Information Pharmacists Research Articles

A comparison of drug information question responses by a drug information center and by ChatGPT.

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. A study was conducted to assess the accuracy and ability of Chat Generative Pre-trained Transformer (ChatGPT) to systematically respond to drug information inquiries relative to responses of a drug information center (DIC). Ten drug information questions answered by the DIC in 2022 or 2023 were selected for analysis. Three pharmacists created new ChatGPT accounts and submitted each question to ChatGPT at the same time. Each question was submitted twice to identify consistency in responses. Two days later, the same process was conducted by a fourth pharmacist. Phase 1 of data analysis consisted of a drug information pharmacist assessing all 84 ChatGPT responses for accuracy relative to the DIC responses. In phase 2, 10 ChatGPT responses were selected to be assessed by 3 blinded reviewers. Reviewers utilized an 8-question predetermined rubric to evaluate the ChatGPT and DIC responses. When comparing the ChatGPT responses (n = 84) to the DIC responses, ChatGPT had an overall accuracy rate of 50%. Accuracy across the different question types varied. In regards to the overall blinded score, ChatGPT responses scored higher than the responses by the DIC according to the rubric (overall scores of 67.5% and 55.0%, respectively). The DIC responses scored higher in the categories of references mentioned and references identified. Responses generated by ChatGPT have been found to be better than those created by a DIC in clarity and readability; however, the accuracy of ChatGPT responses was lacking. ChatGPT responses to drug information questions would need to be carefully reviewed for accuracy and completeness.

Enhancing older Veterans' care: Insights from medication reviews and deprescribing interventions

BackgroundPatient experience during and after health care is a critical indicator of quality of care that encompasses effective communication, respect, dignity, and emotional support. However, qualitative studies exploring the experiences of older adults after deprescribing interventions are sparse, highlighting a knowledge gap. This project seeks to address this gap by exploring Veterans’ experiences during and after a deprescribing intervention provided by a pharmacist.This study aims to: 1. Assess Veteran's experience of the process of their Comprehensive Medication Review and deprescribing intervention visit; 2. Assess the Veteran's experience with the outcomes of their Comprehensive Medication Review and deprescribing intervention. MethodData was collected from 17 Veterans through semi-structured interviews using an interview guide. The Veteran Affairs study site utilizes the VIONE polypharmacy risk calculator to identify high-risk Veterans; the majority of these Veterans were on at least 10 medications. The interview transcripts were analyzed using inductive content analysis. Two research team members independently coded the data for categories and themes. Similarities were identified, and any divergence was discussed and resolved. To enhance the validity of the findings, member checking was performed with Veterans to confirm the results. Result and discussionMost Veterans viewed the process of the pharmacists' visits and recommendations positively. They expressed confidence in pharmacists' knowledge and instructions. They appreciated the clarity of information pharmacists provided about the purpose, proper administration, and interactions of their medications. These enhanced the Veterans’ ability to manage their medication regime. They also desired an increased frequency of interactions with their pharmacist due to these positive interactions. Veterans appreciated interprofessional collaboration between pharmacists, physicians, and other providers. Veterans expressed how pivotal lab test results were for evaluating medication recommendations and effectiveness. Most Veterans reported positive outcomes and/or indicated there were no negative effects as a result of their recent medication changes. Some reported seeking additional information from their providers regarding suggested medication changes to validate recommendations. There was some uncertainty about whether there would be follow-up visits with the professional after the medication change and who should initiate this. A minority indicated problems associated with prior medication discontinuation before the deprescribing intervention and how this limited their openness to future opportunities of deprescribing. ConclusionThis exploration of Veterans' experiences with the process and outcomes of a deprescribing service affirms its importance and overall success in this site as part of the unique publicly funded Veteran healthcare system in the US. Equally important, the positive Veteran response suggests the value of exploring its potential to benefit patients experiencing polypharmacy across a range of other sites and systems.

Nurses’ knowledge and practice regarding mixing medications with food: a multicenter cross-sectional study from a developing country

BackgroundDifferent pharmaceutical characteristics of the dosage form (DF) have a direct effect on how easily oral solid medicine is swallowed. The practice of crushing tablets or opening the capsule occurs daily in the hospital, and most nurses are unknowledgeable regarding these issues. Coadministration of medications with food can cause changes in drug absorption and lead to an alteration in gastrointestinal motility, which can cause an unexpected effect on the dissolution and absorption of the drug. Therefore, this study aimed to investigate nurses' knowledge and practices regarding the mixing of medications with food or drink in Palestine.MethodsFrom June 2019 to April 2020, a cross-sectional study was conducted, encompassing nurses working in government hospitals across various districts of Palestine. The data were collected through face-to-face interviews, using questionnaires that assessed nurses' understanding and implementation of mixing medications with food. The sampling method employed was convenience sampling. To analyze the gathered information, the Statistical Package for the Social Sciences version 21 (IBM-SPSS) was utilized.ResultsA total of 200 nurses participated in the study. The data show a significant difference between the median knowledge scores according to the department of work (p < 0.001). The highest median [interquartile] knowledge score of 15 [12–15] was found for nurses working in the neonatal intensive care unit. In addition, nurses in the pediatric ward and the men’s medical ward had high scores of 13 [11.5–15] and 13 [11–14], respectively. In general, the results show that 88% of nurses modified oral DF prior to administration to patients. Regarding the type of food used, mixing medicine into juice was the most common procedure performed by nurses (approximately 84%); 35% of nurses used orange juice to mix with medicine. The most common reason for crushing was to administer medications to patients with a nasogastric tube (41.5%). In regard to medications, aspirin was the most frequently used drug that was crushed by the nurses (44%); however, 35.5% of nurses did not feel sufficiently trained to carry out this practice. Concerning the sources of information, 58% of nurses usually asked pharmacists for information about medications.ConclusionsThe results of this study show that crushing and mixing medications with food is common among nurses, and most nurses are unaware of the dangerous effect of this practice on patient health. Pharmacists, as medication experts, should participate in sharing knowledge about unnecessary crushing situations or when crushing should be avoided and try to find an alternative, when available, to aid administration.

Patients' Perceptions on Community Pharmacy Services of a Ward (10) of Kathmandu Metropolitan.

Community pharmacists' role is shifting from product-oriented function towards patient-centered care. The patient-centered role of pharmacists is undervalued, as the public is unaware of pharmacists' role. This study aims to identify patients' perceptions and satisfaction with pharmaceutical care services and factors affecting their preferences for community pharmacy services. A quantitative cross-sectional study was conducted for three months on patients visiting registered community pharmacies in Kathmandu metropolitan ward number 10. Out of 406 participants, 30.5% perceive pharmacists to have a balance between business and health aspects of pharmacy practices; 29.1% view them as drug experts; and 11.8% consider pharmacists to be more concerned with business. 43.8% of participants were found to discuss their drug-related queries with pharmacists, possibly due to low treatment costs. Approximately 77% of respondents had no hesitancy when contacting pharmacists for health-related information because they believed pharmacists were sufficiently qualified to address drug-related questions. Around 88% of respondents agreed that the role of pharmacists is to counsel the patient about the directions for the use of medications. The level of satisfaction indicated that 72.4% are highly satisfied with pharmacy services. In addition, patients feel comfortable discussing their health with pharmacists due to their ability to protect the privacy of their medical records. In contrast, more trust in doctors seems to be the most common barrier for patients visiting pharmacists. Overall, pharmacists were regarded as the most trusted health care personnel to contact. However, to facilitate the expansion of pharmaceutical care services, the public should be aware of their distinctive professional talents. It is recommended for future researchers to understand the subjective perspective of pharmacy staff, managers, and pharmaceutical policy makers.

Pharmacists' role in detection and evaluation of adverse drug reactions: Developing proactive systems for pharmacosurveillance.

To identify current challenges in detection of medication-related symptoms, and review technology-based opportunities to increase the patient-centeredness of postmarketing pharmacosurveillance to promote more accountable, safer, patient-friendly, and equitable medication prescribing. Pharmacists have an important role to play in detection and evaluation of adverse drug reactions (ADRs). The pharmacist's role in medication management should extend beyond simply dispensing drugs, and this article delineates the rationale and proactive approaches for pharmacist detection and assessment of ADRs. We describe a stepwise approach for assessment, best practices, and lessons learned from a pharmacist-led randomized trial, the CEDAR (Calling for Detection of Adverse Drug Reactions) project. Health systems need to be redesigned to more fully utilize health information technologies and pharmacists in detecting and responding to ADRs.

Patient Perceptions of Switching to a Generic Dry Powder Inhaler - Increased Understanding Through Journey Mapping.

PurposeThis qualitative study explored patients’ attitudes about and perceptions of generic dry powder inhaler (DPI) substitution for the brand product and patients’ views of generic product quality, efficacy, design, and usability.MethodsForty COPD and asthma patients (36 adults, four adolescents), who were actively using a brand DPI product, participated in one of six focus groups. Participants completed a journey mapping exercise to assess attitudes and opinions about a scenario where they refill their prescription and unexpectedly receive a generic DPI instead of their brand DPI. The focus groups were audio recorded, transcribed, and analyzed thematically.ResultsThe hypothetical scenario of unexpectedly receiving a generic DPI elicited mixed feelings including: happiness and relief about potential cost savings, confusion, disappointment, anger, and/or frustration with the unexpected switch. Participants in most groups anticipated anxiety or hesitation in using the generic DPI due to concerns about potential differences in usability, uncertainty about correct use, and questions about efficacy. Participants across all groups said they would ask a pharmacist or healthcare provider for information or answers to their questions, and some participants said they would use online resources. When participants held the brand and generic DPI devices, most preferred the brand DPI device and found it easier, less cumbersome, or more convenient to use (due to size and weight). However, many participants reiterated that the potential reduced cost of the generic DPI would be a primary factor in their decision-making related to generic DPI substitution for their brand DPI.ConclusionPatients experienced a mixture of positive and negative feelings when faced with an unexpected generic DPI substitution. Some patients have doubts about their ability to successfully navigate differences in generic device design, and most expressed the desire to participate in discussions and decision-making with their HCP about generic DPI sameness and substitution.

Pharmacy Infection Control: Pharmacoepidemiology and infection control surveillance

PTB Reports,2022,8,2,77-83.DOI:10.5530/PTB.2022.8.10Published:July 2022Type:Review ArticleAuthors:Dr. Yousef Ahmed Alomi, Anhar Alyousef, Mohammed Mominul Islam, Nahed Rashid Alyami, Maha Hussein Almadany, and Fatimah Abdaziz Almana Author(s) affiliations:Dr. Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE Critical Care Clinical Pharmacists TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor, and Data Analyst, Riyadh, SAUDI ARABIA. Anhar Alyousef, Pharm D Innova Healthcare Company, Riyadh, SAUDI ARABIA. Mohammed Mominul Islam, MBBS, MPH, MSc, Deputy Director, Department of Infection Prevention and Control (IPC), King Fahad Specialist Hospital, Tabuk, SAUDI ARABIA. Nahed Rashid Alyami, BSc, Mphil, BCPS, BCCCP, CPHQ Head of Clinical Pharmacy Unit, ID and ICU Senior Clinical Pharmacist, Jubail General Hospital, Jubail, SAUDI ARABIA. Maha Hussein Almadany, BSc. Pharm. Health Care Quality Management Professional Diploma (HCQM), Pharmacy Quality, Department King Salman bin Abdulaziz Medical City, Al Madina Al Monwarah, SAUDI ARABIA. Fatimah Abdaziz Almana, BSc, MSc, MSHA, King Fahad Specialist Hospital, Dammam, SAUDI ARABIA. Abstract:Objectives: Pharmacoepidemiology and infection control surveillance is an initiative that provides insights into pharmacy infection control. It involves various guidelines and policies that must be followed to ensure the pharmacy environment and workplace are secured from infections. Different approaches have been considered for the measures to be effective. Documentation of pharmacy practices in every area of the pharmacy department is vital in controlling the pharmacy infections. This study aimed to explore the pharmacoepidemiology and infection control surveillance policy in pharmacy practice as a new initiative in Saudi Arabia. Methods: It is a narrative review of pharmacoepidemiology and infection control surveillance pharmacy practice. Litterateur searched. A literature search was performed using various databases, including PubMed, Medline, and Google Scholar, about specific pharmacy practice infection control policies and procedures. The search period was from the 1960s until October 2021. The terms were in English and included narrative review, systemic review, metaanalysis, and guidelines across all hospitals and community pharmacy services. Moreover, the national and international guidelines of were searched that relates to the study objectives. The committee of pharmacy research formulated and consisted of various experts, including clinical pharmacists, drug information pharmacists, and infection control specialists. Some authors drafted the policy guidelines, and others reviewed and corrected them. The additional author, an infection control specialist, revised the final document. The study emphasizes the pharmacoepidemiology and infection control surveillance of the Pharmacy infection control policy. Results: The Pharmacoepidemiology and infection control surveillance policy consisted of pharmacoepidemiology and infection control surveillance steps in pharmacy practice. The pharmacoepidemiology and infection control surveillance contained multiple performances: infected prepared medications, type of bugs, and sensitivity patterns to medications. In addition to the number of spillage cleaning and needle-stick injuries, the number of cross-tarnsmission of infections. Besides, the search also included adherence to infection control guidelines. Conclusion: Pharmacoepidemiology and infection control surveillance policy is a new pharmacy infection prevention and control initiative. The pharmacoepidemiology and infection control surveillance policy enhances the infection control documentation system. Additionally, it encourages pharmacists to follow infection prevention and control regulations in various locations throughout the public and healthcare systems. Therefore, pharmacoepidemiology and infection control surveillance policies strongly recommend Saudi Arabian pharmacy pratices. Keywords:Control, Infection, Pharmacoepidemiology, Pharmacy, SurveillanceView:PDF (268.25 KB) PDF PDF Images Pharmacoepimedilogy and infection control surveillances steps flow chart.

Use of an Innovative Pharmaceutical Class Scoring Tool for Prioritized Annual Formulary Review.

Background: Though The Joint Commission requires health systems perform annual formulary review, guidance for how to perform this review is lacking. Published methods include comprehensive review of all pharmaceutical classes; however, this approach may not be the most efficient or effective option for a health system with a large formulary. Objective: To create a prioritization system for annual formulary review through development of a pharmaceutical class scoring tool. Methods: Drug information pharmacists developed the scoring tool, which used external and internal data to score pharmaceutical classes in 4 categories: safety, efficacy, cost, and utilization. The primary outcome, number of formulary changes resulting from pharmaceutical class review, was compared between the highest-scoring and lowest-scoring class to assess the tool's ability to prioritize high-yield class reviews. Results: The tool calculated scores for 91 pharmaceutical classes, altogether containing 962 medications. After review of the highest-scoring class, corticosteroids, 2 formulary changes were made: one dosage form was removed from formulary, and one medication was restricted to outpatient use only. Zero formulary changes resulted from review of the lowest-scoring class, pharmaceutical adjuvants. Conclusions: The tool described in this study prioritized annual formulary review efforts by identifying a pharmaceutical class with meaningful formulary optimization opportunities as the highest-scoring class, while correctly identifying a class with no optimization opportunities as the lowest-scoring class.

Education and Training Research Policy in Pharmacy Practice

International Journal of Pharmacology and Clinical Sciences,2022,11,2,48-55.DOI:10.5530/ijpcs.2022.11.10Published:June 2022Type:Review ArticleAuthors:Yousef Ahmed Alomi, Amal Hassan Al-Najjar, Maha Hussein Almadany, and Abeer Hussin Almasoudi Author(s) affiliations:Yousef Ahmed Alomi*, BSc.Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, CDE Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor, and Data Analyst, Riyadh, SAUDI ARABIA. Amal Hassan Al-Najjar, BSc, MSc,Drug and Poison Information Center, Security Forces Hospitals, Riyadh, SAUDI ARABIA. Maha Hussein Almadany, BSc. Pharm. Health Care Quality Management Professional Diploma (HCQM), Pharmacy Quality Department, King Salman bin Abdulaziz Medical City, Al Madina Al Monwarah, SAUDI ARABIA. Abeer Hussin Almasoudi, BSc.Pharm Director, Administration of Research and Studies, Ministry of Health, Tabuk, SAUDI ARABIA. Abstract:Objectives: This study explores the Research policy of Research Education and Training in pharmacy practice as a new initiative in Saudi Arabia. Methods: The current topic is a narrative review of education and training procedures in pharmacy research. Litterateur was searched in various databases. That includes PubMed, Medline, Google Scholar, and academic Microsoft. The period covered for the search is from the 1960s to October 2021. The terms used are in the English language and encompass narrative reviews, systemic reviews, meta-analyses, and guidelines. The search keyword includes all hospital and community pharmacy-related services. Moreover, there are national and international guidelines for conducting general research in research in pharmacy practice. The committee of pharmacy research was formed and comprised numerous expert members, including clinical pharmacists, drug information pharmacists, and clinical research specialists. A member drafted the policy’s guidelines, which were then reviewed and corrected by another member. The research specialist made the third revision. The topic emphasizes the Pharmacy Research policy of Research Education and Training. Results: Pharmacy Research’s policy on Research Education and Training covered various topics, including the program objectives, admission requirements, teaching, educational methodology, and steps in pharmacy practice involving research, education, and training. Five models were used in research education and training. For instance, skills in searching for and reviewing the literature, research design and methodology, survey design, biostatistics, and research proposal writing. In addition, each model included a description of the module and Learning Objectives, Module Outlines, and Competency Items. Conclusion: The pharmacy research policy is a new initiative and a component of the pharmacy strategic plan. The Research Education and Training pharmacy policy aims to enhance pharmacists’ research abilities and encourage pharmacists to conduct various types of research in multiple settings within the public and healthcare sectors. Therefore, the Research Education and Training policy are critical for the pharmacy career in Saudi Arabia. Keywords:Education, Pharmacy, Policy, Research, Saudi Arabia, TrainingView:PDF (152.94 KB) PDFClick here to download the PDF file. Images Education and Training Research Policy in Pharmacy Practice

Medicine Maker: An Outreach Activity for Pharmaceutical Manufacturing and Health Literacy.

Public engagement in medicine has become more important in promoting population health management and literacy. Medicine is a topic of great societal importance, and many public engagement activities have been developed to promote this area. However, they often narrowly focus on patient groups, diseases, a singular pharmaceutical drug or analytical technique. Despite the importance of these activities, general audiences are still heavily reliant on doctors and pharmacists for information about their medicine and lack basic knowledge around medication use and personal safety. Given this, a broader engagement approach is warranted to target health literacy among the wider public. “Medicine Maker” is a hands-on public engagement workshop that provides audiences with the opportunity to “manufacture” and inspect the quality of proxy or “dummy” medicine through guided inquiry. Here, we detail the development of the Medicine Maker workshop from its origins in the teaching of Irish third-level pharmacy students, to its initial application with a variety of lay audiences. Formal and informal feedback from participants indicates that the workshop can help foster a more critical understanding of medicine manufacturing, quality control, and personal health.

Analysis of consumption trends of antibacterial and antivirus medicines in pharmacies during COVID-19 pandemic in Ukraine

Rational pharmacotherapy of COVID-19 in the world, treatment protocols, prescriptions of antibacterial (AB), antiviral (AV) medicines have been systematically improved due to updated data of evidence-based medicine.&#x0D; The study aim was to analyze the trends of AB, AV consumption for outpatients with confirmed COVID-19: to study the reasons of the growing demand for AB, AV; optimization of pharmaceutical care directions for rational cost-effectiveness use, prevention antibiotic resistance.&#x0D; Methods – the survey on consumption trends of AB and AV, side effects of AB; survey data of 205 pharmacists, 5 regions of Ukraine; pharmacoeconomic analysis «cost-minimization», content analysis of instructions, side effects.&#x0D; Analysis of surveys showed that the demand on AB, AV increased by 50.1% to 2019, such groups: beta-lactams, respiratory fluoroquinolones, macrolides. We found the most often were released: azithromycin, cefoperazone, cefipime, piperacillin with tazobactam, meropenem.&#x0D; Pharmacists noted that patients often used AB, AV without a prescriptions, it complicates the release from pharmacies. So it is necessary to implement e-prescriptions for AB, AV for monitoring of effectiveness, side effects, to prevent antibiotic resistance in pandemic.&#x0D; We found 53.7% of pharmacists noted about insufficient of trade names, stocks of AB and AV. It is the difficulties to provide outpatients with covid-19.&#x0D; Content-analysis data showed the most common side effects during AB course. We identified the main directions of information pharmacist providing to prevent side effects, antibiotic resistance.&#x0D; We conducted the demand for AV, AV medicines increased by 50.1% vs to 2019. It was identified the AB groups, trade names in high demand. Used pharmacoeconomic analysis «cost-minimization», we established that depending on the manufacturer, an antibiotic course costs differ by 15.1 times. The necessity of including in the list of the reimbursement program «Affordable Medicines» the essential AB, AV, to reduce costs for COVID-19 outpatients was substantiated.&#x0D; We showed 83,1% of pharmacists consider the need of approval, implementation of «Protocol for symptomatic treatment of uncomplicated forms of COVID-19». It will improve the results of pharmaceutical care for COVID-19 patients due to GPP requirements.

Impact of clinical pharmacist on medication adherence among psoriasis patients: A randomized controlled study

BackgroundPsoriasis is a chronic inflammatory disease and requires long term management due to which patients become non-adherent to the therapy. Hence this study aims to assess the impact of clinical pharmacists to improve medication adherence in patients with psoriasis. Materials and methodsThis is a randomized controlled study conducted at a tertiary care teaching hospital in the dermatology department, among 68 patients. Aged 18–65 years from the outpatient department diagnosed with psoriasis disease and on treatment were enrolled in the study. Patients with multiple co-morbidities like HIV, hepatitis B/C, and vulnerable populations like lactating and pregnant women are excluded from the study. Enrolled patients are then randomized after taking the Informed consent form. The interventional groups of patients were provided with a patient information leaflet and pharmacist education and counselling along with standard care. Medication adherence of the patients was evaluated at the baseline level to the follow-up after 1 month. ResultsTotal of 68 were enrolled in the study, out of which 63 completed the study. There was no difference observed at the pre-test in both the groups. After the intervention, there was a significant difference in the experimental group after post-test (U = 200.00, p = 0.0001). Adherence was improved in the experimental group. ConclusionThere is a need for clinical pharmacists in providing the patients with knowledge about long term disease management like psoriasis. The implement of specialty pharmacists in dermatological disorders is an excellent choice to address the unattended needs of the patient.

Construction of a platform for the transformation from general pharmacists to information pharmacists using the quality control circle

Objective： To explore and construct a platform for the transformation from general pharmacists to information pharmacists using quality control circle（QCC） activities.Methods： The QCC activities were applied to the whole training process of information pharmacists.Training started through the approach of having the pharmacists learn programming sentences，and program writing was finally completed after continuous exploration.Results： Through QCC activities，3 information pharmacists were initially trained，the writing of 2 programs were completed and a set of standard training profiles was summarized.Conclusion： The QCC activities could be used for pharmacy management and personnel training.It is particularly the case when more difficult targets are set for the work.Compared with the general team，the team implementing the QCC is more resolute and clearer in work goals and more liable to complete the project.

Patient perspectives of pharmacists prescribing HIV pre-exposure prophylaxis: A survey of patients receiving antiretroviral therapy

BackgroundGroundbreaking new laws granting community pharmacists the authority to prescribe human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) medications have the potential to substantially expand PrEP access in high-risk communities. However, whether patients will be accepting of pharmacists as PrEP providers is underexplored within the literature. ObjectivesTo assess patient perspectives of pharmacist PrEP prescribing and identify potential barriers to acceptance of pharmacist-prescribed PrEP. MethodsAdult patients currently receiving antiretroviral therapy for HIV prophylaxis or treatment at a specialty pharmacy were surveyed telephonically from January 2020-April 2020. A 4-point Likert scale was used to measure perceptions in addition to open-ended questions. ResultsThe participation rate was 87.5%. Of the 49 included patients, 100% agreed/strongly agreed that pharmacists were knowledgeable about medications, but they were less likely to strongly agree that pharmacists were knowledgeable about HIV drugs (14.3% vs. 75.5% for other drugs, P < 0.001). Most (93.9%) of the patients agreed/strongly agreed that they would feel comfortable seeking a pharmacist for PrEP information or HIV testing. With respect to PrEP prescribing, 16.3% disagreed that they would feel comfortable having a pharmacist prescribe their first fill of PrEP, preferring to speak to their physician or expressing concerns that pharmacists have inadequate training. All patients expressed a desire for additional HIV/PrEP training requirements for pharmacists before allowing them to prescribe PrEP. A portion of the respondents (18.4%) expressed concerns that the increased availability of PrEP would lead to persons becoming lax about barrier protection. However, 100% of the patients agreed/strongly agreed that having pharmacist-prescribed PrEP would benefit their community. ConclusionPatients receiving antiretroviral therapy reported overall favorable perceptions of pharmacist PrEP prescribing; however, some concerns relating to pharmacists’ level of training in HIV exist. This may be ameliorated through increased pharmacist education, including how to counsel patients seeking PrEP on behavioral risk reduction.

Inpatient Perioperative Formulary Restriction of Intravenous Acetaminophen at Vizient Partner Hospitals: A National Survey of Pharmacists.

Purpose: Despite potential benefits of intravenous (i.v.) administration of acetaminophen (APAP), consistent outcome data are lacking. This, combined with the higher acquisition cost of the drug, has led to variation in i.v. APAP management strategies. This project evaluated the contemporary formulary status and restrictions of i.v. APAP in the perioperative setting. Methods: A survey focusing on i.v. APAP formulary restriction in the perioperative setting was developed by the Vizient Pharmacy Research Committee and distributed to Vizient Pharmacy Program participant listservs for Pharmacy Directors or Drug Information Pharmacists. The four survey domains included hospital characteristics, perioperative i.v. APAP formulary status and prescribing restrictions, perioperative i.v. APAP use, and perioperative i.v. APAP medication use evaluation (MUE) results. Responses were collected and summarized, and primary outcomes were evaluated using Fisher's exact test. Results: A total of 1195 surveys were distributed with a response rate of 19%. Respondents were equally distributed between academic medical centers (AMC) and non-academic medical centers (non-AMC). Two cohorts were examined: those with i.v. APAP on formulary and those without. The non-AMCs showed a larger proportion of hospitals with the medication on formulary (P = .041). Regarding formulary decision-making, the AMCs were more considerate of value. Several different practices were employed to limit or restrict i.v. APAP. Conclusion: A survey of directors of pharmacy and drug information specialists revealed that the majority of hospitals have i.v. APAP on formulary for perioperative use, but use is restricted. Differences in i.v. APAP formulary practices between AMCs and non-AMCs warrant further consideration.

Prescriber-Initiated Engagement of Pharmacists for Information and Intervention in Programs of All-Inclusive Care for the Elderly.

Little is known about the types of drug information inquiries (DIIs) prescribers caring for older adults ask pharmacists during routine practice. The objective of this research was to analyze the types of DIIs prescribing clinicians of Programs of All-Inclusive Care for the Elderly (PACE) made to clinical pharmacists during routine patient care. This was a retrospective analysis of documented pharmacists’ encounters with PACE prescribers between March through December, 2018. DIIs were classified using a developed taxonomy that describes prescribers’ motivations for consulting with pharmacists and their drug information needs. Prescribers made 414 DIIs during the study period. Medication safety concerns motivated the majority of prescribers’ inquiries (223, 53.9%). Inquiries received frequently involved modifying drug therapy (94, 22.7%), identifying or resolving adverse drug events (75, 18.1%), selecting or adjusting doses (61, 14.7%), selecting new drug therapies (57, 13.8%), and identifying or resolving drug interactions (52, 12.6%). Central nervous system medications (e.g., antidepressants and opioids), were involved in 38.6% (n = 160) of all DIIs. When answering DIIs, pharmacists made 389 recommendations. Start alternative medications (18.0%), start new medications (16.7%), and change doses (12.1%) were the most frequent recommendations rendered. Prescribers implemented at least 79.3% (n = 268) of recommendations based on pharmacy records (n = 338 verifiable recommendations). During clinical practice, PACE prescribers commonly ask pharmacists a variety of DIIs, largely related to medication safety concerns. In response to these DIIs, pharmacists provide medication management recommendations, which are largely implemented by prescribers.

Medication information and supply behaviours in elite and developing athletes

ObjectivesTo investigate the behaviours of elite and developing athletes in obtaining medications and medication information, and to identify the role of pharmacists in athlete care. DesignCross-sectional survey. MethodsAn electronic, 39-item questionnaire was developed, piloted and distributed to elite and developing athletes aged 18 years and above at a state-based sporting institute. Quantitative data was analysed using descriptive statistics and free text comments were analysed using an inductive reasoning approach. ResultsA total of 98 responses were analysed. Ninety (n=90/98, 91.84%) participants obtained medications in the six months prior to survey completion. Pharmacies were the most common source of both prescription (n=67/69, 97.10%) and non-prescription medications (n=64/75, 85.33%). Forty-five (n=45/98, 45.92%) participants also attended pharmacies when they had a minor ailment. Sixty-two (n=62/98, 63.27%) participants ‘sometimes’ consulted pharmacists for medication information. Only 11 (n=11/98, 11.22%) knew, according to their sporting institute medication policy, that athletes were required to consult a medical practitioner before taking anti-inflammatory, pain-relieving or sleep-inducing medications. Forty (n=40/98, 40.82%) participants believed pharmacists could play a role in their medication management. ConclusionsMany elite and developing athletes visited pharmacies for medication supply and treatment of minor ailments. Doping regulatory agency websites were the most commonly used and trusted sources for medication information, although some athletes believed pharmacists could also contribute to their medication management. Future research should consider whether pharmacists are ready for a role in sports pharmacy.

Patient Feedback on a Warfarin Action Plan Used in a Local Australian Physician Practice Setting.

Warfarin is a high-risk medicine, and older persons (those aged 65 years and older)1,2 who take this therapy need medicines information about it that is at a level which is both understandable and comprehensive to improve their knowledge about the risks and benefits of warfarin therapy.3,4 Therefore, the primary objective of this study was to report patient feedback on a Warfarin Action Plan (WAP) (leaflet) and identify patients' preferences regarding its content and format. The secondary objective was to canvass in-depth feedback regarding the participants' information needs and current information-seeking practices with respect to warfarin therapy. In an Australian General Practice medical centre setting, a qualitative study comprising 34 individual interviews was conducted. Emergent themes were elicited via a qualitative analysis using manual inductive coding. The majority of participants gave very positive feedback on the WAP leaflet, stating that it was a useful and concise resource. In canvasing this feedback, 4 themes emerged: (1) the need for information about warfarin therapy, (2) reliance on doctors and/or pharmacists for information, (3) the need for information to normalize their daily life, and (4) patients and carers acting on the new information. The WAP is a simple and well-received tool that meets the knowledge and education needs about warfarin therapy for older people and their carers.

National Survey of Pharmacy and Therapeutic Committee in Saudi Arabia: Evaluation of Drug Formulary and Decision-Making

International Journal of Pharmacology and Clinical Sciences,2019,8,4,232-236.DOI:10.5530/ijpcs.2019.8.51Published:December 2019Type:Research ArticleAuthors:Yousef Ahmed Alomi, Sultan Mohammed Al-Jarallah, Rasha Abdelsalam Elshenawy, and Faiz A Bahadig Rph Author(s) affiliations:Yousef Ahmed Alomi*, The Former General Manager of General Administration of Pharmaceutical Care, The Former Head, National Clinical Pharmacy and Pharmacy Practice, The Former Head, Pharmacy R & D Administration, Ministry of Health, Riyadh, SAUDI ARABIA. Sultan Mohammed Al-Jarallah, Head, Ambulatory Care Pharmacy, Oncology and Hematology Clinical Pharmacist, Pharmaceutical Care Department, Security Forces Hospital, Riyadh, SAUDI ARABIA. Rasha Abdelsalam Elshenawy, BCS. Pharm. BCPS (AQ-ID), CPHQ, M.Sc., TQM (AUC), SIDP, CEO of FADIC, Ministry of Health, Makkah, SAUDI ARABIA. Faiz A Bahadig Rph, (BSC-Pharm, MBA), Informatics Pharmacist, Pharmaceutical Care Department, King Abdulaziz Medical, City-WR-Jeddah, Ministry of National Guard, SAUDI ARABIA. Abstract:Objective: Ministry of Health (MOH) hospitals in Saudi Arabia should develop, organize and administer a formulary system that follows the principles to optimize patient care by ensuring access to clinically appropriate, safe and cost-effective medications. This can be achieved through the Pharmacy and Therapeutic Committee’s (PTC) role in the evaluation of hospital’s drug formulary and decision-making. The primary purposes of the PTC are policy development, communication and education and formulary management. Therefore, in this study, we aimed to explore the hospital drug formulary evaluation and decision-making at MOH hospitals in Saudi Arabia. Methods: This is a 4-month cross-sectional national survey of PTC at MOH hospitals in Saudi Arabia. The survey consisted of two parts: the first part collected demographic information and the second part consisted on 93 questions divided into four domains. An electronic survey was distributed to all drug information centers at MOH hospitals and analyzed the evaluation of drug formulary and decision-making through the Survey Monkey system. Results: A total of 50 drug information centers responded to the questionnaire (100%). Restricted drug usage (3.88), new drug entities (3.74), new dosage form (3.6) and new strength (3.6) were the majority of the requests for inclusion in the formulary. A total of 1-3 medications were evaluated monthly by the PTC at 41 (82%) hospitals. Most of the healthcare providers were allowed to request for the addition or deletion of medications: PTC members 38 (76%), attending medical staff 35 (70%), pharmacy staff 10 (20%) and formulary subcommittees 10 (20%). The formal economic analysis of the drug formulary revision was rarely or never conducted at 26 (42%) hospitals. The responsible person for the economic evaluation was drug information pharmacist (21 (42%)), pharmacy department (nonspecific) (17 (34%)) and the pharmacy and medical department (14 (28%)). Conclusion: Evaluation of hospital’s drug formulary and decision-making was not adequate at the majority of the hospitals. Education and training about drug evaluation with an emphasis on cost analysis and impact are mandatory. An electronic addition new medications with close formulary is required with close monitoring for all MOH hospitals in Saudi Arabia. Keywords:Decision-Making, Drug Formulary, Evaluation, Ministry of Health, National Pharmacy and Therapeutic Committee, Saudi ArabiaView:PDF (202.48 KB) PDFClick here to download the PDF file. Images The formulary management system.

Patient Feedback on a Warfarin Action Plan Used in a Local Australian Physician Practice Setting.

Warfarin is a high-risk medicine, and older persons (those aged 65 years and older)1,2 who take this therapy need medicines information about it that is at a level which is both understandable and comprehensive to improve their knowledge about the risks and benefits of warfarin therapy.3,4 Therefore, the primary objective of this study was to report patient feedback on a Warfarin Action Plan (WAP) (leaflet) and identify patients' preferences regarding its content and format. The secondary objective was to canvass in-depth feedback regarding the participants' information needs and current information-seeking practices with respect to warfarin therapy. In an Australian General Practice medical centre setting, a qualitative study comprising 34 individual interviews was conducted. Emergent themes were elicited via a qualitative analysis using manual inductive coding. The majority of participants gave very positive feedback on the WAP leaflet, stating that it was a useful and concise resource. In canvasing this feedback, 4 themes emerged: (1) the need for information about warfarin therapy, (2) reliance on doctors and/or pharmacists for information, (3) the need for information to normalize their daily life, and (4) patients and carers acting on the new information. The WAP is a simple and well-received tool that meets the knowledge and education needs about warfarin therapy for older people and their carers.