Pharmacist-led medication review in community-dwelling older patients using the GheOP(3)S-tool : general practitioners' acceptance and implementation of pharmacists' recommendations

Rationale, aims, and objectives: The Ghent Older People's Prescriptions community Pharmacy Screening (GheOP(3)S)-tool was recently developed as an explicit screening tool to detect drug-related problems (DRPs) and to help in performing medication reviews. In this study, we aimed (a) to describe the characteristics of the detected DRPs and the subsequent pharmacists' recommendations with their acceptance and implementation rate resulting from a pharmacist-led medication review using the GheOP(3)S-tool and (b) to assess the potential impact of the intervention. Method: Prospective observational study in community-dwelling older patients (70 years or older, using five or more medications). Community pharmacists performed medication reviews resulting in the documentation of GheOP(3)S-related DRPs and other DRPs with corresponding pharmacists' recommendations. Acceptance was recorded during face-to-face pharmacist-general practitioner (GP) meetings. Implementation was assessed after a 3-month follow-up by consulting the electronic pharmacy record, the patient, and/or GP. The potential impact on the number of medications, the number of GheOP(3)S-related DRPs, the anticholinergic and sedative burden quantified by the Drug Burden Index (DBI), and medication costs was assessed by a pre-post comparison of the patients' medication lists. Results: Twenty-one pharmacists detected 470 DRPs with a median (IQR) of 6 (4-8) per patient in 75 patients (about half GheOP(3)S-related DRPs and half other DRPs). Most prevalent recommendations were stopping (22.9%) and substituting (18.9%) medication. Overall acceptance was 66.9%. At follow-up, 42.9% of all recommendations were implemented. The number of GheOP(3)S-criteria (P < .001) and the DBI scores (P = .033) significantly differed from baseline. This was not the case for the number of chronic medications and medication costs. Conclusions: This study demonstrates a relatively high acceptance of pharmacists' recommendations, although implementation could be improved. Pharmacist-led medication reviews with multidisciplinary meetings using the GheOP(3)S-tool can have a potential impact on the number of DRPs and the anticholinergic and sedative burden of patients

Pharmaceutical Care Network Europe definition of quality indicators for pharmaceutical care: a systematic literature review and international consensus development

Background Over the past 40 years, the tasks of pharmacists have shifted from logistic services to pharmaceutical care (PhC). Despite the increasing importance of measuring quality of care, there is no general defnition of Quality Indicators (QIs) to measure PhC. Recognising this, a working group in a European association of PhC researchers, the Pharmaceutical Care Network Europe (PCNE), was established in 2020. Aim This research aimed to review existing definitions of QIs and develop a definition of QIs for PhC. Method A two-step procedure was applied. Firstly, a systematic literature review was conducted to identify existing QI definitions that were summarised. Secondly, an expert panel, comprised of 17 international experts from 14 countries, participated in two surveys and a discussion using a modifed Delphi technique to develop the definition of QIs for PhC. Results A total of 182 QI definitions were identifed from 174 articles. Of these, 63 QI definitions (35%) cited one of fve references as the source. Sixteen aspects that construct QI definitions were derived from the identifed definitions. As a result of the Delphi study, the panel reached an agreement on a one-sentence defnition of QIs for PhC: “quality indicators for pharmaceutical care are validated measurement tools to monitor structures, processes or outcomes in the context of care provided by pharmacists”. Conclusion Building upon existing defnition of QIs, an international expert panel developed the PCNE definition of QIs for PhC. This definition is intended for universal use amongst researchers and healthcare providers in PhC

All-sky Medium Energy Gamma-ray Observatory: Exploring the Extreme Multimessenger Universe

The All-sky Medium Energy Gamma-ray Observatory (AMEGO) is a probe class mission concept that will provide essential contributions to multimessenger astrophysics in the late 2020s and beyond. AMEGO combines high sensitivity in the 200 keV to 10 GeV energy range with a wide field of view, good spectral resolution, and polarization sensitivity. Therefore, AMEGO is key in the study of multimessenger astrophysical objects that have unique signatures in the gamma-ray regime, such as neutron star mergers, supernovae, and flaring active galactic nuclei. The order-of-magnitude improvement compared to previous MeV missions also enables discoveries of a wide range of phenomena whose energy output peaks in the relatively unexplored medium-energy gamma-ray band

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Patterns of subsistence harvesting of woodland products at the household level: a multi-agent approach

This study introduces the development and implementation of an agent-based model that integrates ecological and social aspects related to change in woodland use and woodland cover in rural villages in southern Africa. The model was developed with the objective of exploring woodland use behaviour and corresponding human impacts on the relative woodland cover and the spatial distribution of woodlands within the landscape. The model does not focus on a particular study site but aims to create a generic tool for the miombo ecoregion in Southern Africa, which is dominated by miombo sensu stricto and related dry woodlands. The model was parameterized based on an extensive review of the miombo woodland literature. Using user-defined inputs, a virtual village representing a typical subsistence-based community is created. The model simulates fuelwood and poles collection behaviour of individual households based on various key factors such as short-term needs of households, the enforcement of traditional rules and formal lawes and the cost of collection, which is in turn related to labour availability, harvesting technologies and resource scarcity. Preliminary results will be prestented to illustrate the application of this model and its ability to explore management and policy actions

[Behavioral Pharmaceutical Care Scale: research on the extent of the implementation of pharmaceutical care in Belgian pharmacies]

In dit onderzoek werd gepeild naar de mate waarin Farmaceutische Zorg toegepast wordt in de Belgische apotheek. Hiervoor werd gebruik gemaakt van de BPCS, een gevalideerde vragenlijst bestaande uit 3 dimensies en 14 domeinen. 623 Belgische apothekers namen aan het onderzoek deel. De totale score op de BPCS schommelde tussen 29 en 131 in het score-interval 15-160. De mediaan was 74. Er werd goed gescoord op adviseren en informatief ondersteunen van patiënten (gemiddelde scores van 72.2 % en 80 %); scores waren eerder laag op het bevragen van de patiënt (41.0 %) en het documenteren (23.7 %). Apothekers die actief farmaceutische zorg verstrekken (gedefinieerd als respondenten met een totale score hoger dan 91) verschilden significant van apothekers die geen farmaceutische zorg verstrekken (totale score lager dan 56) wat betreft het volgen van bijscholing, het deelnemen aan multidisciplinaire vergaderingen en het hebben van een adviesruimte. Verstrekkers van farmaceutische zorg maken ook significant meer gebruik van software om patiëntenprofielen en zelfzorggeneesmiddelen te registreren, eerste uitgifte te begeleiden en therapietrouw na te gaan. Taal en geslacht waren geen determinanten voor verstrekker versus niet-verstrekker. Gezien zowel apotheeksoftware, (na)vorming als multidisciplinair overleg in belangrijke mate blijken bij te dragen tot het toepassen van Farmaceutische Zorg, zijn investeringen van alle betrokken partijen in deze domeinen noodzakelijk en verantwoord.status: publishe

Adaptation and validation of a drug related problem classification tool in community pharmacy

Aim of project/studyThe aims of the study were:1) To translate and adapt the PCNE drug related problems (DRP) classification tool (v.6.2.) to the Belgian community pharmacy setting2) To assess the content validity and the reliability of this classification toolMethodThe translated and adapted version of the tool was submitted to a group of 15 pharmacists, which reviewed the format and content of the items. Content validity indexes were calculated. After adaptation of the tool, 109 DRP were collected in community pharmacy and 56 of these DRP were submitted to 10 community pharmacists to test the inter-rater reliability of the tool.Result(s)The PCNE classification tool has been translated in french and adapted by adding 11 items in the section « causes » (mostly related to the logistics of the prescribing and dispensing process, and related to the behaviour of the patient), and 2 items in the section « interventions ». The process of content validation resulted in modifying the definitions of potential problem and manifest problem, and in adding 2 items in the section “causes”. The final adapted tool included 84 items classified in 4 sections (problems, causes, interventions and outcomes), with full instructions on how to use it. In term of reliability of the tool, the inter-rater agreement was very good between the pharmacists since it was of 90% for the majority of the items. However, the agreement for “potential problem”, “manifest problem” and “effect of drug treatment not optimal” was only of 59%, 61% and 69%, respectively, suggesting some lack of understanding for those items. Concerning the outcomes of pharmacist’s interventions, the agreement was of 80% for the item “problem totally solved”. A difference in pharmacist’s perception to consider that the intervention is sufficient to totally solve the DRP could explain this result. In conclusion, these results showed that the tool is reliable and has adequate validity to measure the frequency and the nature of DRP detected in a Belgian community pharmacy setting.info:eu-repo/semantics/publishe

Medication use evaluation by community pharmacists: impact on patient-reported outcomes

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Studying the impact of medication use evaluation by the community pharmacist (SIMENON): study protocol

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