Alienation and/or anomie in pharmacists: A systematic review and narrative synthesis of the international literature.

Background: Flourishing and belonging are key concepts for the wellbeing of staff and the success of a profession. Alienation and anomie are distinct types of psycho-social ills which inhibit flourishing and belonging. A better understanding of these may offer hope in preventing many negative work endpoints, including burnout and intention to leave.

Alienation and/or anomie in pharmacists: a protocol for a narrative systematic review.

Introduction: Episodes of alienation and/or anomie in pharmacists have been reported in historical accounts since the 19th century. Alienation and anomie are distinct types of psychological or social ills where people are problematically separated from, or their skills and values are misaligned with, others and their environment. Alienation and/or anomie can be important precursors of many negative work experiences, including job dissatisfaction, burnout and/or intention to leave.

A Pharmacist Clinician Model as part of a collaborative clinical workforce: A philosophical critique.

The term 'clinician' is not reserved for any healthcare professional group. However, there is a general acceptance that a clinician would have the knowledge, skills and behaviours to enable them to clinically assess and manage a patient autonomously. The expectation, in a modern collaborative healthcare system, is that this work would be completed as a part of a planned and integrated multi-disciplinary care delivery structure, where any given clinician delivers a devolved element of that patient's care.

Patterns of initial and first-intensifying antidiabetic drug utilization among patients with type 2 diabetes mellitus in Scotland, 2010-2020: A retrospective population-based cohort study.

Aim: To evaluate the utilization and prescribing patterns of antidiabetic drugs (ADDs) for patients with type 2 diabetes mellitus (T2DM) at treatment initiation and first intensification.

Methods: A retrospective cohort study was performed using linked routinely collected data of patients with T2DM who received ADDs between January 2010 and December 2020 in Scotland. The prescribing patterns were quantified using frequency/percentages, absolute/relative change, and trend tests.

A qualitative exploration of chronic pain management of older adults in remote and rural settings.

Background: The World Health Organization predicts that the number of older adults will nearly double between 2015 and 2050. Older adults are at a higher risk of developing medical conditions such as chronic pain. However, there is little information about chronic pain and its management in older adults especially those residing in remote and rural areas.

Meta-analysis of factors associated with antidiabetic drug prescribing for type 2 diabetes mellitus.

Background: There is a lack of consensus on prescribing alternatives to initial metformin therapy and intensification therapy for type 2 diabetes mellitus (T2DM) management. This review aimed to identify/quantify factors associated with prescribing of specific antidiabetic drug classes for T2DM.

Methods: Five databases (Medline/PubMed, Embase, Scopus, Web of Science) were searched using the synonyms of each concept (patients with T2DM, antidiabetic drugs and factors influencing prescribing) in both free text and Medical Subject Heading (MeSH) forms.

General practice pharmacists' implementation of advanced clinical assessment skills: a qualitative study of behavioural determinants.

Background: The role of General Practice Clinical Pharmacists is becoming more clinically complex. Some are undertaking courses to develop their skillsets.

Aim: To explore potential behavioural determinants influencing the implementation of skills gained from Advanced Clinical Examination and Assessment courses by General Practice Clinical Pharmacists.

The Collaborative Care Model: Realizing healthcare values and increasing responsiveness in the pharmacy workforce.

Healthcare values are fairly ubiquitous across the globe, focusing on caring and respect, patient health, excellence in care delivery, and multi-stakeholder collaboration. Many individual pharmacists embrace these core values. However, their ability to honor these values is significantly determined by the nature of the system in which they work.

General practice-based undergraduate pharmacy longitudinal clerkship: a theoretically underpinned qualitative evaluation.

Background: A Pharmacy Longitudinal Clerkship (PLC) was designed to develop student pharmacists' (SPs) competence in a general practice setting.

Aim: The aim was to carry out a theoretically underpinned qualitative evaluation of stakeholder perceptions of influences of behavioural determinants on SP development for clinical practice in general practice.

Method: General practice-based PLCs were delivered in 2019/20 and 2020/21 for two cohorts of SPs in NHS Highland, Scotland.

Using the theoretical domains framework to explore behavioural determinants for medication taking in patients following percutaneous coronary intervention.

Objectives: To investigate relationships between factors influencing medication taking and behavioural determinants in patients who have undergone percutaneous coronary intervention (PCI).

Methods: A cross-sectional survey using a postal questionnaire distributed to PCI patients. The questionnaire was iteratively developed by the research team with reference to the theoretical domains framework (TDF) of behavioural determinants, reviewed for face and content validity and piloted.

Acetylcysteine has No Mechanistic Effect in Patients at Risk of Contrast-Induced Nephropathy: A Failure of Academic Clinical Science.

Contrast-induced nephropathy (CIN) is a major complication of imaging in patients with chronic kidney disease (CKD). The publication of an academic randomized controlled trial (RCT; n = 83) reporting oral (N)-acetylcysteine (NAC) to reduce CIN led to > 70 clinical trials, 23 systematic reviews, and 2 large RCTs showing no benefit. However, no mechanistic studies were conducted to determine how NAC might work; proposed mechanisms included renal artery vasodilatation and antioxidant boosting.

Pharmacy and medical student interprofessional education placement week.

Background: Developing collaborative practice through interprofessional education (IPE) activities in undergraduate healthcare curricula is advocated by the World Health Organisation and the regulatory bodies for Medicine and Pharmacy within the UK.

Approach: Our local faculty, comprising educators from within the Highland Pharmacy Education and Research Centre (HPERC) and Highland Medical Education Centre (HMEC), developed a 5-day IPE placement for pharmacy and medical students on clinical placement within NHS Highland.

Evaluation: We collected qualitative evaluation data using face-to-face focus group discussions with five pharmacy and four medical students (January 2020 cohort).

An innovative General Practice based Pharmacy Longitudinal Clerkship: using theory to characterise its development, implementation and initial evaluation.

Background: Longitudinal Integrated Clerkships exist in undergraduate medicine courses. A pilot Pharmacy Longitudinal Clerkship (pPLC) was funded to investigate delivery of this model of clinical education for student pharmacists.

Objective(s): To investigate the development, implementation and initial evaluation of a pPLC.

Development of innovative simulation teaching for advanced general practice clinical pharmacists.

Background: Advanced General Practice Clinical Pharmacists (GPCPs) are expected to manage patients by undertaking clinical assessment then make safe, competent autonomous decisions. Simulation provides a safe learning environment to develop clinical skills, but is rarely used for postgraduate pharmacist development.

Aim: Design and deliver innovative simulation teaching to support Advanced GPCPs in Scotland.

Advanced pharmacist practice: where is the United Kingdom in pursuit of this 'Brave New World'?

Pharmacy has developed many novel patient-facing roles across the globe, typically delivered through the lens of pharmaceutical care. The macro-level implementation of such interventions is, however, fraught with difficulty. At an individual-level, psychological barriers of pharmacists and their ability to deliver autonomous complex clinical care are key considerations.

External Loop Recorders: Primary Care Placement Is Noninferior to Hospital-Based Cardiac Unit.

External loop recorders (ELRs) are recommended for the investigation of syncope and palpitations. This study aimed to compare rates of arrhythmia detection between primary care (PC) and hospital-based cardiac unit (HBCU) fitted ELRs. Data were captured from January to December 2015.

Prescribers' perceptions of benefits and limitations of direct acting oral anticoagulants in non-valvular atrial fibrillation.

Background: There is an acknowledged lack of robust and rigorous research focusing on the perspectives of those prescribing direct acting oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF).

Objective: The objective was to describe prescribers' experiences of using DOACs in the management of non-valvular AF, including perceptions of benefits and limitations.

Methods: A cross-sectional survey of prescribers in a remote and rural area of Scotland.

Longitudinal evaluation of the effects of illness perceptions and beliefs about cardiac rehabilitation on quality of life of patients with coronary artery disease and their caregivers.

Background: Patients' negative illness perceptions and beliefs about cardiac rehabilitation (CR) can influence uptake and adherence to CR. Little is known about the interpartner influence of these antecedent variables on quality of life of patients with coronary artery disease (CAD) and their family caregivers. The aims of the study were: 1) to assess differences in illness perceptions, beliefs about CR and quality of life between patients with CAD and their family caregivers upon entry to a CR programme and at 6 months follow-up; and 2) to examine whether patients' and caregivers' perceptions of the patient's illness and beliefs about CR at baseline predict their own and their partner's quality of life at 6 months.

Longitudinal study of the relationship between patients' medication adherence and quality of life outcomes and illness perceptions and beliefs about cardiac rehabilitation.

Background: Adherence to medication regimens is essential for preventing and reducing adverse outcomes among patients with coronary artery disease (CAD). Greater understanding of the relation between negative illness perceptions, beliefs about cardiac rehabilitation (CR) and medication adherence may help inform future approaches to improving medication adherence and quality of life (QoL) outcomes. The aims of the study are: 1) to compare changes in illness perceptions, beliefs about CR, medication adherence and QoL on entry to a CR programme and 6 months later; 2) to examine associations between patients' illness perceptions and beliefs about CR at baseline and medication adherence and QoL at 6 months.

A cross-sectional survey of the perspectives of older people in the Scottish Highlands on the management of their chronic pain.

Background: Although there is evidence of suboptimal outcomes in older people with chronic pain, little emphasis has been placed on those in remote and rural settings.

Objective: To describe the perspectives of older people in the Scottish Highlands on their chronic pain management.

Design: Cross-sectional survey.

Emerging Role of Myeloid-derived Suppressor Cells in the Biology of Transplantation Tolerance.

Myeloid-derived suppressor cells (MDSCs), a heterogeneous population of myeloid cells, are characterized by their immunosuppressive abilities through the secretion of various cytokines such as inducible nitric oxide synthase, nitric oxide, reactive oxygen species, transforming growth factor-β, and arginase-1. Accumulating evidence highlights its potential role in maintaining immune tolerance in solid organ and hematopoietic stem cell transplantation. Mechanistically, MDSCs-induced transplant tolerance is mainly dependent on direct suppression of allogeneic reaction or strengthened cross-talk between MDSCs and Treg or NKT cells.

An evaluation of mental health clinical pharmacist independent prescribers within general practice in remote and rural Scotland.

Background A 12-month pilot was implemented in two general practices in remote and rural Scotland, with patients referred by general practitioners to specialist mental health pharmacist independent prescribers. Objective The objective was to evaluate the pilot service from the perspectives of the patients and the care team. Methods The pharmacists routinely recorded patient-specific data of all clinical issues and their actions at the time of each consultation.

Prescribers' views and experiences of using direct acting oral anticoagulants in the management of nonvalvular atrial fibrillation: A survey in remote and rural Scotland.

Aims: A recent systematic review highlighted the lack of robust studies on prescribers' perspectives of direct-acting oral anticoagulants (DOACs) for nonvalvular atrial fibrillation. The aim was to determine prescribers' views and experiences of prescribing DOACs.

Methods: A cross-sectional survey of prescribers in a remote and rural area of Scotland.

A theoretically informed survey of the views and experiences of practicing pharmacists on research conduct, dissemination and translation.

Background: While studies have reported pharmacists' perspectives of research involvement, almost all are limited by sector, have little focus on research translation and have not incorporated behavior change theory.

Objective: To determine pharmacists' views and experiences of research conduct, dissemination and translation.

Methods: This was an electronic cross-sectional survey of pharmacists across six Scottish health board areas.

Comparing ST-segment elevation myocardial infarction care between patients residing in central and remote locations: a retrospective case series.

Introduction: People who experience an ST-elevation myocardial infarction (STEMI) due to an occluded coronary artery require prompt treatment. Treatments to open a blocked artery are called reperfusion therapies (RTs) and can include intravenous pharmacological thrombolysis (TL) or primary percutaneous coronary intervention (pPCI) in a cardiac catheterisation laboratory (cath lab). Optimal RT (ORT) with pPCI or TL reduces morbidity and mortality.