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Holis RV, Elenjord R, Lehnbom EC, Andersen S, Fagerli M, Johnsgård T, Zahl-Holmstad B, Svendsen K, Waaseth M, Skjold F, Garcia BH. How Do Pharmacists Distribute Their Work Time during a Clinical Intervention Trial?-A Time and Motion Study. PHARMACY 2024; 12:106. [PMID: 39051390 PMCID: PMC11270314 DOI: 10.3390/pharmacy12040106] [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: 06/04/2024] [Revised: 06/30/2024] [Accepted: 07/05/2024] [Indexed: 07/27/2024] Open
Abstract
Emergency departments (EDs) handle urgent medical needs for a diverse population. Medication errors and adverse drug events pose safety risks in the ED. Clinical pharmacists, experts in medication use, play a crucial role in identifying and optimizing medication therapy. The aim of this study was to investigate how clinical pharmacists introduced into the ED interdisciplinary teams distribute their work time. In a time and motion study, we used the Work Observation Method By Activity Timing (WOMBAT) to observe pharmacists in two Norwegian EDs. The pragmatic approach allowed pharmacists to adapt to ED personnel and patient needs. The pharmacists spent 41.8% of their work time on medication-related tasks, especially those linked to medication reconciliation, including documenting medication-related issues (16.2%), reading and retrieving written information (9.6%), and obtaining oral information about medication use from patients (9.5%). The remaining time was spent on non-medication-related tasks (41.8%), and on standby and movement (17.4%). In conclusion, ED pharmacists spent 42% of their work time on medication-related tasks, predominantly medication reconciliation. Their relatively new role in the interdisciplinary team may have limited their broader clinical impact. Relative to other ED healthcare professionals, ED pharmacists' goal remains to ensure accurate patient medication lists and appropriate medication use.
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Affiliation(s)
| | - Renate Elenjord
- Hospital Pharmacy of North Norway Trust, 9291 Tromso, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | | | - Sigrid Andersen
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Marie Fagerli
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Tine Johnsgård
- Hospital Pharmacy of North Norway Trust, 9291 Tromso, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Birgitte Zahl-Holmstad
- Hospital Pharmacy of North Norway Trust, 9291 Tromso, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Kristian Svendsen
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Marit Waaseth
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Frode Skjold
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
| | - Beate Hennie Garcia
- Hospital Pharmacy of North Norway Trust, 9291 Tromso, Norway
- Department of Pharmacy, UiT The Arctic University of Norway, 9037 Tromso, Norway (K.S.)
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Hatem NAH, Kubas MA, Yousuf SA, Rassam A, Mohamed Ibrahim MI. Yemeni Physicians' Attitudes and Perceived Barriers Toward Ward-Based Clinical Pharmacist in Hospital Settings. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2024; 13:69-80. [PMID: 38911015 PMCID: PMC11192290 DOI: 10.2147/iprp.s464258] [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: 03/20/2024] [Accepted: 06/13/2024] [Indexed: 06/25/2024] Open
Abstract
Background Clinical pharmacy services (CPSs) are still in their infancy in Yemen. Furthermore, pharmacists are not members of a multidisciplinary healthcare team, so their responsibilities are limited to drug dispensing and marketing. This study examines physicians' attitudes and perceived obstacles regarding the inclusion of clinical pharmacists in hospital medical wards. Methods A descriptive observational study was carried out using a validated, self-administered bilingual questionnaire. The study's questionnaire was conducted among physicians in three leading hospitals. Those hospitals were at the forefront of establishing clinical pharmacy units and embracing clinical pharmacy services. Data were analyzed using descriptive statistics. Results Sixty-five responses were included. Our data results indicated that physicians believed the most important contributions for clinical pharmacists to improve patient care were "attending medical rounds", followed by "order review". About 75% of physicians showed positive attitudes toward the clinical pharmacist role. However, more than 70% of physicians believed that clinical pharmacists should leave patient care to other healthcare professionals and focus on drug products. Not enough clinical pharmacist staff working in the health center was considered the top perceived barrier (83.1%), followed by "clinical pharmacist responsibilities were not clearly defined" and "clinical pharmacist recommendations are not properly documented". Conclusion Strategies to expand clinical pharmacy services in Yemen should focus on several key areas. Protocols must be established to clearly outline the collaboration between clinical pharmacists and physicians. Additionally, fostering inter-professional relationships is crucial to overcoming resistance and increasing awareness and understanding of CPS adoption among healthcare team members.
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Affiliation(s)
- Najmaddin A H Hatem
- Department of Clinical Pharmacy, College of Clinical Pharmacy, Hodeidah University, Al-Hudaydah, Yemen
| | - Mohammed A Kubas
- Clinical Pharmacy Department, School of Pharmacy & Medical Sciences (SPMS), Lebanese International University, Sana’a, Yemen
- Clinical Pharmacy Department, University of Science and Technology (UST) Hospital, Sana’a, Yemen
| | - Seena A Yousuf
- Social Medicine and Public Health Department, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen
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Lee M, Kim SE, Jeong JH, Park YH, Han HW. Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study. BMC Health Serv Res 2024; 24:118. [PMID: 38254141 PMCID: PMC10802065 DOI: 10.1186/s12913-023-10530-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 12/26/2023] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND After the revision of the Korean Pharmaceutical Affairs Act, the certification of specialized pharmacists is scheduled to be legally recognized in 2023. Considering that the specialized pharmacist certification was developed based on the working model of hospital clinical pharmacists, it is necessary to establish standards for clinical pharmacists in hospitals and to calculate appropriate manpower. Through this study, we aim to establish practical standards for clinical pharmacists and propose a method for calculating staffing levels based on an investigation of actual workloads. METHODS This survey-based study consisted of two phases. In the first phase, a literature review was conducted to establish standards for clinical pharmacy services, and tasks in relevant literature were classified to identify clinical pharmacy service tasks that are applicable to the practice of Korean hospitals. Additionally, a preliminary survey was conducted to investigate the essential tasks. In the second phase of the investigation, a multicenter survey was conducted targeting pharmacists in facilities with more than 1,000 beds to explore their perceptions and actual workloads related to tasks. RESULTS According to the standards for clinical pharmacists in Korea, clinical pharmacy services consist of a total of 23 tasks, of which 16 have been identified as essential tasks. Essential tasks accounted for 93% of the total tasks in clinical pharmacy services. The average full-time equivalent (FTE) through workload calculation was 2.5 ± 1.9 for each field, while the FTE allocated to actual practice was 2.1 ± 1.6. The distribution of each type of clinical pharmacy service was as follows: 77% for medication therapy management, 13% for medication education, 8% for multidisciplinary team activities, and 3% for medication use evaluation. CONCLUSION This study identified essential tasks common to clinical pharmacy services across different healthcare institutions. However, the FTE of clinical pharmacists in actual practice was insufficient compared to the required amount. In order to establish and expand clinical pharmacy services in a hospital, it is necessary to ensure an adequate workforce for essential tasks.
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Affiliation(s)
- Mirinae Lee
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Seung-Eun Kim
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Jee-Hye Jeong
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Yoon-Hee Park
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea
| | - Hye-Won Han
- Department of Pharmacy, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, 05535, Seoul, South Korea.
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Wang B, Manskow US. Health professionals' experience and perceived obstacles with managing patients' medication information in Norway: cross-sectional survey. BMC Health Serv Res 2024; 24:68. [PMID: 38218841 PMCID: PMC10790274 DOI: 10.1186/s12913-023-10485-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Access to correct and up to date medication information is crucial for effective patient treatment. However, persistent discrepancies exist. This study examines the experiences and challenges health professionals encounter while utilizing current digital solutions in the Norwegian healthcare system to manage patients' medication information. METHODS A cross-sectional descriptive analysis using quantitative survey data was conducted to investigate how health professionals managed patients' medication information. Content analysis was used to analyze free-text responses concerning challenges they encountered when transferring medication information and to identify factors deemed necessary for implementing the Shared Medication List in Norway. RESULTS A total of 262 doctors and 244 nurses responded to the survey. A higher percentage of doctors (72.2%) expressed concerns regarding obtaining accurate and updated medication lists than nurses (42.9%), particularly for patients with polypharmacy (35.3%) or transitioning between primary and specialist care services (27.6%). The patient's verbal information was the main source for hospital doctors (17%) to obtain an overview of the patient's medication usage, while general practitioners (19%) and nurses (working in both primary and specialist care services, 28% and 27% respectively) predominantly relied on electronic prescriptions. Doctors, in particular general practitioners, reported carrying excessive responsibilities in coordinating with other health actors (84.8%) and managing patients' medication information. The vast majority of both doctors (84.4%) and nurses (82.0%) were in favor of a Shared Medication List. However, about a third of doctors (36.3%) and nurses (29.8%) expressed the need for a more balanced responsibility in updating and managing patients' medication information, while ensuring compatibility with existing digital systems. CONCLUSIONS Fragmented resources for medication information and unclear responsibilities were prevalent concerns among both professional groups. Doctors voiced more concern than nurses about the accuracy of patients' medication list. While both groups are positive about a shared medication list, successful implementation requires proactive training initiatives and clearer role clarification.
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Affiliation(s)
- Bo Wang
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Sykehusvegen 23, Forskningsparken, Tromsø, Norway.
| | - Unn Sollid Manskow
- Norwegian Centre for E-Health Research, University Hospital of North Norway, Sykehusvegen 23, Forskningsparken, Tromsø, Norway
- Department of Health and Care Sciences, Centre for Care Research, UiT- The Arctic University of Norway, Tromsø, Norway
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Shrestha S, Gan SH, Paudyal V, KC B, Sapkota S. Current practices, gaps, and opportunities on the role of clinical pharmacists in cancer pain management: Perspectives from Nepal. J Oncol Pharm Pract 2023; 29:2049-2056. [PMID: 37847760 PMCID: PMC10687799 DOI: 10.1177/10781552231205025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/08/2023] [Accepted: 09/10/2023] [Indexed: 10/19/2023]
Affiliation(s)
- Sunil Shrestha
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Siew Hua Gan
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Vibhu Paudyal
- School of Pharmacy, College of Medical and Dental Sciences, Sir Robert Aitken Institute for Medical Research, University of Birmingham Edgbaston, Birmingham, UK
| | - Bhuvan KC
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Simit Sapkota
- Department of Clinical Oncology, Kathmandu Cancer Center, Tathali, Bhaktapur, Bagmati Province, Nepal
- Department of Clinical Oncology, Civil Service Hospital, Minbhawan, Kathmandu, Bagmati Province, Nepal
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Al-Dujaili Z, Omari S, Pillai J, Al Faraj A. Assessing the accuracy and consistency of ChatGPT in clinical pharmacy management: A preliminary analysis with clinical pharmacy experts worldwide. Res Social Adm Pharm 2023; 19:1590-1594. [PMID: 37696742 DOI: 10.1016/j.sapharm.2023.08.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
BACKGROUND ChatGPT conversation system has ushered in a revolutionary new era of information retrieval and stands as one of the fastest-growing platforms. Clinical pharmacy, as a dynamic discipline, necessitates an advanced comprehension of drugs and diseases. The process of decision-making in clinical pharmacy demands accuracy and consistency in medical information, as it directly affects patient safety. OBJECTIVE The objective was to evaluate ChatGPT's accuracy and consistency in managing pharmacotherapy cases across multiple time points. Additionally, input was gathered from global clinical pharmacy experts, and the agreement between ChatGPT's responses and those of clinical pharmacy experts worldwide was assessed. METHODS A set of 20 cases of pharmacotherapy was entered into ChatGPT at three different time points. Reliability analysis was performed using inter-rater reliability to measure the accuracy of the output generated by ChatGPT at each time point. Test-retest reliability was performed to measure the consistency of the output generated by ChatGPT across the three time points. Pharmacy expert performance was evaluated, and the overall results were compared. RESULTS ChatGPT achieved a hit rate of 70.83% at week 1, 79.2% at week 3, and 75% at week 5. The percent agreement between weeks 1 and 3 was 79.2%, whereas it was 87.5% between weeks 3 and 5, and 83.3% between weeks 1 and 5. In contrast, accuracy rates among clinical pharmacy experts showed considerable variation according to their geographic location. The highest agreement between clinical pharmacist responses and ChatGPT responses was observed at the last time point examined. CONCLUSIONS Overall, the analysis suggested that ChatGPT is capable of generating clinically relevant pharmaceutical information, albeit with some variation in accuracy and consistency. It should be noted that clinical pharmacy experts worldwide may provide varying degrees of accuracy depending on their expertise. This study highlights the potential of AI chatbots in clinical pharmacy.
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Affiliation(s)
- Zahraa Al-Dujaili
- College of Pharmacy, American University of Iraq - Baghdad (AUIB), Baghdad, Iraq
| | - Sarah Omari
- Department of Epidemiology and Population Health, American University of Beirut (AUB), Beirut, Lebanon
| | - Jey Pillai
- College of Pharmacy, American University of Iraq - Baghdad (AUIB), Baghdad, Iraq
| | - Achraf Al Faraj
- College of Pharmacy, American University of Iraq - Baghdad (AUIB), Baghdad, Iraq.
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