Role of dual and triple fixed-dose combination inhalers in the treatment of chronic obstructive pulmonary diseaseSubscription
A review of the current evidence, including the safety and efficacy of dual and triple-combination inhalers for the treatment of stable COPD, and their place in therapy.
Economic, manufacturing and regulatory factors can affect drug shortages and supply chain disruption. By using a mixed-methods approach involving an online survey, semi-structured interviews and three targeted focus groups aimed at acute care hospitals in England, Wales, Northern Ireland and Ireland, this study determined that over half of the responding acute care hospitals did not have 76–100% of medicine lines fulfilled within 8 weeks of a disruption in the supply chain.
The appropriate use of medicines is dependant on the accurate use of clinical indications on inpatient paper and electronic prescriptions. This mixed-methods study involving semi-structured interviews with 64 chief pharmacists, 11 focus groups from three NHS trusts and a medical documentation review of 89 patients determined both positive and negative implications of including clinical indications on healthcare professionals’ clinical workflow.
Through analysing a randomly selected sample of patients with low blood glucose and diabetes over a course of a year, this prospective study found that a significant number of hypoglycaemia episodes were not treated to established protocol.
Asthma is one of the most common respiratory conditions in the UK. Around 30% of asthma patients fail to attend their annual asthma review, which leads to an increase in the number of preventable asthma-related hospital admissions. By using SIMPLE methodology and the PharmOutcomes® web-based system on 27 patients, it was determined that the community pharmacy asthma review service would enhance patient care through close collaboration with GP surgeries.
Point-of-care C-reactive protein testing in community pharmacy to deliver appropriate interventions in respiratory tract infectionsSubscription
This pilot study sought to evaluate the potential use of point-of-care (POC) C-reactive protein (CRP) testing for respiratory tract infections (RTIs) in a rural community pharmacy in North Staffordshire, UK, in conjunction with local GP practices. The study found that the use of POC CRP testing in community pharmacies has the potential to reduce the number of GP appointments caused by RTIs and, therefore, may help reduce unnecessary antibiotic prescribing.
Although clinical commissioning groups (CCGs) are not responsible for monitoring or regulating care homes, Wigan Borough’s approach demonstrates that it is possible for CCG staff to work collaboratively with care home and social care teams to improve outcomes for patients.
NHS Grampian project: treating uncomplicated lower urinary tract infection in community pharmacySubscription
Urinary tract infections (UTIs) are one of the most common conditions seen in female patients in general practice (GP) and account for 1–3% of all GP consultations each year in the UK. Over-the-counter (OTC) treatments for UTIs currently available in community pharmacy only attempt to relieve symptoms, and do not address the bacterial infection. The Grampian project was developed to provide treatment of uncomplicated UTIs through community pharmacies by means of a Patient Group Direction ...
Evaluating a point-of-care C-reactive protein test to support antibiotic prescribing decisions in a general practiceSubscription
C-reactive protein (CRP) is a marker of infection and inflammation. It is high in bacterial infections but very low or close to zero in viral infections. The National Institute for Health and Care Excellence (NICE), England and Wales’s health technology assessment body, has issued guidance on pneumonia in adults; it recommends point-of-care (POC) CRP analysers when clinical assessment is inconclusive. If the CRP level is less than 20mg/L, no antibiotics ...
Local guidance, supported by the 2014 National Institute for Health and Care Excellence (NICE) guideline CG180 for atrial fibrillation (AF), recommends that patients receiving inadequate anticoagulation with a vitamin K antagonist (VKA), including time in therapeutic range (TTR) of <65%, should be reassessed. These patients were identified by the anticoagulation monitoring service (AMS) and highlighted to GPs for review. However, up to 59.3% of patients received ...