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Ex) Article Title, Author, Keywords

  • Original Article 2024-12-31

    Vivian Sum Yee Lam*, Kyton Chan*, Jiahao Liang, Franco Wing-Tak Cheng

    R Clin Pharm 2024; 2(2): 47-54

    https://doi.org/10.59931/rcp.24.0005
    Abstract
    This systematic review and meta-analysis investigated the incidence of major adverse kidney events (MAKE) in patients following COVID-19 infection. A comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and CINAHL databases from their inception to July 18, 2022. Eleven studies met the inclusion criteria. The methodological quality of each study was evaluated using the modified Leboeuf-Yde and Lauritsen tool. Random-effects meta-analysis revealed a pooled MAKE incidence of 6.16 per 100 persons (95% CI: 3.01–12.21). Death had an incidence of 4.28 (95% CI: 2.18–8.26), kidney failure had an incidence of 1.49 (95% CI: 0.27–7.77), initiation of renal replacement therapy had an incidence of 3.54 (95% CI: 0.00–98.43), and worsening of renal function tests had an incidence of 21.82 (95% CI: 0.05–99.42). The analyses revealed high heterogeneity among the pooled data, with I2 values ranging from 88.5–99.8%. Begg’s funnel plot indicated the absence of publication bias. The overall findings suggest that the incidence of MAKE following COVID-19 infection in the general population is higher than expected, highlighting the importance of monitoring kidney disease during postacute care. Notably, the extreme heterogeneity observed in the data and limited number of studies included in the analysis warrant further research to determine the occurrence of MAKE after COVID-19 infection in different geographical regions and to compare risk with appropriate controls.
  • Original Article 2024-12-31

    Tran Thi Ngan1,2 , Ngo Thi Quynh Mai1 , Tran Van Anh1,2 , Nguyen Thi Thu Phuong1,2

    R Clin Pharm 2024; 2(2): 55-64

    https://doi.org/10.59931/rcp.24.0006
    Abstract
    Background: The increasing prevalence of antibiotic resistance and the complexity of treating lower respiratory tract infections (LRTIs) in critically ill patients have brought nebulized antibiotics into focus as a promising therapeutic option. This review explores the current evidence on the efficacy, limitations, and safety of nebulized antibiotics for LRTIs, particularly those caused by gram-negative and multidrug-resistant pathogens.
    Methods: A comprehensive literature search was performed using a systematic approach across databases such as PubMed, Cochrane Library, and Scopus, focusing on studies concerning nebulized antibiotics in adults with LRTIs. The key inclusion criteria emphasized research on the efficacy, safety, and pharmacokinetics of nebulized antibiotics.
    Results: The analysis of randomized controlled trials and meta-analyses indicated that nebulized antibiotics can achieve high concentrations at the site of infection, which may improve clinical outcomes. However, despite favorable pharmacokinetics, clinical trials have demonstrated limited improvements in mortality and overall efficacy compared with traditional intravenous therapies. This review also discussed safety considerations related to nebulized antibiotics, including potential adverse effects and delivery challenges. Current clinical guidelines, including those from the IDSA 2024, recommend cautious use of nebulized antibiotics for LRTIs, particularly for ventilator-associated pneumonia. Significant knowledge gaps in optimal dosing, delivery methods, and patient selection criteria are identified in this review. Moreover, the need for further research to establish clear clinical guidelines that could improve the application of nebulized antibiotics is emphasized.
    Conclusion: Although nebulized antibiotics have potential benefits for managing LRTIs, additional studies are required to optimize their efficacy and safety within clinical settings.
  • Original Article 2024-12-31

    Elida Zairina1,2,3 , Yerlita El Girath4 , Arie Sulistyarini1,2 , Gesnita Nugraheni1,2

    R Clin Pharm 2024; 2(2): 65-72

    https://doi.org/10.59931/rcp.24.0008
    Abstract
    Background: This study aimed to evaluate the risk of developing type 2 diabetes mellitus (T2DM) among individuals with a body mass index (BMI) higher than the normal range.
    Methods: This cross-sectional study used a convenience sampling technique. Data were collected using the Canadian Diabetes Risk (CANRISK) questionnaire.
    Results: Among 121 respondents, 76 (62.8%) had a high-risk factor, 11 (9.1%) had a low-risk factor, and 34 (28.1%) had a medium-risk factor for developing T2DM within the next ten years. Differential analysis indicated significant associations between CANRISK total scores and age (p=0.001), gender (p=0.006), and education level (p=0.002). However, no significant differences were observed based on physical activity, fruit and vegetable consumption, history of high blood glucose, or family history of diabetes.
    Conclusion: Individuals with higher CANRISK scores have an increased likelihood of developing T2DM within ten years. The CANRISK questionnaire is an effective screening tool for identifying at-risk individuals, particularly those with elevated BMI.
  • Original Article 2024-12-31

    Huong Tra Dang1* , Thi La Do1* , Khanh Linh Duong1 , Ngoc-Anh Thi Vu1 , Duc Tuan Cao2 , Nguyen Van Hung3 , Shaun Wen Huey Lee4 , Paul Chi-Lui Ho4 , Jong Seong Kang1 , Hwi-yeol Yun1,5,6 , Jung-woo Chae1,5,6 , Soyoung Lee1

    R Clin Pharm 2024; 2(2): 73-81

    https://doi.org/10.59931/rcp.24.0010
    Abstract
    The international practical training exchange program in clinical pharmacy at Chungnam National University equips pharmacy students and professionals with advanced clinical and research skills through immersive training in different healthcare environments. This program encompasses three core components—clinical pharmacy practice in hospital settings, clinical pharmacy practice in university settings, and research training within the College of Pharmacy—designed to develop clinical competencies, enhance patient-centered care, and foster interdisciplinary collaboration. Participants engage in clinical rotations, laboratory sessions, and active research projects, gaining insights to various international healthcare systems, including partnerships in Germany, Vietnam, Japan, and Malaysia. Based on student feedback and competency evaluations, the program assessment revealed significant improvement in patient assessment, medication management, interdisciplinary communication, and practical skills in pharmaceutical compounding, quality control, and analytical testing. Research training fosters a strong foundation in experimental design and scientific communication, and cross-cultural exposure enhances adaptability and global competence. This program offers a framework for comprehensive clinical pharmacy training aligned with international health standards, promoting cultural awareness, and preparing future pharmacists for the complexities of a globalized healthcare landscape. Future initiatives will include program expansion and evaluation of the long-term effects on participants’ professional growth.
  • Original Article 2024-06-30

    Abstract
    Background: Growing evidence demonstrates that emergency medicine pharmacists (EMPs) can positively improve patient care in the emergency department (ED). In Singapore, ED pharmacy is still generally limited to traditional roles, and EMPs are rarely included as part of the ED clinical team. We sought to investigate the impact of introducing an EMP into an ED.
    Methods: From November 2019, we piloted a new, collaborative multidisciplinary model of care by introducing an EMP to provide clinical pharmacy services in the ED of our institution.
    Results: The EMP’s roles and practices, as described in this report, included clinical and traditional non-clinical as well as administrative activities to support the multidisciplinary teams in the ED. On average, the EMP was involved in 1.2 documented pharmacist activities (involving medication-related enquiries or interventions) per hour spent in the ED.
    Conclusion: Although our initial experience with introducing an EMP into our ED was mostly positive with tangible benefits in optimizing medication use and improving medication safety for ED patients, we also described the challenges that we faced in developing the service. Finally, the necessity of an EMP should be further examined, adapted to the local settings, and evaluated with respect to incorporation of this service into our local healthcare system by conducting further studies.
  • Original Article 2024-06-30

    Abstract
    Background: Menstrual health problems affect over a third of women worldwide, making them a global public health concern. However, both the public and healthcare professionals often lack knowledge about the issue, and cultural and religious beliefs can contribute to the stigmatization of menstrual health. As a result, many women do not receive appropriate treatment. Negative attitudes and perceptions from healthcare workers when handling such cases can also prevent these issues from being taken seriously, further hindering care. Because community pharmacists play a key role in managing menstrual problems in Malaysia, a questionnaire was designed to assess their knowledge, attitudes, perceptions, and practices.
    Methods: Content validation and face validation were performed, enlisting expert panels to discuss the relevance, clarity, and comprehensiveness of each item. The questionnaire was designed using Google Forms and distributed online via email and WhatsApp®.
    Results: The results of the reliability test using Cronbach’s alpha showed that all four domains of the questionnaire had acceptable alpha values. The highest alpha value was 0.835 (perception), while the lowest was 0.511 (practice). The alpha value for the knowledge domain was 0.670, and the attitude domain achieved an alpha of 0.621. Although the alpha values of all four domains fell into the acceptable range, improvements were suggested for the practice domain to increase its alpha value, along with the questionnaire’s overall reliability.
    Conclusion: This study resulted in the development of a reliable, validated survey tool to evaluate the level of knowledge among community pharmacists in Malaysia regarding menstrual health problems, the attitudes toward and perceptions of the management of menstrual health problems within the healthcare system, and practices for handling cases related to menstrual health problems.
  • Original Article 2024-06-30

    Humayera Kabir Hana1 , Sania Siddiqui1 , Siti Maisharah Sheikh Ghadzi1 , Irfhan Ali Hyder Ali2 , Siew Chin Ong1 , Nur Hafzan Md Hanafiah1 , Sabariah Noor Harun1

    R Clin Pharm 2024; 2(1): 18-26

    https://doi.org/10.59931/rcp.24.0003
    Abstract
    Background: Tuberculosis is a considerable hazard in Malaysia. According to the World Health Organization (WHO), the treatment success rate for newly diagnosed pulmonary tuberculosis patients (PTB) is lower than the global success target of 95%. Currently there are limited studies evaluating the predictors of treatment outcomes for newly diagnosed pulmonary tuberculosis patients. The current study aimed to determine the predictors for recently diagnosed PTB patients in Malaysia. The study also aimed to identify the effect of fixed-dose combinations (FDCs) and separate treatment regimens on PTB therapy.
    Methods: In this retrospective cohort study, patients following up at the chest clinic at the Penang General Hospital were included. Convenient sampling was performed to collect data from patients who had been newly diagnosed from January 2014 to December 2017. SPSS version 23 was used for performing Cox regression analysis.
    Results: Treating newly diagnosed PTB patients with FDCs in the intensive phase significantly reduced unfavorable outcomes (HR=0.266; 95% CI: 0.067–0.763). Age <60 years, drug abuse, and treatment interruption were the factors that considerably increased the hazards of unfavorable outcomes with HR=2.21 (95% CI: 1.05–4.65); 3.24 (95% CI: 1.24–8.49); and 2.702 (95% CI: 1.186–6.154) respectively.
    Conclusion: The hazards of unfavorable outcomes in newly diagnosed PTB patients are significantly reduced by treating them with FDCs. However, treatment interruption adversely affects the outcome. Further studies investigating the effects of FDCs along with other factors influencing drug response relationships are paramount to improving treatment strategies.
  • Original Article 2024-06-30

    Abstract
    Background: An Australian consensus statement on the pharmacological prevention and management of heart failure, released in August 2022, recommended initiation of four medications for treating heart failure with reduced ejection fraction (HFrEF): angiotensin- converting enzyme inhibitors or angiotensin receptor-neprilysin inhibitors, heart failure beta blockers, mineralocorticoid receptor antagonists and sodium glucose co-transporter 2 inhibitors. These four medications are classified as the guideline-directed medical therapy (GDMT). Intravenous administration of ferric carboxymaltose (IFC) in the hospital, following an episode of acute heart failure in patients with iron deficiency and an ejection fraction of less than 50% was also recommended to reduce heart failure related hospital admissions as demonstrated in the AFFIRM-AHF trial.
    Methods: A study conducted a retrospective audit of patients with HFrEF discharged by the Cardiology and the General Medicine teams of a tertiary hospital between two time periods, October to December 2021, and October to December 2022. Information including patient demographics, medication allergies and iron studies was collected. Discharge medication lists were extracted, reviewed for GDMT prescription and audited to check the accuracy of heart failure medication documentation. SPSS v29 was used to perform the statistical analysis.
    Results: A greater proportion of patients were discharged on optimal GDMT across both study periods by the Cardiology department compared with the General Medicine department (37% versus 4% respectively, p<0.001). More accurate recording of heart failure medications in discharge summaries was performed by the Cardiology department compared with the General Medicine department (82% versus 68% respectively, p=0.015). Lastly, eligible Cardiology patients were more likely to receive IFC compared with General Medicine patients (71% versus 28%, p=0.003).
    Conclusion: Overall, the audits performed in this study demonstrated that improvements in HFrEF GDMT prescribing adherence, documentation accuracy and IFC administration are warranted since the current practice is suboptimal, particular in General Medicine teams. The barriers to GDMT adherence at the prescribers’ end will require further examination and the appropriate quality improvement tools need to be implemented to ensure that all patients with HFrEF have equal access to optimal healthcare.
  • Original Article 2024-06-30

    Suhyeon Moon1* , Hyunju Yoo2* , Haemin Hwang2 , Yoon Seul Cho2 , Je Heon Kim2 , Tae Woo Kim2 , Jeongmin Kang2 , Bowon Hwang2 , Yunseo Lee2 , Minjeong Shin2 , Yeo Jin Choi3 , Sooyoung Shin1,2

    R Clin Pharm 2024; 2(1): 38-46

    https://doi.org/10.59931/rcp.24.0007
    Abstract
    Background: A Pharmacy Competency Enhancement Program, based on problem-based learning (PBL), was developed to empower students in adopting a patient-centered approach and fostering communication skills. The objective of this program is to investigate its impact on students’ self-competency in the Pharmacists’ Patient Care Process components and patient counseling skills.
    Methods: This program integrates PBL patient case activities and a patient counseling competition (PCC), specifically designed to prepare students for real-world patient care scenarios. Students were prompted to complete a self-assessment survey at the following three distinct time points: post-didactic courses, post-Advanced Pharmacy Practice Experience (APPE) rotations, and post-PCC; their responses were categorized into the following six constructs: collect (1 item), assess (4 items), plan and implement (5 items), follow-up (7 items), knowledge (4 items), and communication (4 items).
    Results: The sum of the Likert-scaled responses for each construct demonstrated consistent improvement in students’ self-efficacy from post-didactic courses to post-APPE rotations to post-PCC. The percentage of students responding “agree” or “strongly agree” increased for each construct, with the most significant improvement observed in “plan and implement” (84.2%) and “knowledge” (82.0%) between post-didactic courses and post-PCC.
    Conclusion: The outcomes of this project emphasize the significant positive impact of PBL activities and PCC in cultivating the fundamental skills required for future pharmacists.
Asian Conference On Clinical Pharmacy

Vol.2 No.2
December 2024

eISSN 2983-0745
Frequency: Biannual

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Aims and Scope

Research in Clinical Pharmacy (RCP) is an international, open-access, peer-reviewed journal of clinical pharmacy published online by Asian Conference on Clinical Pharmacy (ACCP).
1. Journal Title: Research in Clinical Pharmacy
2. Journal Abbreviation: R Clin Pharm
3. Acronym: RCP
4. Frequency: biannual
5. Publisher: ACCP
6. Language: English
7. Format Status: Electronic only ... +MORE