Pharmacy Research Articles

Student Pharmacists’ Perceptions of Artificial Intelligence and Machine Learning in Pharmacy Practice and Pharmacy Education

This study explored student pharmacists' perceptions and attitudes regarding artificial intelligence (AI) and machine learning (ML) in pharmacy practice. Due to AI/ML's promising prospects, understanding students' current awareness, comprehension, and hopes for their use in this field is essential. In April 2024, a Zoom focus group discussion was conducted with 6 student pharmacists using a self-developed interview guide. The guide included questions about the benefits, challenges, and ethical considerations of implementing AI/ML in pharmacy practice and education. The participants' demographic information was collected through a questionnaire. The research team conducted a thematic analysis of the discussion transcript. The results generated by a team member using NVivo were compared with those generated by ChatGPT, and all discrepancies were addressed. Student pharmacists displayed a generally positive attitude toward the implementation of AI/ML in pharmacy practice but lacked knowledge about AI/ML applications. Participants recognized several advantages of AI/ML implementation in pharmacy practice, including improved accuracy and time-saving for pharmacists. Some identified challenges were alert fatigue, AI/ML-generated errors, and the potential obstacle to person-centered care. The study participants expressed their interest in learning about AI/ML and their desire to integrate these technologies into pharmacy education. The demand for integrating AI/ML into pharmacy practice is increasing. Student and professional pharmacists need additional AI/ML training to equip them with knowledge and practical skills. Collaboration between pharmacists, institutions, and AI/ML companies is essential to address barriers and advance AI/ML implementation in the pharmacy field.

Fourth-Year Student Pharmacists’ Perceptions of a Required Student-run Free Clinic Experience

ObjectiveThe University of Michigan Student-Run Free Clinic (UMSRFC) provides quality preventive, acute, and chronic care free of charge to uninsured and underinsured community members. We sought to assess fourth-year student pharmacists’ (P4) attitudes toward providing care as part of a required experience at the UMSRFC during their Ambulatory Care Advanced Pharmacy Practice Experience (APPE). MethodsAll P4s in the 2023-2024 academic year completed an 8-hour experience at the UMSRFC. Pre-clinic and post-clinic surveys were electronically administered, and items related to social determinants of health, patient-centered care, interprofessional teams, and interest in future opportunities were included. Data was analyzed using descriptive statistics and paired t-tests. ResultsA total of 78/83 students (94.0%) participated in the research study. After the experience, students reported higher comfort with providing efficient, cost-effective pharmacy services, assessing patients' healthcare status and needs, and advocating for and assisting patients in obtaining the resources and care they need. Students also reported a higher level of comfort collaborating as part of an interprofessional team after the experience. Most students (92.3%) recommended that the experience continue for future P4s. ConclusionA clinical experience at a SRFC can allow P4s to practice multiple skills that align with the Curricular Outcomes and Entrustable Professional Activities (COEPA). After this experience, P4s felt more comfortable working with underserved populations and collaborating on interprofessional teams and reported being more likely to volunteer at a free medical clinic. We encourage pharmacy programs affiliated with a SRFC to consider implementing a required clinical experience for P4 students.

Preceptor Perspectives Using Entrustable Professional Activity-Based Assessments During Advanced Pharmacy Practice Experiences.

To explore Advanced Pharmacy Practice Experience (APPE) preceptor perspectives including implemenation recommendations, barriers, and facilitators to using entrustable professional activity (EPA) assessment in pharmacy experiential education. Two 90-minute virtual focus group sessions were conducted to elucidate preceptor perspectives on EPA integration into APPEs through semi-structured discussion. Preceptors with experience utilizing entrustment-supervision (ES) scales with EPAs for assessments for at least four APPE learners in the last year were eligible. The primary outcome was a description of implementation guidance for assessing learners using an EPA framework. Secondary outcomes include descriptions of barriers and facilitators to using an EPA framework in APPE learner assessment. All sessions were recorded, transcribed, and analyzed using inductive thematic analysis. Eleven APPE preceptors representing nine institutions participated. Commonly identified implementation recommendations were regular, repetitive preceptor education using case vpractice ignettes, student orientation to assessment expectations, clear delineation of minimum competency level, frequent discussions with preceptors, and use of institutional resources. Identified barriers were the abstractness of entrustability, subjectivity of the ES scale and preceptor assessments, unclear grading schemes, length and complexity of the assessments, and EPA applicability to the specific practice setting. Commonly identified facilitators were clearly defined scales and expectations, preceptor education, student education, pass/fail grading schemes, and shorter, more frequent assessments. EPA-based assessments can be used by preceptors for workplace-based assessments during APPEs. Faculty/preceptor development and student orientation with benchmarking and clear expectations are needed to support implementation.

Bridging the continuity: Practice-enhancing publications about the ambulatory care medication-use process in 2022.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. This article identifies, summarizes, and prioritizes literature on the ambulatory care medication-use process (ACMUP) published in 2022 that can describe ambulatory pharmacy practice. The medication-use process (MUP) is the foundational system that provides the framework for safe medication utilization within the healthcare environment and was reimagined to focus on new innovations and advancements in ambulatory pharmacy practice. The ACMUP is defined in this article as having the following components: transitions of care, prescribing, access, dispensing, adherence, and evaluating. Articles evaluating at least one step of the ACMUP were assessed for their usefulness toward practice improvement. A PubMed search for articles published in 2022 was conducted in January 2023 using targeted Medical Subject Headings (MeSH) keywords and the table of contents of selected pharmacy journals, providing a total of 4,125 articles. A thorough review identified 49 potentially practice-enhancing articles: 6 for transitions of care, 9 for prescribing, 5 for access, 2 for dispensing, 6 for adherence, and 21 articles for evaluating. Trends from the impact articles are described. It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article continues a series of articles defining and evaluating the currently published literature around the ACMUP. As healthcare continues to advance and care shifts to ambulatory settings, the ACMUP will continue to be a crucial process to evaluate.

Impact of a multifaceted intervention programme on antibiotic prescribing and dispensing in four patient-centred settings in five European countries. The HAPPY PATIENT project.

The primary cause of antimicrobial resistance is excessive and non-indicated antibiotic use. To evaluate the impact of a multifaceted intervention aimed at various healthcare professionals (HCPs) on antibiotic prescribing and dispensing for common infections. Before-and-after study set in general practice, out-of-hours services, nursing homes, and community pharmacies in France, Greece, Lithuania, Poland, and Spain. Following the Audit Project Odense method, HCPs from these four settings self-registered encounters with patients related to antibiotic prescribing and dispensing before and after an intervention (February-April 2022 and February-April 2023). Prior to the second registration, the HCPs undertook a multifaceted intervention, which included reviewing and discussing feedback on the first registration's results, enhancing communication skills, and providing communication tools. Indicators to identify potentially unnecessary prescriptions and non-first-line antibiotic choices were developed, and the results of the two registrations were compared. A total of 345 HCPs registered 10 744 infections in the first registration period and 10 207 infections in the second period. In general practice, participants showed a significant 9.8% reduction in unnecessary antibiotic prescriptions in the second period, whereas limited or no effect was observed in out-of-hours services and nursing homes (0.8% reduction and 4.5% increase, respectively). Pharmacies demonstrated an 18% increase in safety checks, and correct advice in pharmacies rose by 17%. External factors like COVID-19, antibiotic shortages, and a streptococcal epidemic impacted the intervention's benefits. Despite this, the intervention successfully improved antibiotic use in both settings.

Understanding the Determinants Influencing Self-Medication with Antibiotics Among Malaysian Residents: A Qualitative Study to Inform Preventive Public Health Strategies

Introduction: Self-medication with antibiotics (SMA)—the use of these drugs without a physician’s diagnosis, supervision, or a medical prescription—has emerged as a significant crisis in many societies, being a particular concern in low- and middle-income countries. SMA practices hinder global efforts to reduce antibiotic consumption in the human health sector and to control antimicrobial resistance (AMR). The aims of the study were to explore the motivations, perspectives, and personal experiences of the Malaysian population related to SMA, analyzing their subjective viewpoints, attitudes, and behaviors. Methods: The present qualitative study applied an interpretivism paradigm to explore the complex topic of SMA; the interview questions were developed and confirmed by experts in AMR and pharmacy practice. Qualitative data analysis was carried out through a thematic approach. Results: Out of twenty-seven (n = 27) eligible individuals, eleven (n = 11) agreed to participate in in-depth interviews. Three main themes and seven subthemes were identified. Participants revealed directly purchasing antibiotics from pharmacies, due to doctors prescribing similar medications for comparable illnesses in the past. Trust issues related to physicians prescribing unnecessary additional medications and suspected personal motives were revealed. Budgetary constraints, timesaving, and aspects of self-care were identified as some of the key drivers for SMA. Conclusions: The current study’s findings contribute to the understanding of the complexities surrounding SMA and provides insights into the public perceptions and behaviors regarding unregulated antibiotic use in Malaysia. Understanding these dynamics may inform targeted public health interventions to address SMA to mitigate the development of AMR.

Clinical outcomes following acute sore throat assessment at community pharmacy versus general practice: a retrospective, longitudinal, data linkage study.

To date, no research has compared longer-term outcomes (antibiotic provision; re-consultations; hospital admissions for quinsy; cost-effectiveness) following presentation with acute sore throat at general practice (GP) versus newer, pharmacy-led services. A retrospective, longitudinal cohort study of sore throat consultations between 1 November 2018 and 28 February 2020 either with the Wales pharmacy-led sore throat test and treat (STTT) service or with a healthcare professional at GP. Individual-level pharmacy consultation data from the national Choose Pharmacy IT application were securely uploaded to the Secure Anonymised Information Linkage Databank and linked to routinely collected, anonymized, population-scale, individual-level, anonymized health and administrative data. Of 72 736 index consultations, 6495 (8.9%) were with STTT and 66 241 (91.1%) with GP. Antibiotic provision at the index consultation was 1382 (21%) with STTT and 25 506 (39%) with GP [adjusted odds ratio (AOR), 0.30; 95% CI, 0.27 to 0.32]. Antibiotic provision within 28 days of index occurred in 1820 (28%) STTT and 26 369 (40%) GP consultations (AOR, 0.44; 95% CI, 0.41 to 0.47). GP re-consultation rate within 28 days of index date was 21% (n = 1389) with STTT compared with 7.4% (n = 4916) with GP (AOR, 3.8; 95% CI, 3.5 to 4.1). Coding limitations may lead to overestimates of GP re-consultations rates in the STTT group. Hospital admissions for quinsy were rare in both STTT (n = 20, 0.31%) and GP (n = 274, 0.41%) (AOR, 0.68; 95% CI, 0.43 to 1.1). STTT was less costly than consultation with GP. The pharmacy-led STTT service is safe, cost-effective, and contributes to antimicrobial stewardship.

Pharma in The Digital Era: The Role of Artificial Intelligence in Drug Development

The integration of Artificial Intelligence (AI) in the pharmaceutical sector marks a transformative era, where technology reshapes traditional drug development processes. This paper delves into the pivotal role AI plays in enhancing efficiency and precision in drug discovery, testing, and approval. Existing methods in drug development often suffer from high costs, extended timelines, and high attrition rates in clinical trials, posing significant barriers to timely patient care. To address these issues, we propose the Drug Development based on Artificial Intelligence (DD-AI) framework, leveraging AI-driven algorithms and machine learning models. The DD-AI framework enhances the identification and optimization of drug candidates, predicts clinical trial outcomes, and personalizes patient treatment plans. AI algorithms analyze vast datasets to discover potential drug molecules, simulate their interactions, and streamline the clinical trial process by identifying the most promising candidates. Implementing the DD-AI framework has demonstrated substantial improvements in reducing drug development costs and timelines while increasing the accuracy of trial outcomes. AI's predictive capabilities also personalize treatments, optimizing efficacy and minimizing adverse effects for patients. The DD-AI framework offers a robust solution to existing challenges in drug development, fostering a more efficient, cost-effective, and patient-centered approach. The findings underscore AI's transformative potential in revolutionizing pharmaceutical practices, ultimately benefiting patients with faster and more precise medical solutions.

Survey to identify barriers and enablers to implementation of genomics in pharmacy practice across healthcare sectors in a rural community

Abstract Introduction The potential for genomics to improve patient outcomes is being harnessed via national strategy to embed genomic testing into NHS practice, and drive use of precision medicines and pharmacogenomics1. The national pharmacy genomics education and training strategic framework aims to empower the pharmacy workforce, across all sectors, to use genomics to support medicines optimisation2. Cornwall, a rural and coastal county, has areas of marked deprivation with poorer health outcomes3 and challenges in recruiting and retaining healthcare professionals. It is key that rural/coastal communities have equitable access to genomic services and expertise to avoid exacerbating pre-existing health inequalities. Aim To identify barriers and enablers to the implementation of genomics into pharmacy practice in a rural community. Methods Pharmacists and pharmacy technicians working in Cornwall were eligible to participate. An anonymised survey was compiled via Microsoft Forms of closed, multiple choice and optional open questions. Following piloting, the survey link was disseminated via email by pharmacy leaders in community pharmacy, primary and secondary care in May 2024. Responses were stored securely via NHS password protected IT systems and analysed via quantitative and thematic analysis. As this project is defined as a service evaluation, according to the UK NHS Health Research Authority, ethical approval was not required. Results Fourteen pharmacists and 7 pharmacy technicians participated, from primary and secondary care and community hospitals, with no participants from community pharmacy. Seven had received prior training in genomics (teaching sessions (n=5), webinars (n=1), podcasts (n=1), articles in journals (n=2)). One participant had received formal undergraduate training. Key barriers to the implementation of genomics included a lack of education and training (n=5), perceived cost of genomic testing (n=2), difficulty in accessing genomic services (n=1) and lack of expert panels (n=1). It was also felt that genomics services were limited to secondary/tertiary care (n=2). Respondents stated that the rural location impacted the availability of face-to-face training and resources to support training (n=17). Key enablers were the opportunity for precision prescribing (n=8), and improved patient outcomes (n=7). Genomics education and training (n=5) and resources to support training (n=11) were viewed as being pivotal to supporting the mainstreaming of genomics. Discussion and conclusion Participants were keen to further their genomics knowledge, with a preference for face-to-face training. Respondents also highlighted the need for allocated resources to support training. As emphasised in the strategic framework2, workforce upskilling is vital to the successful mainstreaming of genomics, particularly when the majority of pharmacy staff had not received any formal training. There were no participants from community pharmacy, indicating a requirement to further explore barriers and enablers in this cohort. Community pharmacy staff may be reluctant to participate if they perceive genomics to relate solely to secondary/tertiary care. Survey methodology also limited the detail that could be obtained from respondents. This provides helpful preliminary insights on barriers and enablers to genomics implementation into pharmacy practice in rural/coastal areas. Themes could be further explored via semi-structured interviews, with the aim of shaping interventions necessary to ensure equitable provision of genomics services and expertise to these communities.

Pharmaceutical care for patients with coronary heart disease: transformation of pharmaceutical practice

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.

Minor ailment interventions and the pivotal role of the community pharmacist in greece

Abstract Introduction Community pharmacists (CPs) play a vital role in providing advice and treatment for minor ailments, offering accessible and convenient healthcare services to the public1. The selection of appropriate management strategies is crucial for promoting self-care and empowering individuals to take an active role in addressing their health issues2. Aim This study aimed to measure the level of knowledge and perceptions of pharmacists regarding primary pharmaceutical care practices and the management of minor ailments. Methods This quantitative, cross-sectional study used a survey-based questionnaire developed after extensive literature review. It consisted of both closed-ended questions (multiple-choice questions) and Likert-type questions scale ranged from 1 to 5 (Strongly Agree to Strongly Disagree) to rate their level of agreement or disagreement. Ethical approval was obtained from the Pharmaceutical Association of Attica (PAA). This study employed purposive sampling to select participants, ensuring their participation was both anonymous and voluntary. The study commenced in December 2023, and data collection (both face-to-face and electronically via the university’s Moodle platform) was completed by March 2024. Data were analysed using Microsoft Excel®. Results The PAA informed 68 CPs from the Southern sector of Athens, and 60 CPs responded, resulting in a response rate of approximately 88.24%. The survey results show that the majority of respondents were women, N=33 (55%). The main age groups were 31-40 and 41-50 years, each with N=13 (21.7%), and most were pharmacy owners, N=34 (38.6%). Most participants were pharmacy graduates, N=52 (86.7%), with only N=8 (13.3%) holding postgraduate degrees. The majority of CPs were able to accurately identify and distinguish minor ailments. Only a small percentage mistakenly included conditions typically classified as chronic, with 8.3% (N=5) listing high cholesterol and 1.7% (N=1) listing hypertension.The survey-results indicate that a significant portion of the respondents perceive the role of the CP as central to the healthcare system, with 78.3% (N=47) affirming its importance. All participants felt confident in detecting and recommending treatment for minor ailments; 83.3% (N=50) considered their university training adequate. The main obstacles for CPs were a lack of time (90%, N=54) and the absence of compensation for extended services (50%, N=30). Additionally, 98.3% (N=59) supported lifelong learning, with continuous professional development in primary care being the top choice (46.7%, N=28), followed by advanced clinical training (36.7%, N=22). Participants hope to play a more active role in disease management within five years (35%, N=21) and seek autonomy in prescribing (30%, N=18). They expect support through collaboration (48.3%, N=29), policy reforms (28.3%, N=17), and compensated services (20%, N=12). Additionally, 96.7% (N=58) feel prepared to offer extensive pharmacy services, viewing it as an opportunity to demonstrate their clinical skills. Discussion/Conclusion This seems to be the first study of its kind in Greece.The study faced limitations such as potential response bias, restriction to a specific pharmacist population, and a limited time frame, which may affect generalisability. Despite these, the findings offer valuable insights into pharmaceutical care practices in Athens' southern sector, providing a foundation for future research and targeted interventions to enhance care in Greece.

Patient privacy and the need for private consultation areas in Kuwait’s polyclinic pharmacies

Abstract Introduction In Kuwait, pharmacists provide essential medication counseling and education. However, the open layout of polyclinic pharmacies often compromises patient privacy, deterring individuals from seeking necessary consultations. Objective This study aims to assess how patients perceive the level of privacy in Kuwait’s polyclinic pharmacies and evaluate patients’ need for a private consultation area. Method A cross-sectional study was conducted among patients at polyclinic pharmacies in Kuwait. Convenience sampling was used to select the polyclinics. Patients were approached after collecting their medications and invited to participate in the study. Those who consented completed a questionnaire that included sections on demographics, six items assessing the privacy construct, four items evaluating the need for a consultation area, and an open-ended question for additional comments. Ethical approval was obtained from the Human Ethical Committee, Health Sciences Center, Kuwait University. Results The study included 210 participants, with a majority residing in the Capital Governorate (55.2%), and being female (70%). The median age was 43 years old (IQR=29-55). Over two-thirds of the participants held a university degree (69%). Most participants were collecting medication for themselves (83.8%), and were exempt from fees (84.3%). When measuring patients’ privacy satisfaction, a score was calculated and a scale was divided into good to excellent (24 - 30), fair (18 - 23), and poor (6 -17). In addition, when measuring the need for a private consultation area score, a scale was divided into high need (16-20), fair need (12-15), and no need (4-11). Regarding perceived privacy, only 20% of participants had a good to excellent score, while 41.9% had a fair score and 38.1% had a poor score. When asked about the need for a private consultation room, 63.8% expressed a high need, while 15.2% believed it was unnecessary. Participants who had lower privacy scores reported a higher need for private consultation areas. Discussion The findings provide valuable insights into patient perspectives and highlight the necessity of improving pharmacy practices in Kuwait. Enhancing privacy in pharmacies could significantly improve the public’s perception of pharmacists as essential healthcare providers. However, several limitations should be noted. The sample is not representative of the population, as the proportion of non-Kuwaiti participants is less than the actual population ratio. Consequently, the results cannot be generalized to the entire population. Future studies should aim for a more representative sample and consider a longer data collection period to address these limitations. Conclusion The results of this study reveal that a significant number of patients perceive privacy in Kuwait's polyclinic pharmacies as fair, with many expressing a strong need for private consultation areas. These findings underscore the importance of enhancing privacy measures in these settings1. Implementing private consultation rooms in polyclinic pharmacies could greatly improve patient satisfaction and the overall quality of healthcare services provided by pharmacists. Reference 1. Waheedi S, Marshall V, Alharbia H, Farris KB. Patients’ perceptions of privacy and the need for a private consultation area in community pharmacy. Poster Abstracts. International Journal of Pharmacy Practice. 2016;24:33–60

MPharm students’ views and experiences of the teaching of pharmaceutical calculations and their importance in pharmacy practice

Abstract Introduction Accurately undertaking pharmaceutical calculations is an important professional skill as part of a pharmacist’s role ensuring patient safety1. Effective teaching in this area supports safe, high-quality care from future pharmacists. In the United Kingdom, the need to accurately perform calculations is stipulated in the General Pharmaceutical Council (GPhC) standards for initial education and training of pharmacists2. During a review of teaching in this area, the views and experiences of pharmacy students were sought, in order to inform course design. Aim This project aimed to explore undergraduate MPharm students’ views regarding the importance of pharmaceutical calculations to their future careers, experiences of current calculations teaching, and opinions on improving course design. Methods A questionnaire was developed and distributed to Years 1-4 pharmacy students (n=524) at the School of Pharmacy, Queen’s University Belfast (QUB), in December 2023. The questionnaire consisted of 45 questions, collecting demographic information, as well as students’ views and experiences of pharmaceutical calculations, various teaching methods, and student confidence with calculations. Data was transcribed into Microsoft Excel, followed by analysis using descriptive statistics in IBM SPSS. Ethical approval was received from the QUB Faculty of Medicine, Health & Life Sciences Research Ethics Committee (MHLS23_159). Results A total of 271 students responded to the questionnaire, providing a response rate of 52%. Students felt that being able to perform calculations is important to their future career, with 97% of respondents agreeing or strongly agreeing with this statement. Hospital pharmacy was considered the sector where calculations were most important (96% agree/ strongly agree). Overall, 75% of respondents agreed/ strongly agreed that they were confident in undertaking pharmaceutical calculations. Students felt most competent using provided formula, and with dose and dosage regimen calculations. Conversely, students felt least competent performing displacement value and dilutions questions. With respect to teaching design, students preferred blended-learning to self-directed study or traditional lectures. Eighty-seven percent of respondents reported blended-learning as beneficial/ very beneficial, compared to 57% and 46% for the other approaches. Students reported formative quizzes as the most beneficial activity for learning (92% beneficial/ very beneficial). This was followed by provision of worked examples, with a preference for handwritten solutions. Recommended textbooks and online discussion boards were considered least beneficial. Having dedicated introductory calculations teaching in Year 1, with repeated opportunities for practice and support in subsequent years had the most support for improving teaching, with 87% stating this would be beneficial/ very beneficial. There was also support for the NUMBAS3 e-assessment system for formative examples, along with video or pencasted worked examples, with 80% and 70% of respondents respectively classing these as beneficial/ very beneficial. Discussion / Conclusion QUB MPharm students appreciate the importance of pharmaceutical calculations to their future careers. They prefer a blended-learning approach to teaching, incorporating formative quizzes and worked examples. Dedicated Year 1 teaching, the use of NUMBAS, and pencasting were identified as methods to improve teaching. These findings will aid future course design, with the aim of improving patient safety relating to pharmaceutical calculations.

Adherence towards good pharmacy practice of community pharmacists in central Visayas, Philippines

Abstract Introduction Community pharmacists play a pivotal role in bridging gaps in the delivery of health care services and for taking the roles of ensuring the rational use of medicines. With the advent of Good Pharmacy Practice, it is essential that there be an established national framework of quality standards and guidelines; however, there is dearth in the evaluation of GPP implementation in the country. Philippine community pharmacist's practices are expected to exhibit expertise in medications nonetheless, their practices often diverge significantly from these expectations. In this literature study, community pharmacists grapple with consultation roles due to lack of clinical guidelines, training, skills, and patient self-selection behavior. Aim The aim of the study was to assess the adherence towards Good Pharmacy Practice among community pharmacists in Central Visayas, Philippines and proposed a policy brief formulated based on the findings to gain a better understanding of the country's existing approach to community pharmacy practice. Methods The study used a quantitative descriptive cross-sectional research design to scrutinize community pharmacist practices in the Philippines, specifically in FDA-registered independent and chain pharmacies in Bohol, Cebu, Negros Oriental, and Siquijor provinces. Ethics approval was obtained from the Institutional Ethics Review Committee and four experts validated the instrument, resulting in a high and acceptable S-CVI and a reliability index of .893, indicating good reliability. The selection process involved stratified random sampling and a modified closed ended questionnaire from Badro et al. (2020) tallying 321 respondents. Data was recorded as 1 for Yes responses and 0 for No. The GPP adherence levels were categorized as poor adherence for <50% or good adherence for >75%. Results The demographic profile of the respondents indicates that the majority belongs to the Millennial generation aged 27- 45 years old. These respondents are predominantly female community pharmacists, mostly in Cebu. They hold a BS Pharmacy degree, having 3 years to less than 6 years of practice. Their work schedule typically exceeds 40 hours per week, and they operate within independent pharmacy. Findings revealed that the majority of community pharmacists in Central Visayas, Philippines have a poor adherence to the GPP indicators on data management and data recording with 69.8% (224), services and facilities with 94.7% (304), dispensing, preparation, administration and distribution of medicines with 96.2% (309) but good adherence to storage with 75.4% (242). The most significant challenges identified were time restrictions, a lack of understanding, a lack of training and resources. Additionally, time constraints, excessive workload, workforce shortage, lack of support from employers and other colleagues were recognized. But the majority shows compliance to FDA storage regulations and standards as a minimum requirement to continue the establishment and pharmacists operate in the community setting. Therefore, a three-pronged strategy is likely necessary: increasing the number of trained pharmacy staff, engaging in professional development and regulatory advocacy. Conclusion The majority of respondents demonstrated good adherence to storage indicators and poor adherence to data management, services and facilities and dispensing indicators. These findings highlight the need for targeted interventions and tailored strategies to elevate standards.

Preparing the future pharmacy workforce: competency-based undergraduate curricula for teaching, learning and assessment with a focus on antimicrobial stewardship

Abstract Introduction Competency-based teaching, learning and assessment underpins the requirements for initial training and education of pharmacists (IETPs) in the UK and is set by the General Pharmaceutical Council (GPhC). This competency-based pedagogic approach is conducive when teaching antimicrobial resistance (AMR) and antimicrobial stewardship (AMS) since it ensures that rather than only reciting and absorbing content, student pharmacists gain the necessary skills and behaviours to apply knowledge effectively in clinical practice. This is particularly relevant since newly graduate pharmacists will need to show competency in independent prescribing at the point of graduation from 2026 and education needs to evolve to incorporate prescribing skills including decision making. Aim The aim of this project was to develop a UK-wide national AMS competency framework specifically tailored for student pharmacists and foundation year trainees. Method A working group of academics and pharmacy practitioners from all four nations and with expertise in AMS was set up in September 2022. Student pharmacists from a national organisation (BPSA) and a professional pharmacy body (RPS) are also members. Development of the consensus indicative curriculum for student pharmacists was adapted from published frameworks including those for UK undergraduate medical students1, and a UK wide set of generic AMS competencies for undergraduate healthcare professional education2. The results of a survey3 conducted across Schools of Pharmacy (SoP) aiming to determine the nature and extent of implementation of the latter generic competencies, also informed this project. To ensure consistency, the group has worked with the British Society for Chemotherapy (BSAC) to align to the Keep Antibiotics Working (KAW) website, that provides resources for pharmacy students and educators, aligned to the curriculum domains. No ethics approval was required for this study since it did not involve any participants. Results The final curriculum consists of six domains: Infection prevention and control, antimicrobials and antimicrobial resistance, antimicrobial prescribing and stewardship, vaccine uptake, person-centred care and interprofessional collaborative practice. Each domain includes a competency statement together with accompanying descriptors (74) clearly outlining the knowledge and application required by the newly qualified pharmacist. To support implementation of the framework, the individual competencies were mapped to the revised GPhC standards for the IETPs together with Royal Pharmaceutical Society Prescribing Competency Framework that link to AMR and AMS. The group has also developed a set of suggested practice-based activities aligned with the framework domains to support pharmacists supervising or assessing students on placement. Discussion/Conclusion This project is timely to support development of future pharmacists as leaders in AMS and ensure a portable workforce, since pharmacists will be independent prescribers at the point of registration from 2026. A limitation of the development is the fact that not all SoP have been involved in the process; however, efforts are being made to communicate curriculum content as widely as possible. Though it is not mandatory to implement this curriculum, it provides a benchmark for embedding the competencies into undergraduate pharmacy curricula and allows identification of topics that may not be adequately covered. It also promotes consistency of approach across schools. (500 words)

Exploring the role of primary care pharmacists in NHS Lanarkshire following the implementation of the pharmacotherapy hub: a service evaluation

Abstract Introduction The General Medical Service (GMS) contract was produced in Scotland in an attempt to tackle General Practitioner (GP) workforce issues. The pharmacotherapy work stream is part of this and provides a framework for pharmacy teams, dividing services into level 1 (core), level 2 (advanced) and level 3 (specialist).1 A statement by the Royal Pharmaceutical Society (RPS) and the British Medical Association (BMA) discussed the introduction of pharmacotherapy hubs to complete level 1 work for multiple practices, centralising the medicines reconciliation process. Theoretically, this would release pharmacists to carry out clinical and more advanced/specialist services.2 There are currently 8 pharmacotherapy hubs within NHS Lanarkshire (NHSL), incorporating level 2 and 3 services into job plans for General Practice Clinical Pharmacists (GPCPs). No work has been undertaken to explore changes in practice since the implementation of these hubs. The qualitative study explored drivers and motivators for pharmacists in practice, shaping future pharmacotherapy services in NHSL and Scotland. Aim To explore the views and attitudes of primary care pharmacists towards their practice role in NHSL following the implementation of the pharmacotherapy hub. Methods Ethical approval was granted from the School of Pharmacy and Life Sciences Ethics Committee (Robert Gordon University). Pharmacists working within the 8 hub localities were invited to participate via email correspondence if they had over 6 months experience in practice pre-hub implementation and then 6 months post-hub implementation. Participants attended a one-to-one interview to share their views towards their practice role since the hub was implemented. Interviews were recorded, transcribed verbatim and thematically analysed. Results Twelve pharmacists across six localities participated. The five key themes identified were job role, managing time, professional development, professional belonging and patient care. The implementation of the hub was an enabler for pharmacists to partake in advanced pharmacotherapy tasks. Pharmacists negatively perceived level 1 core pharmacotherapy tasks in comparison to level 3 clinical patient-facing time. Participants linked the hubs impact on practice with role development, an increase in autonomy, confidence and job satisfaction. Discussion/Conclusion The hub has enabled in-practice pharmacists to move to a more sustainable balance between core and advanced/specialist tasks. Collaboration is required between pharmacy teams and practices to understand the pharmacist role in pharmacotherapy. Further recommendations include continuing the roll-out of pharmacotherapy hubs, standardisation of pharmacist clinical time balanced with core tasks and implementation of protected learning time for pharmacy teams. The study was open to response bias but this was addressed by using semi-structure interview guides in the one-to-one interviews. Researcher bias was minimised by two researchers analysing the data and practicing reflexivity. The study was open to recall bias due to participant’s retrospective thinking. In NHSL prioritising the hub roll-out and collaboration with stakeholders are essential. This will ensure the balance between efficient pharmacotherapy services and maintaining attractive roles, contributing to a sustainable workforce.

Renaissance Goo: Senses and Materials in Early Modern Apothecary Taxonomies and Soft Matter Science

This essay brings together research in the history of science and soft matter physics to consider how early modern Italian apothecaries organised and communicated their knowledge from the fourteenth to the seventeenth century through an “apothecary taxonomy.” This was based on a what we call a “hylocentric” classification scheme (from the Greek hyle = matter, material, stuff) founded on a tactile understanding of materials. We will investigate how the behaviour of medicines under deformation and flow – their “rheology” – is a previously underestimated organisational principle, and consider the specialist vocabulary these author-practitioners used to describe different liquid and liquid-like formulations. We will also suggest that the rheology of these formulations – which today falls under the domain of “soft matter science” – affected the material culture of apothecary shops, in the arrangement and selection of drug bottles and jars, which presented this knowledge visually to visitors and clients. That soft matter scientists organise the substances they study in similar ways to early modern apothecaries suggests the agency of materials in affecting human categorisations.

A mixed method service evaluation of Electronic Prescribing and Medicines Administration (EPMA) within 10 community hospitals in England

Abstract Introduction Electronic Prescribing and Medicines Administration (EPMA) was implemented in 13 adult inpatient wards across 10 community hospitals within one NHS community trust in England, March 2023, replacing paper drug-charts. EPMA, integrates with patients’ electronic health records, includes prescribing, administration, closed-loop supply, discharge prescribing, electronic-tasking between clinicians and provides a medicines audit trail. Laptops enable remote access. Aim To evaluate EPMA against expected safety, quality and efficiencies benefits, assess clinicians’ acceptance of EPMA and impact on pharmacy practice compared to paper-drug charts. Methods Mixed methods1 evaluation conducted in November and December 2023. This evaluation included assessing twenty-six expected multi-dimensional benefits as being achieved, partially achieved or not achieved post-EPMA implementation based on quantitative and qualitative data. Online anonymous surveys were emailed to all eligible clinicians: prescribers, nurses and pharmacy staff working on 13 inpatient wards, containing closed and open questions, adapted according to clinical group for different aspects of EPMA including questions to assess clinicians’ acceptance of EPMA2. These data were analysed using descriptive statistics in Excel. Pharmacy staff working on the inpatient wards and the dispensary were invited to attend separate virtual focus groups for pharmacists, pharmacy technicians and dispensary staff, respectively. These were recorded and transcribed via Microsoft Teams. Eight pharmacists, six pharmacy technicians and five dispensary staff agreed to participate. A semi-structured interview guide was used covering EPMA’s impact on practice, communication, patient safety, benefits and challenges. Thematic-analysis3 of the focus group interviews were undertaken by IA. Themes were validated with pharmacists and pharmacy technicians, respectively. The NHS Health Research Authority decision tool confirmed this evaluation was not NHS Research therefore did not require NHS ethics review or approval. Sussex Community NHS Foundation Trust approved this service evaluation. Results Of 26 expected multi-dimensional benefits post EPMA, 77% were achieved or partially achieved with 13% not achieved. Thirty-seven inpatient ward clinicians responded to the survey: eight prescribers, fifteen nurses, six pharmacists and eight pharmacy technicians. This showed clinicians underutilised some functionalities, although 100% felt confident using EPMA. Overall, 81% of clinicians stated medication safety had improved with EPMA, 16% felt it was the same and 3% felt it was worse, with 92% not wanting to return to paper drug-charts. Clinicians requested further prescribing developments. Thematic analysis identified four themes for pharmacists: maintaining visibility with prescribers, moving towards targeted interactions with prescribers but reducing opportunistic interactions, being increasingly available due to remotely accessing EPMA and improving patient safety through increased prescription checking; and three themes for pharmacy technicians: expanding role, improving workflow and enhancing communication with clinicians. The dispensary staff focus group emphasised that EPMA adversely impacted dispensary workflow. Discussion/Conclusion EPMA achieved some expected benefits. Clinicians have accepted EPMA, perceiving improved medication safety compared to paper-drug charts. Pharmacists are exploring ways of adapting their practice. Pharmacy technicians are enhancing their roles. Recommendations include EPMA system improvements, additional EPMA training, reviewing dispensary and pharmacists’ workflow. EPMA needs time to embed in practice. Limitations of the evaluation included no focus groups for prescribers and nurses, and limited baseline data pre-EPMA.

Working across boundaries

Abstract We are delighted to publish the abstracts presented at the Royal Pharmaceutical Society (RPS) Annual Conference 2024 in this International Journal of Pharmacy Practice Issue Supplement. The conference entitled ‘Working across boundaries: Embracing new opportunities and empowering excellence’ included the themes of: Enhancing patient care; Advancing the workforce; Science & Research; and Your RPS. It was held both online and in person at Convene, 133 Houndsditch, London on 8 November 2024. As the flagship event for the RPS, the conference hosted a full day of discussions centred on the topic of cross-boundary working, from dealing with medicines shortages, to prescribing and clinical supervision, to the strategic work of the RPS, and finally to innovations and research that will be shaping practice. The morning’s keynote presentation was delivered by Dr Liz O'Riordan, a breast oncology surgeon who herself has had breast cancer three times, speaking on the topic of high-quality care from the perspectives of being both a medical doctor and a patient. The conference also included a keynote panel discussion in the afternoon with the four of the United Kingdom’s Chief Pharmaceutical Officers, namely David Webb (NHS England), Andrew Evans (Welsh Government), Cathy Harrison (Northern Ireland), and Alison Strath (Scotland). The event included a multitude of research and innovation presentations, as posters and orals, many published as abstracts herewith. We were particularly pleased to see the return of five oral research presentations selected from the submitted abstracts, covering a breadth of methodologies. We would like to acknowledge all those who have contributed to making this event happen, in particular members of the conference steering committee co-chaired by Helen Chang and Anna Pielach at the RPS; Leah Burton and Lauren Ross from the RPS Science and Research team who managed the abstract processes; Dr Christopher Martin and Dr Diane Ashiru-Oredope, also from the RPS Science and Research team, who joined the Conference Abstract Review Panel; Science and Research Committee members who joined us on the Conference Abstract Review Panel, namely Dr Mar Estupiñan Fdez. de Mesa, Dr Andy Fox, Prof. Amira Guirguis, Dr Gillian Hawksworth, Prof. Delyth James, Dr Rachel Palmer, and Dr Ka-Wai Wan, as well as additional members of the Conference Abstract Review Panel, including Dr Paul Forsyth, Ola Howell, Dr Louise Hughes, Dr Matthew Ivory, Prof. Catriona Mathieson, Prof. Hamde Nazar, Prof. Philip Rogers, Dr Julian Smith, and Dr Sara Visram. In common with previous years, this Supplement has been prepared ahead of the conference, so that it is ready in time. Simon White, Cathrine McKenzie, Christine Bond, Amira Guirguis, and Parastou Donyai Simon White, Deputy Chair of the RPS Science and Research Committee and co-Chair of the Conference Abstract Review Panel Keele University Cathrine A McKenzie, member of the RPS Science and Research Committee and co-Chair of the Conference Abstract Review Panel University of Southampton Christine Bond, Editor-in-Chief of the International Journal of Pharmacy Practice, member of the RPS Science and Research Committee and co-Chair of the Conference Abstract Review Panel University of Aberdeen Amira Guirguis, Chair of the RPS Science and Research Committee Swansea University Parastou Donyai, RPS Chief Scientist The Royal Pharmaceutical Society

Student experiences of cultural competence encounters during MPharm placements and foundation year training

Abstract Introduction Cultural competence is the ability of a healthcare professional to work effectively with clients from different backgrounds. With 18.3% of the UK population identifying with non-white1, pharmacists need to be culturally competent as they have a patient-facing role. Having a multicultural society would require culturally competent pharmacists to effectively deliver healthcare services to patients of different cultures. Exploring pharmacy students' experiences of CC encounters during their MPharm placements and foundation year training is crucial as it helps identify the challenges and barriers they may face when providing healthcare to diverse populations. Understanding these experiences can inform the development of effective training programs to enhance cultural competence among future pharmacists and highlight the impact of cultural factors on patient care and outcomes. Ultimately, this exploration contributes to the overall goal of improving healthcare delivery and promoting patient-centred, culturally sensitive pharmacy practice. Aim This study aimed to explore experiences of student regarding cultural competence encounters during placements and training. Methods A qualitative study was conducted between Oct – Dec 2023. All currently enrolled students in Parts 3, 4 and the foundation year were eligible to participate. Convenience sampling was used. Semi-structured interviews were conducted online using a pilot-tested script. Interviews were audio and video recorded and held online through a Microsoft Teams account, where an automatic electronic transcript was generated. Initial codes were generated from each transcript, to create themes and sub-themes. The researcher scrutinised the themes before defining and naming them. Ethical clearance was obtained. Results A total of 15 students (8 males and 7 females) participated in the study. Four participants were from year 3, five were from year 4, and six were from the foundation year. Six participants were from Asian backgrounds, four were Black, and three were White. All students had a placement in hospital, while 14 had a placement in community pharmacy in addition to hospital, and 8 had a placement in a GP surgery in addition to the hospital and community pharmacy. Key themes identified were 1) Impact of culture on patient health including language barriers and ethnic diversity, 2) Influence of personal culture on practice during placements and training such as using patient’s language to communicate, personal cultural awareness, and the influence of religious teachings, 3) Recommendations for improving cultural competence training in MPharm programme such as having more case studies. Conclusion This study provides a unique exploration into the experiences of pharmacy students and shows the importance of immersing in diverse cultural groups during placements and foundation training. There is a need to enhance pharmacy students’ training through curricular reforms that build on theoretical knowledge to instil confidence during placements and training. This approach will equip future pharmacists to navigate complex cultural dynamics, to meet the demands of an inclusive healthcare system. Ultimately this research extends beyond the current reforms to the MPharm curriculum, and advocates for an equitable and inclusive healthcare system to reduce health disparities. The predominance of participants from Asian backgrounds may limit the generalisability of the findings. Reference 1. Office for National Statistics. Measuring equality: A guide for the collection and classification of ethnic group, national identity and religion data in the UK. Office for National Statistics 2021 https://www.ons.gov.uk/methodology/classificationsandstandards/measuringequality/ethnicgroupnationalidentityandreligion. Accessed 20 Dec 2023.