Anales del Sistema Sanitario de Navarra, Journal Year: 2023, Volume and Issue: 46(3)
Published: Dec. 26, 2023
Language: Английский
Digestive Diseases, Journal Year: 2024, Volume and Issue: 42(3), P. 211 - 220
Published: Jan. 1, 2024
<b><i>Background:</i></b> Despite deprescribing initiatives to curb overutilization of proton pump inhibitors (PPIs), achieving meaningful reductions in PPI use is proving a challenge. <b><i>Summary:</i></b> An international group primary care doctors and gastroenterologists examined the literature surrounding use-reduction clarify: (i) what constitutes rational prescribing; (ii) when whom should be attempted; (iii) strategies attempting use-reduction. <b><i>Key Messages:</i></b> Before starting for reflux-like symptoms, patients educated on potential causes alternative approaches including dietary lifestyle modification, weight loss, relaxation strategies. When commencing PPI, understand reason treatment, planned duration, review date. at hospital discharge not continued without recognized indication long-term treatment. Long-term therapy reviewed least annually. based lack use, concern PPI-associated adverse events. involving switching on-demand or dose tapering, with rescue rebound are more likely succeed than abrupt cessation.
Language: Английский
Citations
7
Age and Ageing, Journal Year: 2024, Volume and Issue: 53(6)
Published: June 1, 2024
Abstract Introduction Problematic polypharmacy is the prescribing of five or more medications potentially inappropriately. Unintentional cascades represent an under-researched aspect problematic and occur when adverse drug reaction (ADR) misinterpreted as a new symptom resulting in initiation medication. The aim this study was to elicit key stakeholders’ perceptions attitudes towards polypharmacy, with focus on cascades. Methods qualitative one-to-one semi-structured interviews were conducted predefined stakeholder groups. Inductive thematic analysis employed. Results Thirty-one stakeholders interviewed: six patients, two carers, seven general practitioners, eight pharmacists, four hospital doctors, professional organisation representatives policymakers. Three main themes identified: (i) ADRs cascades—a necessary evil. Healthcare professionals (HCPs) expressed concern that experiencing ADR would negatively impact patients’ confidence their doctor. However, patients viewed pragmatically unpredictable risk. (ii) Balancing risk/benefit tipping point. complexity decisions context made balancing point challenging. Consequently, HCPs avoided medication changes. (iii) minefield reconciliation. Stakeholders, including reconciliation perilous activity due systemic communication deficits. Conclusion Stakeholders believed at certain depth risk being caused by existing becomes incalculable. Therefore, absence harm, changes avoided. post discharge compelled seen high-risk stakeholders.
Language: Английский
Citations
5
International Journal of Clinical Pharmacy, Journal Year: 2024, Volume and Issue: 46(4), P. 957 - 965
Published: May 30, 2024
Medicines reviews by general practice pharmacists improve patient outcomes, but little is known about the associated economic particularly in patients at higher risk of medicines-related harm. To conduct an cost-benefit analysis providing person-centred medicines to with hyperpolypharmacy (prescribed ≥ 10 regular medicines) and/or high harm across multiple settings. Service delivery costs were calculated based on pharmacist's salary, recorded timings, and a practitioner fee. Direct cost savings from change patients' post review, projected over 1 year. Indirect using two models, population-based model for avoidance hospital admissions due adverse drug reactions intervention-based applying probability reaction avoidance. Sensitivity analyses performed varying workday scenarios. Based 1471 (88.4% hyperpolypharmacy), service was €153 per review. Using model, net ranging €198 €288 review €73,317 €177,696 annum pharmacist calculated. €651-€741 corresponding annual €240,870-€457,197 pharmacist, Savings ratios ranged 181 584% all models inputs. Person-centred result substantial savings. Wider investment will be beneficial minimise both healthcare system expenditure.
Language: Английский
Citations
4
Journal of Oncology Pharmacy Practice, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 3, 2025
Cancer presents significant physical and mental challenges to patients. Therefore, psychological assessment is important following a cancer diagnosis, as well during after chemotherapy. In treatment, the goal of healthcare providers, including pharmacists, should be deliver holistic care that addresses aspects patients’ health, with particular emphasis on their readiness combat diseases. This article reviews published literature from Google Scholar PubMed examine relevant pharmacotherapy psychotherapy approaches managing issues in also discusses how pharmacists can integrated into health care, while highlighting potential benefits associated this approach. We conclude integration support for patients holds promise due knowledge chemotherapy, ability improve about capacity collaborate other professionals treatment.
Language: Английский
Citations
0
British Journal of Clinical Pharmacology, Journal Year: 2025, Volume and Issue: unknown
Published: Feb. 10, 2025
Abstract Aim The aim of this study was to investigate the impact pharmacist‐led person‐centred medicines reviews in general practices on appropriateness, polypharmacy indicators (high‐risk prescribing markers), and patient‐reported outcome measures (PROMs). Methods Four pharmacists conducted ten between January 2021 December 2022 for patients with hyperpolypharmacy (prescribed ≥10 regular medicines) and/or at high risk medicines‐related harm. Prescribing recommendations were provided practitioner followed up healthcare professionals. In single arm study, pre post intervention: (1) documented, a sample patients, (2) Person‐Centred Medication Appropriateness Index (PC‐MAI) scores (3) PROMs gathered. Results Of 1471 included mean age 76 years, 88.4% had hyperpolypharmacy, whilst number 13.8 12.3 review. 1056 indicator occurrences identified, 70.7% resolved 194 pre‐review post‐review PC‐MAI scores, 99% reduction; reduction 17.3 (95% confidence interval [CI] 15.8–18.8, P < .0001) per patient 1.2 CI 1.0–1.3, medicine. collected 179 patients; 87.7% reported review helped their understanding, 63.1% experience side effects, 36.9% ability take correctly, 30.5% daily activities. Conclusions General practice harm delivered substantial improvements appropriateness outcomes, thus providing evidence support wider implementation.
Language: Английский
Citations
0
Research in Social and Administrative Pharmacy, Journal Year: 2025, Volume and Issue: unknown
Published: March 1, 2025
Language: Английский
Citations
0
European Journal of General Practice, Journal Year: 2023, Volume and Issue: 29(1)
Published: Nov. 6, 2023
Pharmacists are increasingly incorporated into general practice teams globally and have been shown to positively impact patient outcomes. However, little research date has focused on determining practitioners' (GPs') perceptions of practice-based pharmacist roles in countries yet establish such roles.To explore GPs' towards integrating pharmacists practices determine if any significant associations were present between their demographic characteristics.In June 2022, a survey was disseminated GPs Ireland via post (n = 500 Munster region), Twitter, WhatsApp, an online GP support education network. Quantitative data captured through multiple option Likert-scale questions analysed using descriptive inferential statistics. Qualitative free-text boxes, with the open comments reflexive thematic analysis.A total 152 valid responses received (24.6% response postal survey). Overall, welcomed role perceived that they would increase safety. Most agreed providing medicine information (98%) vs. 23% agreeing prescribing independently. partake pilot (78.6%). The described current pressures practice, existing relationships pharmacists, funding governance strategies, potential for anticipated outcomes roles.This study provides deeper understanding characteristics associated different perceptions, which may help better inform future initiatives integrate practices.
Language: Английский
Citations
4
BMC Health Services Research, Journal Year: 2024, Volume and Issue: 24(1)
Published: June 22, 2024
Interprofessional collaborative care such as a split-shared model involving family physicians and community pharmacists can reduce the economic burden of diabetes management. This study aimed to evaluate outcome between within pharmacy chain in managing people with uncontrolled type 2 polypharmacy.
Language: Английский
Citations
1
Pharmacy, Journal Year: 2024, Volume and Issue: 12(4), P. 119 - 119
Published: July 30, 2024
Background: This study examines the implementation and perceptions of a pharmacist consultant deprescribing program aimed at reducing risk falls in older adults using opioids benzodiazepines. Methods: qualitative conducted interviews with healthcare providers. The were from August to December 2021 analyzed inductive coding techniques. Results: Five participants, predominantly female MDs or PA-Cs rural clinics, interviewed. participants adopted pharmacist-led due their heightened awareness opioid crisis, dedication patient safety, desire for education. Initially, concerns included resistance provider-driven barriers. However, over time, attitudes shifted toward greater openness program. providers emphasized several critical needs success program: guaranteed access pharmacists, tailored education, resources specific providers, financial support, including telehealth options. These factors deemed essential overcoming initial barriers ensuring effective implementation. Conclusion: Integrating pharmacists into primary care settings shows promise benzodiazepines adults. Future research should explore options patient–pharmacist consultations expand application these findings other settings. highlights importance awareness, (pharmacists), provider support addressing among
Language: Английский
Citations
0
BMJ Open, Journal Year: 2024, Volume and Issue: 14(5), P. e081698 - e081698
Published: May 1, 2024
Introduction Polypharmacy and multimorbidity pose escalating challenges. Despite numerous attempts, interventions have yet to show consistent improvements in health outcomes. A key factor may be varied approaches targeting patients for intervention. Objectives To explore how are targeted intervention by examining the literature with respect to: understanding polypharmacy is defined; identifying problematic practice; addressing through interventions. Design We performed a scoping review as defined Joanna Briggs Institute. Setting The focus was on primary care settings. Data sources Medline, Embase, Cumulative Index Nursing Allied Health Literature Cochrane along ClinicalTrials.gov, Science.gov WorldCat.org were searched from January 2004 February 2024. Eligibility criteria included all articles that had care, incorporating multiple types of evidence, such reviews, quantitative trials, qualitative studies policy documents. Articles focussing single index disease or not written English excluded. Extraction analysis narrative synthesis, comparing themes findings across collective evidence draw contextualised insights conclusions. Results In total, 157 included. Case-finding methods often rely basic medication counts (often five more) without considering medical history whether individual medications clinically appropriate. Other highlight specific drug indicators interactions potentially inappropriate prescribing, failing capture proportion fitting criteria. Different prescribing also significant inconsistencies determining appropriateness medications, neglecting consider underprescribing. This hinder identification precise population requiring Conclusions Improved strategies needed target polypharmacy, which should patient perspectives, factors clinical appropriateness. development cross-cutting measure consistently incorporates adjustment valuable next step address frequent confounding.
Language: Английский
Citations
0