Publications by authors named "Andrea Murphy"

Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is highly effective at reducing the risk of acquiring HIV. PrEP is underused due, in part, to prescriber inaccessibility. The overall aim of this study was to evaluate the impact of pharmacist PrEP management (including prescribing and monitoring) on clinical and acceptance outcomes in patients who are at high risk for HIV exposure.

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Background: Self-harm is widespread and often occurs in the community without resulting in hospital presentation. Individuals with depressive symptoms are at elevated risk. There are limited self-harm interventions designed for community and primary care settings.

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Objective: Pharmacists are taking on more roles in helping to close the gap in care for sexually transmitted infection (STI) management services. The acceptability of pharmacists to perform these services is not yet well understood. The objective of this review was to map, characterize, and explicate the acceptability of pharmacist-delivered STI services.

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  • * A scoping review examined driving performance assessments related to BZRA use, analyzing 183 studies that featured various drugs, with zopiclone being the most researched.
  • * Results showed that a significant number of studies found impairment in driving performance, with an emphasis on using certain measures like the Standard Deviation of Lateral Position (SDLP) in experimental settings, and biological detection methods in observational studies.
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  • A study was conducted to evaluate how direct-to-patient interventions can help older adults stop using long-term benzodiazepine receptor agonists (BZRA) and improve their sleep through cognitive behavioral therapy for insomnia (CBTI).
  • The research compared two mailed behavior change programs against usual treatment (TAU) to assess their impact on BZRA use, sleep quality, and overall health.
  • Conducted in New Brunswick, Canada, the study involved 565 participants aged 65 and older who had been using BZRA for an average of 11.4 years and explored the effectiveness of different informational booklets on reducing BZRA reliance and enhancing sleep outcomes.
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Background: While pharmacists' roles in mental healthcare are expanding, research exploring pharmacists' acceptability and willingness to provide mental health services is limited. This study developed and validated theory-driven measures of pharmacists' acceptability and willingness to screen for perinatal depression in community pharmacy settings.

Materials/methods: Items were developed using published literature and the Theoretical Framework of Acceptability (TFA), then content validated using consensus methods with experts who completed the content validity index (CVI).

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Benzodiazepine receptor agonists are often used for insomnia in older adults contrary to current evidence. The harms outweigh the benefits, which are limited. Cognitive behavioural therapy for insomnia is the first-line recommended treatment.

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  • The study aimed to explore how not having a regular primary care provider affects patients' views on health care and their ability to meet their health needs.
  • Conducted through 41 semistructured interviews in Canadian provinces, findings highlighted two main issues: unmet health needs and the adverse impacts of being unattached to a provider.
  • Key benefits of having a primary care provider include better access to care and stronger relationships with health professionals, while being unattached is linked to negative mental health outcomes and lower confidence in the health care system.
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Objectives: Community pharmacists play an important role in primary care access and delivery for all patients, including patients with a family physician or nurse practitioner ("attached") and patients without a family physician or nurse practitioner ("unattached"). During the COVID-19 pandemic, community pharmacists were accessible care providers for unattached patients and patients who had difficulty accessing their usual primary care providers ("semi-attached"). Before and during the pandemic, pharmacist services expanded in several Canadian provinces.

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Behavioural treatments are recommended first-line for insomnia, but long-term benzodiazepine receptor agonist (BZRA) use remains common and engaging patients in a deprescribing consultation is challenging. Few deprescribing interventions directly target patients. Prescribers' support of patient-targeted interventions may facilitate their uptake.

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Background: Expert consensus-based clinically equivalent dose estimates and dosing recommendations can provide valuable support for the use of drugs for psychosis in clinical practice and research.

Aims: This second International Consensus Study of Antipsychotic Dosing provides dosing equivalencies and recommendations for newer drugs for psychosis and previously reported drugs with low consensus.

Methods: We used a two-step Delphi survey process to establish and update consensus with a broad, international sample of clinical and research experts regarding 26 drug formulations to obtain dosing recommendations (start, target range, and maximum) and estimates of clinically equivalent doses for the treatment of schizophrenia.

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Background: Perinatal depression (PND) screening is often recommended in primary care settings, which includes the community pharmacy setting. However, there is limited research exploring pharmacists' perspectives on their roles in screening for perinatal mental illness.

Aim: This study aimed to explore pharmacists' views of pharmacists' roles in PND screening, as well as training and resource needs for PND screening in community pharmacy settings.

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Importance: Polymicrogyria is the most commonly diagnosed cortical malformation and is associated with neurodevelopmental sequelae including epilepsy, motor abnormalities, and cognitive deficits. Polymicrogyria frequently co-occurs with other brain malformations or as part of syndromic diseases. Past studies of polymicrogyria have defined heterogeneous genetic and nongenetic causes but have explained only a small fraction of cases.

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Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) is a highly effective way to reduce virus transmission. There have been increasing calls to improve access to PrEP in Canada. One way to improve access is by having more prescribers available.

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Article Synopsis
  • Recent findings indicate that stimulants, specifically lisdexamfetamine (LDX), may effectively treat bulimia nervosa (BN), with a study analyzing its effects on various symptoms over eight weeks.
  • Participants showed significant improvements in hunger, food-related impulsivity, and obsessive-compulsive behaviors, while qualitative interviews highlighted themes like increased quality of life and hope for recovery.
  • However, the open-label nature of the trial limits conclusions about the medication's efficacy, suggesting that further research, including controlled trials, is needed to validate these results.
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Background: Pre-exposure prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention is highly effective. Pharmacists can increase PrEP accessibility through pharmacist prescribing. This study aimed to determine pharmacists' acceptance of a pharmacist PrEP prescribing service in Nova Scotia.

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Long-acting injectable antipsychotics (LAIAs) have demonstrated positive outcomes for people with serious mental illnesses. They are underused, and access to LAIAs can be challenging. Pharmacies could serve as suitable environments for LAIA injection by pharmacists.

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Objectives: Pharmacists in Nova Scotia have had legislated authority to prescribe since 2011. This study aimed to describe the prescribing activities of pharmacists and the characteristics of patients who used pharmacist prescribing services.

Methods: Using provincial health administrative databases we identified all community pharmacists who prescribed during the study period (October 2016 to March 2020) and correspondingly patients who had medications prescribed by a pharmacist during this period.

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Background: Recruitment to clinical trials is a challenge for researchers that became more pronounced because of COVID-19 public health protective measures, especially with respect to studies enrolling older adults. We completed an effectiveness and cost analysis of the recruitment methods used in The Your Answers When Needing Sleep in New Brunswick (YAWNS NB) study, a randomized controlled trial of a deprescribing intervention that recruited older adults with chronic use of sedatives during the pandemic.

Methods: Study recruitment began during the COVID-19 pandemic.

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Internationally, 20% of women experience perinatal depression (PND). Healthcare providers including general practitioners and midwives are critical in providing PND screening and support; however, the current workforce is unable to meet growing demands for PND care. As accessible and trusted primary healthcare professionals, pharmacists could provide PND care to complement existing services, thereby contributing to early detection and intervention.

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