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Acute care and resuscitation training. Medical staff undergoing training using a mannequin.

Simulation-based training: applications in clinical pharmacySubscription

4 SEP 2018By , ,

With the evolving role of pharmacists and the growing complexity of healthcare, there is a need for interventions and innovations to enhance both individual task and team performance. Simulation-based training is an educational platform with potential in this area. This article outlines its applications in pharmacy and how it can support the skill acquisition and development of pharmacists.

Drug user injecting heroin in foot

Risk factors for mortality, hospitalisation and imprisonment in substance misuse patientsSubscription

6 JUL 2018By , ,

Pharmacists should be aware of the mortality rates and adverse outcomes, including hospitalisation and imprisonment, that are rife in illicit drug users and patients on opioid substitution therapy, in order to optimise patient safety and reduce adverse outcomes.

Antibiotic testing, antimicrobial resistance (AMR), agar dish

Pharmacy’s role in antimicrobial resistance and stewardshipSubscription

5 JUN 2018By , , Rachel Joynes,

This article summarises the evidence supporting the role of pharmacists and pharmacy teams in antimicrobial stewardship and outlines the impact of their activities.

Leaflets pharmacy services

Community pharmacists' contribution to public health: assessing the global evidence base

6 APR 2018By , , ,

In the UK, community pharmacies are more accessible to the general population than general practices. Therefore, government white papers and briefing documents from pharmacy professional bodies have advocated the expansion of the role of community pharmacists, particularly in relation to the provision of services that contribute to disease prevention and health improvement. It is unknown whether the same evidence exists globally for the expansion of these roles. This article attempts ...

Heart stress test and diabetes test

Glucose-lowering drugs and cardiovascular risk: how recent outcome trials have informed practice

4 APR 2018By ,

Although large clinical trials with glucose-lowering drugs have consistently shown beneficial reductions in microvascular complications, their effects on macrovascular complications have been controversial. Interpreting these trials is complicated by substantial differences in their design, the populations studied and data analysis. This article examines how the trials have evolved and how they impact the use of glucose-lowering agents in the routine care of patients with type ...

Micrograph of T-cell infected with HIV viruses

Optimising the health and wellbeing of older people living with HIV in the United Kingdom Subscription

7 FEB 2018By

Care for people with HIV has improved, meaning that more people are living with HIV into older age with normal life expectancy. Therefore, there are various challenges and opportunities facing healthcare professionals when providing care to this changing demographic.

Illustration showing the path of pain and its inhibition at the level of the neurons of the spinal cord

Treatments for neuropathic pain

Clinical Pharmacist, December 2017, Vol 9, No 12By ,

Neuropathic pain (NP) is a common condition characterised by subjective negative and positive symptoms that range from numbness to debilitating pain. NP can have a significant negative impact on a patient’s quality of life. Pharmacotherapy is typically the first step in treating NP. Guidelines and consensus statements from various organisations around the world appear to be consistent with the classes of medications recommended for both general and specific types of NP, which include ...

Abstract illustration of pain - naked man standing against red background

Pharmacological treatment options for fibromyalgiaSubscription

7 NOV 2017By , ,

Fibromyalgia is a high-impact and prevalent condition. Its clinical features include widespread pain and tenderness — often associated with high levels of poor-quality sleep, fatigue and cognitive dysfunction. The mechanism leading to fibromyalgia development is associated with a change in the sensitivity of the pain-related nervous system, as well as other sensory systems. In turn, emotional distress plays a facilitatory role in this process. Non-pharmacological management focuses ...

13-year-old girl with autism hiding her face in her hands

Pharmacologic treatment options for children and adolescents with autism spectrum disorderSubscription

10 OCT 2017By , , , , ,

Autism spectrum disorder (ASD) is a heterogeneous neuropsychiatric condition that is often associated with severe behavioural challenges that can be as diverse in response to treatment as they are in presentation. While environmental, behavioural, communicative, therapeutic and supportive interventions are critical considerations for any individual with ASD, pharmacologic interventions are often helpful and can be necessary for improving level of functioning and quality ...

Scanning electron micrograph of methicillin-resistant Staphylococcus aureus (MRSA) bacteria

Antimicrobial therapies for Gram-positive infectionsSubscription

12 SEP 2017By , , ,

Gram-positive bacteria are among the most common human pathogens associated with clinical infections, which range from mild skin infections to sepsis. In an era defined by antimicrobial resistance (AMR) and an increasing drive toward delivering patient care via ambulatory pathways, the paradigm for the management of infections is changing. Methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE), the best known cases of ...

Transmission Electron Micrograph view (TEM) of Hepatitis B virus

An update on the management of chronic hepatitis B and C infectionSubscription

9 AUG 2017By , , , ,

Chronic hepatitis B and C infection are leading causes of liver-related morbidity and mortality worldwide. Current therapies for chronic hepatitis B virus (HBV) infection consisting of nucleos(t)ide analogues (NA) rarely lead to functional cure. With a better understanding of the HBV lifecycle, novel agents have been developed with the hope of achieving functional cure. The development of direct-acting antivirals (DAAs) for hepatitis C virus (HCV) therapy has led to ...

Pharmacist preparing prescriptions at a dispensary

Safe dispensing in community pharmacies: applying the software, hardware, environment and liveware (SHELL) model

Clinical Pharmacist, July 2017, Vol 9, No 7By , , , ,

The human aspects of the community pharmacy work system are vulnerable to medication-related errors. Established models of human error can identify actual or potential hazards, and are important in our understanding of the interaction between human and system factors that influence performance. The software, hardware, environment and liveware (SHELL) model, a traditional human factors framework, is used in this article to classify potential sources of error in community ...

Telepharmacy, pharmacist in front of computer screen

Examining the implications of analytical and remote monitoring in pharmacy practiceSubscription

5 JUN 2017By , ,

Remote patient monitoring (RPM) incorporates digital technology that collects health data from individuals in one location and electronically transmits secure data to healthcare providers in a different location for review and assessment. This allows healthcare professionals to make recommendations to optimise patient care without the patient having to be in the healthcare setting. With the implementation of RPM, pharmacists can use objective data obtained by remote ...

Micrograph of Acinetobacter baumannii bacteria

Ceftazidime-avibactam: a novel cephalosporin/β-lactamase inhibitorSubscription

10 MAY 2017By , ,

Over the past decade, infections caused by multidrug-resistant Gram-negative organisms have increased. The limited availability in treatment options for these infections prompted both the UK to create a five-year antimicrobial resistance strategic plan to stimulate the development of new antibiotics, and the Infectious Diseases Society of America to call for ten new antimicrobial agents to be developed by 2020. Ceftazidime-avibactam is a combination of a third-generation ...

Fluoroscopic examination of gastrointestinal (GI) tract showing inflammatory bowel disease (IBD)

Management of patients with inflammatory bowel disease: current and future treatmentsSubscription

6 MAR 2017By ,

Inflammatory bowel disease (IBD) is characterised by chronic inflammation of the gastrointestinal tract and affects patients’ quality of life. Treatment of IBD involves induction and maintenance of remission. Current available therapies include anti-inflammatory aminosalicylates and corticosteroids, immunosuppressive agents, antibiotics and biologic agents. Some patients are not fully responsive to conventional treatment or lose efficacy over time. Recently approved ...

Image 1 shows a normal spine and image 2 shows a spine affected by spondylitis

TNFα-inhibitors for ankylosing spondylitis and non-radiographic axial spondyloarthritisSubscription

13 JAN 2017By , , , , , , , , ,

Spondyloarthropathy refers to a group of articular inflammatory diseases that share common genetic, clinical and radiological features in addition to their association with human leucocyte antigen (HLA)-B27 antigen. The aim of therapeutic management of patients with spondyloarthritis is to improve quality of life, control the symptoms of articular inflammation, prevent the structural damage of joints, and preserve the functional abilities, autonomy and social participation of patients. Although

Close up of a woman's hand holding hormone replacement therapy (HRT) pills

Establishing the risk related to hormone replacement therapy and cardiovascular disease in womenSubscription

10 JAN 2017By ,

Hormone replacement therapy (HRT) has a profound impact on the cardiovascular system in postmenopausal women, achieved through its effects on metabolic risk factors for coronary heart disease (CHD) and on arterial function. Observational studies have consistently shown an association between postmenopausal HRT use and a reduced incidence of CHD. However, the largest randomised trial initially reported no overall benefit on CHD risk. Subsequent analyses and follow-up of the study have ...

Geneticist at the French National Institute for Health and Medical Research (Inserm) researches genetic diseases like cystic fibrosis

Conventional therapies and emergent precision medicines for cystic fibrosis: challenges and opportunitiesSubscription

30 NOV 2016By

Around 27 years ago, the discovery of the cystic fibrosis transmembrane conductance regulator (CFTR) gene – responsible for causing cystic fibrosis (CF) – marked a significant moment in the history of the condition. Despite the early promise of this target for gene therapy, a universally successful treatment has proven elusive in the ensuing years. While clinical trials involving gene therapy continue to make progress, the ‘magic bullet’ remains some way off. Survival continues to ...

Coloured X-ray angiogram of a balloon catheter and stent (brown, upper centre) being placed within a coronary artery of a heart

Role of coronary drug-eluting stents in current clinical practiceSubscription

10 NOV 2016By , ,

Percutaneous coronary intervention (PCI) has continued to evolve, from its origins in balloon angioplasty and bare metal stent (BMS) implantation, to the development and application of contemporary drug-eluting stents (DESs). While first generation DESs significantly decreased risk of in-stent restenosis observed with BMSs, their use was complicated by late and very late stent thrombosis. Second generation DESs have dramatically decreased this risk and the rate of one-year stent thrombosis ...

Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary syndromes.

Cardiovascular side effects of cancer treatmentsSubscription

8 SEP 2016By , ,

The cardiovascular side effects of cancer treatments remain a challenge in oncologic care. Patients with cancer and cancer survivors have an increased risk of adverse cardiovascular outcomes, including left ventricular (LV) dysfunction, heart failure (HF) and acute coronary events. The treatments most frequently associated with cardiovascular side effects include anthracyclines, monoclonal antibodies (mAbs) targeting the HER2 pathway, and small molecule tyrosine kinase inhibitors (TKIs), ...

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