Evaluation of the Effectiveness of Community Pharmacy Services on Rational Medication Use in Elderly Patients with Hypertension and Diabetes

Objective:To explore the effect of community pharmacy services on rational medication use in elderly patients with hypertension and diabetes.Methods:Between November 2022 and December 2023,80 elderly patients with hypertension and diabetes were selected and randomly divided into a control group(routine medication guidance)and an observation group(community pharmacy services),with 40 subjects each.The medication effect scores,blood pressure,blood sugar levels,and quality of life scores before and after intervention were compared between the two groups.Results:Comparison of pharmaceutical knowledge,medication compliance,and safe medication behavior scores showed that the observation group had higher scores as compared to the control group(P<0.05);blood pressure(systolic blood pressure,diastolic blood pressure,heart rate)and blood sugar(fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin)index levels were compared,and the observation group’s index levels were lower than those of the control group(P<0.05);the scores of physical health,mental health,social relationships,and environment in the observation group were higher than those in the control group(P<0.05).Conclusion:Community pharmacy services improved the rational medication effect of elderly patients with hypertension and diabetes,and improved their blood pressure,blood sugar control levels,and quality of life.

Training of clinical pharmacists in psychiatric pharmacy services during the prevention and treatment of COVID-19

A series of pharmacy services of clinical pharmacists at the Wuhan Mental Health Center during the prevention and treatment of Coronavirus disease 2019(COVID-19),such as participation in the formulation of COVID-19 prevention and treatment plans suitable for psychiatric departments,popular science of pharmacy,medical order review,real-time intervention,and medication education are summarized here.Due to the sudden public health incident,the service model of psychiatric clinical pharmacists should be addressed,as clinical pharmacists are an important part of the diagnosis and treatment of psychiatric diseases.Among the majors currently available in the clinical pharmacy training base curriculum,no psychiatry major has been set up in China yet;therefore,in this paper,we provide guidance in psychiatry pharmacy for those who wish to integrate clinical teams.

An Investigation of Oxidative DNA Damage in Pharmacy Technicians Exposed to Antineoplastic Drugs in Two Chinese Hospitals Using The Urinary 8-OHdG Assay

Objective To investigate oxidative DNA damage in pharmacy technicians preparing antineoplastic drugs at the PIVAS （Pharmacy Intravenous Admixture Service） in two Chinese hospitals. Methods Urinary 8-OHdG served as a biomarker. 5-Fluorouracil （5-FU） concentrations in air, masks and gloves were determined. The spill exposure of each PIVAS technician to antineoplastic drugs was investigated. Eighty subjects were divided into exposed group t, II, and control group I, II. Results 5-FU concentration ratios for gloves and masks in exposed group I were significantly higher than those in exposed group II （P〈0.05 or P〈0.01）. The average urinary 8-OHdG concentrations in exposed group I, control group I, exposed group II, and control group II were 24.69＋0.93, 20.68＋1.07, 20.57＋0.55, and 12.96_＋0.73 ng/mg Cr, respectively. Urinary 8-OHdG concentration in exposed group I was significantly higher than that in control group I or that in exposed group 11 （P〈0.02）. There was a significant correlation between urinary 8-OHdG concentrations and spill frequencies per technician （P〈0.01）. Conclusion There was detectable oxidative DNA damage in PIVAS technicians exposed to antineoplastic drugs. This oxidative DNA damage may be associated with their spill exposure experience and contamination of their personal protective equipment.

Investigation on the Current Situation of China’s DTP Pharmacy and Suggestions for Its Development

Objective To summarize the main characteristics and development approaches of direct-to-patient(DTP)pharmacies,and to explore its future development trend.Methods Firstly,relevant policies of DTP pharmacies were sorted out based on some documents on the government website,and related articles were studied.Secondly,499 DTP pharmacies were investigated.Finally,the current status of the industry was summarized and analyzed.Results and Conclusion Policies on China’s DTP pharmacy have been constantly improved.According to industry standards,the current compliance rate of DTP pharmacies is about 46.09%.In terms of varieties,the market share concentration rate of biological products is higher than that of chemical drugs.The regional distribution of these drugs is mainly concentrated in the central and eastern provinces.However,63.45%of DTP pharmacies have less than 50 product specifications.DTP pharmacies have an average of 7.3 pharmacy technicians and 2.3 licensed pharmacists,which is higher than that of ordinary pharmacies.Due to the policy promotion,DTP pharmacies will be paid more attention by the public and the government,and the market share will become larger than before.Patients shifting from hospitals to drug-to-pharmacies can make them better layout.Besides,pharmaceutical services will become more specialized,and disease division will be more detailed.With the deepening of medical reform and the continuous improvement of national medical security as well as drug procurement and medical insurance payment methods,DTP pharmacies can play an important role in the national basic medical security system.

Pharmacy intervention of irrational medical orders on pharmacy intravenous admixture services of outpatient and emergency departments in Fujian Provincial Hospital

In the present study, we aimed to analyze the irrational medical orders and evaluate the effect of pharmacy intervention on pharmacy intravenous admixture services of outpatient and emergency departments in our hospital. The irrational medical orders of PIVAS at the outpatient and emergency departments were retrospectively analyzed in Jun. 2015. We strengthened the pharmacy intervention on irrational medical orders since July 2015. All the cases were selected by systematic sampling method. Cased studied in Jun. 2015 served as the control group, whereas those studied in Jan. 2016 served as the intervention group. The irrational rate and the irrational number of daily average were compared between the control group and intervention group. The common type of irrational outpatient and emergency intravenous orders mainly included irrational use of solvents, irrational dosing interval and inappropriate compatibility of drugs. The irrational rate was reduced from 17.4% to 3.3% （P〈0.01）, and the irrational number of daily average was decreased from 5.23 to 1.00 （P〈0.01）. Pharmacy intervention can reduce the irrational rate of medical orders in our hospital, which is of great significance to promote rational drug use and improve medical quality.

The Impact of a Clinical Pharmacist in the Emergency Department of an Academic Hospital in the Kingdom of Saudi Arabia

Introduction： The department of emergency medicine （DEM） has a high-risk environment due to its unique and complex workflow. Many high-risk medications are ordered and administered at patients’ bedsides without being checked by a pharmacist first, which may lead to an increase in the incidence of patient medication errors （MEs）. Objective： The current study evaluated the needs of the clinical pharmacy service in the DEM at King Saud University Medical City （KSUMC）, Riyadh, Saudi Arabia. Methods： A cross-sectional retrospective study was conducted between Jan 2016 to Dec 2017 and the documentation of clinical pharmacist interventions was extracted from Esihi database. Results： A total of 2,255 interventions for 862 patients were documented. The recommended interventions were as follows： 645 （dose adjustments）, 108 （therapeutic substitutions）, and 354 interventions （initiating drug therapy）. Adverse drug reactions （ADRs） were reported in 16 patients, and drug interactions were managed in 26 patients. The DEM responded to 713 information inquires and 290 pharmacokinetic consultations. Drug discontinuations included 39 incidents （where unjustified drug prescription occurred）, 37 （where contraindications were involved）, and 19 （where duplicate therapy was involved）. The most common interventions were related to the following drugs： antibiotics （34%）, anticoagulants （15%）, and anticonvulsants （10%）. The acceptance rates for the EM clinical pharmacist recommendations increased from 93.9% in 2016 to 99% in 2017. The most common outcome for interventions was to optimize the therapeutic effects of the drugs that were administered （73%）. Reconciliation was done in 796 patients. Conclusions： The clinical pharmacy service plays a critical role in the management of patients in the emergency department （ED）.

Study of Consistency of Needs and Attitudes of Pharmacists towards Consumers/Patients in Retail Pharmacies in Georgia

Background:The demand for the pharmaceutical services in retail pharmacies has increased over the last decade.The aim of the study is to study the requirements of patients/customers in a modern changing environment to ensure that appropriate pharmaceutical care is provided to increase customer loyalty while taking into account the concept of pharmaceutical care.The study also examined the competence and attitudes of pharmacists in pharmaceutical care to meet the patient’s requirements.Methods:The study was conducted in December 2020.526 patients/pharmacy customers and 1,309 pharmacists participated in the study,via the online questionnaire.Participants were presented with questions such as“I visit pharmacy to buy products”and used 3 or 5-point scale to indicate their response.Results:When choosing a pharmacy,the costumers/patients prioritize:the quality of pharmaceutical services,speed of service,assortment,competence of the pharmacist and the price of the products;while receiving pharmaceutical care,customers want pharmacists to be oriented on them,to be professional and communicate in an understandable language.In pharmaceutical care,the pharmacists’visions and attitudes are consistent and meet with costumers’requirements.Conclusions:In Georgia,the pharmacy is no longer perceived as just a place to buy a medication,but 50%of customers go to the pharmacy to purchase cosmetic and hygiene products.Modern patient/costumer expectations tend to increase the speed and quality of pharmaceutical services.Considering the risks of the patients,it is recommended to expand the modern approaches-new technologies and online services to improve/accelerate the processes in retail pharmacies.

Compatibility Rules of Neonatal Parenteral Nutrition Prescriptions Based on Association Rules and Hierarchical Cluster Analysis

[Objectives]To explore the compatibility rules of neonatal parenteral nutrition(PN)prescriptions based on association rules and hierarchical cluster analysis,thereby providing a reference for standardizing neonatal parenteral nutrition supportive therapy.[Methods]The data about neonatal PN formulations prepared by the Pharmacy Intravenous Admixture Services(PIVAS)of the Affiliated Hospital of Chengde Medical University from July 2015 to June 2021 were collected.The general information of the prescriptions and the frequency of drug use were analyzed with Excel 2019;the boxplot of drug dosing was drawn using GraphPad 8.0 software;and SPSS Modeler 18.0 and SPSS Statistics 26.0 were used to perform association rules and hierarchical cluster analysis.[Results]A total of 11488 PN prescriptions were collected from 1421 newborns,involving 18 kinds of drugs,which were divided into 11 types of nutrients.Association rules analysis yielded 84 nutrient substance combinations.The combination of fat emulsion-water-soluble vitamins-fat-soluble vitamins-glucose-amino acids had the highest confidence(99.95%).The hierarchical cluster analysis divided nutrients into 5 types.[Conclusions]The prescriptions of PN for newborns were composed of five types of nutrients:amino acids,fat emulsion,glucose,water-soluble vitamins,and fat-soluble vitamins.According to the lack of electrolytes and trace elements,appropriate drugs can be chosen to meet nutritional demands.This study provides reference basis for reasonable selection of drugs for neonatal PN prescriptions and further standardization of PN supportive therapy in newborns.