Analytical review of the inf l uence of socio-economic factors on the state of pharmaceutical care for patients with cardiovascular diseases.

OBJECTIVE: Aim: To investigate the influence of socio-economic factors on the state of pharmaceutical provision of patients with cardiovascular diseases. PATIENTS AND METHODS: Materials and Methods: To achieve the goal of the research, scientific publications posted in Ukrainian information and scientific databases (NRAT, OUCI) and scientometric databases Scopus, Web of Science, PubMed, MedLine, BMJ, Embase were used. The analysis of international and domestic legal documents was carried out, the sites of global international organizations, the sites of cardiology societies and Ukrainian statistical data bases were researched. The methods of content analysis, synthesis, systematization, and generalization were used. CONCLUSION: Conclusions: As a result of the study, socio-economic factors that af f ect the state of pharmaceutical provision of patients with CVD (in particular, CAD) were determined. In this study, among the specif i ed socio-economic factors, the need to update the regulatory and legal security of the pharmaceutical care process attracts the most of attention. The positive impact of the use of modern drug pharmacotherapy for coronary artery disease on the budget of the health care system in clinical practice proposed by the ESC was determined.

The evolving role of pharmacists in depression care: a scoping review.

BACKGROUND: Worldwide, depression is known to contribute significantly to the global burden of disease. Considering pharmacists are among the most approachable healthcare providers, they are well-placed to assist people with depression achieve positive treatment outcomes. AIM: The primary aim was to examine the evidence regarding pharmacists' roles in interventions, outcomes, and barriers to implementation within depression care globally, with the secondary aim focusing on the Arab region. METHOD: A scoping review was conducted according to the PRISMA-ScR extension guidelines and the Joanna Briggs Institute framework, using Scopus, Cochrane, ProQuest, and Medline databases for studies worldwide and within the Arab region (22 Arab-league countries). Article selection, along with data extraction, analysis, and narrative synthesis were performed independently by two reviewers. Discrepancies were resolved by consensus. RESULTS: Forty studies reporting various roles and services provided by pharmacists in depression management were included. Most articles (24) described studies on pharmacist-led specific/single interventions/management strategies, and 16 described studies in which pharmacists provided comprehensive or team-based services. The majority of studies reported positive impact on patient outcomes. In accordance with the secondary aim, only three studies assessed various pharmacists' services for people with depression in the Arab region. Barriers to effective depression-related care included time constraints and training needs. CONCLUSION: This scoping review supports the expanding role of pharmacists in depression management. The interventions, impact, challenges, and research gaps identified serve as preliminary evidence for advocating for an expanded pharmacists' scope of practice in mental health, both globally and in the Arab region.

Factors influencing the implementation of the CombiConsultation in Dutch clinical practice: a mixed-methods study.

OBJECTIVE: The CombiConsultation is an innovative concise clinical pharmacy service by the community pharmacist for patients with a chronic condition. We aimed to identify relevant factors influencing the implementation of the CombiConsultation in Dutch clinical practice. METHODS: A mixed-methods study involving interviews and a questionnaire. Content analysis topics within TDF domains were derived from the interview data and were related to the COM-B-model (capability-opportunity-motivation-Behaviour). The relevance of the resulting topics was explored using a questionnaire with 19 statements administered to all 27 pharmacists who performed CombiConsultations. KEY FINDINGS: Eighteen topics emerged from the interviews. The questionnaire was completed by 23 of the 27 pharmacists. In the domain 'capability', a small number of participants indicated that they need more expertise in pharmacotherapy (13%) and training in consultation skills (35%). In the domain 'opportunity', all participants indicated that an existing good collaboration with the general practitioner/practice nurse and access to all relevant medical data were necessary to implement the CombiConsultation. In terms of motivation, job satisfaction was most important to all participants, followed by adequate reimbursement (83%) and improving collaboration with other healthcare providers and the relationship with patients (78%). CONCLUSIONS: Capability, opportunity, and motivation were all considered relevant for the implementation of the CombiConsultation. There were crucial factors on the level of the individual pharmacist, on the level of the local collaboration and organization, and on the health system level.

Digital health in pharmacy education: Elective practical course integrating wearable devices and their generated health data.

The widespread adoption of wearable devices (wearables) for monitoring vital signs, including blood pressure and glucose levels, has experienced a considerable surge in recent times. This surge has led to the generation of a substantial amount of health data, accessible to pharmacists during patient consultations as the healthcare sector advances in digitalization. To enhance the digital competencies of future pharmacists required by the rapidly changing digital health landscape, the Institute of Clinical Pharmacy and Pharmacotherapy, Heinrich Heine University (HHU) Duesseldorf has developed an innovative elective practical course aimed to bolster pharmacy students' competencies in handling wearables and the health data generated. The three-week practical elective course employed wearables FreeStyle Libre® 3 (Continuous Glucose Monitoring, CGM) and Aktiia (Cuffless Blood Pressure Monitoring). The hands-on activities allowed participants to obtain and interpret wearable-generated health-related data and acquainted them with simulated patient cases. Final-year pharmacy students' subjective assessments before and after the course depicted the increased knowledge and competence regarding analysing wearables data.

Optimizing short-term in-class process evaluation: analyzing the effectiveness of teaching interventions in pharmaceutical education using repeated measures analysis.

BACKGROUND: The assessment of the effectiveness of teaching interventions in enhancing students' understanding of the Pharmaceutical Care Network Europe (PCNE) Classification System is crucial in pharmaceutical education. This is especially true in regions like China, where the integration of the PCNE system into undergraduate teaching is limited, despite its recognized benefits in addressing drug-related problems in clinical pharmacy practice. Therefore, this study aimed to evaluate the effectiveness of teaching interventions in improving students' understanding of the PCNE Classification System in pharmaceutical education. METHODS: Undergraduate pharmacy students participated in a series of sessions focused on the PCNE system, including lectures (t1), case analyses (t2), and practical implementation (t3). The levels of understanding were evaluated using time-course questionnaires. Initially, paired samples t-Tests were used to compare understanding levels between different time points. Subsequently, Repeated Measures Analysis (RMA) was employed. Pearson correlation analysis was conducted to examine the relationship between understanding levels and the usability and likelihood of using the PCNE system, as reported in the questionnaires. RESULTS: The paired samples t-Tests indicated insignificant differences between t2 and t3, suggesting limited improvement following the practical implementation of the PCNE system. However, RMA revealed significant time effects on understanding levels in effective respondents and the focused subgroup without prior experience (random intercept models: all p < 0.001; random slope models: all p < 0.001). These results confirmed the effectiveness of all three teaching interventions. Pearson correlation analysis demonstrated significant positive correlations between understanding levels and the usability and likelihood of using the PCNE system at all examined time points. This finding highlighted the reliability of the understanding levels reported in the questionnaires. The homework scores were used as external calibration standards, providing robust external validation of the questionnaire's validity. CONCLUSION: The implementation of RMA provided robust evidence of the positive impact of time on understanding levels. This affirmed the effectiveness of all teaching interventions in enhancing students' comprehension of the PCNE Classification System. By utilizing RMA, potential errors inherent in common statistical methods, such as t-Tests, were mitigated. This ensured a more comprehensive and accurate assessment of the effectiveness of the teaching interventions.

A perspectiva do consumo de plantas medicinais porpacientes idosos em tratamento quimioterápico / The perspective of the consumption of medicinal plants byelderly patients undergoing chemotherapy treatment

O câncer, frequentemente relacionado ao envelhecimento, impulsiona pacientes a buscarem tratamento hospitalar ou métodos alternativos, como plantas medicinais. Este estudo visou avaliar os perfis sociodemográfico e clínico e o consumo de plantas para fins medicinais entre pacientes idosos em tratamento oncológico no Hospital Araújo Jorge (HAJ). Dados de 55 pacientes foram analisados, abrangendo informações sociodemográficas, tipos de câncer, tratamento, a utilização de plantas medicinais, o objetivo de uso, as fontes de informações sobre plantas e se notaram alguma reação adversa após o consumo. A faixa etária mais encontrada foi 61 a 70 anos (67,27%), a maioria dos pacientes eram homens (63,64%), com ensino fundamental incompleto (32,73%), casados (56,36%) e que moram no interior de Goiás (43,64%). Quanto ao tratamento, a maioria realizava quimioterapia (40,00%) e o câncer gástrico foi mais relatado (14,54%). Sobre o uso de plantas medicinais, a maioria relatou simpatizar com o consumo (58,18%), e acredita em sua segurança devido à origem natural (59,37%). Informações sobre o uso de plantas medicinais eram obtidas com amigos, vizinhos e familiares (21,81%). Ao relatar sobre o consumo de plantas medicinais durante a quimioterapia, a maioria não percebeu nenhum efeito (40,63%). Foram citadas 17 plantas, que eram utilizadas no tratamento anticâncer (29,00%) e preparadas como infusões (18,75%) pelo uso das folhas frescas (60,00%), principalmente para uso interno (46,87%). Diante disso, a atenção farmacêutica se mostra vital para guiar pacientes nas práticas seguras e eficazes de consumo. Isso inclui direcionar sobre doses adequadas, efeitos colaterais e interações, garantindo bem-estar e prevenindo riscos à saúde.

Cancer, which is often related to ageing, drives patients to seek hospital treatment or alternative methods such as medicinal plants. This study aimed to evaluate the sociodemographic and clinical profile and the consumption of plants for medicinal purposes among elderly patients undergoing cancer treatment at the Araújo Jorge Hospital (AJH). Data from 55 patients was analyzed, covering sociodemographic information, types of cancer, treatment, the use of medicinal plants, the purpose of use, the source of information about plants and whether they noticed any adverse reactions after consumption. The most common age group was 61 to 70 years (67.27%), the majority of patients were men (63.64%), had incomplete primary education (32.73%), were married (56.36%) and lived in the interior of Goiás (43.63%). With regard to treatment, the majority were undergoing chemotherapy (40,00%) and gastric cancer was the most frequently reported (14.54%). With regard to the use of medicinal plants, the majority were sympathetic to their consumption (58.18%) and believed them to be safe due to their natural origin (59.37%). Information on the use of medicinal plants was obtained from friends, neighbors and family members (21.81%). When reporting on the consumption of medicinal plants during chemotherapy, the majority did not notice any effect (40.63%). Seventeen plants were mentioned, which were used for anticancer treatment (29,00%) and prepared as infusions (18.75%) with fresh leaves (60,00%), mainly for internal use (46.87%). In view of this, pharmaceutical care is vital to guide patients in safe and effective consumption practices. This includes guidance on appropriate doses, side effects and interactions, ensuring well-being and preventing health risks.

Knowledge of biological therapy for patients with immune-mediated diseases. BIOINFO Study. / Conocimiento de la terapia biológica en pacientes con enfermedades inmunomediadas. Estudio BIOINFO.

OBJECTIVE: To determine the degree of knowledge about biological therapy and biosimilars in patients with immune-mediated inflammatory diseases treated in Outpatient Pharmaceutical Care Units. METHODS: Observational, prospective and multicenter study during the period May 2020-March 2021. A survey (9 questions) was conducted before starting treatment in which the patients' level of knowledge about biological therapy and biosimilars was assessed. RESULTS: A total of 169 patients were included in the study. The average value for the different questions was 3.3 ± 0.6 out of 5, while the average final result was 29.4 points out of 45. Sixty-four percent of the patients had an acceptable level before starting the medication (>27 points). The multivariate analysis showed a statistically significant correlation (p<0.05) with a better score at the beginning of treatment in those patients whose prescribing service was Rheumatology. CONCLUSIONS: In general, the level of knowledge prior to biological therapy in patients is acceptable, being higher in dosage and administration technique related-factors and what is related to the dosage and administration technique and where to find information related to the medication; the worst rated were those on biosimilars-related. The factor of being followed by rheumatology, was associated with better knowledge.

Clinical guidelines for herpes labialis: recommendations and quality evaluation according to AGREE II.

Cold sores require Healthcare professionals to employ specific approaches for prevention and management, with the need for effective therapeutic guidelines and ongoing improvement in patient care. AIM: To evalúate the methodological quality of Clinical Guidelines (CG), clinical guides and manuals for care of the population affected by herpes labialis, to verify their compliance with evidence-based health standards. MATERIALS AND METHOD: A search was conducted for CG on labial herpes in the MedicalLiteratureAnalysis andRetrieval System Online (Medline) database, Google Scholar, Brazilian Virtual Health Library (BVS), and sites of institutions/professional categories, using the descriptors "herpes labialis" or "oral herpes". Document quality was assessed using the Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II). The Kappa test was used to avoid randomness or poor agreement between results. RESULTS: Analysis of the 12 selected publications on the management of labial herpes revealed flaws in quality, as the publications did not follow a quality standard. The main quality flaws identified were in "rigor in development" and "applicability. ". CONCLUSIONS: Priorities need to be redefined in the development of CG for clinical practice related to fever blisters to reduce the variability of the quality standard, and generate reliable, applicable recommendations.

A Herpes labial requer dos profissionais abordagens específicas para prevenido e manejo, com a ne-cessidade de diretrizes terapéuticas eficazes e continuo aprimoramento do cuidado ao paciente. OBJETIVO: avaliar a qualidade metodológica de documentos que abordaram Diretrizes Clínicas (DC), guias clínicos e manuais para o cuidado da populando afetada pelo herpes labial, verificando sua conformidade com padroes de saúde baseados em evidencias. MATERIAIS E MÉTODO: As DC sobre herpes labial foram pesquisadas na base de dados Medical Literature Analysis and Retrieval System Online (Medline), Google Académico, Biblioteca Virtual em Saúde (BVS) e em sites de instituigoes/categorias profissionais, utilizando os descritores "herpes labial" ou "herpes oral". Utilizamos aferramenta The Appraisal of Guidelines for Research & Evaluation Instrument (AGREE II) para a avaliagdo da qualidade. O teste Kappa também foi utilizado para evitar aleatoriedade ou baixa concordáncia entre os resultados. RESULTADOS: Na análise das 12 publicagoes selecionadas sobre o manejo do herpes labial, foram identificadas falhas na qualidade dos documentos, que ndo seguiram um padrdo de qualidade. As principais falhas de qualidade identificadas foram em "rigor no desenvolvimento" e "aplicabilida-de". CONCLUSÃO: é necessário um reenfoque para definir prioridades no desenvolvimento de DC para a prática clínica do herpes labial, a fim de reduzir a variabilidade do padrdo de qualidade e gerar recomendagoes que possam ser confiáveis e aplicáveis.

Pharmaceutical Care in Mental Health: Pharmacists' Barriers, Collaborations, Attitudes, and Perceptions.

Background: Pharmaceutical care is an essential component of mental healthcare. Objectives: The study assessed pharmacists' collaborations, barriers, perceptions on therapeutic relationships and attitudes toward pharmaceutical care to persons with mental illness. Methods: A questionnaire-based descriptive cross-sectional survey was conducted among 175 pharmacists in a Nigerian state via purposive sampling. Average mean score of >3 (±SD) was considered positive attitude toward pharmaceutical care, and positive for respondents' perception of pharmacists-patient relationship during consultations. Data were analyzed using SPSS version 25.0 for descriptive statistics. Results: A total of 140 (80.0%) respondents participated in the study. Access to patients' medical records 90 (64.3%) was the major barrier to the provision of pharmaceutical care to persons with mental illness. Almost half of the study participants 69 (49.3%) desired collaboration with only general practitioners and psychiatrists. Only 44 (31.4%) had full co-operation from their desired collaborators. Average score for respondents' attitude toward provision of pharmaceutical care to the patients, and perception of pharmacist-patient relationship were 4.5 (±0.7) and 3.8 (±0.9) respectively. Conclusions: Study participants' attitude toward pharmaceutical care, and perception on therapeutic relationship in persons with mental disorder were positive. Lack of access to patients' records mostly hindered provision of pharmaceutical care, and full collaboration with other mental health experts was mostly lacking. Appropriate policies are required to improve these vital components of mental healthcare for desired outcomes.

Exploration of herbal medicine practices, perceptions and knowledge among Spanish community pharmacists: A cross-sectional survey study.

INTRODUCTION: Herbal medicine has seen remarkable growth in consumption over the past few years. Community pharmacists are health care professionals who have an important role in the dispensing and counselling of these products. The aim of this study was to evaluate perceptions, professional practices and knowledge about herbal medicine among community pharmacists in Tenerife (Canary Islands, Spain). METHOD: A descriptive cross-sectional study was conducted in community pharmacies in Tenerife using a questionnaire that included demographic data, perceptions, professional practices and knowledge of herbal medicine. Data from 610 community pharmacists was analyzed using SPSS 26.0 software program. RESULTS: Most of the responders had a positive attitude towards herbal medicine, considering its products useful (80.9%), safe (64.2%) and those sold in pharmacies of high quality and standardized (84.6%). They thought that these products should only be sold in pharmacies (78.0%) and that it was their responsibility to provide information about them (95.5%). However, only 32.1% believed they are well prepared to provide herbal pharmaceutical care services and 36.1% that there are reliable and easily accessible sources of information. Moreover, 60.7% considered lack of training a barrier to recommending herbal medicinal products, being interested in updating their knowledge on it (96.9%). CONCLUSION: This study showed that community pharmacists have a positive perception of herbal medicines, considering them beneficial and safe. However, participants requested reliable sources of information, easy access, and more training to dispense, counsel, and safely label these products. Education and training programs in herbal medicine are needed to enhance their ability to provide herbal pharmaceutical care.

National record and analysis of pharmaceutical interventions in critical care units: PHARMACRITIC study. / Registro nacional y análisis de intervenciones farmacéuticas en unidades de cuidados críticos: estudio FARMACRITIC.

OBJECTIVE: To design a homogeneous methodology for the registration and analysis of pharmaceutical interventions performed in Spanish critical adults' care units. METHOD: Observational, prospective and multicenter study. In the first stage, a national registry of pharmaceutical interventions will be agreed upon and subsequently all the pharmaceutical interventions performed on adult patients admitted to Spanish CCUs during eight weeks will be recorded. Variables related to the type of CCU, the drug involved in the intervention, type of intervention (indication, effectiveness, safety), recommendation made by the pharmacist and the degree of acceptance will be evaluated. Risk and incidence will be calculated for each of the medication errors detected. The χ2-squared test or Fisher exact test will be used for categorical variables and Mann-Whitney U or Kruskal-Wallis test for continuous variables. All tests will be performed with a significance level α = 0.05 and confidence intervals with confidence 1- α. DISCUSSION: The results obtained from this project will make it possible to obtain a homogeneous classification of the pharmaceutical interventions performed in CCU, a national record and an evaluation of the weak points with the aim of developing strategies for improvement in the pharmaceutical care of the critically ill patient.

Concordance between two models of stratification for patients living with HIV infection to providing pharmaceutical care. / [Artículo traducido] Concordancia entre 2 modelos de estratificación de pacientes que viven con el VIH para la prestación de atención farmacéutica.

OBJECTIVE: To determine the degree of agreement of two differents stratification models for pharmaceutical care to people living with HIV. METHODS: This was a single-centre observational prospective cohort study of patients with regular follow-up in pharmaceutical care consultations according to the Capacity-Motivation-Opportunity methodology, conducted between January 1st and March 31th, 2023. Patients received the pharmacotherapeutic interventions applied routinely to ambulatory care patients according to this model. As part of the usual clinical practice, the presence or absence of the variables that apply to both stratification models were collected. The scores obtained and the corresponding stratification level were collected for each patient according to both stratification models published (ST-2017 and ST-2022). To analyze the reliability between the measurements of two numerical score models of the stratification level with both tools, their degree of concordance was calculated using the intraclass correlation coefficient. Likewise, reliability was also evaluated from a qualitative perspective by means of Cohen's Kappa coefficient. Additionally, the existence of correlation between the scores of the two models was assessed by calculating Pearson's correlation coefficient. RESULTS: Of the total of 758 patients being followed in the cohort, finally, 233 patients were enrolled. The distribution of patients for each stratification model was: ST-2017: 59.7% level-3, 25.3% level-2 and 15.0% level-1, while for ST-2022: 60.9% level-3, 26.6% level-2 and 12.4% level-1. It was observed that the reclassification was symmetrical (p=0.317). The qualitative analysis of the agreement between the models showed a good Cohen's kappa value, (K=0.66). A value of 0.563 was found as the intraclass correlation coefficient. Finally, the correlation analysis between the quantitative scores of the two models yielded a Pearson correlation coefficient of 0.86. CONCLUSIONS: The concordance between the two models was good, which confirms that the multidimensional adaptation and simplification of the model were correct and that its use can be extended in routine clinical practice.

Using the Natural Language Processing System Medical Named Entity Recognition-Japanese to Analyze Pharmaceutical Care Records: Natural Language Processing Analysis.

BACKGROUND: Large language models have propelled recent advances in artificial intelligence technology, facilitating the extraction of medical information from unstructured data such as medical records. Although named entity recognition (NER) is used to extract data from physicians' records, it has yet to be widely applied to pharmaceutical care records. OBJECTIVE: In this study, we aimed to investigate the feasibility of automatic extraction of the information regarding patients' diseases and symptoms from pharmaceutical care records. The verification was performed using Medical Named Entity Recognition-Japanese (MedNER-J), a Japanese disease-extraction system designed for physicians' records. METHODS: MedNER-J was applied to subjective, objective, assessment, and plan data from the care records of 49 patients who received cefazolin sodium injection at Keio University Hospital between April 2018 and March 2019. The performance of MedNER-J was evaluated in terms of precision, recall, and F1-score. RESULTS: The F1-scores of NER for subjective, objective, assessment, and plan data were 0.46, 0.70, 0.76, and 0.35, respectively. In NER and positive-negative classification, the F1-scores were 0.28, 0.39, 0.64, and 0.077, respectively. The F1-scores of NER for objective (0.70) and assessment data (0.76) were higher than those for subjective and plan data, which supported the superiority of NER performance for objective and assessment data. This might be because objective and assessment data contained many technical terms, similar to the training data for MedNER-J. Meanwhile, the F1-score of NER and positive-negative classification was high for assessment data alone (F1-score=0.64), which was attributed to the similarity of its description format and contents to those of the training data. CONCLUSIONS: MedNER-J successfully read pharmaceutical care records and showed the best performance for assessment data. However, challenges remain in analyzing records other than assessment data. Therefore, it will be necessary to reinforce the training data for subjective data in order to apply the system to pharmaceutical care records.

Pharmaceutical Care in Primary Healthcare-A Study of Nurses', Pharmacists', and Physicians' Experiences of Interprofessional Collaboration.

Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category "Professional challenges" contained the subcategories "Blurred responsibilities" and "The importance of trust and continuity". The category "Organisational barriers" contained the subcategories "Lack of information exchange and suitable communications channels" and "Lack of time and meeting places". The third category was "Nurses-the important link". This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions.

Pharmacists' Role in Global TB Elimination: Practices, Pitfalls, and Potential.

Tuberculosis (TB) is the top infectious killer in the world despite efforts to eliminate it. Pharmaceutical care roles are pillars of pharmacy practice, and pharmacists are well equipped to serve a unique role in the pathway to provide education about TB. Previous systematic reviews emphasize pharmacists' role in treating TB; however, pharmacists can and do play much broader roles in overall TB elimination efforts. Five researchers searched five electronic databases (PubMed, PsychInfo, CINAHL, Academic Search Premier, and Embase). Search terms included pharmacy, pharmacist, tuberculosis, antitubercular agents, supply, distribution, and drug therapy. Inclusion criteria were studies published from 2010 through March 2023, in English or Spanish, addressed a specific TB-related role for pharmacists/pharmacies, and were peer-reviewed. Exclusion criteria included pharmacology, pharmacokinetics, clinical trials on drug efficacy, and editorials. Two researchers conducted each level of review; for discordance, a third researcher reviewed, and a decision was reached by consensus. Roles were extracted and cross-referenced with traditional pharmaceutical care steps. Of the initial 682 hits, 133 were duplicates. After further review, we excluded 514 records, leaving 37 articles for full extraction. We found nine roles for pharmacists in TB prevention and classified them as implemented, not implemented, or recommended. These roles were: (1) TB symptom screening; (2) Referring to TB care systems; (3) TB testing; (4) Dispensing TB medication correctly and/or directly observed therapy; (5) Counseling; (6) Looking to reduce socioeconomic barriers; (7) Procurement of TB medications; (8) Quality assurance of TB medications; (9) Maintaining and using pharmacy data systems. Pharmacists are well situated to play a vital role in the global fight against TB. Findings suggested pharmacists in many settings have already expanded their roles related to TB elimination beyond traditional pharmaceutical care. Still others need to increase the understanding of TB procurement and treatment, their power to improve TB care, and their contributions to data systems that serve population health. Pharmacy curricula should increase TB-related training to better equip future pharmacists to contribute to TB elimination.

Pharmaceutical interventions for drug-related problems in the neonatal intensive care unit: incidence, types, and acceptability.

Background: Drug-related problems (DRPs) are widespread in hospitalized neonates, but studies on the prevalence of DRPs in this population are limited. The presence of clinical pharmacists on multidisciplinary teams helps prevent and reduce DRPs. Aim: This investigation aimed to identify and classify the incidence of DRPs in the neonatal intensive care unit (NICU), to determine the determining factors associated with DRPs and to document clinical pharmacists' interventions, outcomes, acceptance rates and clinical significance. Method: A prospective descriptive hospital study was conducted from August to November 2023 at the NICU of Children's University Hospital, Assiut University, Egypt. DRPs were classified using the Pharmaceutical Care Network of Europe (PCNE) classification V9.1. Results: Three hundred sixteen neonates were included in the study, with a mean gestational age of 34 ± 4 weeks and a mean birth weight of 2.03 ± 0.85 kg. A total of 1723 DRPs occurred among 283 neonates (89.6%), an average of 5.5 ± 5.1 DRPs per patient. The main types were treatment effectiveness (P1) (799, 46.4%), followed by others (P3) (469, 27.2%), and treatment safety (P2) (455, 26.4%). The leading causes were dose selection (C3) (1264, 61.9%) and "other domain" (C9) (543, 26.6%). Of the 2149 interventions introduced by pharmacists, 98.8% were accepted and 93% were accepted, and fully implemented. As a result, 92% of the DRPs were resolved. Both length of hospital stay and number of medications were significantly associated with DRPs. Conclusion: DRPs are common in the NICU; this study demonstrated the crucial role of clinical pharmacists in identifying and resolving DRPs.

Effect of pharmacist care on clinical outcomes and therapy optimization in perioperative settings: A systematic review.

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. PURPOSE: Integration of pharmacists into the perioperative practice has the potential to improve patients' clinical outcomes. The aim of this systematic review is to systematically investigate the evidence on the roles of pharmacists in perioperative settings and the effects of pharmacist interventions on clinical outcomes and therapy optimization. METHODS: A protocol-led (CRD42023460812) systematic review was conducted using search of PubMed, Embase, CINAHL and Google Scholar databases. Studies that investigated the roles and impact of pharmacist-led interventions in the perioperative settings on clinical outcomes were included. Data were extracted and quality assessed independently by two reviewers using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and the Crowe Critical Appraisal Tool (CCAT), respectively. Studies were grouped according to the clinical area into 5 sections: (1) pain control and opioid consumption; (2) venous thromboembolism (VTE); (3) surgery-related gastrointestinal complications; (4) postoperative medication management; and (5) total parenteral nutritional. RESULTS: Nineteen studies involving a total of 7,168 patients were included; most studies were conducted in gastrointestinal (n = 7) and orthopedics (n = 6) surgical units. Most included studies (n = 14) employed a multicomponent intervention including pharmaceutical care, education, guideline development, drug information services, and recommendations formulation. The processes of developing the implemented interventions and their structures were seldom reported. Positive impacts of pharmacist intervention on clinical outcomes included significant improvement in pain control and reductions in the incidence of VTE, surgery-related stress ulcer, nausea, and vomiting. There is inconsistency in the findings related to medication management (ie, achieving desired therapeutic ranges) and management of chronic conditions (hypertension and type 2 diabetes). CONCLUSION: Whilst there is some evidence of positive impacts of pharmacist intervention on clinical outcomes and optimizing drug therapy, this evidence is generally of low quality and insufficient volume. While this review suggests that pharmacists have essential roles in improving the care of patients undergoing surgery, more research with rigorous designs is required.

[Translated article] Pharmaceutical care in respiratory diseases: Current situation and opportunities for hospital pharmacy in Spain.

OBJECTIVE: Respiratory diseases present a challenge for the healthcare system due to their prevalence and clinical impact. The aim of this study was to explore the current situation of hospital pharmacy in the field of respiratory diseases. METHOD: Observational, cross-sectional study, with a national scope, divided into 2 parts. In an initial phase, the activity and level of pharmaceutical care in respiratory diseases was evaluated through an online questionnaire using REDCap. The survey was addressed to department chiefs and consisted of 17 items, divided into 2 modules: general data and general activity. The second phase was open to hospital pharmacists, with the aim of exploring their opinion on care, training, and improvement needs. The number of items in this phase was 19, divided into 5 modules: general data, pharmaceutical care, competencies, training, and degree of satisfaction. RESULTS: In the first phase, 23 hospitals were included. Most of them (n=20) had a pharmacist in charge of respiratory diseases. However, a large proportion of them dedicated less than 40% of their working day to this activity. The pharmacist's activity occurred at the level of external patients (n=21), hospitalised patients (n=16), and secondarily in management (n=8). Integration is greater in pathologies such as asthma, IPF, pulmonary hypertension, and bronchiectasis. Participation in committees was present in 15 hospitals, with variability in pathologies and degree of involvement. In the second phase, 164 pharmacists participated, who considered pharmaceutical care in cystic fibrosis, asthma, and lung transplant as a priority. 51% considered integration to be adequate and 91% considered it necessary to implement prioritisation criteria. Professional competencies ranged from 6.5 to 6.9 out of 10 points. Only 45% of participants had received specific training in the last 4 years, indicating greater priority for asthma, pulmonary hypertension, and IPF. CONCLUSIONS: Most centers have pharmacists specialised in respiratory diseases. However, there is room for improvement in terms of subspecialisation, participation in multidisciplinary committees, implementation of prioritisation criteria, diversification in pathologies treated, as well as greater specific training in this area.

Application of a WeChat Mini Program to provide pharmaceutical care for cancer pain patients: A randomized controlled trial.

Objective: This study aimed to develop an individual WeChat Mini Program to provide pharmaceutical care to better manage cancer pain patients and to evaluate its feasibility and the differences in analgesic efficacy, medication adherence and safety versus conventional pharmacy interventions. Methods: In this parallel randomized clinical trial, 42 cancer pain patients were equally allocated into the experimental group and the control group. The experimental group received individualized pharmaceutical care based on the "Yao Nin You Wo" WeChat Mini Program, while the control group received conventional care during the 4-week period. Main outcomes contained pain scores, medication adherence, incidences and relief rates of breakthrough pain, and incidences of adverse events. Relief rates of pain were also calculated according to pain scores. Results: At the beginning of intervention, none of the pain scores and medication adherence showed relevant differences between the two groups (all P > .05). After intervention, the experimental group had significantly lower pain scores compared to the control group (P = .003). Breakthrough pain of both groups was alleviate; not only the incidence of breakthrough pain considerably was lower at 4 weeks than at baseline, but the relief rate of breakthrough in the experimental group was higher than that in the control group. Compared with the control group, the medication adherence rate of the experimental group was significantly improved (P = .02). Types of adverse events that happened in experimental and groups were similar, but the total incidence of adverse events in the experimental group was lower than that in the control group. Conclusions: WeChat Mini Program is a useful and facilitative tool with the potential to improve cancer pain self-management ability in discharged patients. In addition, pharmacists could play a key role through the Mini Program to connect with patients successfully by providing personalized pharmaceutical services.