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BackgroundWorldwide the demands on emergency and primary health care services are increasing. General practitioners and accident and emergency departments are often used unnecessarily for the treatment of minor ailments. Community pharmacy is often the first port of call for patients in the provision of advice on minor ailments, advising the patient on treatment or referring the patient to an appropriate health professional when necessary. The potential for community pharmacists to act as providers of triage services has started to be recognised, and community pharmacy triage services (CPTS) are emerging in a number of countries. This review aimed to explore whether key components of triage services can be identified in the literature surrounding community pharmacy, to explore the evidence for the feasibility of implementing CPTS and to evaluate the evidence for the appropriateness of such services.MethodsSystematic searches were conducted in MEDLINE, EMBASE and International Pharmaceutical Abstracts (IPA) databases from 1980 to March 2016.ResultsKey elements of community pharmacy triage were identified in 37 studies, which were included in the review. When a guideline or protocol was used, accuracy in identifying the presenting condition was high, with concordance rates ranging from 70 % to 97.6 % between the pharmacist and a medical expert. However, when guidelines and protocols were not used, often questioning was deemed insufficient. Where other health professionals had reviewed decisions made by pharmacists and their staff, e.g. around advice and referral, the decisions were considered to be appropriate in the majority of cases. Authors of the included studies provided recommendations for improving these services, including use of guidelines/protocols, education and staff training, documentation, improving communication between health professional groups and consideration of privacy and confidentiality.ConclusionWhilst few studies had specifically trialled triage services, results from this review indicate that a CPTS is feasible and appropriate, and has the potential to reduce the burden on other healthcare services. Questions still remain on issues such as ensuring the consistency of the service, whether all pharmacies could provide this service and who will fund the service.

2 Objective 3To review the effects of pharmaceutical care on hospitalizations, mortality and clinical outcomes in 4 patients. 5 Methods 6Systematic searches were conducted in MEDLINE, EMBASE and International Pharmaceutical Abstracts 7 (IPA) databases to identify studies that were published between 2004 and January 2017. Studies 8 included in this review were randomized controlled trials (RCTs) that spanned across both community and 9 hospital settings. Using strict inclusion/exclusion criteria studies were included if they reported level 1 or 2 10 outcomes in the hierarchy of outcome measure i.e. clinical and surrogate outcomes (e.g. blood pressure 11(BP) control, blood glucose level, cholesterol BMI). Each study was assessed for quality using the Jadad 12 scoring system. 13 Results 14Fifty-four RCTs were included in the present review. Forty-six of these studies ranked high quality 15 according to the Jadad scoring system. Studies were categorized into their general condition groups. 16Interventions in patients with diabetes, depression, respiratory disorders, cardiovascular disorders, 17 epilepsy, osteoporosis, and interventions in older adults were identified. In the majority of studies

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Sustained lidocaine release via a thermoresponsive poloxamer-based in situ gelling system has the potential to alleviate pain following knee arthroplasty. A previously developed formulation showed a promising drug release profile in synthetic phosphate-buffered saline (PBS). To support the translation of this formulation, ex vivo characterisation was warranted. This study therefore aimed (1) to modify the previously developed formulation to reduce the burst release, (2) to compare the release behaviour into ex vivo human intra-articular fluid (IAF) and PBS and (3) to determine the formulation spread in an ex vivo human knee using magnetic resonance imaging (MRI). All formulations provided sustained release out to 72 h; polyvinyl pyrrolidone was the most effective additive yielding a small yet significant decrease (p < 0.05) in the burst release. Release of lidocaine from the formulation occurred significantly faster into IAF compared to PBS (1.4 times greater release in the first 24 h), correlating with faster rates of gel erosion in IAF. Injection was easily achieved through a 21-gauge (G) needle into the synovial space of a human cadaveric knee, and MRI scans revealed effective spreading of the formulation throughout the joint cavity. The pattern of spread is promising for the drug to reach the widespread nerve endings in the joint capsule; the effect of this spread on release in an in vivo setting will be the subject of future studies. The demonstrated properties indicate that the in situ gelling formulation has the potential to be used clinically to treat post-operative pain following knee arthroplasty.

Objectives: The role of the pharmacist has evolved and continues to evolve. The traditional role of the dispenser has been replaced with a patient-centered profession. This requires integration and application of pharmaceutical knowledge and skills to solve patient therapeutic problems and advance patient care. Therefore, having evidence-based teaching strategies for learning within pharmaceutical sciences is essential. New and maturing technologies enable traditional principles of pharmaceutical science to be visualized. We aimed to explore pharmacy students' performance before and after visual aids for learning are integrated within pharmaceutical science teaching. Student's opinions and views of the visual aids were determined.Methods: Students were taught about selected pharmaceutical science concepts at two time points; during the second teaching point, visual aids were introduced. Students' performance was compared before and after the implementation of visual aids using pre and post-quizzes. Alongside the post-quiz an evaluation was also completed by the students; a descriptive analysis was conducted for the Likert-type responses and an in-depth thematic analysis of the student's free-text questions was completed using an iterative process.Results: Significant differences were seen between pre and post-quiz sessions for total score and questions that mapped to the revised-Bloom's taxonomy lower and higher categories. Student evaluation of the visual aids were positive. Interesting themes and subthemes emerged regarding the perspectives of pharmacy students to these visual aids. Students indicated visual aids made it easier to understand, compared to written or verbal explanations, and helped with the application of pharmaceutical science concepts. However, a minority of students reported that the visual aids were irrelevant, or they did not understand them.Conclusion: Students had better performance after the introduction of, and favorable responses to, the visual aids. Visual aids were a beneficial tool in regards to understanding and application of complex concepts. Improvements can be made; tailoring accompanying descriptions and using more repetition.

The use of economic evaluation studies in G.C.C was limited. Different factors that affect the quality of articles such as performing a full economic evaluation and choosing societal perspective were identified. Strategies to improve the quality of future studies were recommended.