Role Of Pharmacist Research Articles

Advancing the role of pharmacists in infectious diseases: Fostering critical thinking and collaboration

Disclaimer 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.

Pandemic preparedness of Egyptian community pharmacists and potential facilitators to the successful implementation of a community pharmacy coronavirus disease 2019 referral service: a cross-sectional survey.

The coronavirus disease 2019 (COVID-19) pandemic resulted in an increased need for essential community services including new roles for pharmacists. Globally, community pharmacists are a highly accessible point of contact for referral. To assess the preparedness of and facilitators to community pharmacists referring patients with suspected COVID-19 symptoms for testing. A cross-sectional survey was administered using a structured questionnaire to 1023 pharmacists (one respondent in each pharmacy) in Egypt between 17 and 30 May 2020. Pharmacists who had received pandemic referral training were significantly more familiar with the referral system in comparison to those who had not (n = 180; 17.6% vs. n = 841; 82.4%, P = .014). Case referral was significantly associated with the referrer (n = 161, 15.8%), demographics of region (P = .001), graduation year (P = .035), and gender (P = .015). The vast majority of respondents identified facilitators to referring, namely university-level teaching (n = 984, 96.7%), continuing professional development (n = 958, 94.3%), smartphone app (n = 809, 80.5%) or telephone hotline (n = 933, 91.5%), IT access (n = 861, 84.7%), and managing patients' attitudes through the media in terms of the importance of declaring symptoms to (n = 998, 97.7%) and cooperating with (n = 977, 96.2%) referrers. Pharmacists' lack of preparedness to engage with the referral process and related roles contributing to tracking the national COVID-19 infection rate could be mitigated by the provision of facilitators suggested by respondents. These included improved cooperation from local healthcare authorities, educational interventions, technological solutions, and the use of the media. Demographics associated with pharmacists' attitudes to referral, and hence the reliability and validity of the national infection rate, demand further investigation.

Qualitative exploration of the barriers and facilitators to community pharmacy PrEP delivery for UK pharmacists and underserved community members using the COM-B model of behaviour change

ObjectivesExpanding delivery of oral pre-exposure prophylaxis (PrEP) to community pharmacies could improve access, aligning well with the UK government’s goals to eliminate new HIV acquisitions by 2030. Using the Capability,...

DIABETES MELLITUS TIPO 2 COMO FATOR DE RISCO PARA O AGRAVO DA COVID-19 NA POPULAÇÃO BRASILEIRA: UMA REVISÃO SISTEMÁTICA

INTRODUCTION: The novel coronavirus, named SARS-CoV-2, is the etiological agent of COVID-19, a highly contagious infectious disease that primarily affects the lower respiratory tract. Type 2 diabetes mellitus may be a factor worsening this condition. OBJECTIVE: To identify the prevalence of diabetes mellitus as a risk factor for COVID-19 in Brazil from 2019 to 2023, assess the severity of cases in different states, analyze the sociodemographic factors affecting prognosis, and clarify the role of pharmacists in monitoring and managing the therapy of these patients. METHODOLOGY: This is a systematic review study using the PRISMA method, divided into four stages. The first stage involved searching for scientific works to answer the question about the frequency of worsening COVID-19 cases associated with type 2 diabetes mellitus in Brazil. The databases consulted were Scielo, PubMed, and the Virtual Health Library (BVS), using keywords such as “Diabetes mellitus,” “COVID-19,” “Brazil,” “Worsening,” and “Death.” RESULTS: Seveteen articles that met the inclusion criteria were selected. The studies indicate that diabetes mellitus is a significant risk factor for the severity and mortality of COVID-19 in Brazil, with mortality rates between 40% and 55% among diabetic patients. Additionally, the disease is associated with other comorbidities, such as hypertension and obesity, contributing to the need for ICU admissions and longer hospital stays. CONCLUSION: Type 2 diabetes mellitus is a significant risk factor for complications and mortality in COVID-19 patients, resulting in higher ICU admission rates and deaths, highlighting the need for rigorous glycemic control. The pharmacist's role is essential in monitoring glycemic levels and educating patients about treatment, contributing to reducing complications and improving clinical outcomes.

Pharmacological Innovations in Space: Challenges and Future Perspectives.

Since the first human experience in space, the interest in space research and medicine to explore universe is growing day by day. The extreme space conditions mainly radiation and microgravity effects on human physiology, antimicrobial susceptibility, and efficacy, safety, and stability of drugs. Therefore, the aim of this review is to address the impact of extreme space conditions, mainly microgravity and radiation, on human physiology and highlights the need for future approaches by evaluating the effectiveness of strategies to prevent or mitigate health problems. Published papers and NASA technical documents were searched in Pubmed and Google Scholar databases using the keywords ''antimicrobial susceptibility or drug resistance or drug stability or innovations or pharmacokinetic or pharmacodynamics'' and ''radiation or microgravity or space environments or space medicine or space pharmacy'' to prepare this review. In this review, the challenges regarding physiological effects and drug-related problems are examined through the evaluation of extreme conditions in space. Medications used in spaceflight are summarized, and the role of pharmacists specializing in space medicine is briefly explained. Last but not least, to overcome the aforementioned issues, novel approaches have been addressed, such as personalised treatments, development of space-resistant formulations and various microbial applications. Further research in the space medicine is required to facilitate the safe and healthy travel of humans to the Moon, Mars and other extraterrestrial destinations. One bear in mind that space research will contribute not only to the exploration of the universe, but also to the advancement of health and technological discoveries on Earth.

Qualitative analysis of clinical pharmacy interventions in an inpatient leukemia service.

Leukemia, a complex hematological malignancy, requires a multidisciplinary treatment approach, with clinical pharmacists playing a crucial role. However, their involvement in clinical practice is not well-documented in the literature. This study aimed to examine the characteristics of clinical pharmacy interventions (CPIs) reported by clinical pharmacists. This retrospective study involved extraction of CPIs entered into a pharmacy documentation database "Quantifi®" between January 2019 and June 2023. These CPIs included direct clinical pharmacist interventions (DCPIs), detected medication errors (MEs) and adverse drug reactions (ADRs). A total of 6286 CPIs were extracted, of which DCPIs, MEs and ADRs accounted for 5701 (90.7%), 357 (5.7%) and 228 (3.6%) reports, respectively. The most prevalent DCPIs were drug therapy discontinuation (n = 1080, 18.9%). Antimicrobials were the most common medications associated with DCPIs (n = 1991, 34.9%). Physicians accepted 99.4% of DCPIs and 64.1% (n = 3656) of direct interventions were considered significant. Among detected MEs, antimicrobials were the most reported medications (n = 158, 44.3%), with pharmacy internal errors being the most prevalent cause of the events (n = 172, 48.2%). Among the reported ADRs, hematological reactions were the most common (n = 81, 35.5%), and antineoplastic agents were the most frequently associated medications with ADRs (n = 164, 71.9%). This study highlights the crucial role of clinical pharmacists in managing leukemia patients, emphasizing their key interventions and ability to identify MEs and ADRs. Further research is needed to explore the clinical outcomes and financial impact of their involvement.

ASAM affirms pharmacists are needed in SUD treatment

After a spate of reports showing that physicians don't want to or can't prescribe treatment for opioid use disorder (OUD) (see ADAW https://onlinelibrary.wiley.com/doi/10.1002/adaw.34212), the American Society of Addiction Medicine (ASAM) has reiterated its July recommendations that pharmacists play a greater role in providing medications. In “The Role of Pharmacists in Medications for Addiction Treatment,” ASAM noted that pharmacists already help by dispensing buprenorphine. However, some pharmacies are reluctant to provide it, “possibly conflating harms associated with diversion of medications like oxycodone and alprazolam with buprenorphine's diversion risks,” ASAM wrote in the introduction to the policy statement. “Pharmacies are crucial to accessing and improving the utilization of medications for addiction treatment, however.”

Minor ailment interventions and the pivotal role of the community pharmacist in greece

Abstract Introduction Community pharmacists (CPs) play a vital role in providing advice and treatment for minor ailments, offering accessible and convenient healthcare services to the public1. The selection of appropriate management strategies is crucial for promoting self-care and empowering individuals to take an active role in addressing their health issues2. Aim This study aimed to measure the level of knowledge and perceptions of pharmacists regarding primary pharmaceutical care practices and the management of minor ailments. Methods This quantitative, cross-sectional study used a survey-based questionnaire developed after extensive literature review. It consisted of both closed-ended questions (multiple-choice questions) and Likert-type questions scale ranged from 1 to 5 (Strongly Agree to Strongly Disagree) to rate their level of agreement or disagreement. Ethical approval was obtained from the Pharmaceutical Association of Attica (PAA). This study employed purposive sampling to select participants, ensuring their participation was both anonymous and voluntary. The study commenced in December 2023, and data collection (both face-to-face and electronically via the university’s Moodle platform) was completed by March 2024. Data were analysed using Microsoft Excel®. Results The PAA informed 68 CPs from the Southern sector of Athens, and 60 CPs responded, resulting in a response rate of approximately 88.24%. The survey results show that the majority of respondents were women, N=33 (55%). The main age groups were 31-40 and 41-50 years, each with N=13 (21.7%), and most were pharmacy owners, N=34 (38.6%). Most participants were pharmacy graduates, N=52 (86.7%), with only N=8 (13.3%) holding postgraduate degrees. The majority of CPs were able to accurately identify and distinguish minor ailments. Only a small percentage mistakenly included conditions typically classified as chronic, with 8.3% (N=5) listing high cholesterol and 1.7% (N=1) listing hypertension.The survey-results indicate that a significant portion of the respondents perceive the role of the CP as central to the healthcare system, with 78.3% (N=47) affirming its importance. All participants felt confident in detecting and recommending treatment for minor ailments; 83.3% (N=50) considered their university training adequate. The main obstacles for CPs were a lack of time (90%, N=54) and the absence of compensation for extended services (50%, N=30). Additionally, 98.3% (N=59) supported lifelong learning, with continuous professional development in primary care being the top choice (46.7%, N=28), followed by advanced clinical training (36.7%, N=22). Participants hope to play a more active role in disease management within five years (35%, N=21) and seek autonomy in prescribing (30%, N=18). They expect support through collaboration (48.3%, N=29), policy reforms (28.3%, N=17), and compensated services (20%, N=12). Additionally, 96.7% (N=58) feel prepared to offer extensive pharmacy services, viewing it as an opportunity to demonstrate their clinical skills. Discussion/Conclusion This seems to be the first study of its kind in Greece.The study faced limitations such as potential response bias, restriction to a specific pharmacist population, and a limited time frame, which may affect generalisability. Despite these, the findings offer valuable insights into pharmaceutical care practices in Athens' southern sector, providing a foundation for future research and targeted interventions to enhance care in Greece.

Exploring the role of primary care pharmacists in NHS Lanarkshire following the implementation of the pharmacotherapy hub: a service evaluation

Abstract Introduction The General Medical Service (GMS) contract was produced in Scotland in an attempt to tackle General Practitioner (GP) workforce issues. The pharmacotherapy work stream is part of this and provides a framework for pharmacy teams, dividing services into level 1 (core), level 2 (advanced) and level 3 (specialist).1 A statement by the Royal Pharmaceutical Society (RPS) and the British Medical Association (BMA) discussed the introduction of pharmacotherapy hubs to complete level 1 work for multiple practices, centralising the medicines reconciliation process. Theoretically, this would release pharmacists to carry out clinical and more advanced/specialist services.2 There are currently 8 pharmacotherapy hubs within NHS Lanarkshire (NHSL), incorporating level 2 and 3 services into job plans for General Practice Clinical Pharmacists (GPCPs). No work has been undertaken to explore changes in practice since the implementation of these hubs. The qualitative study explored drivers and motivators for pharmacists in practice, shaping future pharmacotherapy services in NHSL and Scotland. Aim To explore the views and attitudes of primary care pharmacists towards their practice role in NHSL following the implementation of the pharmacotherapy hub. Methods Ethical approval was granted from the School of Pharmacy and Life Sciences Ethics Committee (Robert Gordon University). Pharmacists working within the 8 hub localities were invited to participate via email correspondence if they had over 6 months experience in practice pre-hub implementation and then 6 months post-hub implementation. Participants attended a one-to-one interview to share their views towards their practice role since the hub was implemented. Interviews were recorded, transcribed verbatim and thematically analysed. Results Twelve pharmacists across six localities participated. The five key themes identified were job role, managing time, professional development, professional belonging and patient care. The implementation of the hub was an enabler for pharmacists to partake in advanced pharmacotherapy tasks. Pharmacists negatively perceived level 1 core pharmacotherapy tasks in comparison to level 3 clinical patient-facing time. Participants linked the hubs impact on practice with role development, an increase in autonomy, confidence and job satisfaction. Discussion/Conclusion The hub has enabled in-practice pharmacists to move to a more sustainable balance between core and advanced/specialist tasks. Collaboration is required between pharmacy teams and practices to understand the pharmacist role in pharmacotherapy. Further recommendations include continuing the roll-out of pharmacotherapy hubs, standardisation of pharmacist clinical time balanced with core tasks and implementation of protected learning time for pharmacy teams. The study was open to response bias but this was addressed by using semi-structure interview guides in the one-to-one interviews. Researcher bias was minimised by two researchers analysing the data and practicing reflexivity. The study was open to recall bias due to participant’s retrospective thinking. In NHSL prioritising the hub roll-out and collaboration with stakeholders are essential. This will ensure the balance between efficient pharmacotherapy services and maintaining attractive roles, contributing to a sustainable workforce.

Adherence and quality of life in patients with epilepsy in Cyprus

Abstract Introduction Epilepsy affects about 50 million people globally1. Patients often struggle with medication adherence due to forgetfulness, side effects, or lack of understanding, yet consistent use is vital for reducing seizures and improving quality of life2. Community pharmacists can improve outcomes by educating patients, aiding adherence, and clarifying drug effects and interactions, beyond just dispensing prescriptions. Aim The study aimed to assess epileptic patients’ adherence and quality of life in Cyprus. Methods This quantitative study, conducted from September 2022 to October 2023, received ethical approval from the Cyprus National Ethics Committee. Data were collected via phone calls using tools translated into Greek to assess adherence among epileptic patients. These tools included the MMAS-8 Morisky, with 8 items (7 Yes/No questions and 1 Likert 5-Point question), and the Readiness for Change scale, featuring a 0-10 ruler and 3 open-ended questions. The MARS-5, with 5 Likert 5-Point questions, and the QOLIE-31 were also used, along with demographic data collection. Inclusion criteria were patients over 18 with epilepsy, on antiepileptic therapy, and Greek-speaking. Of the 151 patients in the registry, 16 were excluded by the Neurologist of the Limassol's General Hospital due to factors like communication issues, recent stroke, quadriplegia, brain paralysis, mental retardation, and Down syndrome. Statistical analysis was performed using SPSS V28. Results In total, 85 epileptic patients participated in the study (out of the 135 patients- response rate 62.96%). The study's demographics included 47 males (55.3%) and 38 females (44.7%), with 18 participants aged 18-34 (21.2%), 46 participants aged 35-64 (54.1%), and 21 participants over 65 (24.7%). Additionally, the age of epilepsy onset was categorised as follows: 39 participants (45.9%) had an onset before 18 years of age, and 46 participants (54.1%) had an onset at 18 years of age or older. The Morisky MMAS-8 results showed 47 participants (55.3%) with high compliance, 26 (30.6%) with medium, and 12 (14.1%) with low compliance. The MARS-5 results indicated 79 participants (92.9%) had high compliance (≥20), while 6 (7.1%) had low compliance (<20). The readiness for change ruler had a mean score of 9.48 (SD = 0.16). Specifically, the distribution of scores was as follows: 1 participant (1.2%) scored 2, 4 participants (4.7%) scored 5, 2 participants (2.4%) scored 7, 4 participants (4.7%) scored 8, 2 participants (2.4%) scored 9, and 72 participants (84.7%) scored 10. The overall quality of life (QoL) score averaged 75.3 (SD = 2.16). Discussion/Conclusion This study is the first comprehensive assessment of adherence and quality of life among epileptic patients in Cyprus. Some patients did not participate due to lack of time and interest. Using the Morisky MMAS-8 and MARS-5 scales, over half showed high medication compliance, but a significant portion had medium to low compliance, indicating a need for targeted interventions. The findings underscore the critical role of community pharmacists in supporting adherence and enhancing quality of life through education, counseling, and personalized care. This study provides a foundation for future research and interventions to improve epilepsy management in Cyprus.

Support for pharmacy professionals returning to (clinical) practice after a break: a cross-sectional survey

Abstract Introduction The continuing expansion of clinical roles for pharmacists, combined with National Health Service workforce shortages and the COVID-19 pandemic, have significantly increased pressure on pharmacy professionals.1 These pressures have heightened stress levels, causing many to consider leaving the field.2 Addressing workforce shortages and retension is crucial, with a particular focus on the reintegration of professionals returning to practice after a break. However, those returning after extended breaks often face challenges such as decreased skills and confidence. Nevertheless, research on the effectiveness of reintegration programmes to help pharmacy professionals return remains limited. Aim To explore participants’ reasons for leaving and returning and to assess the effectiveness of the Centre for Pharmacy Postgraduate Education (CPPE)’s Return to practice (RTP) and Return to the register (RTTR) programmes in helping individuals return to pharmacy practice in England. Methods CPPE emailed an anonymous link to an online survey, with two reminders, in December 2023 and January 2024, to individuals who participated in the RTP and/or RTTR programme(s) before March 2023 (n=701) and had given consent to be contacted for evaluation purposes. The survey employed closed, Likert-type and free-text questions. Quantitative data were analysed using the Statistical Package for Social Sciences (SPSS), with inferential statistics for subgroup comparisons and thematic analysis for qualitative comments (statistical significance p≤0.05).3 Using the university’s ethical approval tool, this study did not require approval due to not collecting personal, confidentical or sensitive information, with no vulnerable groups included, or risk of disclosure. Results The valid response rate was 15% (n=106). Most respondents were female (n=67, 79.8%), aged 35 and older (n=82, 97.6%), and pharmacists (n=77, 85.6%) or pharmacy technicians (n=8, 8.9%). The primary reasons for leaving included family responsibilities, career transition, and relocation, while the main motivations for returning were career reconnection, relocation, and other personal reasons. Participants reported a high degree of satisfaction with both programmes; those who perceived high content relevance reported significantly higher satisfaction (8.90±1.47 for RTP and 8.75±1.58 for RTTR on a 10-point scale). Overall, 70.8% (n=75) successfully returned to pharmacy practice and/or the GPhC register after completing the programme(s). Of those who returned, 68.1% (n=47) took less than 6 months. It was found that those who were more satisfied and more likely to recommend the programme(s), had been off the register for less than 10 years (n=41, 78.8%), and completed the programme(s) before 2020, prior to the shift to online delivery due to COVID-19 (n=41, 83.7% for RTP and n=16, 88.90% for RTTR), were more likely to have returned. Discussion/Conclusion The CPPE RTP and RTTR programmes supported participants effectively in returning to pharmacy practice. Increasing the number of pharmacy professionals returning to practice using reintegration course(s) positively impacts workforce shortages and addresses skill gaps after a break. One study limitation is the lack of information about those who did not use or are unaware of these support programmes. Further research could explore the support needs of all those wishing to return to practice or the GPhC register.

Scoping the requirements for a genomic competency framework to inform the integration of genomics into pharmacy undergraduate curricula

Abstract Introduction The application of genomics is due to have a significant impact on the role of pharmacy within future healthcare systems. Since 2021, the updated GPhC education standards have included a requirement to apply the principles of genomics,1 but a lack of consistency across UK pharmacy programmes has led to inequity of genomics literacy for pharmacy students.1 National UK genomic workforce strategies include a pharmacy undergraduate indicative syllabus focussing on upskilling the NHS workforce in readiness for the wider implementation of genomics.2,3 There is a lack of UK research exploring the undergraduate genomic education requirements of pharmacy professionals. Aim Scope the requirements of a genomic competency framework for undergraduate pharmacy curricula. Methods Ethics approval was obtained from Swansea University ethics committee in July 2023. Fifteen multi-professional stakeholders from across the UK, perceived as genomic experts and/or pharmacy educationalists from each devolved nation, were selected using purposive sampling and all were invited to participate within a virtual semi-structured interview (SSI) and a consecutive focus group. SSIs and the focus group were facilitated and recorded using Microsoft® Teams and pre-designed open question topic frameworks were used. All data was anonymously transcribed verbatim and analysed using thematic analysis. Results Twelve participants consented and SSIs were held between September/October 2023. Five participants attended the consecutive focus group in December 2023. Five SSI themes were identified: Competency development - where the need for pharmacists to have comprehensive knowledge of the aspects and factors affecting the use of genomic testing within clinical practice (e.g. research and consent) was identified, whilst others described the need for pharmacists to focus on pharmacogenomics only; Curriculum approach – where there were variations in the depth of general genomic training and appropriate topics needed by pharmacists and the requirement for genomics to be scattered throughout undergraduate programmes; Future practice roles - the current postgraduate pharmacogenomic module could be used to establish the future undergraduate requirements and the need for pharmacy curricula to focus on the application of genomics to medicines rather than as a diagnostic tool; Genomic topics - participants acknowledged the complex nature of determining the genomic undergraduate curricula requirements without routine mainstream use of genomics within clinical practice but suggested pharmacy genomic competencies needing further refinement; Level of knowledge - participants highlighted the need for overall genomic pharmacy knowledge but a deeper level of pharmacogenomic knowledge and recommended that the competency framework should be relevant and achievable across healthcare sectors. Discussion and conclusion Genomic competencies should be established for pharmacy professionals as appropriate to their job roles. Once genomics is widely implemented, clarity around genomic competence requirements will develop, following workforce upskilling. The varied backgrounds of study participants impacted their opinions which were potentially influenced by their knowledge of the pharmacist role across sectors and their lack of familiarity with current pharmacy training. Study limitations are small participant numbers and low data generalisability. A genomic competency framework is needed to standardise pharmacy training and study findings will be used to develop a UK consensus for UK genomic undergraduate pharmacy training.

Qualitative study exploring perceptions and experiences of Pharmacy technicians’ professional identity in NHS Scotland

Abstract Introduction Pharmacy technicians worldwide share workplace challenges including: job role; scope of practice; level of pharmacist’ supervision; and education1. In the USA, Canada and many European countries, pharmacy technicians require national or state registration2. In the UK, Pharmacy technicians became registered professionals in 2011, as a means of improving patient safety through compliance with General Pharmaceutical Council (GPhC) standards. There are approximately 2,500 pharmacy technicians and 5,500 pharmacists registered with the GPhC in Scotland3. Given the importance of professional identity, and the lack of research exploring pharmacy technicians’ professional affiliation, we explored the perspectives and experiences of pharmacy technicians’ professionalism across Scotland. Aim To explore pharmacy technicians’ perceptions and experiences of their professional status and professional identity. Methods Following West of Scotland Research and Ethics Service Scientific Officer’s approval, Pharmacy technicians from all fourteen Scottish territorial health boards were invited by email using snowball sampling technique to provide a national representation. A draft semi-structured interview was piloted on four pharmacy technicians. Between May and August 2023, 36 pharmacy technicians were recruited: 23 from acute services; mental health (n=1); rehabilitation hospitals (n=1); primary care (n=8); and community pharmacy (n=3). Twenty two participants were interviewed in person and 14 on line. Interviews lasted between 17-91 minutes, were audio recorded, transcribed verbatim and accuracy checked, then analysed thematically using a framework approach and NVivo software. Three researchers analysed data including initial coding, categorisation, and theme generation. Any disagreements were discussed and addressed within the research team. Results Seven themes emerged from the data describing pharmacy technicians: feeling stuck in the shadow of pharmacists; underrepresented in policy and practice; and marginalised, undervalued and underpaid. There was frustration at the lack of awareness of pharmacy technician roles amongst the wider healthcare team. Primary care pharmacy technicians were thought to have more opportunities than secondary care colleagues. There was a pervasive feeling that pharmacy technicians were increasingly squeezed between pharmacists and support workers and a lack of confidence and feeling unsupported in the delivery of clinical roles. Pharmacy technicians acknowledged that they may not have used their initiative to take new opportunities, but did not feel they had sufficient clinical and educational opportunities. Catalysts to professional development were recognised including pharmacy technician led management and leadership, readiness to undertake traditional pharmacist roles and the potential positive impact of strengthened professional identity. Interviewees described the absence of a structured, funded career framework, and lack of post-registration higher-level professional qualification as inhibiting increased responsibility and scope of practice. Discussion/Conclusion Professional registration does not appear to have strengthened pharmacy technicians’ professional identity. There is a pervasive lack of development opportunities impacting negatively on pharmacy technicians and therefore, service delivery across Scotland. A review of defined roles is required. A lack of previous qualitative evaluation limits comparisons with the perceptions and experiences of pharmacy technicians worldwide. Findings offer a starting point to inform practice and policy. Further research could explore pharmacy technicians’ perceptions of the potential impact of the emerging career framework on developing roles and responsibilities. Keywords: Pharmacy technician, Professional identity

A RELEVÂNCIA DOS FARMACÊUTICOS NO AVANÇO E NOS DESAFIOS DO DESENVOLVIMENTO DE ANTIDEPRESSIVOS: EFICÁCIA, SEGURANÇA E ADESÃO AO TRATAMENTO.

Introduction: This article explores the crucial role of pharmacists in advancing and managing the challenges related to antidepressant development, focusing specifically on efficacy, safety, and treatment adherence. The collected data highlight how pharmacists contribute to the efficacy of antidepressants through appropriate medication selection, dose adjustment, and continuous patient monitoring. Additionally, it discusses the merit of pharmacists in ensuring patient safety, inferring the identification and management of side effects, as well as strategies to achieve better treatment adherence, which is often compromised by adverse effects and the complexity of therapeutic regimens. Methodology: Studies from 2020 to 2024 were included, employing a combination of quantitative and qualitative approaches, with data gathered from bibliographic references within the platforms: PubMed, Scielo, Lilacs, and DeCS from BVS, which provided a cohesive basis for the creation of this work. Results: The research revealed that pharmacists play a fundamental role in optimizing antidepressant efficacy and reducing associated safety risks, as well as in implementing strategies to improve treatment adherence, such as patient education and personalized support. Conclusion: Despite advancements in antidepressant development, challenges related to efficacy, safety, and adherence remain significant. Pharmacists are essential in overcoming these challenges and ensuring more effective and safe treatment for patients. Continued research is necessary to explore new management strategies and support the ongoing advancement of antidepressant pharmacotherapy.

Desprescribing antihypertensives in older people in primary care: subgroup analysis of the MINOR randomised clinical trial.

Polypharmacy is often required for older adults with hypertension, and excessive treatment is associated with a high risk of adverse reactions, including hypotension. To evaluate the deprescribing of antihypertensive medications guided by pharmacists using home blood pressure monitoring in older adults with hypotension. A subgroup of older adults with signs or symptoms of hypotension, included in the MINOR clinical trial, was analysed. In the MINOR procedures, each patient was provided with a device to conduct blood pressure measurement at home for 1week, following which a report was generated and shared with pharmacists (intervention group) or family physicians (control group). In the intervention group, a pharmacist suggested optimising pharmacotherapy; meanwhile, in the control group, a family physician alone determined the necessary treatment adjustments. Differences in mean blood pressure, the patients with symptoms/signs of hypotension, and the antihypertensive medication deprescribing between both groups were analysed. Seventy-two patients were evaluated (35, control group; 37, intervention group). The intervention group showed a significant reduction in medication prescriptions (- 28.6%; P < 0.001), especially beta-blockers (- 74.2%), loop diuretics (- 83.3%), and aldosterone antagonists (- 80%). The mean office blood pressure in the intervention group increased (14.1mmHg systolic and 6.9mmHg diastolic), remaining below the target range (140/90mmHg). The intervention group showed a significantly reduction in hypotensive symptoms than the control group (64.9% vs. 20%) (P < 0.001). The data highlight an important role for pharmacists in optimizing hypertension management in older people. Deprescribing antihypertensives can limit symptomatic hypotension. Registered on ClinicalTrials.gov under number NCT04861727.

Angiotensin-Converting Enzyme Inhibitor Washout Period Prior to Angiotensin Receptor/Neprilysin Inhibitor Initiation in the Inpatient Setting.

The 2022 AHA-ACC HFSA Guideline for Management of Heart Failure recommend initiating an angiotensin receptor/neprilysin inhibitor (ARNI) in patients with heart failure with reduced ejection fraction (HFrEF) who can tolerate an angiotensin-converting enzyme inhibitor (ACEi). The manufacturer recommends initiating a 36-hour washout period when switching from ACEi to ARNI due to an increased risk of adverse effects, including angioedema. This study investigated the adherence to the washout period when transitioning from ACEi to ARNI at a community hospital. The primary objective was to assess the rate of adherence to the 36-hour washout when transitioning patients from ACEi to ARNI. Secondary outcomes included heart failure exacerbation readmission rates within 90 days and the rate of adverse effects (angioedema, hypotension, acute kidney injury, and hyperkalemia). This was a retrospective cohort study including patients with HFrEF who were transitioned from ACEi to ARNI during their hospital stay between March 1, 2016 and December 31, 2022. Patients were excluded if they did not receive an ACEi or ARNI during their admission or if they had an ejection fraction >40%. Pearson chi-square was used to analyze categorical data. Of 33 patients included in this study, 67% received the full 36-hour washout period when transitioning from ACEi to ARNI. There were no significant differences between the rates of hospital readmissions or adverse effects between the groups. No patients experienced hyperkalemia or angioedema. This is the first study to our knowledge to describe real-world prescribing practices when transitioning patients from ACEi to ARNI for the treatment of HFrEF. Larger, multicenter studies are needed to provide more data on prescribing practices outside this single center. Future research should also include pharmacist's role in adhering to the recommended washout.

The Evolving Role of Pharmacists in Healthcare: A Systematic Review of Clinical, Community, and Digital Health Interventions

The Evolving Role of Pharmacists in Healthcare: A Systematic Review of Clinical, Community, and Digital Health Interventions

The opinion of pharmacists about the pharmaceutical category of herbal medicines. Survey of pharmacy retail employees

Abstract. The category of herbal medicines is represented in the domestic pharmaceutical market in the form of two main groups of pharmacy product assortment – herbal medicinal preparations (HMP) and dietary supplements (DS). They often have similarities in terms of composition, dosage form, and scope of application. Hence, attitude of professional specialists that influence consumer demand and choice, to these groups of pharmacy products is important to be considered. Aim. The purpose of the study is to assess the level of knowledge, prevailing ideas, differences in the perception of HMP and DS among pharmacists working in pharmacy retail. Materials and methods. The survey of pharmacists was conducted using a specially designed questionnaire using the Google forms electronic resource. 162 specialists with at least 1 year of experience in the pharmacy sector participated in the study. The study was conducted on the basis of the “Evalar Pharmacy” pharmacy network, specializing in the sale of herbal medicines. Results. The majority of the surveyed specialists noted urological (54.0%) and neurological diseases (52.1%) as therapeutic areas where herbal medicines have real clinical value. The leading role of retail pharmacists in the choice of products by consumers was noted by 40.1% of respondents. The possibility of replacing HMP with DS in 38.0% of cases is completely denied by them, in 50.0% and 12,0% it is allowed if desired by the patient himself or in any case respectively. 59.3% of specialists point out the difference in the regulatory status of HMP and DS to consumers in their practice. In the majority of cases, they need reliable information about clinical trials on efficacy (73.6%), as well as the quality and safety of products (52.1%). Conclusions. The results of the survey show that pharmaceutical specialists are well aware of the scope, advantages and disadvantages of the phytopreparation category, see differences in HMP and DS, but in their professional activities they are more guided by the opinion of consumers.

Nexus of Quality Use of Medicines, Pharmacists’ Activities, and the Emergency Department: A Narrative Review

Acute care provided in the hospital’s emergency department (ED) is a key component of the healthcare system that serves as an essential bridge between outpatient and inpatient care. However, due to the emergency-driven nature of presenting problems and the urgency of care required, the ED is more prone to unintended medication regimen changes than other departments. Ensuring quality use of medicines (QUM), defined as “choosing suitable medicines and using them safely and effectively”, remains a challenge in the ED and hence requires special attention. The role of pharmacists in the ED has evolved considerably, transitioning from traditional inventory management to delivering comprehensive clinical pharmacy services, such as medication reconciliation and review. Emerging roles for ED pharmacists now include medication charting and prescribing and active participation in resuscitation efforts. Additionally, ED pharmacists are involved in research and educational initiatives. However, the ED setting is still facing heightened service demands in terms of the number of patients presenting to EDs and longer ED stays. Addressing these challenges necessitates innovation and reform in ED care to effectively manage the complex, rising demand for ED care and to meet government-imposed service quality indicators. An example is redesigning the medication use process, which could necessitate a shift in skill mix or an expansion of the roles of ED pharmacists, particularly in areas such as medication charting and prescribing. Collaborative efforts between pharmacists and physicians have demonstrated positive outcomes and should thus be adopted as the standard practice in improving the quality use of medicines in the ED.

Empowering Thai community pharmacists in combating antimicrobial resistance: Qualitative insight and sentiment analysis

BackgroundAntimicrobial resistance (AMR) is increasing globally and poses a significant public health challenge. Community pharmacists, especially in primary care settings, play a pivotal role in mitigating the irrational use of antibiotics, a key driver of AMR. ObjectivesThis study aims to explore qualitative insights from community pharmacists regarding antibiotic supply and usage, analyze sentiments related to AMR, and highlight the crucial role of community pharmacists in AMR stewardship at the primary care/community level. MethodsThis study engaged community pharmacists in Thailand through semi-structured interviews to obtain in-depth insights into the antibiotic supply and perceptions of AMR. Additionally, sentiment analysis, which evaluates the emotional tone of the pharmacists' responses, was conducted to enrich the findings. ResultsInterviews with 23 community pharmacists highlighted the practices, challenges, and strategies related to antibiotic supply and use. Key findings include the identification of barriers such as patient demand and lack of awareness about antimicrobial resistance (AMR), alongside strategies for improvement such as public education and professional development. Sentiment analysis reveals a cautiously optimistic perspective toward enhancing rational antibiotic use, underscoring the importance of comprehensive approaches that combine education, ethics, and regulatory measures to address the complexities of antibiotic management at community pharmacies. ConclusionThis study underscores the necessity of public awareness, pharmacist–patient relationships, and regulatory reforms for the rational use of antibiotics in community pharmacies. These findings emphasize that pharmacist education and adherence to professional ethics are essential for mitigating antimicrobial resistance and promoting rational antibiotic use.