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de Castro Araújo-Neto F, Dosea AS, da Fonseca FL, Tavares TM, Pimentel DMM, Mesquita AR, Lyra-Jr. DPD. Formal leadership perceptions about the autonomy of Pharmacy: a SWOT analysis. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100443. [PMID: 38655194 PMCID: PMC11035047 DOI: 10.1016/j.rcsop.2024.100443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION Autonomy is considered a vital principle of professionalism. In recent years, despite important advances, the Pharmacy and pharmacists' autonomy has been questioned due to conflicts that jeopardize the consolidation of this profession in the division of work in health. OBJECTIVE to understand the construct of autonomy based on perceptions of formal leaders associated with professional organizations. METHODS A qualitative study was conducted through interviews with key informants. The data obtained were submitted to content analysis. RESULTS Perceptions about the autonomy in pharmaceutical practice were categorized according to strengths, weaknesses, opportunities, and threats to this construct. CONCLUSION The findings allowed us to understand the autonomy of pharmaceutical practice in Brazil, generate hypotheses about the future of Pharmacy, and build strategies to maintain its occupational status.
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Affiliation(s)
- Fernando de Castro Araújo-Neto
- Graduate Program in Pharmaceutical Sciences. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Health Sciences Graduate Program. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Aline Santana Dosea
- Health Sciences Graduate Program. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Francielly Lima da Fonseca
- Graduate Program in Pharmaceutical Sciences. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Thaís Maria Tavares
- Graduate Program in Pharmaceutical Sciences. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | | | - Alessandra Rezende Mesquita
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Divaldo Pereira de Lyra-Jr.
- Graduate Program in Pharmaceutical Sciences. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Health Sciences Graduate Program. Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
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Tharmalinga Sharma JJ, McMillan SS, Samaranayake NR, Waas DA, Coombes ID, Wheeler AJ. Multifaceted pharmacist-led interventions in secondary care settings between countries of various income levels: a scoping review protocol. BMJ Open 2024; 14:e083726. [PMID: 38594185 PMCID: PMC11015257 DOI: 10.1136/bmjopen-2023-083726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Clinical pharmacy services often involve multifaceted pharmacist-led interventions. However, current pharmacy practice models vary across different countries. Despite the documented benefits of clinical pharmacy services, the characteristics of pharmacist-led interventions in different countries have not yet been adequately explored and described. Therefore, this protocol outlines the methodology for a proposed scoping review aiming to investigate various types of multifaceted pharmacist-led interventions and the outcomes used to evaluate their effectiveness within secondary care settings. Additionally, the scoping review will map the current evidence surrounding the characteristics of interventions and outcomes reported across various countries of socioeconomic status. METHODS AND ANALYSIS The scoping review will be conducted according to the JBI Methodology for Scoping Reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews. We will systematically search the following electronic databases: MEDLINE (Ovid), CINAHL (EbscoHost), Embase (embase.com), Scopus (scopus.com), Cochrane Library (cochranelibrary.com) and APA PsycInfo (Ovid). Additionally, the reference lists of identified reviews and included full texts will be searched for relevant papers. Grey literature sources, such as International Pharmaceutical Abstracts and the International Pharmaceutical Federation (FIP) website, will be searched. We will include primary studies published in the English language from January 2013 to December 2023, involving secondary care multifaceted pharmacist-led interventions. Two independent reviewers will screen studies against eligibility criteria and use a piloted data extraction form to extract relevant information. We will extract relevant data, complete a tabular summary from each included publication and analyse it. ETHICS AND DISSEMINATION Ethical approval is not required as we will be using data from publicly available literature sources. Findings will be disseminated in publications and presentations with relevant stakeholders. We aim to map available evidence across the breadth of studies that have reported multifaceted pharmacist-led interventions and their outcomes.
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Affiliation(s)
| | - Sara S McMillan
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Centre for Mental Health and Menzies Health Institute, Griffith University, Brisbane and Gold Coast, QLD 4111 & 4222, Australia
| | - Nithushi R Samaranayake
- Department of Pharmacy and Pharmaceutical sciences, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Dulshika A Waas
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Colombo South Teaching Hospital, Kalubowila-Dehiwela 10350, Sri Lanka
| | - Ian D Coombes
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD 4102, Australia
- Pharmacy Department, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
- Collaboration of Australians and Sri Lankans for Pharmacy Practice, Education and Research (CASPPER), woolloongabba, QLD 4102, Australia
| | - Amanda J Wheeler
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Centre for Mental Health and Menzies Health Institute, Griffith University, Brisbane and Gold Coast, QLD 4111 & 4222, Australia
- Faculty of Health and Behavioural Sciences, University of Auckland, Auckland 1142, New Zealand
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Iskandar D, Pradipta IS, Anggriani A, Postma MJ, van Boven JFM. Multidisciplinary tuberculosis care: leveraging the role of hospital pharmacists. BMJ Open Respir Res 2023; 10:e001887. [PMID: 37949612 PMCID: PMC10649469 DOI: 10.1136/bmjresp-2023-001887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 10/31/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Optimal pharmacological treatment of tuberculosis (TB) requires a multidisciplinary team, yet the hospital pharmacist's role is unclear. We aimed to analyse hospital pharmacist-provided clinical pharmacy services (CPS) implementation in TB care. METHOD A nationwide survey-based online cross-sectional study was conducted on hospital pharmacists in Indonesia from 1 November 2022 to 22 November 2022. Outcomes were the extent of pharmacists' involvement in multidisciplinary TB care, TB-related CPS provided and views on TB-related CPS. The probability of pharmacists' involvement in multidisciplinary TB teams was assessed using logistic regression. RESULTS In total, 439 pharmacists (mean age 31.2±6.22 years, 78% female) completed the survey. Thirty-six per cent were part of multidisciplinary TB care, and 23% had TB-related tasks. Adherence monitoring (90%) and drug use evaluation (86%) were the most conducted TB-related CPS. Pharmacists' views on TB-related CPS implementation were generally positive, except for financial incentives. Work experience (OR 1.99, 95% CI 1.09 to 3.61), ever received TB-related training (OR 3.51, 95% CI 2.03 to 6.14) and specific assignments to provide TB-related CPS (OR 8.42, 95% CI 4.99 to 14.59) significantly increased pharmacist involvement in multidisciplinary TB care. CONCLUSION Around one-third of hospital pharmacists are part of multidisciplinary TB care, with medication adherence and drug use monitoring as primary tasks. Pharmacists' experience, training, assignment to provide TB-related CPS and financial incentives are key elements for further implementation in multidisciplinary TB care. Pharmacists should proactively support current TB care and conduct operational research, sharing data with healthcare peers and fostering a collaborative multidisciplinary TB care team.
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Affiliation(s)
- Deni Iskandar
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands
- Faculty of Pharmacy, Bhakti Kencana University, Bandung, Indonesia
| | - Ivan S Pradipta
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Padjadjaran University, Bandung, Indonesia
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Bandung, Indonesia
- Indonesian Tuberculosis Research Network/JetSet TB, Bandung, Indonesia
| | - Ani Anggriani
- Faculty of Pharmacy, Bhakti Kencana University, Bandung, Indonesia
| | - Maarten J Postma
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center, Groningen, The Netherlands
- Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Bandung, Indonesia
- Research Institute Science in Healthy Aging and healthcaRE (SHARE), University of Groningen, University Medical Center, Groningen, The Netherlands
- Department of Economics, Econometrics & Finance, Faculty of Economic & Business, University of Groningen, Groningen, Netherlands
| | - Job F M van Boven
- Department of Clinical Pharmacy & Pharmacology, University of Groningen, University Medical Center, Groningen, The Netherlands
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center, Groningen, The Netherlands
- Center for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia
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Sin CMH, Huynh C, Maidment ID. Physicians' and nurses' perceptions of the factors influencing the implementation of paediatric clinical pharmacy services in Hong Kong: a qualitative study. Eur J Hosp Pharm 2023:ejhpharm-2023-003796. [PMID: 37541776 DOI: 10.1136/ejhpharm-2023-003796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023] Open
Abstract
OBJECTIVES To identify barriers and facilitators that influence the implementation of paediatric clinical pharmacy services in Hong Kong public hospitals from physicians' and nurses' perspectives. METHODS A qualitative study was conducted based on semistructured interviews of physicians and nurses who worked in the field of paediatrics in four public hospitals in Hong Kong. Interviews were held via telephone conversations using spoken Cantonese which were audio recorded, then translated and transcribed directly into English by the research team. Thematic analysis was used for data analysis and reflexivity was engaged through member checking, making field notes and reporting using the Consolidated Criteria for Reporting Qualitative Studies checklist. RESULTS A total of six barriers and five facilitators were identified from interviewing 17 participants, which included 7 physicians and 10 nurses. The barriers identified were the public's lack of understanding and recognition of clinical pharmacists, a culture of medical dominance, lack of resources and heavy workload, the need for a more transparent and defined role of clinical pharmacist at the institutional level, lack of proactive approach and involvement in direct patient care activities. The facilitators identified were the belief in the improvement of patient outcomes and the overall pharmaceutical service efficiency, trust and confidence in clinical pharmacy services, filling the clinical gap as a medicine information provider, and direct and coherent communication as a multidisciplinary team member. CONCLUSIONS Physicians and nurses reported that the implementation of paediatric clinical pharmacy services was adequate, but several key barriers were identified at both the external and internal levels.
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Affiliation(s)
- Conor Ming-Ho Sin
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
- Pharmacy Department, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
| | - Chi Huynh
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Ian D Maidment
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
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Chen L, Yang N, Huang Y, Xi X. Development and validation of pharmaceutical care barriers scale in Chinese hospitals: a cross-sectional survey. Front Pharmacol 2023; 14:1194901. [PMID: 37521472 PMCID: PMC10373295 DOI: 10.3389/fphar.2023.1194901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/23/2023] [Indexed: 08/01/2023] Open
Abstract
Introduction: Chinese hospitals still face various barriers to implementing pharmaceutical care. The quantitative instrument for measuring these barriers in China is scarce. This study aims to develop and validate a scale for measuring barriers to providing pharmaceutical care in Chinese hospitals from the perspective of clinical pharmacists. Methods: The scale was developed based on existing literature and qualitative interviews with 20 experts. The scale was included in a small-range pilot survey and then administered to a validation survey in 31 provinces in China. Exploratory factor analysis was used to identify the structure of the scale. Confirmatory factor analysis was applied to verify the structure of the scale and to validate the scale's convergent and discriminative validity. Known-group validity was also examined. Cronbach's alpha examined the internal consistency reliability of the scale. Results: 292 scales were completed and returned for a response rate of 85.6% in the pilot study. Exploratory factor analysis of the scale suggested a five-factor solution (Cognition and attitude, Knowledge and skills, Objective conditions, External cooperation, and Support from managers) accounting for 66.03% of the total variance. 443 scales were sent out in the validation study, with a response rate of 81.0%. Confirmatory factor analysis demonstrated a good fit of the structural model for pharmaceutical care barriers. It showed the scale's good convergent and discriminative validity (The average variance extracted >0.5 and composite reliability >0.7). The scale could also identify the differences in total score among the clinical pharmacists from different hospital grades (p < 0.05). Cronbach's alpha is between 0.658 and 0.896, indicating good internal consistency. Conclusion: From the perspective of clinical pharmacists, this study has developed a scale to assess obstacles to pharmaceutical care. The scale comprehensively encompasses barriers to clinical pharmacists' cognitive and ability-related aspects, hindrances encountered in collaborating with other health professionals and patients, and barriers to the working environment. The reliability and validity have been established through verification.
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Affiliation(s)
- Liangjiang Chen
- Research Center of National Drug Policy and Ecosystem, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Nan Yang
- West China School of Pharmacy, Sichuan University, Chengdu, China
| | - Yuankai Huang
- Research Center of National Drug Policy and Ecosystem, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
| | - Xiaoyu Xi
- Research Center of National Drug Policy and Ecosystem, School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China
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Kilonzi M, Mutagonda RF, Mlyuka HJ, Mwakawanga DL, Mikomangwa WP, Kibanga WA, Marealle AI, Mallya B, Katabalo D, Sanga S, Kalokola F, Rwegasha J, Magambo R, Mmassy J, Kabissi S, Balati JA, Maduki P, OmaryMashikuMinzi, Kamuhabwa AAR. Barriers and facilitators of integration of pharmacists in the provision of clinical pharmacy services in Tanzania. BMC PRIMARY CARE 2023; 24:72. [PMID: 36932338 PMCID: PMC10021921 DOI: 10.1186/s12875-023-02026-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Collaboration between medical doctors and nurses in the provision of healthcare services has been there for decades. The concept of clinical pharmacy services as a main goal for pharmacy practice is relatively new and is yielding more positive results for healthcare providers (HCPs), patients, and the health system. This study assessed barriers and facilitators toward the integration of pharmacists in the provision of CPS in Tanzania. METHODS A qualitative study was conducted in five tertiary hospitals representing Tanzania mainland. Ten (10) focus group discussions (FGDs) with 83 HCPs and 14 in-depth interviews (IDIs) with hospital administrators in referral hospitals were conducted between August and September 2021. The experienced qualitative researchers moderated the IDIs and FGDs, and all discussions were audio-recorded. Finally, the audios were transcribed verbatim, and analysis was done using a thematic approach. RESULTS Limited skills, lack of confidence, poor communication, inferiority, and superiority behaviors among HCPs were among the mentioned barriers. Shortage of pharmacists, lack of in-job training, standard operating procedures (SOPs), and guidelines were also mentioned. The study noted the high acceptability of CPS by other HCPs, the positive perception of pharmacists, and the recognition of CPS by the Tanzania Pharmacy Act and regulation. CONCLUSION The facilitators and barriers to the integration of pharmacists in the provision of CPS lie at the individual, health facility, and health system levels. Therefore, the study recommends in-job pharmacists training, fostering teamwork among HCPs, and development of CPS SoPs, and guidelines.
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Affiliation(s)
- Manase Kilonzi
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania.
| | - Ritah F Mutagonda
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Hamu J Mlyuka
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Dorkasi L Mwakawanga
- School of Nursing, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65001, Dar Es Salaam, Tanzania
| | - Wigilya P Mikomangwa
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Wema A Kibanga
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Alphonce Ignace Marealle
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Bertha Mallya
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Deogratias Katabalo
- School of Pharmacy, the Catholic University of Health and Allied Sciences, P. O. BOX 1464, Mwanza, Tanzania
| | - Sofia Sanga
- Department of Internal Medicine, Muhimbili National Hospital, P. O. BOX 65000, Dar Es Salaam, Tanzania
| | - Fredrick Kalokola
- School of Medicine, the Catholic University of Health and Allied Sciences, P. O. BOX 1464, Mwanza, Tanzania
| | - John Rwegasha
- Department of Internal Medicine, Muhimbili National Hospital, P. O. BOX 65000, Dar Es Salaam, Tanzania
| | - Rose Magambo
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - John Mmassy
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Sungwa Kabissi
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Josephine A Balati
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Peter Maduki
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - OmaryMashikuMinzi
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Appolinary A R Kamuhabwa
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
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Cerqueira-Santos S, Rocha KSS, Araújo DCSA, Santos Júnior GA, Menezes PWS, Sanchez JM, Mesquita AR, Lyra Júnior DP. Which factors may influence the implementation of drug dispensing in community pharmacies? A qualitative study. J Eval Clin Pract 2023; 29:83-93. [PMID: 35789071 DOI: 10.1111/jep.13731] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/21/2023]
Abstract
RATIONALE, AIMS AND OBJECTIVES Implementation of clinical pharmacy services, such as drug dispensing, is a complex process. It is necessary to understand the challenges associated with this practice from the perspective of the actors involved to help ensure optimal service provision. Thus, this study aimed to understand the factors that may influence the implementation of drug dispensing in community pharmacies, according to the perceptions of pharmacists. METHOD This qualitative study was based on semistructured, face-to-face interviews. The participants were pharmacists who worked in a chain of community pharmacies in Brazil, selected based on their direct participation in the implementation process. The interview recordings were transcribed full verbatim and were independently analyzed using thematic analysis, followed by consensus meetings between researchers. The factors identified by the participants were classified according to the Apoteca framework. This study was approved by the Committee of Ethics in Research and all participants signed an informed consent form. RESULTS We conducted 18 interviews, with 47 factors that may influence the implementation of drug dispensing in community pharmacies being identified. These factors were allocated to seven categories: support from community pharmacy chain (4), pharmacy infrastructure (11), characteristics of the pharmacy, medicines and other health products (4), pharmacist (16), dispensing work process (2), pharmacy team (2) and patient (8). The classification of factors according to the Apoteca framework allocated most of them to administrative (14) and technical (15) domains, followed by attitudinal (13) and political (5) domains. CONCLUSION(S) This study identified several factors that can influence the implementation of drug dispensing and classified them according to the domains of the Apoteca framework, highlighting the multifactorial nature of the implementation process. The results of this study can guide the planning of strategies aimed at providing efficient drug dispensing in community pharmacies.
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Affiliation(s)
- Sabrina Cerqueira-Santos
- Graduate Program in Pharmaceutical Sciences, Department of Pharmacy, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Kérilin S S Rocha
- Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Dyego C S A Araújo
- Health Sciences Graduate Program, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Genival A Santos Júnior
- Research Group on Implementation and Integration of Pharmaceutical Care, Federal University of Espírito Santo, Alegre, Espírito Santo, Brazil
| | - Pedro W S Menezes
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Júlia M Sanchez
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Alessandra R Mesquita
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
| | - Divaldo P Lyra Júnior
- Graduate Program in Pharmaceutical Sciences, Department of Pharmacy, Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil.,Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Federal University of Sergipe, São Cristóvão, Sergipe, Brazil
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Jesus TS, Kamalakannan S, Bhattacharjya S, Bettger JP, Jacobs K, Hoenig H. Which factors affect the implementation of telerehabilitation? Study protocol for a mixed-methods systematic review with a framework synthesis. Work 2023:WOR210745. [PMID: 36683522 DOI: 10.3233/wor-210745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Telehealth approaches are promising for the delivery of rehabilitation services but may be under-used or under-implemented. OBJECTIVE To report a review protocol to identify how much telerehabilitation (telehealth approaches to the delivery of rehabilitation services) have been used and implemented, and which factors have affected such implementation. METHODS A mixed-methods systematic review with a framework synthesis. Six databases for the scientific literature will be searched, complemented by snowballing searches and additional references coming from key informants (i.e., rehabilitation researchers from a networking group in health services research). We will include English-language empirical research examining the routine use or implementation of telehealth technologies in physical rehabilitation services or by physical rehabilitation professionals from a range of study designs, excepting case studies, case reports, and qualitative studies with n < 5. Two independent reviewers will perform the screenings, quality appraisals (using the Joanna Briggs Institutes' appraisal checklists), and the data extractions. The Consolidated Framework for Implementation Research will be used to synthesize the data on the enablers and barriers of the implementation of telerehabilitation approaches. All the authors will be involved at this synthesis, and key informants will provide feedback. CONCLUSION The results can inform further implementation endeavours.
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Affiliation(s)
- Tiago S Jesus
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Sureshkumar Kamalakannan
- Public Health Foundation of India (PHFI), South Asia Centre for Disability Inclusive Development and Research (SACDIR), Indian Institute of Public Health - Hyderabad (IIPH-H), Hyderabad, India
| | - Sutanuka Bhattacharjya
- Department of Occupational Therapy, Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, Atlanta, GA, USA
| | | | - Karen Jacobs
- Department of Occupational Therapy, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, USA
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham Veterans Administration Medical Center, Durham, NC, USA.,Division of Geriatrics, Department of Medicine, Duke University Medical Center, Durham, NC, USA
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Dong PTX, Trinh HT, Nguyen DH, Nguyen ST, Pham VTT, Ngo HB, Hua S, Li SC, Nguyen HTL. Implementing clinical pharmacy activities in hospital setting in Vietnam: current status from a national survey. BMC Health Serv Res 2022; 22:878. [PMID: 35799184 PMCID: PMC9264624 DOI: 10.1186/s12913-022-08242-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Background Clinical pharmacy activities have evolved over the past decades contributing to all stages of the patient care process, especially in the hospital setting. However, these practice roles may differ to a significant extent depending on the healthcare policy of countries. In Vietnam, the magnitude of adopting clinical pharmacy activities in hospital settings throughout the country is still unknown since these activities have been implemented. This study aimed to ascertain the current status of clinical pharmacy activities performed within the Vietnamese hospital setting. Methods A nation-wide survey was conducted from December 2017 to January 2018. Two online questionnaires, one for the Heads of Pharmacy Department and one for clinical pharmacists, were designed based on the national legal regulations about implementing clinical pharmacy activities in the hospital setting. These questionnaires were sent to all hospitals and healthcare facilities with a department of pharmacy. Results A total of 560 Heads of Pharmacy and 574 clinical pharmacists participated in the study, representing a response rate of 41.2%. Among the participating hospitals, non-patient specific activities were implemented widely across all hospital classes, with pharmacovigilance, medication information, and standard operating procedures development implemented in ≥88% of all hospitals. In contrast, there was a significant variation in the level of implementation of patient-specific activities among hospital classes. With activities such as medication counselling, monitoring of adverse drug reactions, and obtaining patient’s medication histories provided at a considerably lower level in between 49 and 57% of hospitals. Conclusion Clinical pharmacy activities have been initiated in most of the surveyed hospitals. In general, clinical pharmacy is more established in higher-class hospitals in Vietnam. However, the current implementation status is focused on non-patient-specific activities, while patient-oriented activities remained insufficiently established. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08242-5.
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Affiliation(s)
- Phuong Thi Xuan Dong
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam.,Department of Pharmacy, Friendship Hospital, Hanoi, Vietnam.,School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Hieu Trung Trinh
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam
| | - Duy Huu Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam
| | - Son Tu Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam
| | - Van Thi Thuy Pham
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam.,Department of Pharmacy, Friendship Hospital, Hanoi, Vietnam
| | - Ha Bich Ngo
- Medical Services Administration, Ministry of Health, Hanoi, Vietnam
| | - Susan Hua
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia
| | - Shu Chuen Li
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, 2308, Australia.
| | - Huong Thi Lien Nguyen
- Department of Clinical Pharmacy, Hanoi University of Pharmacy, 13-15 Le Thanh Tong Street, Hanoi, Vietnam.
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10
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Alcântara TDS, Lima HF, Valença-Feitosa F, Aires-Moreno GT, Santos GAD, Araujo DC, Cavalcante-Santos LM, Cunha LC, Lyra DPD. Development and implementation of a medication reconciliation during pediatric transitions of care in a public hospital. J Am Pharm Assoc (2003) 2021; 62:1400-1406.e3. [PMID: 34998691 DOI: 10.1016/j.japh.2021.12.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 11/19/2021] [Accepted: 12/16/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To generate effective changes in the work processes of an institution, such as hospitals, strategies are needed for the implementation of services. These should be based on the needs of the practice scenario and evidence that may develop programs applied to the routine of health care. This study aimed to implement medication reconciliation (MR) at the transition of care in the pediatric department of a public hospital located in Northeast Brazil. SETTING A step-by-step approach was adopted to implement MR in the studied hospital and conducted from March 2019 to December 2019. PRACTICE INNOVATION The implementation of MR used the "Model for Improvement" framework. The processes were built and tested in the Plan-Do-Study-Act (PDSA) cycles. Children admitted to the hospital's pediatrics department were included in the study. The objective of the PDSA cycles was to reach 75% of the patients included, with the service performed in at least one transition of care episode. EVALUATION This study used the following indicators: number of steps performed, number of discrepancies identified, and resolution of discrepancies. Descriptive statistical analysis was performed for all variables. RESULTS In the first cycle, all patients (n = 34) had the best possible medication history (BPMH) completed, and 26.4% went through all the MR stages. Seventy-two discrepancies were identified and 90.3% of them were resolved. In the second cycle, all patients (n = 35) had the BPMH completed, and 20% went through all the stages. A total of 32 discrepancies were identified and 96.8% of them were resolved. In the third cycle, all patients (n = 30) had the BPMH completed, and 56.6% of patients went through all the stages. Twenty-four discrepancies were identified and resolved. CONCLUSION The use of the "Model for Improvement" framework effectively contributed to the implementation of the service according to the characteristics of the studied hospital.
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11
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Experiences of key stakeholders with the implementation of medication reviews in community pharmacies: A systematic review using the Consolidated Framework for Implementation Research (CFIR). Res Social Adm Pharm 2021; 18:2944-2961. [PMID: 34420864 DOI: 10.1016/j.sapharm.2021.07.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 07/12/2021] [Accepted: 07/16/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Though medication reviews have shown positive patient outcomes, they are still not widely implemented in community pharmacies. Published reviews on their implementation often include several other pharmacy services, making them non-specific. Using the Consolidated Framework for Implementation Research (CFIR) to focus solely on the experiences of different stakeholders with the implementation of medication reviews will help to better understand relevant facilitators and barriers. OBJECTIVES To critically appraise, synthesise and present the available evidence on experiences of key stakeholders with the implementation of medication reviews and to identify barriers and facilitators to its implementation in community pharmacies. METHODS A systematic literature search was conducted in four databases for studies published in English, Spanish or German. Key search terms included: implementation, pharmac*, medication review, facilitator, barrier. Study selection, quality assessment and data extraction were performed by two independent reviewers. Findings were mapped directly against the constructs of the CFIR. RESULTS Out of 924 retrieved records 24 articles from 9 countries met the inclusion criteria. Key facilitators identified included pharmacists' openness to practice change and a high degree of patient satisfaction post medication review. Attracting patients to the service was stated as challenging due to an unawareness of the scope and potential benefit of a medication review. The dominant barrier was inadequate remuneration, as it impacted all additional resourcing and ultimately the viability of the service. Further barriers included difficult professional relationships with doctors and little mandate from health authorities. Most reports were from the employed pharmacists' perspective and concerned the inner setting, other perspectives were under-reported. CONCLUSIONS Results of this systematic review illustrate different stakeholders' experiences and add to the understanding of challenges in the implementation process. Nevertheless, findings also highlight how scarce reporting of external stakeholders' views is and that filling this gap can unveil hidden barriers and facilitators. REGISTRATION PROSPERO register (CRD 42019122836).
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12
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Factors influencing the implementation of pharmaceutical care in outpatient settings: A systematic review applying the Consolidated Framework for Implementation Research. Res Social Adm Pharm 2021; 18:2579-2592. [PMID: 34158263 DOI: 10.1016/j.sapharm.2021.06.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 05/18/2021] [Accepted: 06/13/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pharmaceutical care in outpatient settings is a type of health service that has been shown to contribute to decreasing drug-related morbidity and mortality rates. However, every process of implementing a new service brings about changes and transformations in the work routine, thus posing challenges. OBJECTIVES This systematic review aims to identify barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings by applying the CFIR method, a framework based on the theory of health services, used to analyze and synthesize research data, which can direct strategies for the service to work as planned. METHODS A systematic review was conducted exploring the barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings. The MEDLINE, EMBASE, CINAHL, COCHRANE, and LILACS databases were consulted. RESULTS Eight studies were included: five qualitative ones, two mixed-method ones, and a quantitative one. The most frequent CFIR constructs identified were Patient Needs and Resources (n = 30, 10.75%), Knowledge and Beliefs about the Intervention (n = 31, 11.11%), Networks and Communications (n = 34, 12.19%), and Available Resources (n = 56, 20.07%). The most cited barriers were: insufficient human resources, patients' unawareness of the existence of the pharmaceutical care service, and pharmacists' resistance to changes. Facilitators included: the opportune presentation of the service to the healthcare team; the use of electronic devices for specific guidance; and the assessment of patient satisfaction. CONCLUSIONS This systematic review allowed detecting key guidelines to improve the implementation process, including (1) defining an implementation method and exploring it extensively during the pre-implementation phase, (2) ensuring human and financial resources, (3) determining how the new service will interact with other existing services. More research is needed to understand how these factors can affect the implementation of clinical services.
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13
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Dascanio SA, Nowa S, Nicholas S, Kumwenda H, Urick BY, Steeb DR. Implementation and evaluation of clinical pharmacy services through quality improvement in a Tertiary Hospital in Malawi. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Sarah A. Dascanio
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy Chapel Hill North Carolina USA
| | | | | | | | - Benjamin Y. Urick
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy Chapel Hill North Carolina USA
| | - David R. Steeb
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy Chapel Hill North Carolina USA
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14
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Dos Santos Júnior GA, Silva ROS, Onozato T, Silvestre CC, Rocha KSS, Araújo EM, de Lyra-Jr DP. Implementation of clinical pharmacy services using problematization with Maguerez Arc: A quasi-experimental before-after study. J Eval Clin Pract 2021; 27:391-403. [PMID: 32790199 DOI: 10.1111/jep.13448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/07/2020] [Accepted: 07/03/2020] [Indexed: 11/28/2022]
Abstract
RATIONALE, AIMS, AND OBJECTIVES The growth of clinical pharmacy services (CPS) has positively impacted clinical, economic, and humanistic health outcomes. However, detailed studies on the process of implementing CPS in healthcare systems are incipient. Thus, the present study aimed to evaluate the CPS implementation in certain public health units in a metropolis in northeast Brazil. METHODS A quasi-experimental before-and-after study was carried out in Recife City, from July 2015 to March 2016. The study was carried out using the Methodology of Problematization with Maguerez Arc and was divided into: initial evaluation (before), planning, interventions, and preliminary evaluation (after). The participants were pharmacists, patients, health professionals, and local health managers. Descriptive statistics were used to report data. The statistical significance of the comparison between variables was evaluated using the Wilcoxon test (95% CI; P ≤ .05). RESULTS Initial evaluation: Identified incipient CPS, a lack of structure and work process of pharmacists. Planning: Sixteen brainstorming meetings were held with the different actors resulting in a strategic plan. INTERVENTION Twenty-two political-administrative meetings were held with managers and health teams and 768 hours of theoretical and practical training with mentoring for pharmacists. Preliminary evaluation: Structure indicators presented a statistically significant difference, differently from the process indicators. Pharmacists attended 842 patients and performed 1465 pharmaceutical consultations in 6 months. Regarding the outcome indicators, it was possible to identify changes in the clinical status of the most prevalent diseases among those patients who attended three pharmaceutical consultations. CONCLUSIONS It was possible to evaluate the CPS implementation in certain public health units in a metropolis in Brazil, through the Methodology of Problematization with Maguerez Arc. This methodology may be part of models for future implementations of CPS in health systems.
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Affiliation(s)
| | - Rafaella Oliveira Santos Silva
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Sergipe, Brazil
| | - Thelma Onozato
- Department of Pharmacy and Nutrition, Federal University of Espírito Santo, Espírito Santo, Brazil
| | | | - Kérilin Stancine Santos Rocha
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Sergipe, Brazil
| | - Elton Matos Araújo
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Sergipe, Brazil
| | - Divaldo Pereira de Lyra-Jr
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Sergipe, Brazil
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15
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Measuring implementation of medication optimization services: Development and validation of an implementation outcomes questionnaire. Res Social Adm Pharm 2021; 17:1623-1630. [PMID: 33526353 DOI: 10.1016/j.sapharm.2021.01.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/23/2020] [Accepted: 01/03/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Implementation outcomes serve as progress and success indicators of the implementation process. They are also key antecedents to achieving the more traditional clinical outcomes typically associated with a service. Despite their importance, there are few implementation outcomes measures with appropriate psychometric properties, none of which have yet been adapted for medication optimization services. OBJECTIVES This study aims to develop and validate the Implementation Outcomes Questionnaire (IOQ) to assess implementation of medication optimization services, starting with Comprehensive Medication Management (CMM). The resulting IOQ is a 40-item self-report instrument for six implementation outcomes, including adoption, acceptability, feasibility, appropriateness, penetration, and sustainability. METHODS A three-phase approach was used to develop and validate the IOQ. Development of the instrument, Phase I, was informed by a targeted search of existing implementation outcomes measures in other fields, a review of suitableoptions options by an expert panel, and item adaptation. To assess content validity, Phase II, an internal vetting process was conducted using an adapted version of Rubio and colleagues' methodology. Evidence of reliability and construct validity, Phase III, was obtained through a pilot test with 167 pharmacists within 78 different care settings. RESULTS Overall, the results supported the reliability and validity (both content and construct) of the IOQ, with further psychometric testing needed for adoption. The items' relevance, clarity, and alignment with each implementation concept were high, except for Penetration. As a result, the Penetration items were refined for further use. Best-fit models were identified for each outcome based on the MCFA analyses, thereby providing insights into the factor structures and interpretation for each measure. Cronbach' alphas indicated good internal consistency. CONCLUSIONS This questionnaire is the first of its kind tailored to medication optimization services, starting with CMM. Access to this survey should facilitate measurement of implementation outcomes, thereby increasing the likelihood of achieving the desired clinical outcomes.
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16
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Sin CMH, Huynh C, Dahmash D, Maidment ID. Factors influencing the implementation of clinical pharmacy services on paediatric patient care in hospital settings. Eur J Hosp Pharm 2021; 29:180-186. [PMID: 33472818 DOI: 10.1136/ejhpharm-2020-002520] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This systematic review (SR) was undertaken to identify and summarise any factors which influence the implementation of paediatric clinical pharmacy service (CPS) from service users' perspectives in hospital settings. METHODS Literature search from EMBASE, MEDLINE, Web of Science (Core Collection), Cochrane Library, Scopus and CINAHL databases were performed in order to identify any relevant peer-reviewed quantitative and qualitative studies from inception until October 2019 by following the inclusion criteria. Boolean search operators were used which consisted of service, patient subgroup and attribute domains. Studies were screened independently and included studies were quality assessed using Mixed Methods Appraisal Tool. The study was reported against the 'Enhancing Transparency in Reporting the Synthesis of Qualitative Research' statement. RESULTS 4199 citations were screened by title and abstract and 6 of 32 full publications screened were included. There were two studies that were graded as 'high' in quality, with four graded as 'moderate'. The analysis has led to the identification of seven factors categorised in five predetermined overarching themes. These were: other healthcare professionals' attitudes and acceptance; availability of clinical pharmacist on ward or outpatient settings; using drug-related knowledge to perform clinical activities; resources for service provision and coverage; involvement in a multidisciplinary team; training in the highly specialised areas and development of communication skills. CONCLUSION Evidence for paediatric CPS was sparse in comparison to a similar SR conducted in the adult population. An extensive knowledge gap within this area of practice has therefore been identified. Nevertheless, majority of the factors identified were viewed as facilitators which enabled a successful implementation of CPS in paediatrics. Further research is needed to identify more factors and exploration of these would be necessary in order to provide a strong foundation for strategic planning for paediatric CPS implementation and development.
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Affiliation(s)
- Conor Ming-Ho Sin
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK .,Pharmacy Department, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
| | - Chi Huynh
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Dania Dahmash
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Ian D Maidment
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
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17
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Cheong MWL. 'To be or not to be in the ward': The Impact of Covid-19 on the Role of Hospital-Based Clinical Pharmacists - A Qualitative Study. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2020; 3:1458-1463. [PMID: 32838225 PMCID: PMC7436366 DOI: 10.1002/jac5.1315] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 11/17/2022]
Abstract
Introduction The coronavirus disease 2019 (COVID‐19) pandemic has significantly affected health care systems around the world. In many hospitals and health care facilities, services and health care workers have been reorganized and restructured to meet the demands of the pandemic. The impact of the pandemic on hospital‐based clinical pharmacists and their ability to deliver pharmaceutical care is currently unknown. Objective This study aimed to explore the impact of the COVID‐19 pandemic on hospital‐based clinical pharmacists working in Malaysia and the implications on how clinical pharmacy is perceived as a health care service. Methods A qualitative study was designed to meet the research objectives. Nineteen hospital‐based clinical pharmacists consented and participated in one‐on‐one, semi‐structured interviews. The interviews were transcribed and analyzed using an iterative thematic analysis approach. Results The experiences and views of the participants were reported. Three main themes were developed: “Reassignment and other changes in clinical pharmacist roles,” “Adapting clinical pharmacy services to COVID‐19,” and “The need for clinical pharmacists in the ward.” The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment. Despite this, clinical pharmacists continued to support patient care in hospitals through the use of technology. The withdrawal of clinical pharmacy services, however, raises concern that the role of clinical pharmacists is still poorly recognized. Conclusion Clinical pharmacists in hospitals continue to support patient care despite the disruption caused by the COVID‐19 pandemic. Greater support and recognition of their role is required in order to empower and enhance their ability to deliver pharmaceutical care.
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