Varenicline and Nicotine Replacement Therapy for Smokers Admitted to Hospitals: A Randomized Clinical Trial.

Importance: Varenicline is the most effective sole pharmacotherapy for smoking cessation. If used in combination with nicotine replacement therapy (NRT), cessation rates may be further improved, but the efficacy and safety of the combination need to be evaluated.

Objective: To examine whether hospitalized smokers treated with varenicline and NRT lozenges achieve higher prolonged smoking abstinence rates compared with those treated with varenicline alone.

Which smokers enroll in a hospital based smoking cessation trial? Survey of smoking related behaviors, quit attempts, and motivation to quit.

Background: Understanding smoking behaviors in hospital patients who smoke may improve inpatient cessation treatments. This study aimed to describe smoking-related behaviors, past-quit attempts, and self-reported difficulties experienced in quitting among those who enrolled in a smoking cessation trial of varenicline.

Methods: Baseline data were obtained from adult hospitalized smokers (average ≥ 10 cigarettes/day in 4-weeks prior to hospitalization) who enrolled in a randomized, placebo-controlled trial of varenicline ± nicotine lozenges at five Australian public hospitals.

Depression and anxiety prevalence in people with cystic fibrosis and their caregivers: a systematic review and meta-analysis.

Background: Prevalence of depression and anxiety in people with cystic fibrosis (PwCF) and their caregivers is high, however, results have been inconsistent. This systematic review and meta-analysis aimed to estimate the prevalence of depression and anxiety in PwCF and their caregivers and explore sources of heterogeneity.

Method: MEDLINE, EMBASE, CINAHL plus and PsychINFO databases were searched from inception to January 2021.

Developing a Global Community of Practice for Pharmacy Workforce Resilience-Meet GRiT.

Workforce resilience in pharmacy is required to ensure the practice, education, and administrative systems remain viable and sustainable over time and when facing challenges. Whether it is addressing burnout of pharmacists or students, or the structure and policies/procedures of employment and professional organizations, working to increase resilience across all individuals and sectors is essential to relieve pressure and promote better well-being, especially during the recent pandemic. The purpose of this article is to describe the development of a community of practice global group focused on development of resilience within the pharmacy workforce that is inclusive of students, pharmacy interns/preregistration and registered pharmacists.

Reducing Medical Admissions and Presentations Into Hospital through Optimising Medicines (REMAIN HOME): a stepped wedge, cluster randomised controlled trial.

Objective: To investigate whether integrating pharmacists into general practices reduces the number of unplanned re-admissions of patients recently discharged from hospital.

Design, Setting: Stepped wedge, cluster randomised trial in 14 general practices in southeast Queensland.

Participants: Adults discharged from one of seven study hospitals during the seven days preceding recruitment (22 May 2017 - 14 March 2018) and prescribed five or more long term medicines, or having a primary discharge diagnosis of congestive heart failure or exacerbation of chronic obstructive pulmonary disease.

Validation of a risk stratification tool for a Hospital Outreach Medication Review (HOMR) program.

Background: Early hospital readmissions are a challenging and costly experience for both patients and the healthcare service. Reducing hospital readmission rates is a priority for health services globally and this is evident with the establishment of multiple outpatient services to promote early follow-up and to initiate secondary preventative care measures. One such intervention has been the introduction of a pharmacist-led, Hospital Outreach Medication Review (HOMR) service.

Reducing Medical Admissions into Hospital through Optimising Medicines (REMAIN HOME) Study: protocol for a stepped-wedge, cluster-randomised trial.

Introduction: A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients.

Methods And Analysis: This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up.

An Advanced Pharmacy Practice Framework for Australia.

The need to develop (the "APPF") was identified during the 2010 review of the competency standards for Australian pharmacists. The Advanced Pharmacy Practice Framework Steering Committee, a collaborative profession-wide committee comprised of representatives of ten pharmacy organisations, examined and adapted existing advanced practice frameworks, all of which were found to have been based on the (the "CoDEG Framework") from the United Kingdom. Its competency standards were also found to align well with the Domains of the (the "National Framework").

Impact of a specialist clinical cancer pharmacist at a multidisciplinary lung cancer clinic.

Aim: Medication misadventure contributes to unplanned hospital admissions. General practitioners (GPs) may lack experience in managing problems involving complex cancer-related medication. A previous survey explored the unmet needs of lung cancer outpatients and highlighted their desire for more medication information.

A review of the evidence for occupational exposure risks to novel anticancer agents - A focus on monoclonal antibodies.

Introduction: Evidence of occupational exposure risks to novel anticancer agents is limited and yet to be formally evaluated from the Australian healthcare perspective.

Methods: From March to September 2013 medical databases, organizational policies, drug monographs, and the World Wide Web were searched for evidence relating to occupational exposure to monoclonal antibodies, fusion proteins, gene therapies, and other unclassified novel anticancer agents.

Results: Australian legislation, national and international guidelines, and drug company information excluded novel agents or provided inconsistent risk assessments and safe handling recommendations.

Challenging historical perspectives of the 24-h chemotherapy day: Flexible chemotherapy dose-timing guidelines.

Aim: Variation in dose-timing within multiday chemotherapy regimens is largely unknown with convention being to administer subsequent days of treatment at 24-h intervals. However, in reality there are many occasions where doses are given either earlier or later to accommodate a variety of clinical and operational priorities. This project aimed to evaluate the degree of existing variation in chemotherapy dose-timing and to investigate whether deliberate variation could improve quality and efficiency outcomes such as reduction of after hours chemotherapy administration or reduced inpatient length of stay.

Developing a performance data suite to facilitate lean improvement in a chemotherapy day unit.

Purpose: A multidisciplinary team from the Peter MacCallum Cancer Centre in Melbourne, Australia, developed a performance data suite to support a service improvement project based on lean manufacturing principles in its 19-chair chemotherapy day unit (CDU) and cytosuite chemotherapy production facility. The aims of the project were to reduce patient wait time and improve equity of access to the CDU.

Methods: A project team consisting of a pharmacist and CDU nurse supported the management team for 10 months in engaging staff and customers to identify waste in processes, analyze root causes, eliminate non-value-adding steps, reduce variation, and level workloads to improve quality and flow.

Pharmacoeconomic evaluation of fluconazole, posaconazole and voriconazole for antifungal prophylaxis in patients with acute myeloid leukaemia undergoing first consolidation chemotherapy.

Background: Fluconazole, posaconazole and voriconazole are used prophylactically in patients with acute myeloid leukaemia (AML). This study evaluated the clinical and economic outcomes of these agents when used in AML patients undergoing consolidation chemotherapy.

Methods: A retrospective chart review (2003-10) of AML patients receiving consolidation chemotherapy was performed.

Thromboprophylaxis prescribing and thrombotic event rates in multiple myeloma patients treated with lenalidomide or thalidomide at a specialist cancer hospital.

Aim: To assess thromboprophylaxis prescribing patterns against current guidelines and report thromboembolism (TE) incidence in multiple myeloma (MM) patients treated with thalidomide (thal) or lenalidomide (len) at a specialist cancer hospital over a one-year period.

Method: Dispensing records of thal and len, diagnosis of MM, patients' characteristics, disease status, co-prescribed medicines including thromboprophylaxis and incidence of TE were extracted from patients' records and a patient survey conducted to identify patients who sourced thromboprophylactic medicines outside the hospital.

Results: Enoxaparin was most the commonly prescribed thromboprophylactic agent (43%), followed by low-dose aspirin (26%) and therapeutic warfarin (6%).

Thalidomide thromboprophylaxis in multiple myeloma: a review of current evidence.

Currently multiple antithrombotic agents are used for thalidomide thromboprophylaxis in multiple myeloma patients. Agents used include low-dose aspirin, fixed low-dose and therapeutic warfarin and prophylactic low molecular weight heparin. To evaluate the evidence for the efficacy and safety of aspirin, warfarin and low molecular weight heparin thromboprophylaxis in multiple myeloma patients on thalidomide a literature search was conducted in May and June 2011.

A controlled before and after study to evaluate a patient and health professional partnership model towards effective medication reconciliation.

Unlabelled: Preventable medication errors impact substantially on the Australian healthcare system. Where 'poor communication of medical information at transition points is responsible for as many as 50% of all medication errors', a leading contributor for this type of medication error is lack of consumer knowledge about medicines information. This study was aimed at designing and testing the effectiveness of a consumer-healthcare professional partnership model towards effective medication reconciliation.

A survey of reimbursement practices of private health insurance companies for pharmaceuticals not covered under the Pharmaceutical Benefits Scheme 2008.

Objective: To describe the current practices and policy of Australian private health insurance (PHI) companies with respect to cover for pharmaceuticals not subsidised under the Pharmaceutical Benefits Scheme (PBS).

Design, Setting And Participants: A 2008 review of web-published policy statements for top-level hospital and comprehensive general treatment insurance, and survey of reimbursement practices by way of questionnaire, of 31 Australian-registered, open-membership PHI companies.

Main Outcome Measures(s): Description of the level of pharmaceutical cover and important considerations identified by PHI companies for funding non-PBS pharmaceuticals through benefit entitlements or ex-gratia payments.

Reducing workplace cytotoxic surface contamination using a closed-system drug transfer device.

Background: The potential for staff exposure to antineoplastic agents exists in the workplace despite current recommended safe handling procedures. Reliance on cytotoxic drug safety cabinets (CDSC) to provide total protection from exposure to hazardous drugs is insufficient. Preventing workplace contamination is the best strategy to minimise exposure.

Impact of an electronic antibiotic advice and approval system on antibiotic prescribing in an Australian teaching hospital.

The impact of a computer-based infectious diseases electronic antibiotic advice and approval system ("IDEA(3)S") was assessed as an alternative to a labour-intensive, phone-based approval system. IDEA(3)S-based approvals replaced 48% of all approvals for the most frequently requested antimicrobial agents (ceftriaxone/cefotaxime, vancomycin) and were associated with stable overall rates of antimicrobial use. Antibiotic prescribing for community-acquired pneumonia was 76% concordant with IDEA(3)S recommendations, and clinical acceptance of IDEA(3)S was excellent.

Ceftriaxone and cefotaxime use in Victorian hospitals.

Objective: To determine patterns of use of ceftriaxone and cefotaxime (CEFX) in Victorian hospitals and to identify areas for improvement.

Design, Patients And Setting: A concurrent, observational evaluation of CEFX use in patients commencing a course of these drugs between 8 and 14 September, 1999, in 51 Victorian hospitals.

Main Outcome Measures: Proportion of patients treated with CEFX; indications; duration of use; concordance with recommendations of national antibiotic guidelines (Therapeutic guidelines: antibiotic, 10th edition [AG10]).