Pharmaceutical care in Italy and other European countries: between care and commerce?

HIV Patients' Satisfaction with Pharmaceutical Care at a Nigerian Tertiary Healthcare Facility During the Covid-19 Pandemic

Background: Patients' satisfaction is an important indicator of determining the quality of pharmaceutical care (PC). This study investigated Human Immunodeficiency Virus (HIV) patients' satisfaction with PC at Federal Medical Centre, Keffi-Nigeria and determined the statistical correlation between the respondents' socio-demographic variables and their satisfaction with PC. Methods: This cross-sectional survey study involved 351 randomly selected HIV-positive patients receiving PC in the facility. A Likert-type questionnaire was used for the data collection. Results: The Cronbach's alpha of the questionnaire was .916. The "overall perception of pharmacists' care or service" had a mean satisfaction score of 4.24 ± 0.749 and "the amount of time spent with the pharmacists" had a mean score of 3.94 ± 0.791. No significant association was found between socio-demographic variables and overall patients' satisfaction with PC. Conclusion: The reliability of the questionnaire was high and the HIV patients had a good satisfaction with the PC they received in the facility.

Patient satisfaction with clinical pharmacy services and the affecting factors: a literature review

Service quality is measured to assess the consistency of medical services provided to fulfill patient expectations. This article provides an overview of patient satisfaction with clinical pharmacy services and the influencing factors. A literature search from MEDLINE and EBSCO databases was performed with the keywords “patient satisfaction”, “pharmacy service”, “hospital pharmacy service”, and “clinical pharmacy service”. The inclusion criteria for articles are original articles, full papers, articles in English, and published in 2011–2021. A total of 25 articles from 1,118 articles discussed patient satisfaction with clinical pharmacy services such as counseling, drug therapy monitoring, patient support programs, and pharmaceutical care. Generally, patients are satisfied with clinical pharmacy services such as counseling, drug therapy monitoring, patient support programs, and pharmaceutical care. The most influencing factors with clinical pharmacy services are the quality, convenience, ease of information, and confidence in pharmacist competence. Pharmacists should equip themselves with the appropriate knowledge and competencies in clinical pharmacy services for benefits their patients.

Problem-based learning case studies: Delivery of an educational method and perceptions at two schools of pharmacy in Italy

BACKGROUND AND PURPOSE

Problem-based learning (PBL) case studies are not currently offered in the pharmacy school curriculum in Italy. This study sought to assess the perceptions of a PBL case study activity delivered at two pharmacy schools in Italy.

EDUCATIONAL ACTIVITY AND SETTING

A total of 64 pharmacy students and three pharmacy faculty from Italy participated in the live PBL activity. They collaborated on teams with pharmacy students from the United States to discuss a patient case and prepare drug therapy recommendations. A cross-sectional survey was performed to assess the Italian participants' perceptions before and after partaking in the PBL activity.

FINDINGS

Results from the survey utilizing a five-point Likert-type scale (1 = strongly disagree to 5 = strongly agree) demonstrated that students and faculty from both pharmacy schools in Italy perceived the value in applying information learned in PBL to their current or future practices (4.48 ± 0.79) and in collaborating with a team to improve patient care (4.66 ± 0.79). In addition, the vast majority (93%) of participants agreed or strongly agreed that they would be interested in continuing to participate in PBL in the future.

SUMMARY

Students and faculty at two pharmacy schools in Italy found the delivery of a PBL exercise to be beneficial for their professional development. This may suggest an opportunity for pharmacy schools in Italy to add the PBL case-based teaching method into their curriculum.

Determinants of Satisfaction with Services, and Trust in the Information Received in Community Pharmacies: A Comparative Analysis to Foster Pharmaceutical Care Adoption

Patient’s satisfaction with community pharmacy services, and patients’ trust in the information received in community pharmacies are important drivers of pharmaceutical care adoption. An online questionnaire assessing patient satisfaction with the services received in pharmacies and trust in the pharmacist’s advice, along with their determinants, was administered to 343 Romanian chronic and non-chronic patients. Using various statistical tests, exploratory factor analysis, and robust regression we explored determinants of satisfaction and trust. We found that satisfaction with services is predicted by pharmacists’ attitude (β = 631, p < 0.001), low waiting time (β = 0.180, p < 0.001), affordable cost of the drugs (β = 0.09, p = 0.009), and drug availability (β = 0.157, p < 0.001). At the same time, trust in the information received is driven by pharmacists’ attention (β = 0.610, p < 0.001), whether the patient received precautionary information (β = 0.425, p < 0.001), low waiting time (β = 0.287, p < 0.001), and whether the respondent is a chronic patient or not (non-chronic patients express more trust, β = 0.328, p = 0.04). Our study expands the existing paradigm that sees trust as a simple predictor of satisfaction by showing that trust and satisfaction are predicted by different variables, and thus they should be addressed using different strategies. In fact, we found that they share only one predictor—waiting time, highly significant in both cases. Our findings show that, without prioritizing trust in the information received in community pharmacies to reduce information asymmetry between patient and pharmacist, the focus only on patient satisfaction may lead to a scenario in which community pharmacies will end up to be better integrated in the business sector and not in the public health system.

Empowering Public Health Pharmacy Practice-Moving from Collaborative Practice Agreements to Provider Status in the U.S

This article describes the history and evolution of pharmacist-physician collaborative practice agreements (CPAs) in the United States with future directions to support pharmacists’ provider status as the profession continues to evolve from product-oriented to patient-centered care and population health. The pharmacy profession has a long history of dispensing and compounding, with the addition of clinical roles in the late 20th century. These clinical roles have continued to expand into diverse arenas such as communicable and non-communicable diseases, antimicrobial stewardship, emergency preparedness and response, public health education and health promotion, and critical and emergency care. Pharmacists continue to serve as integral members of interprofessional and interdisciplinary healthcare teams. In this context, CPAs allow pharmacists to expand their roles in patient care and may be considered as a step towards securing provider status. Moving beyond CPAs to a provider status would enable pharmacists to be reimbursed for cognitive services and promote integrated public health delivery models.

Community and hospital pharmacists in Europe: encroaching on medicine?

Pharmacy has been historically regarded as a discipline between health and chemistry devoted to drug development, production, and compounding. These tasks have been almost lost with the industrial manufacturing, and dispensing remains the main activity of pharmacists. Hospital pharmacists are usually employees in their workplace, while the professional framework of community pharmacists is very different, being pharmacies predominantly private shops in almost all European countries. In the last years pharmacists have strongly advocated that the focus of their services should switch from 'product' to 'patient'. Clinical pharmacy and pharmaceutical care are the two most cited concepts to support this shift. Clinical pharmacy was originally defined as the area of pharmacy concerned with the science and practice of rational medication use, pharmaceutical care as the responsible provision of drug therapies to achieve definite outcomes. The practice of clinical pharmacy should embrace the philosophy of pharmaceutical care. The new wave of pharmacists' patient-centered care in Europe still seems to be a reaction against the loss of their traditional professional role after the drug manufacturing revolution. To depict a realistic scenario for progress, it is worth differentiating between hospital and community. Hospital pharmacists should strengthen their pivotal role of medication gatekeepers to improve among clinicians the appropriateness of drug prescriptions and generate savings in expenditures. Any proposal for clinical services provided by community pharmacists is inevitably affected by the issue of their potential remuneration, especially in countries where the remuneration for reimbursable drugs is still a proportion of the retail price.

Patients satisfaction with free healthcare pharmaceutical services in Sierra Leone: a national cross-sectional study

Background Patient satisfaction is a critical construct of quality of pharmaceutical care in that it reflects whether a given service is meeting patients' expectations and consistent with their values. The government of Sierra Leone in 2010 introduced a free healthcare policy, which includes free pharmaceutical services for under-five children, lactating mothers, and pregnant women at all governments hospitals nationawide. Objectives The main objective of this study is to evaluate patient's satisfaction with the pharmaceutical services received from public hospitals implementing the free healthcare policy. Setting Four randomly selected public hospitals in Sierra Leone, one from each of the four regions, providing free healthcare services. Methods A cross-sectional design, using an interview-administered questionnaire, was employed in this study. Data were analyzed in SPSS, continuous and categorical data were computed descriptively. Responses to the open question were quantified and analyzed thematically. Adjusted and crude logistical models were used to assess factors associated with satisfaction, and significance was taken at p < 0.05. Main outcome measure Patients satisfaction with pharmaceutical services provided in public hospitals in Sierra Leone. Results Overall, 797 questionnaires were analyzed. The majority of patients seeking free pharmaceutical services were satisfied (n = 470, 56%) or very satisfied (n = 229, 28.7%) with the services they received. Pharmacy staff which includes pharmacists and pharmacy techincians demonstrated good communication skills while delivering services, but lacked technical details like; how to handle (n = 187, 23.5%) and store (n = 135, 16.9%) drugs and their potential side effects (n = 253, 31.8%). Low satisfaction was observed with the lack of private area for patients counseling (n = 474, 60.1%), and a convenient waiting area (n = 229, 28.7%). Respondents also thought the pharmacy was too small (n = 191, 24.6%) and with less than optimal lighting system (n = 120, 15.0%). Dissatisfaction was associated with college/university students or graduates [AOR: 0.211 (0.083-0.537), p = 0.001] and those with household incomes less than SLL 1,000,000 [AOR: 0.391 (0.155-0.987) p = 0.047]. Conclusions Patients were generally satisfied with pharmaceutical services received; however, infrastructural upgrades of the pharmacy like a comfortable waiting area and private counselling area within the pharmacy scores low in their satisfaction level. Improvement on the pharmacy structure, and motivated pharmacy staff with the right technical training will enhance the effective delivery of quality pharmaceutical care within the free healthcare.

Factors influencing pharmacists' over-the-counter drug recommendations

BACKGROUND

Self-care is a growing trend all over the world, and pharmacists have a major role in it since they are the most easily accessible medical experts.

OBJECTIVES

Our aim was to investigate factors influencing pharmacists' over-the-counter (OTC) drugs recommendations in Croatia.

SETTING

A random sample of 565 (50%) of all pharmacies in Croatia.

METHODS

A cross-sectional study with a five-point Likert scale online questionnaire covering medical and non-medical factors influencing OTC drug recommendation was distributed in October 2017 to a random sample of pharmacies.

RESULTS

206/565 (response rate 36.5%) responses were collected. The most important factors influencing pharmacists' recommendation were: composition of the OTC product and its active component (4.76±0.47), scientific evidence of effectiveness (4.54±0.60), feedback from the patients (4.32±0.61) and information from professional journals (4.22±0.67). On average, medical factors had greater importance (4.5±0.58) for pharmacists' OTC recommendation than marketing (3.18±0.84) and social factors (3.15±0.79). Female pharmacists appeared less inclined to recommend an OTC product based on advice of other pharmacists (OR=0.61, CI=0.43 to 0.86, p=0.005) and pharmacists working directly in a pharmacy attached more importance to active components of OTC products during their OTC product counselling (OR=2.28, CI=0.92 to 5.65, p=0.03).

CONCLUSION

It is vital to know that pharmacists' OTC recommendations are mainly influenced by medical factors and to a lesser degree by marketing and social factors.

The Responsibility of Clinical Pharmacists for the Safety of Medication Use in Hospitalized Children: A Middle Eastern Experience

Objective:

We aimed to detect and report the frequency of occurrence of drug-related problems (DRPs) in a Middle Eastern University Children's Hospital (Isfahan, Iran) and classify them in terms of their nature and cause to clarify the responsibility of clinical pharmacists for the safe utilization of medications in hospitalized children.

Methods:

In this cross-sectional study which was carried out in Imam Hossein Children's University Hospital affiliated with Isfahan University of Medical Sciences (Isfahan, Iran) from September 2017 to May 2018, DRPs during the hospitalization of pediatric patients in three medical wards, the pediatric intensive care unit, and two neonatal intensive care units were detected and identified concurrently with the treatment process using Pharmaceutical Care Network of Europe data gathering form for DRPs v. 8.01. All cases were verified and validated in a professional focus group before documentation.

Findings:

We detected 427 DRPs in 201 out of 250 randomly included hospitalized children in which 86% of them were directly reported by the hospital's clinical pharmacist. The highest frequency of DRPs (47.3%) was observed in the age range of 1 month–2 years. Safety of treatment was the most frequently reported as the nature of the problem (43.5%), followed by effectiveness issues (36.8%). The most frequent cause of DRPs was dose selection issues (34.2%), followed by drug-type selection (25.5%), and unavailability of appropriate dosage forms (13.6%). Ninety-eight interventions were proposed by the clinical pharmacist, in which 59.2% of them were accepted.

Conclusion:

This study confirms the necessity for the active role of clinical pharmacists before, during, and after drug therapy in hospitalized pediatric patients for the safety and proper utilization of drugs in this vulnerable population.