Strategy to Improve Efficiency of Comprehensive Medication Reviews in a Community Pharmacy.

Background: Comprehensive medication reviews (CMRs) provide opportunities for pharmacists to perform clinical services to their patients. However, pharmacists are often not able to perform CMRs due to time constraints. Studies have shown that incorporating support staff into the CMR workflow may lead to increases in the completion of CMRs. Objective: The primary objective was to examine the change in the number of CMRs completed at the pharmacy after a new strategy was implemented to perform and prepare for CMRs. The secondary objective was to examine the changes in the revenue generated from CMRs. Methods: This study was a pre-post retrospective, observational study performed at an independent pharmacy. Data were collected and analyzed 10 months before and after implementation of a new strategy. The new strategy called for pharmacy interns to use a template for working up patients prior to CMRs. Wilcoxon signed-rank tests were run on IBM SPSS, Version 24.0, to determine the significance of the changes. Results that generated P values <.05 were considered statistically significant. Results: The total number of CMRs completed increased from 29 before the intervention to 158 after the intervention (P = .009). The revenue generated from CMRs improved statistically (P = .007). Conclusions: Implementing a strategic workflow that uses pharmacy interns and a patient workup template can significantly increase the number of CMRs completed in a community pharmacy. Appropriate delegation of such tasks may allow more time for pharmacists to deliver more CMRs. Additional benefits include increased compensation from delivering more CMRs.

Complex Diagnostic Dilemma of Viral Hepatitis vs. Drug-Induced Hepatitis: A Case Report.

This case report explores the intricate diagnostic challenges encountered in a 30-year-old male patient with abdominal pain, jaundice, and a history of acetaminophen use. Initially presenting as a potential case of drug-induced hepatitis due to acetaminophen overdose, the diagnosis took an unexpected turn when the patient tested positive for hepatitis B surface antigen. The case highlights the complexity of diagnosing acute hepatitis, considering multiple potential etiologies, including viral and drug-induced factors. Differential diagnoses for this case involve considering drug-induced hepatitis, autoimmune hepatitis, various viral hepatitis types, and the potential contribution of cocaine-induced hepatitis as individual possibilities or in combination. This case emphasizes the need for a comprehensive evaluation, the consideration of multiple potential causes, and the importance of ongoing monitoring and follow-up to ensure optimal patient care in cases of acute hepatitis.

COVID-19, Suffering and Palliative Care: A Review.

According to the WHO guideline, palliative care is an integral component of COVID-19 management. The relief of physical symptoms and the provision of psychosocial support should be practiced by all healthcare workers caring for COVID-19 patients. In this review, we aim to provide a simple outline on COVID-19, suffering in COVID-19, and the role of palliative care in COVID-19. We also introduce 3 principles of palliative care that can serve as a guide for all healthcare workers caring for COVID-19 patients, which are (1) good symptom control, (2) open and sensitive communication, and (3) caring for the whole team. The pandemic has brought immense suffering, fear and death to people everywhere. The knowledge, skills and experiences from palliative care could be used to relieve the suffering of COVID-19 patients.

Exploring young pharmacists' and pharmaceutical scientists' needs and expectations within an international pharmacy organization: Findings from FIP's needs assessment survey.

BACKGROUND: Engaging youth in the activities of health organizations is imperative to achieve the Sustainable Development Goals (SDGs). The International Pharmaceutical Federation Young Pharmacists Group (FIP YPG) was formally launched in 2001 to increase the engagement of young pharmacists and pharmaceutical scientists. Additionally, FIP YPG was set up to foster their potential for leadership within the various Sections and Special Interest Groups of FIP in the areas of pharmacy practice, pharmaceutical sciences and pharmacy education. With the new ONE FIP strategy, achieving the goal of advancing pharmacy together as ONE organization, FIP and FIP YPG looked into the needs and expectations of its members to achieve synergy and amplify outcomes. OBJECTIVES: FIP YPG carried out a needs-assessment survey to explore the needs and expectations of its members in order to better align FIP's goals and its members' needs. METHODS: An online survey was conducted between 1 May 2019 and 2 June 2019 of the members of FIP YPG. Invitations to complete the questionnaire were sent out by email to all FIP YPG members. The questionnaire included participant demographics; satisfaction on current FIP YPG activities, participation in FIP YPG activities; preferred activities of FIP YPG; expectations from FIP YPG and presence of national/regional YPG in the members' respective geographies. RESULTS: The survey elicited a response rate of 37.25%. Sixty-seven percent of members were satisfied with current FIP YPG activities. The most preferred activity and the main reason for joining the organization was 'networking opportunities.' 'Newsletter' (as a reader) was the most common resource selected by participants (71%). Newsletters were also the preferred platform for communication (75.32%). 'International YPG conference' was found to be the focus of members' preference (59.49%). Nearly a majority FIP YPG members preferred webinars focused on 'Career development' (44.94%). The preferred type of project to be involved in were 'Inter-professional collaboration projects' (45.57%). 'Exploration of opportunities and incentives for implementing new professional services' was found to be the preferred topic for research survey (33.54%). CONCLUSION: FIP YPG members' needs were descriptively analyzed for the purpose of better alignment of the organization's goals with members' goals. Networking, collaborations, career and leadership development and effective communication, among other aspects, were found to be the main interests of the members surveyed. The survey findings have been employed in the development of strategic plans for FIP YPG members and how FIP YPG can be an effective launching platform for the future roles in FIP.

Screening Tool of Older Person's Prescriptions/Screening Tools to Alert Doctors to Right Treatment Medication Criteria Modified for U.S. Nursing Home Setting.

OBJECTIVES: To develop a set of prescribing indicators measurable with available data from electronic nursing home (NH) databases by adapting the European-based 2014 Screening Tool of Older Person's Prescriptions (STOPP) and Screening Tools to Alert Doctors to Right Treatment (START) criteria of potentially inappropriate and underused medications for the U.S. DESIGN: A two-stage expert panel process. In the first stage, the investigator team reviewed 114 criteria for compatibility and measurability. In the second stage, an online modified e-Delphi (OMD) panel was convened to rate the validity of criteria, and two webinars were held to identify criteria with highest relevance to U.S. NHs. PARTICIPANTS: Seventeen experts with recognized reputations in NH care participated in the e-Delphi panel and 12 in the webinar. MEASUREMENTS: Compatibility and measurability were assessed by comparing criteria with U.S. terminology and setting standards and data elements in NH databases. Validity was rated using a 9-point Likert-type scale (1 = not valid at all, 9 = highly valid). Mean, median, interpercentile ranges, and agreement were determined for each criterion score. Relevance was determined by ranking the mean panel ratings on criteria that reached agreement; the webinar participants reviewed and approved half of the criteria with the highest mean values. RESULTS: Fifty-three STOPP/START criteria were deemed to be compatible with the U.S. NH setting and measurable using data from electronic NH databases. E-Delphi panelists rated 48 criteria as valid for U.S. NHs. Twenty-four criteria were deemed to be most relevant, consisting of 22 measures of potentially inappropriate medications and two measures of underused medications. CONCLUSION: This study created the first explicit criteria for assessing the quality of prescribing in U.S. NHs.