•A method to quantify ciprofloxacin in plasma by HPLC–UV.•Simple protein precipitation from serum with good recovery.•Validated method with acceptable reproducibility, precision, accuracy and ...stability.•Useful to quantify the concentration of ciprofloxacin in patients with Peripheral Arterial Disease.•Study will establish if an appropriate dosage regimen is being given to such patients.
A rapid and sensitive HPLC–UV method for the determination of ciprofloxacin in human plasma is described. Protein precipitation with acetonitrile was used to separate the drug from plasma protein. An ACE® 5 C18 column (250mm×4.6mm, 5μm) with an isocratic mobile phase consisting of phosphate buffer (pH 2.7) and acetonitrile (77:23, v/v) was used for separation. The UV detector was set at 277nm. The method was validated in the linear range of 0.05–8μg/ml with acceptable inter- and intra-assay precision, accuracy and stability. The method is simple and rapid and can be used to quantify this widely used antibiotic in the plasma of patients suffering from Peripheral Arterial Disease.
Pharmaceuticals and the environment Sammut Bartolo, Nicolette; Azzopardi, Lilian M.; Serracino-Inglott, Anthony
Early human development,
April 2021, 2021-Apr, 2021-04-00, 20210401, Letnik:
155
Journal Article
Recenzirano
The marked progress and increase in the number of medications available for the treatment of conditions and diseases left a footprint on the surrounding environment. The consumption of medications ...for human and veterinarian use impact the terrestrial and marine environment and affects the ecosystem. The increase in environmental awareness regarding pharmaceutical related activities led to the development of principles and measures to mitigate a negative environmental impact. Various measures were introduced to promote green manufacturing and practices which led to the development of alternative techniques and processes, which are of benefit to both the environment and the industry. Distributors and pharmacists can contribute through the efficient management of everyday operations which include better stock taking and rotation, grouping deliveries and reducing unused medications.
The incorporation of green practices in the pharmacy curriculum empowers future pharmacists with skills and competences required at the place of work to decrease the impact of processes and medicines on the environment. The presence of a pharmacist workforce which is more conscientious about the environment leads to the needed ripple effect to embrace and implement green principles in different pharmacy related settings. Patients should also be educated to avoid hoarding of medications and dispose of medication in a safe and appropriate manner. The implementation of green practices results in a decrease in the use of chemicals and production of waste which in turn leads to a decrease in pollutants which have an impact on climate change.
Introduction:
Interprofessional Education (IPE) activities are a first experience of real-world patient care practice for students, where collaboration with different professions is appreciated. ...Methods and timing of inclusion of IPE are not well-defined, and it is interesting to assess students’ perception on IPE activities.
Objective:
To assess changes in pharmacy students’ perception of IPE before (t0) and after (t1) an IPE activity.
Methods:
The ‘Student Perceptions of Interprofessional Clinical Education–Revised 2’ (SPICE-R2) tool was adopted to assess perception of IPE activities in third year pharmacy students, final year pharmacy students and in postgraduate Doctorate in Pharmacy (PharmD) students at t0 and t1.
Results:
The SPICE-R2 tool was completed at t0 and t1 by 61 students: 12 third year pharmacy students, 13 final year students and 36 PharmD students. A significant improvement between t0 and t1 (P < .05) was measured in the three groups of students for all three subscales of the tool. The largest improvement was observed in the ‘Roles/Responsibilities for Collaborative Practice’ subscale in all three groups of students.
Conclusion:
Perception of IPE was positively increased in all three student groups. The results could be useful to support the design of IPE activities within pharmacy programmes.
Defined competencies are not currently established for technical personnel working in the pharmaceutical wholesale distribution setting who must adhere to Good Distribution Practice (GDP). ...Educational development for the Responsible Person (RP) position is topic-driven and not competency based. This research aimed to establish a validated tool to identify competencies relevant for the role of the Responsible Person (COMP-RP tool). There were 62 criteria based on competencies, knowledge, and skills across six domains which were included in the draft COMP-RP tool developed. The tool was based on a Likert scale ranking. Two Delphi rounds by a panel of experts were applied for validation. Data were statistically analysed and passed through cut-off points to reach final version of the COMP-RP Tool. The selection of wholesale distribution, quality and leadership skills, knowledge and competencies were consistently rated both Delphi rounds. The final validated COMP-RP Tool consisted of 58 criteria across the six domains.
Background
Effective communication strategies in health care help to enhance patient empowerment and improve clinical outcomes.
Objective
Adapt the original Communication Assessment (CAT) ...instrument for the pharmacist profession (CAT-Pharm) and to test its validity and reliability in two different settings.
Setting
Five hospital pharmacies in Italy and five community pharmacies in Malta.
Method
Pilot study involving a standardized multi-step process adhering to internationally accepted and recommended guidelines. Corrections and adjustments to the translation addressed linguistic factors and cultural components. CAT-Pharm, compared to the original CAT, maintained 10 out of the 14 items: one was slightly modified; three were changed to better fit the pharmacist role; one was added.
Main outcome measures
CAT-Pharm development and testing its practicality to assess patient perceptions of pharmacists’ interpersonal and communication skills.
Results
CAT-Pharm was tested on 97 patients in the Italian setting and 150 patients in the Maltese setting to assess the practicality of the tool and its usefulness in investigating gaps and priorities for improving pharmacist-patient communication. Results Show reliability and internal validity of the CAT-Pharm tool. The analysis of patient perceptions of communication with the pharmacist in Italy indicated differences from that in Malta. The different settings provided insight into the utility of CAT-Pharm.
Conclusion
This study provided a valid and reliable tool that could be applied to assess patient perception of the pharmacist's communication abilities.
Introduction
A paediatric cancer ward is a setting where pharmacists participate in direct patient care, acting as coordinators between the patient, caregivers and healthcare professionals. The aim ...of the study was to develop a Gap Finding Tool to support the setting up of a pharmaceutical care model at a Paediatric-Adolescent Cancer Ward.
Methods
The Standards of Practice for Clinical Pharmacy Services by the Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Clinical Pharmacy (2013), the American College of Clinical Pharmacy (2014) and the European Association of Hospital Pharmacists (2014) were used to compile the Gap Finding Tool. The developed Tool was tested for content validity by a panel of experts and subsequently implemented over 2 months.
Results
The Gap Finding Tool comprised of nine sections with an average of eight statements each about pharmacy services that should be provided at ward level. For each statement, the rater indicates whether these contributions are provided. When the Tool was implemented at the Paediatric-Adolescent Cancer Ward, four major gaps were identified, namely, absence of a clinical pharmacist, lack of medicines information, vetting of chemotherapy prescriptions by pharmacist with limited access to patient data and lack of pharmacist-input on medicines availability. Processes requiring optimisation included discharge medication advice and documentation processes.
Conclusion
The developed Gap Finding Tool is an innovative tool which is versatile and can be used in ward or ambulatory clinical settings to identify gaps in pharmaceutical processes and services and compare national or regional practices to international standards.
To assess the perception of pharmacists and physicians towards pharmacogenetic testing.
A self-administered questionnaire was developed, validated, tested for reliability and disseminated to ...pharmacists and physicians in Malta.
The study population consisted of 292 participants; 61% pharmacists (64% female, 38% practicing >10 years) and 39% physicians (50% female, 54% practicing >10 years). Pharmacists and physicians felt they lack sufficient competence in the area (95.0% and 97.4%, respectively; P > 0.05) and agreed that further training is required (92.7% and 91.2%, respectively; P > 0.05).
The need for further training was identified by the participants to support competency development and sustain confidence on the topic, hence facilitating the clinical implementation of pharmacogenetic testing.
To ensure the sustainability of pharmacy practice and provide health for all, pharmacy as a profession must embrace the digital transformation that has been changing healthcare at a rapid pace. The ...International Pharmaceutical Federation (FIP) has conducted a global study on digital health in pharmacy education to describe the readiness, adaptability, and responsiveness of pharmacy education programmes to train the current and future pharmaceutical workforce on digital health and to identify the knowledge and skill gaps of the existing pharmaceutical workforce with regard to digital health. An online survey was distributed to collect feedback from academics, pharmacy schools, pharmacists, and pharmacy students. The findings showed that a large proportion of pharmacy schools do not offer any digital health education, and the skillsets and knowledge of how to apply digital health technologies to solve existing clinical problems and improve care have been identified as a gap. The future of pharmacy and pharmaceutical sciences is digital and exciting. A digitally enabled and agile pharmaceutical workforce will capitalise on the benefits of digital health to serve the higher purpose of providing good health and wellbeing for all, leaving no one behind. Therefore, pharmacy and pharmaceutical sciences education should act now.
Background
Medicine use review by pharmacists has the potential to improve anticoagulation therapy management in patients on warfarin.
Objective
To develop, implement and evaluate a pharmacist-led ...medication use review service for patients on warfarin.
Setting
Six community pharmacies in Malta.
Method
Patients (N = 100) aged 18 or older and on warfarin were recruited through pre-selected community-pharmacies. These patients were then invited to attend two sessions: a review session (t
1
) and a follow-up session after 2 months (t
2
). During the medication use review session, medication reconciliation was performed (a) to detect drug-related problems using the DOCUMENT classification system, (b) to develop an individualised care plan for each patient and (c) to recommend an action for each identified problem for physician, pharmacist or patient consideration. At t
2
, the degree of acceptance of the recommendations was determined by assessing the number of drug-related problems for which action was taken to address the problem. International normalisation ration (INR) control was evaluated by calculating the percentage Time in Therapeutic Range (TTR) at t
1
and t
2
using the Rosendaal linear interpolation method.
Main outcome measures
Frequency and type of drug-related problems detected; percentage of accepted recommendations; and INR control.
Results
A total of 481 drug-related problems were identified; 40% (n = 190) were related to warfarin treatment. Need for monitoring (30%; n = 145), lack of compliance (20%; n = 97) and need for patient education (19%; n = 90) were the top three problems identified. There was a significant correlation between frequency of the problems and number of chronic medications (Spearman Correlation 0.583,
p
< 0.001), number of comorbidities (Spearman Correlation 0.327,
p
= 0.001) and older age (Spearman Correlation 0.285,
p
= 0.04). A total of 475 recommendations were followed-up; 49% (n = 234) were referred for consideration by the physician. The percentage of recommendations accepted (84%; n = 397) was significantly higher than the percentage of recommendations not accepted (16%; n = 78) (
p
< 0.001). The time in therapeutic range improved significantly from 68.7% at t
1
to 79.8% at t
2
(
p
= 0.01).
Conclusions
The high percentage of accepted recommendations and the improvement in INR control indicate that a pharmacist-led medication use review service in community pharmacy contributes to improving anticoagulation therapy management in patients on warfarin.
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