Hospital Pharmacy Research Articles

Feasibility of automated surveillance of implantable devices in orthopaedics via clinical data warehouse: the Studio study

BackgroundTotal hip, knee and shoulder arthroplasties (THKSA) are increasing due to expanding demands in ageing population. Material surveillance is important to prevent severe complications involving implantable medical devices (IMD) by taking appropriate preventive measures. Automating the analysis of patient and IMD features could benefit physicians and public health policies, allowing early issue detection and decision support. The study aimed to demonstrate the feasibility of automated cohorting of patients with a first arthroplasty in two hospital data warehouses (HDW) in France.MethodsThe study included adult patients with an arthroplasty between 2010 and 2019 identified by 2 data sources: hospital discharge and pharmacy. Selection was based on the health insurance thesaurus of IMDs in the pharmacy database: 1,523 distinct IMD references for primary THSKA. In the hospital discharge database, 22 distinct procedures for native joint replacement allowing a matching between IMD and surgical procedure of each patient selected. A program to automate information extraction was implemented in the 1st hospital data warehouse using natural language processing (NLP) on pharmacy labels, then it was then applied to the 2nd hospital.ResultsThe e-cohort was built with a first arthroplasty for THKSA performed in 7,587 patients with a mean age of 67.4 years, and a sex ratio of 0.75. The cohort involved 4,113 hip, 2,630 knee and 844 shoulder surgical patients. Obesity, cardio-vascular diseases and hypertension were the most frequent medical conditions.DiscussionThe implementation of an e-cohort for material surveillance will be easily workable over HDWs France wild. Using NLP as no international IMD mapping exists to study IMD, our approach aims to close the gap between conventional epidemiological cohorting tools and bigdata approach.ConclusionThis pilot study demonstrated the feasibility of an e-cohort of orthopaedic devices using clinical data warehouses. The IMD and patient features could be studied with intra-hospital follow-up and will help analysing the infectious and unsealing complications.

Convenience and price drive online pharmacy usage by veterinary clients.

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

The administration of immune checkpoint inhibitors via an elastomeric pump versus conventional intravenous infusion: an economic perspective

BackgroundRecent studies have underscored the potential of innovative administration methods to mitigate the capacity burden on healthcare systems, without compromising the quality of care. This study assessed and compared the resource utilization and associated costs of two distinct administration modes of immune checkpoint inhibitors: the innovative elastomeric pump and conventional intravenous infusion. This comparison can inform sustainable healthcare practices and healthcare decision-making to optimize treatment efficiency in an era of escalating healthcare demands.MethodsIn this micro-costing study, data on resource use and time allocation for drug preparation and administration were collected using an observational, non-interventional study design. Data were registered at the oncology daycare unit and hospital pharmacy. Cost categories included drug acquisition, disposable materials, healthcare professional time for drug administration, drug preparation, and patient time spent at the oncology day care unit.ResultsDrug administration through the elastomeric pump resulted in substantially lower healthcare costs when compared to conventional infusion, particularly due to reduced labor and chair time. The elastomeric pump reduced the total chair time by 78% and nurse time by 55%. Total average costs (excluding drug costs) were €103,47 and €77.99 for conventional infusion and the elastomeric pump, respectively, showcasing potential savings of €25.48 (P < 0.001) per administration.ConclusionsThis study demonstrated that the elastomeric pump not only offers substantial cost savings but also enhances the treatment capacity of the oncology day care unit. These findings support the adoption of the elastomeric pump in clinical settings as a cost-saving and efficient alternative to conventional infusion.Trial registrationThis study has been registered in the National Trial Register (NTR), with the reference number NTR NL9473. Registration date: 05-05-2021.

Assessment of miligram(Mg) content of some notable analgesics used by residents of Maiduguri Metropolis: evidence from high performance liquid chromatographic technique

Diclofenac sodium and paracetamol are Over the counter (OTC) medications used as analgesic and antipyretic agents to relieve pains, fever and headaches. The aim of this work was determine the mg content of paracetamol and diclofenac sodium in selected samples across the Maiduguri metropolis using High Performance liquid chromatography (HPLC) method. For paracetamol samples an intersil ODS-3V column (150 mm × 4.6 mm; 5 μm pore size) was used at the temperature of 35oC the mobile phase was methanol: water (20:80) using isocratic elution at the flow rate of 2 mL/min, injection volume of 10 μL and a diode array detector. For diclofenac sodium samples, the chromatographic conditions were the same except the mobile phase which was methanol: water (63:37), flow rate of 0.8 mL min, injection volume of 20 μL and column temperature was set at 30 oC. A total of 45 samples were analysed; which comprised of paracetamol tablet, paracetamol syrup and diclofenac sodium tablet which were randomly selected from three different sources; hospital pharmacy, community pharmacy and drug patent stores. The percentage mg content for paracetamol tablets ranged from 48 to 83 % while that of the paracetamol syrups ranged from 72 to 120 % and finally diclofenac sodium tablets ranged from 73 to 174 %. Adopting the United State Pharmacopoeia (USP) as reference for assessment tool, it was observed that all the paracetamol tablet samples failed, 4 out of 15 paracetamol syrup samples failed, and 11 out of 15 diclofenac sodium tablet samples failed. There was statistical significance (p&lt; 0.05) between class of drug and percentage mg content but there was no significance (p&lt; 0.05) between source of drug and percentage constituent. HPLC technique was used successfully for quantitative determination of paracetamol and diclofenac sodium dosage forms.

Eco-Sustainability in Hospital Pharmacy: A Pilot Survey on 'Going Green'.

Purpose: Between 2009 and 2015, the Canadian health care system was estimated to be responsible for 4.6% of national carbon emissions. Determine awareness of and describe eco-initiatives that the department of pharmacy can implement to aim to reduce the carbon footprint in hospital pharmacy in an effort to 'go green'. Methods: In a quality improvement initiative, pharmacy employees (i.e. pharmacists and pharmacy technicians) completed a cross-sectional survey designed to gauge willingness to 'go green' at work, to identify actionable areas of waste, and to assess commuting practices. Results: A total of 15 respondents completed the survey conducted March 14th -April 7th, 2022. Most respondents (73%) were willing to engage in more sustainable practices at work. The main barriers to implementing green practices at work were 'too time consuming' (20%), 'adds too much complexity' (20%), and 'cost' (16%). For commuting, 60% indicated the primary mode of transportation as 'personal vehicle', where 'subsidized transit' and was listed as the greatest incentive that could encourage a greener commute. The three largest areas of waste cited were 'single use plastic' (36%), 'limited of awareness of green practices' (15%), and 'lights left on in empty rooms' (12%). Conclusions: Pharmacy staff shared willingness to engage in more sustainable 'go green' practices but raised challenges to do so. With the knowledge that Canada has the second most climate intensive health system, there is a need for future research to describe how hospital pharmacies can contribute strategically to 'go green', advancing with implementing low carbon sustainable pharmacy practices.

Optimización de la triple terapia en el tratamiento del cáncer de próstata hormonosensible metastásico

Triple therapy with docetaxel, androgen deprivation therapy (ADT) and androgen receptor pathway inhibitors (ARPIs) has demonstrated survival benefits in patients with metastatic hormone-sensitive prostate cancer (mHSPC), especially in those with high-risk disease. However, once the use of ADT and docetaxel is established, guidelines do not clearly specify which ARPI is most appropriate. In this work, a literature review to identify phase III clinical trials, systematic reviews, meta-analyses, and clinical practice guidelines on triple therapy in mHSPC was carried out. Evidence and recommendations were qualitatively reviewed to provide guidelines on the most suitable ARPI based on patient risk, disease volume, and nature of metastases (synchronous or metachronous). This review aims to update the previously published consensus on the optimal pharmacological treatment for mHSPC and to expose the opinions of hospital pharmacy, urology and medical and radiation oncology experts.

Performance Analysis of Slamet Riyadi Hospital Pharmacy Installation Surakarta Using Balanced Scorecard Method

This study aims to determine the extent to which the performance of the Pharmacy Installation of the Hospital Class III 04.06.04 Slamet Riyadi Surakarta with the Balanced Scorecard method. This study is a non-experimental study with an exploratory and descriptive design. Data were collected retrospectively and simultaneously with in-depth interviews with pharmacists of the pharmacy facility, staff and patient questionnaires, and direct observation. Data were analyzed descriptively and compared with existing standards. The findings indicate that 1) Financial perspective performance, TOR values are not yet in accordance with standards, the average GPM value is in accordance with the standard of 20-33% and the GROS value has not met the standard. 2) Customer perspective performance shows that there is high patient satisfaction with the performance of the Hospital Pharmacy Installation. However, there is a significant gap between satisfaction with its performance and patient expectations. Customer retention has increased customer acquisition in period one to period two. 3) Internal business perspective performance shows that drug availability reaches an optimal 100%, dispensing time for compounded prescriptions meets the standard, but for non-compounded prescriptions has not met the standard. PIO is delivered optimally 100% on information on indications, dosages, rules of use, side effects and related contraindications and how to store drugs have not been given to all patients. 4) The performance of the learning and growth perspective shows that satisfaction and work enthusiasm have a high category and the Hospital Information Management (SIM) system has not been optimally integrated. 5) The results of the SWOT analysis are included in quadrant II with a diversification strategy.

Evaluating the Efficiency and Staff Satisfaction of the Point-of-Care IV Activated System Versus Traditional Piggyback in Administering IV Antibiotics at a Saudi Tertiary Hospital.

This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system.

Hospital pharmacy emergency preparedness: Developing a strategy to respond to emergencies and major incidents.

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.

Analysis of Drug Sales Patterns in the Belawan Naval Hospital Pharmacy Using Apriori Algorithm

Hospital pharmacy plays an important role in ensuring drug availability and effective stock management. With the increasing number of drug redemptions, manual data management becomes inefficient and can lead to understocking or overstocking. Therefore, a method is needed that is able to automatically analyze drug sales patterns to improve stock management efficiency. One approach that can be used is the Apriori algorithm, an effective data mining technique for finding patterns in drug redemptions. This study aims to analyze drug redemption patterns at the Belawan Navy Hospital Pharmacy using the Apriori algorithm. The data used is drug redemption data. The Apriori algorithm is applied to find relationships between drug items that are often purchased together, so that it can provide useful insights in drug stock management. The results of the study showed that the Apriori algorithm successfully identified several significant drug redemption patterns. These patterns can be used to improve the efficiency of drug stock management and ensure timely drug availability, as well as reduce the risk of understocking or overstocking. The results of the study used logistic regression to predict discrete (binary) values from a column based on values from other columns and the accuracy obtained was 1.0 or 100%. This study concludes that the application of data mining with the Apriori algorithm can provide significant benefits in optimizing the management of drug stock redemption in hospital pharmacies.

Constructing a measure for self-perceived open organizational culture in a university hospital pharmacy.

An open organizational culture in the workplace represents an environment where information, ideas, and feedback are freely exchanged among all members, regardless of position or rank. Currently, there are no valid survey instruments to measure this culture within a healthcare context. To address this gap, we developed a survey instrument to measure self-perceived open organizational culture at a university pharmacy using a test re-test study design. Data were collected during classroom training on basic mediation skills study. Participants completed the same questionnaire before (test phase) and after the training (validation phase). The questionnaire included statements assessing open organizational culture. The data were analyzed using standardized psychometric methods, including correlations, Exploratory Factor Analysis (structural validity), and construct validity by correlating the open organizational culture scores with the Interpersonal Communication Inventory. In the test phase, 191 participants (161 females, 84%; response rate = 39.7%) contributed to the initial construction of the self-perceived open organizational culture survey instrument. In the validation phase, 81 of the original respondents completed the questionnaire again. Three latent factors were identified, retaining 22 of the 37 items: "enabling systems" (7 items), "open behavior" (8 items), and "trusting and supporting coworkers" (7 items). High correlations were found among the three factors (r > 0.6), and between these factors and the Interpersonal Communication Inventory (r > 0.35). Cronbach's alphas were all above 0.85, indicating good internal consistency. During the validation phase, the factors demonstrated high internal consistency, test/re-test correlations, and agreement. This study presents a 22-item survey instrument for measuring individual differences in self-perceived open organizational culture within a university hospital pharmacy. The instrument demonstrates internal consistency and construct validity. Further validation of its psychometric properties and testing in other healthcare departments are recommended.

An assessment of the factors contributing to the unavailability of drugs at outpatient pharmacy of tertiary care hospital: an observational study

Introduction Throughout history and up until the present, there has been a medicine shortage. In the early 1920s, there was a shortage of insulin, which is when drug scarcity first appeared in the records. Drug shortages are now more prevalent globally than they were back then. The goal of this essay is to pinpoint the key components that make up a definition for medication shortages and to pinpoint the circumstances that should be considered when reporting drug shortages in databases. Understanding the factors that led certain organizations to create their own definition of a medicine shortage was crucial for achieving these goals. The pharmaceutical regulatory environment can be connected to several reasons why there are medication shortages, including parallel trading, quality standards, and business choices to halt or reduce manufacturing. The many rules governing medicine shortages have not yet been the subject of a thorough investigation. This protocol’s objective is to analyze the pertinent legislative and regulatory frameworks in the European pharmaceutical system that affect medication shortages. The objectives of the study will be the non–availability of drugs at an outpatient pharmacy and to analyze the reason of non–availability of drugs. Methods An observational study will be adopted in this study. It includes a collection of data from the patient coming to the outpatient pharmacy of AVBRH Sawangi (Meghe) Wardha. Expected result It can lead to delayed treatment for patients seeking alternative medication. It can also lead to increased healthcare costs if patients seek alternative treatments that are more expensive or require additional medical care. The unavailability of drugs can also lead to frustration and anxiety for patients who need medication to manage their health condition. It can also negatively impact the reputation of the hospital.

Work-life balance and health among pharmacists: physical activity, sleep quality, and general health

BackgroundPharmacists face unique occupational challenges that can impact their health and well-being. This study examines the relationships between work-life balance factors, physical activity, sleep quality, and general health among pharmacists in Shiraz, Iran.MethodsA cross-sectional survey was conducted from 7 August 2021 to 21 November 2021 among 136 pharmacists working in community and hospital pharmacies in Shiraz. Participants were selected using stratified random sampling. The Persian versions of the International Physical Activity Questionnaire (P-IPAQ), Pittsburgh Sleep Quality Index (P-PSQI), and General Health Questionnaire (P-GHQ-28) were used to assess physical activity, sleep quality, and general health status, respectively. Data were analyzed using descriptive statistics, Chi-square, Fisher’s exact, Mann-Whitney U, and Kruskal-Wallis tests. Statistical significance was set at p < 0.05.ResultsLow physical activity was reported by 35.3% of pharmacists, with longer work hours significantly associated with lower physical activity (p = 0.009). Poor sleep quality was prevalent in 57.4% of participants, with no significant associations with demographic variables. General health was categorized as unhealthy for 50.7% of pharmacists, with female pharmacists more likely to be in this category (χ2 = 4.383, p = 0.036). Older pharmacists reported better general health status (Mann-Whitney U = 1792.500, p = 0.024).ConclusionsPharmacists face significant challenges in maintaining work-life balance, evidenced by low physical activity, poor sleep quality, and compromised general health. Targeted interventions, including workplace exercise programs, optimized schedules, and comprehensive wellness initiatives, are needed to support pharmacists’ well-being and enhance patient care quality.

A dynamic management model for sustainable drug supply chain in hospital pharmacies in Iran.

Sustainable supply chain management encompasses the strategic coordination and control of material, information, and financial flows, as well as the collaborative efforts among the entities engaged in the medicinal supply chain. This research proposes a dynamic and sustainable supply chain management model tailored explicitly for the inpatient pharmacies of Medical Centers and Hospitals affiliated with Iran University of Medical Sciences. This is a quantitative study in terms of research objective and a qualitative study based on the stages in the conceptual development of the model. Therefore, the current study can be considered a mixed-methods approach. After identifying the key factors influencing the sustainability of the medicine supply chain, we conducted a dynamic analysis of the problem using system dynamics methodology. In order to simulate the system's behavior over 24 months, we utilized a combination of existing documentary information and expert opinions. The developed model was implemented using Vensim PLE software, allowing us to simulate and analyze the impact of various policies on the system. Medicine disposal exhibited an upward trend, particularly during the second 12-month period. Conversely, the trend of medicine expirations remained relatively stable in the initial months but showed an upward trajectory after that. The cost associated with disposed medicine experienced a consistent increase, with a higher rate observed during the second 12-month period. In contrast, sales of low-consumable medicine experienced a significant initial surge followed by a slower growth rate. Finally, the pharmacy's profit demonstrated an overall increasing trend, although the rate of increase was higher during the first 12 months. Among the various scenarios considered, namely "increasing the adequacy of human resources," "increasing the speed of response," and "utilizing pharmacists in the drug prescribing team," it was found that these interventions had a substantial effect on both enhancing the pharmacy's profit and reducing medication waste. Therefore, these scenarios were identified as having the most significant impact. The proposed model can serve as a valuable tool for forecasting and informing policy-making, providing insights into addressing the challenges associated with the sustainable drug supply chain in hospital pharmacies.

Drug utilization and medication adherence for the treatment of psoriatic arthritis: an Italian study.

This study aims to evaluate the persistence, treatment adherence and drug cost associated with biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the management of psoriatic arthritis (PsA) in Italy, with a focus on biosimilar drugs. This was a retrospective observational study involving eight hospital pharmacies, between January 2017 and December 2020, on naïve patients with at least one b/tsDMARD dispensation indicated for PsA. Patients were followed up for 12 months and persistence and adherence were evaluated by proportion of days covered (PDC). The originator and biosimilar for adalimumab and etanercept were compared. Furthermore, the real annual cost per patient based on adherence to therapy was calculated. Patients initiating b/tsDMARDs for PsA had a mean persistence of 263 days and 48.6% remained persistent for 1 year. Adherent patients (PDC ≥ 0.8) were 47.6% for the overall population. Similar persistence and adherence were observed between patients treated with the adalimumab originator and its biosimilar, while patients treated with the etanercept originator showed lower persistence and adherence compared to those treated with its biosimilar (mean persistence: 222 vs. 267 days, patient persistent at 1 year: 29.4% vs. 51.5%, mean PDC: 0.53 vs. 0.70, adherent patients: 23.5% vs. 51.5%). The average annual drug cost ranged from €8,724 (etanercept) to €14,783 (ustekinumab), with an annual saving of more than €2,500 by using biosimilars. Poor adherence to medications contributes to suboptimal clinical outcomes. The comparison between biosimilar and originator offers further evidence in support of the biosimilar to optimizing resources in healthcare.

Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023

BackgroundThe Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.MethodsThis study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.ResultsAfter rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.ConclusionsThe uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.

Comparative evaluation of access to emicizumab (Hemlibra®) for people with haemophilia A in community and hospital pharmacies in France.

Since June 2021 in France, patients with haemophilia A with anti-factor VIII inhibitors and patients with severe haemophilia A without anti-factor VIII inhibitors have the choice between the community and the hospital pharmacy for dispensing emicizumab (Hemlibra®). This study aims to investigate patient-centred access to treatment by evaluating and comparing the dimensions of the Penchansky and Thomas model, between community and hospital pharmacies. The evaluation of access to treatment was based on the dimensions of the Penchansky and Thomas model: accessibility, availability, acceptability, accommodation and affordability. These were assessed using appropriate and specific indicators in the study context and calculated for patients choosing community pharmacy or hospital pharmacy for emicizumab dispensing. Geographical data collected as part of the national 'PASO DOBLE DEMI' study were used for this analysis. The findings reveal that dispensing emicizumab in community pharmacies improves accessibility by significantly reducing travel time. The availability of healthcare services is also improved due to the territorial coverage of community pharmacies. The extended opening hours and low waiting time also contribute to better access to emicizumab in community pharmacies. The dimension of acceptability must be improved, and further investigations are needed to address the affordability dimension. Several months after emicizumab became available in French community pharmacies, access to treatment has significantly improved, reducing the burden of this rare chronic disease for patients and their careers. These results suggest that this innovative model could be extended to other medicines and even other therapeutic areas.

A Survey Analysis of Motivations and Perceived Consequences of Work Hours Among Pharmacy Students.

To determine pharmacy students' weekly work hours during PharmD semesters, the primary reasons for working or not working, and how work hours impact their pharmacy education experience. A multicenter cross-sectional survey was conducted among P1 - P4 students enrolled in PharmD programs at three colleges of pharmacy between January and February 2024. The 22-item anonymous survey queried about student characteristics, current and ideal paid work hours, primary reasons for working, and perceived consequences of work hours on pharmacy education. A total of 622 pharmacy students participated in this survey (61% response rate). Community pharmacies (39%, n=242) and inpatient hospital pharmacies (29%, n=179) were the most common work settings for participants. Mean reported student work hours per week were statistically higher than ideal hours (12.3 vs. 10.8). Most students were comfortable with their weekly work hours (63%, n=307). Academic commitment was the main reason for students working fewer than ideal hours (76%, n=65) while financial necessity was the primary reason for students working more than their ideal hours (86%, n=82). Reduced study time (90%, n=84), increased stress and fatigue (72%, n=67), and limited extracurricular involvement (59%, n=55) were consequences of working beyond ideal work hours. Most students are comfortable with their average 12-hour/week work hours. Financial necessity is a primary reason for students working more than their ideal hours, and excess work hours may contribute to reduced student engagement in pharmacy education. Faculty can use this information in their discussions with students balancing work and academic commitments.

Impact of automated pop-up alerts on simultaneous prescriptions of antimicrobial agents and metal cations

BackgroundAntimicrobial agents (AMAs) are essential for treating infections. A part of AMAs chelate with metal cations (MCs), reducing their blood concentrations. That drug-drug interaction could lead to a reduction of therapeutic efficacy and the emergence of drug-resistant bacteria. However, prescriptions ordering concomitant intake (co-intake) of AMAs and MCs are frequently seen in clinical settings. A method for preventing such prescriptions is urgently needed.MethodsWe implemented pop-up alerts in the hospital's ordering and pharmacy dispensation support system to notify the prescriptions ordering co-intake of AMAs and MCs for physicians and pharmacists, respectively. To assess the effectiveness of the pop-up alerts, we investigated the number of prescriptions ordering co-intake of AMAs and MCs and the number of pharmacist inquiries to prevent co-intake of AMAs and MCs before and after the implementation of pop-up alerts.ResultsBefore the implementation of pop-up alerts, 84.5% of prescriptions containing AMA and MCs ordered co-intake of AMAs and MCs. Implementing pop-up alerts time-dependently reduced the proportion of prescriptions ordering co-intake of AMAs and MCs to 43.8% and 29.5% one year and two years later, respectively. The reduction of tetracycline-containing prescriptions was mainly significant. Before the implementation of pop-up alerts, the proportion of prescriptions in which pharmacists prevented co-intake of AMAs and MCs was 3.4%. Implementing pop-up alerts time-dependently increased proportions of such prescriptions to 20.9% and 28.2% one year and two years later.ConclusionImplementing pop-up alerts reduced prescriptions ordering co-intake of AMAs and MCs and accelerated pharmacists to prevent co-intake of AMAs and MCs. The implementation of dual pop-up alerts in the hospital's ordering and pharmacy dispensation support system could help prevent co-intake of AMAs and MCs.

Impact of hospital pharmacy interventions on length of stay in hospitals: a protocol for a systematic review and meta-analysis

Background Length of stay (LOS) is an essential metric for hospital efficiency, patient outcomes and satisfaction. Studies indicate hospital pharmacy interventions positively affect LOS and other outcomes, yet results vary due to study differences. No systematic review or meta-analysis has been conducted on this topic; thus, the aim of this study is to systematically assess the effect of interventions on LOS. Methods This review will conduct a systematic search across MEDLINE, EMBASE, Cochrane Trials, Cochrane Reviews and the Cumulative Index to Nursing and Allied Health Literature to identify pertinent studies. An expert librarian will craft the search strategy, ensuring our review adheres to standard guidelines. We will use Covidence, a specialized systematic review management software, to optimize data management, the selection process and data extraction. A dedicated team of reviewers will independently evaluate titles and abstracts in duplicate, progressing to full-text examination of articles, to determine inclusion in our review and analysis. Data will be extracted by one reviewer, with independent data extraction by a second reviewer in a proportion of papers, and checking for consistency by a third. A template in Covidence will guide extraction of study, setting, participant, intervention and outcome characteristics and findings. The findings will be described narratively, and if possible given the methodological and statistical heterogeneity, meta-analysis will be undertaken. Discussion Considering the inconsistency of previous studies, this systematic review aims to clarify the potential impact of hospital pharmacy interventions on LOS. It will expand and reinforce existing knowledge, and provide detail about which intervention types have the most impact on LOS.