Current Issue : January - March Volume : 2020 Issue Number : 1 Articles : 6 Articles
Although India is known as “Pharmacy of Global South,” 65% of its population does not have access to EMs. Pharmacists play a crucial role in providing quality health care. EMs concept, adapted for a particular national setting depending on prevalence pattern of diseases and availability of new medicines is currently a highly rational and sensible strategy to provide the best of modern, evidence-based, safe and cost effective health care. The study objective was to assess and promote the Essential Drug Use (EDU) at selected tertiary care hospitals and pharmacies in Mysore city. It’s a prospective, observational and survey study conducted in CSI Holdsworth Memorial Hospital, Bharath Hospital and Institute of Oncology and Asha Kirana Hospital; selected hospital and community pharmacies for a period of 6 months. The study was approved by Institutional Ethics Committee. A total of 546 patients were enrolled in the study. Among them average number of drugs prescribed per encounter-10.29, drugs prescribed by generic names-27.2%, drugs prescribed from NEML-77.0%, total number of treatment charts with antibiotics-65.20% and total number of treatment charts with injections-99.81%. NEML 2015 was available in only 8 out of 35 pharmacies. More than half the pharmacists, 60.0% had no idea of what EMs are before the awareness whereas the percentage increased to 81.80% after the promotion of EMs concept indicating an update of knowledge in pharmacists. Lack of knowledge and availability of EMs was found to be the major constraint for inappropriate prescribing and dispensing of drugs in hospitals and pharmacies. EMs, a basic need of majority of population, should be available to all the people in adequate amounts at all times. Periodic awareness and continuous pharmacy programs can be implemented to update each and every practicing pharmacist on the latest updates in pharmacy profession....
Our objective was to explore the implementation of a novel NHS England (NHSE)-funded\npilot project aimed at deploying clinical pharmacists in an integrated urgent care (IUC) setting\nincluding the NHS 111 service. Eight integrated urgent care clinical pharmacists (IUCCPs) within\nthe participating North East of England Trusts. Individuals participated in semi-structured 1-to-1\ninterviews by an experienced qualitative researcher, either face-to-face or via the telephone. Each\nrecording was transcribed, and the five stages of framework analysis (familiarisation, identifying a\nthematic framework, indexing, charting, mapping and interpretation) took place to establish emerging\nthemes. All interviews took place between November 2018-February 2019. Four higher-order themes\nwere identified: 1. Personality Traits, 2. Integration, 3. Benefits, 4. Training. The IUCCP programme\nis an innovative NHSE initiative. It provides an opportunity to extend the role of clinical pharmacists\ninto the hard-pressed clinical environment of urgent and emergency care. Our evaluation has\nhighlighted the potential for this professional group to contribute clinically in this area. Better\ncommunications, standard operating procedures and induction will improve how individuals\ndevelop in these novel roles....
Around the world, changes in scope of practice regulations for pharmacists have been used\nas a tool to advance practice and promote change. Regulatory change does not automatically trigger\npractice change; the extent and speed of uptake of new roles and responsibilities has been slower than\nanticipated. A recent study identified 9 pre-requisites to practice change (the 9Ps of Practice Change).\nThe objective of this study was to describe how educationalists could best apply these 9Ps to the\ndesign and delivery of continuing professional development for pharmacists. Twenty community\npharmacists participated in semi-structured interviews designed to elicit their learning needs for\nscope of practice change. Seven supportive educational techniques were identified as being most\nhelpful to promote practice change: (i) a coaching/mentoring approach; (ii) practice-based experiential\nlearning; (iii) a longitudinal approach to instructional design; (iv) active demonstration of how to\nimplement practice change; v) increased focus on soft-skills development; (vi) opportunities for\npractice/rehearsal of new skills; and (vii) use of a 360-degree feedback model. Further work is required\nto determine how these techniques can be best applied and implemented to support practice change\nin pharmacy....
Methotrexate (MTX) is first line drug used in the management of rheumatoid arthritis. Side effects of MTX high dose (MTX-HD) can be life threatening. MTX mainly affects bone marrow, gastrointestinal mucosa and hair. This is the case report of a rheumatoid arthritis patient treated with methotrexate (7.5 gm), methyl prednisolone (500 mg), sulfasalazine (8 mg). Patient has taken 4 tablets of methotrexate (7.5 mg) for 4 days continuously instead of taking once a week as prescribed. Patient also did not take folic acid as prescribed to him. After 10 days he was hospitalized with severe leukocytopenia associated with fever, loose stools, dysphagia, abdominal pain at GSL General Hospital, Rajahmundry. He further developed right lung pneumonia, toxic epidermal necrolysis (TEN), oral candidiasis, GI side effects due to immunosuppression caused by methotrexate. He was treated with intravenous antibiotic therapy, corticosteroids, Filgrastim injection, IV potassium supplements. The MTX toxicities are based on the duration and cumulative dosing of drug and its use in combination with other drugs. Myelosuppression and consequent pancytopenia are the most frequent hematologic toxicity, which occur mostly later during low dose methotrexate administration. He was treated with intravenous antibiotic therapy, corticosteroids, Inj. Filgrastim, IV Potassium supplements and limited transfusion dependence as a result of renal failure caused due to low dose methotrexate....
There are numerous definitions of polypharmacy to describe the use of many medications\namong older adults, but there is a need to clarify if they are purposive and meaningful. By means of\na systematic review, we identified definitions of polypharmacy used in multimorbid older adults\n(Greater than equal to 65 years). We evaluated if the definitions align among the domains of research, clinical practice,\nand public health and appraised whether concepts of polypharmacy are based on strong foundations.\nMore than 46 definitions of polypharmacy were retrieved from 348 publications (research: n = 243;\nclinical practice: n = 88; public health: n = 17). Several thresholds based on the number of medications\nwere mentioned. The majority of the publications (n = 202, 58%) used a minimal threshold of five\nmedications. Heterogeneous qualitative definitions were identified, mostly stating that polypharmacy\nis â??more drugs than neededâ?. There was no significant divergence between domains as to the type of\ndefinitions used, although qualitative definitions were more common in clinical practice........................
Distance education is becoming more and more common, and today distance education is\nwell established within academic settings. The aim was to investigate first-year pharmacy studentsâ??\nexpectations and perceptions of web-based pharmacy programs and of their future profession.\nFurthermore, student characteristics were compared over time. A questionnaire was distributed\nto all first-year students admitted to the pharmacy programs at UmeaUniversity in 2017. The\nstudents were asked questions about their background, motives for choosing pharmacy education,\nand their expectations and perceptions of their education and profession. Factors of most importance\nwhen choosing the education were: the education is interesting, leads to an interesting job, and is\nweb-based. The studentsâ?? expectations of the education were high, and they want to learn as much as\npossible and be well prepared for their future profession. Regarding the studentsâ?? perception of their\nfuture profession, three themes were identified: to help other people, professional development, and\nemployment related issues. Student characteristics have changed over the years, suggesting that the\nweb-based pharmacy education and the flexibility it entails attracts other groups of students today\ncompared with when the programs started....
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