Education and Assessment of Pharmacists on the Use of the Drug Burden Index in Older Adults Using a Continuing Professional Development Education Method

Kouladjian, Lisa; Chen, Timothy; Gnjidic, Danijela; Hilmer, Sarah N.

doi:10.5688/ajpe80463

Cited by 12 publications

(9 citation statements)

References 39 publications

(38 reference statements)

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“…An example of alternate substrate inhibition is observed with paroxetine as its methoxy diene carbon moiety was found to be responsible for the formation of covalent bonds at the active site of CYP2D6 [21,22]. Another example of this type of inhibition was observed with clarithromycin when the nitrosoalkene intermediate generated by N-demethylation forms covalent bonds with the active site of CYP3A4 [23].…”

Section: Mechanism-based Inhibitionmentioning

confidence: 99%

Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice

et al. 2020

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In an ageing society, polypharmacy has become a major public health and economic issue. Overuse of medications, especially in patients with chronic diseases, carries major health risks. One common consequence of polypharmacy is the increased emergence of adverse drug events, mainly from drug–drug interactions. The majority of currently available drugs are metabolized by CYP450 enzymes. Interactions due to shared CYP450-mediated metabolic pathways for two or more drugs are frequent, especially through reversible or irreversible CYP450 inhibition. The magnitude of these interactions depends on several factors, including varying affinity and concentration of substrates, time delay between the administration of the drugs, and mechanisms of CYP450 inhibition. Various types of CYP450 inhibition (competitive, non-competitive, mechanism-based) have been observed clinically, and interactions of these types require a distinct clinical management strategy. This review focuses on mechanism-based inhibition, which occurs when a substrate forms a reactive intermediate, creating a stable enzyme–intermediate complex that irreversibly reduces enzyme activity. This type of inhibition can cause interactions with drugs such as omeprazole, paroxetine, macrolide antibiotics, or mirabegron. A good understanding of mechanism-based inhibition and proper clinical management is needed by clinicians when such drugs are prescribed. It is important to recognize mechanism-based inhibition since it cannot be prevented by separating the time of administration of the interacting drugs. Here, we provide a comprehensive overview of the different types of mechanism-based inhibition, along with illustrative examples of how mechanism-based inhibition might affect prescribing and clinical behaviors.

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Section: Mechanism-based Inhibitionmentioning

confidence: 99%

Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice

et al. 2020

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“…Given the importance of self‐medication in many allergic diseases and in iatrogenic disease, pharmacist interventions are well placed to maximize the benefits and minimize the adverse events associated with pharmacotherapy. This is particularly important in AR and asthma multimorbidity as well as in the elderly patients, a large number of whom present with allergic diseases in combination with other chronic diseases . Moreover, most AR medications are available over‐the‐counter (OTC) .…”

Section: Pharmacist Challenge In Allergic Rhinitismentioning

confidence: 99%

ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”

Bosnic‐Anticevich

Costa

Menditto

et al. 2019

Allergy

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Pharmacists are trusted health care professionals. Many patients use over‐the‐counter (OTC) medications and are seen by pharmacists who are the initial point of contact for allergic rhinitis management in most countries. The role of pharmacists in integrated care pathways (ICPs) for allergic diseases is important. This paper builds on existing studies and provides tools intended to help pharmacists provide optimal advice/interventions/strategies to patients with rhinitis. The Allergic Rhinitis and its Impact on Asthma (ARIA)‐pharmacy ICP includes a diagnostic questionnaire specifically focusing attention on key symptoms and markers of the disease, a systematic Diagnosis Guide (including differential diagnoses), and a simple flowchart with proposed treatment for rhinitis and asthma multimorbidity. Key prompts for referral within the ICP are included. The use of technology is critical to enhance the management of allergic rhinitis. However, the ARIA‐pharmacy ICP should be adapted to local healthcare environments/situations as regional (national) differences exist in pharmacy care.

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“…For example, passive interventions such as printed educational material are commonly used [ 11 ]. A study by Kouladjian et al [ 12 ] reported that journal articles are appropriate for educating pharmacists on estimating drug burden index, a measure of the total exposure to medications with anticholinergic and sedative properties. However, pharmacists may prefer more active interventions such as computer-based education [ 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the Effectiveness of the Computer-Based Education Platform, Pharmacy5in5, on Pharmacists’ Knowledge of Anticholinergic Toxicity Using a Randomized Controlled Trial

Hussein

Bareham

et al. 2022

Pharmacy

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Background: Computer-based education has been widely implemented in healthcare professional development education. However, there has been little examination of the potential for computer-based education to enhance pharmacists’ knowledge. This study aims to assess the effectiveness of computer-based education on improving pharmacists’ knowledge compared to printed education material. Methods: This study was a web-based randomized controlled trial. Participants were randomly allocated to either an intervention group where they had access to the computer-based education module on Pharmacy5in5.ca or to a control group where they had access to printed educational material. Knowledge gain was assessed using a pre- and post-knowledge test. Results: A total of 120 pharmacists were recruited and 101 completed the post-knowledge test (50/60 in the intervention group; 51/60 in the control group). Both groups showed a significant increase in knowledge gain (intervention group: pre-test mean score 19.35 ± 3.56, post-test mean score 22.42 ± 3.812, p value < 0.001; control group pre-test mean score 19.22 ± 3.45, post-test mean score 23.29 ± 3.087, p value < 0.001). However, the difference in knowledge change was not significant between the two groups (22.42 vs. 23.29, p value = 0.333). Conclusions: In this study, a computer-based education module enhanced pharmacists’ knowledge to a similar degree to printed education material. Efforts should be made to provide computer-based education as an option to support pharmacists’ professional development.

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Education and Assessment of Pharmacists on the Use of the Drug Burden Index in Older Adults Using a Continuing Professional Development Education Method

Cited by 12 publications

References 39 publications

Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice

Mechanisms of CYP450 Inhibition: Understanding Drug-Drug Interactions Due to Mechanism-Based Inhibition in Clinical Practice

ARIA pharmacy 2018 “Allergic rhinitis care pathways for community pharmacy”

Evaluating the Effectiveness of the Computer-Based Education Platform, Pharmacy5in5, on Pharmacists’ Knowledge of Anticholinergic Toxicity Using a Randomized Controlled Trial

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