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Helgesen AK, Nome CM, Stenbjerg JK, Arnesen MH, Aardalen TR, Dilles T, Grøndahl VA. Pharmaceutical Care in Primary Healthcare-A Study of Nurses', Pharmacists', and Physicians' Experiences of Interprofessional Collaboration. Healthcare (Basel) 2024; 12:1100. [PMID: 38891175 PMCID: PMC11171861 DOI: 10.3390/healthcare12111100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 05/15/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
Implementation of pharmaceutical care for the benefit of patients and health services has been highlighted worldwide. Interprofessional collaboration between nurses, pharmacists, and physicians may contribute to raising awareness of pharmacological challenges, increasing quality, and minimising errors in pharmaceutical care. This study aimed to investigate how nurses, pharmacists, and physicians experience interprofessional collaboration in pharmaceutical care within community healthcare in Norway. The study had an explorative and descriptive design with a qualitative approach. Individual interviews were conducted with 12 healthcare personnel with key roles in pharmaceutical care within community healthcare services. The data were analysed using systematic text condensation. The results revealed three categories and four subcategories: The category "Professional challenges" contained the subcategories "Blurred responsibilities" and "The importance of trust and continuity". The category "Organisational barriers" contained the subcategories "Lack of information exchange and suitable communications channels" and "Lack of time and meeting places". The third category was "Nurses-the important link". This study reveals challenges to and factors of success in increasing high-quality and safe pharmaceutical care, knowledge that can be used in quality work in the community health services and as input in curriculum development for the three professions.
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Affiliation(s)
- Ann Karin Helgesen
- Faculty of Health, Welfare, and Organisation, Østfold University College, P.O. Box 700, NO-1757 Halden, Østfold, Norway;
| | - Carina Marie Nome
- Haugvoll Nursing Home, Sarpsborg Kommune, Myrvollveien 25, NO-1743 Klavestadhaugen, Sarpsborg, Norway
| | - Julie Kjølhede Stenbjerg
- Emergency Room, Fredrikstad Kommune, Jens Wilhelmsens Gate 1, NO-1671 Kråkerøy, Fredrikstad, Norway
| | - Marie Helen Arnesen
- Home Nursing Care Centre, Fredrikstad Kommune, Faunsvei 3-6, NO-1654 Sellebakk, Fredrikstad, Norway
| | | | - Tinne Dilles
- Centre for Research and Innovation in Care, Nurse and Pharmaceutical Care, University of Antwerp, Prinsstraat 13, 2000 Antwerp, Belgium;
| | - Vigdis Abrahamsen Grøndahl
- Faculty of Health, Welfare, and Organisation, Østfold University College, P.O. Box 700, NO-1757 Halden, Østfold, Norway;
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S. Jarab A, Muflih S, Almomani R, Abu Heshmeh S, Abu Hammour K, L. Mukattash T, Al-Qerem W, Alefishat EA. Hospital pharmacists' knowledge, attitudes and practice of pharmaceutical care and the barriers for its implementation at the hospital setting. Heliyon 2024; 10:e28227. [PMID: 38644867 PMCID: PMC11033057 DOI: 10.1016/j.heliyon.2024.e28227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 04/23/2024] Open
Abstract
Objective To assess hospital pharmacists' understanding of pharmaceutical care and their attitudes regarding the adoption of the patient-centered model, as well as investigate Jordan's current state of pharmaceutical care implementation and the associated barriers. Methods A validated survey was distributed to hospital pharmacists in different major tertiary hospitals in Jordan. The study questionnaire contained five sections to assess sociodemographic characteristics, pharmacists' understanding of pharmaceutical care, attitudes towards pharmaceutical care, potential barriers that may limit the delivery of pharmaceutical care, and the extent of pharmaceutical care implementation in the hospital setting. Results The survey was completed by 152 hospital pharmacists. Participants in this study demonstrated adequate levels of knowledge about pharmaceutical care (Mean = 9.36 out of 11, SD = 1.23) and expressed favorable perceptions of pharmaceutical care (mean = 3.77 out of 5; SD = 0.7). Although more than one-third of the pharmacists practiced pharmaceutical care, the study revealed a number of impediments to the delivery of pharmacological care services. Regression analysis revealed that age (P < 0.05) and years of experience (P < 0.05) were significant predictors of knowledge, while age (P < 0.05), gender (P < 0.05), the graduation university (governmental vs. private) (P < 0.05), and years of experience (P < 0.05) were significant predictors of attitude. Furthermore, Doctor of Pharmacy degree holders had fewer barriers to pharmaceutical care implementation but were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.01 and P < 0.05 respectively). Pharmacists with a Master's degree or higher in pharmacy were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.05). Pharmacists working in the Ministry of Health and the Royal Medical Services experienced more barriers than those working in teaching hospitals (P < 0.05). Conclusions Although the current study indicated high knowledge and perceptions regarding pharmaceutical care among hospital pharmacists, the provision of pharmaceutical care is not widely practiced in Jordan. Moreover, several barriers to the practice of pharmaceutical care were identified, highlighting the need for effective strategies to be put in place to overcome these obstacles. These strategies should include increasing the number of pharmacy staff, resolving timing issues, providing adequate financial initiatives, improving communication skills, changing the layout of pharmacies to include a private counseling room, developing specific policies that support the role of the pharmacist in patient care, and providing effective training and continuing professional education programs.
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Affiliation(s)
- Anan S. Jarab
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid, 22110, Jordan
- College of Pharmacy, AL Ain University, P. O. Box: 122612, Abu Dhabi, United Arab Emirates
| | - Suhaib Muflih
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid, 22110, Jordan
| | - Rawan Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid, 22110, Jordan
| | - Shrouq Abu Heshmeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid, 22110, Jordan
| | - Khawla Abu Hammour
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, the University of Jordan, Jordan
| | - Tareq L. Mukattash
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology. P.O. Box 3030. Irbid, 22110, Jordan
| | - Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan. P.O. Box 130, Amman, 11733, Jordan
| | - Eman A. Alefishat
- Department of Medical Sciences, College of Medicine and Health Science, Khalifa University of Science and Technology, Abu Dhabi, 127788, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, the University of Jordan, Jordan
- Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi, 127788, United Arab Emirates
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Osae SP, Palmer R, Harvey A, Keedy CA, Lavender DL, Phillips BB, Johnson BR, Young HN, Stone RH. Collaborative drug therapy modification (CDTM): Facilitators, barriers, and perceptions of individual pharmacist participation in Georgia. J Am Pharm Assoc (2003) 2024:102041. [PMID: 38367860 DOI: 10.1016/j.japh.2024.102041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/25/2024] [Accepted: 02/13/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Georgia Board of Pharmacy (BOP) regulations permit pharmacists to engage in collaborative drug therapy modification (CDTM) with physicians, allowing them to perform patient assessments, adjust pharmacotherapy, and order laboratory tests. Pharmacist-led CDTM can positively affect health outcomes leading to reduced healthcare expenditures. CDTM is underutilized, with < 1% of Georgia pharmacists holding an active license to practice CDTM. OBJECTIVE(S) The objective of this study was to examine CDTM licensed pharmacists' perceptions of facilitators and barriers in providing CDTM. METHODS Georgia-licensed CDTM pharmacists were invited to participate in a 60-minute qualitative interview. Interview questions were developed from electronic survey responses. The interview was designed to elicit information regarding perceived benefits and barriers to CDTM implementation. Guided by the Consolidated Framework for Implementation Research, thematic analysis was applied to identify themes using ATLAS.ti software to code. Themes were described qualitatively and prevalence of each was reported. RESULTS Nine interviews were conducted, and data saturation was achieved at interview 6. After resolution of discrepancies, 100% coding agreement was reached among 2 independent researchers. Nine themes were identified, and each was categorized as a facilitator or barrier to establishing pharmacist-led CDTM in Georgia. Themes associated with facilitating were (prevalence %) (1) practice autonomy (100), (2) personal attributes (100), (3) having support (100), and (4) institutional logistics (88). Barrier themes included issues concerning (5) the Georgia BOP (100), (6) pharmacist autonomy (88), (7) lack of provider status (88), (8) institutional restrictions (75), and (9) personal development (e.g., confidence) (22). CONCLUSION Facilitators to the establishment of pharmacist-led CDTM exist and pharmacists can capitalize on these to create successful CDTM programs. Barriers are varied, and it may be difficult to systematically address individual barriers such as pharmacist autonomy and personal development. Barriers associated with institutional restrictions, the Georgia BOP, and lack of provider status can likely be removed or addressed by policy.
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Kilonzi M, Mutagonda RF, Mwakawanga DL, Mlyuka HJ, 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, Minzi OM, Kamuhabwa AAR. Establishment of clinical pharmacy services: evidence-based information from stakeholders. HUMAN RESOURCES FOR HEALTH 2024; 22:6. [PMID: 38200603 PMCID: PMC10782669 DOI: 10.1186/s12960-023-00887-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024]
Abstract
High morbidity and mortality related to the use of drugs resulted in demand for clinical pharmacy services (CPS) globally. In developed countries, the evolution of pharmacists' role in direct patient care started in the 1960s. The participation of pharmacists in CPS has resulted in positive clinical, economic, and humanistic outcomes. In developing countries, efforts have started to ensure pharmacists are engaged in the provision of CPS. However, the efforts are hampered by poorly defined pharmacist career paths, financial constraints, and a lack of political willingness. In Tanzania, efforts started in 2008, in which CPS was introduced into the Bachelor of Pharmacy curriculum, followed by the initiation of a postgraduate program on hospital and clinical pharmacy in 2013. A regulation was released by the Tanzania Ministry of Health in 2020 to enforce pharmacists' engagement in providing CPS. In 2021, a project was launched in the country, aiming to strengthen the provision of CPS in public and faith-based hospitals by training on-job pharmacists. The project was implemented in phases, including stakeholders' engagement, baseline survey, training, and supportive supervision of the trained pharmacists. Therefore, this commentary aims to share what we experienced during project implementation, the achievements, challenges, and key lessons learned.
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Affiliation(s)
- Manase Kilonzi
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania.
| | - Ritah F Mutagonda
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Dorkasi L Mwakawanga
- School of Nursing, Muhimbili University of Health and Allied Sciences, P. O. BOX 65001, Dar es Salaam, Tanzania
| | - Hamu J Mlyuka
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Wigilya P Mikomangwa
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Wema A Kibanga
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Alphonce Ignace Marealle
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Bertha Mallya
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Deogratias Katabalo
- School of Pharmacy, 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, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - John Mmassy
- Christian Social Services Commission, P.O. BOX 9433, Dar es Salaam, Tanzania
| | - Sungwa Kabissi
- Christian Social Services Commission, P.O. BOX 9433, Dar es Salaam, Tanzania
| | - Josephine A Balati
- Christian Social Services Commission, P.O. BOX 9433, Dar es Salaam, Tanzania
| | - Peter Maduki
- Christian Social Services Commission, P.O. BOX 9433, Dar es Salaam, Tanzania
| | - Omary Mashiku Minzi
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
| | - Appolinary A R Kamuhabwa
- School of Pharmacy, Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar es Salaam, Tanzania
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