The latest medical research on Clinical Pharmacology

The research magnet gathers the latest research from around the web, based on your specialty area. Below you will find a sample of some of the most recent articles from reputable medical journals about clinical pharmacology gathered by our medical AI research bot.

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Pharmacy services and role development in UK general practice: a cross-sectional survey.

International Journal of Epidemiology

The 'Clinical Pharmacists in General Practice' (CPGP) pilot provided a template for general practice pharmacy professionals' (GPPPs) roles encouraging NHS England to fund >2000 practice-based pharmacists. However, many GPPPs work outside the CPGP initiative and little is known about the services they provide.

To explore services provided by all UK GPPPs (pharmacists/pharmacy technicians), including the types of services, perceived benefits and barriers to role development.

A 26-item electronic questionnaire was developed using SurveyMonkey and piloted during cognitive interviews. A cross-sectional survey was conducted via social media, primary care organisations and emails to CPGP pilot sites between November 2018 and March 2019. Three reminders were sent 1 week apart.

Ninety-one complete responses were received (81 pharmacists; 10 technicians). Over 80% of pharmacists provided clinical services, such as medication reviews or management of long-term conditions. More pharmacists within CPGP pilot managed repeat prescribing requests (P = 0.035). Technicians took responsibility for primarily non-clinical roles, including commissioning or safety alerts/drug recalls. A third of GPPPs wished to develop care home services. Perceived benefits of GPPPs' services included improved utilisation/development of professional skills, identifying medicines-related issues and reduction in medication waste. Respondents were satisfied with professional relationships but reported workload issues, limited patient awareness of their roles and restricted opportunities to contribute to service development, which was associated with unsatisfactory support/mentorship (P < 0.001).

General practice pharmacy professionals deliver clinical and non-clinical services which may benefit patients, general practice and the healthcare system. General practices and national organisations should provide GPPPs with tailored support and exploit the combined strengths of pharmacists and pharmacy technicians to tackle increased workload.

Toward dynamic phenotypes and the scalable measurement of human behavior.

Neuropsychopharmacology

Precision psychiatry demands the rapid, efficient, and temporally dense collection of large scale and multi-omic data across diverse samples, for b...

Corticosterone after acute stress prevents the delayed effects on the amygdala.

Neuropsychopharmacology

Even a single 2-hour episode of immobilization stress is known to trigger anxiety-like behavior and increase spine-density in the basolateral amygd...

Hippocampal subfield morphology in monozygotic twins discordant for affective disorders.

Neuropsychopharmacology

Unipolar and bipolar disorders aggregate in families and have been associated with a reduced gray-matter volume in hippocampal and prefrontal corte...

Advances in the computational understanding of mental illness.

Neuropsychopharmacology

Computational psychiatry is a rapidly growing field attempting to translate advances in computational neuroscience and machine learning into improv...

Evaluation of a Novel Antiplatelet Therapy Strategy in Patients Undergoing Elective Percutaneous Coronary Intervention.

Journal of Pharmacy and Pharmacology

Ticagrelor presents less thrombotic risk compared to clopidogrel in acute coronary syndromes. However, its role in dual antiplatelet therapy (DAPT)-naive patients with stable ischemic heart disease (SIHD) undergoing elective percutaneous intervention (PCI) remains unclear, including uncertainty in the method of conversion to clopidogrel for adequate coverage without increased bleeding risk.

Determine the safety and efficacy of ticagrelor loading and transitioning to clopidogrel in patients with SIHD undergoing elective PCI.

This is a retrospective cohort review of patients with SIHD who underwent elective PCI. The Switch Rx patients were treated with ticagrelor immediately before PCI, converted to clopidogrel 300 mg the day after, and discharged with clopidogrel 75 mg daily. Standard Rx patients, who received a clopidogrel load and received clopidogrel 75 mg daily after the procedure, were analyzed as a matched comparator cohort. The safety outcomes were any bleeding event at 24 hours and 30 days. The efficacy outcomes included major adverse cardiac events (MACE) at 24 hours and 30 days.

Five Switch Rx patients (n = 54) experienced bleeding academic research consortium type I bleeding within 24 hours, with no subsequent bleeding observed out to 30 days. When comparing the Switch Rx patients (n = 39) to their matched Standard Rx cohort (n = 39), no MACEs occurred within 30 days and there were no significant differences in safety and efficacy outcomes.

In DAPT-naive patients undergoing elective PCI for SIHD, a strategy of in-lab ticagrelor transitioning to clopidogrel with a 300-mg load was not associated with increased bleeding or other adverse events.

Using an Algorithm to Assess Vaccination Among Patients Who Attended a Pharmacy Student-Driven Statewide Free Health Screening.

Journal of Pharmacy and Pharmacology

National vaccination rates remain below goals. Given the geographic availability of community pharmacies, pharmacists are uniquely positioned to provide immunizations. However, many pharmacists may not be proactively recommending vaccinations to patients.

The objective of this project was to assess recommendation acceptance rates among patients who attended a pharmacy student-driven statewide free health screening.

A brief algorithm addressing 4 routine adult vaccinations was created for use by student pharmacists to initiate conversations regarding potentially indicated vaccines with patients. This algorithm was employed at statewide screenings in 2014 and 2015 with expert users available for further discussion. Follow-up to determine recommendation acceptance and identify barriers to immunization occurred 3 to 12 months after screening. The primary end point of change in immunization recommendation acceptance rates between 2014 and 2015 was analyzed using a chi-square test; secondary objectives included changes in consent rates and thematic analysis of reported barriers.

A total of 1016 patients were screened. Of these, 403 (39.7%) patients gave consent for student pharmacists to follow-up on vaccine recommendations. The overall recommendation acceptance rate was 27%, with approximately 46% of patients accepting at least 1 recommendation. Acceptance rates significantly decreased in the second year (36.5% vs 23.5%, P < .001), while consent for follow-up significantly increased (20% vs 64%, P < .001). Commonly reported barriers to immunization included resistance to vaccines, forgetfulness, and cost.

This algorithm provided a method for novice users to initiate conversations with patients about immunizations and may allow novices to act as pharmacist extenders to improve immunization rates.

Where are oral and dental adverse drug effects in product information?

International Journal of Epidemiology

Oral adverse drug reactions are common and are associated with some of our most frequently used medicines. It is important to identify and manage oral adverse drug effects promptly as they not only negatively impact dental health, but also adversely affect medication adherence, clinical outcomes and patient quality of life. This study assessed the location of oral drug-induced adverse effects in the registered drug company product information (PI) of the top 100 most commonly used drugs in Australia as dispensed on the Pharmaceutical Benefits Scheme in 2018.

Publicly available data on dispensed medicines were accessed from the Australian Commonwealth Department of Health, to determine the top 100 medicines. The drug company PI for each of these drugs was manually searched to find their oral adverse effects. The number, type and location of the oral adverse drug reactions (ADRs) were recorded.

Oral ADRs were commonly found varying in nature and severity. However, they were difficult to find as there is no dedicated section for oral/dental adverse effects in the PI and the section they are in is inconsistently applied.

We recommend that regulatory authorities such as the Therapeutic Goods Administration in Australia create an additional section for oral/dental adverse effects so they are easier to find, which may assist health professionals detect recognise and report adverse drug effects manifesting in the oral cavity.

Short-Term Surgical Missions: Role of Pharmacist Volunteers.

Journal of Pharmacy and Pharmacology

Health care professionals often participate in short-term surgical missions in underserved areas of the world. Surgical missions often rely on the ...

Management of Cannabinoid Hyperemesis Syndrome: Focus on Capsaicin.

Journal of Pharmacy and Pharmacology

Cannabinoid hyperemesis syndrome is a condition characterized by cyclic severe nausea, vomiting, and abdominal pain associated with frequent, long-...

Dynamics of HBV surface antigen related endpoints in chronic hepatitis B infection: a systematic review and meta-analysis.

Antiviral Therapy

In chronic hepatitis B (CHB) treatment, hepatitis B virus surface antigen (HBsAg) is regarded as a promising clinical endpoint associated with long-term clinical outcomes. We performed a meta-analysis to characterize the dynamics and influencing factors of HBsAg.

Literature search was conducted through PubMed from January 1995 to May 2015 for papers reporting HBsAg in patients receiving various anti-viral treatments. We conducted weighted linear regression to select for potential influencing factors on maximum HBsAg loss percentage, and subgroup analysis to calculate the pooled estimates of maximum HBsAg loss and seroconversion percentage following treatment of interferon (IFN), nucleoside analogue (NUC), or combination therapies (NUC+IFN), respectively. Study heterogeneity was assessed through sensitivity test and I-square statistics.

We collected data from 24 papers involving 6674 adult CHB patients. In most studies, average HBsAg level decreased during treatment but relapsed after treatment cessation, while HBsAg loss or seroconversion percentage continued to increase or remain stable after treatment cessation. No strong relationship was observed between maximum HBsAg change and its baseline level. The pooled estimates of maximum HBsAg loss percentage for IFN (5.3%, 2.7%-7.9%) and NUC+IFN (5.2%, 3.1%-7.4%) were significantly higher than that of NUC (0.93%, 0.29%-1.6%). Higher maximum HBsAg loss percentage is associated with longer peak time. Pooled maximum HBsAg seroconversion percentage estimates were 1.6%, 0.56% and 6.2% for IFN, NUC and NUC+IFN.

With respect to HBsAg lowering, this meta-analysis confirmed the importance of longer treatment duration and addition of IFN, which revealed the potential value of immune-based therapies.

Characteristics of drug-related problems among hospitalized ischemic stroke patients in China.

International Journal of Epidemiology

Background Patients with ischemic stroke are often taking multiple medications and are at increased risk for drug-related problems (DRPs). However,...