1
|
Al-Maqbali JS, Taqi A, Al-Hamadani B, Gamal S, Al-Lawati E, Himali NA, Bahram F, Al-Jabri S, Al-Sharji N, Homood S, Siyabi BA, Siyabi EA, Al-Ajmi S, Al-Balushi K, Al-Zakwani I. Levels of agreement among clinical pharmacists on the impact of pharmaceutical interventions in Oman: A retrospective analysis. Pharm Pract (Granada) 2022; 20:2708. [PMID: 36733521 PMCID: PMC9851816 DOI: 10.18549/pharmpract.2022.3.2708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 08/05/2022] [Indexed: 02/05/2023] Open
Abstract
Objectives Disagreement between health care providers on medication-related interventions can affect clinical outcomes. We aimed to study the outcomes and significance of clinical pharmacists' interventions and evaluate the levels of agreement between different clinical pharmacists on the impact of pharmaceutical interventions. Methodology A retrospective study was conducted at a tertiary care hospital in Oman. The study included all documented interventions by clinical pharmacists for all categories of admitted patients that met the inclusion criteria. Results The originator clinical pharmacists interjected to improve the efficacy of treatment in (58%, n=1740) of the interventions, followed by toxicity reduction (24%). The level of agreement in the clinical significance resulted in substantial Scotts' kappa (k) between the originator and the first reviewer, the first and second reviewers, and the second reviewer and supervisor (86%; k=0.77; P<.001), (77%; k=0.63; P<.001), (84%; k=0.77; P<.001), respectively. In terms of grading of clinical significance, the originator clinical pharmacists recorded moderate significance in 50% of the interventions, followed by major (30%), not applicable (8.4%), and minor (7.3%). The level of agreement in the clinical significance resulted in substantial Scotts' k between the originator and the first reviewer, and between the second reviewer and supervisor (82%; k=0.72; P<.001), (84%; k=0.77; P<.001), respectively. The level of agreement between the first and second reviewer was fair (55%; k=0.28; p<0.001). Conclusion Clinical pharmacists' interventions have a crucial impact on patient safety, improving efficacy and reducing toxicities. Overall, there was a substantial agreement among clinical pharmacists on the clinical significance and grading of the interventions..
Collapse
Affiliation(s)
- Juhaina Salim Al-Maqbali
- Department of Pharmacy, Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.
| | - Aqila Taqi
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | | | - Sara Gamal
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Esra Al-Lawati
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Najwa Al Himali
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Fatima Bahram
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Suad Al-Jabri
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Nashwa Al-Sharji
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Saud Homood
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Bushra Al Siyabi
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Ekram Al Siyabi
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Samyia Al-Ajmi
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Kifah Al-Balushi
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Ibrahim Al-Zakwani
- Department of Pharmacy, Department of Pharmacology and Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman.
| |
Collapse
|
2
|
Valentino AS, Eddy E, Woods Z, Wilken L. Pharmacist Provided Spirometry Services: A Scoping Review. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2021; 10:93-111. [PMID: 34485107 PMCID: PMC8409516 DOI: 10.2147/iprp.s248705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/30/2021] [Indexed: 12/12/2022] Open
Abstract
Purpose Despite international guidelines' recommendations, spirometry is underutilized in the diagnosis and management of asthma and COPD. Spirometry may be an opportunity for trained pharmacists to meet the needs of patients with suspected or diagnosed lung conditions. The aim of this scoping review is to describe the literature including pharmacist provided spirometry services, specifically to identify: 1) the models of pharmacist provided spirometry services, and additional services commonly offered alongside spirometry, 2) pharmacist training and capability to obtain quality results, and (3) pharmacist, physician, and patient perspectives. Methods In September 2020, a comprehensive literature search in PubMed and EMBASE was conducted to identify all relevant literature on the topic of pharmacist provided spirometry services using the search term: "pharmacist or pharmacy" and "spirometry or pulmonary function test or lung function test." Literature was screened using inclusion/exclusion criteria and selected articles were charted and analyzed using the themes above. Results A total of 27 records were included. The scoping review found that pharmacist provided spirometry has been conducted around the world in community pharmacies and clinic settings. Community pharmacists may increase access to spirometry screening; the lack of communication with primary care providers and remuneration are barriers that need to be overcome to optimize the utility of the service. Clinic-based services are interprofessional and collaborative, allowing a patient to receive the test, results, diagnosis, and medication changes in one visit. Following comprehensive training, pharmacists felt confident in their ability to perform spirometry and met quality standards at acceptable rates. Conclusion Spirometry is an opportunity for pharmacists to improve evidence-based practice for screening and diagnosing lung conditions along with providing comprehensive services to complement testing. Data around provider and patient perspectives is limited and should be further investigated to determine if providers and patients would value and collaborate with pharmacists providing spirometry services.
Collapse
Affiliation(s)
- Alexa Sevin Valentino
- Pharmacy Practice and Science, The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Emily Eddy
- Pharmacy Practice, Ohio Northern University, Ada, OH, USA
| | - Zachary Woods
- Pharmacy Education and Innovation, The Ohio State University College of Pharmacy, Columbus, OH, USA
| | - Lori Wilken
- Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| |
Collapse
|
3
|
Waszyk-Nowaczyk M, Guzenda W, Kamasa K, Pawlak K, Bałtruszewicz N, Artyszuk K, Białoszewski A, Merks P. Cooperation Between Pharmacists and Physicians - Whether It Was Before and is It Still Ongoing During the Pandemic? J Multidiscip Healthc 2021; 14:2101-2110. [PMID: 34393489 PMCID: PMC8357703 DOI: 10.2147/jmdh.s318480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Nowadays, it is very important to put an emphasis on widely understood teamwork. This is of great importance for achieving and maintaining success in all areas, especially in medicine. This kind of unity has many advantages, including unique ideas that are very helpful in a competitive environment, improve performance and knowledge, and create stronger supportive work relationships. Patient’s health can be improved by using comprehensive treatment. This provides an urgent need for multidisciplinary partnership in the medical community. Optimal pharmacological treatment is crucial to achieving treatment goals. To ensure excellent quality of medical care, interprofessional cooperation between physicians and pharmacists and/or other medical professionals is necessary. Their complementary knowledge and experience can lead to improved health outcomes and can also reduce treatment costs. There are also many barriers and difficulties in legal systems that would allow for more effective inter-professional cooperation. The COVID-19 pandemic contributed to emphasizing the role of the pharmacist, increasing powers, and at the same time to teamwork, sometimes forced by the situation. The purpose of this publication is to view the literature on the cooperation of physicians and pharmacists in the provision of medical services for patients. Professional cooperation has been well known in many countries for years, as it is a key medium supporting optimized patient care. Analyzing the challenges and approaches can lead to better and improved health care.
Collapse
Affiliation(s)
- Magdalena Waszyk-Nowaczyk
- Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Weronika Guzenda
- Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Karolina Kamasa
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Kornel Pawlak
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Natalia Bałtruszewicz
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Karolina Artyszuk
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Artur Białoszewski
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, 02-091, Poland
| | - Piotr Merks
- Faculty of Medicine, Cardinal Stefan Wyszyński University, Warsaw, 01-938, Poland
| |
Collapse
|
4
|
Murray S, Labbé S, Kaplan A, Petrasko K, Waserman S. A multi-stakeholder perspective on asthma care in Canada: findings from a mixed methods needs assessment in the treatment and management of asthma in adults. Allergy Asthma Clin Immunol 2018; 14:36. [PMID: 30214459 PMCID: PMC6130055 DOI: 10.1186/s13223-018-0261-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/30/2018] [Indexed: 01/29/2023] Open
Abstract
Background Although several aspects of asthma care have been identified as being sub-optimal in Canada, such as patient education, practice guideline adoption, and access to care, there remains a need to determine the extent to which these gaps remain, so as to investigate their underlying causes, and potential solutions. Methods An ethics-approved mixed methods educational needs assessment was conducted in four Canadian provinces (Alberta, British Columbia, Ontario, and Quebec), combining a qualitative phase (45-min semi-structured interviews with community-based healthcare providers and key stakeholders) and a quantitative phase (15-min survey, healthcare providers only). Results A total of 234 participants were included in the study, 44 in semi-structured interviews and 190 in the online survey. Five clinical areas were reported to be suboptimal by multiple categories of participants, and specific causes were identified for each. These areas included: Integration of guidelines into clinical practice, use of spirometry, individualisation of asthma devices to patient needs, emphasis on patient adherence and self-management, and clarity regarding roles and responsibilities of different members of the asthma healthcare team. Common causes for gaps in all these areas included suboptimal knowledge amongst healthcare providers, differing perceptions on the importance of certain interventions, and inadequate communication between healthcare providers. Conclusions This study provides a better understanding of the specific causes underlying common gaps and challenges in asthma care in Canada. This information can inform future continuing medical education, and help providers in community settings obtain access to adequate materials, resources, and training to support optimal care of adult patients with asthma.
Collapse
Affiliation(s)
- Suzanne Murray
- 1AXDEV Group Inc., 210-8, Place du Commerce, Brossard, QC J4W 3H2 Canada
| | - Sara Labbé
- 1AXDEV Group Inc., 210-8, Place du Commerce, Brossard, QC J4W 3H2 Canada
| | - Alan Kaplan
- 2Department of Family and Community Medicine, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7 Canada
| | | | - Susan Waserman
- 4Division of Clinical Immunology and Allergy, McMaster University, 1280 Main St West, HSC 3V49, Hamilton, ON L8S 4K1 Canada
| |
Collapse
|
5
|
Sakeena MHF, Bennett AA, McLachlan AJ. Enhancing pharmacists' role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review. Antimicrob Resist Infect Control 2018; 7:63. [PMID: 29744044 PMCID: PMC5930749 DOI: 10.1186/s13756-018-0351-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 04/19/2018] [Indexed: 12/03/2022] Open
Abstract
Background Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR. Objective The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists’ role can be enhanced to combat AMR in developing countries. Method The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists’ contributions in antimicrobial use in both developed and developing nations. Key findings In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists’ role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing. Conclusions This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists’ role in developing countries has the potential to positively impact the global issue of AMR.
Collapse
Affiliation(s)
- M H F Sakeena
- 1Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka.,2Sydney Pharmacy School, The University of Sydney, Sydney, NSW Australia
| | | | - Andrew J McLachlan
- 2Sydney Pharmacy School, The University of Sydney, Sydney, NSW Australia
| |
Collapse
|