Pharmaceutical Care Research Articles

Treatment effects of two pharmaceutical skin care creams for xerotic feet among persons with diabetes: Rationale and design of a two-armed double blind randomized controlled trial.

To minimize the risk of developing foot-ulcers, persons with diabetes are given the advice to daily inspect their feet and to apply skincare formulations. However, commercially available skincare products have rarely been developed and evaluated for diabetes foot care specifically. The primary aim of this randomized controlled trial (RCT) is to evaluate the effects in reducing foot xerosis in persons with diabetes without foot-ulcers using two skincare creams containing different humectants (interventions) against a cream base non-humectant (comparator). Secondary outcomes are to evaluate differences on skin barrier integrity, low-molecular weight biomarkers and skin microbiota, microcirculation including transcutaneous oxygen pressure, degree of neuropathy, and HbA1c between intervention-comparator creams. Two-armed double-blind RCT, registered in ClinicalTrials.gov Identifier: NCT06427889. With 80% power, two-tailed significance of 2.5% in each arm, 39 study persons is needed in each arm, total 78 persons, 98 including dropouts, to be able to prove a reduction of at least one category in the Xerosis Severity Scale with the intervention creams compared to the comparator. In one arm, each participant will treat one foot with one of the intervention creams (Oviderm® or Canoderm®), while the opposite foot will be treated with the comparator cream (Decubal®lipid cream), twice a day. If needed, participants are enrolled after a wash-out period of two weeks. The participants will undergo examinations at baseline, day 14 and day 28. This RCT evaluate the potential effects of humectants in skin creams against foot xerosis in persons with diabetes.

Assessment of knowledge, perception, and readiness for telepharmacy-assisted pharmaceutical services among young pharmacists in rural Indonesia

BackgroundThe implementation of telepharmacy technology has expanded significantly, particularly during the COVID-19 pandemic, to ensure continuous pharmaceutical care services. This practice is vital in rural and underserved areas where access to healthcare is limited. ObjectiveThis study aims to assess the knowledge, perception, and readiness of young pharmacists in rural Indonesia towards telepharmacy-assisted pharmaceutical services. MethodsA cross-sectional study was conducted from January to July 2023 in rural areas of Java, Sumatra, and Kalimantan, Indonesia. A convenience sampling method was employed with the aim of recruiting 520 registered pharmacists under 35 years of age (23–34 years old). Data were collected using an online questionnaire adapted for the local context and analyzed using SPSS version 26.0. ResultsThe study achieved an 86.67 % response rate. Most participants were female (73.1 %) and aged between 26 and 30 years (53.8 %). Nearly all pharmacists (97.1 %) held a Pharm.D degree. The knowledge assessment showed high awareness of telepharmacy's importance and its role during the COVID-19 pandemic, with 96.15 % recognizing the need for a strong internet connection. Positive perception was noted, with 90.38 % agreeing that telepharmacy enhances medication access in rural areas. However, concerns about increased error rates and workload were highlighted. A substantial proportion of pharmacists expressed readiness for conducting drug counselling via video consultation (44.23 %) and showed a willingness to undergo relevant training (59.62 %). ConclusionYoung pharmacists in rural Indonesia demonstrate a good level of knowledge and generally positive perceptions about telepharmacy, with notable readiness among pharmacists with less than five years of experience. While there is notable willingness to engage in telepharmacy practices and training, addressing concerns about workload and data security through targeted support and training will be crucial for the successful implementation of telepharmacy, potentially enhancing healthcare access in rural areas.

A polifarmáciás idős betegek gyógyszerészi gondozásának gazdasági előnyei

The danger of polypharmacy (polypragmasia) lies in the fact that it usually affects older people who suffer from several chronic diseases and who are also less likely to medication adherence. For this reason, it is important to follow the drug therapy of these patients in the pharmacies, where feedback to general practitioners and specialists can take place in the event of a problem. For this reason, the development of pharmaceutical care is crucial. In the case of polypharmacy patients, inadequate drug therapy greatly increases the development of adverse drug effects and thus may increase mortality and morbidity indicators. Knowing the facts, it can be said that although pharmaceutical care involves additional costs, the adverse drug effects filtered out by it mean reduction in expenses.

Quality Management in Spanish Community Pharmacy: Implementation of ISO 9001.

Spanish community pharmacy has been incorporating some methods and approaches in the evaluation and improvement of quality, with the ISO 9001 standard being the most used reference. The experience of a community pharmacy in Spain is presented. The pharmacy implemented a management system based on the ISO 9001 standard in 2020, using the Deming cycle with the aim of enhancing the quality of pharmaceutical care. The results obtained in the processes over the following 2 years are also presented. The ISO 9001 standard was reviewed to ensure compliance. The Quality Management System control documentation was updated and included the following documents: quality manual, process map, operational processes and procedures, quality indicators and incident records. The pharmacy has planned and implemented a process of monitoring, measurement, analysis of results and continuous improvement for operational, strategic and support processes during the time period of the study. The main operational processes were associated with a set of indicators which permitted to know the results obtained, analyse deviations and implement improvements. The planning and development of the project encompassed approximately 1 year and involved several key stages: (1) diagnosis and assessment of quality situation, (2) analysis of processes, (3) preparation of documentation, (4) implementation of the Quality Management System, (5) internal audit, (6) monitoring of activities and continuous improvement, (7) follow-up audit by the certifying body, (8) obtaining the ISO 9001:2015 quality certificate. The planned schedule was adhered and the documents were successfully drafted. In total, eight operational processes, nine support processes and six strategic processes were reviewed and included in the Quality Management System. Twenty indicators were established to monitor and analyse the performance of these processes. During audits, deviations in the system or nonconformances were identified and analysed. In the first year of system implementation, five nonconformances were identified, decreasing to two in the subsequent two periods. In 2020, three improvement actions were implemented with the objective of: (1) implementing a medication reconciliation service, (2) developing a medication dose adjustment service for polymedicated patients, and (3) implementing a service to measure and improve inhalation technique in patients using inhalers. The implementation of a methodology based on the ISO 9001 standard has facilitated: (1) Integrating process management as a regular working methodology, (2) A focus on the continuous improvement of services, (3) Achieving recognition of the staff efforts and involvement.

Medication Errors in Psychiatric Hospitals: A Nationwide Real-World Evidence Study in Saudi Arabia

Background: Medication errors are among the most prevalent medical errors and result in significant morbidity and mortality. They pose a major threat to patient safety in psychiatric hospitals. However, the lack of a comprehensive investigation into the root causes of these errors restricts the development of effective corrective measures. Objective: This study aimed to characterize the types of errors, determine the stages of the medication use process, and identify factors associated with errors occurring among government psychiatric hospitals in Saudi Arabia. Methods: This cross-sectional study was conducted from August 2019 to June 2020. All medication error reports submitted to the Ministry of Health General Administration of Pharmaceutical Care database from 18 government psychiatric hospitals in Saudi Arabia were assessed. The database is de-identified and contains information on all medication errors, including patient demographics, medication information, error information, causes of errors, and reporter information. Medication use was categorized as ordering/prescribing, transcribing, dispensing, administration, and monitoring. The present findings represent a descriptive analysis of the data using Statistical Analysis Software (SAS) version 9.4. Result: A total of 23,355 medication error reports were reported to the database during the study period. Among Saudi Arabian cities, Riyadh (n = 8972, 38.4%) had the highest medication error reporting rate, followed by Taif (n = 3705, 15.9%) and Jeddah (n = 2621, 11.2%). Most reported errors were frequently made by physicians (n = 20,284, 86.9%) and were primarily detected by pharmacists (n = 20,974, 89.8%). Approximately half of them (n = 13,150, 56.3%) were classified as “Category B” that occurred, but they did not reach patients. Most medication errors were reported in adults (n = 22,589, 96.7%) and male patients (n = 16,393, 70.2%). Most error reports were detected at the prescription stage (n = 16,481; 70.6%) during the medication-use process. Work overload of the staff (n = 2911, 12.8%) and drug labeling, packaging, and nomenclature (n = 2826, 12.1%) were the most common contributing factors associated with the reported errors. Olanzapine (n = 1650, 7.1%), omeprazole (n = 1350, 5.8%), and quetiapine (n = 1273, 5.5%) were the most common medications associated with medication errors. Conclusions: Preventable medication errors are typical in psychiatric hospitals and may result in severe consequences. Increased efforts are needed to control and minimize prescribing errors and improve reporting in Saudi Arabia.

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.

Teaching innovation: enhancing undergraduate student pharmacist consultation skills by introducing ‘Fishbowl’ prescribing workshops

Abstract Introduction The new ‘Standards for the initial education and training of pharmacists’1 outline the skills, knowledge, and attributes required to enable pharmacists to independently prescribe at the point of registration. Third-year MPharm students at the University of Nottingham have previously practised consultation skills in professional practice workshops, conducting shorter form, over the counter-type consultations. These lacked the depth required for pharmacy students to develop skills they will now need. Therefore, we identified a requirement for advanced consultation practice, including prescribing, alongside clinical history taking, to better prepare students to be prescribers. Creation of a new module occurred, ‘Pharmaceutical Care and Prescribing’, including ‘Fishbowl’ workshops. ‘Fishbowl’ is a small group teaching method where an individual student engages in a discussion, while observers form a circle around them2. Students were able to ‘tap out’ of consultations at any point, to discuss consultation direction with their peers. Five case studies were written to incorporate a variety of clinical conditions, patient demographics and clinical settings, with a key emphasis of holistic, patient-centred care. All third-year students were timetabled for five workshops, in groups of around 25. Facilitators regularly discussed consultation progress, outstanding care issues and gave feedback on areas done well or needing improvement. Aim Do students perceive ‘Fishbowl’ workshops to enhance their clinical history taking skills and prescribing knowledge? Methods Following the five workshops, all third-year students (n=256) were invited via email to complete a Microsoft Forms questionnaire, to evaluate the workshop aims . The questionnaire included ten 5-point Likert-scale questions and free-text answers. Primarily quantitative methods were used with free-text responses used to contextualise results. This study obtained ethical approval from the University of Nottingham, School of Pharmacy Postgraduate Research Projects Ethical Approval group. Results 82 students (32%) completed the questionnaire. 91% of students felt they helped practice taking a clinical history. 80% of students felt they better understood how to include share care decision making into their consultations. One student commented, they were ‘very thought-provoking sessions and easy to interact and learn from each other’. 67% said the sessions helped them to better understand the pharmacist’s role in prescribing. With regards to prescribing awareness, a student commented ‘It would have been nice to have scenarios where we prescribed a POM in the end for more of the sessions to help us get used to thinking like prescribers.’ 85% of students would recommend the teaching technique to other MPharm students, 76% felt these sessions should be introduced in earlier years of the MPharm course. A few students commented that the facilitation style varied considerably depending on academics involved. Discussion/Conclusion ‘Fishbowl’ method of teaching provides a suitable environment for practising clinical history taking and prescribing and were generally well received by students. Further work is needed to integrate this teaching technique earlier in the MPharm programme. Facilitator skills play a significant part in student engagement, we need to ensure there is appropriate staff training to run this session type. Limitations of the study include lack of comparison against other student teaching tools.

Drug-related problems among pediatric intensive care units: prevalence, risk factors, and clinical pharmacists’ interventions

BackgroundDrug-related problems (DRPs) are frequently observed in intensive care units, resulting in a higher occurrence of drug side effects and increased treatment expenses. This study aimed to assess the prevalence of DRPs in pediatric patients admitted to the most prominent surgical and medical pediatric intensive care units (PICUs) in southern Iran, given the susceptibility of children to the effects of DRPs.MethodThis cross-sectional study was conducted at Namazi Hospital, which is affiliated with Shiraz University of Medical Sciences in Shiraz, Iran, from June 2022 to March 2023. The research focused on identifying and detecting drug-related problems (DRPs) among pediatric patients during their hospital stays across three medical wards, two pediatric intensive care units, and a surgical intensive care unit. The identification process occurred concurrently with patient treatment and utilized the Pharmaceutical Care Network of Europe’s data collection form for DRPs version 8.01. Before any documentation, all cases were thoroughly reviewed and validated by a professional focus group. The data gathered were then statistically analyzed using SPSS to evaluate the study’s outcomes.ResultDuring the study, 323 pediatric patients were involved, of whom 57% experienced at least one DRP. The primary issues identified during the study were suboptimal drug treatment, accounting for 41.13% of cases, followed by concerns related to treatment safety, which constituted 38.53% of cases. Drug-drug interactions were found to be the leading cause of DRPs, accounting for 36.26% of cases. Two significant factors associated with DRP occurrence were the number of prescribed drugs and the number of prescribed anticonvulsants. Out of all clinical pharmacist interventions, 97% were accepted.ConclusionPatients admitted to the PICUs experience a high occurrence of DRPs. It is essential to consider optimal dosage adjustment, particularly for pediatric patients with impaired kidney function.

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.

Establishing a biologics and biosimilars committee/network: assessing educational requirements of pharmacy and other healthcare professionals

Abstract Introduction Successful professional networking involves shared, mutually beneficial interactions between individuals and/or individuals and groups1. Biologics and biosimilar medicines prescribing is rapidly evolving with an increasing number of clinical indications in healthcare2,3. Despite their importance, the absence of a structured national network dedicated to these complex therapies has left a gap in professional education and resource sharing among pharmacists. Recognising the necessity for a cohesive support system, this work explores the learning and professional needs of pharmacists regarding biologics and biosimilars and the potential development of a national pharmacy network to address these gaps. Aim The survey aimed to explore the educational needs and preference for a network and/or committee for pharmacy and other healthcare professionals focused on biologics and biosimilars medicines. Methods An electronic survey was developed and deployed for pharmacy and other healthcare professionals involved in the management of biologics and biosimilars via email cascade and social media, 12th February - 6th March 2023. The survey explored the preferred structure of the proposed group; formal committee and/or informal network, what the group would deliver, and any educational needs for members. The survey included questions about the respondent’s roles, sectors of work, regions and their clinical area(s). The open text responses were themed. The NHS health Research Authority tool was used to identify this project as service improvement and development, therefore did not require ethical approval. Results The responses received were from 46 pharmacists, 1 pharmacy technician, 15 doctors and nurses and 4 participants whose roles were unknown, working across multiple sectors; hospital, community, industry, and academia with representation from the devolved nations (n=3) and internationally (n=1). Most respondents expressed a need for a dedicated network and committee n=52 (79%), n=10 (15%) formal network, and n=4 (6%) informal committee. Common themes in response to what the group should deliver and educational needs included; harmonisation of approaches to guidelines and policies, pathway design, reduction in unwarranted variation (68%); platform to share new ideas, knowledge and peer advice (44%); strategy and leadership in service delivery and promotion of best practice and cost training, horizon scanning (29%); working collaboratively to produce multi-centre research projects (24%); to create a structured training programme for health care professionals (9%). Discussion/Conclusion The survey results highlight a gap in the current educational and professional support systems for PP’s concerning biologics and biosimilar medicines. The identified learning needs point to a strong demand for a structured network that can provide targeted education, share best practices and facilitate professional networking. The expertise within the group can also create formal eLearning programmes for healthcare professionals. This work serves as a foundational step towards the development this network, highlighting the critical areas of focus and the collective interest of the pharmacy community in bridging these gaps. The network should also facilitate communication and collaboration across different sectors, fostering a more cohesive and informed pharmacy community. Such an innovative network would not only enhance individual competency but also contribute to the overall advancement of pharmaceutical care in this specialised area.

Pharmacist interventions in the control of hypertension and adherence to anti-hypertensive treatment: A systematic review and meta-analysis of randomised controlled trials

Abstract Introduction Non-adherence to antihypertensive therapy is one of the major barriers for the achievement of blood pressure (BP) control and has a significant cost burden1. Non-adherence is also thought to be one of the leading factors leading to ethnic disparities in hypertension control in the UK2. Pharmacists have an important role in the management of hypertension and non-adherence due to their ideal position to promote optimal use of medication3. Many have advocated for pharmacist involvement in team-based hypertension management, however which pharmaceutical care interventions are most effective remains unclear. There have been many new studies in recent years exploring the effect of pharmacist interventions in hypertension and this meta-analysis provides an update of the current literature and quantification of the results. Aim This study aimed to systematically evaluate the efficacy of pharmacist-delivered interventions for adults with hypertension and examine the intervention characteristics associated with greater BP-lowering efficacy. The primary outcome was the change in BP and secondary outcomes were % achieving BP control. Methods Systematic review and meta-analysis of randomized controlled trials (RCTs). This review was registered on PROSPERO. Embase, CENTRAL, MedLine, Psychinfo and CINAHL were searched until February 2024. Eligible studies included adult patients with a diagnosis of essential hypertension where a pharmacist intervention (alone or collaborative care) targeting BP control was compared with control (usual care). Exclusion criteria included secondary hypertension, pregnancy, children and review articles/case studies. The risk of bias was assessed by the Cochrane risk-of-bias tool for RCTs. The primary outcome was change in BP. We extracted data on sample and intervention characteristics. Meta-analysis was performed using Comprehensive Meta-Analysis Software v4. Moderator analyses examined the association between intervention effects and intervention features. This study was a systematic review and meta-analysis of already completed trials and so ethical approval was not required. Results 2402 articles were retrieved. After removal of duplicates, 1538 were screened by title and abstract against the inclusion criteria. 88 studies with 25,516 participants were included. Mean intervention duration was 7.2 months (range 1-14 months). The overall pooled mean differences in systolic BP (SBP) and diastolic BP (DBP) between pharmacist intervention and control were -7.39 (-8.56, -6.23) mmHg and -3.99 (-4.61, -3.37) mmHg respectively, both P<0.001. With BP control, pharmacist interventions caused a significant increase in those achieving BP control compared to usual care (+21 (16.88, 25.27) %, P<0.001). Duration of intervention had no influence on change in SBP or DBP (both P>0.05). Discussion Pharmacists can make a significant impact in the management of hypertension in respect to increasing treatment adherence and improving BP control and this study highlights the importance of including them as part of the multidisciplinary team responsible for patient care. Limitations of the present study include the inability to extract individual patient data and stratification by ethnicity, socioeconomic status and gender. However, pharmacist interventions in hypertension significantly reduced SBP and DBP and improved BP control. Identifying the characteristics of the most effective interventions can lead to better treatment adherence and BP-lowering in patients with hypertension.

Bibliometric analysis of scientific literature on the use of suppositories in the treatment of prostate cancer patients

Nowadays, cancer remains one of the main causes of death worldwide. Statistical data from various literary sources indicate that more than 130,000 people in Ukraine receive this diagnosis as a sentence every year. Cancer can affect any organs of the human body and, over time, the entire organism. In 2024, the agency of the World Health Organization on cancer and the International Agency of Cancer Research published the latest statistical estimates of this pathology in a global format, where prostate cancer is among the five most common oncological pathologies and takes the fourth place. Oncological diseases are one of the priority areas of healthcare development in accordance with the Order of the Ministry of Health of Ukraine No. 1832 dated 07.10.2022 “On Approval of Priority Areas of Healthcare Development for 2023–2025”. It was this fact that determined the choice of the direction of this research in the matter of finding information on the provision of pharmaceutical care, namely the use of a drug – a rectal suppository for the treatment of prostate cancer. The aim of the work is to carry out a bibliometric analysis and further generalize the data of the scientific literature to study the prognostic value and features of the prescription of suppositories in the treatment of prostate cancer. Materials and methods. The data search was conducted in the PubMed electronic database using the following key terms: “prostate cancer and suppositories”, “prostate cancer”. To monitor and analyze international scientific research, with the help of visualization tools and modern SciVal citation metrics using the online platform, bibliometric analysis can be performed. Using the VOSviewer functional program, bibliometric networks were constructed and visualized. Results. A map of the relationships between the most used keywords on the topics of “prostate cancer” and “prostate cancer and suppositories”, grouped into clusters for the period from 1986 to 2024, was built. The clustering of the most used keywords on the subject of “prostate cancer” for the specified period is summarized. According to the bibliographic analysis, interest in the above topic was highest in 2014 and 2021. Conclusions. According to the bibliographic analysis, the interest in the subject of the patients’ treatment with prostate cancer disease continues to grow from 1998 up to the present. The analysis of publication activity using the visualization tool of bibliometric networks VOSviewer for the period from 2014 to 2024 for the key words “prostate cancer” has shown the presence of 14 clusters. The largest cluster is devoted to modern methods of prostate cancer treatment, studies of gene rearrangement, target therapy, carcinogenesis.

Enhancing emergency preparedness and disaster management: perceptions from high-fidelity simulation workshops for pharmacy students

Abstract Introduction As climate change intensifies, natural disasters like floods and disease outbreaks increase, straining communities worldwide. During emergencies, healthcare professionals are crucial for ensuring essential healthcare services despite limited access to medicines and facilities. Pharmacists are vital in safeguarding medicine supply chains, providing pharmaceutical care, and aiding in emergency response, which emphasizes the need for thorough preparation during their training1,2. However, little is currently taught on emergency preparedness in undergraduate pharmacy curricula3. Therefore, two emergency preparedness workshops, on a flood scenario and bioterrorism with anthrax, were co-created between academics and 3rd year students from Master of Pharmacy (MPharm) Programme at the University of Nottingham. These workshops were offered as a volunteer learning opportunity and final year and 3rd year MPharm students were invited. Aim The study aimed to explore final-year and 3rd year MPharm students’ perspectives on the high-fidelity simulation workshops of emergency preparedness. It seeks to assess their perceived readiness for pharmacy practice in emergency scenarios and how the workshops contributed to enhancing confidence and competence in disaster response. Methods Data were collected through a focus group, with semi-structured questions. All attendees of the co-created emergency preparedness workshops were invited to the focus group right after the workshops. With their consent, the focus group discussion was audio-recorded and transcribed verbatim, and analysed using thematic analysis. The discussions focused on the participants' opinions of the high-fidelity simulation workshops and their perceived preparedness for pharmacy practice in emergencies. This study does not require ethical approval. Results The study included five participants: three final-year and two 3rd year MPharm students. Five themes were developed, including: 1. ‘High engagement’: Participants defined workshops as enjoyable, highly engaging, with diverse, hands on, student-led activities. 2. ‘Upskilling by immersion’: Exploration of the pharmacist’s role during disaster scenarios was seen as helpful for participants' preparedness, especially in decision-making and facing ethical dilemmas. 3. ‘Lack of realism’: As a perceived challenge, they noted that high-fidelity simulations mirrored regular MPharm training, lacking the pressure of real emergencies. They recommended more closely simulating real disaster scenarios, particularly in the flood workshop. 4. ‘Insufficient briefing/debriefing’: Participants missed a briefing providing details about the activities, such as specifics of the disaster scenario, and feedback on performance to boost confidence. 5. ‘Partial confidence’: Despite improved preparedness, students lacked full confidence in handling emergencies. They emphasized the need for additional training, alongside the realism and feedback enhancements previously suggested, to bolster their confidence further. Discussion / Conclusion Incorporating high-fidelity simulations into pharmacy education is important for preparing students to manage real-life emergencies. MPharm students regularly experience realistic simulations in common pharmaceutical practices, which shapes their perception of the workshops. This familiarity raises their expectations but also provides a solid basis for evaluation. They found the workshops highly engaging and beneficial for developing essential skills. However, they identified gaps in realism and debriefing processes that impacted their confidence and perceived readiness. Addressing these issues and providing repeated training could significantly boost students' confidence and competence in emergency preparedness, ultimately strengthening their role in disaster response.

Short-term outcome of personalized theory-based pharmaceutical care service on the medication administration problems of family caregivers: a pre-post intervention study.

Family caregivers face many problems during administration of medications. Pharmacists are reliable and accessible healthcare providers in addressing family caregivers' medication related inquiries in primary care. This study aimed to evaluate theshort-term outcome of apersonalized theory-based pharmaceutical care service on the medication administration problems of family caregivers. This pre-post intervention study was carried out among family caregivers at a community pharmacy in Istanbul, Türkiye from May through December 2022. The service was developed by mapping problems using theTheoretical Domains Framework and selecting related behavioural change techniques. The primary outcome was the change in the scores on the Turkish version of the Family Caregiver Medication Administration Hassles Scale (FCMAHS-TR) from baseline to the one-month follow-up assessment. Secondary outcomes were their ability to read health related materials, care burden, and satisfaction. Among family caregivers (n = 100), total score of FCMAHS-TR was significantly reduced after receiving theory based pharmaceutical care service (median [IQR]23.0 [17.0-27.0] vs 17.0 [10.3-20.0]; p < 0.001). The proportion of family caregivers with high ability to read health related materials was significantly increased (34.0% vs 48.0%; p < 0.05) with non-significant change in the proportion of family caregiver with high burden (97.0% vs 94.0%; p > 0.05). Younger family caregivers had significantly higher scores on the Turkish version of Patient-Oriented Pharmacy Services Questionnaire (PSPSQ) 2.0 when compared with the older ones (≥ 65 y) (p < 0.05). Family caregivers' medication administration problems werereduced after receiving thetheory based pharmaceutical care service. Long term impact and national implementation of this service should be assessed in the further studies.

Investigating novel thin-film nanocomposite membranes for sustainable water recovery using fertilizer-driven forward osmosis – Experimental and machine learning approaches

Water recovery from municipal wastewater can augment freshwater resources to meet increasing demand. An osmotic-driven membrane separation process- forward osmosis (FO) is currently being explored as a sustainable technology. This work proposes to address the challenges associated with FO namely (i) robust membrane and (ii) draw solute (DS) recovery. Robust thin-film nanocomposite membranes incorporating a) nickel ferrite or b) nitrogen-enriched nanoporous polytriazine (NENP-1) covalent organic framework were fabricated with enhanced hydrophilicity, surface roughness and anti-fouling properties. The optimum membranes M2 and C2 displayed a pure water flux of 4.86 ± 0.11 and 5.4 ± 0.2 L/m2h respectively and a specific reverse solute flux (SRSF) <<1 when using 1 M NaCl solution as the DS (feed solution – DI water). Fertilizer-driven FO (FDFO) was proposed as the diluted DS need not be recovered but could be used directly for irrigation. The pure water flux for both M2 and C2 membranes were in the following order for the fertilizers used as DS (1 M) - (NH4)2SO4 + (NH₄)₂HPO₄ > (NH4)2SO4 > (NH₄)₂HPO₄ which indicates that the mixed ions in the DS enhanced the water permeance. In all cases, the SRSF was < 1 g/L indicating the feasibility of the process. The membranes exhibited a TOC removal of > 90 % from synthetic municipal wastewater containing persistent organic pollutants and personal & pharmaceutical care products and the membranes could be regenerated after washing with a 10 mM solution of SDS for 5 cycles of operation. Further, ANN was used to develop a predictive model for water flux in FO membranes and the optimized architecture of 7–5–50–40–1 displayed a remarkable overall R2 value of 0.98 (MSE= 0.027). The FDFO process using the fabricated thin-film nanocomposite membranes holds enormous potential to be investigated in larger-scale studies.

Indirect photodegradation of pharmaceutical and personal care products in dissolved black carbon solution: The role of microheterogeneous distribution of hydroxyl radical and sorption

Dissolved black carbon (DBC) with a hyperconjugated structure is ubiquitous in nature, and plays a crucial role in the migration and transformation of environmental contaminants due to its prominent properties of accepting electrons and sorption. However, little is known about the DBC-induced phototransformation of pharmaceutical and personal care products (PPCPs) in natural waters. Herein, the photodegradation kinetics of PPCPs were investigated in DBC solution under simulated solar irradiation and compared with those in Suwannee River natural organic matter (SRNOM) solution. The decay rates for the positively charged PPCPs (mean 1.484 ± 0.041 h-1) were significantly higher than those for the negatively charged PPCPs (mean 0.014 ± 0.002 h-1) in DBC solution due to the charge interaction. Moreover, the decay rates for the positively charged PPCPs in DBC solution were approximately 3–16 times of those in SRNOM solution due to the discrepant sorption and ability to produce bonded HO•. Finally, a microheterogeneous photodegradation mechanism of HO•-labile PPCPs in DBC solution involving the sorption and subsequent reaction with bonded HO• in the DBC microphase was proposed, which was verified using isopropanol and isopropamide as selective HO• scavengers. This work will provide useful insights into the photochemistry of DBC and also the DBC-involved phototransformation of PPCPs in aquatic environments.

[Artículo traducido] Adherencia al tratamiento con quimioterapia oral en pacientes con cáncer de pulmón no microcítico localmente avanzado o metastásico: protocolo para un estudio de vida real realizado en farmacia hospitalaria

ObjectiveThis article describes a study protocol for evaluating adherence to oral chemotherapy (OCT) in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) in Spain. MethodsThis multicenter, observational, prospective study will be conducted by six hospital pharmacists from six Spanish hospitals. The study will include men and women aged 18 years or older with a diagnosis of locally advanced or metastatic NSCLC who are being treated or have been prescribed OCT. Once included, the patient will be active and prospectively followed up for 3 months, including four study visits to record information on sociodemographic variables, antineoplastic treatment and adherence, pharmaceutical care, clinical variables, and patient-reported outcomes (PRO) (the 3-level version of EQ-5D, the EORTC Core Quality of Life Questionnaire, the Brief Illness Perception Questionnaire, the Treatment Satisfaction with Medicines Questionnaire, and the PRO version of Common Terminology Criteria for Adverse Events). Twelve months after patient inclusion, we will record information on the disease progression status and dispensed prescriptions. The primary outcome is the percentage of treatment adherence that will be calculated based on the pill count as follows: the difference between the number of pills dispensed minus the number of unused pills will be divided by the number of days of treatment multiplied by the number of pills/day prescribed by the oncologist; this quotient will be multiplied by 100 to obtain the percentage of adherence. Based on the that pill count reconciliation, those with a percentage adherence greater than80% will be primarily categorized as adherent. Secondarily, treatment adherence will be also calculated based on the proportion of days covered and the 4-items Morisky Green Levine Medication Adherence Scale. To analyze the impact of patients' and treatment characteristics on adherence, bivariate analyses will be performed using different adherence cut-off points. To evaluate the impact of adherence on treatment efficacy as evaluated by progression-free survival, we will be using the Kaplan–Meier method and compare it with the log-rank test and univariate Cox regression analysis. ConclusionsWe expect that our study will provide initial information on key aspects of adherence to OCT (measurement, facilitators, and barriers) and its relationship with patients' and clinically relevant outcomes in the setting of NSCLC, and that this information will help in designing pharmaceutical interventions to improve adherence.

Innovative healthcare solutions for resource-limited settings expanding pharmaceutical care to remote populations

Access to essential healthcare and pharmaceutical services remains a significant challenge in resource-limited settings. This paper explores innovative strategies for expanding pharmaceutical care to remote populations, focusing on the integration of mobile health technologies and community-based interventions. Mobile health (mHealth) technologies, including telemedicine and mobile pharmacies, offer a cost-effective means of delivering healthcare services, enhancing access, and improving real-time monitoring. Community-based interventions, such as the deployment of community health workers, health education campaigns, and peer support groups, play a critical role in addressing healthcare disparities and improving health literacy and medication adherence. The paper also discusses the integration of pharmaceutical care models, emphasizing the importance of collaboration among healthcare providers, pharmacists, and community health workers. Future directions highlight emerging innovations like AI and blockchain technology, while policy recommendations emphasize the need for investment in healthcare infrastructure, professional training, and regulatory support. By leveraging these strategies and innovations, healthcare outcomes and equity in resource-limited settings can significantly improve.

МАРКЕТИНГОВЫЙ АНАЛИЗ АССОРТИМЕНТА ОСНОВНЫХ МОНОПРЕПАРАТОВ, ПРИМЕНЯЕМЫХ ДЛЯ ТЕРАПИИ РАССТРОЙСТВ СНА

In recent years, many studies have noted that the number of occurrence of various sleep disorders is increasing among the population, while such problems as self-medication, untimely access to a doctor, the presence of concomitant diseases, the development of acute forms of disorders into chronic ones are highlighted, all this affects the quality and life expectancy of the population and makes it relevant to study pharmacotherapy of drugs for the treatment of these disorders in the field of pharmaceutical care [1-6; 11]. The purpose of the study was to establish a list and conduct a marketing analysis of the assortment of the main groups of monopreparations used for the treatment of sleep disorders presented on the domestic pharmaceutical market for their subsequent use in more extensive comprehensive marketing research in the context of sleep disorder therapy. The materials for the study were data from the State Register of Medicines and regulatory documents reflecting the attitude of objects to accounting and control of their sale on the market. The following methods were used: comparisons, systematization, grouping, statistics, as well as structural and assortment analyses. The article presents the results of a study of the Russian market of monopreparations of this orientation. The systematization of the main monopreparations was carried out, as a result, 7 groups were identified, which include 25 international nonproprietary names of medicines represented by 78 trade names, the proportion of manufactured drugs within each group and relative to the total number of trade names were calculated. The next step was to analyze the conditions for the release of drugs, their inclusion in lists reflecting accounting and control during implementation in accordance with regulatory documentation. In conclusion, it is noted that the obtained ranking data and the corresponding calculations will serve as a basis for further research in the field of the pharmaceutical market of drugs used for sleep disorders.

Enhancing Patient Counselling in Community Pharmacy Setting: Strategies, Challenges, and Best Practices Points : A Review

Patient counselling is their fore an interaction between care provider and patient during which the patient is provided with information about the health condition, medications etc. Patient counselling as a component of pharmaceutical care delivery can provide the launching pad for increased recognition of the role of pharmacist as care giver. Patient counselling is a vital component of community pharmacy practice, influencing medication adherence, health outcomes, and patient satisfaction. However, pharmacists face numerous challenges in providing effective counselling. This presentation aims to explore strategies, challenges, and best practices for enhancing patient counselling in community pharmacy settings, ultimately improving patient care and health outcomes. A comprehensive review of literature and expert opinions identified key strategies, challenges, and best practices for patient counselling. These include effective communication skills, patient- centered care, medication therapy management, technology integration, and inter-professional collaboration. Enhancing patient counselling in community pharmacy settings requires a multifaceted approach. By adopting effective strategies, addressing challenges, and implementing best practices, pharmacists can improve patient outcomes, satisfaction, and adherence to medication regimens.