International journal of clinical pharmacy
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Stroke is one of the leading causes of death and disability. Significant proportions (33 %) of stroke presentations are by patients with a previous stroke or transient ischaemic attack. Consequently, the stroke management guidelines recommend that all ischaemic stroke patients should receive three key evidence-based preventive drug therapies: antihypertensive drug therapy, a statin and an antithrombotic drug therapy (anticoagulant and/or antiplatelet). ⋯ There is a scope for improvement in implementing the stroke management guidelines when it comes to prescribing secondary preventive drug therapies using antihypertensives, antithrombotics and statins. Appropriate risk/benefit assessment is indispensable for optimal prescribing and maximizing patient outcomes, particularly in older people.
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To provide better patient care, it is very important for the physicians to be willing to accept clinical pharmacy services (CPSs). ⋯ From the perspective of improving physicians' overall attitudes, the prioritization strategy of developing CPSs in China should focus on the role of clinical pharmacists within the decision support system for medication management, thus encouraging clinical pharmacists to interact more frequently with physicians at the ward level.
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Surveillance of antimicrobial prescribing, in order to control the increase in antimicrobial resistance, is recommended by the Guidelines for Antimicrobial Stewardship in Hospitals in Ireland. ⋯ Around half of Irish hospitals do not have an antimicrobial management team in place but most hospitals have an antimicrobial prescribing policy. Most AMTs have representation by Consultants and Pharmacists, but audit and feedback of antibiotic prescribing activities is limited. Significant differences in audit activities were found between public and private hospitals, with private hospitals performing less well.
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Adherence to therapy is a key to achieving good clinical outcomes. Promoting medication adherence requires a range of strategies that primarily focus on fostering behavioral change. Community pharmacists are well placed to deliver adherence support to patients. ⋯ Community pharmacists employed a limited range of strategies to identify and address non-adherence to medications. Moreover, the provision of adherence support was episodic and infrequent. However, the majority of pharmacists believed that it is their role to promote patients adherence. Time pressures for both pharmacists and patients were perceived to be a major barrier.
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Medication adherence is a multifaceted issue that is influenced by various factors. One factor may be the concurrent use of over-the-counter (OTC)medicines. The use of OTC medicine has been reported as common amongst elderly patients. ⋯ Amongst elderly patients on multiple medications a positive relationship was found between the overall use of OTC medicines and adherence to prescription drugs, in contrast to none when adherence were defined different or herbal medicines, dietary supplements, or non-prescribed drugs were analysed separately.