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Tsuchiya M, Kikuchi D, Hatakeyama S, Tasaka Y, Uchikura T, Funakoshi R, Obara T. Trend analysis of pharmacist involvement in cancer care in Japan from 2015 to 2020: A nationwide survey study on hospital pharmacy practice. J Oncol Pharm Pract 2024:10781552241263997. [PMID: 39052978 DOI: 10.1177/10781552241263997] [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: 07/27/2024]
Abstract
INTRODUCTION Pharmacists are needed as members of oncology teams. The Japanese Society of Hospital Pharmacists (JSHP) conducts a nationwide survey annually to analyze the actual situation and generate fundamental information about hospital pharmacy practice in Japan. Using data from this large-scale survey, we described pharmacists' involvement in cancer chemotherapy. We explored the factors related to the acceleration of pharmacists' tasks or involvement in clinical practice, primarily in oncology. METHODS Data were obtained from annual surveys conducted by JSHP from 2015 to 2020. All variables were expressed as categorical variables and tabulated. The Chi-square and Fisher's exact tests were used to compare the categorical variables. The Cochran-Armitage trend test was used to identify significant trends. RESULTS From 2015 to 2020, 22,362 responses were recorded. After applying the exclusion criteria, 20,906 were analyzed. The proportion of hospitals enrolling pharmacists with oncology-related certifications significantly increased in all hospitals providing cancer care. Multivariable logistic regression analysis indicated that a smaller number of beds per pharmacist significantly correlated with additional fees for outpatient pharmacy services (p = 0.0002 for trend). CONCLUSION Hospitals charging increased fees for outpatient oncology pharmacy services were associated with a smaller number of beds per pharmacist, regardless of hospital size. A balance between the number of beds and pharmacists, particularly certified oncology pharmacists, is crucial for safe and high-quality cancer treatment.
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Affiliation(s)
- Masami Tsuchiya
- Department of Pharmacy, Miyagi Cancer Center, Miyagi, Japan
- Laboratory of Biomolecule and Pathophysiological Chemistry, Tohoku University Graduate School of Pharmaceutical Sciences, Miyagi, Japan
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Division of Drug Informatics, Keio University Faculty of Pharmacy, Tokyo, Japan
| | - Daisuke Kikuchi
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University Hospital, Miyagi, Japan
| | - Shiro Hatakeyama
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Division of Pharmacy, Yamagata University Hospital, Yamagata, Japan
| | - Yuichi Tasaka
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Laboratory of Clinical Pharmacy, School of Pharmacy, Shujitsu University, Okayama, Japan
| | - Takeshi Uchikura
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
| | - Ryohkan Funakoshi
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Department of Pharmacy, Kameda General Hospital, Chiba, Japan
| | - Taku Obara
- The First Subcommittee, Committee on Academic, The Japanese Society of Hospital Pharmacists, Tokyo, Japan
- Department of Pharmaceutical Sciences, Tohoku University Hospital, Miyagi, Japan
- Division of Preventive Medicine and Epidemiology, Tohoku University Tohoku Medical Megabank Organization, Miyagi, Japan
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Sun Q, Wang Y, Wang P, Huang Y, Xi X. Residents Preferences for Pharmacist-Managed Clinic in China: A Discrete Choice Experiment. Patient Prefer Adherence 2024; 18:1409-1422. [PMID: 38978750 PMCID: PMC11228533 DOI: 10.2147/ppa.s457655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 06/14/2024] [Indexed: 07/10/2024] Open
Abstract
Purpose This study aimed to survey and analyze the preferences for pharmacist-managed clinic among urban residents in China. Materials and Methods A discrete choice experiment was conducted in Nanjing, China. A D-efficient fractional factorial design was used to generate the questionnaire. Three models were used to investigate each patient's strength of preference and preference heterogeneity. The relative importance for each treatment attribute was also determined. Results 156 usable questionnaires (of 228 questionnaires sent out) were received. Respondents preferred pharmacist-managed clinics with the following characteristics: good pharmacists' knowledge and clinical medication practice competency, lower consultation fees, a dedicated consultation room, physician-pharmacist joint clinic, with pharmacists' knowledge competency receiving the highest priority. Latent class analysis revealed three classes (Experiential Type, Content Type and Economic Type) were identified based on respondents' preferences for pharmacist-managed clinics. Conclusion The respondents were willing to choose a PMC relative to the current situation. When deciding on a pharmacist-managed clinic, residents are driven by pharmacists' competency, consultation fee, availability of consultation rooms and collaborative care or independent pharmacist service. Differences in patients' preferences identified in the study provide information on pharmacist-managed clinics that meet residents' expectations.
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Affiliation(s)
- Qingran Sun
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yi Wang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Pei Wang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Yuankai Huang
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
| | - Xiaoyu Xi
- National Medical Products Administration Key Laboratory for Drug Regulatory Innovation and Evaluation, China Pharmaceutical University, Nanjing, Jiangsu Province, People’s Republic of China
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Tadesse TA, Abiye AA, Endale S, Yadeta D, Chelkeba L, Fenta TG. Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study. J Multidiscip Healthc 2022; 15:743-754. [PMID: 35418756 PMCID: PMC8995148 DOI: 10.2147/jmdh.s359558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/22/2022] [Indexed: 12/01/2022] Open
Abstract
Pupose To explore the challenges of anticoagulation management (AMS) and assess the need for establishing a pharmacist-led anticoagulation clinic (PLAC) at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. Methods We conducted a qualitative study at TASH. Using a semistructured interview guide, we interviewed 15 physicians from different specialties, heads of pharmacy and laboratory departments. We also included 20 patients to explore their general perceptions, and experiences with and challenges of AMS; and the need to implement PLAC in the hospital. Results Only three physicians responded that they had protocols for initiating and maintaining warfarin dosing. Having protocols for venous thromboembolism (VTE) risk assessment, VTE prophylaxis and treatment, bleeding risk assessment, and contraindication to anticoagulant therapy were reported by seven, six, four, and three participants, respectively. Lack of trained healthcare professionals and a separate AMS clinic, inconsistency in INR testing and anticoagulant availability, and longer appointment times were the biggest challenges of the existing AMS, according to 80% of respondents. Fourteen patient respondents indicated that their satisfaction with the AMS was affected by long wait times and inconsistent availability of anticoagulants and INR testing. The head of the laboratory stated that the facilities for INR testing are inadequate and affect the quality of AMS and customer satisfaction, and supplemented by the head of the pharmacy by adding irregularities of supplies and inadequate counseling on anticoagulants. Respondents suggested that there is a need to establish a PLAC with well-adopted standard operating procedures, qualified manpower, adequate training of assigned staff, and sustained supply of anticoagulants and INR testing. Conclusion The hospital’s AMS is not optimal to provide adequate services during the study period. Based on these findings and recommendations, the supporting literature, and the experiences of other facilities, the PLAC was established in TASH.
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Affiliation(s)
- Tamrat Assefa Tadesse
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Correspondence: Tamrat Assefa Tadesse, Email
| | - Alfoalem Araba Abiye
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sisay Endale
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Dejuma Yadeta
- Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Legese Chelkeba
- Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Teferi Gedif Fenta
- Department of Pharmaceutics and Social Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Hias J, Van der Linden L, Walgraeve K, Lemper JC, Hellemans L, Spriet I, Tournoy J. Optimizing pharmacotherapy on geriatric hospital units in Belgium - a national survey. Acta Clin Belg 2022; 77:321-328. [PMID: 33345741 DOI: 10.1080/17843286.2020.1864162] [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: 10/22/2022]
Abstract
OBJECTIVE Inappropriate prescribing remains highly prevalent on geriatric units. The aim of this investigation, initiated by the Belgian College for Geriatrics, was to evaluate the implementation of strategies to optimize pharmacotherapy on geriatric units in Belgium. METHODS A literature search was performed to identify strategies to support the appropriate use of medications in very old inpatients. These strategies were subsequently validated based on Delphi consensus rounds and a national survey was developed. Experts were selected by the research team in collaboration with the Belgian College for Geriatrics. The survey was sent to the heads of the geriatric departments of all Belgian hospitals (n = 100). RESULTS After 3 months a response rate of 55% was achieved. Strategies that were implemented more frequently were the use of electronic prescribing (85%), performing a structured medication review (69%) and providing patient education (76%). In a minority (24%) of hospitals, a clinical pharmacist was directly involved in the multidisciplinary geriatric team. Implementation of clinical decisions support systems (CDSS) was reported by 36% of the hospitals. Educational strategies for healthcare professionals and strategies to optimize transitional care were variable. CONCLUSION Taking into account the current body of evidence, strategies that include transitional care components, CDSS or ward-based clinical pharmacy services should be further promoted on Belgian geriatric units.
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Affiliation(s)
- Julie Hias
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Lorenz Van der Linden
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | - Jean-Claude Lemper
- Department of Geriatric Medicine, University Hospitals Brussels, Brussels, Belgium
| | - Laura Hellemans
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Isabel Spriet
- Pharmacy Department, University Hospitals Leuven, Leuven, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Jos Tournoy
- Department of Geriatric Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Maiguma T, Komoto A, Shiraga E, Hagiwara S, Onishi J, Li M, Teshima D. Influence of Pharmacist Intervention on Re-Elevation of Glycated Hemoglobin for Diabetic Outpatients. Hosp Pharm 2021; 56:191-197. [PMID: 34024928 DOI: 10.1177/0018578719883806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: The effect of pharmacist intervention on blood sugar control in diabetic outpatients in a pharmacist-managed clinic was studied by focusing on the re-elevation of the glycated hemoglobin (A1c) level defined as a continuous variable. Methods: A retrospective chart review was performed at the Mizushima Kyodo Hospital from April 2014 to March 2016. Of the 221 diabetic outpatients who were provided guidance by nurses and nutritional managers, 62 further consulted the pharmacist-managed clinic. The remaining 159 patients were enrolled in a nonintervention group. Finally, the data of 115 patients with A1c level of ≥7.5% and A1c re-elevation were extracted. Intergroup comparison was performed between the pharmacist intervention (n = 26) and nonintervention (n = 89) groups. In both the groups, the starting point (baseline) was the time when the A1c level of ≥7.5% was observed. Subsequent monitoring was performed once in every 3 months. The average cumulative level of A1c re-elevation (CARE) was compared between groups. Patients with A1c level of ≥8.0% and A1c level between 7.5% and 8.0%, and male and female patients were also compared. Furthermore, the number of days until the re-elevation of the A1c level from the baseline was also compared. Results: The CARE values were 0.89 ± 0.86% and 1.51 ± 1.25% in the pharmacist intervention and nonintervention groups, respectively, showing a significant difference (P = .0195). There were no significant differences between patients with A1c level of ≥8.0% and A1c level between 7.5% and 8.0%, or between males and females. The number of days until the re-elevation of A1c level from the baseline also showed no significant difference. Conclusion: Pharmacist intervention for diabetic outpatients in pharmacist-managed clinics significantly suppressed CARE when compared with effects of no intervention, and this could be useful for preventing the exacerbation of diabetes.
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Affiliation(s)
| | | | | | | | | | - Miyoshi Li
- Mizushima Kyodo Hospital, Okayama, Japan
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Wu SE, Wen MJ, Chen JH, Shen WC, Chang EH. A qualitative study on the development of pharmacist-managed clinics in Taiwan. J Clin Pharm Ther 2021; 46:966-974. [PMID: 33569839 DOI: 10.1111/jcpt.13378] [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: 12/28/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Pharmacist-managed clinics (PMCs) are established to solve drug-related problems and enhance the quality of care of ambulatory patients. Although the benefits of such services have been demonstrated, little is known about PMC operations, especially outside the United States. The aim of this study was to explore how PMCs were established and to discuss implementation issues of PMCs in Taiwan. METHODS A purposive sample of pharmacists, pharmacy administrators and physicians involved with PMCs was recruited from hospitals of varying scales across Taiwan. Semi-structured, individual interviews were conducted to understand the perceptions of the clinical service of PMCs. Interviews were transcribed verbatim and analysed by thematic analysis to find underlying themes. RESULTS A total of 12 pharmacists, 5 pharmacy administrators and 3 physicians from 8 institutions were interviewed. Pharmacists spent 4 to 20 h per week at PMCs, and the practice experiences of PMC ranged from 1 to 6 years. PMCs have been provided in these institutions for 4 to 11 years with an average volume of 28 h and 25 patient visits weekly. Study participants described influential factors in establishing PMCs, including clinical expertise, attitude towards patient care and trust building with collaborating physicians. Operational concerns in implementing PMCs included role clarifications, manpower shortage, inadequate advanced training or certification, regulatory issues and a lack of service promotion. WHAT IS NEW AND CONCLUSION This research broadens the understanding of operating PMC services and reveals key requirements and concerns regarding the care model, which can be useful for other countries. Resolving perceived barriers and collecting other stakeholders' perspectives may reinforce the integration of PMCs into patient care in the future.
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Affiliation(s)
- Shang-En Wu
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Taipei City Hospital Songde Branch, Taipei, Taiwan
| | - Meng-Jung Wen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Jo-Hsin Chen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chen Shen
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Elizabeth H Chang
- Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.,Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
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Satsuma Y, Ikesue H, Kusuda K, Maeda M, Muroi N, Mori R, Kogo M, Hirabayashi R, Nagata K, Nakagawa A, Tachikawa R, Tomii K, Hashida T. Effectiveness of Pharmacist-Physician Collaborative Management for Patients With Idiopathic Pulmonary Fibrosis Receiving Pirfenidone. Front Pharmacol 2020; 11:529654. [PMID: 33324201 PMCID: PMC7725709 DOI: 10.3389/fphar.2020.529654] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 10/16/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Pirfenidone is an anti-fibrotic agent used to treat patients with idiopathic pulmonary fibrosis (IPF). Managing adverse drug events and ensuring compliance with pirfenidone treatment for a prolonged period are important to reduce the rate of disease progression. To maximize the benefits of pirfenidone treatment, we established and evaluated an ambulatory care pharmacy practice, a model of pharmacist-physician collaborative management, for patients receiving pirfenidone. Methods: We conducted a retrospective chart review of 76 consecutive patients treated with pirfenidone in the Kobe City Medical Center General Hospital, Japan, between January 2012 and January 2019. The first group (61 patients) received pirfenidone treatment as conventional management, whereas the second group (15 patients) started pirfenidone based on collaborative pharmacist-physician management. The drug discontinuation rate and time to drug discontinuation were compared between the groups. To analyze factors associated with pirfenidone discontinuation, we used a multivariate Cox regression analysis to evaluate the baseline characteristics of patients, including those receiving the collaborative management. Clinical outcomes were compared using a propensity score matched analysis. Results: In the collaborative management group, pharmacists made 56 suggestions, including suggestions for supportive care (51 suggestions), to the physicians. Among these suggestions, 52 were accepted by the physicians. The discontinuation rates at 3 [6.7% (1/15) vs. 26.2% (16/61)] and 6 [9.1% (1/11) vs. 36.1% (22/61)] months were lower in the collaborative management group than in the conventional management group. Multivariate analysis revealed that collaborative management [hazard ratio (HR) 0.34, 95% CI 0.08-0.96, p = 0.041] and predicted baseline forced vital capacity <60% (HR 2.13, 95% CI 1.17-3.85, p = 0.015) were significantly associated with pirfenidone discontinuation. The time to drug discontinuation was also significantly longer in the collaborative management group than in the conventional management group (p = 0.034, log-rank test). Propensity score matched analysis confirmed a significant correlation between collaborative management and drug discontinuation time (HR 0.20, 95% CI 0.03-0.84, p = 0.027). Conclusions: We established an ambulatory care pharmacy practice for out-patients with IPF receiving pirfenidone. The results suggest that collaborative management may help prevent pirfenidone discontinuation compared with conventional management.
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Affiliation(s)
- Yukari Satsuma
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroaki Ikesue
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kaori Kusuda
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mami Maeda
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuyuki Muroi
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryobu Mori
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Mariko Kogo
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryosuke Hirabayashi
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kazuma Nagata
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Atsushi Nakagawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tohru Hashida
- Department of Pharmacy, Kobe City Medical Center General Hospital, Kobe, Japan
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Pharmacist-led Medication Counseling for Patients Undergoing Hemodialysis: A Path to Better Adherence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072399. [PMID: 32244700 PMCID: PMC7177809 DOI: 10.3390/ijerph17072399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The primary objective was to assess the satisfaction of patients undergoing hemodialysis regarding counseling services provided by pharmacists. The secondary objectives were to compare the effect of years on dialysis and the presence of comorbidities on patient satisfaction. METHODS A total of 138 patients were included in the study, and all demographic and clinical variables were retrieved from the dialysis unit records of King Abdulaziz Medical City over a period of 4 months from July to October 2015. Chi-square test and Fisher's exact test were used for group comparisons at a significance level of 0.05. Results: Most patients aged between 51 and 75 years and had been on dialysis for 1 to 5 years; 94.9% of them had comorbidities. The overall satisfaction of patients toward pharmacy services was excellent (77.5%), and approximately 38.4% of patients thought that pharmacists were providing clear information about their prescribed medications. In addition, 55.8 % of the patients did not know that hemodialysis could affect the efficacy of their medications. Conclusions: Patients undergoing hemodialysis were somewhat satisfied with the counseling provided by the pharmacist. Moreover, there is a need for educational programs for patients undergoing hemodialysis that would increase awareness among hospital pharmacists to improve patients' medication knowledge.
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Kanorskii SG. [How to maintain an adherence to oral anticoagulant in a patient with atrial fibrillation?]. KARDIOLOGIIA 2019; 59:76-83. [PMID: 31849302 DOI: 10.18087/cardio.2019.11.n724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Accepted: 07/11/2019] [Indexed: 06/10/2023]
Abstract
Less onerous, compared with warfarin, treatment with direct oral anticoagulants (DOA) can lead to better adherence to treatment of patients with atrial fibrillation (AF). However, in a certain number of patients with AF, who were recommended by DOA, cardioembolic stroke recurs, which is largely due to the patients' failure to comply with medical recommendations. The appointment of DOA as first-line drugs does not guarantee a high adherence of patients with non-valvular AF. For elderly and old patients with AF and numerous comorbidities, the proposal of a simpler pharmacotherapy regimen is especially important. In a number of large modern studies performed in clinical practice, high adherence to rivaroxaban therapy has been established, which may be a result of taking this DOA 1 time per day, its safety and effectiveness.
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Noormandi A, Karimzadeh I, Mirjalili M, Khalili H. Clinical and economic impacts of clinical pharmacists' interventions in Iran: a systematic review. ACTA ACUST UNITED AC 2019; 27:361-378. [PMID: 30674033 DOI: 10.1007/s40199-019-00245-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 01/15/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES There are many studies about Iranian clinical pharmacists' interventions and their impacts on medication safety and cost. The aim of this study is to collect data and critically evaluate the clinical and economic effects of Iranian clinical pharmacist interventions and activities. To our best of knowledge, this research is the first review of publications about Iranian clinical pharmacists' interventions and activities. EVIDENCE ACQUISITION Six online databases, including PubMed, Scopus, Medline, Cochrane Central Register of Controlled Trials, Cochrane Database of Systemic Reviews, and Google Scholar were searched using the terms '"Iranian", "clinical pharmacist", 'adverse drug reactions", "medication errors", "drug interaction", "drug utilization evaluation", "cost", and "interventions" for English studies conducted in Iran and described clinical pharmacist-initiated interventions, published before December 2018. The search and extraction process followed PRISMA guidelines. Observational or retrospective studies, clinical trials, congress abstracts, and case reports or case series were excluded. The search strategy after full-text review identified 39 articles matching the eligibility criteria. RESULTS Thirty-nine articles were recruited. They included establishing pharmaceutical care in out-patient clinics and drug information centers (n = 4); prevention, detection, and management of adverse drug reactions(n = 4), designing protocols and improving drug utilization pattern(n = 16), prevention, detection, and management of medication errors (n = 11), and all clinical pharmacist services(n = 4). Most clinical pharmacist interventions and activities were regarding designing protocols, improving drug utilization pattern, as well as detection, prevention, and management of medication errors. About three-fourth (74.35%) of included studies were from either ambulatory care or in-patient settings in Tehran. The median (interquartile range) duration of intervention as well as follow-up phases was 9 (5) months. CONCLUSION Data of our review support the beneficial role of clinical pharmacists in the improvement of quality, safety, and efficiency of patients' pharmaceutical care in Iran. Graphical abstract Clinical pharmacists' interventions in Iran.
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Affiliation(s)
- Afsaneh Noormandi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, P.O. Box: 14155/6451, Tehran, 1417614411, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahtabalsadat Mirjalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Khalili
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, P.O. Box: 14155/6451, Tehran, 1417614411, Iran.
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Cheong JYV, Hie SL, Koh EW, de Souza NNA, Koh MJA. Impact of pharmacists' counseling on caregiver's knowledge in the management of pediatric atopic dermatitis. Pediatr Dermatol 2019; 36:105-109. [PMID: 30408232 DOI: 10.1111/pde.13708] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Atopic dermatitis (AD) is a common skin condition in childhood. AD management can be complex, and caregivers may have inadequate information on the disease, aggravating factors, and management. Comprehensive therapeutic education has been closely associated with increased compliance and is recommended for all patients. There are, as yet, no studies on the impact of a pharmacist-led eczema counseling service. OBJECTIVES The primary objective was to assess the impact of a pharmacist-led eczema counseling service on improving caregivers' knowledge. The secondary objective was to evaluate caregivers' satisfaction of the service and their confidence in handling the patient's condition after counseling. METHODS This was a prospective, questionnaire-based observational study. After obtaining informed consent, caregivers were required to complete questionnaire A, containing items on demographics and knowledge assessment. Caregivers then underwent a counseling session by a dermatology-trained pharmacist. After counseling, caregivers were required to complete questionnaire B containing items on satisfaction and confidence level. A follow-up phone call was conducted after initial counseling session, during which knowledge-based questionnaire C would be completed. RESULTS Data from 32 participants were included in the analysis. There was a significant improvement in caregivers' knowledge score after receiving counseling, with mean precounseling score of 8.38 ± 3.92 and mean postcounseling score of 13.88 ± 3.65 (P < 0.001). Majority was satisfied with the service and was confident in handling their child's condition. CONCLUSION Pharmacist-led eczema counseling has a positive impact on caregiver's knowledge and can lead to improved compliance. The service was well received, although more time could be spent during the counseling.
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Affiliation(s)
| | - Szu Liang Hie
- Department of Pharmacy, KK Women's and Children's Hospital, Singapore
| | - En Wei Koh
- Department of Pharmacy, KK Women's and Children's Hospital, Singapore
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Mills R, Haga SB. Qualitative user evaluation of a revised pharmacogenetic educational toolkit. PHARMACOGENOMICS & PERSONALIZED MEDICINE 2018; 11:139-146. [PMID: 30214267 PMCID: PMC6128278 DOI: 10.2147/pgpm.s169648] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Introduction Pharmacogenetic (PGx) testing is a leading application for personalized and precision medicine; however, there are barriers, including limited provider and patient understanding, which affect its uptake. There is a need for tools that can enhance the patient and provider experience with testing and promoting the shared and informed decision-making. Materials and methods In this study, we sought to gather additional feedback on a PGx toolkit comprised of four educational tools that had been previously evaluated through an online survey by pharmacists. Specifically, we conducted semi-structured interviews with pharmacists and members of the public regarding their understanding and utility of the toolkit and its individual components. Results Participants found three of the four toolkit components, a test information sheet, flipbook, and results sheet, to be useful and important. The fourth component, results card, was viewed less favorably. Participants differed in their preference for medical jargon and detailed results nomenclature (namely star * alleles). Conclusion User input during the development of educational materials is essential for optimizing utilization, effectiveness, and comprehension.
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Affiliation(s)
- Rachel Mills
- Duke Center for Applied Genomics and Precision Medicine, Duke University Medical Center, Durham, NC, USA,
| | - Susanne B Haga
- Duke Center for Applied Genomics and Precision Medicine, Duke University Medical Center, Durham, NC, USA,
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Shrestha S, Shrestha S, Palaian S. Can clinical pharmacists bridge a gap between medical oncologists and patients in resource-limited oncology settings? An experience in Nepal. J Oncol Pharm Pract 2018; 25:765-768. [PMID: 29950148 DOI: 10.1177/1078155218784734] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The clinical pharmacist's part is emerging as a key extension to the human services care team bringing about enhanced patient care in the world. The main objective of this article is to highlight the role of clinical pharmacist in an oncology setting of Nepal. An enrollment of clinical pharmacist in an oncology hospital or in oncology settings can work as a bridge between medical oncologist and patients.
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Affiliation(s)
- Sunil Shrestha
- 1 Department of Clinical Pharmacy, Nepal Cancer Hospital and Research Center, Harisiddhi, Lalitpur, Nepal
| | - Sudip Shrestha
- 2 Department of Medical Oncology, Nepal Cancer Hospital and Research Center, Harisiddhi, Lalitpur, Nepal
| | - Subish Palaian
- 3 Department of Pharmacy Practice, College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
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Mohd-Sidik S, Akhtari-Zavare M, Periasamy U, Rampal L, Fadhilah SI, Mahmud R. Effectiveness of chemotherapy counselling on self-esteem and psychological affects among cancer patients in Malaysia: Randomized controlled trial. PATIENT EDUCATION AND COUNSELING 2018; 101:862-871. [PMID: 29336859 DOI: 10.1016/j.pec.2018.01.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/23/2017] [Accepted: 01/04/2018] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The aim of this study was to implement and evaluate the outcomes of chemotherapy counselling based on the "Managing Patients on Chemotherapy" module on self-esteem and psychological affect (anxiety, depression) of cancer patients by pharmacists in ten selected government hospitals in Peninsular Malaysia. METHODS A randomized control trial was conducted among 2120 cancer patients from April 2016 to January 2017 in ten selected government hospitals in Peninsular Malaysia. Cancer patients were randomly assigned to intervention and control groups. The intervention group received chemotherapy counselling by pharmacists based on the "Managing Patients on Chemotherapy" module. The outcomes were assessed at baseline, 1st, 2nd and 3rd follow-ups after counselling. In the course of data analysis; independent sample t-test, chi-square and two-way repeated measures ANOVA were conducted. RESULTS Mean scores of self-esteem in the intervention group had significant difference in comparison with those of the control group in the 1st, 2nd and 3rd follow-ups after counselling (P < 0.0001). Also, among those with depression and anxiety at baseline, there was reduction in depression and anxiety scores after the 1st, 2nd and 3rd follow-ups after counselling (p < 0.05). CONCLUSION Repetitive counselling by pharmacists based on the "Managing Patients on Chemotherapy" module had positive effect on improving self-esteem and psychological affect of cancer patients undergoing chemotherapy in Peninsular Malaysia. PRACTICE IMPLICATIONS This module can be used for all Malaysian cancer patients undergoing chemotherapy to improving self-esteem and psychological affect.
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Affiliation(s)
- Sherina Mohd-Sidik
- Cancer Resource & Education Center, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
| | - Mehrnoosh Akhtari-Zavare
- Cancer Resource & Education Center, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; Department of Public Health, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | | | - Lekhraj Rampal
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Siti Irma Fadhilah
- Department of Psychiatry, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rozi Mahmud
- Cancer Resource & Education Center, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
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Maura G, Pariente A, Alla F, Billionnet C. Adherence with direct oral anticoagulants in nonvalvular atrial fibrillation new users and associated factors: a French nationwide cohort study. Pharmacoepidemiol Drug Saf 2017; 26:1367-1377. [PMID: 28752560 PMCID: PMC5697683 DOI: 10.1002/pds.4268] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/12/2017] [Accepted: 06/15/2017] [Indexed: 12/14/2022]
Abstract
Purpose Direct oral anticoagulants (DOACs) have been promoted in patients with nonvalvular atrial fibrillation (nv‐AF) as a more convenient alternative to vitamin K antagonists. We estimated 1‐year dabigatran and rivaroxaban adherence rates in nv‐AF patients and assessed associations between baseline patient characteristics and nonadherence. Methods This cohort study included OAC‐naive nv‐AF patients with no contraindications to OAC, who initiated dabigatran and rivaroxaban, using nationwide data from French national health care databases. One‐year adherence was defined by the proportion of days covered of 80% or more over a fixed 1‐year period after treatment initiation. Associations between nonadherence and baseline patient characteristics were assessed using multivariate logistic regression models. Results The population was composed of 11 141 dabigatran (women: 48%; mean age: 74 ± 10.7 y; ≥80 y: 34.9%) and 11 126 rivaroxaban (46.5%; 74 ± 10.9 y; 34.8%) new users. One‐year adherence was 53.3% in dabigatran‐treated and 59.9% in rivaroxaban‐treated patients, consistent with numerous subgroup analyses. A switch to vitamin K antagonist was observed in 14.5% of dabigatran and 11.7% of rivaroxaban patients; 10.2% and 5.9% of patients switched to another DOAC, respectively; and 4.3% of patients died in the 2 cohorts. In patients who did not die or switch during the follow‐up, 1‐year adherence was 69.6% in dabigatran‐treated and 72.3% in rivaroxaban‐treated patients. Having concomitant ischemic heart diseases was associated with an increased risk of nonadherence in the 2 cohorts. Conclusion In this real‐life study, 1‐year adherence to DOAC is poor in nv‐AF new users. Despite the introduction of DOAC, adherence to OACs may remain a significant challenge in AF patients.
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Affiliation(s)
- Géric Maura
- Department of Studies in Public Health, French National Health Insurance (Assurance maladie, CNAMTS), Paris Cedex, France.,Team Pharmacoepidemiology, Bordeaux Population Health Research Center, Inserm, Univ. Bordeaux, Bordeaux, France
| | - Antoine Pariente
- Team Pharmacoepidemiology, Bordeaux Population Health Research Center, Inserm, Univ. Bordeaux, Bordeaux, France.,Pharmacologie, CHU de Bordeaux, Bordeaux, France
| | - François Alla
- Department of Studies in Public Health, French National Health Insurance (Assurance maladie, CNAMTS), Paris Cedex, France
| | - Cécile Billionnet
- Department of Studies in Public Health, French National Health Insurance (Assurance maladie, CNAMTS), Paris Cedex, France
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Voukalis C, Shantsila E, Lip GY. Clinical Stroke prevention in atrial fibrillation. J R Coll Physicians Edinb 2017; 47:13-23. [PMID: 28569277 DOI: 10.4997/jrcpe.2017.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Oral anticoagulation therapy has reduced the risk of ischaemic stroke and improved the outcomes for patients with atrial fibrillation considerably. The emergence of the non-vitamin K oral anticoagulants as alternatives to vitamin K antagonists has significantly changed the practice of stroke prevention in atrial fibrillation. As the main complication with antithrombotic therapy is bleeding, physicians should always balance the risk of ischaemic stroke against intracranial haemorrhage and intervene where appropriate to reduce both risks. Individual approach is often mandatory due to heterogeneity of the risks and patient preferences. The purpose of this review is to summarise the current knowledge of the oral anticoagulation therapy in atrial fibrillation patients and guide physicians with the management of anticoagulants based on data from clinical trials and systematic reviews.
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Affiliation(s)
- C Voukalis
- GYH Lip, University of Birmingham, Institute of Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK.
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Gu H, Sun L, Jin R, Li F, Wei Y, Xie Z. Evaluation of counseling environmental alteration on pharmacy-patient communication qualifications: A case-control study. Medicine (Baltimore) 2016; 95:e5738. [PMID: 28033282 PMCID: PMC5207578 DOI: 10.1097/md.0000000000005738] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The closed pharmaceutical counseling room was so hard to be established for most of hospitals in China since limited space in the out-patient lobby, which dramatically affected the qualification of medication consultant. Few reports studied the importance of closed pharmaceutical counseling room construction.To investigate the necessary of closed pharmaceutical counseling room construction in the outpatient lobby.The closed pharmaceutical counseling room was established and equipped with hospital electronic information system, patient education flashes, and we-Chat in web. We collected the pharmaceutical counseling records before and after counseling room establishment and analyzed the results systematically.After the consulting venue transferred to the closed space, methods adopted by pharmacists in patient educations were diversification. Numbers of counseling people were increasing 4 folds after room establishment and questions were transferred from drug information supply to high professional pharmaceutical relation such as the usage of respiratory devices, drug-drug interaction, and so on.The alterations of consultant space provided a powerful platform on security, properly and suitable of patients' medication usage, keep the medication errors and poor compliance out of the serious consequence, and improve hospital satisfaction. Therefore, it is necessary in outpatient lobby to develop the independent room for medication service.
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Saleem Z, Saeed H, Ahmad M, Yousaf M, Hassan HB, Javed A, Anees N, Maharjan S. Antibiotic Self-Prescribing Trends, Experiences and Attitudes in Upper Respiratory Tract Infection among Pharmacy and Non-Pharmacy Students: A Study from Lahore. PLoS One 2016; 11:e0149929. [PMID: 26919465 PMCID: PMC4769098 DOI: 10.1371/journal.pone.0149929] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 02/05/2016] [Indexed: 11/24/2022] Open
Abstract
Pharmacists are the custodians of drugs; hence their education, training, behaviors and experiences would affect the future use of drugs at community and hospital pharmacies. Therefore, we aimed at evaluating the self-prescribing antibiotic trends, knowledge and attitudes among pharmacy and non-pharmacy students. We found that pharmacy students had higher risks of experiencing URIs related symptoms such as cough (RR; 1.7, p = 0.002), allergy (RR; 2.07, p = 0.03) and running nose (RR; 3.17, p<0.005), compared to non-pharmacy students -resulting in higher probabilities of selecting cough syrups (OR; 2.3, p<0.005), anti-histamines (OR; 1.8, p = 0.036) and anti-inflammatory/anti-pyretic (OR; 2.4, p<0.005) drugs. Likewise, bachelor’s degree pupils (OR; 2, p = 0.045), urban area residents (OR; 2.44; p = 0.002) and pharmacy students (OR; 2.9, p<0.005) exhibited higher propensities of antibiotic self-use–notable classes include, b-lactams (45.9%) followed by macrolides (26.5%) and augmentin (28.94%), respectively. Surprisingly, pharmacy and non-pharmacy students had higher odds of using antibiotics in common cold (OR; 3.2, p<0.005) and pain (OR; 2.37, p = 0.015), respectively. Unlike non-pharmacy students, pharmacy students were likely to select alternative therapy, such as Joshanda (OR; 2.22, p = 0.011) and were well acquainted with antibiotic hazards, with 77% reduction in risk of antibiotics re-use. In conclusion, university students exhibited antibiotic self-prescribing trends in conditions that does not warrant their use, thus are irrational users. The pharmacy education confers very little benefit to rational self-prescribing practices among students, while non-pharmacy students are more vulnerable to repeated antibiotic usage. Thus, the educational and training modules should be designed for university students to disseminate targeted information regarding the potential hazards of antibiotic self-use and importance of consultation with qualified and registered medical doctor/pharmacist before starting with antibiotics.
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Affiliation(s)
- Zikria Saleem
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Hamid Saeed
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
- * E-mail:
| | - Mobasher Ahmad
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Mahrukh Yousaf
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Hafsa Binte Hassan
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Ayesha Javed
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Nida Anees
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
| | - Sonu Maharjan
- Clinical Pharmacy Section, University College of Pharmacy, University of the Punjab, AllamaIqbal Campus, 54000, Lahore, Pakistan
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