Assessment of the Impact of Clinical Pharmacology Consultations Provided to Hospital Clinicians From the Drug Information Center-An Outcome Research in a Developing Country

Naturalistic Evaluation of ERAS Bundle Implementation Feasibility in Elective Cesarean Deliveries of Tertiary Care Hospital in a Low-Middle-Income Country

The present study assessed whether applying enhanced recovery after surgery (ERAS) guidelines for cesarean delivery is feasible in the tertiary care setting with an add-on objective to identify barriers to successful implementation. The cross-sectional study included women undergoing elective CS and willing to participate. The study attempted to understand barriers to ERAS implementation through timely interviewing study participants. Sixty-two patients participated in the study. Antenatal and fetal complications were observed in 39(63%) and 32(51%) participants. The study observed that at least 80% of the proposed components could be applied to 71% of the study population. All 15 components could be applied to 7(11.2%) patients, and at least 50% could be applied to 58(94%) patients. The least applied component was minimizing starvation by taking clear liquids until 2 hrs before surgery in 26(42%) patients due to waiting hours outside the operation-theater (OT). When fitness-for-discharge was assessed against the percent components of ERAS implemented, the area under the curve (AUC) value was 0.75, with a specificity value of 95.65% and a positive predictive value of 94.12%. In the postoperative ERAS bundle, fitness-for-discharge on day-two was statistically associated with early and frequent breastfeeding (p = 0.000) and prevention of intra-op hypotension (p = 0.03). In conclusion, the primary barriers to implementing ERAS were resource limitations in the form of single functional OT and limited doctors.

Perceived satisfaction and outcomes from drug information center services provided with a telehealth approach

BACKGROUND AND AIM

Telehealth expansion is dependent on the acceptance and satisfaction of the providers and users of the telehealth service and the impact on the overall health-care system. This study was conducted to evaluate the outcome of pharmacist-led telehealth services and satisfaction of their users.

MATERIALS AND METHODS

The telehealth-based drug information center service was an 8-month retrospective, descriptive study that evaluated users' service satisfaction (quality of service), general health outcomes, recommendations, and personal health outcomes by electronically distributing a questionnaire to the users using a Donabedian model approach.

RESULTS

The feedback response rate was 87.33% (N = 131). The majority of users were 25-34-year-old young adults, while regarding the background status of the enquirers (health-care worker, medical doctor, nurse, patient, phar macist, practitioner/scientist), 35 (26.7%) pharmacists and 34 (26.0%) patients were the most prevalent users. In terms of service satisfaction and health outcome, medical doctors had the highest mean ratings of 4.67 ± 0.76 and 4.95 ± 0.21, respectively. Evaluation of the pharmacist-led telehealth impact was measured with four variables, which showed a statistical significance of P < 0.001 and a highly positive mean rating generally (service satisfaction 4.44 ± 0.83, general health outcome 4.54 ± 0.85, personal health outcome 4.80 ± 0.58, and recommendation 4.85 ± 0.43). The findings also showed that user satisfaction significantly impacted on personal health outcomes (P < 0.001), and that there was an insignificant relationship between user background status and continents.

CONCLUSIONS

The study reveals the significant impact of pharmacist-led telehealth services and the importance of incorporating telehealth services into drug information centers.

Clinical-pharmacological drug information center of Hannover Medical School: experiences and analysis from a tertiary care university hospital

Drug information centers (DICs) are institutions dedicated to provide objective, independent, and up-to-date information on drugs and their rational use. To overcome the lack of recent DIC reports from central Europe, we analyzed all queries (n = 594) submitted to the DIC run by the Institute for Clinical Pharmacology of Hannover Medical School between October 2018 and April 2022. Approximately one in three queries (31.1%; 185/594) was submitted by internists. 82.8% (492/594) of the queries were patient-specific, while the remaining 17.2% (102/594) were general queries. Adverse drug reactions (ADRs), indications/contraindications, and pharmacodynamic interactions (PDIs) represented the three most frequently addressed query categories, being involved in 44.8% (266/594), 43.3% (257/594), and 34.3% (204/594) of all queries, respectively (assignment of more than one category per query was possible). As compared to general queries, patient-specific queries were statistically significantly more often related to ADRs, PDIs, and pharmacokinetic interactions (PKIs) (ADRs: 35.3% vs. 46.7%, P = 0.034; PDIs: 14.7% vs. 38.4%, P < 0.001; PKIs: 20.6% vs. 31.5%, P = 0.028). To demonstrate the complexity of queries submitted to the clinical-pharmacological DIC, we present and comment on an illustrative selection of queries.

Drug Information Services in Low-Resource Setting: A Responsibility of Pharmacists or Pharmacologists or Both the Professions Conjointly

OBJECTIVE

The objective of this study was to assess the pharmacy professionals' understanding and viewpoints on drug information center (DIC) services and differences, if any, with pharmacologist's survey conducted earlier.

MATERIALS AND METHODS

An electronic cross-sectional knowledge, practice, and attitude survey was carried out. A questionnaire in the form of the hyperlink was sent to pharmacy professionals through e-mail, Facebook messenger, and WhatsApp. Factors linked to pharmacy professionals' vision in expanding countrywide DIC services were studied with logistic regression in R.

RESULTS

A total of 125 pharmacy professionals responded. The participant believing in the published literature as a standard reference for establishing and running the DIC services; participants identifying more challenges in the day-to-day DIC functioning; and participants believing in the ability of DIC in reducing morbidity, mortality, and cost of care had 4.76 (95% confidence interval [CI] = 0.97-6.44), 4.24 (95% CI = 0.97-6.44), and 2.43 (95% CI = 0.97-6.44) times association with good knowledge score. Good attitude scores were discovered of participants working in fully and partially functional DIC (odds ratio [OR] = 9.66, CI = 0.97-6.44 and OR = 9.49, CI = 0.97-6.44) to participants not involved in DIC duties. The participant who understood DIC services' real purpose had 2.83 (95% CI = 0.97-6.44) times association with good practice scores. Overall, pharmacy professionals carried better attitude scores, but lesser knowledge, and practice scores than pharmacology professionals.

CONCLUSION

Lower knowledge and practice score of pharmacy professionals asks for training in critical appraisal of published literature and due modifications in graduate and postgraduate curricula. A collaborative approach between pharmacists and pharmacologists is needed to improve the quality of drug information services and evidence-based medicine practice in low-resource countries like India.