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Hatem NAH, Ibrahim MIM, Yousuf SA. Exploring knowledge, attitudes and practice toward medication therapy management services among pharmacists in Yemen. PLoS One 2024; 19:e0301417. [PMID: 38578732 PMCID: PMC10997124 DOI: 10.1371/journal.pone.0301417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/16/2024] [Indexed: 04/07/2024] Open
Abstract
Medication therapy management (MTM) refers to the activities provided by pharmacists that patients recognize as evidence of care being provided. It encompasses the services that patients value and consider valuable. Many developing nations like Yemen have had poor implementation of MTM services. Thus, this research assessed the Knowledge, Attitudes, and Practices (KAP) of Yemen pharmacists regarding MTM. We conducted a cross-sectional study using a self-administered questionnaire among pharmacists in Sana'a, Yemen. They were recruited through convenience sampling. The alpha level of 0.05 was used to determine statistical significance. Four hundred and sixty-one (461) pharmacists completed the questionnaire. About 70% were working in community pharmacies and 57.3% had (1-5) years of experience in pharmacy practice. The younger pharmacists had a higher level of knowledge than pharmacists with older age with median and IQR of 1.2(1.2-1.4) and 1.2(1-1.4) respectively (p < 0.001). Yemen pharmacists have positive attitudes toward MTM indicating a moderated level of attitudes with a median and IQR of 3.8(3.5-4). Hospital pharmacists expressed more positive attitudes toward MTM (P < 0.001) than pharmacists from other areas of practice. Only 11% of sampled pharmacists frequently offered MTM services. The top MTM service reported by Yemen pharmacists was "Performing or obtaining necessary assessments of the patient's health status". However, "Formulating a medication treatment plan" received the least provided MTM service among Yemen pharmacists. Even though MTM services are not commonly utilized in pharmacy practice, Yemeni pharmacists have positive attitudes concerning MTM. Efforts are needed to enhance their MTM knowledge and the value of providing MTM services as well as to develop a culture of continuing pharmacy education about MTM among pharmacists.
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Affiliation(s)
- Najmaddin A. H. Hatem
- Department of Clinical Pharmacy, College of Clinical Pharmacy, Hodeidah University, Al-Hudaydah, Yemen
| | | | - Seena A. Yousuf
- Social Medicine and Public Health Department, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen
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Al-jedai AH, Mayet AY, Khurshid F, Alsultan MS. Pharmacy practice in hospital settings in GCC countries: Pharmacists' medication therapy monitoring activities. Saudi Pharm J 2024; 32:101952. [PMID: 38283152 PMCID: PMC10820306 DOI: 10.1016/j.jsps.2024.101952] [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: 11/26/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Purpose Our study aims to provide an overview of medication therapy monitoring practices carried out by pharmacists in hospitals across the Gulf Cooperation Council (GCC) countries. Methods This is a cross-sectional questionnaire-based study of hospitals located in the GCC. Questions were adopted from the American Society of Health-System Pharmacists (ASHP) national survey. Frequency analyses were used to examine the number and percentages of specific responses to the survey questions. Results A total of 64 hospitals participated in this survey, reflecting an overall response rate of 52.0%. Almost half of participating hospitals (48.4%) were from Saudi Arabia. Among the 64 participating hospitals, 54.7% monitored their patients daily, 40.6% assigned pharmacists to patient care units for at least eight hours per day, and 42.2% held pharmacists accountable for medication-related outcomes. Moreover, the criteria used to identify patients requiring monitoring, 35.9% relied on the list of high-risk medications, 26.5% relied on specific medical services, 21.9% relied on directions from the hospital committee, and 17.2% relied on lab abnormalities. The most frequently utilized method for monitoring adverse drug events (ADEs) was through notifications from nurses or physicians, observed in 60.9% of participating hospitals. Conclusion The survey emphasizes the need for hospitals in the GCC to promote increased pharmacist accountability for medication-related outcomes, explore technological solutions to enhance monitoring efficiency and extend the presence of pharmacists in patient care units beyond the current level.
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Affiliation(s)
- Ahmed H. Al-jedai
- Therapeutic Affairs, Ministry of Health, Riyadh, Saudi Arabia
- Colleges of Medicine and Pharmacy, Al-Faisal University, Riyadh, Saudi Arabia
| | - Ahmed Y. Mayet
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
| | - Fowad Khurshid
- Department of Pharmacy, Institute of Biomedical Education and Research, Mangalayatan University, Aligarh 202145, India
| | - Mohammed S. Alsultan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P.O. Box: 2457, Riyadh 11451, Saudi Arabia
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Zaraa S, Steve White H, Stergachis A, Novotny EJ, Protos C, Simic G, Bacci JL. Using design thinking to strengthen the community pharmacist's role in epilepsy care. Epilepsy Behav 2024; 150:109542. [PMID: 38035539 DOI: 10.1016/j.yebeh.2023.109542] [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: 08/02/2023] [Revised: 11/12/2023] [Accepted: 11/13/2023] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To use design thinking to develop a community pharmacist-led intervention for people living with epilepsy (PWE) with desirable, feasible, and viable features. METHODS This study used design thinking. Three patient personas were created based on previous research: a newly diagnosed PWE, a well-controlled PWE, and a complex PWE with uncontrolled seizures. An intervention prototype was developed for each of the three personas. Structured interviews were conducted with pharmacists, pharmacy students, patients with diagnosed epilepsy, and caregivers to elicit feedback on which features of each intervention prototype were desirable, feasible, and viable. Interviews were analyzed using rapid content analysis. A multidisciplinary advisory group and the research team prioritized features of the prototypes to include in the final intervention. RESULTS The following four features were identified as desirable, feasible, and viable for a pharmacist-led intervention for PWE: (1) pharmacist-patient consultations, (2) care plan development, (3) regular check-ins, and (4) care coordination with other health care providers. SIGNIFICANCE This study identified evidence-based features for a community pharmacist intervention to support epilepsy care using design thinking. A pilot study to evaluate this intervention on the quality of life (QoL), health outcomes and satisfaction of PWE can inform the implementation and feasibility of such patient services.
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Affiliation(s)
- Sabra Zaraa
- Department of Pharmacy, University of Washington School of Pharmacy, 1959 NE Pacific Street, Box 357630, Seattle, WA 98195, USA.
| | - H Steve White
- Department of Pharmacy, University of Washington School of Pharmacy, 1959 NE Pacific Street, Box 357630, Seattle, WA 98195, USA
| | - Andy Stergachis
- Department of Pharmacy, University of Washington School of Pharmacy, 1959 NE Pacific Street, Box 357630, Seattle, WA 98195, USA; Department of Global Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Edward J Novotny
- Department of Neurology, University of Washington School of Medicine, Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA
| | | | | | - Jennifer L Bacci
- Department of Pharmacy, University of Washington School of Pharmacy, 1959 NE Pacific Street, Box 357630, Seattle, WA 98195, USA
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Alotaibi FM, Bukhamsin ZM, Alsharafaa AN, Asiri IM, Kurdi SM, Alshayban DM, Alsultan MM, Almalki BA, Alzlaiq WA, Alotaibi MM. Knowledge, Attitude, and Perception of Health Care Providers Providing Medication Therapy Management (MTM) Services to Older Adults in Saudi Arabia. Healthcare (Basel) 2023; 11:2936. [PMID: 37998428 PMCID: PMC10671085 DOI: 10.3390/healthcare11222936] [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: 10/08/2023] [Revised: 11/04/2023] [Accepted: 11/08/2023] [Indexed: 11/25/2023] Open
Abstract
INTRODUCTION Medication Therapy Management (MTM) is identified as a group of services provided to the patient in order to optimize the medication use in order to mitigate adverse drug reactions (ADRs), drug-drug interaction (DDI), and polypharmacy. Elderly populations above 60 years old are at high risk for Medication-related Problems (MRPs) due to several factors. Therefore, MTM programs showed good contributions globally regarding enhancing medication use in the elderly population. Thus, evident information regarding its implementation in Saudi Arabia is lacking in the literature. OBJECTIVE Our objective is to assess community pharmacists' knowledge, attitude, and barriers to providing MTM services to the older adult population in Saudi Arabia. METHODOLOGY A cross-sectional study has been conducted among community pharmacists across the Kingdom. It was survey-based research that was designed and conducted through (QuestionPro). The survey was distributed for the community pharmacists from Feb-May 2023 via (QuestionPro). Descriptive analysis was performed using SAS OnDemand to analyze the categorical variables and test it with the outcome of interest. RESULTS Out of the 528 participants who have viewed our questionnaire, 319 participants have completed the survey in 5 min average time. Most of our participants were male, holding a bachelor's degree, and had an average working load of more than 40 h a week, respectively (84.95%, 92.48%, and 76.18%). In addition, the participants were from different regions of the Kingdom, which enhanced the generalizability of our findings. Moreover, 65.52% have reported a higher level of knowledge, while 34.48% have reported a moderate to low level of knowledge regarding MTM service. Most of those with a higher level of knowledge maintain a positive attitude regarding MTM service, its implementation, and dealing with older adult patients in the community pharmacy. In addition, lacking the time, training, and presence of a private consultation room were the top barriers to provide MTM services in the community pharmacy in Saudi Arabia. CONCLUSION Educational sessions regarding MTM services among the older adult population are highly recommended for community pharmacists before its implementation.
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Affiliation(s)
- Fawaz M. Alotaibi
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Zainab M. Bukhamsin
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Alanoud Nasser Alsharafaa
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Ibrahim M. Asiri
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Sawsan M. Kurdi
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Dhafer M. Alshayban
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Mohammed M. Alsultan
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Bassem A. Almalki
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Wafa Ali Alzlaiq
- Pharmacy Practice Department, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia; (Z.M.B.); (A.N.A.); (I.M.A.); (S.M.K.); (D.M.A.); (M.M.A.); (B.A.A.)
| | - Mansour M. Alotaibi
- Pharmacy Practice Department, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
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Rendrayani F, Alfian SD, Wahyudin W, Puspitasari IM. Knowledge, attitude, and practice of medication therapy management: a national survey among pharmacists in Indonesia. Front Public Health 2023; 11:1213520. [PMID: 37529431 PMCID: PMC10388185 DOI: 10.3389/fpubh.2023.1213520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/27/2023] [Indexed: 08/03/2023] Open
Abstract
Introduction The use of medication therapy management (MTM) is a proven method for reducing medication errors. MTM services rely heavily on pharmacists as service providers, particularly in community health centers (CHCs). Thus, understanding the knowledge, attitudes, and practices (KAP) of MTM among pharmacists in CHCs is crucial to the strategy for the implementation of MTM program in Indonesia. This study aimed to assess the level of KAP regarding MTM among pharmacists working at CHCs and its associated factors and investigate pharmacists' perceptions of the barriers and facilitators of MTM provision in the future. Methods A cross-sectional online survey was conducted. The respondents were pharmacists working at CHCs in 28 provinces in Indonesia. Descriptive statistics were used to summarize the responses. Demographic differences were determined using Chi-square and Kruskal-Wallis tests, and associations were identified using multivariable ordinal regression for knowledge and multivariable logistic regression for attitude and practice. Barriers and facilitators were determined from codes and categories of frequency derived from pharmacists' responses to the open-ended questions. Results Of the 1,132 pharmacists, 74.9% had a high level of knowledge, 53.6% had a positive attitude, and 57.9% had a positive practice toward MTM. Gender, practice settings, province of CHCs, years of practice, and experience in MTM services were factors associated with the KAP level. Respondents perceived that the chronic disease conditions in Indonesia, MTM service features, and current practices were facilitators of MTM provision. The lack of interprofessional collaboration, staff, pharmacist knowledge, patient cooperation, facilities/drug supply/documentation systems, stakeholder support, and patient compliance were the most common barriers to MTM implementation in the future. Conclusion Most of the pharmacists had high knowledge of MTM; however, only half had positive attitudes and practices toward MTM. Information about factors associated with the KAP level suggests that direct involvement is essential to improve pharmacists' understanding and view of MTM. Pharmacists also perceived barriers to the MTM provision in the future, such as interprofessional and pharmacist-patient relationships. A training program is needed to improve the KAP of MTM and develop skills for collaborating with other healthcare professionals and communicating with patients.
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Affiliation(s)
- Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Sofa Dewi Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
| | - Wawan Wahyudin
- Ciloto Health Training Centre, Ministry of Health Republic of Indonesia, Cianjur, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
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Deng ZJ, Gui L, Chen J, Peng SS, Ding YF, Wei AH. Clinical, economic and humanistic outcomes of medication therapy management services: A systematic review and meta-analysis. Front Pharmacol 2023; 14:1143444. [PMID: 37089963 PMCID: PMC10113465 DOI: 10.3389/fphar.2023.1143444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 03/27/2023] [Indexed: 04/08/2023] Open
Abstract
Background: Medication therapy management (MTM) services is a method that can effectively improve patients’ conditions, but the efficacy of economic and humanistic outcomes remain unclear. This systematic review and meta-analysis aim to use economic, clinical and humanistic outcomes to evaluate the multi-benefits of MTM services.Method: A systematic review and meta-analysis was conducted by retrieving PubMed, EMBASE, the Cochrane Library and ClinicalTrial.gov from the inception to April 2022. There were two reviewers screening the records, extracting the data, and assessing the quality of studies independently.Results: A total of 81 studies with 60,753 participants were included. MTM services were more effective in clinical outcomes with decreasing the rate of readmission (OR: 0.78; 95% CI: 0.73 to 0.83; I2 = 56%), emergency department visit (OR: 0.88; 95% CI: 0.81 to 0.96; I2 = 32%), adverse drug events (All-cause: OR: 0.68; 95% CI: 0.56 to 0.84; I2 = 61%; SAE: OR: 0.51; 95% CI: 0.33 to 0.79; I2 = 35%) and drug-related problems (MD: −1.37; 95% CI: −2.24 to −0.5; I2 = 95%), reducing the length of stay in hospital (MD: −0.74; 95% CI: −1.37 to −0.13; I2 = 70%), while the economic and humanistic outcomes were less effective.Conclusion: Our systematic review and meta-analysis demonstrated that MTM services had great ability to improve patients’ clinical conditions while the efficacy of economic and humanistic outcomes, with some of the outcomes showing high degree of heterogeneity and possible publication bias, required more future studies to provide stronger evidence.Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=349050], identifier [CRD42022349050].
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Affiliation(s)
| | | | | | | | | | - An-Hua Wei
- *Correspondence: Yu-Feng Ding, ; An-Hua Wei,
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Meng Q, Sun L, Ma Y, Wei Y, Ma X, Yang L, Xie Z, Li F, Wang Z, Tao X, Zhen X, Jin R, Gu H. The impact of pharmacist practice of medication therapy management in ambulatory care: an experience from a comprehensive Chinese hospital. BMC Health Serv Res 2023; 23:176. [PMID: 36810022 PMCID: PMC9945368 DOI: 10.1186/s12913-023-09164-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 02/08/2023] [Indexed: 02/23/2023] Open
Abstract
BACKGROUD With the reform of medical system in China, Beijing municipal hospitals explored a new pharmaceutical care model and set up medication therapy management services (MTMs) in ambulatory care since 2019. We were one of the first hospitals to set up this service in China. At the present, there were relatively few reports about the effect of MTMs in China. In this study, we summarized the implementation of MTMs in our hospital, explore the feasibility of pharmacist-led MTMs in ambulatory care and the impact of MTMs on patients' medical costs. METHODS A retrospective study was conducted in a university-affiliated, tertiary comprehensive hospital in Beijing, China. The patients who received at least one MTMs and with complete medical records and pharmaceutical documents from May 2019 to February 2020 were included. Pharmacists provided pharmaceutical care for patients according to the MTMs standards issued by the American Pharmacists Association, identified the numbers and classification of the patients' perceived medication-related demands, identified medication-related problems (MRPs), and developed the medication-related action plans (MAPs). All MRPs found by pharmacists, pharmaceutical interventions, and resolving recommendations were documented, and calculate the cost of treatment drugs that patients can reduce. RESULTS A total of 112 patients received MTMs in ambulatory care, among them 81 cases with the completed record were included in this study. 67.9% of patients had five or more diseases, 83% of them co-took over 5 drugs. While performing MTMs, 128 patients' perceived medication-related demands were recorded in all, monitoring and judgment of adverse drug reaction (ADR) (17.19%) was the most common demand. 181 MRPs were found, with an average of 2.55 MPRs per patient. Nonadherence (38%), excessive drug treatment (20%), and adverse drug events (17.12%) were the top three MRPs. Pharmaceutical care (29.77%), adjustment of drug treatment plan (29.10%) and referral to the clinical department (23.41%) were the top three MAPs. Whereby the MTMs provided by pharmacists, the cost-saving of each patient was about $ 43.2 monthly. CONCLUSION By participating in the MTMs of outpatients, the pharmacists could identify more MRPs and develop personalized MAPs timely for patients, thereby promoting rational drug use and reducing medical expenses.
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Affiliation(s)
- Qingli Meng
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Lulu Sun
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Yingjie Ma
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Yuanyuan Wei
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Xiaowei Ma
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Lu Yang
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Zhengzheng Xie
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Fang Li
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Zhe Wang
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Xiaomei Tao
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Xia Zhen
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Rui Jin
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038 China ,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China ,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038 China
| | - Hongyan Gu
- Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China. .,Beijing Key Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China. .,International Cooperation & Joint Laboratory of Bio-Characteristic Profiling for Evaluation of Rational Drug Use, Beijing, 100038, China.
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Li N, Song JF, Zhang MZ, Lv XM, Hua HL, Chang YL. Impact of medication therapy management (MTM) service model on multi-morbidity (MMD) patients with hypertension: a pilot RCT. BMC Geriatr 2023; 23:10. [PMID: 36609228 PMCID: PMC9824935 DOI: 10.1186/s12877-023-03725-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 01/02/2023] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND This study explored the impact of MTM service on MMD patients with hypertension. METHODS A total of 120 MMD inpatients from September to November 2019 were received and randomly divided into intervention group and control group. General services for noninfectious chronic diseases were given to the control group, while a standard MTM service was given to the intervention group. Patients' blood pressure, EQ-5D utility value, readmission rate, drug-related problems, and average daily medication therapy cost were compared between the two groups and within the groups. This was done at the initial admission phase and in the first, third, sixth, and twelfth months after discharge. RESULTS The intervention group had significantly lower blood pressure and average daily medication therapy cost 12 months after discharge compared to the control group (systolic blood pressure: P = 0.023, diastolic blood pressure: P < 0.001, average daily medication therapy cost: P = 0.049); the number of DRPs decreased in both groups 12 months after discharge; the number of DRPs solved in the intervention group in the third, sixth and twelfth months after discharge were statistically higher compared with that in the control group (P = 0.013, P = 0.012, P = 0.001); there was no significant difference in the EQ-5D utility value and readmission rate between the two groups (P > 0.05). CONCLUSIONS MTM implementation in MMD patients can improve health outcomes and reduce healthcare-related costs among MMD patients. TRIAL REGISTRATION Chinese Clinical Trial Register ChiCTR2200065111, date of registration: October 28, 2022.
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Affiliation(s)
- Na Li
- grid.479690.50000 0004 1789 6747Department of Pharmacy, Taizhou People’s Hospital, No.366, Taihu Road, Taizhou City, 225300 Jiangsu Province China
| | - Jin-fang Song
- grid.459328.10000 0004 1758 9149Department of Clinical Pharmacy, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu Province China ,grid.417303.20000 0000 9927 0537Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, Jiangsu Province China
| | - Ming-zhu Zhang
- Shandong Provincial Third Hospital, Jinan, Shandong Province China
| | - Xiao-min Lv
- grid.479690.50000 0004 1789 6747Department of Pharmacy, Taizhou People’s Hospital, No.366, Taihu Road, Taizhou City, 225300 Jiangsu Province China
| | - Hui-lian Hua
- grid.479690.50000 0004 1789 6747Department of Pharmacy, Taizhou People’s Hospital, No.366, Taihu Road, Taizhou City, 225300 Jiangsu Province China
| | - Yi-ling Chang
- grid.479690.50000 0004 1789 6747Department of Pharmacy, Taizhou People’s Hospital, No.366, Taihu Road, Taizhou City, 225300 Jiangsu Province China
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Rendrayani F, Alfian SD, Wahyudin W, Puspitasari IM. Pharmacists' Knowledge, Attitude, and Practice of Medication Therapy Management: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10122513. [PMID: 36554036 PMCID: PMC9778396 DOI: 10.3390/healthcare10122513] [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: 11/09/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Understanding pharmacists' knowledge, attitudes, and practices (KAP) and their perceptions of challenges, barriers, and facilitators towards medication therapy management (MTM) provision are vital in informing the design and implementation of successful service delivery. Thus, this review examined pharmacists' knowledge, attitudes, and practices, and their perceived challenges, barriers, and facilitators to MTM services provision, globally. A systematic search was conducted on 1-31 August 2022 to identify relevant studies on PubMed and EBSCO, supplemented with a bibliographic and a particular hand search. We focused on original research in quantitative survey form with the key concepts of "medication therapy management", "pharmacists", and "knowledge, attitude, practice". We assessed the reporting quality using the Checklist for Reporting of Survey Studies (CROSS). Results are reported narratively and according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. From 237 articles identified, 17 studies met the eligibility criteria. Of the included studies, five reported that pharmacists had a considerable level of knowledge, seven suggested a positive attitude among pharmacists, and five revealed that pharmacists had been practicing some MTM elements. Factors associated with pharmacists' KAP may include age, educational degree, additional qualification, income, years of practice, practice setting, and experience in patient care service. The challenges toward MTM provision were related to the pharmacist-patient and pharmacist-physician relationship. Insufficient time, staff, compensation, and training were the barriers, while patients' willingness to participate and educational background were the facilitators of MTM provision. These findings of studies on KAP could help develop an MTM program and design an intervention to improve program effectiveness. Further research focusing on other quantitative and qualitative studies of KAP is needed to obtain a comprehensive approach to MTM provision.
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Affiliation(s)
- Farida Rendrayani
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Sofa Dewi Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
| | - Wawan Wahyudin
- Ciloto Health Training Centre, Ministry of Health Republic of Indonesia, Cianjur 43253, West Java, Indonesia
| | - Irma Melyani Puspitasari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang 45363, West Java, Indonesia
- Correspondence:
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Cheng HT, Zhao M, Liu HT, Shen GL, Zhao T, Feng ZE. The prevalence of chronic medication therapy problems and pharmacists' interventions among hospitalized perioperative patients: a retrospective observational study. BMC Health Serv Res 2022; 22:1483. [PMID: 36474239 PMCID: PMC9724277 DOI: 10.1186/s12913-022-08897-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Inadequate preoperative management of chronic medications can place perioperative patients at risk and cause unnecessary delays in surgical procedures. This study aims to investigate the prevalence of chronic medication therapy problems (CMTPs) in hospitalized perioperative patients and assess the relevance of pharmacists' interventions. METHODS We conducted a retrospective study of pharmacist-led preoperative management of chronic medications in hospitalized adult patients from November 2018 to April 2019. The recorded drug-related problems (DRPs) were retrospectively reviewed and categorized according to the Pharmaceutical Care Network Europe classification V9.1 and were analyzed with a multinomial regression model to identify risk factors. RESULTS A total of 254 DRPs were recorded, with an average of 0.52 DRPs per patient. Treatment safety (66.9%) was the most common DRP. The most frequent causes of perioperative DRPs and nonperioperative DRPs were drug selection (72.9%) and patient related (50.8%), respectively. Of the 292 documented interventions, 71.6% were fully accepted by the clinicians and patients. The majority (68.9%) of the recorded problems were completely resolved. The number of comorbidities (OR = 3.815) and the number of chronic medications taken (OR = 1.539) were risk factors for the occurrence of DRPs. CONCLUSION The findings of this study suggest that pharmacist-led chronic medication therapy management in surgical wards may be an effective method to help reduce medication-related surgical risks and optimize the medication therapies used for the long-term treatment of chronic diseases.
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Affiliation(s)
- Hai-Ting Cheng
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050 China
| | - Ming Zhao
- grid.506261.60000 0001 0706 7839Department of Pharmacy, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences; Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application (Beijing Hospital), Beijing, 100730 China
| | - Hong-Tao Liu
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050 China
| | - Guo-Liang Shen
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050 China
| | - Ting Zhao
- grid.24696.3f0000 0004 0369 153XDepartment of Pharmacy, Beijing Stomatological Hospital, Capital Medical University, Beijing, 100050 China
| | - Zhi-En Feng
- grid.24696.3f0000 0004 0369 153XDepartment of Oral and Maxillofacial-Head and Neck Oncology, Beijing Stomatological Hospital, Capital Medical University, 100050 Beijing, China
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11
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Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review. Healthcare (Basel) 2022; 10:healthcare10091630. [PMID: 36141242 PMCID: PMC9498522 DOI: 10.3390/healthcare10091630] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 11/17/2022] Open
Abstract
Pharmacists are essential members of the healthcare team. The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has led pharmacists to undertake additional clinical roles. We aim to conduct a systematic review on the interventions and impact of pharmacist-delivered services in managing COVID-19 patients. We searched PubMed, Embase, Scopus, CINAHL plus, International Pharmaceutical Abstracts, and Web of Science from 1 December 2019 (the first case of COVID-19 emerged) to 13 January 2022 to retrieve the articles. Cochrane handbook and PRISMA guidelines were followed respectively to perform and report the review. The pharmacist-led interventions were reported following the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2. The protocol of systematic review was registered on PROSPERO (CRD42021277128). Studies quality was assessed with the modified NOS scale. In total, 7 observational studies were identified from 10,838 studies. Identification of dosage errors (n = 6 studies), regimen modifications (n = 5), removal of obsolete/duplicate medications (n = 5), identification and management of adverse drug reactions (n = 4), drug interactions prevention (n = 2), and physicians acceptance rate (n = 3) of therapy-related services delivered in-person or via tele-pharmacy were among the pharmacist-delivered services. Common interventions delivered by pharmacists also included optimizing the use of antibacterial, antivirals, and anticoagulants in COVID-19 infected patients. The acceptance of pharmacist-delivered services by physicians was high (88.5–95.5%). Included studies have described pharmacists’ beneficial role in managing patients with COVID-19 including detection, resolution, and prevention of medication-related problems, with physicians demonstrating high trust in pharmacists’ advice. Future research should assess the feasibility and scalability of such roles in real-world settings.
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12
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Wushouer H, Shi L, Guan X, Cui Y. China starts to pay for pharmaceutical services. J Clin Pharm Ther 2022; 47:1079-1080. [PMID: 35735168 DOI: 10.1111/jcpt.13721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/19/2022] [Accepted: 05/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Haishaerjiang Wushouer
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Luwen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Xiaodong Guan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,International Research Center for Medicinal Administration, Peking University, Beijing, China
| | - Yimin Cui
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.,Department of Pharmacy, Peking University First Hospital, Beijing, China.,Institute of Clinical Pharmacology, Peking University, Beijing, China
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Kadakia N, Horn E, Fawcett N, Ou A, Illingworth K. Utilization of an implementation framework to obtain provider perspectives of pharmacist-led clinical services. J Am Pharm Assoc (2003) 2022; 62:1659-1665.e3. [DOI: 10.1016/j.japh.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/02/2022] [Accepted: 04/11/2022] [Indexed: 10/18/2022]
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Strumia M, Fargeas JB, Marcellaud E, Del M, Dintilhac A, Remenieras L, Dmytruck N, Moreau S, Jaccard A, Jost J. Development of a decision tree for the pharmacy-led consultation of elderly patients with haematological malignancies. J Oncol Pharm Pract 2022; 29:685-694. [PMID: 35225044 DOI: 10.1177/10781552221080419] [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: 11/16/2022]
Abstract
INTRODUCTION Elderly patients with haematological malignancies are a population at risk of iatrogenic for whom these activities could optimize therapeutic management. However, the limitation of human resources requires optimization of the process in order to improve the efficiency of pharmaceutical activities. The objective was to build a decision tree to optimize the pharmaceutical consultation in these population within a multidisciplinary team in haematology. METHOD Pharmaceutical consultations were proposed to elderly subjects with haematological malignancies followed up in a haematology day hospitalization at the University Hospital of Limoges. Risk factors for prescribing risky drugs in this population were determined by logistic regression models. A decision tree was constructed based on these results and by agreement between pharmacist, geriatrician and hematologist. RESULTS Female gender (aOR[CI95%] = 1.71 [1.14-2.57]), polypharmacy (aOR[CI95%] = 1.89 [1.14-3.13]), hyper-polypharmacy (aOR[CI95%] = 5.73 [3.03-10.84]) and moderate cholinergic load (aOR[CI95%] = 2.15 [1.04-4.45]) were risk factors for the prescription of inappropriate medicine. Female gender (aOR[CI95%] = 1.55 [1.02-2.35]) and hyper-polypharmacy (aOR[CI95%] = 6.19 [1-1.28]) were risk factors for prescribing anticholinergic drugs or anticoagulants; in contrast, frailty status was a protective factor for prescribing anticholinergics (aOR[CI95%] = 0.51 [0.33-0.81]). Prioritization of pharmaceutical consultations is based on frailty status, prescription of a target drug and polypharmacy. DISCUSSION Pharmaceutical consultations during the day hospitalization of elderly subjects with hematological diseases allow to propose therapeutic optimizations. The prioritization proposed in our study would increase the efficiency of pharmaceutical activities in order to improve quality and safety throughout the care pathway of these patients.
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Affiliation(s)
| | | | | | - Mathilde Del
- INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, 539079Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
| | | | | | | | - Stéphane Moreau
- 37925Hematologic and Cell Therapy Department, CHU Limoges, France
| | - Arnaud Jaccard
- 37925Hematologic and Cell Therapy Department, CHU Limoges, France
| | - Jeremy Jost
- Pharmacy Department, CHU Limoges, France.,INSERM, Univ. Limoges, CHU Limoges, IRD, U1094 Tropical Neuroepidemiology, 539079Institute of Epidemiology and Tropical Neurology, GEIST, Limoges, France
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