ObjectiveThis study aimed to investigate the prevalence, disclosure and adverse effects of complementary and alternative medicine (CAM) use in hospitalised patients, and to explore the associations between patients' perceived side-effects and relevant factors.MethodsPatients who were admitted to a district general hospital and met the eligibility criteria were interviewed using a semi-structured questionnaire. Their medications and pertinent details were verified from the medical notes. All quantitative and qualitative data were collated and analysed. A chi-squared test was performed to test the associations of the perceived CAM side-effects with the significance level determined at α=0.05.ResultsA total of 240 in-patients completed the study. They were mostly white British (98.8%). The prevalence of CAM use within two years was 74.6% and one month 37.9%. Only 19 of 91 patients (20.9%) using CAM within one month disclosed their current CAM applications. Nearly half of patients (45.8%) who used CAM within two years experienced various CAM side-effects that tended to resolve after discontinuation. Slightly more than half (57.6%) perceived CAM side-effects and their perceptions were significantly associated with gender (P=0.048) and consideration for future CAM use (P=0.033). Potential interactions between herbal remedies/dietary supplements and prescribed drugs, such as garlic with lisinopril or aspirin, were assessed in 82 patients (45.8%).ConclusionsMost in-patients used CAM and experienced some adverse effects. The disclosure of CAM use and its adverse outcomes should be encouraged by healthcare professionals.

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ObjectivesTo evaluate the effectiveness of a pharmacist-led educational intervention to reduce the use of high-risk abbreviations (HRAs) by healthcare professionals.DesignQuasi-experimental study consisting of a single group before-and-after study design.SettingA public emergency hospital in Mecca, Saudi Arabia.Participants660 (preintervention) and then 498 (postintervention) handwritten physician orders, medication administration records (MRAs) and pharmacy dispensing sheets of 482 and 388 patients, respectively, from emergency wards, inpatient settings and the pharmacy department were reviewed.InterventionThe intervention consisted of a series of interactive lectures delivered by an experienced clinical pharmacist to all hospital staff members and dissemination of educational tools (flash cards, printed list of HRAs, awareness posters) designed in line with the recommendations of the Institute for Safe Medical Practices and the US Food and Drug Administration. The duration of intervention was from April to May 2011.Main outcomeReduction in the incidence of HRAs use from the preintervention to postintervention study period.FindingsThe five most common abbreviations recorded prior to the interventions were ‘IJ for injection’ (28.6%), ‘SC for subcutaneous’ (17.4%), drug name and dose running together (9.7%), ‘OD for once daily’ (5.8%) and ‘D/C for discharge’ (4.3%). The incidence of the use of HRAs was highest in discharge prescriptions and dispensing records (72.7%) followed by prescriptions from in-patient wards (47.3%). After the intervention, the overall incidence of HRA was significantly reduced by 52% (ie, 53.6% vs 25.5%; p=0.001). In addition, there was a statistically significant reduction in the incidence of HRAs across all three settings: the pharmacy department (72.7% vs 39.3%), inpatient settings (47.3% vs 23.3%) and emergency wards (40.9% vs 10.7%).ConclusionsPharmacist-led educational interventions can significantly reduce the use of HRAs by healthcare providers. Future research should investigate the long-term effectiveness of such educational interventions through a randomised controlled trial.

Objectives Herbal and dietary supplements (HDS) can cause adverse effects or interact with diseases and medications. Community pharmacists have a role in ensuring the safe use of HDS, but they have been reported to not being proactive in providing pharmacist care (PCare) for HDS users. The reasons for this warranted investigation. The study aimed to explore pharmacists’ understanding of PCare for HDS users, and to investigate the underlying beliefs or factors influencing its provision by community pharmacists, guided by the theory of planned behaviour. Methods A qualitative study using a semi‐structured interview guide was conducted in a purposive sample of community pharmacists working in Bangkok, Thailand, from December 2016 to June 2017. All interviews were audio‐recorded, transcribed and analysed using qualitative content analysis. Key findings Twenty‐two pharmacists were interviewed. Several professional pharmacy activities were regarded as PCare for HDS users. The pharmacists reported that the provision of such care was advantageous in terms of promoting rational use of HDS, ensuring safety of users, enhancing own knowledge and promote customers’ loyalty. Facilitators for PCare included the initiation of conversation about HDS by the users, professional training and the availability of reference materials. The reluctance of HDS users to accept pharmacists’ opinions, insufficient education in HDS and limited sources of information were identified as barriers. Most pharmacists believed that PCare for HDS users is part of their responsibilities. Conclusions The pharmacists expressed their views on the meaning of PCare for HDS users, and described the beliefs and factors that facilitate or impede its provision. Information from this study can be used to inform strategies that can promote pharmacists to become more proactive in providing PCare for HDS users.

The review provides the overview of research philosophy and its application in pharmacy practice research. Further discussion on this vital issue is warranted to help generate quality evidence for pharmacy practice.

Objectives:This study aimed to investigate the prevalence and perceived outcomes of complementary and alternative medicine (CAM) use in secondary care patients and to find out determinants for CAM utilization and perceived effectiveness and side-effects. Materials and Methods: Patients who met the eligibility criteria in this cross-sectional study were interviewed using a semi-structured questionnaire. Patients' medications and relevant details were verified from the medical notes. A logistic regression analysis was performed and the significance level set at α = 0.05. Results: A total of 240 in-patients were interviewed. The prevalence of CAM use during admission, within 1 month, within 1 year, and at some point in life was 90.4%, 68.8%, 37.9%, and 8.3%, respectively. Diverse reasons for CAM use or non-use were cited. Nearly two-thirds of patients (63.1%) perceived CAM effectiveness and approximately half (57.6%) were aware of its side-effects. The determinants for CAM use at some point in life and perceived effectiveness could be predicted approximately 20% by two models: Logit P use = 3.404 − 1.044 × Educ + 1.314 × Ward − 1.539 × Consider and Logit P eff = 3.244-0.995 × Gender-0.025 × Age − 1.503 × Consider. Conclusion: Patients decided to use CAM for various reasons and perceived different outcomes. The specific CAM use and its outcomes warrant further studies.

Background:Little is known about health-related quality of life (HRQoL) of Thai patients after heart surgery. The Thai government initiated a cardiac surgery project to celebrate the 80 th birthday anniversary of His Majesty The King. Objectives: To evaluate the HRQoL of Thai patients after heart surgery, as part of the Thai government's cardiac surgery project, and to investigate the association of HRQoL instruments and patient characteristics. Methods: Of 7,863 patients in the project, 386 were randomly selected for a telephone interview by trained researchers during June-November 2008. The HRQoL of Thai patients was measured using 12-item Short Form version 2 and EuroQoL (EQ-5D) plus an EQ-5D visual analog scale (EQ-VAS). Results: The mean age of patient participants was 50.4 ± 13.7 years (range 17−82) and 49.5% were male. The Physical Component Summary (PCS) and Mental Component Summary (MCS) scores were reported as 46.91 and 54.44, respectively, compared with the US norm scores of 50. The EQ-5D and EQ-VAS utility scores of 0.81 and 0.84 were comparable to those of Thai general population (0.77−0.84), but higher than those of Thai patients with heart disease (0.73−0.75). Patients with older age, female sex, unemployment, and presence of comorbidity rated a lower HRQoL. The multiple linear regression models showed that both EQ-5D and EQ-VAS were associated with PCS and MCS and could be predicted by 40%-50%. Conclusion: Overall, the HRQoL of patients after the heart surgery was satisfactory. The QoL in patients with a specific types of heart surgery warrants further study.

The SMP provided by the health care settings is marginally cost-effective, and the persistence results support the implementation of the program to minimize the complications and economic burden of patients with MetS.