Pharmacy Research Articles

How do community pharmacists perceive practice-based research?

Practice-based research (PBR) is an integral part of community pharmacy practice. The results obtained from PBR allow community pharmacists to gain the knowledge necessary to develop new patient services and acquire strategies to strengthen their role in the health system. The study aimed to assess pharmacists' attitudes and barriers towards PBR and investigate the factors that prevent or motivate community pharmacists from participating. The cross-sectional study was conducted in May to Jun 2023 via an online structured pretested questionnaire. All licensed pharmacists registered in the Registry of Pharmacists of the Croatian Pharmaceutical Chamber, who listed community pharmacy as a place of work participated, i.e. 500 community pharmacists. The questionnaire consisted of two sections. Section A collected the respondents' sociodemographic characteristics. Section B contained two groups of relevant statements on a 5-point Likert scale divided into two sections: pharmacists' attitudes towards research in PBRs and barriers to participation in PBRs. The results showed that 97% of community pharmacists considered PBR important for developing new pharmacy services, and almost two-thirds considered participation in research to be part of pharmacy practice. The most often perceived barrier to research participation was the workload of daily tasks necessary for normal pharmacy functioning, recognized by 68% of community pharmacists. This study revealed community pharmacists' perception of the importance of PBR for the pharmacy profession. Involvement in PBR was important for the community pharmacists. The motivation for the PBR was present, despite the detected barriers. The results indicate the directions the community pharmacists should inspire.

EXPRESS: When a Mighty Competitor Comes to Town, Can Adjusting Product Variety Shield Incumbent Stores from Sales Loss? Insights from Retail Collocation, Category, and Pre-Existing Competition

When a competitor enters a market, incumbent retail stores often adjust their product variety to maintain sales. However, no empirical evidence has been provided in the literature to justify the value of such product variety adjustments after a rival’s entry. One difficulty is that the change in consumer demand due to rival’s entry and changes in product variety simultaneously affect incumbents’ sales. When changes in sales at incumbent stores are observed after rivals’ entries, it is unclear whether the sales changes result from product variety adjustments or changes in consumer demand directly resulting from the entry. Even if adjusting product variety can potentially mitigate sales loss due to rivals’ entries, it is unclear whether such product variety adjustments provide a universal solution to all incumbent stores. This paper applies the difference-in-difference research design to develop a system of equations for product variety and sales at incumbent stores after rivals’ entries by exploiting the entries of warehouse clubs. The findings reveal that, on average, product variety at incumbent stores increased after the entries. This increased product variety mitigates the sales decreases caused by the entries with a diminishing return. After the entry of a warehouse club store, incumbent stores collocated with the new store have less sales loss than the non-collocated stores due to the trade-off between the substitution and agglomeration effects. Product variety adjustments at collocated incumbent stores experience greater sales benefits than non-collocated stores. Moreover, the sales loss that was mitigated by increased product variety at incumbent stores within the retail category of entrants is larger than others after the entry of a warehouse club store. Interestingly, the mitigation effect is not significant for certain incumbents, such as convenience and drug stores, which belong to different retail categories from entrants. This study also explores the heterogeneous effects by investigating pre-existing competition and different warehouse club chains. The empirical findings offer valuable insights to managers of incumbent stores on how to adjust product variety to reduce sales loss resulting from a rival’s entry.

Assessment of Residual [99mTc]Tc-Tetrofosmin Activity in Routine Nuclear Medicine Practice at Hospital Kuala Lumpur.

Myocardial perfusion imaging using the radiopharmaceutical [99mTc]Tc-tetrofosmin plays a crucial role in diagnosing cardiac conditions. However, variations in the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration may impact imaging quality and patient safety. This study aimed to evaluate the residual activity of [99mTc]Tc-tetrofosmin in plastic syringes after administration during routine nuclear medicine procedures at Hospital Kuala Lumpur, assessing compliance with department protocols and variability among different syringe brands. Methods: A single-center prospective observational study was conducted using stratified quota sampling, encompassing 396 samples across 3 syringe brands (SJ, BD, and Ciringe). Residual activity was measured immediately after administration, and statistical analysis was performed to compare brands and assess compliance with the department dosage protocol range of 333-555 MBq. Results: All injected activities aligned with the department protocol dose, with a mean effective activity of 451.23 ± 30.73 MBq and a mean residual activity of 12.63% ± 4.73%. However, variability in residual activity was observed among syringe brands. BD exhibited the highest mean residual activity (16.45%), significantly differing from SJ (9.95%) and Ciringe (11.50%) (P < 0.001). Conclusion: Rigorous syringe selection is crucial in myocardial perfusion imaging procedures to minimize residual activity and ensure compliance with dosimetry standards, emphasizing the importance of integrating pharmacy practices into nuclear medicine protocols. Standardized protocols and quality assurance measures are essential to optimize imaging outcomes and prioritize patient safety. These findings highlight the importance of ongoing monitoring and interdisciplinary collaboration to navigate residual activity management effectively in routine nuclear medicine practice.

Study on Drug Usage, Storage and Wastage among Households in Chengalpattu, Tamil Nadu, India - A Cross-Sectional Study

Background: Improper drug storage is immensely prevalent in households. A significant number of families do not follow prescribed practices for maintaining the safety and efficacy of medications. Increased rates of unintentional poisoning, decreased drug efficacy, and the emergence of antibiotic resistance are just a few adverse consequences that might result from such negligence. Methodology: A total of 213 households were selected using multi-stage random sampling techniques. A pretested structured questionnaire on drug storage, usage, wastage in the households was used and detailed interview was conducted with the participants. Results: Majority of the participants 56.3% (120) belonged to the age group of 30- 40 years, most of the participants are graduates 39.4% (83). The prevalence of self-medication was 30.5%. Safe storage conditions with appropriate packing were used by 81.5% (167) of people. About 69.9% (149) has good knowledge on correct dosage of medications.91.2% (187) of households discard unused medications in the garbage. Commonly stored medicine was analgesics and antipyretics 21.6% (86). In this study Increasing age, Education and Family with senior citizens above 60 years have a strong association with storage condition of medicines at home. Conclusions: This study shows 96.3% prevalence of in-home storage medication practices. Ensuring the efficacy, safety, and cost-effectiveness of medications requires proper management from storage to use and waste prevention.

A Comprehensive Review of Challenges in Oral Drug Delivery Systems and Recent Advancements in Innovative Design Strategies.

The oral route of drug administration is often preferred by patients and healthcare providers due to its convenience, ease of use, non-invasiveness, and patient acceptance. However, traditional oral dosage forms have several limitations, including low bioavailability, limited drug loading capacity, and stability and storage issues, particularly with solutions and suspensions. Over the years, researchers have dedicated considerable effort to developing novel oral drug delivery systems to overcome these limitations. This review discusses various challenges associated with oral drug delivery systems, including biological, pharmaceutical, and physicochemical barriers. It also explores common delivery approaches, such as gastroretentive drug delivery, small intestine drug delivery, and colon-targeting drug delivery systems. Additionally, numerous strategies aimed at improving oral drug delivery efficiency are reviewed, including solid dispersion, absorption enhancers, lipidbased formulations, nanoparticles, polymer-based nanocarriers, liposomal formulations, microencapsulation, and micellar formulations. Furthermore, innovative approaches like orally disintegrating tablets (ODT), orally disintegrating films (ODF), layered tablets, micro particulates, self-nano emulsifying formulations (SNEF), and controlled release dosage forms are explored for their potential in enhancing oral drug delivery efficiency and promoting patients' compliance. Overall, this review highlights significant progress in addressing challenges in the pharmaceutical industry and clinical settings, offering novel approaches for the development of effective oral drug delivery systems.

Integrating a naloxone-focused population health management experience into an ambulatory care advanced pharmacy practice experience.

Population-health management (PHM) is using healthcare analytics to target clinical interventions across a population. Many pharmacists are asked to engage in PHM, as these efforts improve outcomes. Veterans Health Administration has developed a population health dashboard (the Overdose Education and Naloxone Distribution [OEND] Dashboard) to identify patients eligible for naloxone, an opioid overdose reversal agent. Integrating PHM experiences within pharmacy education is supported by current curricular outcomes. Thus, the primary purpose of this project is to determine whether a naloxone-focused PHM experience has positive outcomes in terms of students' perceived skills, knowledge, and attitudes related to PHM and naloxone counseling. This single-site, prospective, observational study examined fourth-year student pharmacists on their ambulatory care advanced pharmacy practice experience (APPE). Students used the OEND Dashboard to independently make naloxone interventions throughout the rotation. A survey containing multiple Likert scale questions was administered at the beginning and end of the APPE to assess changes in students' perceived skills, knowledge, and attitudes related to PHM and naloxone counseling. Results were assessed using a two-tailed Wilcoxon Signed-Rank test for paired data. Between August 2022 and August 2024, 30 students completed an APPE at the study site. Overall, there were positive changes on all six Likert scale items assessing the domains of perceived skills, knowledge, and attitudes. In the post-survey, 96.2% (27/28) of students responded "Agree" or "Strongly Agree" to "I believe that my efforts on this rotation had a direct impact on patient safety." Integration of a naloxone-focused PHM experience had positive outcomes in terms of students' perceived skills, knowledge, and attitudes toward the concepts of PHM and naloxone counseling.

The role of digital health in modern pharmacy: A review of emerging trends and patient impacts

The integration of digital health into modern pharmacy practices has revolutionized patient care and medication management, ushering in a new era of convenience, accessibility, and personalized healthcare services. This review provides an insightful review of the evolving role of digital health in pharmacy, focusing on emerging trends and their impacts on patients. Digital health technologies, such as telepharmacy services, mobile health applications, and virtual consultations, have transformed the traditional pharmacy model by bridging geographical barriers and expanding access to healthcare services. Pharmacists can now engage with patients remotely, providing medication counselling, monitoring, and adherence support through digital platforms. These innovations enhance patient convenience, empower individuals to take control of their health, and ultimately improve health outcomes. Furthermore, digital health solutions leverage advanced technologies like artificial intelligence (AI) and data analytics to optimize medication therapy and personalize patient care. AI-driven algorithms analyze patient data to identify trends, predict health outcomes, and optimize medication regimens, leading to more effective treatment plans and reduced medication errors. Moreover, digital health fosters greater collaboration and communication among healthcare providers, enabling seamless coordination of care and improved patient outcomes. Through secure electronic health records and interoperable systems, pharmacists can access comprehensive patient information, facilitating informed decision-making and enhanced patient safety. However, the adoption of digital health in pharmacy also presents challenges, including data privacy concerns, regulatory complexities, and disparities in digital literacy among patients. Addressing these challenges is crucial to ensure the ethical and effective implementation of digital health technologies in pharmacy practice. In conclusion, the integration of digital health into modern pharmacy represents a paradigm shift in patient care delivery, offering unprecedented opportunities to enhance accessibility, efficiency, and quality of care. By embracing emerging digital health trends, pharmacists can revolutionize medication management, improve patient engagement, and ultimately contribute to better health outcomes for individuals and communities.

Phytochemical Research and Screening of Pharmacological Activity in Eryngium planum L. Herb Extracts

Species of the genus Eryngium L. of the Apiaceae family are successfully used in folk medicine in various countries worldwide, but they are hardly implemented in official medicinal and pharmaceutical practices. Therefore, it is advisable to conduct phytochemical and pharmacological research in E. planum L. herb extracts to develop and implement new phytomedicines based on this raw material. Purified water, and 40% and 70% ethanol were used for obtaining soft extracts. A total of seven hydroxycinnamic acids, six flavonoids, and three tannin metabolites were identified and quantified in the E. planum extracts by HPLC. These extracts were characterized as practically non-toxic medicines (V toxicity class, LD50 &gt; 5000 mg/kg). The hepatoprotective activity of the E. planum extracts has been established. They were affected to reduce serum thiobarbituric acid (TBA) levels by 29.3%, 31.5%, and 32.4%, respectively, compared to untreated animals and in liver homogenate by 59.5%, 65.4%, and 66.8%, respectively. The alanine transaminase (ALT) activity decreased by 26.9%, 30.8%, and 33.8%, respectively. The aspartate transaminase (AST) activity decreased by 23.9 %, 25.7 %, and 30.5 %, respectively. The sedative activity of E. planum extracts was studied for the first time. The 70% ethanol extract has the most pronounced sedative effect due to a significant decrease in motor activity (by 2.4 times compared to the control group) in the «Open Field test» and reduction in concern in the «Cube tests», «Raised Cross Maze», and "Black and White Camera". This extract also demonstrates a moderate antibacterial effect against gram-positive microorganisms (8–10 mm), including staphylococci, streptococci, and bacilli. These results provide a foundation for further preclinical and clinical studies of the dry extract of E. planum herb (extractant: 70% ethanol) to integrate it into modern medical practice and develop new supplements.

A survey of current trends in postgraduate year 2 pediatric pharmacy residencies and growth of pediatric ambulatory care pharmacy practice.

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. This study sought to characterize current trends in the program structure of postgraduate year 2 (PGY2) pediatric pharmacy residencies and to describe the growth of pediatric ambulatory care as a practice specialty. A 99-question survey was designed to collect information regarding the current structure of PGY2 pediatric pharmacy residency programs. The survey was distributed electronically to PGY2 residency program directors (RPDs) and was open for 6 weeks from September to November 2023. 75 distinct programs were eligible for participation; 43 programs (response rate, 57.3%) were included in the final analysis. Of the 43 respondents, 14 (32.6%) indicated their program was at a stand-alone children's hospital. The majority of programs (22 of 43, 51.2%) require residents to spend 7 to 9 months of their residency year on required rotations. Nineteen of 40 respondents (47.5%) indicated their residents staff in both clinical and operational areas. The most commonly reported frequency was every third weekend. Most respondents indicated requiring up to 15 presentations of varying types. A total of 41 respondents participated in the ambulatory care section of the survey; 75% of respondents (30 of 40) reported there has been growth in the number of pharmacists in pediatric ambulatory care at their institution in the last 5 years. This study describes the current state of PGY2 pediatric pharmacy residency programs, including educational opportunities and trends in staffing and academic activity requirements. This study also adds to available literature on pediatric ambulatory care and potential opportunities for resident-led expansion.

The Impact of Tele pharmacy in Rural Healthcare

In many nations, the rapid expansion of information and telecommunication technology use has a significant impact on healthcare delivery. Geographical and demographic characteristics, however, frequently make it difficult for rural areas and residents to access healthcare services. Telepharmacy, a relatively new term for pharmaceutical services, allows a qualified pharmacist to provide healthcare services, including medication reviews, patient counseling, and prescription verification, to patients who live far from a hospital, pharmacy, or healthcare facility. Economic benefits, patient satisfaction due to medication access and information in rural areas, easy access to healthcare services in remote and rural locations, effective patient counseling, and a lack of local pharmacists and pharmacy services are just a few of the well-known advantages of telepharmacy. Although telepharmacy is an excellent idea, its implementation can occasionally be difficult. There are hazards and legal issues that come with implementing these techniques that must be resolved. Significant time, money, and effort are required for the technology, software, connectivity, and operational costs associated with telepharmacy startup. One of the main obstacles to telepharmacy services for rural hospitals with fewer patients seems to be cost.Furthermore, there are still issues with the execution and uniformity of the telepharmacy law. A properly-designed system, however, has the power to transform pharmacy practice in ways that benefit rural communities as well as the hospitals or retail pharmacies that provide these services.

P-954. Integration Station - The Train Stops Here: Measuring Effectiveness of Integration of Medicinal Chemistry and Clinical Practice Content in a Required Infectious Diseases Pharmacotherapy Course for Pharmacy Students

Abstract Background Pharmacy school accrediting bodies require curricular integration with medicinal chemistry, pharmacology and practice in the curriculum. No studies discuss how to execute that integration effectively. Two pharmacy faculty (one from pharmaceutical sciences and one from pharmacy practice) developed an innovative method to integrate their content in a required ID course. The goal was to determine if exam scores improved. Methods Two faculty at one school of pharmacy developed an innovative method to deliver integrated content in a required ID pharmacotherapy course. They utilized methods of backward design and in-class application during the 2024 course delivery. Objectively, exam scores were compared to prior years (both overall scores and individual content questions such as pharmaceutical science and pharmacy practice) to assess effectiveness of content delivery. Results All of the infectious diseases content was assessed on two exams (exam 3 and 4) in the required course. The exam 3 average from 2024 was 71% and average scores from the three years prior were 72% (2023), 73.3% (2022), and 65.8% (2021). The exam 4 average from 2024 was 80.4%, and past average scores were 68.4% (2023), 69.3% (2022), and 67.1% (2021). Individual content between pharmaceutical sciences and pharmacy practice content from the exam scores from 2024 were higher than all previous exam scores, with a range of 1.6-14% points better in practice content, and 1.6-12.2% points better in science content. Conclusion While there may not have been a dramatic increase in exam scores from the 2024 iteration compared to the previous years, it can be noted that there were some improvements with the newly implemented method of integrated content delivery. Despite the fact that the overall exam 3 average did not increase in 2024 compared to 2023/2022, it is important to note that the content of the exam was weighted differently. There was 1.5x the amount of medicinal chemistry content on the 2024 exam vs previous exams. Students tend to perform worse on medicinal chemistry content. With improved exam scores, this method of integrated science and practice content appears to have been delivered more effectively than in past years. Disclosures All Authors: No reported disclosures

Utilizing IT-supported precision management measures to enhance rational drug use in primary healthcare institutions: a study of an internet-based regional prescription audit center

This study aimed to elevate the qualified rate (QR) of prescriptions and improve rational drug use while also minimizing adverse drug events in primary healthcare institutions within a designated region through information technology (IT)-supported precision management.In this study, a retrospective analysis was performed to evaluate the changes in the QR and adverse event rate associated with 5,923,764 prescriptions across 13 community health service centers in Tianhe District, Guangzhou, Guangdong Province, before and after the implementation of IT support. Detailed records and analyses were conducted on specific psycho-narcotic drugs, the appropriate use of antimicrobial prescriptions, and the incidence of adverse events following the introduction of IT support.Following the IT-supported precision management, 13 community health service centers witnessed a notable surge in the average QR of prescriptions, rising from 91.90% to 96.97% from 2018 to 2021 (P < 0.05). Among this, the average QR of psychotropic and anesthetic drugs, as well as antibiotics prescriptions at the same center showed a significant increase, while the average utilization rate of antibiotics demonstrated a marked decrease. Furthermore, the average incidence rate of adverse events caused by high-alert drugs dwindled from 225 cases/year in 2020 to 109 cases/year in 2021.The integration of a regional remote prescription audit center for IT-supported precision management of drug use in primary healthcare institutions has improved prescription quality and diminished the incidence rate of adverse drug events, indicating a significant contribution to the distribution of high-quality pharmacy resources of Grade IIIA hospitals to primary healthcare institutions. This initiative also improves rational drug use, marking a pioneering innovation in pharmacy practice that deserves commendation.

P-967. Impact of simulated ID rounds for third year pharmacy students (P3s) in an infectious diseases (ID) elective

Abstract Background ID Rounds simulate real-world multidisciplinary ID rounds for P3s enrolled in the ID elective. Two faculty play the ID attending and 4th year pharmacy students on their Advanced Pharmacy Practice Experiences play the roles of the ICU fellow, nurse, microbiologist, and radiologist. An ID consult for a patient with post-influenza pneumonia along with the patient’s general information and basic labs are presented. P3s are guided to navigate the patient care process, collecting and assessing information, and formulating, implementing, and evaluating therapeutic recommendations. Challenges incorporated include a weight discrepancy, altering antimicrobials, monitoring drug levels, following cultures, and discharge planning. The purpose of this study was to assess the impact of ID Rounds on achieving Doctor of Pharmacy educational outcomes and professional activities. Methods An anonymous, electronic survey was distributed to P3s to assess the impact of ID Rounds. Survey questions were designed in accordance with the standards set by the American Association of Colleges of Pharmacy Curriculum Outcomes and Entrustable Professional Activities, using a Likert scale. Student perceptions were also collected. Results 36 P3s responded and all strongly agreed or agreed that ID Rounds helped them learn foundational knowledge of inpatient rounds and enhanced their professional skills by building and maintaining trust among their colleagues. Majority strongly agreed or agreed that ID Rounds helped them understand the role of a pharmacist in optimizing antimicrobial use (94.5%, 34/26), become better communicators (94.5%, 34/36), and support the achievement of shared goals on a team (97.2%, 35/26). Majority rated ID Rounds a 4 out of 5 in difficulty, found the activity as an engaging way of learning about inpatient rounds, and enjoyed participating. Conclusion ID Rounds allowed pharmacy students to achieve key standards in Doctor of Pharmacy educational outcomes and professional activities. Students responded positively to ID Rounds, which actively involved them in a real-world scenario, enabling the application of critical skills such as collaborative practice, critical thinking, and effective communication. These competencies are fundamental to the practice of pharmacy. Disclosures All Authors: No reported disclosures

P-1806. ABLE to De-Label: Liberating Patients from Penicillin Chart Allergies

Abstract Background The Veterans Affairs Clinical Pharmacy Practice Office Allergy to Beta Lactam Evaluation (ABLE) initiative was launched at the at the Michael E DeBakey VA Medical Center in October 2023. The primary implementation tool was a standardized note template, streamlining the documentation and assessment of penicillin allergy information. Patients who had tolerated penicillins since reaction or had side effects were eligible for immediate de-labeling. Those with unknown reactions, IgE-mediated allergies &amp;gt;10 years ago, or non-severe IgE-mediated allergies &amp;gt;5 years ago were considered candidates for penicillin allergy testing. All other reactions were considered ineligible for further evaluation. Results of ABLE intervention Results of ABLE intervention from October 2023-February 2024 Methods Patients labeled as penicillin allergic who were previously seen in ID clinic were contacted via unscheduled telephone calls to clarify allergy histories, identify opportunities for de-labeling, and provide recommendations for alternative beta-lactam use. The primary outcome was the proportion of “penicillin-allergic” patients successfully de-labeled. ABLE Intervention Flowchart Results Of 88 patients identified, 16 (18%) were deceased and 13 (15%) were de-labeled prior to ABLE implementation in October 2023. 56 of the 59 remaining patients received at least one attempt at telephone contact. 24 patients received the ABLE intervention. Of these, 8 patients (33%) were immediately de-labeled, and 1 declined to have the allergy removed despite being eligible. Another 13 patients (54%) were eligible for further allergy testing, of which 5 (21%) accepted a referral to Allergy clinic. Two patients (8%) were not eligible for further testing. One patient who was successfully de-labeled regained the penicillin allergy label. Conclusion The ABLE initiative improves antimicrobial stewardship and patient care by accurately assessing and managing penicillin allergies. These findings suggest those who are eligible for immediate de-labeling based on chart review should be prioritized for intervention. However, based on the acceptance rate of this telephonic intervention, alternative modalities of implementation should be explored. Disclosures All Authors: No reported disclosures

Efficacy and potentiality of vitamins and micronutrients oral sprays supplementation (review)

Introduction. Modern pharmaceutical development enables to introduce into practice more than ever new active ingredients delivery systems and forms enhancing actives activity compared to traditional approach (methods). A nowadays pace of life often providing improper feeding and micronutrients intake imbalance leads to necessary administration of micronutrient additional doses in the form of different pharmacies. Over the last years vitamins and minor nutrient elements spray forms are becoming more attractive for introduction into pharmaceutical practice. These dosage forms are characterized by the production availability, usability, easy dosage and sufficiently high bioavailability for both normal patients and ones having gastrointestinal tract diseases and other problems connecting with the food consumption and digestion.Text. Drug delivery by oral mucosa attracts more attention due to its potential advantages compared to other methods. Until recently this administration way was considered mainly for topical application. However, in recent years number of developments connecting with oral cavity application as a portal for delivery of drugs active ingredients, vitamins and micronutrients into systemic blood has kept steadily growing. Diverse forms of oral drugs for sublingual and buccal administration have been developed by many scientific and clinical teams. Spray forms among them are of particular interest as the most economically viable and easy to use. Most of these developments deal with vitamins D and B12, which arises from the acutest problems of their deficiency among global population, on the one hand, and low bioavailability due to negative effects by dietary intake, gastrointestinal tract health condition and other factors, on the other hand. Other micronutrients such as thiamin, niacin, pyridoxin, ascorbic acid, coenzyme Q and iron are examined and launched into the market in an oral spray form for sublingual application.Conclusion. The current results of development and comparison study of micronutrients oral forms, in particular, randomized controlled trial data indicate a sublingual administration efficiency which either is similar to or exceeds traditional administration ways.

Knowledge and management practices of infantile colic among mothers attending the paediatric outpatient clinic in port Harcourt, Nigeria

Background: Infantile colic is a functional gastrointestinal disorder not explained by organic or biochemical abnormalities. The aim of the study was to assess the knowledge and practice of infantile colic management among mothers in Southern Nigeria. Methods: It was a cross-sectional study carried out over one-year period using interviewer-administered questionnaires. Results: Of 327 mothers recruited, most were of age group 28-37 years 204 (62.4%), had tertiary level of education 226 (69.1%), with parity of two 214 (65.4%) and were presently nursing infants of 1-12 months of age 227 (69.4%). Majority 259 (79.2%) lived in urban areas and belonged to the upper socioeconomic class 163 (49.8%). Most mothers 249 (76.1%) had heard of infantile colic majorly from parents/relatives/in-laws (29.1%). Majority of them said colic was a physiologic process 201 (82.0%) while 142 (58.0%), due to gas in the intestines. Incorrect knowledge of features of colic included vomiting, passage of green-coloured stools and fever. Most mothers had good knowledge of infantile colic (44.3%) and this was significantly associated with higher level of education and socioeconomic class. Most children 206 (63.0%) brought to the clinic had had infantile colic which started mostly at 0-4 months 223 (68.2%) and resolved by 3-5 months of age 171 (52.3%). The most common treatment practices were the use of nospamin (38.1%) and grippe water (33.5%), prescribed mostly by healthcare workers (27.3%) and purchased from chemist shops (71.8%). Conclusion: There was good knowledge of infantile colic among mothers in the study. However, there is still need to increase public enlightenment on the benign and self-limiting nature of infantile colic.

Bridging the continuity: Practice-enhancing publications about the ambulatory care medication-use process in 2023.

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. This article identifies, summarizes, and prioritizes published literature on the ambulatory care medication-use process (ACMUP) from 2023 that can describe ambulatory pharmacy practice. The medication-use process is the foundational system that provides the framework for safe medication utilization within the healthcare environment. The ACMUP is defined in this article as having the following components: transitions of care, prescribing, access, dispensing, adherence, and evaluating. Articles evaluating at least one step of the ACMUP were assessed for their usefulness toward practice improvement. A PubMed search was conducted in January 2024 for the publication year 2023 using targeted Medical Subject Headings (MeSH) keywords and the table of contents of selected pharmacy journals, providing a total of 2,903 articles. A thorough review identified 52 potentially practice-enhancing articles: 6 for transitions of care, 11 for prescribing, 5 for access, 6 for dispensing, 8 for adherence, and 16 articles for evaluating. Trends gleaned from the highest-impact articles are described. It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article continues a series of articles defining and evaluating the currently published literature around the ACMUP. As healthcare continues to advance and care shifts to ambulatory settings, the ACMUP will continue to be a crucial process to evaluate.

Pharmacy students’ opinion on mandatory summer internships carried out in community and hospital pharmacies

BackgroundPharmacy internships are an important part of pharmacy education in Poland; they are an integral part of professional studies. The first two internships are held after the third and fourth year of study during the summer break and last for four weeks. The study aims to analyze the didactic process of the pharmacy students taking place during the summer internship in community and hospital pharmacies in Poland. The analysis emphasizes the acquisition of skills built on the master-student contact, and the results are based on trainees’ feedback.MethodsThe research tool was a questionnaire addressed to fifth-year pharmacy students who had previously completed summer internships in both community and hospital pharmacy. The survey contained 17 questions that sought to gain insight into their perceptions of the internship’s supervision and guidance of work by tutors and pharmacy staff, involvement in different workplace routines and comparison between formal education and everyday practice. The data collection was carried out in the academic year 2015–2016 among the ninth-semester pharmacy students from four Medical Universities in Poland. Information about internships performed in community and hospital pharmacies were collected separately.ResultsThe paper presents the results of selected questions related specifically to the legitimacy of summer internships and learning about professional responsibilities. Altogether 447 questionnaires, evaluating summer internships in both community and hospital pharmacies were collected. For the majority of students the summer internship made them aware of the profession; however, the internship in some pharmacies did not always provide them with all aspects of pharmaceutical practice. 14–40% of students admitted that their mentors did not introduce the internship program at the beginning of the internship. Only 35–46% of students performed drug formulations on a daily basis. Less than 30% of respondents indicated that drug formulary process in community pharmacies was the same as they have learned at university. Almost every day or very often students were involved in checking or spreading out the drugs delivered to the pharmacy from the wholesale institution. Only two universities conducted regular audits of the internship process by the supervisors (academic teachers).ConclusionsThe summer internship of pharmacy students complements the opportunity to acquire practical skills in the training of future pharmacists. The quality of this didactic process should be subjected to constant verification. What is important is that pharmacists who are tutors of students participating in summer internships should obtain an academic support in the area of education and training, relevant to the professional preparation for the didactic process. Similar rules for summer internships should be developed, despite maintaining distinctiveness, across faculties. The students’ responses indicate varying levels of mentor involvement in the implementation of practical vocational training. What is worrying is the lack of substantive and practical supervision during the internship.

Evaluation of Community Pharmacy Practices in Pakistan: Insights into Asthma, Diabetes, HCV and Tuberculosis Management

Patient counseling is an integral part of pharmaceutical services at community pharmacies as community pharmacists are health care professionals most accessible to general public. In this cross sectional qualitative study counseling quality of pharmacists and senior pharmacy technician was evaluated by using pseudo patient method. The study was conducted for 12 weeks at 35 community pharmacies randomly selected from various areas of Lahore. Four diseases which are most prevalent in developing countries were selected for this study. This study revealed that pharmacists were present at 52% of pharmacies visited. Counseling was offered hundred per cent on demand. On 6% pharmacies pharmacy technician refused to counsel on demand. Frequency, administration and storage of drugs were counseled frequently. Parameters like drug’s side effects, disease complications, drug interactions and contraindications were rarely addressed. Quality of counseling was much better in pharmacies where pharmacists were present, pharmacists counseled effectively about dose, frequency, administration, storage, side effects, drug interactions and complications. In order to improve quality of counseling at community pharmacies presence of pharmacist designated for patient counseling should be mandatory and continuing education programs should be run to update pharmacist and pharmacy technician knowledge.

Ethical Considerations in Pharmaceutical Gift-Giving Practices: A Case Study of Bangladesh

The Bangladeshi healthcare system grapples with the entrenched practice of pharmaceutical companies showering medical representatives (MRs) with gifts to influence healthcare professionals (HCPs). Despite legal frameworks like the Drug Act (1940), which, until 2023, served as the core of Bangladesh's pharmaceutical sector regulation framework, was repealed by the Drugs and Cosmetics Act, 2023 and Drug Rules (1946) prohibiting the exchange of gifts and incentives to HCPs, a 2022 survey by Transparency International Bangladesh (TIB) revealed that 77% of physicians acknowledge receiving gifts from pharmaceutical companies. This article explores the reasons behind this phenomenon, including fierce industry competition, manipulation of prescribing habits, and financial allure for HCPs. Further, the article examines the multifaceted impact of gift-giving on patient care, healthcare expenditure, and public trust in the medical profession. It delves into the ethical considerations surrounding conflicts of interest, transparency, and accountability in the pharmaceutical-HCP nexus. Additionally, it analyzes the evolving role of regulatory bodies like the Directorate General of Drug Administration (DGDA) in enforcing regulations governing gift-giving practices. Through a critical examination of recent case studies and relevant literature, this article sheds light on the complex dynamics at play and proposes evidence-based recommendations for fostering transparency, integrity, and ethical conduct within the Bangladeshi pharmaceutical industry and healthcare sector. By drawing comparisons with international regulatory frameworks and ethical standards, the article aims to provide a comprehensive understanding of the challenges and potential solutions to curb unethical practices in Bangladesh.