| 1. |
- Beer, Netta, et al.
(författare)
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Magistral Compounding with 3D Printing : A Promising Way to Achieve Personalized Medicine
- 2023
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Ingår i: Therapeutic Innovation and Regulatory Science. - : Springer Nature. - 2168-4790 .- 2168-4804. ; 57:1, s. 26-36
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Tidskriftsartikel (refereegranskat)abstract
- Background Magistral compounding has always been an integral part of pharmacy practice. The increasing demand worldwide for personalized drug treatments might be accommodated by an increase in magistral compounding. The new, flexible technology of 3D medicine printing could advance this process even further. However, the issue of how 3D medicine printing can be implemented within the existing magistral compounding infrastructure has not been explored. Aims To investigate how 3D printing can be integrated into the existing compounding system by taking regulatory, economic, and profession-oriented aspects into account. Methods Semi-structured interviews were conducted with relevant Dutch stakeholders representing various health institutions, such as health ministries and boards, professional bodies, and different types of pharmacies. Participants were identified through purposeful sampling. Content analysis was applied to identify the main themes. Results A total of 15 Dutch stakeholders were interviewed. It was found that the prevalence of compounding in community pharmacies in the Netherlands has decreased as a result of the practice shifting to specialized compounding pharmacies due to higher costs, lack of space, and the need to fulfill quality requirements. All interviewees considered 3D printing to be a promising compounding technique for community pharmacies, as it offers an automated approach with high digital flexibility and enables adapted formulations, including 'polypills.' Regulatory and quality assurance challenges were considered comparable to those of normal magistral products; however, there remain pending regulatory issues regarding quality control, particularly for Active Pharmaceutical Ingredients containing intermediate feedstock materials (e.g., prefilled cartridges) in 3D printing. 3D printing was believed to become cost effective over time. Conclusion In the Netherlands, specialized compounding pharmacies have largely taken over compounding activities. 3D printing could be introduced within this system; however, challenges regarding how to regulate prefilled cartridges have yet to be addressed. Compounding using 3D printing in regular community pharmacies could enhance patients' individualized treatment; however, this activity would require incentives to stimulate the return of compounding to normal pharmacy practice.
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| 2. |
- Beer, Netta, et al.
(författare)
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Scenarios for 3D printing of personalized medicines : A case study
- 2021
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Ingår i: Exploratory Research in Clinical and Social Pharmacy. - : Elsevier. - 2667-2766. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background3D printing is a promising new technology for medicines' production. It employs additive manufacturing techniques, and is ideal for producing personalized medicines (e.g., patient-tailored dose, dosage form, drug release kinetics).ObjectiveTo investigate how 3D printing technologies can be implemented in a European pharmaceutical system, by suggesting different scenarios and assessing aspects that could affect its implementation.MethodQualitative, semi-structured interviews were conducted with key stakeholders (e.g., from ministry, authorities, research organizations, pharmacies) in the Netherlands to elicit perspectives on 3D printing of personalized medicines. The Netherlands were chosen since it has a strong tradition in compounding. Five general scenarios were investigated: placing the 3D printers in industry, community pharmacies, hospital pharmacies, compounding facilities, and in patients' homes. Content analysis was used, building on verbatim transcripts.ResultsFifteen stakeholders were interviewed. Regulatory, economic, ethical and organizational challenges were identified to varying degrees in the different scenarios. The industry and home scenarios were associated with the most challenges, hospital pharmacies and compounding facilities with the least. Other important aspects identified were the role of community pharmacies, and who should design the tablets to be printed.ConclusionAll potential scenarios for 3D printing of personalized medicines include challenges. These should be taken into account when pursuing the use of 3D printing of medicine.
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| 3. |
- Cantarero-Arevalo, Lourdes, et al.
(författare)
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A Qualitative Analysis of the Culture of Antibiotic Use for Upper Respiratory Tract Infections Among Patients in Northwest Russia
- 2022
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Ingår i: Frontiers in Pharmacology. - : Frontiers Media S.A.. - 1663-9812. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Due to the globally persistent threat of Antimicrobial Resistance (AMR), the purpose of this study was to gain an in-depth understanding of the antibiotic (AB) practices, knowledge and attitudes among patients residing in five regions in the northwest part of Russia. Given the high prevalence, this study focused on ABs for Upper Respiratory Tract Infections (URTI).Methods: The qualitative, semi-structured interviews followed a guide organized by major themes such as common symptoms, consultations with doctors and external influences in decision-making. Patient participants were recruited via convenience sampling. Fifty-five interviews were conducted among patients using ABs for URTIs purchased with or without prescription. Data was analyzed using a direct content analysis and validation rounds were conducted between interviewers and data analyzers.Results: Self-medication with ABs seemed a common practice across all five Russian regions; in some cases, patients tried to persuade pharmacists into selling them ABs without prescription. Factors, such as time spent going to the doctor, need of a sick leave or self-persuasion, influenced the decisions of whether or not to seek the doctor for symptoms of URTIs. Knowledge of ABs and AMR was generally low; however, some patients with seemingly good knowledge practiced self-medication from time to time. Family members and friends were often involved in decisions about how to handle symptoms of URTIs, especially among those patients using ABs without prescription. Few patients had noticed ABs awareness campaigns, and very few reported having learned something important from them.Conclusion: Despite enforced regulation of AB use in Russia, self-medication still exists. Knowledge is not always linked to appropriate use of AB, and the few campaigns conducted were not always noticed.
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| 4. |
- Costa, Filipa A., et al.
(författare)
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Provision of pharmaceutical care by community pharmacists across Europe : Is it developing and spreading?
- 2017
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Ingår i: Journal of Evaluation In Clinical Practice. - : John Wiley & Sons. - 1356-1294 .- 1365-2753. ; 23:6, s. 1336-1347
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, Aims, and Objectives: Pharmaceutical care involves patient-centred pharmacist activity to improve medicines management by patients. The implementation of this service in a comprehensive manner, however, requires considerable organisation and effort, and indeed, it is often not fully implemented in care settings. The main objective was to assess how pharmaceutical care provision within community pharmacy has evolved over time in Europe. Method: A cross-sectional questionnaire-based survey of community pharmacies, using a modified version of the Behavioural Pharmaceutical Care Scale (BPCS) was conducted in late 2012/early 2013 within 16 European countries and compared with an earlier assessment conducted in 2006. Results: The provision of comprehensive pharmaceutical care has slightly improved in all European countries that participated in both editions of this survey (n=8) with progress being made particularly in Denmark and Switzerland. Moreover, there was a wider country uptake, indicating spread of the concept. However, due to a number of limitations, the results should be interpreted with caution. Using combined data from participating countries, the provision of pharmaceutical care was positively correlated with the participation of the community pharmacists in patient-centred activities, routine use of pharmacy software with access to clinical data, participation in multidisciplinary team meetings, and having specialized education. Conclusions: The present study demonstrated a slight evolution in self-reported provision of pharmaceutical care by community pharmacists across Europe, as measured by the BPCS. The slow progress suggests a range of barriers, which are preventing pharmacists moving beyond traditional roles. Support from professional bodies and more patient-centred community pharmacy contracts, including remuneration for pharmaceutical care services, are likely to be required if quicker progress is to be made in the future.
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| 5. |
- Fastø, Mark Møller, et al.
(författare)
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Perceptions, preferences and acceptability of patient designed 3D printed medicine by polypharmacy patients : a pilot study.
- 2019
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Ingår i: International Journal of Clinical Pharmacy. - : Springer Science and Business Media LLC. - 2210-7703 .- 2210-7711. ; 41:5, s. 1290-1298
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Tidskriftsartikel (refereegranskat)abstract
- Background 3D-printing, compared to conventional medicine manufacturing technologies, is a versatile and highly modifiable technique that has the flexibility to produce medicine that meet patients' specific requirements such as individualized dosing, but also to customize the appearance of the dosage form, e.g., shape and colour. Objective To explore polypharmacy patients' perceptions and preferences regarding 3D-printed medicine, including their acceptability of patient-designed medicine. Setting The study was conducted in Zealand, Denmark. Method Polypharmacy patients were recruited using convenience sampling (mostly on Facebook) and interviewed twice using semi-structured interviews. Interviews were analysed thematically into five predetermined themes (shapes, colours, embossing designs, polypills, and patient-designed dosage forms). At the first interview patients were asked about their perceptions and preferences towards 3D-printed solid dosage forms, and were presented to different shapes, colours, embossing designs and examples of polypills. They were also invited to design their own medicine from the ones presented. Their self-designed medicines were presented at the second interview, where acceptability of both their self-designed medicine and the concept of designing one's own medicine, was investigated. Main outcome measure Patients' perceptions, preferences towards and acceptability of 3D-printed medicines. Results Eight patients were included. They tended to prefer shapes similar to conventional medicine. Different colours were preferred by different people. The presented embossing designs seemed to be irrelevant. Polypills were generally believed to be a good idea due to the reduction of number of medicines. Acceptability of patient-designed medicine was mainly determined by whether patients thought 3Dprinting technology was reliable or not. Conclusions The patients had various perceptions and preferences of 3D-printed medicine. Factors affecting the patient views were aesthetic (appealing), physiological (swallowing), practical (handling), pedagogical (understanding) and psychological (relate to). Trust in the technology seemed to be important for acceptability.
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| 6. |
- Jacobsen, Ramune, et al.
(författare)
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Online and Blended Learning Courses for Healthcare Professionals and Policymakers on Patients' Perspectives on Medicine : A Project Report.
- 2022
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Ingår i: Pharmacy. - : MDPI AG. - 2226-4787. ; 10:2
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Tidskriftsartikel (refereegranskat)abstract
- In order for healthcare professionals to better engage with patients, they need to understand and integrate the perspectives of patients into their daily work. In this project, we developed two courses for healthcare professionals on patients' perspectives on medicine. One course was an online course that introduced the patients' perspectives on medicine and explained its importance for healthcare and health policy. The second course was a blended learning course, consisting of online modules and face-to-face webinars, which specified how to explore patients' perspectives in qualitative interviews, and how to develop implementation plans. Patients participated in the development, execution, and evaluation of both courses. Overall, more than 2000 healthcare professionals enrolled in the first course and, in just over a year, 191 participants completed the online course; 57 healthcare professionals registered in the second blended learning course and six participants completed both components of the course. The relevance of knowledge gained was positively evaluated. Participants especially appreciated the participation of patients. Based on the feedback, the second blended learning course was adapted to run online and both courses continue to be freely available to all interested healthcare professionals on the Coursera platform.
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| 7. |
- Jakupi, Arianit, et al.
(författare)
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Culture of antibiotic use in Kosovo - an interview study with patients and health professionals.
- 2019
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Ingår i: Pharmacy Practice. - 1885-642X .- 1886-3655. ; 17:3, s. 1540-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Kosovo is a new state and has a high consumption of antibiotics in relation to other European countries. Existing quantitative studies have shown that practices exist that is not optimal when it comes to antibiotic use in Kosovo, this includes citizens' use of antibiotics, pharmacy practices of selling antibiotics without prescriptions and physicians' prescribing behaviours. To address these problems, there is a need for a deeper understanding of why antibiotics are handled in a suboptimal way.OBJECTIVE: The objective was to explore antibiotic users', community pharmacists' and prescribers' attitudes towards, experiences of, and knowledge about antibiotics in Kosovo.METHODS: Semi-structured interviews were conducted with patients who recently received an antibiotic prescription for an upper respiratory tract infection (URTI), patients who recently received antibiotics for a URTI without a prescription, community pharmacists, and physicians. Interviews were recorded, translated into English, and analysed using deductive content analysis.RESULTS: In total, 16 interviews were conducted in the period from 2015-2016. Five themes were identified: Obtaining antibiotics, Choice of antibiotics, Patient information, Patients' knowledge and views on when to use antibiotics, and Professionals' knowledge and attitudes towards antimicrobial resistance. Antibiotics were sometimes obtained without a prescription, also by patients who currently had received one. The specific antibiotic could be chosen by a physician, a pharmacist or the patient him/herself. Former experience was one reason given by patients for their choice. Patients' knowledge on antibiotics was mixed, however health professionals were knowledgeable about e.g. antimicrobial resistance.CONCLUSIONS: There is currently a culture of antibiotic use in Kosovo, including attitudes and behaviours, and hence also experiences, which is possibly underlying the high consumption of antibiotics in the country. The culture is reproduced by patients, pharmacists and physicians. There is, however, an awareness of the current problematic situation among practitioners and policy makers; and as Kosovo is a new country, opportunities to effectively tackle antimicrobial resistance exist.
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| 8. |
- Jowkar, Nima, et al.
(författare)
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A Presentation of Central Communication Aspects in the Patient-Provider Relationship-Potential Learnings for Community Pharmacists
- 2020
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Ingår i: Pharmacy. - : MDPI. - 2226-4787. ; 8:4
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Several studies have shown that communication between patients and HCPs is still not optimal in integrating patients' perspectives on how best to manage their diseases and their medication. One such area where encounters between patients and professionals still needs to develop to better incorporate the patient's perspective is pharmacy practice. The aim of this study was therefore to explore and present new typologies and communication aspects of HCP-patient relationships since a comprehensive literature search in 1997 conducted by Sondell and Soderfeldt, and relate the findings to pharmacy practice. In total, 11 articles were identified by applying the techniques of a purposeful literature search. The articles covered aspects of: shifting and adapting roles during the encounter, techniques to ensure individualizing in the encounter, avoiding inappropriate routines, coping with internet-informed patients, achieving mutual goals, dealing with uncertainty including avoiding rigid preconceptions, using social conversation, incorporating patients' prior experiences, aligning language, adapting greetings and exploring the cultures and communication patterns of patients from other ethnic backgrounds. The variety of these communication aspects points to the immense complexity of communication as a practice discipline. This article has presented some of the literature that pharmacists can consult, in the endeavor of improving their communication practices.
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| 9. |
- Kaae, Susanne, et al.
(författare)
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Experiences from a pilot study on how to conduct a qualitative multi-country research project regarding use of antibiotics in Southeast Europe.
- 2016
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Ingår i: Journal of pharmaceutical policy and practice. - : Springer Science and Business Media LLC. - 2052-3211. ; 9, s. 20-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In 2014, a qualitative multi-country research project was launched to study the reasons behind the high use of antibiotics in regions of Southeast Europe by using previously untrained national interviewers (who were engaged in other antibiotic microbial resistance-related investigations) to conduct qualitative interviews with local patients, physicians and pharmacists. Little knowledge exists about how to implement qualitative multi-country research collaborations involving previously untrained local data collectors. The aim of this paper was therefore to contribute to the knowledge regarding how to conduct these types of research projects by evaluating a pilot study of the project.METHODS: Local data collectors conducted the study according to a developed protocol and evaluated the study with the responsible researcher-team from University of Copenhagen. The pilot study focused on 'local ownership', 'research quality' and 'feasibility' with regard to successful implementation and evaluation. The evaluation was achieved by interpreting 'Skype' and 'face to face' meetings and email correspondence by applying 'critical common sense'.RESULTS: Local data collectors achieved a sense of joint ownership. Overall, the protocol worked well. Several minor challenges pertaining to research quality and feasibility were identified, in particular obtaining narratives when conducting interviews and recruiting patients for the study. Furthermore, local data collectors found it difficult to allocate sufficient time to the project. Solutions were discussed and added to the protocol.CONCLUSIONS: Despite the challenges, it was possible to achieve an acceptable scientific level of research when conducting qualitative multi-country research collaboration under the given circumstances. Specific recommendations to achieve this are provided by the authors.
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| 10. |
- Kaae, Susanne, et al.
(författare)
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Patient responses to inhaler advice given by community pharmacies : The importance of meaningfulness.
- 2017
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411 .- 1934-8150. ; 13:2, s. 364-368
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The value of counseling in community pharmacy depends on its ability to help patients improve their use of medicine and thereby health status, by their adherence to recommendations. Studies showing how patients respond to daily pharmacy counseling are, however, scarce. The aim of this study was therefore to investigate how patients respond to medical advice given by pharmacy staff.METHODS: A heterogeneous sample of patients who received the 'Inhaler Technique Assessment Service' (ITAS) in Denmark were interviewed, using a semi-structured schedule. Meaning condensation and theoretical analysis were conducted.RESULTS: Twenty-two patients who had received the ITAS were included in the analysis. Participants found recommendations about optimal inhalation technique meaningful and accepted these without questioning. This contrasted how they accepted advice toward their medicines, in general. Participants experienced various difficulties when trying to adhere with ITAS recommendations at home. Participants who used inhalers for a long time did not feel an improvement in disease symptoms due to having improved their inhalation technique; however, they still continued to inhale the way proposed by pharmacy staff.CONCLUSIONS: ITAS recommendations seemed important to adhere with for patients despite experiencing difficulties when doing so and secondly not feeling an immediate improvement of health. Reasons for this appear to be connected with the concept of meaningfulness. Hence, this aspect should be investigated further, as this could help staff providing adequate counseling to patients. Further, pharmacy staff should focus more on supporting patients implementing their health advice at home.
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