Practice Of Pharmacists Research Articles

Development of a medication review intervention by seconding a hospital pharmacist to primary care

BackgroundMedication reviews (MRs) are a well-described initiative that improves health outcomes for polypharmacy patients. However, there is limited knowledge about the performance of medication reviews carried out in general practice especially under the leadership of hospital clinical pharmacists. When developing complex interventions, such as MRs, it is essential to describe the development process to ensure transparency and avoid research waste. ObjectiveThus, this study aimed to describe the steps of developing a new MR intervention targeting general practice to ensure transparency and transferability. MethodsA stepwise approach inspired by the Medical Research Council framework was utilised in the process, covering two of the phases, i.e., development and feasibility, divided into four steps: 1) intervention drafting by a literature search, 2) expert opinion, 3) pilot testing in general practice clinics, and 4) evaluation of quantitative MR data. ResultsBased on the results from the first three steps, four main themes which influenced the success of the MR intervention were identified: general practitioner resources, patient involvement, implementation difficulties and interdisciplinarity. These themes guided the pilot evaluation in step four. ConclusionA new feasible, complex MR intervention utilising clinical pharmacists in general practice involving hospital clinical pharmacists in a real-life setting was developed.

Evaluation of Knowledge, Attitude, and Practice of Community Pharmacists in Managing Chronic Diseases in Lahore, Pakistan

Background: The rising number of chronic illnesses such as asthma, diabetes, osteoarthritis, hypertension, and chronic kidney disease (CKD) presents a major danger to the worldwide health community. The ability of individuals to successfully manage their medical problems with the help of healthcare professionals is essential to the effective control of chronic illnesses. Objective: The current study focuses to evaluate the knowledge of community pharmacist’s regarding chronic disease management, their attitude, and their practice to control chronic diseases. Methods: A cross-sectional survey-based study was conducted using random sampling method in Lahore, Pakistan. The samples collected for this study was 110. However, the final sample size was 93, the remaining forms were discarded. Data was collected by visiting community pharmacies in Lahore. The filled questionnaires were analyzed by using Statistical Package for Social Sciences program software (SPSS Inc., version 21.0, IBM corp., Armonk NY, USA). P-value of less than 0.05 were considered as statistically significant values. Results: The results, with a p value of 0.001, indicate a significant difference in adequacy of knowledge between the male and female groups. Majority of the participants have bachelor’s education and are unmarried. The p-value of 0.871 for level of education shows insignificant association between the higher education and better practice scores. The most important finding in this study is significant relationship between technology proficiency and adequacy of knowledge with p-value of 0.005. This shows that those who are more proficient in the technology are significantly more likely to have adequate knowledge. Conclusion: This study concludes that the majority of community pharmacists had adequate knowledge regarding chronic disease management. But showed neutral attitude and fair practice towards the control of chronic diseases. In order to optimize the management of chronic diseases, community pharmacists need to exhibit best practices and a positive attitude.

Community pharmacists' knowledge and practices towards antimicrobial stewardship: findings and implications.

Antimicrobial stewardship (AMS) programmes have been implemented around the world to optimally manage antimicrobial use to attenuate antimicrobial resistance (AMR). This study assessed the knowledge and practices of community pharmacists towards AMS strategies in the Lusaka District, Zambia. This cross-sectional study was conducted among 194 community pharmacists in the Lusaka district using a structured questionnaire from August 2022 to September 2022. Data analysis was done using Statistical Package for Social Science (SPSS) version 22.0. Of the 194 participants, 86% of the community pharmacists had good knowledge of AMS. The present study found that 83.5% were aware of AMS strategies used in community pharmacy practice. Further, 83.5% of the CPs were familiar with the goals of AMS and 89.2% believed that AMS was necessary for their pharmacy practice. Furthermore, 66.7% of the participants exhibited good practice towards the AMS strategies. Finally, 61.3% frequently avoided the use of broad-spectrum antimicrobials that were not necessary. According to the findings of this study, the majority of community pharmacists had good knowledge of the AMS strategies that were employed to combat AMR; nonetheless, some of them had poor practices. Therefore, there is a need for community pharmacists to have access to sufficient ongoing professional development programmes and educational activities through AMS programmes to address AMR.

Managing opioids and mitigating opioid risks in patients with cancer: An environmental scan of the attitudes, confidence, and practices of ambulatory, community and hospital pharmacists practicing in Canada.

Canada is in the midst of an overdose crisis. The use of prescription opioids in Canada has increased steadily over the past two decades, with stark increases in opioid-induced respiratory depression and related deaths. Opioids are the mainstay of treatment for cancer-related pain. Patients with cancer are not immune to the risks associated with opioid use but are underrepresented in available literature outlining risk mitigation strategies. Pharmacists are ideally placed to employ opioid risk mitigation practices to support safe and effective opioid use for patients with cancer-related pain. However, the current attitudes, confidence, and safety practices of pharmacists around how to best support these patients are not known. This study was a descriptive environmental scan of pharmacists who provide direct patient care in Canada. An electronic questionnaire was built using the web based Opinio software. It was distributed via email by several provincial and national pharmacy organizations and online platforms. The questionnaire consisted of Likert-scale and open-ended questions and was open to participants for a 6-week period from February 12th to March 23rd, 2020. Analysis was conducted using descriptive statistics and qualitative content analysis. Eighty-one responses from pharmacists in nine provinces were included in the analysis. Respondents endorsed limited and varied practices when caring for patients receiving opioids for cancer-related pain. Further, they demonstrated wide ranging confidence and attitudes regarding opioid risk mitigation practices and beliefs. Less than 50% of pharmacists were aware of resources available for their patients with non-medical opioid use, and/or patients at high risk of opioid-induced respiratory depression. Education, resources, and communication were the most commonly reported perceived facilitators and barriers to resource use. Pharmacists in Canada report employing opioid risk mitigation practices with low and varied frequency when caring for patients receiving opioids for cancer-related pain. They endorsed varied confidence and limited awareness of available provider and patient resources. These findings may help inform the development of new education models and evidence-based guidelines. New education models and evidence-based guidelines will support pharmacists in their pharmaceutical care of this vulnerable patient population, ultimately aiming to improve patient outcomes.

Knowledge, attitudes, and practice of physicians and pharmacists regarding the prevention and treatment of cardiovascular toxicity associated with cancer treatment

This study aimed to explore physicians’ and pharmacists’ knowledge, attitudes, and practice (KAP) regarding the prevention and treatment of cardiovascular toxicity associated with cancer treatment. A multicenter cross-sectional study included physicians and pharmacists between April 2023 and June 2023. The study included 918 participants (514 physicians and 404 pharmacists). The average scores of knowledge, attitudes, and practice were 11.6 ± 3.39, 24.7 ± 2.6, and 26.3 ± 6.8 points. Sufficient knowledge was significantly associated with age ≥ 41 years (odds ratio (OR) = 2.745, 95% confidence interval (CI) 1.086–6.941, P = 0.033), male (OR = 2.745, 95% CI 1.150–2.223, P = 0.005), bachelor’s degree (OR = 0.084, 95% CI 0.013–0.533, P = 0.009), master’s degree and above (OR = 0.096, 95% CI 0.015–0.609, P = 0.013), physician occupation (OR = 7.601, 95% CI 1.337–43.207, P = 0.022), pharmacy department (OR = 18.858, 95% CI 3.245–109.57, P = 0.001), oncology department (OR = 4.304, 95% CI 2.426–7.634, P < 0.001), cardiology department (OR = 3.001, 95% CI 1.387–6.492, P = 0.005), hospitals located in Eastern China (OR = 1.957, 95% CI 1.120–3.418, P = 0.018), and hospitals located in Western China (OR = 3.137, 95% CI 1.783–5.518, P < 0.001). Positive attitudes were significantly associated with a senior professional title (OR = 2.989, 95% CI 1.124–7.954, P = 0.028) and hospitals located in Eastern China (OR = 0.424, 95% CI 0.257–0.698, P = 0.001), Western China (OR = 0.231, 95% CI 0.136–0.394, P < 0.001), and Southern China (OR = 0.341, 95% CI 0.198–0.587, P < 0.001). Proactive practice was significantly associated with male (OR = 1.414, 95% CI 1.029–1.943, P = 0.033), senior professional title (OR = 3.838, 95% CI 1.176–12.524, P = 0.026), oncology department (OR = 3.827, 95% CI 2.336–6.272, P < 0.001), and cardiology department (OR = 2.428, 95% CI 1.263–4.669, P = 0.008). Both physicians and pharmacists had positive attitudes toward the prevention and treatment of cardiovascular toxicity associated with cancer treatment, while their knowledge and practice were not as proactive.

Knowledge, Attitudes and Practice About Vitamin Supplements Counseling in Libyan Community Pharmacies

Pharmacists play an important role in the healthcare system and have a greater impact on the outcome of public health programs. Patients who seek vitamin advice presume the role of community pharmacists including the recommendation of effective vitamin supplements. This study aimed to evaluate knowledge, attitudes and professional practices of Libyan community pharmacists in counselling patients about the safe consumption of vitamins. A cross-sectional study was conducted in pharmacies located in Tripoli, Libya between October 2023 and February 2024. Data collection was carried out using semi-structured self-administrated questionnaire. A total of 235 pharmacists participated in this study. The majority (75.3%) of pharmacists believed that a balanced diet is more achievable by eating healthily than by vitamins supplements. 76.6% of participants believed that chronic consumption of certain vitamins would not shorten life spans, while 65.5% agreed that vitamin supplements could be toxic or might contain unlabeled harmful ingredients. Less than half of pharmacists (35.3) were aware that some antioxidant vitamins have been verified to be of unproven value, or may even cause cancer. 80% of pharmacists would recommend vitamins on a regular basis without prescription, the majority agreed that counselling on vitamin supplements is part of their role in pharmaceutical care (94.5%), in addition to providing relevant information to other healthcare professionals (76.6%). Moreover, responses to specific knowledge questions, such as the interactions of vitamins with drugs or the recommended dietary allowance of vitamins for infants, children, and pregnant women, were negative. Furthermore, only a minority of pharmacists (48.5%) would recheck the accuracy of dose regimens in prescriptions and 50.6% of participants would follow up patients to record any consequences of vitamins consumption. The questionnaire revealed satisfactory awareness of community pharmacists about their role in counselling; however, further programmes to update their knowledge are mandatory to emphasise the importance of vitamin supplements as part of complementary medicine, and their exclusion from being considered as merely over the counter (OTC) products.

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.

Pharmaceutical Communication Strategies for Increasing Marketing Outreach During Covid 19 Pandemic

COVID-19 virus proved to be very contagious resulting in a public health emergency by the World Health Organization (WHO), posing overall public health system and governance challenges. Amid the pandemic period and the unprecedented increase in healthcare demands, pharmacy services are an important mainstay to combat the COVID-19 virus pandemic. However, not all pharmacies have inventive and adaptive pharmacist practices, particularly pharmacists working in rural areas. In the present article, we observed how pharmaceutical swiftly acted response in to marketing during the COVID-19 period. The populations of focus were employees in marketing divisions with an emphasis on product sales. The data were obtained through in depth interviews and documentative observations. The findings showed, that the communication transition from offline to online is the emergent strategy followed by establishing and promoting remote pharmacy services. The information and suggestions offered in this manuscript could help in the restructuring of existing pharmacy services by governments, public health bodies, and policymakers in response to a pandemic.

Non-Vitamin K Antagonist Oral Anticoagulant Use in Underrepresented Populations in Atrial Fibrillation: A Survey of Australian Pharmacist Practice

Non-Vitamin K Antagonist Oral Anticoagulant Use in Underrepresented Populations in Atrial Fibrillation: A Survey of Australian Pharmacist Practice

Assessment of the Knowledge and Practice on Safe Handling of Anticancer Drugs among Pharmacists in Iraqi Healthcare Settings

Background: Occupational exposure to hazardous drugs occurs in all aspects of anticancer drug handling. Proper recommendations and guidelines should be applied to control and reduce exposure. Objective: To assess pharmacists' knowledge and practice regarding the safe handling of anticancer drugs. Methods: A cross-sectional study was conducted at seven major hospitals in Baghdad City, Iraq, from December 2023 to February 2024. A pre-designed questionnaire was given to pharmacists who handled anticancer drugs in chemotherapy units. The questionnaire comprises sociodemographic data, knowledge of the safe handling of cytotoxic drugs and thoughts about exposure and risk, practices for safely handling cytotoxic drugs, and challenges for safely handling cytotoxic drugs. Results: A total of 126 pharmacists were enrolled in the study. Less than half of the participants (46%) received training on anticancer drugs. While more than a third (42.9%) of the pharmacists were handling more than 100 cytotoxic preparations weekly, the total knowledge score was 7.14, while the total practice score was 73.36, with less than half of the pharmacists having good knowledge (44.44%) or practice (48.41%). Pharmacists who received training had significantly higher total practice scores than those who did not. Pharmacists with more than 100 weekly preparations were more knowledgeable than those with 50–99 preparations. Conclusions: The majority of participating pharmacists had fair to excellent knowledge and practice regarding the safe handling of cytotoxic medications. However, there were some gaps regarding important knowledge and practice issues. To improve knowledge and practices regarding anticancer handling, training is necessary.

Insight into Current Practices of Community Pharmacists in Topical Corticosteroid Prescribing and Counseling: Cross-Sectional Survey Study from Saudi Arabia.

Topical corticosteroids are commonly used to treat several skin conditions, most notably atopic dermatitis. Many studies have found that patients lack knowledge about the safety, potency, and appropriate use of topical corticosteroids. This can be due to ineffective education by pharmacists and other healthcare providers. This study aims to evaluate the appropriateness of dispensing and counseling practices of community pharmacists towards topical corticosteroids in Saudi Arabia. A cross-sectional survey study was conducted in Saudi Arabia among 418 community pharmacists from different regions of Saudi Arabia. Data were collected using a validated questionnaire that covered community pharmacists' sociodemographic information, their perceptions of patient knowledge about topical corticosteroid use, and their dispensing and their counseling practices, in addition to their perceived barriers to counseling. The majority of the participating community pharmacists were Saudi (57.4%), female (66.7%), holding a bachelor's degree (63.4%), and full-time workers (91.1%). Most of the time, community pharmacists counseled patients on the frequency of application per day and the duration of treatment (75.8% and 74.8%, respectively). The median counseling practice score was 17, with an IQR of 14-21. The main barrier to counseling was lack of time (33.7%). Only 15% of community pharmacists accurately identified all scenarios that necessitate medical referrals. Dry skin, itchiness, and irritation were the most common side effects reported by community pharmacists for patients to complain about (69.4%). Most pharmacists agreed that misuse is the most likely cause of topical corticosteroid adverse drug events (53.7%), followed by medication overuse, such as patient self-treatment (48%). Community pharmacists counseling practices to their patients about the use of topical corticosteroids require improvement. Continuing education and hands-on training are needed for community pharmacists regarding counseling about topical corticosteroids use.

Is Community Pharmacies’ Personnel Well-Oriented about Cosmeceuticals? A Cross-sectional Survey and Costumer Simulation

Background: The cosmetics business is one of the most profitable and advanced global trade sectors, and academic and industrial investments have expanded to provide high-quality products to the right consumers. Thus, this cross-sectional survey assessed Iranian pharmacists and pharmacy technicians' (PT) cosmetic product knowledge, attitudes, and behaviors. Methods: Between December 2021 and July 2022, pharmacists and PTs who worked in CPs in Tehran province. Demographics were the first questionnaire section after eligibility and consent. Ten questions test knowledge in the second phase. The third portion has nine pharmacist cosmetic product attitudes self-developed questions. We used five-point Likert spectrum scaling. The final component of the questionnaire includes a pharmacist practice checklist. This fulfilled 12 pharmacists' obligations. PT demographics, knowledge, and attitude were measured using an eight-, five-, and eight-item questionnaire. A cosmetic sales checklist with eight practice items was devised to evaluate PTs. Pharmacists and PTs were evaluated for scientific advice on exfoliating lotion and anti-stain sunscreen use, skin type, history, and brand presentation. Using a 95% confidence interval, binary logistic regression found significant relationships between categorical dependent and independent variables. Pearson correlation measured knowledge-performance linearity. Results: The study included 325 pharmacists and 324 PTs. The average knowledge score for pharmacists was 6.38 ± 1.95, while their practice score was 6.35 ± 1.92 out of 10. The overall knowledge score for PTs was 2.8 ± 0.92 out of 5. Results indicate a strong association between pharmacist and PT knowledge and cosmeceutical performance (r= +0.635 and +0.564, respectively, P &lt; 0.001). Conclusion: This study indicates community pharmacists and PTs in Tehran have a moderate knowledge about cosmeceuticals. Also, a significant correlation between knowledge and performance was observed in both groups.

A Multidisciplinary Approach to Increase Dysphagia Compliance in Stroke Patients.

BACKGROUND: The objective was to optimize conditions that increase dysphagia compliance after stroke-a measure recognized by The Joint Commission in designating institutions as primary or comprehensive stroke centers and by the American Heart Association that promotes stroke treatment adherence and bestows achievement and quality awards. Failure to meet stroke measures, including medication documentation, may produce poor patient outcomes that directly affect consumer confidence and choice of treatment facility. Stroke patient care requires multidisciplinary team collaboration to manage multiple factors; variations in practice create fallouts that need correction, the absence of which jeopardizes standards for maintaining stroke center designation. PURPOSE: Aims were to determine the nature of dysphagia fallouts in our quaternary academic teaching hospital, assess multidisciplinary workflows and barriers to success, and develop strategies to enhance dysphagia compliance. DESCRIPTION: We used a multidisciplinary approach using James Reason's Swiss cheese model to examine compliance. The clinical nurse specialist interviewed physicians, advanced practice providers, pharmacists, speech-language pathologists (SLPs), nurses, and informaticists to ascertain discipline-specific success barriers, targeting top issues for each discipline to develop solutions. Unit educators unified their dysphagia reduction strategies; physicians, pharmacists, and informaticists collaborated to clarify standardized medication route orders and to increase electronic health record swallow screen visibility to multidisciplinary users; and SLPs adjusted workflow and documentation. EVALUATION: Outcomes included reinforcing correct nursing charting, pharmacy oral-to-feeding tube conversion order revision, optimization of delivery and awareness of medication routes, electronic health record system enhancements, and SLPs aligning documentation with nursing medication administration. The multidisciplinary approach proved successful and increased dysphagia compliance by 9.6% ( P = .001). These outcomes contributed to a successful The Joint Commission survey, redesignation as a comprehensive stroke center, and American Heart Association Gold Plus achievement award.

Advancing clinical interprofessional education to prepare student pharmacists for interprofessional collaborative practice

AbstractInterprofessional education (IPE) is a pivotal force shaping the future of health care delivery. While recent studies underscore positive student experiences resulting from IPE, a critical gap remains: the scarcity of data on patient outcomes within health systems that embrace this collaborative care approach. In this focused literature review, authors with expertise in the field of IPE and interprofessional collaborative practice (IPCP) aimed to provide pharmacists with practical suggestions on how they can advance interprofessional patient care while also optimizing the opportunities for student pharmacists to further develop IPCP competencies. Through a knowledgeable selection of current, high‐quality publications on the topic and expert opinion, we sought to identify characteristics of high‐quality IPE in practice environments. Pharmacists, in conjunction with Schools/Colleges of Pharmacy, should aspire to attain these characteristics to ensure that graduates of Doctor of Pharmacy (Pharm.D.) degree programs are entering the workforce primed to contribute to IPCP. The Interprofessional Education Collaborative (IPEC) has crafted competencies to harmonize curricula across health disciplines, with the promise of enhancing patient and population health outcomes. These competencies should serve as guiding principles for pharmacy educators as they develop and assess student pharmacists' collaborative practice skills. Pharmacists play a vital role in cultivating these skills within experiential environments. Leveraging existing pharmacy practice experiences presents an opportunity to achieve this aim effectively. As we look ahead, the future of health professional training must prioritize measuring the impact of IPE on patient outcomes. In this transformative landscape, IPE stands ready to mold the next generation of team‐based, patient‐centered care.

Awareness, Practice, and Views of Pediatricians, General Physicians, and Pharmacists about Prescribing Off-label Medication in Pediatric Patients in Eastern Province, Saudi Arabia.

An off-label medication involves the use of an approved drug for an unapproved indication, population, route of administration, or dosage.The physiological state of children differs from that of adults, making the adult formulation potentially dangerous to children. Off-label prescribing is quite common in children due to challenges in the development of pediatric formulations. The current study was conducted to determine the awareness, practice, and views of pediatricians, general physicians, and pharmacists about prescribing Off-label medication to pediatric patients in Eastern Province, Saudi Arabia. A cross-sectional study based on a questionnaire was conducted among pediatricians, general physicians, and pharmacists (clinical and community) in Eastern Province, Saudi Arabia. Statistical analysis was conducted using the data exported from Google Forms (Mountain View, California, USA) and Microsoft Excel (Version 2016) and then exported into Statistical Package for Social Sciences (SPSS) version 26.0 (IBM, Inc., Armonk, NY, USA). Chi-square was deemed suitable. The level of significance was set at 0.05. Among the study participants, 53(35.09%) were pharmacists, followed by 24(15.89%) others, 22(14.565) pediatricians, 19(12.58%) other specialists, 17(11.25%) general physicians, and 16(10.59%) were clinical pharmacist. About 73(48.34%) described the definition of off-label correctly. About 114(75.49%) believed that parents and guardians must be informed about off-label medicine prescribed to their children. About 52(34.43%) had concerns about the safety of the medication, and 98(64.90%) believed they should be tested in pediatrics during clinical trials. Further, 97(64.23%) considered themselves not enough knowledgeable about off-label medications. The barriers reported by the participants were as follows: 89(58.945%) said lack of information resources, 71(47.01%) said lack of training, 56(37.08%) said lack of information on the safety of excipients used in pediatrics, 47(31.12%) said lack of formulary, 44(29.13%) said lack of guidelines, and 58(5.29%) said lack of information related to the safety of excipient concentration in pediatrics. The proportion of healthcare professionals who agreed that excipients in adult medication may be harmful to pediatrics was 103(68.21%). The drugs most often prescribed as off-label were paracetamol 54(21.68%), followed by Phenobarbital 35(14%), and Amoxicillin 33(13.25%). There are a considerable number of healthcare professionals unaware of the description of off-label medication. The majority have concerns over the safety and efficacy of the off-label drugs and believe that most frequently used off-label drugs in pediatrics must be tested in pediatrics during clinical trials. In addition, excipient safety data are of considerable importance to ensure off-label drug safety in pediatrics, who believe their knowledge is inadequate and need proper guidelines and training on this issue.

A Pharmacist Clinician Model as part of a collaborative clinical workforce: A philosophical critique

The term ‘clinician’ is not reserved for any healthcare professional group. However, there is a general acceptance that a clinician would have the knowledge, skills and behaviours to enable them to clinically assess and manage a patient autonomously. The expectation, in a modern collaborative healthcare system, is that this work would be completed as a part of a planned and integrated multi-disciplinary care delivery structure, where any given clinician delivers a devolved element of that patient's care. Forthcoming changes to regulation and professional development pathways in the UK will have a profound impact on pharmacist professional identity and practice. From 2026, all new UK pharmacist registrants will have full independent prescribing rights. A paradigm shift is expected to enable the development of a Pharmacist Clinician Model, incorporating pharmaceutical care needs with wider clinical assessment, diagnostic, and clinical management responsibilities. Consideration is given to this model and its implications. Changes to regulation, policy, education, and the governance required to deliver safe and effective pharmacist clinicians are outlined. A philosophical critique on the nature of being a clinician, and the differentiation of pharmacist clinician roles compared to other healthcare professions, is given. A further examination of the projected risks and expected benefits of this transformative practice model are then explored.

Assessment of knowledge, attitudes, and practices among community pharmacists in Lahore regarding antibiotic dispensing without prescription: A cross-sectional study.

The irrational dispensing practices are responsible for antibiotic abuse and the spread of antibiotic resistance. Thus, the present study aims to evaluate the knowledge, attitudes, and practices of community pharmacists (CPs) regarding dispensing antibiotics without prescription (DAwP). A descriptive, cross-sectional study was conducted between March 1, 2023, and March 31, 2023, in community pharmacy settings of Lahore, Pakistan. A self-administered and pretested questionnaire was used for the data collection. Logistic regression analysis was used to determine the factors associated with the practices of community pharmacists. Data were analyzed using SPSS (version 26) and MS Office (2016). Among 359 respondents, many strongly agreed/agreed with the statements "DAwP is contributing to the development of antimicrobial resistance" (83%, n = 298) and "Antibiotic resistance has become a public health issue" (81.9%, n = 249). Overall, most of the community pharmacists claimed that the unwillingness of patients to visit physicians for non-serious infections (75.2%, n = 270) and good knowledge of pharmacists about the use of antibiotics (51%, n = 183) were the most common reasons attributable to dispensing of antibiotics without prescription. Cephalosporin (n = 260, 72.4%), penicillin (n = 254, 70.8%), and tetracyclines (n = 170, 47.4%) were the most commonly dispensed classes of antibiotics without prescription due to cold, flu and diarrhea. Most community pharmacists never/sometimes warn patients about the potential side effects of medicines (79.1%, n = 284). Logistic regression analysis revealed that community pharmacists 31-40 years of age (OR = 0.568, 95%CI = 0.348-0.927, p-value = 0.024) were significantly less associated with poor practices of dispensing antibiotics without prescription (DAwP) while those who were 'Managers' (OR = 4.222, 95%CI = 2.542-7.011, p-value = <0.001), had 3-5 years of experience (OR = 2.241, 95%CI = 1.183-4.243, p-value = 0.013), dispensed ≤25 antibiotics per day (OR = 12.375, 95%CI = 5.177-29.583, p-value = <0.001), were more likely to be associated with poor practices of dispensing of antibiotics without prescription. The community pharmacists had adequate knowledge, positive attitudes, and poor practices towards DAwP. Demographical factors such as age, job status, and work experience were the determinants of community pharmacists' practices towards dispensing antibiotics without prescription (DAwP). Hence, a multifaceted approach, including educational interventions, is needed to reduce the dispensing of antibiotics without prescription (DAwP).

Assessing the knowledge, attitude, and practice of hospital-based pharmacists in reporting adverse drug reactions in Lagos, Nigeria

Assessing the knowledge, attitude, and practice of hospital-based pharmacists in reporting adverse drug reactions in Lagos, Nigeria

An exploration of Northern Ireland general practice pharmacists’ views on their role in general practice: a cross-sectional survey

BackgroundThere is limited research examining the views of general practice pharmacists (GPPs) on their role and their impact in general practice. The aim of this study was to explore GPPs’ views regarding this role and its potential impact within general practice in Northern Ireland (NI).MethodsA paper-based self-administered questionnaire was mailed to 319 general practices in NI in 2022, directed to the GPP who spent most time at the practice. A variety of closed and open questions were included in six sections. Responses to closed questions were analysed descriptively whilst open question responses were analysed using content analysis. To ascertain associations between variables (e.g. GPP prescribing status, working arrangements and aspects of collaboration with GPPs), Fisher’s exact test was employed with an a priori significance level of p < 0.05.Results155 responses were received equating to a response rate of 48.5%. Most participants (72.3%) were female, independent prescribers (71%), and 64.5% were currently using their independent prescriber qualification. Services that were provided by most GPPs were medication reconciliation (99.4%) and medication reviews (97.4%). The most common method of communication between GPPs and general practitioners (GPs) was face-to-face (89.0%). Telephone was the most common method of communication between GPPs, community pharmacists (97.4%) and patients (98.7%). Most GPPs (> 80%) showed positive attitudes towards collaboration with GPs and those who worked in multiple practices were more likely to agree with the Attitudes Towards Collaboration Instrument for pharmacists (ATCI-P) statements compared to those who worked in a single practice (p < 0.05). Less than 40% (36.8%) of GPPs agreed that patients were aware of the role they provided. The majority of GPPs (80.6%) expressed positive views on their impact on primary care. Analysis of the free-text comments revealed the need for more GPP patient-facing activities, GPP-specific training, and promotion of the GPP role.ConclusionThe findings indicated that GPPs had largely positive views about their role and their impact on primary care. The results may be helpful for practices and service commissioners. Further research is necessary to explore the perspectives of patients regarding the role of the GPP and to enhance patients’ awareness of the GPP.

Clinician Views of Proactive Tobacco Treatment Programs: A Qualitative Evaluation.

Proactive tobacco treatment programs are an evidence-based strategy to recruit patients who smoke to make supported quit attempts. However, such programs are rarely implemented. We performed a qualitative assessment of clinicians to inform the creation of a proactive outreach program for patients with chronic obstructive pulmonary disease (COPD) who smoke. Informed by the Consolidated Framework for Implementation Research, we conducted semi-structured interviews to assess clinician views of proactive outreach, including barriers, program structure, and the use of technology. Clinicians included primary and specialty care physicians, nurses and advanced practice providers, pharmacists, respiratory therapists, a psychologist, and relevant members of leadership. Interviews were transcribed and analyzed using directed content analysis. Clinicians in all roles identified that proactive outreach could be an effective use of resources to help patients with COPD who smoke quit with several advantages over the current state. Clinicians disagreed on the priority population (e.g., younger patients, sicker patients), and to some extent on whether proactive outreach is a clinical priority. Though they supported that technology could be part of the outreach program, most advocated for multiple avenues (phone calls, drop-in clinic, texting), as these patients were perceived to be low technology utilizers. The primary implementation barriers were competing priorities and cost, as well as unclear billing and staffing models. Clinicians support proactive outreach for patients with COPD, but the optimal way to structure, staff, and fund such programs remains unclear. Health systems should leverage implementation strategies to speed uptake of these potentially life-saving programs.