bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Analysis of Rural Community Pharmacy Practice in Western Australia in 2002 and 2006
Authors: Wibowo Yosi , Berbatis Constantine G , Joyce Andrew , Sunderland V Bruce 
Published: April 2015

ABSTRACTBackgroundData are lacking on the characteristics of rural and remote community pharmacies in Western Australia (WA).AimTo analyse characteristics of community pharmacies and pharmacists in rural WA in 2006 and to compare these with the results of a national survey conducted in 2002.MethodA survey was conducted in 2006 using a questionnaire similar to that used in a national survey conducted in 2002. The questionnaires were mailed to all 103 rural pharmacies in WA, of which 51 were returned (response rate 50%). Chi2 tests were used to compare the 2002 (rural WA) and 2006 data.ResultsPharmacist demographic characteristics were mostly unchanged. A trend towards increased employment of younger female pharmacists was found in 2006. 60% of respondents devoted less than 5 hours per month to continuing pharmacy education in both surveys. There were no significant differences in the characteristics of pharmacies in terms of PhARIA location, setting, banner group membership, inclusion of counselling areas, operations, trading hours and annual turnover. Pharmacies accredited by the Quality Care Pharmacy Program (QCCP) increased from 42% in 2002 to 86% in 2006.ConclusionMany characteristics of rural WA pharmacies and pharmacists in 2006 were similar to 2002. Increased QCCP accreditations indicated higher quality assurance of rural pharmacy practice. The low uptake of ‘forward pharmacy’ in rural pharmacies warrants further evaluation.
Chiral Stability Study of Oral Liquid Clopidogrel Formulations for Infants
Authors: Mihaila Bianca , Ellis David , Rozek Thomas , Milne Robert 
Published: April 2015

ABSTRACTBackgroundClopidogrel is used in at‐risk infants to prevent thrombotic complications. There is no commercially available liquid preparation and existing formulations have not been evaluated for the chiral stability of clopidogrel.AimTo determine the stability of clopidogrel 1 mg/mL liquid formulations using chiral chromatography.MethodClopidogrel 1 mg/mL suspension was formulated using Plavix (clopidogrel) tablets and Ora‐Plus:Ora‐Sweet 1:1, and stored at room temperature and under refrigeration. Samples were also prepared using a variety of co‐solvents and stored at room temperature. Samples were taken for up to 49 days and assayed for S‐clopidogrel, R‐clopidogrel and S‐acid using high‐performance chiral liquid chromatography. Percentage of S‐clopidogrel remaining (at least 90% of nominal content) and percentage of degradation product formation were used to estimate shelf‐life.ResultsOnly the refrigerated Ora‐Plus:Ora‐Sweet mixture did not have degradation products that exceeded USP limits for clopidogrel impurities for at least 30 days. The estimated shelf‐lives of the Ora‐Plus:Ora‐Sweet mixtures at room temperature (25 °C) and under refrigeration (4 °C) were 19 and 37.5 days, respectively. There was no improvement in stability when mixtures were prepared using a variety of co‐solvents.ConclusionClopidogrel 1 mg/mL suspension made with Ora‐Plus:Ora‐Sweet and stored in amber glass bottles was stable for 1 month under refrigeration and 2 weeks at room temperature.
Two Examples of Student Placement Tasks: Drug Use Evaluations
Authors: Flavel Daniel , Grey Luka , Morrissey Hana , Ball Patrick 
Published: April 2015

ABSTRACTBackgroundExperiential clinical placement is a compulsory component of the pharmacy course at Charles Sturt University. The Rural Pharmacy Practice subject, in addition to addressing the National Competency Standards, tasks students to undertake a number of projects during their clinical placements.AimTo present 2 examples of student conducted drug use evaluations where the outcomes of the activities were perceived to have benefited the placement site.MethodThis was an observational study involving 2 student projects considered to be of benefit by the placement sites. Both studies investigated adherence to local guidelines to inform optimal patient care.ResultsProject 1 evaluated intravenous versus oral paracetamol use and concluded that the prescribing guidelines for intravenous paracetamol were adhered to in around 50% of cases. Project 2 evaluated OxyContin (oxycodone) use and concluded that oxycodone dosages prescribed complied with guidelines. However, the treatment regimens of around 35% of patients assessed could be improved by using non‐opioid analgesics, such as paracetamol.ConclusionStudent placement projects, such as drug use evaluations, represent an excellent way for students to benefit the clinical placement site.
National Survey of Clinical Pharmacy Services and Pharmacy Technician Roles for Subacute Aged‐Care Inpatients
Authors: Elliott Rohan A , Perera Dhineli , O'Leary Karen 
Published: April 2015

ABSTRACTBackgroundSubacute aged‐care inpatients usually have multiple risk factors for adverse medication events. There is evidence that clinical pharmacy services can improve their medication management.AimTo describe clinical pharmacy services, pharmacist and pharmacy technician staffing levels, and pharmacy technician roles in the subacute aged‐care inpatient setting.MethodA pre‐piloted online survey was e‐mailed to directors of pharmacy listed in the Society of Hospital Pharmacists of Australia Directory of Hospital Pharmacy Services 2011. The survey included items about the hospital, number of full‐time equivalent (FTE) pharmacists and pharmacy technicians providing clinical and medication distribution services to subacute aged‐care beds, clinical pharmacy services provided, and tasks undertaken by pharmacy technicians.Results31 evaluable responses were received (estimated response rate 25%). 11 (36%) respondents provided a comprehensive clinical pharmacy service to most subacute aged‐care inpatients at least 5 days/week; 8 (26%) respondents were unable to provide a basic clinical pharmacy service. The number of subacute aged‐care beds per 1 FTE pharmacist (20–128 beds) and pharmacy technician (15–630 beds) was highly variable. Pharmacy technicians predominantly assisted with distribution of medicines (restocking ward imprest and individual patient supply) and infrequently assisted with clinical pharmacy tasks.ConclusionClinical pharmacy service provision to subacute aged‐care inpatients was suboptimal at most participating hospitals. Increased FTE pharmacists would be needed to consistently deliver comprehensive clinical pharmacy services. Expanding pharmacy technicians' roles could support the provision of clinical pharmacy services.
Vanishing Valproate: Significant Reductions in Serum Levels of Valproate with Meropenem Coadministration
Authors: Tong Erica Y , Ooi Sheue‐Ching , Choo Shin , Dooley Michael J , Skinner Matthew J 
Published: April 2015

ABSTRACTBackgroundThe first report of a valproate–meropenem interaction was published in 1998 and a warning was issued by the US Food and Drug Administration in 2001. Despite the documentation of this clinically significant drug interaction, there may be limited awareness among clinicians in Australia.Clinical Details: We report a case of a patient stabilised on valproate and topiramate for epilepsy who was started on intravenous meropenem for neutropenic sepsis. Within 48 hours of starting meropenem, the patient experienced multiple tonic–clonic seizures and the trough serum valproate concentration was 161 micromol/L. 2 weeks prior to meropenem initiation, a trough serum valproate concentration was 672 micromol/L. Our patient experienced a 75% reduction in serum valproate concentration within 48 hours of starting meropenem.ConclusionCo‐administration of valproate and meropenem should be avoided due to the rapid onset and extent of the interaction.
Complementary and Alternative Medicines Use by Cancer Patients and the Role of the Drug Information Pharmacist
Authors: Mellor James D , Sanders Julie , Thakerar Arti 
Published: April 2015

ABSTRACTBackgroundCancer patients are increasingly using complementary and alternative medicines (CAM). Oncology pharmacists need to be able to discuss CAM use with patients, and identify potential interactions with conventional cancer therapies. At the study oncology hospital, the Drug Information (DI) centre responds to around 25 complex inquiries on CAM each month.AimTo highlight the role of DI pharmacists in advising cancer patients and health professionals on the safe use of CAM with conventional cancer therapies.Method3 case studies on CAM researched by the DI centre are presented.ConclusionDI pharmacists provide safe and informed advice to health professionals and patients on CAM use with conventional cancer therapies.
Pharmacists', General Practitioners' and Consumers' Views on Integrating Pharmacists into General Practice
Authors: Freeman Christopher , Cottrell W Neil , Kyle Greg , Williams Ian D , Nissen Lisa 
Published: April 2015

ABSTRACTBackgroundIntegrating pharmacists into general practice is not a novel concept. However, it is new to Australia and evidence supporting this role is limited.AimTo seek the views of pharmacists, general practitioners and consumers on integrating pharmacists into general practice.MethodQuestionnaires were used to elicit the opinions of pharmacists, general practitioners and consumers on integrating pharmacists into general practice.Results1038 participants (829 pharmacists, 167 consumers, 42 general practitioners) completed the survey. Commonly agreed roles for pharmacists in general practice included drug information and medication review. Perceived barriers to service provision included the pharmacist's clinical ability and turf protection. Remuneration was viewed as a facilitator and a barrier. Perceived facilitators included additional training for pharmacists and an existing rapport with the general practitioners.ConclusionThere was support for integrating pharmacists' professional activities into general practice. These findings will guide the development of a new model of integrated primary care with practice pharmacists.
Combined Neem Oil 6% w/w and Eucalyptus Oil 16% w/w Lotion for Treating Head Lice: In Vitro and In Vivo Efficacy Studies
Authors: Thawornchaisit Prasutr , Amornsak Weerawan , Mahannop Pakpimol , Buddhirakkul Prayute , Pandii Wongdyan , Connellan Paul , Thompson Dion , Brushett Don , Morris Carol 
Published: April 2015

ABSTRACTAimTo test a combined neem oil 6% w/w and eucalyptus oil 16% w/w lotion for the whole‐of‐life cycle treatment of human head lice (Pediculus humanus var. capitis) infestation.MethodPreliminary formulations of dilutions of neem and eucalyptus oils in isopropanol were tested for pediculicidal and ovicidal efficacies against Pediculus humanus var. capitis. This trial informed the development of a stable formulation consisting of neem oil 6% w/w and eucalyptus oil 16% w/w in a hydrophobic carrier (mixture of lanolin and silicones), which was also tested in vitro for pediculicidal and ovicidal efficacies against Pediculus humanus var. capitis. The lotion was then tested in vivo (clinical study) in volunteer Thai female students. At the conclusion of the in vivo study, participants and their parents/guardians completed a questionnaire pertaining to their perceptions and acceptance of the treatment.ResultsInitial in vitro testing demonstrated pediculicidal and ovicidal efficacies of 96% and 100%, respectively. The clinical study involving 45 volunteer Thai female students aged 7 to 12 years, with 2 applications of the lotion on the scalp and hair 1 week apart, showed significant in vivo activity. Pediculicidal efficacies of 93% and 97% and ovicidal efficacies of 80% and 100% were measured 2 days after the first and second application of the lotion. Participants and their parents/guardians indicated strong acceptance of the formulation.ConclusionThe combined neem oil 6% w/w and eucalyptus oil 16% w/w lotion demonstrated high pediculicidal and ovicidal efficacy for Pediculus humanus var. capitis infestation.
Complexity and Workload of Cytotoxic Manufacturing at a Regional Hospital: A Comparative Study
Authors: Robertson Kelvin , Roberts Lynden , Plummer David , Ede Judy 
Published: April 2015

ABSTRACTBackgroundAt The Townsville Hospital, the largest tertiary facility in northern Australia, cytotoxic workload statistics are only recorded as a single quantitative measure – the number of items. Complexity of the cytotoxic products manufactured are not known.AimTo determine the complexity of cytotoxic products manufactured at the hospital; to compare the cytotoxic preparation workload to another Australian hospital; and to ascertain the resources needed to manufacture cytotoxic products at a regional hospital.MethodThe pharmacy department's medication database was searched to identify retrospectively all locally manufactured cytotoxic products for 4 years from 2008. The complexity score (CS) was applied to each identified cytotoxic product. The CSs were collated and compared to the number of items manufactured per year. Data from Austin Health, Melbourne were used as a comparator.ResultsOver 4 years, the number of products manufactured dramatically increased by 800% while the CSs decreased by 28%. There was an average increase per year of 266% in the number of items manufactured while the CS per item decreased an average of 9%. Compared to Austin Health, The Townsville Hospital manufactured fewer cytotoxic products of low complexity.ConclusionThese workload statistics provide useful data to inform staffing levels and resources required for expansion of oncology services in regional hospitals.
Pain Severity Cut‐Points and Analgesic Use by Community‐Dwelling People for Chronic Pain
Authors: Brown Kathryn E , Swift Ian , Spark M Joy 
Published: April 2015

ABSTRACTAimTo define a descriptive scale for mild, moderate and severe chronic pain experienced by community‐dwelling people; and to use this scale to investigate chronic pain management in community‐dwelling people.MethodPeople with chronic pain were recruited through 20 randomly selected rural and urban community pharmacies in Victoria, Australia. Participants received a survey pack with their prescription medication and chose to participate in the study by returning the completed anonymous questionnaire. Multivariate analysis of variance was used to determine cut‐points on the 0 to 10 average pain intensity scale of the Brief Pain Inventory (short form) from participants' reports of pain interference in daily activities during the previous week.ResultsQuestionnaires were returned by 219 people (response rate 31%). Cut‐points on the average pain intensity scale of 3 and 6 were found to categorise chronic pain. Therefore, an average pain intensity of 1 to 3 can be considered mild, 3 to 6 moderate and 6 to 10 severe, with each increase in category indicating a significant increase in pain interference in daily activities. Gender, age and locality did not influence reported pain intensity. 191 participants (91%) reported experiencing moderate or severe pain during the previous week.ConclusionCut‐points on the average pain intensity scale of the Brief Pain Inventory (short form) for mild, moderate and severe pain are 3 and 6. Pain management of community‐dwelling people with chronic pain can be improved.
Medicines Management by the Older‐Aged Living Independently in Different Types of Retirement Villages
Authors: Doggrell Sheila A , Kairuz Therése 
Published: April 2015

ABSTRACTBackgroundResources to assist the older‐aged manage their medicines should target those in greatest need. Little is known about whether socioeconomic status (SES) influences medicines management by the older‐aged.AimTo explore whether there is a difference in medicines management by the older‐aged living independently in different types of retirement villages.MethodSemi‐structured interviews were conducted with 56 older‐aged residents living in 5 different types of retirement villages. A purposefully designed instrument was used to inform the researchers' perceptions of medication adherence.Results92% of residents from the freehold retirement village (metropolitan city, high SES) were perceived to be adherent to their medicines and not likely to have problems with adherence within the next 6 to 12 months. While in the 2 rental retirement villages (low SES), 50% or fewer residents were in this category. Participants from the freehold retirement village had a good understanding of about 80% of their illnesses, which was significantly lower in the 2 rental villages (10% to 20%). More medicines per person were prescribed in the 2 rental retirement villages than in the freehold village. Cardiovascular drugs were the most commonly prescribed in all of the retirement villages, but prescribing of psychotropic drugs was greater in rental than freehold villages. Pooled data showed that lack of knowledge about medicines and illness was associated with a medication organiser dispensed by a pharmacy.ConclusionThe older‐aged living in low SES rental retirement villages may need assistance and resources to manage their medicines.
Stability of Oral Cholecalciferol (Vitamin D3) Liquid Formulations in Olive Oil
Authors: Joseph Pathma D , Hemmens Violet J , Munns Craig F 
Published: April 2015

ABSTRACTBackgroundVitamin D deficiency states in children are treated with extemporaneously prepared oral cholecalciferol liquid in olive oil at The Children's Hospital at Westmead. No formal stability data are available for these cholecalciferol dose forms.AimTo investigate the stability of extemporaneously prepared oral cholecalciferol liquid formulations in olive oil.MethodThree different concentrations of cholecalciferol formulations were prepared extemporaneously. Cholecalciferol contents were assayed using ultra‐performance liquid chromatography. Determinations of the specific gravity and cholecalciferol concentrations were made over 9 months. Formulations were tested for microbial contamination at the beginning and end of the study.ResultsThe initial concentrations of cholecalciferol in the formulations were assayed at 60 178 IU/mL, 5680 IU/mL and 400 IU/mL. Over the 9‐month study period, specific gravity determinations indicated that no major changes had occurred in the physical nature of the formulations. Linear regression analysis showed that all data points fell within the 95% confidence interval of the starting concentrations. The negative trend over time indicated that the cholecalciferol concentration decreased slowly, but remained within the British Pharmacopoeia limits for solid dose forms of 90% to 125%. The formulations passed microbial testing after 9 months.ConclusionThese stability data support the current 3‐month expiry date for cholecalciferol liquid formulations in olive oil. The limitations of extemporaneous manufacture support the use of commercial products when possible.
Measuring and Describing Dose Omissions using an Electronic Medication Management System
Authors: Munzner Eyra E , Welch Susan A , Richardson Katrina L 
Published: April 2015

ABSTRACTBackgroundOmitted doses are the most common cause of medication errors in hospital. The impact of an electronic medication management system (eMMS) on rates of omitted doses is unclear.AimTo determine the rate of omitted doses in inpatients using MedChart and to identify non‐valid omissions involving high‐risk medications.MethodRetrospective reports were generated using eMMS and omitted doses were identified across inpatient wards (except the ED) at a tertiary hospital over a 2‐week period in 2011. Omissions were classified to highlight non‐valid omissions and the prevalence of high‐risk medications. Results were compared to voluntary incident reports for the same period and institutional data from 2001.Results7.5% (5308//70 774) of doses were recorded as omitted, mirroring 2001 results (7.6%). Non‐valid omissions accounted for 11% (571/5308) of total omissions. ‘Medication unavailable’ was the reason for omission in 19% (111/571) of non‐valid omissions. 24% (137/571) involved high‐risk medications, with anti‐infectives the most commonly missed group (52%, 71/137). Only 2 omitted doses were reported in the voluntary system.ConclusionAlthough eMMS did not reduce the rate of omitted doses, there was a decrease in ‘missed’ doses. High‐risk medications were prevalent in non‐valid dose omissions. Omitted doses were significantly under‐reported via the voluntary system.
Validated Competency Framework for Delivery of Pharmacy Services in Pacific‐Island Countries
Authors: Brown Andrew N , Gilbert Ben J , Bruno Andreia F , BPharm Gabrielle M Cooper 
Published: April 2015

ABSTRACTBackgroundScarcity of health personnel with relevant competence is an impediment to achieving the UN health‐related Millennium Development Goals in many Pacific‐Island Countries (PICs). A systematic approach to improving essential medicines supply management and workforce competence has begun in the region. The development of a pharmacy competency framework has been identified as a priority.AimTo develop a validated pharmacy competency framework for PICs.MethodAcademics, Ministry of Health officials and health personnel collaborated to articulate a competency framework using participatory action research. The draft framework was revised via a process of workplace interviews and focus groups in Vanuatu and Papua New Guinea with wider regional validation undertaken using an online survey tool.ResultsA validated pharmacy competency framework was developed for PICs. 113 competencies required for delivery of pharmacy services, organised into four clusters: organisation and management (n = 24), professional/personal (n = 24), pharmaceutical public health (n = 24) and pharmaceutical care (n = 24) were identified.ConclusionThe pharmacy competency framework for PICs is service‐based and not cadre‐specific, allowing wide application to the Pacific region where a myriad of personnel provide pharmacy services. Pharmacy service personnel in PICs are encouraged to use this tool when training staff and monitoring their effectiveness in local environments.
Medication Reconciliation Challenges at Discharge from Hospital using an Electronic Medication Management System and Electronic Discharge Summaries
Authors: Ng Carmen , Welch Susan A , Luddington Jane , Bui Diana , Glasson Elizabeth , Richardson Katrina L 
Published: April 2015

ABSTRACTBackgroundContinuity of care can be facilitated by reconciling changes made to electronic discharge medicines profiles (eDPs) in the electronic medication management system (eMMS) and electronic discharge summaries (eDSs).AimTo review eDPs containing discrepancies and to discern the proportion of discrepancies reconciled in the eMMS and eDSs.MethodAll eDPs presented to the pharmacy during 4 one‐week periods: September/October 2009, March 2011, January 2012, February/March 2012 were reviewed retrospectively. eDPs with changes were identified and the number, type of changes and potential severity assessment were recorded. An eDS was introduced in January 2012, with discharge medicines listed in the eMMS populating the eDSs. eDPs identified by the pharmacist as requiring edits by the prescriber were cross checked with the final version in the eMMS and eDSs.ResultsNumber of eDPs reviewed were: 67 (2009), 150 (2011) and 382 (2012). Percentage of eDPs with changes made were: 40% (2009), 33% (2011) and 20% (2012). Percentage of items on eDPs with changes not reconciled in the eMMS were: 100% (2009), 81% (2011) and 31% (2012) (p < 0.0001). Of the eDPs that had changes made, 59% (34) had accurate eDSs in 2012 compared with 11% of handwritten discharge summaries in 2009.ConclusionWhile there has been a substantial improvement in the reconciliation of discharge medicines in the eMMS, further work is required to ensure these are imported into the eDSs so that an accurate list is maintained in both systems.