ontario pharmacists favoured a combination H2RA + antacid for the milder case, while the Québec pharmacists preferred a solo H2RA. For the more severe case, both groups often chose nonRx H2RA followed by nonRx PPI. Despite the differences, the pharmacists demonstrated confidence in managing these situations. These findings highlight potential debates regarding optimal therapeutic approaches and the impact of drug scheduling on patient care. Full article
11 pages, 1155 KiB  
Article
Evaluation of Steroid-Induced Osteoporosis Prevention Using Tracing Reports in Collaboration between Hospitals and Community Pharmacists
by Nonoko Ishihara, Shuji Yamashita, Shizuno Seiki, Keito Tsutsui, Hiroko Kato-Hayashi, Shuji Sakurai, Kyoko Niwa, Takuyoshi Kawai, Junko Kai, Akio Suzuki and Hideki Hayashi
Pharmacy 2024, 12(3), 80; https://doi.org/10.3390/pharmacy12030080 - 15 May 2024
Viewed by 1287
Abstract
Glucocorticoid-induced osteoporosis (GIOP) is a side effect of glucocorticoid (GC) treatment; however, despite established prevention guidelines in various countries, a gap persists between these guidelines and clinical practice. To address this gap, we implemented a collaborative intervention between hospitals and community pharmacists, aiming [...] Read more.
Glucocorticoid-induced osteoporosis (GIOP) is a side effect of glucocorticoid (GC) treatment; however, despite established prevention guidelines in various countries, a gap persists between these guidelines and clinical practice. To address this gap, we implemented a collaborative intervention between hospitals and community pharmacists, aiming to assess its effectiveness. Pharmacists recommended to the prescribing doctor osteoporosis treatment for patients who did not undergo osteoporosis treatment with a fracture risk score of ≥3 via tracing reports (TRs), between 15 December 2021, and 21 January 2022. Data were extracted from electronic medical records, including prescriptions, concomitant medications, reasons for not pursuing osteoporosis treatment, and TR contents. Of 391 evaluated patients, 45 were eligible for TRs, with 34 (75.6%) being males. Prednisolone was the most common GCs administered, and urology was the predominant treatment department. Among the 45 patients who received TRs, prescription suggestions were accepted for 19 (42.2%). After undertaking the intervention, guideline adherence significantly increased from 87% to 92.5%. This improvement indicates that TRs effectively bridged the evidence–practice gap in GIOP prevention among GC patients, suggesting their potential utility. Expansion of this initiative is warranted to further prevent GIOP. Full article
(This article belongs to the Special Issue Medication Use and Patient Safety in Clinical Pharmacy)
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7 pages, 393 KiB  
Article
The Divergence between Self- and Preceptor-Assessments of Student Performance during Advanced Pharmacy Practice Experiences
by Tonya Brim-Dauterman and Shantanu Rao
Pharmacy 2024, 12(3), 79; https://doi.org/10.3390/pharmacy12030079 - 15 May 2024
Viewed by 1087
Abstract
(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: [...] Read more.
(1) Objectives: A divergence in self- and preceptor-evaluations of clinical skills has been noted during Advanced Pharmacy Practice Experiences (APPEs). The goal of this study was to determine the domains of overestimation of clinical skills by students during their APPE rotations. (2) Methods: Preceptor-assigned grades for APPE rotations from 2017–2022 were analyzed to identify instances of letter grade B or lower. The self- and preceptor-evaluations of APPE rotation were compared to determine the domains of divergence in evaluation between students and preceptors. (3) Results: Between 2017 and 2022, 305 student APPE rotations were graded as B or lower (~14%) by the preceptors. A statistically significant difference was noted between self- and preceptor-assigned letter grades across all practice settings including ambulatory patient care, community pharmacy, general medicine patient care, hospital/health system pharmacy, and special population patient care APPE rotations. In addition, examining the self- and preceptor evaluation rubric for these rotations revealed a statistically significant overestimation of clinical skills by students in all 9 domains of APPE evaluation. Finally, the divergence in the rating of clinical skills between student- and preceptor evaluation was found to be highest in the domains of planning and follow-up of patient care, disease knowledge, and communication with patients. (4) Conclusions: Students who fail to exhibit exemplary practice readiness during APPEs tend to overestimate their clinical skills in all domains of APPE evaluation. The results from our study support the need for additional avenues to assist in the identification of deficits in student learning before APPEs to increase their self-awareness (metacognition). Full article
(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)
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9 pages, 212 KiB  
Case Report
Buprenorphine Use for Analgesia in Palliative Care
by Leanne K. Jackson, Ivy O. Poon, Mary A. Garcia, Syed Imam and Ursula K. Braun
Pharmacy 2024, 12(3), 78; https://doi.org/10.3390/pharmacy12030078 - 13 May 2024
Cited by 1 | Viewed by 1709
Abstract
Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at [...] Read more.
Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, available formulations, drug–drug interactions, initiation and conversion strategies, and identifies ideal populations for use, especially within the palliative care patient population. Full article
10 pages, 237 KiB  
Article
Understanding Pharmacy Students’ Preparedness towards Counseling over Cannabis Use Disorder
by Sourab Ganna, Jerusha Daggolu and Sujit S. Sansgiry
Pharmacy 2024, 12(3), 77; https://doi.org/10.3390/pharmacy12030077 - 13 May 2024
Viewed by 974
Abstract
The rise in cannabis use prompts significant concerns regarding pharmacy students’ abilities to counsel patients over cannabis use disorder. This study aims to understand pharmacy students’ preparedness to counsel patients with cannabis use disorder (CUD) and evaluate the relationship between knowledge, attitudes towards [...] Read more.
The rise in cannabis use prompts significant concerns regarding pharmacy students’ abilities to counsel patients over cannabis use disorder. This study aims to understand pharmacy students’ preparedness to counsel patients with cannabis use disorder (CUD) and evaluate the relationship between knowledge, attitudes towards medical cannabis (MC) and recreational cannabis (RC), and behavior intention (BI) to counsel over CUD. A cross-sectional survey was administered to pharmacy students. Descriptive analyses of sample characteristics were assessed with the t-test and one-way ANOVA test. Pearson correlation and linear regression were conducted, measuring the strength and direction of relationships. The average scores for knowledge, attitudes towards MC use and RC, and behavioral intention were 81% (SD 16%), 4.13 (SD 0.75), 3.28 (0.80), and 2.74 (1.00). Significant correlations were observed between knowledge–attitudes toward MC, knowledge–attitudes towards RC, and attitudes towards RC–behavioral intentions. Linear regression indicated attitudes towards MC use and RC, academic year, awareness of MC use legality, obtained knowledge, and past patient interaction were significantly associated with behavioral intention on confidence in counseling over CUD. There is a gap in students’ behavioral intention to counsel. These findings emphasize the importance of ample preparation that enables student pharmacists to address patient needs related to cannabis use confidently. Full article
12 pages, 223 KiB  
Article
An Over-the-Counter Hearing Aid Clinical Trial in Rural Alabama: Project Design and Potential Implications for Pharmacy and Audiology Interprofessional Collaborations
by Marcia J. Hay-McCutcheon, Abigail F. Hubbard, Emma B. Brothers, Rebecca S. Allen and Xin Yang
Pharmacy 2024, 12(3), 76; https://doi.org/10.3390/pharmacy12030076 - 11 May 2024
Viewed by 1178
Abstract
Over-the-counter hearing aids (OTC HAs) have the potential to help adults with perceived mild-to-moderate hearing loss across the US, especially in rural communities, where access to hearing healthcare is extremely limited or non-existent. The purpose of this study was to describe an OTC [...] Read more.
Over-the-counter hearing aids (OTC HAs) have the potential to help adults with perceived mild-to-moderate hearing loss across the US, especially in rural communities, where access to hearing healthcare is extremely limited or non-existent. The purpose of this study was to describe an OTC HA clinical trial being conducted in five rural counties of Alabama and to provide preliminary anecdotal data related to the use and care of these hearing aids by the participants. In brief, for this clinical trial, adults with hearing loss were randomly placed in one of three groups where they received varying levels of support for setting, using, and maintaining their OTC HAs. Listening tests and surveys were administered to assess the extent to which they benefitted from the hearing aids as related to word understanding, communication with others in natural settings, and hearing aid use and care. Currently, anecdotal findings suggested that, although some participants required very little support to successfully use their hearing aids, others had difficulty setting and caring for their devices and could have benefitted from individualized guidance. Future quantitative studies will assess the extent of support needed for successful hearing aid benefit and use. Potentially, collaborations among pharmacy and audiology professionals could lead to increased access to hearing healthcare by supporting the use and purchase of OTC HAs in rural pharmacy settings. Full article
(This article belongs to the Topic The Promotion and Development of Community Health for Personal Health: Theories and Applications)
17 pages, 241 KiB  
Article
Peer Ambassador Perspectives in a Culturally Tailored Self-Management Intervention for African Americans with Type 2 Diabetes: A Qualitative Study
by Meng-Jung Wen, Ejura Y. Salihu, Choua Yang, Martha Maurer and Olayinka O. Shiyanbola
Pharmacy 2024, 12(3), 75; https://doi.org/10.3390/pharmacy12030075 - 8 May 2024
Viewed by 1334
Abstract
Objective: Diabetes disproportionately affects African Americans, leading to higher morbidity and mortality. This study explores the experiences of African American adults who successfully self-manage their type 2 diabetes (called Peer Ambassadors) and provided phone-based peer support in a 6-month culturally tailored diabetes self-management [...] Read more.
Objective: Diabetes disproportionately affects African Americans, leading to higher morbidity and mortality. This study explores the experiences of African American adults who successfully self-manage their type 2 diabetes (called Peer Ambassadors) and provided phone-based peer support in a 6-month culturally tailored diabetes self-management program for African Americans guided by the information–motivation–behavioral skills model. Design: A group discussion using a semi-structured discussion guide was conducted. Qualitative content analysis was used to identify the facilitators and barriers to completing the role of a Peer Ambassador and to develop strategies for overcoming possible challenges in the future. Setting: Key informant discussions were conducted in a community location to gain insights into Ambassadors’ motivations and challenges in delivering peer support. Participants: Three Peer Ambassadors completed ethics training and peer mentor training and received a phone call guide before providing support to their peers. Results: There were four core themes related to Peer Ambassador experiences: (1) Motivation to be a Peer Ambassador, (2) program elements that supported Peer Ambassador role, (3) key elements of achieving engagement, and (4) challenges related to being a Peer Ambassador. Conclusions: This study showed Peer Ambassadors in a culturally tailored peer supported self-management program found fulfillment in sharing experiences and supporting peers. They highly valued educational group sessions for knowledge updates and sustaining their health-related goals, suggesting the potential benefits of recognizing milestones or providing advanced training for future program sustainability. Findings suggest the importance of recruiting motivated patients and providing effective facilitation for peer support roles, including addressing barriers such as time commitment and lack of socialization opportunities. Full article
19 pages, 383 KiB  
Review
Exploring Feedback Mechanics during Experiential Learning in Pharmacy Education: A Scoping Review
by Dania Alkhiyami, Salam Abou Safrah, Ahsan Sethi and Muhammad Abdul Hadi
Pharmacy 2024, 12(3), 74; https://doi.org/10.3390/pharmacy12030074 - 7 May 2024
Viewed by 1508
Abstract
(1) Background: This scoping review aims to explore the literature on feedback for pharmacy students during experiential learning, with a focus on identifying the modes of delivery of feedback and the perceived impact of feedback on student learning outcomes. (2) Methods: The scoping [...] Read more.
(1) Background: This scoping review aims to explore the literature on feedback for pharmacy students during experiential learning, with a focus on identifying the modes of delivery of feedback and the perceived impact of feedback on student learning outcomes. (2) Methods: The scoping review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology and reported following the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR) guidelines. PubMed, Web of Science, Embase, EBSCO, ERIC, and ProQuest Central were searched electronically from their inception until the end of February 2023 using a combination of keywords and MeSH terms related to feedback, pharmacy education, and student learning outcomes. Data were synthesized narratively. (3) Results: This review included 13 studies published between 2008 and 2022. Almost half of the included studies were conducted in the USA (n = 6, 46%) and reported the perspective of undergraduate pharmacy students (n = 6, 46%). Verbal feedback was the most common mode of feedback delivery (n = 6, 46%). The enablers of effective feedback included timely feedback (n = 6, 46%), feedback provided in a goal-oriented and objective manner (n = 5, 40%), and student-specific feedback (n = 4, 30%). On the other hand, the most common impediments to feedback efficacy were providing extremely positive feedback and lack of constructive criticism. (4) Conclusions: Our findings highlight the importance of feedback model implementation in pharmacy education and preceptor training programs to ensure effective and quality feedback to pharmacy students. Full article
(This article belongs to the Special Issue Advances in Experiential Learning in Pharmacy)
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16 pages, 4555 KiB  
Article
Development and Implementation of an Ultraviolet-Dye-Based Qualification Procedure for Hand Washing and Disinfection to Improve Quality Assurance of Pharmacy Preparations and Compounding, Especially in Cleanrooms: A Pilot Study
by Catharina W. J. Knol, Paul H. Stob and Herman J. Woerdenbag
Pharmacy 2024, 12(3), 73; https://doi.org/10.3390/pharmacy12030073 - 25 Apr 2024
Viewed by 1881
Abstract
Even though, nowadays, most medicines are manufactured industrially, patients may have medical needs that can only be met by a tailor-made approach. This requires the availability of pharmacy preparations made under Good Manufacturing Practice (GMP) conditions. An efficient hand hygiene practice is essential [...] Read more.
Even though, nowadays, most medicines are manufactured industrially, patients may have medical needs that can only be met by a tailor-made approach. This requires the availability of pharmacy preparations made under Good Manufacturing Practice (GMP) conditions. An efficient hand hygiene practice is essential herewith, especially if sterile products that are prepared in a cleanroom are concerned. The effectiveness of hand washing and hand disinfection procedures greatly relies on adequate training. We carried out an observational cross-sectional pilot study aimed at optimizing hand hygiene training with objective and measurable quality assessments using an ultraviolet (UV) dye. Practical acceptance criteria for qualifying personnel through this method were set and evaluated. In total, 25 GMP-qualified cleanroom operators washed and disinfected their hands with UV dye hand wash lotion and UV dye hand alcohol, respectively. To obtain a proof-of-concept, the results were judged based on adherence to the WHO six-step protocol and associated acceptance criteria. Commonly missed areas were brought to light, and the influence of procedure duration was investigated. UV-dye-based assessments appeared to be more valuable in hand disinfection than in hand washing. In both procedures, the back of the hands and the thumbs were frequently missed. This underpins the need for enhanced and repeated education on hand washing and disinfection. Additionally, a dry skin gave rise to extra cleaning challenges. From this pharmacy practice pilot study with a focus on pharmaceutical product care, it may be concluded that the application of UV-dye-based assessments offers valuable insights for pharmacists to optimize hand hygiene, thereby increasing the safety of tailor-made medicines and on-site preparations. Full article
(This article belongs to the Section Pharmacy Practice and Practice-Based Research)
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