ABSTRACT
The importance of global vaccines for various infectious agents has been emphasized through our experience with the current COVID-19 vaccine. Physicians trained in allergy and immunology are considered experts in vaccines and adverse reactions from vaccines. This chapter will emphasize how to approach vaccines for various populations, including immunodeficient patients, how to determine best paths for patients who miss vaccine doses, and how to address adverse reactions to vaccines, as noted in Case 2, where the patient experienced an anaphylactic reaction to the measles, mumps, and rubella (MMR) vaccine. In addition, mechanisms behind adverse vaccine reactions are discussed. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
OBJECTIVE: We aimed to identify, appraise, synthesize, and contextualize rapidly emerging reports on medication taking (adherence) among patients with rheumatic diseases during the COVID-19 pandemic. METHODS: We searched MEDLINE, EMBASE, and CINAHL for peer-reviewed communications, letters, and articles published during the COVID-19 pandemic evaluating medication taking among individuals with rheumatic diseases. We appraised assessment and reporting of medication adherence according to established definitions of 3 distinct problems of medication taking (i.e., noninitiation, poor implementation, and discontinuation) and pooled findings using random-effects models. RESULTS: We included 31 peer-reviewed studies in our synthesis from various jurisdictions, of which 25 described medication taking among rheumatology patients and 6 described medication prescribing among rheumatology providers. The pooled prevalence of overall medication nonadherence was 14.8% (95% confidence interval [95% CI] 12.3-17.2) and that of medication discontinuation (i.e., stopping of prescriptions) and poor implementation (i.e., not taking medication at the dose/frequency prescribed) as 9.5% (95% CI 5.1-14.0) and 9.6% (95% CI 6.2-13.0), respectively. Noninitiation (i.e., not starting/not filling new prescriptions) was not addressed. CONCLUSION: Medication taking among individuals with rheumatic diseases during the COVID-19 pandemic varies globally. Unclear reporting and extensive variation in research methods between studies create barriers to research replication, comparison, and generalization to specific patient populations. Future research in this area should use consistent and transparent approaches to defining and measuring medication taking problems to ensure that findings appropriately describe the epidemiology of medication adherence and have the potential to identify modifiable targets for improving patient care.
ABSTRACT
Objective: This study aims to understand Canadian pharmacists’ use, experiences, and perspectives of telepharmacy. Methods: We conducted a cross-sectional online survey. Individuals were eligible to participate if they were currently a registered, licensed pharmacist practicing in Canada. We collected perspectives of both telepharmacy users and non-users by creating a survey logic that asked specific and shared questions between the two groups. Data was analyzed using descriptive statistics including means and standard deviations (SD) for continuous variables and proportions for categorical variables. Results: Between October and December 2020, 136 pharmacists completed the survey, including 61 (52.6%) telepharmacy users and 55 (47.4%) non-users. Among those who use telepharmacy, the majority of participants (39, 72.2%) expressed that telepharmacy augmented their clinical practice and feel comfortable managing minor ailments using telepharmacy (41, 80.4%). Among non-users, 45 (84.9%) indicated that telepharmacy will augment their clinical practice and 48 (90.6%) would feel comfortable managing minor ailments using telepharmacy. Important considerations for successful implementation of telepharmacy for those who use telepharmacy included easier system implementation (29, 19.3%), better privacy & data protection (28, 18.7%) and simple to learn technology (23, 15.3%). Conclusion: Despite the growing recognition of benefits of telepharmacy, our findings suggest that utilization among pharmacists in Canada is still quite low. Nonetheless, our study identified areas of consideration for better integration of telepharmacy in pharmacy practice including optimizing workflow, addressing barriers, and providing training to pharmacy students.