Pilot and quantitative evaluation of the TARGET acne toolkit by UK pharmacy professionals working in general practice.

Background: Acne vulgaris (acne) is a common skin condition sometimes needing topical or oral antibiotic treatment. Pharmacists and pharmacy technicians (together known as pharmacy professionals) working in general practice are well placed to ensure their appropriate use.

Objectives: The objectives of this study are to pilot an evidence-based intervention ('How to…' tool) to review treatments in the management of acne and evaluate the capability, opportunity, motivation and behaviour (COM-B) of pharmacy professionals working in general practice before and after the use of this tool.

Perspectives of community pharmacy staff on commonly encountered skin conditions and the key challenges towards enhancing their role in dermatology.

This research letter discusses the perspectives of community pharmacy staff on commonly encountered skin conditions and the key challenges towards enhancing their role in this area. A mixed methods online survey was created, and a total of 174 community pharmacy staff completed the survey. The results highlight the range of conditions currently encountered in community pharmacy and the breadth of challenges facing community pharmacy staff, in particular challenges surrounding providing a differential diagnosis.

How can community pharmacists be supported to manage skin conditions? A multistage stakeholder research prioritisation exercise.

Objective: To establish research priorities which will support the development and delivery of community pharmacy initiatives for the management of skin conditions.

Design: An iterative, multistage stakeholder consultation consisting of online survey, participant workshops and prioritisation meeting.

Setting: All data collection took place online with participants completing a survey (delivered via the JISC Online Survey platform, between July 2021 and January 2022) and participating in online workshops and meetings (hosted on Microsoft Teams between April and July 2022).

Perceived current and future roles of UK-based community pharmacy professionals in the long-term management of acne.

Introduction: Acne is a common skin condition treated in community pharmacy but moderate to severe cases may need referral to general practice for treatment that may include topical or oral antimicrobial treatments. Pharmacy teams working in the community are well-placed to manage acne treatments in line with NICE guidance.

Objectives: To explore the perceived current and future roles of community pharmacy (CP) teams alongside needs to achieve potential future roles.

Scaling-up a pharmacist-led information technology intervention (PINCER) to reduce hazardous prescribing in general practices: Multiple interrupted time series study.

Background: We previously reported on a randomised trial demonstrating the effectiveness and cost-effectiveness of a pharmacist-led information technology intervention (PINCER). We sought to investigate whether PINCER was effective in reducing hazardous prescribing when rolled out at scale in UK general practices.

Methods And Findings: We used a multiple interrupted time series design whereby successive groups of general practices received the PINCER intervention between September 2015 and April 2017.

The potential of multispectral imaging flow cytometry for environmental monitoring.

Environmental monitoring involves the quantification of microscopic cells and particles such as algae, plant cells, pollen, or fungal spores. Traditional methods using conventional microscopy require expert knowledge, are time-intensive and not well-suited for automated high throughput. Multispectral imaging flow cytometry (MIFC) allows measurement of up to 5000 particles per second from a fluid suspension and can simultaneously capture up to 12 images of every single particle for brightfield and different spectral ranges, with up to 60x magnification.

An ethnographic evaluation of a speciality training pathway for general practice nursing in the UK.

Aims: The aim of the study was to evaluate the implementation and impact of the General Practice Nurse - Specialty Training (GPN-ST) programme across seven sites in one geographical location in the UK. The objectives were to understand, describe and evaluate: 1) the implementation of the 'proof of concept' training scheme; 2) the learning undertaken during the training; and 3) the impact of the training scheme on individual nurses. These objectives offer the opportunity to describe the potential return on investment for General Practices supporting nurses new to General Practice through the programme.

Astropharmacy: Pushing the boundaries of the pharmacists' role for sustainable space exploration.

Background: Human physiology undergoes extensive changes in space potentially leading to alterations in the way a medication functions. Understanding the efficacy behind Pharmacological Countermeasures (PCMs) and deliverable pharmacy services is imperative for the future presence of humans in space. However, while the pharmacist plays an integral role for human health terrestrially, pharmacist input has been minimal for human health in the space sector.

Perspectives of pharmacists in general practice from qualitative focus groups with patients during a pilot study.

Background: Utilising skill mix in general practice is proposed as a solution to the demand-supply issue. Pharmacists can play an important role in this context, leading to an increase in training and funding for independent prescriber roles. A role for pharmacists in general practice was funded, piloted, and evaluated by NHS England (NHSE) from 2015.

The role of clinical pharmacists in general practice in England: Impact, perspectives, barriers and facilitators.

Background: By 2020/1 NHS England plans to invest over 100 m to ensure that there is one clinical pharmacist post in primary care for every 30,000 patients. A recent realist review identified key questions in the literature related to the implementation of a clinical pharmacist (CP) in a general practice role. These relate to the impact of the role, perspectives on the role (patients, GPs and pharmacists), and barriers and facilitators to the implementation process.

Incidence, nature and causes of avoidable significant harm in primary care in England: retrospective case note review.

Objective: To estimate the incidence of avoidable significant harm in primary care in England; describe and classify the associated patient safety incidents and generate suggestions to mitigate risks of ameliorable factors contributing to the incidents.

Design: Retrospective case note review. Patients with significant health problems were identified and clinical judgements were made on avoidability and severity of harm.

Validation analysis of Global Health Security Index (GHSI) scores 2019.

Introduction: The COVID-19 pandemic powerfully demonstrates the consequences of biothreats. Countries will want to know how to better prepare for future events. The Global Health Security Index (GHSI) is a broad, independent assessment of 195 countries' preparedness for biothreats that may aid this endeavour.

Exploring barriers to the sustainability of an electronic administration system in long-term care facilities: A case study approach.

Background: The safe provision of medicines administration is a fundamental challenge faced in long-term care facilities (LTCFs). Many residents of LTCFs are frail older persons with multiple morbidities, and in addition to polypharmacy, are particularly at risk of harm due to concomitant disease and disability. One potential method to optimise medication safety and facilitate medicines administration within LTCFs is the introduction of technology.

'New Medicine Service': supporting adherence in people starting a new medication for a long-term condition: 26-week follow-up of a pragmatic randomised controlled trial.

Objective: To examine the effectiveness and cost-effectiveness of the community pharmacy New Medicine Service (NMS) at 26 weeks.

Methods: Pragmatic patient-level parallel randomised controlled trial in 46 English community pharmacies. 504 participants aged ≥14, identified in the pharmacy when presenting a prescription for a new medicine for predefined long-term conditions, randomised to receive NMS (n=251) or normal practice (n=253) (NMS intervention: 2 consultations 1 and 2 weeks after prescription presentation).

Identifying 'avoidable harm' in family practice: a RAND/UCLA Appropriateness Method consensus study.

Background: Health care-related harm is an internationally recognized threat to public health. The United Kingdom's national health services demonstrate that upwards of 90% of health care encounters can be delivered in ambulatory settings. Other countries are transitioning to more family practice-based health care systems, and efforts to understand avoidable harm in these settings is needed.

The role of pharmacists in general practice: A realist review.

Background: The review was carried out to inform the evaluation of the clinical pharmacists in general practice pilot scheme, a world leading initiative to improve health care delivery in England. Around 500 pharmacists are already working in general practice as part of the pilot, launched in July 2015.

Objectives: The review attempts to explain the how pharmacists working in general practice is being implemented in the UK and beyond, what works well, what does not work so well and everything in-between.

'I expected just to walk in, get my tablets and then walk out': on framing new community pharmacy services in the English healthcare system.

Reconfiguration of the healthcare division of labour is becoming increasingly attractive in the context of increased patient demand and resource constraints. One example is the introduction of extended roles for pharmacists to provide patients additional support to manage their medicines, while also reducing work pressures experienced by other health professionals. Understanding how such policies are framed by those delivering and receiving care has been under-theorised.

Differential degradation patterns of photovoltaic backsheets at the array level.

There are relatively few field studies on the degradation of non-fluoropolymer-based backsheets, and understanding their in-field behavior is critical for further development of such products. In this study, backsheet degradation of modules with one of these new types of backsheets (polyethylene naphthalate (PEN)-based) was documented at a four-year old utility-scale array located in Maryland (USA). Visual inspection, colorimetry, glossimetry, and Fourier-transform infrared spectroscopy (FTIR) revealed highly varied properties depending on module position within the array.

Comparative Performance and Model Agreement of Three Common Photovoltaic Array Configurations.

Three grid-connected monocrystalline silicon arrays on the National Institute of Standards and Technology (NIST) campus in Gaithersburg, MD have been instrumented and monitored for 1 yr, with only minimal gaps in the data sets. These arrays range from 73 kW to 271 kW, and all use the same module, but have different tilts, orientations, and configurations. One array is installed facing east and west over a parking lot, one in an open field, and one on a flat roof.

Impact of a novel interprofessional dental and pharmacy student tobacco cessation education programme on dental patient outcomes.

The dental setting presents a unique opportunity to assist patients with tobacco cessation. Many dental providers do not feel prepared to provide tobacco cessation, particularly with regard to education on pharmacological treatments. An interprofessional practice experience with dental and pharmacy students provides a novel approach to tobacco cessation in the dental setting, but it is not known whether such methods affect patient outcomes.

Cost Effectiveness of Support for People Starting a New Medication for a Long-Term Condition Through Community Pharmacies: An Economic Evaluation of the New Medicine Service (NMS) Compared with Normal Practice.

Background: The English community pharmacy New Medicine Service (NMS) significantly increases patient adherence to medicines, compared with normal practice. We examined the cost effectiveness of NMS compared with normal practice by combining adherence improvement and intervention costs with the effect of increased adherence on patient outcomes and healthcare costs.

Methods: We developed Markov models for diseases targeted by the NMS (hypertension, type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma and antiplatelet regimens) to assess the impact of patients' non-adherence.

High-Speed Monitoring of Multiple Grid-Connected Photovoltaic Array Configurations and Supplementary Weather Station.

Three grid-connected monocrystalline silicon photovoltaic arrays have been instrumented with research-grade sensors on the Gaithersburg, MD campus of the National Institute of Standards and Technology (NIST). These arrays range from 73 kW to 271 kW and have different tilts, orientations, and configurations. Irradiance, temperature, wind, and electrical measurements at the arrays are recorded, and images are taken of the arrays to monitor shading and capture any anomalies.