Substandard and falsified medicines: global and local efforts to address a growing problemSubscription
Substandard and falsified medicines pose a risk to public health all around the world.
Antidepressants in the treatment of major depression: a changing landscape for clinical decision makingSubscription
With publication of the update to the National Institute of Health and Care Excellence depression guideline postponed until late 2019, this article aims to examine the findings of the Cipriani et al. meta-analysis in the wider context of the management of depression in the UK.
What could UK pharmacy teams learn about suicide prevention from North America?Subscription
From the perspective of their clinical and holistic role, and restriction of access to means, there are opportunities to involve pharmacy teams in suicide prevention. This article examines the published evidence-base and the success of ongoing programmes and initiatives in the United States and Canada to produce a set of recommendations for the benefit of UK practice on the opportunities community pharmacy teams have to raise awareness and help prevent suicide and self-harm.
Impact of an integrated pharmacy service on hospital admission costsSubscription
Northumberland was chosen as one of the national vanguard sites in early 2015, in response to the Five year forward view initiative. This article describes the evolution of the integrated pharmacy service, which now operates across organisational boundaries and in collaboration with other healthcare professionals, as well as the improvements in patient care, harm reduction and increased efficiencies achieved using a sustainable model of care.
The implications of the Montgomery judgment on pharmacy practice and patients with learning disabilitySubscription
The judgment in Montgomery v Lanarkshire (Scotland) 2015 introduced a new definition of informed consent which has implications for all healthcare professionals. This article focuses specifically on the implications for pharmacy practice and patients with learning disability. During consultations, both pharmacist prescribers and non-prescribing pharmacists must adhere to the provisions of the judgment to ensure patients provide informed consent. Particular issues arise where patients ...
Demonstrating the patient benefit and value for the NHS of community pharmacy: insight from the Community Pharmacy Future modelSubscription
In the face of funding and efficiency cuts to community pharmacy, the role of the sector is coming under increasing pressure. The importance of outcomes evidence (particularly health economic evidence) is being brought sharply into focus. The profession must come together to produce the evidence needed to justify the services provided by community pharmacy and to support its future development. This article uses the Community Pharmacy Future (CPF) project, and the services developed ...
A new way to look at acute cough in the pharmacySubscription
Cough is the most common symptom for which people seek medical advice, and patients with cough frequently present to community pharmacy. Cough can be either acute or chronic. Acute cough, defined as being of less than three weeks’ duration, is often caused by viral respiratory tract infection and is probably one of the most common reasons for accessing healthcare in the community. For these infections, no antiviral treatment exists and antibiotics have been shown to be ineffective in ...
The impact of the human papillomavirus vaccine in Scotland: a changing landscapeSubscription
In the UK, cervical cancer is the second most common cancer in women aged under 35 years. Human papillomavirus (HPV) types 16 and 18 (both high risk) are necessary precipitants in at least 70% of cervical cancers but may contribute to more than 80% of cervical cancers in Scotland. Both the prophylactic bivalent (Cervarix; GlaxoSmithKline) and quadrivalent (Gardasil; Merck) vaccines prevent infection with HPV types 16 and 18, and have been shown to induce avid and sustained neutralising ...
Examining the emerging roles for pharmacists as part of the urgent, acute and emergency care workforceSubscription
In the future urgent, acute and emergency medicine clinical workforce, new models of care and care delivery need to be developed, in order to maintain and enhance standards of safe and accessible patient care. A departure from traditional (doctor-led) approaches to workforce planning, and an understanding of scope and governance surrounding emerging clinical roles is necessary to develop a sustainable, multi-skilled workforce across primary, community and secondary care. Today’s ...
Pre-exposure prophylaxis should be a key component of a comprehensive HIV prevention package fully funded on the NHSSubscription
Pre-exposure prophylaxis (PrEP) is the medication taken by HIV-negative individuals to reduce their risk of contracting HIV infection. The large evidence base for the use of PrEP has been reviewed and recommended by the World Health Organization (WHO), a specialised agency of the United Nations that is concerned with international public health, the Joint United Nations Programme on HIV and AIDS (UNAIDS) and the National Institute for Health and Care Excellence (NICE), England’s health ...
Improving long-term adjuvant anti-oestrogenic therapy for breast cancerSubscription
Long-term (five years) adjuvant tamoxifen treatment for oestrogen receptor-positive, or ER-positive, breast cancer post-surgery is recognised as a major advance in healthcare. Clinical trials comparing standard and extended tamoxifen therapy found a major decrease in mortality occurred in the ten years following a decade of adjuvant therapy. Studies in premenopausal breast cancer patients showed that ovarian function suppression (OFS) plus an aromatase inhibitor (AI), ...
E-cigarettes in smoking cessation: a harm reduction perspectiveSubscription
Electronic cigarettes (e-cigarettes) are novel devices that simulate aspects of cigarette smoking and deliver nicotine to users. Evidence for their efficacy in smoking cessation, based on several randomised controlled trials of older devices, suggests a modest effect. They appear to be far less harmful than tobacco smoking, but the health effects of long-term use are unknown. Possible adverse population effects of widespread e-cigarette use, such as renormalising smoking ...
Carbapenems have stood the test of time so far but resistance is emergingSubscription
Jenny Bryan takes a look at the discovery of carbapenem antibiotics and their role as the last line of defence against drug-resistant Gram-negative bacteria.
Involving patients and the public in the delivery of pharmacy educationSubscription
Gordon Becket and colleagues explain how pharmacy students at the University of Central Lancashire benefited from speaking directly to patients about their medical conditions
It may not be perfect, but the influenza vaccine has saved many people’s lives Subscription
Vaccination has helped reduced the spread of seasonal and pandemic influenza in the UK for over 50 years. Jenny Bryan takes a look at the history of the flu vaccine
How filgrastim has helped control neutropenia and prevent sepsisSubscription
How the granulocyte colony-stimulating factor filgrastim has become part of the staple diet of chemotherapy
Pharmacists offer a clinical service to vulnerable care home residentsSubscription
NICE advice about medicines in care homes was due to be published as The Journal went to press. Debbie Andalo looks at how pharmacists currently support residents
