Designing a primary care pharmacist-led review for people treated with opioids for persistent pain: a multi-method qualitative study.

BACKGROUND: Opioids are frequently prescribed for persistent non-cancer pain despite limited evidence of long-term effectiveness and risk of harm. Evidence-based interventions to address inappropriate opioid prescribing are lacking. AIM: To explore perspectives of people living with persistent pain to understand barriers and facilitators in reducing opioids in the context of a pharmacist-led primary care review, and identify review components and features for optimal delivery. DESIGN & SETTING: Primary care multi-method qualitative study. METHOD: Adults with experience of persistent pain and taking opioids participated in semi-structured interviews (n=15, 73% female) and an online discussion forum (n=31). The Theoretical Domains Framework (TDF) provided a framework for data collection and thematic analysis, involving deductive analysis to TDF domains, inductive analysis within-domains to generate subthemes, and subtheme comparison to form across-domain overarching themes. The behaviour change technique taxonomy v.1 and motivational behaviour change technique classification system were used to systematically map themes to behaviour change techniques to identify potential review components and delivery features. RESULTS: 32 facilitator and barrier subthemes for patients reducing opioids were identified across 13 TDF domains. These combined into six overarching themes: learning to live with pain, opioid reduction expectations, assuming a medical model, pharmacist-delivered reviews, pharmacist-patient relationship and patient engagement. Subthemes mapped to 21 unique behaviour change techniques, yielding 17 components and five delivery features for the proposed PROMPPT review. CONCLUSION: This study generated theoretically-informed evidence for design of a practice pharmacist-led PROMPPT review. Future research will test the feasibility and acceptability of the PROMPPT review and pharmacist training.

Syntax Error: Variations in the Verbiage of Prescription Labels for Pediatric Liquid Medications.

Background Pharmacists can modify prescriptions from prescribers for clarity and patient understanding, provided the confines of the original order are met, yet the verbiage used by pharmacists is not standardized. Prescription directions for children, especially children eight years old and younger, should be written with the verb "give" instead of "take" as their parents or caregivers are expected to administer them. Errors in prescribing, dispensing, and administering medication comprise a significant portion of preventable medical errors in children. To intervene and assist pharmacies, we must first identify and characterize the problem. This study aimed to determine if there is a relationship between prescribers and pharmacists using the verb "give" or "take" when prescribing and printing prescription labels for pediatric liquid medications. In addition, it aimed to determine if there is a relationship between chain pharmacies and independent pharmacies using the verb "give" or "take" when printing labels for pediatric liquid medications. Methodology The participants in this study were caregivers of children eight years old and younger who had been prescribed a new liquid medication. We recruited prescribers in North Louisiana to serve as a referral base for the study. Caregivers were referred to the study by prescribers. A rubric was created to investigate the text of prescription labels. Fisher's exact test was used to determine the relationship between verb choice and prescribers and pharmacists, as well as the relationship between verb choice and chain pharmacies and independent pharmacies. Results A total of 11 (26.83%) prescriber texts used the verb "give," while 12 (29.27%) prescriber texts used the verb "take." Overall, 18 (43.90%) prescriber texts did not use a verb at all. Of these 18 prescriber texts that did not include a verb, 14 prescription labels used the verb "give," and four used the verb "take." In total, 10 (23.81%) chain pharmacy prescription labels used the verb "give," and 10 (23.81%) chain pharmacy prescription labels used the verb "take." The two-tailed p-value of Fisher's exact test comparing verb choice between prescribers and pharmacists equaled 0.0001. A total of 19 (46.34%) independent pharmacy prescription labels used the verb "give," and two (4.88%) independent pharmacy prescription labels used the verb "take." The two-tailed p-value of Fisher's exact test comparing verb choice between chain pharmacies and independent pharmacies equaled 0.0063. Conclusions The relationship between prescriber texts and pharmacist prescription labels shows a relationship between their verb choice (p = 0.0001). The relationship between chain pharmacy and independent pharmacy prescription labels shows a relationship between their verb choice (p = 0.0063). This study has illuminated how medication orders begin before they are modified, if necessary, for the patient's clarity and understanding. This study can be used to instruct prescribers on writing more accurate prescription instructions to prevent medical errors, and it can help pharmacists recognize potential dangers and prevent them through editing.

Development and implementation of ambulatory care pharmacy services at an internal medicine clinic.

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: This report describes the step-by-step process that led to expansion of ambulatory care pharmacy services at a newly established internal medicine clinic within a patient-centered medical home in North Carolina. SUMMARY: Implementation of clinical pharmacist services at the clinic was led by a postgraduate year 2 (PGY2) pharmacy resident and guided by the 9 steps described in the book Building a Successful Ambulatory Care Practice: A Complete Guide for Pharmacists. After a needs assessment and review of the demographics and insurance status of the clinic's target population, it was determined that pharmacist services would focus on quality measures including diabetes nephropathy screening, diabetes eye examination, blood glucose control in diabetes, discharge medication reconciliation, annual wellness visits, and medication adherence in diabetes, hypercholesterolemia, and hypertension. Clinic appointments were conducted under 3 models: a pharmacist-physician covisit model, a "floor model" of pharmacist consultation on drug information or medication management issues during medical resident sign-out sessions with supervising physicians (medical residents could also see patients along with the pharmacist at a covisit appointment), and a covisit model of stacked physician and pharmacist appointments. The pharmacist's services were expanded from 2 half-day clinic sessions per week initially to 5 or 6 half-day clinic sessions by the end of the residency year. CONCLUSION: By the fourth quarter of the first PGY2 residency year in which ambulatory care pharmacy services were provided in the clinic, the clinical and financial impact of those services justified the addition of a second full-time pharmacist to the clinic team.

Knowledge and attitude of healthcare prescribers and pharmacists toward antimicrobial stewardship program and the barriers for its implementation.

BACKGROUND: Antimicrobial stewardship (ASP) is considered a key prevention strategy in addressing the worldwide concern of accelerating antimicrobial resistance. Limited research is available regarding healthcare providers' knowledge and attitude toward antimicrobial stewardship and the barriers for its implementation. METHODS: The present cross-sectional study was conducted on pharmacists and healthcare prescribers (HCPs) in different hospital sites across Jordan. A validated survey was used to evaluate HCPs and pharmacists' knowledge, and attitudes towards ASP and the barriers for its implementation. Logistic and linear regression were conducted to identify the factors associated with knowledge and attitude toward ASP, respectively. RESULTS: A total of 603 participants, 69 (11.4%) pharmacists and 534 (88.6%) HCPs completed the study questionnaire, with a response rate of 80.4%. The overall mean knowledge about ASP was 7.16 out of 10, ranging from 0 to 10 (SD 2.22). Being a pharmacist and increased awareness/familiarity about ASP were associated with improved ASP knowledge. The overall average attitude score was = 3.8 ± 0.49 (range: 1.8-4.8). Results revealed that being a pharmacist and improved knowledge were associated with improved attitude toward ASP. Lack of specialized staff with expertise in ASP and lack of access to education and training programs were the major barriers hinder ASP implementation. CONCLUSION: Despite the reasonable knowledge and the positive attitude toward the ASP, several barriers were reported, particularly by the pharmacists. Therefore, promoting the presence of adequately skilled healthcare personnel, creating easily accessible online courses, and establishing a comprehensive database of ASP resources are all suggested approaches to improve the application of ASP in healthcare settings.

Understanding Australian pharmacy degree holders' job preferences through the lens of motivation-hygiene theory.

Increasing the contribution of pharmacists to primary care has been long discussed, particularly in the context of health workforce shortages and the push to better integrate all providers across primary care. This study examines the employment preferences of Australian pharmacy degree holders (PDHs) elicited through a discrete choice experiment (DCE), to better understand the drivers of current labour force choices. A labelled DCE was developed incorporating the six employment sectors: hospital pharmacy, community pharmacy, primary healthcare settings, pharmaceutical industry, government/academia, and non-pharmacy-related sector. Each alternative was described by five attributes using Herzberg's Two Factor Theory as a conceptual framework. They include motivators - role and career opportunities, and hygiene factors-flexible work schedule, geographic location, and salary. Unforced choice data were analysed using conditional logit and mixed logit models. Based on a sample of 678 PDHs in Australia, our findings indicated pharmaceutical industry is the least preferred sector, followed by non-pharmacy-related sector. Motivators in the form of role and career opportunities are the most important attributes in hospital pharmacy while hygiene factors - geographic location and salary significantly drive the choice of community pharmacy and primary care settings. We provided evidence of a willingness to adopt expanded roles in community pharmacy. This unique interpretation of the key drivers of employment preference in light of motivators and hygiene factors provides policy makers with important information when designing policies to attract and retain PDHs across employment sectors.

HIV Care Continuum and Preexposure Prophylaxis Program in Federal Bureau of Prisons, United States.

In 2019, the US Department of Health and Human Services launched the Ending the HIV Epidemic in the US initiative (EHE) with the goal of reducing new HIV infections by 90% by 2030. This initiative identifies 4 pillars (diagnose, treat, prevent, and respond) to address the HIV epidemic in the United States. To advance the EHE goals, the Federal Bureau of Prisons (FBOP) has implemented interventions at all points of the HIV care continuum. The FBOP has addressed the EHE pillar of prevention through implementing preexposure prophylaxis, developing a strategy to decrease the risk of new HIV infection, and providing guidance to FBOP healthcare providers. This article describes the implementation of programs to improve the HIV care continuum and end the epidemic of HIV within the FBOP including a review of methodology to implement an HIV preexposure prophylaxis program.

Student pharmacists' perceptions of a NAPLEX preparation module in the pharmacy curriculum at one United States college of pharmacy.

BACKGROUND AND PURPOSE: To investigate final-year student pharmacists' experiences of a new module for North American Pharmacist Licensure Examination® (NAPLEX®) preparation at one college of pharmacy in the United States. EDUCATIONAL ACTIVITY AND SETTING: All student pharmacists enrolled in a new Spring 2023 module for NAPLEX preparation (n = 118) were invited to complete an electronic questionnaire and participate in a semi-structured interview. The questionnaire investigated the perceived helpfulness, grading, importance, prioritization, structure, and timing of the module in the curriculum, as well as assignment choices, confidence building, and time management using a six-point Likert scale. Semi-structured interviews investigated experiences with NAPLEX modules, time management, and course format. Questionnaire data were descriptively analyzed; interview data were thematically analyzed. FINDINGS: Forty-one completed questionnaires and seven interviews were analyzed. Median scores for questionnaire items were six (denoting strongly agree) for three items, five (denoting agree) for seven items, and four (denoting somewhat agree) for two items. Twenty-three (56%) students desired an online self-directed (asynchronous) course structure. Seventeen (42%) students desired a mixture of short and long course assignments with a greater proportion of short course assignments while another 17 (42%) desired only short course assignments. Two themes were constructed from interviews: timing (when to study for NAPLEX) and structure (how to study for NAPLEX). SUMMARY: Study findings indicated typically positive perceptions of a module for NAPLEX preparation among final-year student pharmacists at a college of pharmacy in the United States. Recommendations from students can be used to improve the module in future years.

Understanding Factors Affecting Health Providers' Perceptions of Pharmacist Roles in HPV Vaccine Administration.

Human papillomavirus (HPV) is a viral infection that sexually active females and males may be exposed to in their lifetime. The HPV vaccine is highly recommended especially among children to protect them before their anticipated exposure to HPV, however, vaccination uptake in Hawai'i remains low. As of 2017, legislation allows pharmacists to vaccinate for adolescent vaccines with the potential to increase access and opportunities for patients to complete the HPV vaccine series. Physicians in Hawai'i were surveyed to examine physicians' awareness of this law, their perceptions of the role of pharmacists, and willingness to send adolescent patients to pharmacies; 137 responses were received and analyzed. Overall, 72% (n=99) of respondents were willing while 28% (n=38) were unwilling to send patients to pharmacies for vaccines. Physicians view pharmacists' role as helpful but have concerns regarding correct administration and tracking doses given. Results show potential for more physician-pharmacist collaborations through further education and trainings for pharmacists and health providers to increase physician referrals for adolescent vaccine services in pharmacies.

Drug-related problems in cancer patients: A systematic review.

BACKGROUND: Cancer patients are at a significantly increased risk of drug-related problems due to multiple drugs. An inclusive review of drug-related problems would offer an approach for healthcare providers to decrease the frequency of drug-related problems in cancer patients. The purpose of this study was to assess all characteristic components of drug-related problems in cancer patients, and explore actions taken to resolve the detected drug-related problems the results could be used as a baseline for epidemiology and potential related risk factors for drug-related problems in cancer patients. METHODS: The present systematic review was done according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The search consisted of studies listed from January 2015 and up to May 2023. A systematic review was carried out using an electronic database with a combination of Medical subject Headings of key words Medical Subject Heading terms. RESULTS: This evaluation included 17 studies from 11 different nations having 11 prospective and 6 retrospective studies. Pharmaceutical Care Network Europe classification system is the most commonly used to classify the drug-related problems. The prevalence of drug-related problems varied from 9.6% to 92.8%. The key predictors of the drug-related problems were age, polypharmacy, multiple comorbidities, and the stage of the disease. CONCLUSION: Drug-related problems are significantly more common among cancer patients. The age, polypharmacy, multiple comorbidities, and the stage of the malignancy all enhance the risk of acquiring drug-related problems. This review raises awareness of drug-related problems, encourages their early detection, and emphasizes the necessity for framing effective drug-related problem management strategies which will enhance patient care.

Knowledge, Attitudes, and Practices (KAP) of community pharmacists regarding antibiotic use and resistance: a cross-sectional study from the United Arab Emirates.

One of the main contributing factors of antibiotic resistance is the dispensing of antibiotics without prescription. This study investigated community pharmacists' knowledge, attitudes, and practices in relation to antibiotic dispensing and resistance in United Arab Emirates (UAE). A cross-sectional survey was conducted using validated questionnaire. (40.1%) had an overall positive KAP score. A total of (88%) respondents were aware of the illegality of dispensing antibiotics without a prescription. Only (31%) had good knowledge regarding amoxicillin dosage for upper respiratory tract infection. The primary misconduct found numerous pharmacists prescribing antibiotics without a prescription, even though they were aware that this should never be done. Pharmacists who attended events focused on antibiotic use and resistance were more likely to have good knowledge about antibiotics (Adjusted Odd Ratio (AOR): 1.673; 95%CI: 1.029-2.719; p = 0.038), more likely to have positive attitude (AOR: 1.889; 95%CI: 1.133-3.149; p = 0.015), and more likely to have good practice (AOR: 3.182; 95%CI: 1.541-6.572; p = 0.002).

Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt: "cross-sectional observational study".

BACKGROUND: Diabetes recently has been identified as a growing epidemic. Although insulin's vital role in both types of diabetes, it is considered one of the harmful medications if used incorrectly. In Egypt, effective usage of insulin remains a challenge due to insufficient knowledge of insulin and diabetes management, leading to errors in insulin therapy. As pharmacists are experts in pharmacological knowledge, they are uniquely situated to assess adherence to treatment regimens, the effect of drug therapy, or potential alterations in drug therapy to meet patient goals. To provide effective patient education and counseling, community pharmacists in Egypt should be efficiently knowledgeable about diabetes and insulin. OBJECTIVE: To identify the knowledge, attitude, and practice of pharmacists and patients about insulin. To identify pharmacists' educational preparedness and confidence in counseling diabetic patients. METHODS: A descriptive, cross-sectional study was conducted with two knowledge, attitude, and practice surveys. This study was carried out from September 2016 to February 2023. Face-to-face interviews were conducted with patients, and a paper-based questionnaire was administered to pharmacists. The two questionnaires were adapted from previous studies. RESULTS: A total of 492 patients and 465 pharmacists participated in this study. The mean knowledge score of correct answers among patients and pharmacists was 10.67 ± 1.9 and 15 ± 3.6. Most of the patients and pharmacists had a positive attitude regarding insulin's role in improving health and to better control blood glucose. On the negative side, around half of the patients reported that they believe that regular use of insulin leads to addiction, while only 14.5% of the pharmacists believed that insulin could cause addiction. Self-confidence scores for pharmacists differed statistically with sex, years of experience, and pharmacist's direct exposure to diabetic patients. CONCLUSIONS: This study uncovers considerable deficiencies in patients' and pharmacists' knowledge about insulin therapy. This study also strongly recommends higher education and a more structured pharmacist training schedule.

Competências gerais, específicas e dificuldades para a atuação dos farmacêuticos como preceptores: revisão integrativa / General and specific competencies and difficulties for pharmacists to act as preceptors: an integrative review / Competencias generales y especificas y dificultades del farmacéutico para el trabajo como preceptor: una revisión integrativa

O presente estudo teve como objetivo descrever e analisar as competências gerais, específicas e as dificuldades para a atuação dos farmacêuticos como preceptores. Para isso, foi realizada uma revisão de literatura nas bases de dados eletrônicas PubMed, Web of Science, Embase e Scopus, utilizando artigos publicados sobre competências gerais e específicas dos preceptores farmacêuticos. A busca inicial identificou 355 artigos, dentre os quais 14 atenderam aos critérios de inclusão. Foram encontradas como principais competências gerais: habilidade de comunicação, conhecimento, resolução de problemas, desenvolvimento de pensamento crítico e profissionalismo; como específicas: feedbacks, relacionamento interpessoal, atividades baseadas nas necessidades dos alunos, planejamento, expectativa compartilhada e liderança; e foram vistas como principais dificuldades: necessidade de maior qualificação dos preceptores e falta de tempo para exercer as atividades da preceptoria. O conhecimento dessas competências e dificuldades pode contribuir para uma melhor força de trabalho na educação acadêmica e experiencial em farmácia

The present study aimed aimed at describing and analyzing the general and specific skills and difficulties for pharmacists to act as preceptors. To this end, a literature review was carried out in the electronic databases PubMed, Web of Science, Embase and Scopus, for articles published on general and specific competencies of pharmaceutical preceptors. The initial search identified 355 articles and 14 using articles published met the inclusion criteria. The main general competencies were found to be: communication skills, knowledge, problem solving, development of critical thinking and professionalism; as specific: feedback, interpersonal relationships, activities based on student needs, planning, shared expectations and leadership; and the main difficulties were seen as: need for greater qualification of preceptors and lack of time to carry out preceptorship activities. Knowledge of these skills and difficulties can contribute to a better workforce in academic and experiential pharmacy education

El presente estudio tuvo como objetivo describir y analizar las competencias generales y específicas y las dificultades para la actuación de los farmacéuticos como preceptores. Para ello, se realizó una revisión de literatura en las bases de datos electrónicas PubMed, Web of Science, Embase y Scopus, usando artículos publicados sobre competencias generales y específicas de los preceptores farmacéuticos. La búsqueda inicial identificó 355 artículos, dentro de los quales 14 cumplieron con los criterios de inclusión. Se encontraron como principales competencias generales: habilidad de comunicación, conocimiento, resolución de problemas, desarrollo de pensamiento crítico y profesionalismo; como específicas: retroalimentación, relaciones interpersonales, actividades basadas en las necesidades de los alumnos, planificación, expectativa compartida y liderazgo; y fueron vistas como principales dificultades: necesidad de más cualificación de los preceptores y falta de tiempo para ejercer las actividades de la preceptoría. El conocimiento de estas competencias y dificultades puede contribuir a una mejor fuerza laboral en la educación académica y experiencial en farmacia

Optimizing Antimicrobial Stewardship in the Emergency Department.

Antibiotic stewardship is a core component of emergency department (ED) practice and impacts patient safety, clinical outcomes, and public health. The unique characteristics of ED practice, including crowding, time pressure, and diagnostic uncertainty, need to be considered when implementing antibiotic stewardship interventions in this setting. Rapid advances in pathogen detection and host response biomarkers promise to revolutionize the diagnosis of infectious diseases in the ED, but such tests are not yet considered standard of care. Presently, clinical decision support embedded in the electronic health record and pharmacist-led interventions are the most effective ways to improve antibiotic prescribing in the ED.

Evaluation of an e-Learning Program for Community Pharmacists for Dispensing Emicizumab (Hemlibra) in France: Nationwide Cross-Sectional Study.

BACKGROUND: Since June 2021, patients with hemophilia A with antifactor VIII inhibitors and those with severe hemophilia A without antifactor VIII inhibitors treated with Hemlibra have had to choose between a community or hospital pharmacy. The French reference center for hemophilia developed the HEMOPHAR e-learning program for community pharmacists for dispensing emicizumab. OBJECTIVE: This study aims to evaluate the efficiency and safety of this new care pathway by assessing the HEMOPHAR e-learning program. METHODS: The methodology is based on Kirkpatrick's model for evaluating the immediate reaction of trained community pharmacists (level 1), their level of acquired knowledge (level 2), and their professional practice after 3 months of dispensation (level 3). RESULTS: The HEMOPHAR e-learning program reached a large audience, with 67% (337/502) of the eligible community pharmacists following it. The immediate reaction was overall satisfying. High rates of engagement were reported with 63.5% (214/337) to 73.3% (247/337) of completed training modules, along with high rates of success with quizzes of 61.5% (174/337) to 95.7% (244/337). We observed that 83.9% (193/230) of the community pharmacists needed less than 2 attempts to pass the quiz of the module related to professional practice, while the other quizzes required more attempts. Advice on compliance and drug interactions were most frequently provided to patients by the community pharmacists. CONCLUSIONS: This study suggests ways to improve the training of community pharmacists and to optimize coordination with treatment centers. This study also reports on the feasibility of switching to a community pharmacy in a secure pharmaceutical circuit, including in the context of a rare bleeding disease. TRIAL REGISTRATION: ClinicalTrials.gov NCT05449197; https://clinicaltrials.gov/study/NCT05449197. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/43091.

Actual practices of community pharmacists in the management of diabetes: a comparison of simulated patient-based study with perceived role of involvement.

Objectives: This study evaluated the level of community pharmacy professionals' (CPPs) actual practices and contrasted it with their self-reported perceived involvement in diabetes management. Methods: A self-reported cross-sectional and simulated patient (SP)-based study were employed at community drug retail outlets (CDROs) in Northwest Ethiopia. SP-case scenarios were used to examine the actual practices of CPPs in diabetes management and were compared with self-reported perceived involvement. The data were managed and analysed using SPSS version 26. Results: About 184 participants in the self-reported and 100 CPPs' actual practices using three SP visits were included. The overall actual practice (17.8%) was found to be significantly different compared with the perceived level of involvement (73.5%) (p-value <0.05). About 94.3% of CPPs dispensed requested medications to the SP without a prescription. Despite most participants being perceived to be involved, more than 76% of CPPs did not counsel the SP for lifestyle modifications, avoiding risky behaviours, adherence to treatment, routine blood glucose checkups, diabetic foot care techniques, or consultation with physicians for further management. Conclusion: A significant discrepancy between actual practices and perceived CPPs' involvement in the management of diabetes was observed. The findings may suggest that exploring possible gaps may be crucial.

A cross-sectional study on the proper administration of eye medications and its determinants among outpatients attending Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea.

OBJECTIVE: This study aimed to assess the administration technique of eye medications, its determinants and disposal practices among ophthalmic outpatients. DESIGN: An analytical cross-sectional study was conducted. SETTING: Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea. PARTICIPANTS: Samples of ophthalmic outpatients aged >18 years who visited Brhan Aini Ophthalmic National Referral Hospital in Asmara, Eritrea. Systematic random sampling was used to select the study participants. DATA COLLECTION AND ANALYSIS: Data were collected from August 2021 to September 2021, using an interview-based questionnaire. The collected data were entered and analysed using CSPro (V.7.3) and SPSS (V.26), respectively. Descriptive statistics and independent samples t-test were performed. P-values less than 0.05 were considered as significant. RESULTS: A total of 333 respondents with a mean age of 56.4 (SD: 18.76) years were recruited in the study. More than half of the respondents (57.4%) did not have any information on the time interval between two successive eye medications. However, only 16.5% of the respondents managed to close their tear ducts after the administration of eye medication. The mean (SD) score for proper administration of eye medication was 4.16 (1.07) out of 7.0. Female sex (p=0.002), the absence of glaucoma (p=0.035) and the presence of cataract (p=0.014) were significant determinants of the proper administration technique of eye medication. The most favoured disposal practice for unused and/or expired eye medications was disposing of regular garbage (79.9%). CONCLUSION: This research revealed that there was an inappropriate administration technique and disposal practices of eye medications among ophthalmic outpatients. This requires immediate attention from policy-makers, programme managers and healthcare professionals to ensure the appropriate use of eye medications by the patients.

Assessment of the appropriateness of stress ulcer prophylaxis use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital, Ethiopia. A hospital-based cross-sectional study.

Introduction: Pharmacological stress ulcer prophylaxis (SUP) has been recommended for many years to reduce the risk of clinically significant upper gastrointestinal (GI) bleeding caused by stress ulcers (SUs). Stress-related ulcer bleeding in surgical patients significantly increases morbidity and mortality. Therefore, preventing stress-induced hemorrhage is the most appropriate measure for patients who are at increased risk. However, the inappropriate use of SUP has increased in recent years, and its use in Ethiopian surgical patients has not been well studied. Objective: The aim of this study was to assess the appropriateness of SUP use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital (DBUHGH), Ethiopia. Methods: We randomly selected 230 patients from the whole cross-sectional group of all surgical patients at DBUHGH from 1 February to 30 June 2023. The risk of stress ulcer (SU) development was assessed using the modified American Society of Health-System Pharmacists (ASHP) guidelines. For data analysis, we used SPSS version 25. Results: The mean age of study participants was 47.2 years (SD ± 20.4), and out of the total of 230, 130 (56.5%) were women. Approximately 66% of study participants took inappropriate SUP based on ASHP guidelines criteria. The most commonly used drug class for SUP was histamine-2 receptor blockers 115 (50%). Study participants who have a Charlson Comorbidity Index Score of moderate and GI bleeding have been significantly associated with the inappropriate use of SUP. Conclusion: In our study, inappropriate SUP use was common in the surgical ward of DBUHGH. This may be an area that requires further and more focused working together among clinical pharmacists and medical professionals in an institution-specific SUP protocol that aids clinicians in identifying appropriate candidates for SUP medication.

The role of pharmacist in community palliative care-a scoping review.

OBJECTIVES: Dynamic and adaptive services that provide timely access to care are pivotal to ensuring patients with palliative needs experience high-quality care. Patients who have palliative care needs may require symptomatic relief with medicines and, therefore, may engage with community pharmacists frequently. However, there is limited evidence for pharmacists' involvement in community palliative care models. Therefore, a scoping review was conducted to identify pharmacists' role in community palliative care. METHODS: A systematic search strategy was implemented across PubMed, PsychINFO, CINAHL, and Embase databases. Articles were screened by abstract and full text against inclusion and exclusion criteria. KEY FINDINGS: Five articles (two from Australia, two from England, and one from Scotland) met the inclusion criteria and described interventions involving pharmacists in community palliative care. This review has identified that the inclusion of trained pharmacists in community palliative care teams can improve the quality of care provided for patients with palliative needs. Pharmacists are able to undertake medication reviews and provide education to patients and other healthcare professionals on the quality use of palliative care medicines. Additionally, the underutilization of community pharmacists in palliative care, the need for further training of pharmacists, and improved community pharmacy access to patient information to deliver community palliative care were identified. CONCLUSION: Pharmacists can play a vital role in community palliative care to enhance the quality of life of patients. There is a need for greater pharmacist education/training, improved interprofessional communication, improved access to patient information and sustainable funding to strengthen community-based palliative care.

Pharmacovigilance Concept Knowledge, Perspectives and Attitudes: A Cross-Sectional Study Among Community Pharmacists.

The concept of pharmacovigilance (PV) is currently highlighted after emergency authorization and worldwide distribution of the urgently launched COVID-19 novel vaccinations. As they typically serve as the initial point of patient contact for medication-related issues, understanding the knowledge, perspectives, and attitudes of community pharmacists in PV and reporting adverse drug reactions (ADRs) is crucial to improving the healthcare system and public health policies. However, previous studies in Jordan have not focused entirely on community pharmacists. This study aimed to assess community pharmacists' knowledge, perspectives, and attitudes on PV and ADRs reporting in Jordan. The applied methodology in this study was based on a cross-sectional study design using a validated questionnaire distributed to a convenient sample of Jordanian community pharmacists. Seventeen questions were designed from different pieces of literature relating to knowledge, perspectives, and attitudes of PV among community pharmacists. Descriptive statistics (frequencies and percentages) were used to report the results data. The study questionnaire was completed by 180 of 325 community pharmacists willing to participate (a response rate of 55.4%). Of them (n = 132, 73%) were aware of the concept of PV. Additionally (n = 84, 47%) of the community pharmacists would use the concept and policy of PV in their everyday work. Nevertheless, only (n = 36, 20.0%) of the community pharmacists thought an ADR should be reported if seen, and approximately 120 pharmacists (67.0%) believed it was essential to report ADRs as patient health matters. Although community pharmacists in Jordan showed a considerable awareness level of PV, they demonstrated a low level of its application. Thus, ADR reporting is not considered a mainstay among them, and the implementation of PV is not yet addressed. The results from this study shed light on community pharmacists' perceptions and attitudes regarding ADR reporting and PV.