Novel opportunities for clinical pharmacy research: development of a machine learning model to identify medication related causes of delirium in different patient groups.

The advent of artificial intelligence (AI) technologies has taken the world of science by storm in 2023. The opportunities of this easy to access technology for clinical pharmacy research are yet to be fully understood. The development of a custom-made large language model (LLM) (DELSTAR) trained on a wide range of internationally recognised scientific publication databases, pharmacovigilance sites and international product characteristics to help identify and summarise medication related information on delirium, as a proof-of-concept model, identified new facilitators and barriers for robust clinical pharmacy practice research. This technology holds great promise for the development of much more comprehensive prescribing guidelines, practice support applications for clinical pharmacy, increased patient and prescribing safety and resultant implications for healthcare costs. The challenge will be to ensure its methodologically robust use and the detailed and transparent verification of its information accuracy.

Artificial intelligence in academic writing and clinical pharmacy education: consequences and opportunities.

The current academic debate on the use of artificial intelligence (AI) in research and teaching has been ongoing since the launch of ChatGPT in November 2022. It mainly focuses on ethical considerations, academic integrity, authorship and the need for new legal frameworks. Time efficiencies may allow for more critical thinking, while ease of pattern recognition across large amounts of data may promote drug discovery, better clinical decision making and guideline development with resultant consequences for patient safety. AI is also prompting a re-evaluation of the nature of learning and the purpose of education worldwide. It challenges traditional pedagogies, forcing a shift from rote learning to more critical, analytical, and creative thinking skills. Despite this opportunity to re-think education concepts for pharmacy curricula several universities around the world have banned its use. This commentary summarizes the existing debate and identifies the consequences and opportunities for clinical pharmacy research and education.

Application of behavioural theories, models, and frameworks in pharmacy practice research based on published evidence: a scoping review.

BACKGROUND: Pharmacy practice research often focuses on the design, implementation and evaluation of pharmacy services and interventions. The use of behavioural theory in intervention research allows understanding of interventions' mechanisms of action and are more likely to result in effective and sustained interventions. AIM: To collate, summarise and categorise the reported behavioural frameworks, models and theories used in pharmacy practice research. METHOD: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and EBSCO (CINAHL PLUS, British Education index, ERIC) were systematically searched to capture all pharmacy practice articles that had reported the use of behavioural frameworks, theories, or models since inception of the database. Results were filtered to include articles published in English in pharmacy practice journals. Full-text screening and data extraction were independently performed by two reviewers. A narrative synthesis of the data was adopted. Studies were reviewed for alignment to the UK Medical Research Council (MRC) framework to identify in which phase(s) of the research that the theory/model/framework had been employed. RESULTS: Fifty articles met the inclusion criteria; a trend indicating an increasing frequency of behavioural theory/frameworks/models within pharmacy practice research was identified; the most frequently reported were Theory of Planned Behaviour and Theoretical Domains Framework. Few studies provided explicit and comprehensive justification for adopting a specific theory/model/framework and description of how it underpinned the research was lacking. The majority were investigations exploring determinants of behaviours, or facilitators and barriers to implementing or delivering a wide range of pharmacy services and initiatives within a variety of clinical settings (aligned to Phase 1 UK MRC framework). CONCLUSION: This review serves as a useful resource for future researchers to inform their investigations. Greater emphasis to adopt a systematic approach in the reporting of the use of behavioural theories/models/frameworks will benefit pharmacy practice research and will support researchers in utilizing behavioural theories/models/framework in aspects of pharmacy practice research beyond intervention development.

More than coffee - a World Café to explore enablers of pharmacy practice research.

BACKGROUND: Pharmacists are in demand now more than ever to provide high-quality expertise about the effectiveness, safety and use of medications. Amidst an increasingly complex and costly healthcare system, policy makers need robust evidence to justify public spending on pharmacy services. Research on the impact of existing and emerging pharmacy practices is required. OBJECTIVE: To explore barriers and opportunities to enhance research among pharmacists in Ireland utilising a World Café methodology. METHODS: A pharmacy research discussion day was held in November 2018, open to all pharmacists in Ireland. A World Café methodology was utilised as a mechanism to facilitate group discussions about pharmacy practice research. RESULTS: Discussions with 63 attendees identified four themes and seventeen subthemes. The four themes were challenges undertaking research, research motivations, leadership and training. Subthemes included robust evidence, clinical, economic and societal outcomes, alignment with national and international health system priorities, need for incentives from professional training bodies, competitive business model and embed within schools of pharmacy. CONCLUSIONS: The most commonly discussed barriers inhibiting research were workload, technology limitations and financial considerations. Organisational leadership to prioritise and coordinate research efforts, training to build research capacity, building on existing examples of excellence and initiation of bottom-up community-based research projects were identified in our study as opportunities to enhance pharmacist involvement in research and ultimately patient health outcomes.

Community pharmacist workflow: Space for Pharmacy-based Interventions and Consultation TimE study protocol.

BACKGROUND: Pharmacists' roles are expanding to delivering a wider set of professional services including medication management optimisation, vaccinations and screening services. Robust research determining whether pharmacists have the capacity to offer such services in the Australian community pharmacy setting is lacking. This protocol details a mixed methods study that investigates the variation in pharmacists' daily tasks and the workspace they work in as a measure of their workload capacity for expanding pharmacy services. METHODS: An observational time and motion study will be conducted in up to twenty community pharmacies in metropolitan and rural regions of Australia. A trained observer will follow a pharmacist and record the type, location and duration of tasks undertaken over the course of their working day. Data will be collected and analysed using the electronic Work Observation Method By Activity Timing (WOMBAT) tool. Pharmacists' work patterns will be described as time for each task, and by proportionating multitasking and interruptions. This information will be combined with workspace data collected using floor plans, photographs and a qualitative assessment of the working environment completed by the observer. Analysis will include heat-mapped floor plans visually highlighting pharmacist movements. DISCUSSION: Pharmacists may provide solutions to the strained health workforce and system. There is limited quantitative evidence on whether pharmacists have the time or work setting to support such needs. The use of time and motion methodology is novel to Australian community pharmacy research, and the findings will provide a better understanding of pharmacists' capacity and work environment.

Augmenting Cost-Effectiveness Analysis for Uncertainty: The Implications for Value Assessment-Rationale and Empirical Support.

DISCLOSURES: This study received unrestricted funding from the Pharmaceutical Research Manufacturers of America. The authors also do consulting, personally or through their employment, with numerous pharmaceutical manufacturers, payers, and other stakeholders with a general interest in this subject matter.

Piloting the Describing and Evaluating community Pharmacy practice to Improve patients' Care and Treatment tool.

OBJECTIVE: To pilot the Describing and Evaluating community Pharmacy practice to Improve patients' Care and Treatment (DEPICT) tool to determine its utility in collecting data about Australian community pharmacist activities and patient-related encounters. METHODS: DEPICT tool was developed and tested. Two pharmacy students recruited study patients and collected data in four urban pharmacies. KEY FINDINGS: Fourteen pharmacists completed 189 DEPICT forms. Pharmacists' evaluations indicated overall high levels of satisfaction and provided valuable recommendations for improvement. CONCLUSIONS: Pharmacists' feedback will be incorporated into future iterations of DEPICT that will include electronic collection of regional data in urban and rural settings.

Characterization of pharmacy practice research centers across the United States.

BACKGROUND: Schools of Pharmacy are important contributors to pharmacy practice research and several have created research centers focusing on this area. OBJECTIVES: To identify and characterize pharmacy practice research centers in the United States. METHODS: A comprehensive list of research centers was gathered using three sources: 1) websites of Schools of Pharmacy obtained from the American Association of Colleges of Pharmacy website; 2) Google; and 3) department chairs. Two independent reviewers applied the following exclusion criteria to the list: 1) no affiliation with a School of Pharmacy; 2) no focus on research; 3) not an independent unit recognized at the school or university levels; and 4) research not focused on advancing pharmacy practice. Inter-rater reliability was calculated using a prevalence-adjusted bias-adjusted kappa (PABAK). A questionnaire was developed comprising 24 questions grouped into three sections - overall structure of the center, research and educational activities - and disseminated through center directors. Descriptive statistics of survey data were obtained. RESULTS: Twenty centers across 20 different states were identified. Survey response rate was 100%. Three-quarters of centers were at public institutions and half had an advisory board. Full-time equivalents ranged from 0.2 to 21. Areas of research primarily focused on medication and disease-state management and interprofessional collaboration in the ambulatory/outpatient setting. Few centers (35%) conducted experimental studies. Despite 85% centers conducting multi-site studies, the median number of sites engaged was low (range 1-3). Seven centers received over USD 1 million in total funding since inception. A majority of centers (90%) offered educational activities for both students and professionals. CONCLUSIONS: Pharmacy practice research centers are relatively small, received low funding and few conduct multi-site experimental studies. Collaboration among centers could be a means to overcome these issues.

Missing data reporting in clinical pharmacy research.

PURPOSE: This study aimed to document the ways by which missing data were handled in clinical pharmacy research to provide an insight into the amount of attention paid to the importance of missing data in this field of research. METHODS: Our cross-sectional descriptive report evaluated 10 journals affiliated with pharmacy organizations in the United States, Canada, the United Kingdom, and Australia. Randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in 2018 were included. The primary outcome measure was the proportion of studies that reported the handling of missing data in their methods or results. RESULTS: A total of 178 studies were included in the analysis. Of these, 19.7% (n = 35) mentioned missing data either in their methods (3.4%, n = 6), results (15.2%, n = 27), or in both sections (1.1%, n = 2). Only 4.5% (n = 8) of the studies mentioned how they handled missing data, the most common method being multiple imputation (n = 3), followed by indicator (n = 2), complete case analysis (n = 2), and simple imputation (n = 1). One study using multiple imputation and both studies using an indicator method also combined other strategies to account for missing data. One study only used complete case analysis for subgroup analysis, and the other study only used this method if a specific baseline variable was missing. CONCLUSIONS: Very few studies in clinical pharmacy literature report any handling of missing data. This has the potential to lead to biased results. We advocate that researchers should report how missing data were handled to increase the transparency of findings and minimize bias.

A Primer for Managed Care Residents: How to Conduct Research Using Live Medical and Pharmacy Claims Data.

Managed care organizations are growing more sophisticated in their ability to analyze data. There are increasing numbers of data analysts at managed care organizations, as well as more types of real-time, or "live," data available. These data range from pharmacy claims and enrollment files to medical claims, medical records, and linkages to external data. Moreover, the data are often curated in a way that allows for easier data analysis. Using these data, managed care residents are often required to perform a project to evaluate a utilization management policy or clinical program. Yet, there is a lack of guidance specific to managed care organizations on how to conduct such a research study using "live" claims data. This Viewpoint article provides a primer for managed care residents and other managed care professionals who are seeking to use data to help inform decisions on how to manage their beneficiaries' health and costs. DISCLOSURES: There was no funding source for this manuscript. Hung reports a grant from the Agency for Healthcare Research and Quality and personal fees from Blue Cross Blue Shield Association, outside the submitted work. Gedey, Groeneweg, and Jay have nothing to disclose.

Design-based research: Connecting theory and practice in pharmacy educational intervention research.

OUR SITUATION: Interventional research in pharmacy education includes the study of complex challenges that can be difficult to navigate. Design-based research (DBR), is a systematic and iterative approach to interventional research that is attentive to the practical and theoretical contributions to education. Practical contributions include the creation of novel solutions to complex problems that improve learning while theoretical contributions include refining our understanding of context-specific learning. In this paper, we describe how we addressed challenges associated with student collaboration in pharmacy education by applying DBR to bridge theory and practice. METHODOLOGICAL LITERATURE REVIEW: DBR is characterized as authentic, contextually aware, collaborative, theoretically focused, methodologically diverse, practical, iterative, and operation-oriented. DBR includes three iterative phases: (1) analysis and exploration, (2) design and construction, and (3) evaluation and reflection. OUR RECOMMENDATIONS AND THEIR APPLICATIONS: To integrate DBR into interventional research, scholars should work collaboratively with diverse teams of experts. DBR also requires extensive planning, a toolkit of expansive research methodologies, and attention to practical and theoretical considerations. Finally, scholars should share their work as often as possible and engage in creative exercises to promote innovative solutions to challenges in education. POTENTIAL IMPACT: DBR offers an approach to generate practical, theoretical, and scholarly contributions to pharmacy education research. In summary, DBR can aid pharmacy educational scholars by using a flexible, iterative, and systematic process to generate novel and creative solutions to complex problems.

A novel learning approach to pharmaceutical sciences research in a pharmacy research advanced pharmacy practice experience (APPE) elective course.

BACKGROUND AND PURPOSE: This project investigates the use of pharmacy student metacognitive learning in a laboratory-based science research advanced pharmacy practice experience (APPE). EDUCATIONAL ACTIVITY AND SETTING: We describe a five-week research APPE. This course is separated into two parts which run simultaneously. In part 1, students read and discuss papers from primary literature to learn the context of the project and the theory behind each laboratory procedure. In part 2, students perform experiments in the laboratory that contribute to the primary investigator's (PI's) ongoing research project and relate directly to the readings from part 1. Metacognitive processes allow students to better understand and evaluate the primary literature and to connect that information with the hands-on experiments being performed. FINDINGS: Currently, this APPE has run five times with a total of eight students. Student learning was assessed by several written and oral assignments graded with rubrics. Students' perceptions of their own learning and metacognitive development following the course was assessed using a survey. SUMMARY: This APPE seems to be a useful experience for both faculty and students. Students obtain laboratory and metacognitive skill development, while the collaborating laboratory is supplied with material required for further experiments. Importantly, the APPE preceptor is not the PI, so the preceptor is able to focus on the learning skills (both metacognition and hands-on) portion of the APPE.

De la antigua historia de los métodos iodométricos: de los inicios a Robert Bunsen / From the early history of iodometric methods: from its inception to Robert Bunsen

Los halógenos han constituido un campo de batalla particular de los investigadores farmacéuticos. Cloro, bromo y iodo, se encuentran estrechamente relacionados con los métodos volumétricos, en sus comienzos. El color azul del complejo iodo-almidón que sirve como indicador para la detección de cantidades traza de iodo, es observado por Colin y Gaultier de Claubry, y Stromeyer (1814). Houtou de Labillardière (1825), introduce el uso del iodo en volumetría, proponiendo un procedimiento alternativo para la estimación del contenido de cloro en hipoclorito cálcico comercial. Dupasquier (1840), advierte la posibilidad de valorar exacta y rápidamente sulfuro de hidrógeno (gas hepático) libre o combinado, con la ayuda de una disolución valorada de iodo en presencia de almidón como indicador. Fordos y Gelis muestran en 1843 que dos átomos de iodo oxidan cuantitativamente dos moléculas de hiposulfito (tiosulfato) de sodio, reacción que constituye la base fundamental de la iodometría. En este trabajo se pasa revista a los métodos iodométricos de análisis desde sus inicios hasta Bunsen, cubriendo aspectos de la vida y obra de los investigadores implicados, así como sus mutuas conexiones, incluidas las transnacionales

Halogens have been a particular battlefield of pharmaceutical researchers. Chlorine, bromine and iodine, are closely related to the volumetric methods, in its beginnings. The blue colour of the iodine-starch complex observed by Colin and Gaultier de Claubry, and Stromeyer (1814), serves as an indicator for the detection of trace quantities of iodine. Houtou de Labillardière (1825) introduces the use of iodine in volumetry, proposing an alternative procedure for the estimation of the chlorine content in commercial calcium hypochlorite. Dupasquier (1840) warns the possibility of accurately and quickly assessing hydrogen sulfide (hepatic gas) free or combined, with the help of a titrated solution of iodine in the presence of starch as an indicator. Fordos and Gelis show in 1843 that two iodine atoms quantitatively oxidize two molecules of sodium hyposulfite (thiosulfate), a reaction that constitutes the fundamental basis of iodometry. This paper reviews the iodometric methods of analysis from its inception to Bunsen, covering aspects of the life and work of the researchers involved, as well as their mutual connections, including transnational ones

Community pharmacists' interest in and attitude to pharmacy practice research in Ethiopia: A cross-sectional study.

Pharmacy practice-research became an important component in the pharmacy practice. However, limited studies were conducted in sub-Saharan Africa to understand the pharmacists' interest and attitude towards pharmacy practice-research. We aimed to assess the community pharmacists' interest and attitude towards pharmacy practice-research in Ethiopia. A cross-sectional survey was conducted among community pharmacists in eight major cities in Ethiopia. A validated 25-item self-administered questionnaire covering interest and attitude related to pharmacy practice-research was distributed. Responses were analysed using descriptive and inferential statistics. A total of 389 community pharmacists responded to the survey (response rate- 88.4%). Most of community pharmacists showed a high level of interest and positive attitude in being involved in all aspects of pharmacy practice-research. The median summary score for interest and attitude were 38 (IQR 20-40) (range possible 10-50) and 30 (IQR 18-39), respectively. Sixty-seven percent of the respondents thought about being involved in research, felt research is important for their career (57.6%), confident to conduct the research (56.2%), and agreed that research is a part of pharmacy practice (48.5%). However, only forty-six percent agreed that they underwent research training. A multivariate analysis showed that females were more interested in pharmacy practice research than males [AOR: 1.50, 95% CI: 0.99-2.27; p<0.05]. Community pharmacists showed high interest towards several areas of research competencies and demonstrated positive attitude towards pharmacy practice-research. Our findings suggest that providing research training to community pharmacists may contribute in undertaking research activities and build the research capacity in Ethiopia.

A Program to Increase Research Productivity Among Hospital Pharmacists.

OBJECTIVE: To describe the development, implementation, and outcomes of a structured research training program that aimed to increase the research productivity among hospital pharmacists. METHODS: The program was conducted in a step-wise approach and started with educational sessions on evidence-based medicine and research methods. After about a year, pharmacists were trained and mentored on how to conduct and publish a research project. We evaluated the number of research projects and publications for the pharmacy department before and after the implementation of the program. RESULTS: In the 5 years prior to implementing the program, there were a total of 4 institutional review board (IRB) proposals, 4 abstracts, and 2 manuscripts, which had pharmacists as primary investigators. After 5 years of running the program, there were 24 pharmacist-initiated research proposals submitted to the IRB, 29 abstracts, and 11 published manuscripts. The major challenges were the lack of sufficient time and the extensive training and mentorship required. CONCLUSION: Implementing a structured pharmacy research program at a hospital setting was feasible and was associated with an increase in the pharmacist-led research and publications. The success of such a program requires training and mentorship, strong commitment, and administrative support.