Sabina Schlottau

Introduction: Hypertension and its pre-stages are the leading cardiovascular risk factors worldwide, why awareness and prevention are highly relevant. Novel blood pressure devices can provide a broader picture at an earlier stage and enable an assessment of elevated values. The aim of this pilot study was to provide pharmacist-led support for the use, analysis and communication of a 14-day-cuffless blood pressure monitoring in potential hypertensive adults. Methods: For this pilot study ten adults were enrolled, who had elevated blood pressure values (>130 mmHg systolic and/ or >85 mmHg diastolic) in the past but no current cardiovascular diagnosis or medication. Participants were guided to use a cuffless blood pressure device (Aktiia/ Hilo bracelet) for 14 full days. The blood pressure profiles were analyzed with a previously developed blood pressure model and compared with profiles of normotensive adults. Results: The blood pressure profiles demonstrated individual blood pressure patterns in all participants. Six of ten participants were above the recommended 24-hour-threshold of 135/85 mmHg, one was at the threshold and three were under the threshold during the study period. Besides the blood pressure levels, there were differences regarding variability, night-dips and number of measurements. Compared to normotensives, base blood pressure was higher in potential hypertensives. Finally, the results were communicated to the participants for further discussion with other healthcare professionals. Discussion: The combination of a cuffless device, model-based analysis and pharmacist support represents a promising translational approach for individualized blood pressure monitoring. The results of the CareBP study show the extended value of 14 days of individual blood pressure monitoring and underline the relevance of this approach for cardiovascular disease prevention.

Background: As accessible health care professionals, pharmacists are increasingly expected to engage with wearable technology, such as with continuous glucose monitors (CGM) and their associated data that are driven by the ongoing digital transformation. However, formal education on CGM data and its interpretation as well as related digital tools is not yet routinely integrated into pharmacy curricula, leaving a gap in students' preparation. The aim of this study was to enhance pharmacy students' competencies and confidence in CGM counseling through targeted training and to evaluate the effectiveness of this intervention. Methods: A 4‐h seminar was delivered focusing on CGM data and counseling procedures, including practical examples. Students' performance in CGM‐counseling and self‐assessment of their CGM competencies were assessed in a pre–post manner using Objective Structured Clinical Examination (OSCE) checklists. Additionally, training satisfaction and perceptions of the future integration of wearables and their role in pharmacy practice were captured. Results: Following the training intervention, pharmacy students demonstrated a significant improvement in their consultation skills, with OSCE increasing from a mean of 19.12 (±7.66) to 63.47 (±12.34) percentage points ( p < 0.001). Additionally, participants reported a significantly higher self‐assessed performance and expressed notable satisfaction with the module. Conclusion: Targeted training in CGM counseling significantly improves pharmacy students' competencies specific to CGM data and enhances their confidence in this area. This training prepares students for interpreting CGM data as one example of digital health solutions and wearables. Whether similar training effects extend to other digital health technologies remains to be determined by future research.

Introduction: Blood pressure follows a circadian rhythm and is influenced by various factors. Blood pressure rises in the morning and decreases at night. It is known that deviations from this pattern are associated with an increased cardiovascular risk. Therefore, it is important to analyze blood pressure profiles and blood pressure variability.Methods: A blood pressure model was developed based on data from cuffless blood pressure measurements of six healthy volunteers over a 14-day period. Exponential formulas were applied for the description of blood pressure curves (systolic and diastolic), which were used for a non-linear regression model in R.Results: All six subjects showed a circadian pattern in systolic and diastolic blood pressure over a 14-day period. Both the measured values and the predicted values show that each subject's blood pressure was lower at night than during the day. Differences emerged in the level of blood pressure, the fluctuation, and the sleep times, which revealed individual characteristics in the daily blood pressure curves.Discussion: This novel blood pressure model can be used to visualize blood pressure profiles for several days and enables the assessment of the intra- and inter-individual variability of blood pressure.

Background: Clinical decision support systems (CDSSs) already support community pharmacists in conducting medication reviews (MRs) by identifying important information on interactions and suggesting clinical solutions. However, their impact in terms of quality and time savings is widely unexplored. The aim of our study was to investigate whether MRs are performed faster and better with or without using a CDSS. Methods: In a randomized controlled study with a cross-over design, 71 pharmacists performed a total of four MRs, two with and two without the use of a CDSS. The primary endpoint was defined as the time required for the MRs. The secondary endpoints were the number of predefined relevant drug-related problems (DRPs) detected and pharmacist satisfaction. Results: Without the use of a CDSS, pharmacists needed between 25.7% and 30.7% more time to perform a MR than with a CDSS. In addition, significantly more relevant DRPs were detected in the MRs with CDSS than without CDSS (70% vs. 50%; p = 0.0037). Furthermore, participants stated that they felt more confident using a CDSS for MRs than without. Conclusions: Our results demonstrate that MRs can be performed both faster and better when using a CDSS than without. Consequently, community pharmacists benefit from the use of CDSSs for MRs, as do patients in terms of their drug therapy safety.

Digital Medication Review Tools (DMRTs) are increasingly important in pharmacy practice. To ensure that young pharmacists are sufficiently competent to perform medication reviews after graduation, the introduction of DMRTs teaching in academic education is necessary. The aim of our study was to demonstrate the effect of DMRTs use on pharmacy students’ performance when conducting a medication review (MR) in a randomized controlled pre-post design. Forty-one pharmacy students were asked to complete a MR within 60 min, followed by a 10-min consultation with (intervention group) and without a DMRT (control group). The MR performance was subdivided into four categories: communication skills, subjective and objective patient data, assessment, and plan. Performance was assessed using objective structured clinical examinations (OSCEs) and analytical checklists. With the use of DMRTs, the overall performance was improved by 17.0% compared to the control group (p < 0.01). Improvement through DMRTs was seen in the subcategories “Assessment” and “Plan”. Furthermore, pharmacy students liked using DMRTs and felt more confident overall. Our study results demonstrate that DMRTs improve the performance of MRs, hence DMRTs should become an integral part of pharmacy curriculum. Consequently, digitally enabled pharmacists using DMRTs will be better prepared for their professional careers in pharmacy practice.

Personal digital health apps for managing diabetes should include functions that enable the provision of pharmaceutical care services and allow within-app communication with pharmacists and other healthcare providers, thereby improving patient outcomes. The primary aim of this study was to assess the functions of diabetes apps that were relevant to providing pharmaceutical care services (i.e., medication management, adherence, non-pharmacological management, interoperability, and communication). Sixteen criteria related to pharmaceutical care were developed and then used to assess ten popular diabetes apps. The highest numbers of pharmaceutical care criteria were met by the apps Diabetes:M and mySugr (11 criteria); Contour™Diabetes, Dario Health, and OneTouch Reveal^® (ten); and DiabetesConnect and ESYSTA (nine); followed by Glucose Buddy (eight), meala (seven), and lumind (three). The most prevalent functions were related to promoting adherence and non-pharmacological management, but most criteria relevant to medication management were lacking. Five apps allowed within-app communication between patients and healthcare professionals (HCPs); however, no app included communication with pharmacists. High-quality diabetes apps are powerful tools to support pharmaceutical care and remotely monitor diabetes patients. Improvements are needed as they often lack many medication management functions, including within-app communication with HCPs (especially pharmacists). To maximize diabetes app use and improve outcomes, app developers should consider including pharmacists alongside other healthcare providers when customizing app designs.

Obarcanin E, Ali-Sherazi B, Dabidian A, Schlottau S, Deters MA, Läer S. Introducing m-Health and Digital Diabetes Apps in Clinical Pharmacy Education in Germany. J Diabetes Clin Res. 2022;4(1):17-19.