Joining the professional doctorate in pharmacy

The Pharm D programme is a new post-graduate course being offered by the Department of Pharmacy of the University of Malta in collaboration with the College of Pharmacy at the University of Illinois at Chicago in Chicago, USA. This course was developed to provide for the rapidly growing niche in pharmacy related to a professional doctorate. It is a means to develop professionals with a research-oriented approach and with skills in advanced clinical pharmacy practice with a focus on patient safety. Pharmacists who would like to take up the area of Clinical Pharmacy as their specialisation will be able to develop the skills and attributes of undertaking research in the field while reading for a level 8 Doctorate level degree.peer-reviewe

Joining the professional doctorate in pharmacy

The Pharm D programme is a new course being offered by the Department of Pharmacy of the University of Malta in collaboration with the College of Pharmacy at the University of Illinois at Chicago in Chicago, USA. This course was developed to provide for the rapidly growing niche area in pharmacy related to a professional doctorate. It is a means to develop professionals with a research oriented approach and with skills in advanced clinical pharmacy practice.peer-reviewe

Labelling and testing of foods designated as suitable for diabetic and low calorie diets

The aim of this project was to assess whether consumers, especially those following a diabetic or low calorie diet, would benefit from newly designed food labels denoting glycaemic load and whether these labels would help them make a faster food selection.peer-reviewe

Storing medicines while reducing electricity consumption

Temperature storage requirements for medicinal products stored at room temperature were compiled. The rate of heat loss in a local pharmacy was investigated. Necessary measures required to achieve temperature controlled storage conditions in the most efficient manner were proposed. Energy efficiency together with carbon emission reductions were calculated.peer-reviewe

Extemporaneous preparations from the past

Compounding involves the preparation, packaging and labelling of a drug specifically for a particular patient according to a medical prescription. Until the mid-1900s, the compounding of such 'ondemand' pharmaceutical preparations, also known as extemporaneous preparations, was the basis of pharmacy. In Italy, in 1580, descriptive catalogues and standards for quality and uniformity of pharmacy formulas for pharmaceutical preparations were compiled. These became known as the 'pharmacopoeia' . In the 1930s and 1940s, about 60% of all drugs were compounded. However, in the 1960s, manual preparation declined. 2 The objectives of the study were to demonstrate different methods of preparations of various drug formulations irrespective of the active ingredients used and to compile a List of extemporaneous preparations that were compounded between the years 1955 to 1965.peer-reviewe

Compliance with protocols in dental conditions

The aims of this study were to assess compliance with the developed treatment protocols through the dissemination of case studies. Out of 203 questionnaires distributed, 125 (62%) were collected. Community pharmacists were asked to complete case studies within a fortnight to indicate their line of action in three conditions presented. Average percentage compliance with the protocols was 73%.peer-reviewe

Pharmacy of Your Choice scheme and management of hypertension

Objective: The aim of this project was to assess pharmacist intervention in patients suffering from hypertension to improve management of their condition by identifying risk factors, evaluating side-effects, monitoring, assessing drug-drug interactions and providing advice to help control blood pressure. Method: Two questionnaires were used in the study; the first questionnaire intended to identify drug-related problems and risk factors and a second questionnaire was developed as a shorter version of the first questionnaire. The questionnaires were used on 3 occasions when the patients came to collect their Pharmacy of Your Choice (POYC) medications from a local community pharmacy. The first questionnaire was used at time=0 (visit 1) and the second questionnaire was used twice, at t=2 months (visit 2) and t=4 months (visit 3). Blood pressure and pulse readings were recorded each time and patients were referred in cases of abnormal readings and in cases of interactions or side-effects. Advice was given to the patients on all the 3 occasions and any care issues were addressed. Key findings: Out of the 35 patients who participated, initially 22 patients were hypertensive. This number decreased to 20 patients at t=2 months and 16 patients at t=4 months. Abnormal pulse readings were initially found in 7 patients that in the subsequent visits decreased to 4 patients with 2 patients being investigated. The need for patient referral decreased from 24 patients at t= 0, to 21 patients at t= 2 months and 17 at t= 4 months. Conclusion: Pharmacist intervention in patient monitoring of chronic conditions supported patients in managing their blood pressure. Several comorbidities and mortalities can be reduced when the patient is regularly monitored by a pharmacist and any drug-related problems identified, addressed and patient is referred as necessary.peer-reviewe

Perception and critical analysis of the medicines entitlement system

OBJECTIVES: To determine the perceived, actual and desired knowledge of healthcare professionals regarding free medicines’ entitlement, to identify strengths and weaknesses of the present entitlement system and to recommend improvements to the system to enhance patient care and sustainability. METHOD: Qualitative interviews with the Medicines Entitlement Unit (MEU) staff were carried out to identify customer care-related issues encountered. This information was used to devise a questionnaire to assess perceived, actual and desired knowledge on medicines’ entitlement. The questionnaire was distributed to physicians, pharmacists and pharmacy technicians. A strengths, weaknesses, opportunities and threats analysis of the medicines’ entitlement system was undertaken through qualitative interviews. KEY FINDINGS: A total of 26 strengths, 7 weaknesses, 6 opportunities and 15 threats on the present entitlement system were identified during the discussion sessions with 20 participants. Strengths included legislation, reference documentation and customer care service while the main weakness identified was the current IT system. Opportunities included an improved IT system and premises. Threats identified included manual applications, misconceptions by the public and healthcare professionals and patients’ attitudes and expectations. A total of 207 physicians, pharmacists and pharmacy technicians from different professional backgrounds completed the questionnaire. The participants obtained an average score of 72.2%. The respondents obtained a significantly higher mean score (p<0.001) for questions related to Fifth (V) Schedule conditions and entitlement (81.60%), compared to the mean score for the questions related to the Government Formulary List (GFL) and related policies (63.57%). Pharmacists obtained a significantly (p=0.005) higher total mean score (75.89%) than physicians (66.21%). A positive relationship between the self-rating and actual overall knowledge was found; the mean total scores vary significantly between the overall knowledge self-rating (p<0.001). CONCLUSION: The results show that healthcare professionals have appropriate insight of the medicines’ entitlement system and are very interested in improving their knowledge. Measures to increase their knowledge should be considered. The weaknesses and opportunities identified should be addressed to improve the current entitlement system both for the patients and healthcare professionals.peer-reviewe

Pharmacist-led diabetic patient monitoring

Objective: To assess pharmacist intervention in diabetic patients on patient compliance to medication and blood glucose self-monitoring and to evaluate patient therapeutic plans through monitoring of glycated haemoglobin (HbA1c) levels. Method: Thirty type 2 diabetic patients receiving their medication through the Pharmacy of Your Choice (POYC) scheme were assessed. Patient compliance to medication and to self-blood glucose monitoring was reported before (t=0) and following pharmacist intervention (t=1). The pharmacist intervention included an educational session and distribution of a ‘Diabetes Patient Information Leaflet’. HbA1c testing was performed and patients with out-of-range values were referred. Key findings: Patient compliance to medication improved following pharmacist intervention, with 24 patients claiming to ‘rarely miss a dose’ of medication prior to the intervention (t=0), decreasing to 8 patients at t=1. At t=0, 1 patient reported to ‘never miss a dose’ of medication which increased to 22 patients at t=1. Fifteen patients reported to monitor glucose levels less than once a month at t=0, while 23 patients claimed to monitor their glucose levels on a weekly basis at t=1. The mean value for HbA1c was 6.5%. Two patients obtained HbA1c values of 7.0 and 7.1% and were referred. Conclusion: Pharmacist-led medication reviews, through monitoring of blood glucose and HbA1c levels and suggesting optimal pharmacological treatment, can help diabetic patients use their medications more effectively to achieve maximal treatment benefits. Point-of-care HbA1c testing may be an accessible means of assessing glucose control and may motivate patients who seek to monitor glycaemia more closely.peer-reviewe

Use of NSAIDs and patient safety

Objective: To assess the pattern of use of nonsteroidal anti-inflammatory drugs (NSAIDs) and propose methods whereby pharmacists can help to improve patient safety when these drugs are used. Method: A psychometrically-evaluated questionnaire was administered to 261 patients aged 18 and over who visited 13 different community pharmacies, 1 from each electoral district in Malta and Gozo, chosen by stratified random sampling. Information about the sociodemographic status, symptoms and disease states and the drugs taken in the past 6 months was collected. Analysis of data was carried out using Microsoft Office Excel 2007 and the Biomedical Data Package (BMDP ) Software. Key findings: Results show a high prevalence of analgesic (>80% per district) and NSAID use (about 50% per district). The first drug of choice to relieve analgesia was paracetamol (67.1%) followed by diclofenac (37.2%). Ibuprofen was the fourth drug of choice (7.3%). About 65% of patients who took diclofenac stated that they self-prescribe the medication. Statistical analysis of data showed an association between the use of NSAIDs, musculoskeletal pain and menstrual pain (both p=0.010). A number of patients at risk of gastro-intestinal bleeds, cardiovascular events and those suffering from asthma reported taking NSAIDs occasionally. The presence of risks of drug interactions was identified with various drugs. Conclusion: NSAIDs are overused in Malta and are often administered indiscriminately. Pharmacist intervention could ensure the rational and safe use of NSAIDs. This could be achieved by having a shared protocol between pharmacists and prescribers for appropriate prescribing and dispensing and by identifying scenarios where pharmacist prescribing can be carried out to ensure that the analgesic used is appropriate for the individual patient.peer-reviewe