Pharmacy Research Articles

National Recommendations for Pharmacoeconomic Evaluations Reporting for Reimbursement and Procurement of New Pharmaceutical Applications in Egypt.

To improve resource allocation within our healthcare system, the Egyptian Authority for Unified Procurement, Medical Supply and the Management of Medical Technology (UPA) and Universal Health Insurance Authority (UHIA) established a joint economic evaluation process to support UHIA reimbursement decisions and UPA procurement decisions. The main objective of this study is to describe the developed national pharmacoeconomic guidelines in Egypt, especially for reimbursement and procurement for new pharmaceuticals. A focus group was formed as a national initiative activity by governmental authorities in Egypt. The aim of this focus group was to develop national pharmacoeconomic guidelines for the evaluation of innovative and high-budget pharmaceutical products. This group consisted of various stakeholders with experience in health economics, outcomes research, public health, and pharmacy practice. To develop our national pharmacoeconomic guidelines, three steps were taken. First, the focus group reviewed the European Network for Health Technology Assessment (EUnetHTA) methods for health economic evaluations for new pharmaceuticals as well as the Canadian Agency for Drugs and Technologies in Health (CADTH) guidelines and the Academy of Managed Care Pharmacy (AMCP) Format for Formulary Submissions. Second, the focus group used the EUnetHTA guideline as a reference and adapted it to our local context. The focus group added the value assessment component, using the CADTH and AMCP guidelines. Third, the focus group collected input and feedback from key stakeholders through a focus group by using the quasi-Delphi panel approach. The results of the focus group are a main structure of national pharmacoeconomic guidelines for the evaluation of innovative and high-budget pharmaceutical products, consisting of seven main topics. Economic evaluation is a core element of Health Technology Assessment, (HTA); therefore, the UHIA and UPA were encouraged to produce unified joint pharmacoeconomic guidelines for innovative products as an initial step in their commitment to implement the use of HTA in decision-making. This standardization of guidelines not only ensures transparency but also guarantees an accurate and transparent process to support evidence-based decision-making. These guidelines are expected to help decision-makers improve their process and attain better health outcomes for Egyptian patients.

Concordance between pharmacy dispensing and electronic monitoring data of direct oral anticoagulants - A secondary analysis of the MAAESTRO study

BackgroundDirect oral anticoagulants are the preferred treatment for stroke patients with atrial fibrillation. Pharmacy dispensing data represent a practical method to identify suboptimal medication adherence. ObjectiveThis study investigates whether pharmacy dispensing data are indicative of real-life adherence behavior, using data from 130 patients in the MAAESTRO study (2018–2022) in Basel, Switzerland. MethodsThis secondary data analysis of the MAAESTRO study (Dietrich, 2024) included patients with electronic monitoring (EM) and dispensing data for 12 months. Patients with at least two refills were included in the analysis.We categorized refill series into three adherence patterns using the Delta T method (Baumgartner, 2022): all refills on time, erratic refills, end-gaps ≥10 days. EM-adherence was assessed through “taking adherence” and “missing days” (24h without intake). We analyzed: i) all dispensing data (“all refills”); ii) all data independently of the MAAESTRO phase (“all phases”); iii) the last two dispensing data (“last”), and iv) EM data from the MAAESTRO phase that match the date of the last refill (“matched”). Associations between refill patterns and adherence were examined using Spearman correlation and Fisher's exact test. ResultsData analyzed from 50 patients (mean age 76.4 ± 9.1 years, 56.0 % male) included 252 refills with a median of 4 refills per patient. Refill patterns were: all refills on time (40.0 %), erratic refills (36.0 %), and end-gaps >10 days (24.0 %). Mean taking adherence was 89.3 ± 13.7 %. EM data revealed missing days in 82.0 % of patients, with 61.0 % having irregular refill patterns. Matched taking adherence was moderately associated with Delta T over all refills (p = 0.034) and the last refill (p = 0.013). ConclusionsDispensing data processed with the Delta T method correlate moderately with EM data. The Delta T value for the last two refills shows promise for estimating irregular adherence, suggesting potential for targeted interventions in pharmacy practice.

Medication Disposal Patterns and Practices with Awareness of Environmental Contamination Caused by Pharmaceuticals among the General Public in Malaysia.

The proper disposal of pharmaceuticals has become a prime concern in contemporary healthcare and environmental management. The evolving awareness highlights the ecological and public health risks associated with pharmaceutical waste. Therefore, evaluating medication disposal patterns and public awareness regarding pharmaceutical-related environmental issues is crucial for promoting responsible practices. The primary aim of this study is to identify the determinants of participation in the Medicine Return Program (MRP) among Malaysians. This cross-sectional study employed snowball sampling and an online questionnaire, disseminated via multiple social media platforms. Results: Out of 389 respondents, 46% were 18 to 29 years old, 61% were female, and 69.7% attained a tertiary educational level. Most of them (71.5%) reported disposing of their unused medicines into the rubbish bin, indicating that this disposal method is prevalent among Malaysians. Only 26.2% participated in the MRP program. The study revealed that 73.0% of respondents were aware of pharmaceutical-related environmental contamination. Furthermore, significant associations were demonstrated between a factor of receiving advice from healthcare professionals (p < 0.001), awareness level on environmental pharmaceutical contamination (p < 0.001) and MRP (p < 0.001) and willingness to participate in MRP (p < 0.001) with MRP support. This study provides valuable insights on Malaysian pharmaceutical disposal practices and the factors influencing MRP participation. These findings can inform targeted interventions and public health campaigns to improve medication disposal behaviors and reduce pharmaceutical waste's environmental impact.

Impact of VA Hematology/Oncology Clinical Pharmacy Practitioners in the Review of Community Prescriptions for Specialty Medications.

Within the US Department of Veterans Affairs (VA), eligible veterans can receive covered health care through the community care network. Many prescriptions for specialty medications made by community care prescribers are filled by outpatient VA pharmacies. Trained hematology/oncology clinical pharmacy practitioners (CPPs) review specialty medication prescriptions from community-based prescribers. This study's primary objective was to evaluate clinical interventions initiated by hematology/oncology CPPs at the Veterans Affairs North Texas Health Care System (VANTHCS) during their review of hematology/oncology specialty prescriptions from community care prescribers. A retrospective chart review of VANTHCS patients enrolled in the community care program with a specialty hematology/oncology prescription received and reviewed by a VA clinical hematology/oncology CPP was conducted for records from January 1, 2015, to June 30, 2023. The primary outcome was the number and types of clinical interventions. Secondary outcomes include the number of interventions accepted and/or denied by the prescriber and the financial implications of these interventions. Two hundred twenty-one specialty hematology/oncology prescriptions met the study inclusion criteria. VANTHCS hematology/oncology CPPs completed clinical interventions for 82 prescriptions (37%). Among those prescriptions, CPPs documented 97 clinical interventions. The most commonly documented interventions included managing/preventing a drug interaction (26%) and dose adjustment requests (25%). Hematology/oncology CPPs at VANTHCS are essential in reviewing anticancer medication prescriptions from community-based practitioners ; CPPs completed clinical interventions for more than one-third of the prescriptions and prescribers approved most of these interventions.

CRITICAL ANALYSIS OF CLAIMS IN DRUG PROMOTIONAL LITERATURE AVAILABLE TO MEDICAL PRACTITIONERS

Context: Objective: To ascertain whether the pharmaceutical companies are following the World Health Organisation (WHO) criteria for Ethical Medicinal Drug Promotion 2015 and Organisation of Pharmaceutical Producers of India (OPPI) Code of Pharmaceutical Marketing Practices, 2019 and to what extent. Also, to evaluate the therapeutic claims made by them in their drug promotional literature (DPL) and to classify them. Methods: DPL brochures were collected from different pharmaceutical companies from various medical practitioners and assessed for ethical promotion based on guidelines. Therapeutic claims made by them were classified as authentic, exaggerated, controversial, false, misinterpreted, and ambiguous. Results: A total of 100 DPLs were collected and critically analyzed for authenticity of the content. It was observed that the majority of the DPLs did not comply with the criteria mentioned in the WHO Criteria of Ethical Promotion 2015 and the OPPI Code of Pharmaceutical Practices 2019. International non-proprietary names and the brand name were mentioned by 100% of DPLs. The amount of active ingredients and approved therapeutic indications were mentioned by (99%) and (96%) respectively. The dosage form or regimen was mentioned by 87% of DPLs. Criteria like side effects, precautions/contraindications, and major interactions were mentioned in 28%, 29%, and 14% respectively. Based on the therapeutic claims 23% of the DPLs were found to be authentic and the remaining 77% were extravagant. Conclusions: This study enabled us to find out to what extent the pharmaceutical industries follow the standard criteria for DPL and evaluate the claims made by them. The majority of the DPLs did not follow ethical guidelines and were inadequate in terms of their adequacy, quality, and reliability.

Understanding antibiotic purchasing practices in community pharmacies: A potential driver of emerging antimicrobial resistance

IntroductionAntimicrobial resistance (AMR), a transboundary health issue, critically impacting low- and middle-income countries (LMICs) where 80% of antibiotics are used in the community, with 20–50% being inappropriate. Southeast-Asia, including Bangladesh, faces heightened AMR risk due to suboptimal healthcare standard and unregulated antibiotic sales. This study aimed to audit antibiotic dispensing patterns from community pharmacies, identifying factors influencing purchasing behaviors. MethodsA cross-sectional survey of 385 antibiotic customers and structured observations of 1000 pharmacy dispensing events were conducted in four urban and rural areas in Bangladesh. Descriptive analysis defined antibiotic use, while Poisson regression examined how patients' demographics and health symptoms influenced prescription behaviors. ResultsAmong 1000 observed medicine dispensing events, 25.9% were antibiotics. Commonly purchased antibiotics included macrolides (22.8%), third-generation-cephalosporins (20.8%), and second-generation-cephalosporins (16.9%). Following WHO-AWaRe classifications, 73.5% of antibiotics were categorized as Watch, and 23.1% as Access. From the survey, 56.6% antibiotics were purchased without a prescription from drug-sellers and informal healthcare providers, primarily for “non-severe” health-symptoms such as upper-respiratory-tract infections (37.4%), fever (31.7%), uncomplicated skin infections (20%), gastrointestinal-infections (11.2%), and urinary-tract infections (7.9%). The likelihood of presenting a prescription while purchasing antibiotics was 27% lower for individuals aged 6–59 compared to those ≤5 or ≥ 60. Lower-respiratory-tract infections and enteric-fever had higher prescription rates, with adjusted prevalence ratios of 1.78 (95% CI: 1.04, 3.03) and 1.87 (95% CI: 1.07, 3.29), respectively. After adjusting for confounders, sex, urban-rural locations, income, education, and number of health-symptoms exhibited no significant influence on prescription likelihood. ConclusionThis study underscores unregulated antibiotic sales without prescriptions, urging tailored interventions considering prevailing health-seeking practices in diverse healthcare settings in LMICs. Enforcing prescription-only regulations is hindered by easy access through community pharmacies and conflicts of interest. Future strategies should consider how stewardship impacts the financial interests of pharmacy personnel in settings lacking clear authority to ensure optimal compliance.

Correlating Advanced Pharmacy Practice Experience Exam Scores and Pharmacist Licensure Status in a Single Program

ObjectivePharmacist licensure exam first-time pass rates have declined for several years. Predictors of licensure exam performance, including the Pharmacy College Admission Test, are no longer required, necessitating alternative strategies. Our aim is to assess the relationship between numerical scores on advanced pharmacy practice experience (APPE) exams and pharmacist licensure exams first-time pass rates. MethodsWe conducted a single-center, retrospective, observational analysis. APPE examination results between May 2020 and November 2023 were analyzed for association with licensure information from the Texas State Board of Pharmacy. Exam scores were collected for student cohorts graduating from 2021 to 2022 as study cohort data. Correlation between exam scores and probability of successful licensure was assessed using logistic regression. A classification and regression tree analysis identified the most significant threshold. Predictive ability of the best-fit model was prospectively validated using the 2023 graduate cohort. ResultsThe overall licensure success rate was 80.6% for the study cohort (2021–2022, n = 206). Exam scores were well correlated to the likelihood of licensing success. The most significant threshold was 77.8%. The success rate was 82.5% vs 16.7% for those scoring above and below the threshold, respectively. The observed and predicted licensure success rates were 91.0% and 88.8%, respectively, in the validation cohort (2023, n = 89). The positive and negative prediction values were 94.9% and 40.0%, respectively. ConclusionThe performances on APPE exams were reasonable in predicting the first-time licensure success rate for a graduating class. Our assessment appears promising as a risk-stratification tool for students in gaining successful pharmacist licensure.

Best practice in dementia health care: Key clinical practice pointers from a national conference and innovative opportunities for pharmacy practice

ObjectiveSub-optimal care of people living with dementia has serious consequences for older populations. The 2021 Australian Royal Commission noted that a large proportion of older adults in aged care live with dementia, yet there are limitations in the knowledge and understanding of staff who care for them. In the pursuit of educating pharmacists, physicians, allied health care professionals, researchers, academics, people living with dementia and their carers, and the public, who are facing the challenges of dementia management, the ‘Best Practice in Dementia Health Care’ conference was held on November 10, 2022 at Western Health (Sunshine Hospital, Melbourne, Australia). MethodsSixteen experts presented on the current practice and challenges associated with delivering best practice dementia health care to older Australians, often highlighting how medication-related challenges impacted on their area of practice. ResultsPresenters highlighted the importance of individualised medication management plans, considerations of culture and Indigenous communities, the role of technology, and the impact of exercise and the physical environment on care of people living with dementia. Key clinical practice messages from each expert presenter fit into four main topics: ‘navigating complexities of medication management’; ‘enhancing wellbeing’; ‘supportive settings and environments’; and ‘programs and services improving care’. ConclusionsPharmacists are crucial members of allied health care teams. They have the necessary medication and comorbidity expertise to review medication regimens, liaise with all health care providers, and provide holistic, pharmacological and non-pharmacological patient education. Towards providing best practice dementia health care, pharmacists can contribute in several ways, such as providing health practitioner education to increase understanding about medications and how they can impact on allied health practice, to ensure that medications are prescribed appropriately and safely. Further, pharmacists can make available resources to ensure people living with dementia receive culturally safe and appropriate care, while advocating for greater understanding of the history and experiences of people living with dementia to ensure care aligns with their day-to-day routines. Finally, pharmacists can provide peer-support to other health care professionals and care staff to ensure optimal management of behavioural and psychological symptoms of dementia. The information and insights shared at the conference can serve as a valuable resource for pharmacists and other health care professionals and researchers working to improve the lives of those living with dementia.

Improving malaria case management with artemisinin-based combination therapies and malaria rapid diagnostic tests in private medicine retail outlets in sub-Saharan Africa: A systematic review.

Private medicine retailers (PMRs) such as pharmacies and drug stores account for a substantial share of treatment-seeking for fever and malaria, but there are widespread concerns about quality of care, including inadequate access to malaria rapid diagnostic tests (RDTs) and artemisinin-based combination therapies (ACTs). This review synthesizes evidence on the effectiveness of interventions to improve malaria case management in PMRs in sub-Saharan Africa (PROSPERO #2021:CRD42021253564). We included quantitative studies evaluating interventions supporting RDT and/or ACT sales by PMR staff, with a historical or contemporaneous control group, and outcomes related to care received. We searched Medline Ovid, Embase Ovid, Global Health Ovid, Econlit Ovid and the Cochrane Library; unpublished studies were identified by contacting key informants. We conducted a narrative synthesis by intervention category. We included 41 papers, relating to 34 studies. There was strong evidence that small and large-scale ACT subsidy programmes (without RDTs) increased the market share of quality-assured ACT in PMRs, including among rural and poorer groups, with increases of over 30 percentage points in most settings. Interventions to introduce or enhance RDT use in PMRs led to RDT uptake among febrile clients of over two-thirds and dispensing according to RDT result of over three quarters, though some studies had much poorer results. Introducing Integrated Community Case Management (iCCM) was also effective in improving malaria case management. However, there were no eligible studies on RDT or iCCM implementation at large scale. There was limited evidence that PMR accreditation (without RDTs) increased ACT uptake. Key evidence gaps include evaluations of RDTs and iCCM at large scale, evaluations of interventions including use of digital technologies, and robust studies of accreditation and other broader PMR interventions.

Preceptor Feedback on Utilization and Pre-APPE Performance Expectations of Pharmacy Practice Skills

ObjectiveThis study aimed to determine the frequency with which preceptors perform skills in their practice setting and the degree of competency that preceptors expect from students to perform those skills upon starting their advanced pharmacy practice experiences (APPEs). MethodsA survey assessing skill utilization and expected pre-APPE student competency level upon entry to APPEs was developed by pharmacy practice faculty and distributed to preceptors. Preceptors were asked to rank their utilization of skills and expected pre-APPE student competency of each skill. Investigators assigned each skill a categorical ranking of high, moderate, or low priority. ResultsThe survey was completed by 448 pharmacy preceptors. Skills related to communication, patient education, documentation, collecting medication histories, and drug therapy review/reconciliation were the most utilized. Skills related to physical assessment and point-of-care testing were the least utilized, and the expected student competency level was also low. Skills identified as highest-priority included those related to patient counseling/education, problem-solving/critical thinking, and information gathering and management. ConclusionThe results of this survey suggest that the frequency with which preceptors perform specific skills in practice and their corresponding competency expectations for APPE students vary and are skill-dependent, allowing for prioritization. Stratifying individual skills according to how commonly they are encountered in practice and the competency levels expected by APPE preceptors can assist institutions in prioritizing skills-based laboratory content and assessment and in addressing curricular bloat and hoarding.

Identifying gaps in communication skills between pharmacy curricula and pharmacy practice

Identifying gaps in communication skills between pharmacy curricula and pharmacy practice

Trend analysis of pharmacist involvement in cancer care in Japan from 2015 to 2020: A nationwide survey study on hospital pharmacy practice.

Pharmacists are needed as members of oncology teams. The Japanese Society of Hospital Pharmacists (JSHP) conducts a nationwide survey annually to analyze the actual situation and generate fundamental information about hospital pharmacy practice in Japan. Using data from this large-scale survey, we described pharmacists' involvement in cancer chemotherapy. We explored the factors related to the acceleration of pharmacists' tasks or involvement in clinical practice, primarily in oncology. Data were obtained from annual surveys conducted by JSHP from 2015 to 2020. All variables were expressed as categorical variables and tabulated. The Chi-square and Fisher's exact tests were used to compare the categorical variables. The Cochran-Armitage trend test was used to identify significant trends. From 2015 to 2020, 22,362 responses were recorded. After applying the exclusion criteria, 20,906 were analyzed. The proportion of hospitals enrolling pharmacists with oncology-related certifications significantly increased in all hospitals providing cancer care. Multivariable logistic regression analysis indicated that a smaller number of beds per pharmacist significantly correlated with additional fees for outpatient pharmacy services (p = 0.0002 for trend). Hospitals charging increased fees for outpatient oncology pharmacy services were associated with a smaller number of beds per pharmacist, regardless of hospital size. A balance between the number of beds and pharmacists, particularly certified oncology pharmacists, is crucial for safe and high-quality cancer treatment.

Challenges and Opportunities in Access to Essential Medicines in Rural Uganda

Access to essential medicines in rural Uganda is hindered by multifaceted challenges related to infrastructure, logistics, regulatory frameworks, and financial constraints. Poor road networks and inadequate transportation systems delay the delivery of medicines, while storage and supply chain management issues compromise medication quality and availability. Human resource shortages further impede distribution efforts, alongside financial limitations that affect procurement and sustainability. Regulatory reforms aimed at enhancing pharmacy practice have improved standards but pose implementation challenges. This review article employed a comprehensive literature review and analysis of existing research, policy documents, and case studies related to access to essential medicines in rural Uganda. Despite these obstacles, opportunities such as community-based interventions, technological innovations like mHealth, and public-private partnerships (PPPs) offer promising avenues to address these barriers. Strategic investments in infrastructure, regulatory compliance, and sustainable funding are crucial to improving access to essential medicines and healthcare outcomes in rural Uganda. Keywords: Essential Medicines Access, Rural Healthcare Challenges, Pharmacy Regulation Uganda, Medication Distribution Logistics, Public-Private Partnerships Healthcare

The Impact of Motivational Interviewing and MOTIVE Tool Use by Pharmacists on Vaccine Acceptance.

Vaccines have played a significant role in reducing infectious disease burden. However, vaccine hesitancy remains a persistent challenge in public health, including for pharmacists who often interact with patients regarding vaccines. Thus, this study assesses the impact of motivational interviewing (MI) training and the MI-based vaccine hesitancy discussion tools (MOTIVE) on pharmacists' management of vaccine hesitancy. Pharmacists in eight Midwestern pharmacy practices who completed MI and MOTIVE training and engaged with vaccine-hesitant patients participated in this study. The pharmacist participants completed post-encounter surveys identifying the vaccine discussed, the tool utilized, and the outcome of the conversation. Descriptive results from 362 encounters indicated that the primary reasons for hesitancy were safety (39%), care coordination (31.5%), and efficacy (30.4%). Post encounter, 35.4% of patients received vaccines, 26% planned to, 25.1% considered it, and 13.5% were uninterested. The findings highlight the importance of patient-centered communication, such as MI, between patients and pharmacists to identify and address reasons for vaccine hesitancy. Pharmacists, equipped with conversation tools such as the MOTIVE tools, may effectively influence vaccine acceptance. Future research should evaluate the utility of MI and the MOTIVE tools in other settings and regions.

Perception on hematology/oncology pharmacy practice and education needs in Nigeria: A national survey.

Nigeria is a low-middle income country located in sub-Saharan Africa. Although cancer burden has continued to increase over time, there is a lack of pharmacists who specialize in oncology providing pharmaceutical care. The objectives of this study were to understand the perception of hematology/oncology pharmacy practice in Nigeria as well as the unmet education needs. This is a cross-sectional survey conducted in December 2023. Pharmacists who were active members of various pharmacy organizations in Nigeria were invited to complete the survey. The survey focused on the perceptions of training needs in oncology pharmacy, current challenges and opportunities, as well as resources and support needed. Descriptive statistics were utilized for the data analysis. Of the 263 responders, the largest group fell between 25 and 34 years old (35%), over half received a Bachelor of Pharmacy as their highest degree (53%), and majority did not receive any oncology pharmacy training as part of their education (73%). Many respondents strongly agreed that pharmacists in Nigeria need specialized training to better serve cancer patients (79%). Cancer therapeutics and chemotherapy pharmacology were more prioritized compared to other training needs (mean (SD): 2.63(1.95) and 2.69(1.64), respectively). The main challenge that respondents faced was a lack of relevant skills and knowledge in oncology pharmacy (mean (SD): 2.23(1.53)). More than a fourth of the respondents were aware about the board certification process (28.8%), citing overcoming the cost barrier as the main obstacle for taking the board examination (mean (SD): 1.92 (1.38)). Respondents preferred online courses and onsite specialty training (75%) as the mode of training to address unmet needs. Despite the challenges and unmet education needs in hematology/oncology clinical practice, Nigerian pharmacists are very willing to expand their knowledge and improve their skills in patient care. The findings of this study can inform policy makers, healthcare administrators, and pharmacy educators in developing global partnerships among pharmacy organizations which employ targeted strategies like sponsorships to address such unmet needs.

Equity, diversity, and inclusion in oncology pharmacy practice: Everyone's business.

Equity, Diversity, and Inclusion (EDI) is gaining increased attention within all industries healthcare being no exception. The terminology Equity, Diversity, and Inclusion and its abbreviation EDI gained popularity in the early 2000's when varied socio-political factors prompted many organisations to examine EDI concepts and how to operationalise them. The growing diversity of our society requires cross-cultural inclusive approaches to increase equity and access to services. This unique research is community-led research supported by the British Oncology Pharmacy Association, in which the members of the BOPA community are equal partners to inform action on policies that address EDI. This research was a cross-sectional study involving an online survey of financial BOPA members. Demographic data was extracted, and the quotes were analysed for common themes. The majority of respondents were women, and the largest age group was between 34 and 44. The first cause of microaggressions identified by the respondents was of racial and ethnic origin, followed by marital status and religious nature. Participants described the lack of diversity in senior positions and the microaggressions experienced by those who hold leadership positions. Some participants described how some situations at work made them feel excluded or alienated. The impact of discrimination and bullying/microaggressions extended to patients was also reported. Despite strategic directions encompassing this aspect, this research underscores the pressing need for more evidence on the lack of EDI in healthcare institutions. Our findings, located in the pharmacy oncology specialty, have identified the problem and highlighted the potential benefits of addressing it. More needs to be done in training and professional development to address unconscious bias and change behaviours.

Drug-related problems among breastfeeding patients treated for depressive spectrum disorders.

Depressive spectrum disorders are common and can hinder breastfeeding success. While medications typically pose minimal risk, the concerns persist. This is the first study that investigates the prevalence and characteristics of drug-related problems among breastfeeding mothers with depressive spectrum disorders. We analyzed those problems to understand their nature, severity, and contributing factors. Additionally, we evaluated the outcomes of pharmacist-led interventions in reducing them. Understanding drug-related problems is crucial for informing evidence-based practices to optimize both maternal mental health and breastfeeding success. This prospective observational study was conducted at a specialized pharmacy office in Poznan, Poland, which focuses on lactation support and medication consultations. 47 breastfeeding patients were enrolled. Pharmaceutical consultations were conducted according to Joint Commission of Pharmacy Practitioners Pharmacists' Patient Care Process standards. Novel MILC Questionnaire was used for efficient and optimal pharmaceutical interview. Drug-related problems were assessed basing on PCNE Classification System version 9.1. For adverse events in lactation, MedDRA v27 nomenclature was used; for causality, Naranjo Scale and LCAT were utilized. CTCAE was used for grading. Among the 47 patients, pharmacist identified 49 medication-related problems, with inadequate treatment effect due to underdosing or not taking the medication at all being the most common (57.1%). Pharmacist interventions focused on medication safety information and counseling. Overall, 78.7% of patients accepted these interventions, resulting in problem resolution for 71.4%. Twelve mothers (25.5%) reported adverse events in their infants, but after causality evaluation, only four (8.5%) might have been linked to maternal medication. None required medical intervention beyond one hospitalization for a serious adverse event possibly connected to maternal medication. The study identified high rates of drug-related problems among breastfeeding mothers with depression, primarily due to non-adherence. Pharmacist interventions significantly improved DRP outcomes. Adverse events were reported, but most were mild and did not require intervention. Our findings suggest that lactating mothers with depressive spectrum disorders may benefit from pharmacist-led support to optimize treatment adherence and address medication safety concern.

Revealing the synergetic influence of pharmaceutical marketing strategies on physician prescription patterns: a moderated mediation investigation

PurposeThis study aims to investigate the combined impact of pharmaceutical marketing strategies, specifically free drug samples and interactions with medical representatives, on physicians’ attitudes and prescribing behavior in Jammu and Kashmir, India.Design/methodology/approachTo achieve this objective, data were collected from a sample comprising 425 physicians. A six-point forced-choice Likert scale was used for data collection, and cluster sampling techniques were used in the study design.FindingsThe study reveals significant insights into pharmaceutical marketing’s influence on physician behavior. Free drug samples exert a positive influence on both physician attitudes and prescribing behavior. Physicians’ attitudes, in turn, significantly affect their prescribing decisions. Mediation analysis demonstrates that free drug samples indirectly influence prescribing behavior through shifts in physician attitudes. Effective medical representatives amplify this influence, as stronger associations between free drug samples and physician attitudes are observed when representatives are more effective.Originality/valueThis research contributes by unraveling the intricate dynamics between marketing strategies, physician attitudes and prescribing behavior in Jammu and Kashmir, India. It underscores the importance of ethical pharmaceutical marketing practices, highlighting the substantial role of free drug samples and the crucial function of effective medical representatives in shaping physician behavior. Ultimately, this study sheds light on how responsible pharmaceutical marketing and adept medical representatives can improve health-care outcomes in the region.

Design and Refinement of a Faculty Workload Estimator

ObjectiveThis paper describes the creation and refinement of a Workload Estimator to be used at Colleges/Schools of pharmacy to calculate faculty workload. MethodsWe describe the initial development of the Workload Estimator for pharmacy practice faculty, including the consensus-building methodology and the implementation process. Additionally, we describe the annual refinement and expansion of use to pharmaceutical and administrative sciences faculty. ResultsThe final product is an Excel file with built-in multiplication factors used to estimate pharmacy faculty workload. ConclusionThis Workload Estimator was identified as the most comprehensive and readily adaptable tool to estimate pharmacy faculty workload in July 2023 by the American Association of Colleges of Pharmacy, Council of Faculties, and Council of Deans Task Force on Faculty Workload. The Workload Estimator is currently being studied in a multi-institutional implementation study across dozens of diverse programs across the country with norming data and qualitative perspectives on its use being collected and shared with the Academy in 2024.

Libyan Pharmacy Professionals' Knowledge, Attitudes and Practices Regarding Generic Substitution for Prescribed Brand Medications

Libyan Pharmacy Professionals' Knowledge, Attitudes and Practices Regarding Generic Substitution for Prescribed Brand Medications