Aim: Opioid replacement therapy (ORT) is an established therapy for a patient group that has been associated with nutrition-related comorbidities. This paper aims to assess the nutritional intake and supplementation in ORT patients, determine the extent of nutritional/dietary advice supplied to ORT patients and to briefly examine patients' perception of pharmacists' provision of nutritional advice. Methods: The nutritional intake of ORT patients receiving treatment in community pharmacies within the Australian Capital Territory was assessed via a 24-hour recall survey. Food intake data were analysed via nutrient analysis software and compared with Australian Nutrition Reference Values and the nutrient intakes of the Australian population. Patients were surveyed to determine supplement use and perceptions of nutritional advice gained by pharmacists. Results: Potential insufficient intake of various macronutrients and micronutrients was observed in both sexes. Less than 25% of patients recorded supplement use. Fifteen percent of males and 21% of females stated that they had approached a pharmacist with a nutrition-related query. All patients who received nutritional advice followed the advice. Conclusions: ORT patients dosing at community pharmacies appear to have poor nutritional intake. ORT patients appear to be receptive to pharmacist's advice. Community pharmacists can potentially increase the beneficial health outcomes in this population through the proactive supply of accurate nutritional advice.
Global community pharmacist knowledge of dietary supplements appears to be poor. Community pharmacists have an professional responsibility to provide accurate health information about dietary supplements as they do for any other therapies they provide to patients. Further research including that which assesses pharmacists' therapeutic knowledge of commonly sold vitamins and minerals is suggested.
Medication was often used for the correct indication in television medical dramas; however, key safety checks were frequently omitted and other medication-related advice, including dose, was less reliable and accurate. Pharmacists were rarely involved in providing medication advice. Viewers should not base medication-related decisions solely on what they see in television medical dramas, and any medication-related advice should be interpreted with extreme caution.
BackgroundThe use of Complementary Medicines (CMs) has significantly increased in Australia over the last decade. This study attempts to determine the extent to which complementary and alternative medicines are recorded, ceased or initiated in the acute hospital setting and investigate which health professionals have a role in this process.MethodsA cross-sectional study of inpatients was conducted at a major tertiary teaching hospital. Patient’s medical records were examined to determine the rates of complementary medicine (CM) use and recording on medication charts and discharge prescriptions. Patient progress notes were audited to determine which health professionals were involved with the initiation or cessation of CMs during the inpatient stay.ResultsThree hundred and forty-one patients were included for analysis of which 44.3% (n = 151) participants were recorded as utilizing a CM. Patients were admitted on a mean of 2 (±1.4[Sd]; 0–9[range]) CMs and discharged on a mean of 1.7 CMs (±1.3[Sd]; 0–5[range]). 274 individual CMs were recorded on inpatient medication reconciliation forms with multivitamins, magnesium, fish oil and cholecalciferol recorded the most frequently. One hundred and fifty-eight changes to patient CM usage were recorded during the patient hospitalisation. One hundred and seven of these changes (68%) were not accounted for in the patient progress notes.ConclusionPatients use of CM in this hospital setting do not reflect the national estimated usage. On the occasions that CM products are included in patient records, they are subsequently deprescribed following patient examination in hospital. It is currently unclear which health professionals have a role in this deprescribing process.
Aim This systematic review aimed to determine the level of existing research that investigates the intake, specifically macro and micronutrient intake, of patients undergoing opioid replacement therapy. Methods A systematic review was conducted across PubMed, Embase, Cochrane and CINAHL databases using a pre‐determined protocol. Studies published between 2001 and 2022 assessing macronutrient or micronutrient intake in opioid replacement therapy patients were included. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was utilised for quality appraisal. Data from each of the included papers was synthesised in a narrative manner. Data extracted included all measurements of nutrition including macronutrient, and micronutrient intake and any bioanalysis results and methods utilised. Results Seven papers (one cohort study and six cross‐sectional studies, n = 443) were included that investigated an aspect of nutritional intake in patients receiving opioid replacement therapy. The majority of included papers reported an assessment of both macro and micronutrient and resulting energy intake as determined by food consumption. The included papers described a picture of irregular nutritional intake in patients undergoing opioid replacement therapy. Conclusion Minimal research into the nutritional intake of opioid replacement therapy patients exists. The existing research is suggestive of irregular nutritional intake from both macro and micronutrient consumption and indicates a need for further studies and increased attention on this vulnerable patient group.
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