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1.
BMC Med Educ ; 24(1): 521, 2024 May 10.
Artículo en Inglés | MEDLINE | ID: mdl-38730316

RESUMEN

BACKGROUND: The New Medicine Service (NMS) was developed in England more than ten years ago, as a three-stage consultation led by community pharmacists to support patients taking new medication for a chronic disease. In Poland, the scheme was officially introduced in January 2023. However, its implementation into common practice has been presented with various obstacles, including the need to develop relationships with general practitioners, resolve the payment structure, and provide training with adequate supporting materials. Hence, written materials have been designed for use as an optional tool for counselling patients receiving an NMS in community pharmacies. METHODS: The present study evaluates the ability of these materials to inform patients about the need to adhere to anti-hypertensive medication. A group of 401 randomly-selected adult visitors to pharmacies and/or healthcare centres were surveyed; one third had hypertension in their history. RESULTS: The structure, grammar and readability of the text achieved the required threshold of 40% according to the Plain Language Index. The designed materials effectively informed the patients about anti-hypertensive medication, reflected in an increased score in a knowledge test, and were rated positively regarding information level, comprehensibility and presentation. CONCLUSION: The proposed material may serve as an additional, "patient-friendly" educational tool for use as part of an NMS.


Asunto(s)
Consejo , Hipertensión , Educación del Paciente como Asunto , Humanos , Polonia , Hipertensión/tratamiento farmacológico , Hipertensión/terapia , Masculino , Femenino , Persona de Mediana Edad , Adulto , Antihipertensivos/uso terapéutico , Folletos , Cumplimiento de la Medicación , Servicios Comunitarios de Farmacia/organización & administración , Anciano
2.
Front Pharmacol ; 15: 1348400, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38434703

RESUMEN

Background: Pharmacist-led medication reviews (MR) are one of the key methods to support medication safety in polypharmacy patients. The aims of this study were to pilot MRs in Eastern European community pharmacies, describe medication use in polypharmacy patients, and evaluate the usability of medication safety assessment tools. Methods: The MR pilot was undertaken in Estonia, Latvia, Poland, Hungary, Romania, and Bulgaria. Patients who used at least five medicines were directed to the service by their GPs. Data on drug-related problems (DRPs) and adherence were collected by pharmacists through structured patient interviews. Databases for identification of potential drug-drug interactions (pDDIs) and adverse drug reactions (ADRs) named Inxbase/Riskbase, as well as an integrated tool comprising potentially inappropriate medicines (PIMs) lists EU(7)-PIM and EURO-FORTA, were applied retroactively to the MR pilot data to investigate possibilities for their use and to describe medication use and potential risks in the study population. Results: A total of 318 patients were included in the study, 250 of them elderly (≥65 years). One hundred and eighty (56.6%) participants had a total of 504 pDDIs based on Inxbase analysis. On average, there were 1.6 pDDIs per participant. Twenty-five (5.0%) of the 504 pDDIs were in a high-risk category. A total of 279 (87.7%) participants had a potential ADR in at least one of 10 Riskbase categories. One hundred and fifty-four (20.8%) of the potential ADRs were in a high-risk category. Twenty-seven pDDIs and 68 ADRs documented as DRPs during the service were not included in the databases. Using the integrated EU(7)-PIM/EURO-FORTA PIM list, a total of 816 PIMs were found in 240 (96%) of the 250 elderly participants (on average 3.4 PIMs per elderly participant). Seventy-one (29.6%) of the participants were using high-risk PIMs. Twenty-one percent of high-risk PIMs and 13.8% of medium-risk PIMs were documented as DRPs by the pharmacists during the pilot. Conclusion: Medication safety assessment tools can be useful in guiding decision-making during MRs; however, these tools cannot replace patient interviews and monitoring. Tools that include a thorough explanation of the potential risks and are easy to use are more beneficial for MRs.

3.
BMC Med Educ ; 24(1): 283, 2024 Mar 14.
Artículo en Inglés | MEDLINE | ID: mdl-38486206

RESUMEN

BACKGROUND: The transformation of a pharmacist's role from that of a drug dispenser to an advisor and patient educator, partially accelerated by the COVID-19 pandemic, requires a thorough change in the pharmacy curriculum. Preparation for the provision of modern pharmaceutical services requires the use of the most advanced teaching methods, such as pharmaceutical simulation. Knowledge alone does not guarantee students' readiness and motivation to take on new challenges in their professional work, but it seems crucial that graduates of medical faculties have the ability to practically apply their knowledge, including in new and nonstandard situations. Therefore, in our study, we proposed an intervention using a simulation method (peer role play) in teaching pharmaceutical care, and we assessed its impact on students' levels of self-perceived confidence and self-efficacy in accordance with Bandura's theory. The aim of the study was to verify whether the introduction of these types of classes could be a useful element of pharmacy curriculum renewal. METHODS: The questionnaire-based study was conducted during pharmaceutical care peer role-playing classes in a simulation environment with a debriefing session among 85 final-year pharmacy students at Poznan University of Medical Sciences, Poland. The questionnaire consisted of two surveys: the General Self-Efficacy Scale (GSE) and a pre-post self-assessment and self-efficacy questionnaire. RESULTS: There was a positive correlation between the GSE score and self-efficacy (R = 0.52, p < 0.0001). A statistically significant increase in the post-self-assessment of all the skills and competencies included in the survey in the field of pharmaceutical care of a patient with diabetes compared to the pre-values was also observed (p < 0.001). Additionally, the students' self-efficacy in terms of communicating with patients was greater following the class than before the class (p < 0.001). CONCLUSIONS: The peer role-play active teaching method was found to be a cost-effective method allowing for an increase in the self-assessment and self-efficacy of pharmacy students in diabetic patient pharmaceutical care. However, further in-depth research is needed to fully confirm the effectiveness of simulation exercises for teaching pharmacy undergraduates.


Asunto(s)
Diabetes Mellitus , Educación en Farmacia , Servicios Farmacéuticos , Estudiantes de Farmacia , Humanos , Polonia , Proyectos Piloto , Pandemias , Curriculum , Educación en Farmacia/métodos , Percepción
4.
BMC Med Educ ; 24(1): 153, 2024 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-38374024

RESUMEN

BACKGROUND: Patients with asthma and chronic obstructive pulmonary disease could benefit from education on using inhalers provided by pharmacists. However, pharmacists may have limited competencies, indicating the necessity to implement appropriate postgraduate courses. The study aimed to evaluate an inhaler use course for pharmacists, including its impact on participants' knowledge and satisfaction. METHODS: The study involved 261 pharmacists from community pharmacies and was conducted between September 2019 and March 2021. A pre-post analysis of their knowledge of the topic was applied. Additionally, at the beginning of the course, participants were asked about their educational needs, and at the end, they completed a satisfaction survey. The preferred learning formats indicated by participants were interactive workshops and lectures. RESULTS: As a result of the course, both their actual and self-assessed level of knowledge significantly increased. The percentage of correct answers in the test before the training was 24.4%, while after, it was 84.3% (p < 0.0001). Before the course, their average self-assessed level of knowledge was 52.0%, and after the training, it increased to 90.0% (p < 0.0001). Almost all respondents stated that the course met their expectations. They estimated their satisfaction at 94.0% and the usefulness of the provided information at 98.0%. CONCLUSIONS: Improved preparation of pharmacists resulting from their participation in the course can contribute to providing more professional advice to patients, thereby positively influencing the pharmaceutical care process in community pharmacies.


Asunto(s)
Servicios Comunitarios de Farmacia , Enfermedad Pulmonar Obstructiva Crónica , Humanos , Farmacéuticos , Educación del Paciente como Asunto , Nebulizadores y Vaporizadores , Enfermedad Pulmonar Obstructiva Crónica/tratamiento farmacológico , Resultado del Tratamiento
5.
J Clin Med ; 12(8)2023 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-37109373

RESUMEN

BACKGROUND: existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on supporting disease management for hospitalized patients with heart failure (HF). The present paper reviews the effects of inpatient, discharge and/or after-discharge interventions performed on hospitalized HF patients by multidisciplinary teams, including pharmacists. METHODS: articles were identified through search engines in three electronic databases following the PRISMA Protocol. Randomized controlled trials (RCTs) or non-randomized intervention studies conducted in the period 1992-2022 were included. In all studies, baseline characteristics of patients as well as study end-points were described in relation to a control group i.e., usual care and a group of subjects that received care from a clinical and/or community pharmacist, as well as other health professionals (Intervention). Study outcomes included all-cause hospital 30-day re-admission or emergency room (ER) visits, all-cause hospitalization within >30 days after discharge, specific-cause hospitalization rates, medication adherence and mortality. The secondary outcomes included adverse events and quality of life. Quality assessment was carried out using RoB 2 Risk of Bias Tool. Publication bias across studies was determined using the funnel plot and Egger's regression test. RESULTS: a total of 34 protocols were included in the review, while the data from 33 trials were included in further quantitative analyses. The heterogeneity between studies was high. Pharmacist-led interventions, usually performed within interprofessional care teams, reduced the rates of 30-day all-cause hospital re-admission (odds ratio, OR = 0.78; 95% CI 0.62-0.98; p = 0.03) and all-cause hospitalization >30 days after discharge (OR = 0.73; 95% CI 0.63-0.86; p = 0.0001). Subjects hospitalized primarily due to heart failure demonstrated reduced risk of hospital admission within longer periods, i.e., from 60 to 365 days after discharge (OR = 0.64; 95% CI 0.51-0.81; p = 0.0002). The rate of all-cause hospitalization was reduced by multidimensional interventions taken by pharmacists: reviews of medicine lists and/or their reconciliation at discharge (OR = 0.63; 95% CI 0.43-0.91; p = 0.014), as well as interventions that were based mainly on patient education and counseling (OR = 0.65; 95% CI 0.49-0.88; p = 0.0047). In conclusion, given that HF patients often have complex treatment regimens and multiple comorbid conditions, our findings highlight the need for greater involvement from skilled clinical and community pharmacists in disease management.

6.
Heliyon ; 9(2): e13227, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36785825

RESUMEN

Background: The pharmacists in a community pharmacies have already provided, or will provide in the near future advanced pharmaceutical care services. This requires modifying the approach to teaching pharmacy students as well as adapting the curriculum to the changing professional realities. It has been proven that in the field of medical and related sciences, learners-centered active teaching methods allow to achieve learning outcomes effectively, especially in the field of practical skills. Objectives: As the pharmaceutical services are only being introduced in many European countries, the question arises as to what active learning methods to use to prepare pharmacy graduates for this. Thus the review of worldwide literature occurred to be helpful in identifying what active learning methods are being used specifically in teaching aspects of pharmaceutical care. Methods: Three electronic databases: Pubmed, Scopus and Web of Science were searched using the keywords "active learning" and "pharmaceutical care". Results: On the basis of the publications included in the review, 7 methods were distinguished. Case-study, role play and simulation exercises turned out to be the most popular. It was also possible to make preliminary conclusions on how to properly match the method to the learning outcomes. Moreover, a weak point of many studies was the lack of structured methods of assessing the skills acquired by the students. Conclusions: In conclusion, the curriculum renewal in pharmacy is necessary and requires taking many aspects into account, from the types of tasks assigned to pharmacists, through the selection of appropriate teaching methods, to the verification of assessment methods.

7.
Artículo en Inglés | MEDLINE | ID: mdl-36673701

RESUMEN

The study aimed to get to know patients' opinions on implementing pharmaceutical care for diabetic patients in a community pharmacy to prevent and effectively and holistically approach the treatment of people with diabetes. It was based on an authorial survey form and conducted from August to October 2021 in a community pharmacy in Poznan, Poland. A total of 131 pharmacy patients over 18 years were included in the study. Results showed that the vast majority of patients confirmed their interest in pharmaceutical care in diabetes conducted by pharmacists. Moreover, 79.4% of respondents would like to benefit from medicines use review, while 87.0% confirmed an interest in the 'New Drug' service, with diabetic patients being particularly interested in this (p = 0.2447). Most respondents were also interested in education on how to use a glucose meter, administer insulin and use a lancing device. In addition, the study showed patients' insufficient knowledge about risk factors and prevention of diabetes with the need for patient education. As the source of funding, 91.7% of diabetic patients indicated the National Health Fund. Given that such a service has not been implemented in Poland yet, this study may support established teams at the Supreme Pharmaceutical Chamber or the Ministry of Health in introducing such new services.


Asunto(s)
Servicios Comunitarios de Farmacia , Diabetes Mellitus , Humanos , Polonia , Diabetes Mellitus/tratamiento farmacológico , Encuestas y Cuestionarios , Factores de Riesgo , Farmacéuticos
8.
Artículo en Inglés | MEDLINE | ID: mdl-36141986

RESUMEN

BACKGROUND: Getting to know the experience gained so far between professions such as pharmacists and nurses allows for introducing changes aimed at better cooperation, and that can improve the quality of patient care. The aim was to obtain the nurses' opinions on the ongoing cooperation with pharmacists and to analyze the possibilities of cooperation between these groups. METHODS: The survey was conducted from January to March 2021 among 124 nurses in Poland. The link to the electronic questionnaire was sent by e-mails sourced from online social groups for nurses. Before completing the questionnaire, each participant was informed about the anonymous research and the purpose of the data obtained. RESULTS: In total, 80.6% of the respondents confirmed that the pharmacist is a reliable advisor in the field of general information about a drug and 60.9% in the field of clinical information about the drug, and 54.8% of the nurses agreed that a pharmacist should carry out such practices as measuring blood pressure or glucose in a community pharmacy, with 70.1% agreeing that a pharmacist should provide pharmaceutical care in a community pharmacy in the future and the most convinced of this were people with a master's degree. Of the respondents, 74.1% indicated that pharmacist advice should be fully reimbursed by the National Health Fund or another insurance institution. CONCLUSIONS: The study showed that the nursing community appreciates the role of pharmacists and has a positive attitude towards cooperation with this professional group. What is more is that it indicates willingness for interdisciplinary cooperation.


Asunto(s)
Servicios Comunitarios de Farmacia , Farmacéuticos , Actitud del Personal de Salud , Humanos , Motivación , Rol Profesional , Encuestas y Cuestionarios
9.
Artículo en Inglés | MEDLINE | ID: mdl-35805468

RESUMEN

Despite the functioning of the Bologna Declaration, the knowledge and skills of graduates educated in different countries may differ significantly. Therefore, this article aims to present the differences in results of the final exam in pharmacy among Polish pharmacy students. This exam was modeled on the British national exam supervised by the General Pharmaceutical Council. The exam was conducted in three cities in Poland, among a total of 175 final-year students (a full sample of those eligible was 451 with 276 refusals (38.58% response rate)). Taking the exam was voluntary and anonymous. The results indicate that none of the Polish students achieved the 70% mark required to pass the Great Britain exam. Significant differences in test results were noticed between cities. Students achieved the best average exam result in Bydgoszcz (46.35%), then in Warsaw (38.81%) and Lódz (38.35%). The pharmaceutical education system in Poland requires complete changes that will prepare future pharmacists for clinical work.


Asunto(s)
Servicios Farmacéuticos , Estudiantes de Farmacia , Humanos , Farmacéuticos , Proyectos Piloto , Polonia
10.
Artículo en Inglés | MEDLINE | ID: mdl-35742606

RESUMEN

It is necessary to monitor and adapt pharmacy curricula to make graduates ready to effectively meet the health needs of the society. Therefore, the aim of the study was to obtain Polish final year pharmacy students' opinions on the activities related to pharmaceutical care (PC) andtheir perception of PC. Two questionnaires were used: one evaluating a PC regarding classes and in practice (n = 64), and the other on the assessment of existing educational solutions in the field of professional counseling (n = 118). Statistical analysis showed that the students agreed that there are not enough hours of a PC classes, since these are necessary to enable them to provide PC services in the future (R = 0.05, p = 0.0007). In previous classes, teachers' knowledge was rated the highest on a five-point scale (4.74), and role play (3.92) and the duration of the classes (3.77) were rated the lowest. Although the students were aware of the role of a PC in the work of a pharmacist, they indicated that more extensive use of active learning methods would better prepare them for the profession. Therefore, pharmacy students' self-efficacy survey and a curriculum renewal would be recommended in Poland.


Asunto(s)
Servicios Farmacéuticos , Estudiantes de Farmacia , Actitud del Personal de Salud , Estudios Transversales , Curriculum , Humanos , Polonia , Estudiantes de Farmacia/psicología , Encuestas y Cuestionarios , Enseñanza
11.
Kardiol Pol ; 80(7-8): 813-824, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35554929

RESUMEN

BACKGROUND: The application of a circulating miR-195 inhibitor could be a helping factor in the in vitro model of human skeletal muscle-derived stem/progenitor cells (SkMDS/PCs). Previously, microRNA-195 (miR-195) expression has been reported to be a negative factor for myogenesis. AIMS: The study aimed to obtain anti-apoptotic and anti-aging effects in in vitro cultured myoblasts and to improve their ability to form myotubes by suppressing miR-195 expression. METHODS: Human wild-type (WT) SkMDS/PC cells incubated with control (nonspecific) miRNA inhibitor and miR-195-inhibited SkMDS/PCs were studied. Functional assays (myotube formation and cell aging), antioxidant, and myogenic gene expression analyses were performed at two time points, at the seventh and eleventh cell passages. RESULTS: Myotube formation was found to be almost 2-fold higher in the miR-195-inhibited SkMDS/PCs population (P < 0.05) compared to WT cells. miR-195 inhibition did not appear to affect cell aging or rejuvenate human SkMDS/PCs. Antioxidant (SOD3 and FOXO) gene expression was augmented in the miR-195-inhibited SkMDS/PCs population, but no positive effect on the remaining antioxidant genes (SOD1, SOD2, and catalase) was observed. A significant increase in MyoD gene expression with a concomitant decrease in MyoG (P < 0.05) was further documented in miR-195- -inhibited SkMDS/PCs compared to WT cells (the eleventh cell passage). CONCLUSIONS: The performed studies may lead to the preconditioning of myogenic stem cells to extend their potential for pro-regenerative activity. The miR-195 inhibitor may serve as a conditioning factor augmenting selective antioxidant gene expression and proliferative potential of SkMDS/PCs, but it does not have an impact on cell aging and/ or apoptosis.


Asunto(s)
Antioxidantes , MicroARNs , Diferenciación Celular/genética , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético , Mioblastos/metabolismo , Células Madre/metabolismo
12.
Artículo en Inglés | MEDLINE | ID: mdl-35206255

RESUMEN

BACKGROUND: Following the example of other countries, it is very important to educate patients on the correct use of inhalers by properly trained healthcare professionals, including pharmacists. OBJECTIVES: The aim of the study was to assess the quality and comprehensiveness of professional advice given by pharmacists on the use of inhalers, which was determined by the pharmacists' level of training. METHODS: The study was conducted from June 2019 to March 2020. 150 pharmacists from Poznan and Warsaw (Poland) were involved. Before the study began, the professional education of 240 pharmacists was conducted in Warsaw to implement standard operating procedures. The study used the model of a mystery shopper. RESULTS: The conversation with a trained pharmacist lasted on average 5.5 min, with an untrained one-3.0 min (p < 0.0001). Placebo inhalers were used more often by trained pharmacists during patients' education (p < 0.0001). Moreover, 10.3% of untrained pharmacists did not provide any education. Additionally, untrained employees' quality of advice was assessed on an average of 3.5 points, while trained ones-7.6 points (p < 0.0001). CONCLUSIONS: This study has shown that there is a need for professional training among pharmacists in Poland, which translates into better patient education in the field of inhalation techniques.


Asunto(s)
Servicios Comunitarios de Farmacia , Farmacias , Humanos , Farmacéuticos , Polonia , Rol Profesional
13.
Artículo en Inglés | MEDLINE | ID: mdl-35162889

RESUMEN

INTRODUCTION: Pharmacists play an important role in healthcare. Their functions are evolving and, in many countries, they actively participate in interdisciplinary patient treatment. One of the most common services provided by pharmacists as part of pharmaceutical care in community pharmacies involves medication reviews. OBJECTIVE: The objective of this study was to evaluate the readiness of pharmacists to conduct medication reviews in community pharmacies. MATERIALS AND METHODS: This study comprises 493 pharmacists from community pharmacies in Poland. A questionnaire (developed for the purposes of this study) was used. It consisted of eight questions regarding readiness to conduct medication reviews, along with personal data. RESULTS: A total of 63.9% of the pharmacists were ready to conduct medication reviews, and 23.1% already had experience in this area. Participants were of the opinion that this service should be funded by the Ministry of Health or a third-party public payer, and overall was valued by the participants at PLN 169.04 (SD = 280.77) net per patient. CONCLUSIONS: Pharmacists in Poland have expressed their readiness to conduct medical reviews. Implementation of this service in community pharmacies in Poland can have a significant impact on optimising patient health outcomes.


Asunto(s)
Servicios Comunitarios de Farmacia , Farmacias , Humanos , Farmacéuticos , Polonia , Rol Profesional
14.
Nanomaterials (Basel) ; 11(10)2021 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-34684935

RESUMEN

The biocompatibility of pNiPAM (Poly N-isopropylacrylamide) copolymers has been examined and they did not exert any cytotoxic effects. Their properties and vulnerable temperature characteristics make them candidates for use in medical applications. We synthesized a well-characterized nanoparticles-based cargo system that would effectively deliver a biological agent to human skeletal myogenic cells (SkMCs); among other aspects, a downregulating apoptotic pathway potentially responsible for poor regeneration of myocardium. We confirmed the size of the pNiPAM based spheres at around 100 nm and the nanomeric shape of nanoparticles (NP) obtained. We confirmed that 33 °C is the adequate temperature for phase transition. We performed the dynamics of cargo release. A small amount of examined protein was detected at 10 min after reaching LCTS (lower critical solution temperature). The presented results of the test with BSA (bovine serum albumin) and doxorubicin loaded into nanoparticles showed a similar release profile for both substances. SkMCs incubated with NP loaded with antiapoptotic agent, BCB (Bax channel blocker), significantly diminished cell apoptosis (p < 0.01). Moreover, the lowest apoptotic level was detected in SkMCs treated with camptothecin and simultaneously incubated with pNiPAMs loaded with BCB. Application of nanoparticles loaded with BCB or subjected to BCB alone did not, however, diminish the amount of apparently necrotic cells.

15.
Healthcare (Basel) ; 9(9)2021 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-34574981

RESUMEN

Polypharmacy is a common issue in patients with chronic diseases. Eastern-European countries and Iran are exploring possibilities for implementing the Medication Use Review (MUR) as a measure for optimizing medication use and ensuring medication safety in polypharmacy patients. The aim of this study was to gain insights into the development of the community pharmacy sector and map facilitators and barriers of MUR in Eastern Europe and Iran. The representatives of the framework countries received a questionnaire on community pharmacy sector indicators, current and future developments of pharmacies, and factors encouraging and hindering MUR. To answer the questionnaire, all representatives performed document analysis, literature review, and qualitative interviews with key stakeholders. The socio-ecological model was used for inductive thematic analysis of the identified factors. Current community pharmacist competencies in framework countries were more related to traditional pharmacy services. Main facilitators of MUR were increase in polypharmacy and pharmaceutical waste, and access to patients' electronic list of medications by pharmacists. Main barriers included the service being unfamiliar, lack of funding and private consultation areas. Pharmacists in the framework countries are well-placed to provide MUR, however, the service needs more introduction and barriers mostly on organizational and public policy levels must be addressed.

16.
J Multidiscip Healthc ; 14: 2101-2110, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34393489

RESUMEN

Nowadays, it is very important to put an emphasis on widely understood teamwork. This is of great importance for achieving and maintaining success in all areas, especially in medicine. This kind of unity has many advantages, including unique ideas that are very helpful in a competitive environment, improve performance and knowledge, and create stronger supportive work relationships. Patient's health can be improved by using comprehensive treatment. This provides an urgent need for multidisciplinary partnership in the medical community. Optimal pharmacological treatment is crucial to achieving treatment goals. To ensure excellent quality of medical care, interprofessional cooperation between physicians and pharmacists and/or other medical professionals is necessary. Their complementary knowledge and experience can lead to improved health outcomes and can also reduce treatment costs. There are also many barriers and difficulties in legal systems that would allow for more effective inter-professional cooperation. The COVID-19 pandemic contributed to emphasizing the role of the pharmacist, increasing powers, and at the same time to teamwork, sometimes forced by the situation. The purpose of this publication is to view the literature on the cooperation of physicians and pharmacists in the provision of medical services for patients. Professional cooperation has been well known in many countries for years, as it is a key medium supporting optimized patient care. Analyzing the challenges and approaches can lead to better and improved health care.

17.
Antioxidants (Basel) ; 10(6)2021 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-34203726

RESUMEN

The aim of the study was to modify human skeletal muscle-derived stem/progenitor cells (SkMDS/PCs) and demonstrate the optimal cell preparation protocol for application in post-infarction hearts. We used conditioned SkMDS/PC culture medium with α-phenyl-N-tert-butyl nitrone (PBN). SkMDS/PCs were cultured under hypoxic conditions and the results were compared to the standard ones. We observed a significant increase of CD-56 positive phenotypic marker the ability to form functional myotubes, increase in the proportion of young cells in cell primary suspensions, and a decrease in the percentage of apoptotic cells among PBN-conditioned cells in normoxia an hypoxia. We also observed significantly higher levels of SOD3 expression; maintained expression of SOD1, SOD2, and CAT; a higher level of BCL2 gene expression; and a rather significant decrease in Hsp70 gene expression in PBN-conditioned SkMDS/PCs compared to the WT population under hypoxic conditions. In addition, significant increase of myogenic genes expression was observed after PBN addition to culture medium, compared to WT population under hypoxia. Interestingly, PBN addition significantly increased the lengths of telomeres under hypoxia. Based on the data obtained, we can postulate that PBN conditioning of human SkMDS/PCs could be a promising step in improving myogenic cell preparation protocol for pro-regenerative treatment of post-infarction hearts.

18.
Antioxidants (Basel) ; 9(9)2020 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-32887483

RESUMEN

In the present study, the genetic modification of human skeletal muscle-derived stem/progenitor cells (SkMDS/PCs) was investigated to identify the optimal protocol for myogenic cell preparation for use in post-infarction heart therapy. We used two types of modifications: GFP-transfection (using electroporation) and SOD3 transduction (using a lentiviral vector). SkMDS/PCs were cultured under different in vitro conditions, including standard (21% oxygen) and hypoxic (3% oxygen), the latter of which corresponded to the prevailing conditions in the post-infarction heart. Transfection/transduction efficacy, skeletal myogenic cell marker expression (CD56), cellular senescence, and apoptosis, as well as the expression of antioxidant (SOD1, SOD2, and SOD3), anti-aging (SIRT1 and FOXO), anti-apoptotic (BCL2), and myogenic (MyoD and MyoG) genes, were evaluated. The percentage of GFP-positive SkMDS/PCs was determined as an indicator of the efficacy of transfection, which reached 55%, while transduction showed better efficiency, reaching approximately 85% as estimated by fluorescence microscopy. The CD56-positive SkMDS/PCs were present in approximately 77% of the tested cells after transient transfection and approximately 96% after transduction. Under standard in vitro culture conditions, the ability of the differentiated, transfected SkMDS/PCs to form myotubes was greater than that of the wild type (WT) cell population (p < 0.001), while the cells transduced with the SOD3 gene exhibited an increase in cell fusion under both standard (p < 0.05) and hypoxic conditions (p < 0.001). In transduced SkMDS/PCs, we observed a positive influence of SOD3 overexpression on cell ageing and apoptosis. We observed an increase in the percentage of young cells under standard (p < 0.05) and hypoxic (p < 0.001) in vitro culture conditions, with a notable decrease in the percentage of senescent and advanced senescent cells in the SOD3-overexpressing cell population detected compared to that observed for the untransduced muscle-derived cells. A lower percentage of apoptotic cells was observed for transduced SkMDS/PCs than that for WT cells under hypoxic in vitro culture conditions. In transiently transfected SkMDS/PCs, we observed significantly higher gene expression levels of SOD2 (almost 40-fold) (p < 0.001) and FOXO (p < 0.05) (approximately 3-fold) under both normoxic and hypoxic culture conditions and of BCL2 under hypoxia compared to those observed in untreated cells (WT). In addition, myogenic genes showed a significant increase in MyoD (almost 18-fold) expression under standard culture conditions (p < 0.0001) and decreased MyoG expression (approximately 2-fold) after transfection (p < 0.05) compared with that detected in the WT skeletal muscle-derived cell control. Taken together, these results demonstrate that SOD3-tranduced skeletal muscle-derived cells may have potential for use in the regenerative treatment of the post-infarction heart.

19.
Sci Rep ; 10(1): 14336, 2020 08 31.
Artículo en Inglés | MEDLINE | ID: mdl-32868771

RESUMEN

Although less attention was paid to understanding physical localization changes in cell nuclei recently, depicting chromatin interaction maps is a topic of high interest. Here, we focused on defining extensive physical changes in chromatin organization in the process of skeletal myoblast differentiation. Based on RNA profiling data and 3D imaging of myogenic (NCAM1, DES, MYOG, ACTN3, MYF5, MYF6, ACTN2, and MYH2) and other selected genes (HPRT1, CDH15, DPP4 and VCAM1), we observed correlations between the following: (1) expression change and localization, (2) a gene and its genomic neighbourhood expression and (3) intra-chromosome and microscopical locus-centromere distances. In particular, we demonstrated the negative regulation of DPP4 mRNA (p < 0.001) and protein (p < 0.05) in differentiated myotubes, which coincided with a localization change of the DPP4 locus towards the nuclear lamina (p < 0.001) and chromosome 2 centromere (p < 0.001). Furthermore, we discuss the possible role of DPP4 in myoblasts (supported by an inhibition assay). We also provide positive regulation examples (VCAM1 and MYH2). Overall, we describe for the first time existing mechanisms of spatial gene expression regulation in myoblasts that might explain the issue of heterogenic responses observed during muscle regenerative therapies.


Asunto(s)
Diferenciación Celular , Cromatina/metabolismo , Dipeptidil Peptidasa 4/metabolismo , Expresión Génica , Mioblastos Esqueléticos/metabolismo , Humanos , Mioblastos Esqueléticos/citología
20.
Artículo en Inglés | MEDLINE | ID: mdl-32932684

RESUMEN

Although pharmacy employees' involvement in patient education has great potential, the extent to which they actually provide cognitive services seems inadequate. Given the overburdening of the healthcare system and limited access to medical services due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, this study aimed to evaluate the preparedness of Polish pharmacy employees for patient education on the new threat. The study was conducted using the mystery shopper method. Two interviewers phoned 90 randomly chosen community pharmacies throughout Poland and presented some inquiries on the SARS-CoV-2. Pharmacists devoted more time to patients than pharmacy technicians (2:22 vs. 1:54), and the information they provided was significantly more comprehensive (p = 0.006). The majority of respondents provided an evidence-based recommendation on prevention, symptoms, and management of SARS-CoV-2; however, the scope of advice significantly varied. Community pharmacy staff often expressed their concern about the lack of time to address patients' questions adequately. No statistically significant differences were found in recommendations provided by chain and non-chain pharmacy staff. Obtained results seem to confirm the possibility of involving pharmacists in public health activities during a pandemic. Nevertheless, providing proper working conditions and adequate just-in-time learning solutions is crucial.


Asunto(s)
Servicios Comunitarios de Farmacia , Infecciones por Coronavirus/epidemiología , Educación del Paciente como Asunto , Farmacéuticos , Neumonía Viral/epidemiología , Rol Profesional , Betacoronavirus , COVID-19 , Estudios Transversales , Conocimientos, Actitudes y Práctica en Salud , Humanos , Pandemias , Polonia/epidemiología , SARS-CoV-2
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