Pharmacy Patronage: Identifying the Roles of Nepalese Pharmacists in Tacking COVID-19

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

Pharmacists are essential members of the healthcare team. The emergence of the novel coronavirus disease 2019 (COVID-19) pandemic has led pharmacists to undertake additional clinical roles. We aim to conduct a systematic review on the interventions and impact of pharmacist-delivered services in managing COVID-19 patients. We searched PubMed, Embase, Scopus, CINAHL plus, International Pharmaceutical Abstracts, and Web of Science from 1 December 2019 (the first case of COVID-19 emerged) to 13 January 2022 to retrieve the articles. Cochrane handbook and PRISMA guidelines were followed respectively to perform and report the review. The pharmacist-led interventions were reported following the Descriptive Elements of Pharmacist Intervention Characterization Tool (DEPICT) version 2. The protocol of systematic review was registered on PROSPERO (CRD42021277128). Studies quality was assessed with the modified NOS scale. In total, 7 observational studies were identified from 10,838 studies. Identification of dosage errors (n = 6 studies), regimen modifications (n = 5), removal of obsolete/duplicate medications (n = 5), identification and management of adverse drug reactions (n = 4), drug interactions prevention (n = 2), and physicians acceptance rate (n = 3) of therapy-related services delivered in-person or via tele-pharmacy were among the pharmacist-delivered services. Common interventions delivered by pharmacists also included optimizing the use of antibacterial, antivirals, and anticoagulants in COVID-19 infected patients. The acceptance of pharmacist-delivered services by physicians was high (88.5-95.5%). Included studies have described pharmacists' beneficial role in managing patients with COVID-19 including detection, resolution, and prevention of medication-related problems, with physicians demonstrating high trust in pharmacists' advice. Future research should assess the feasibility and scalability of such roles in real-world settings.

Optimal Management of the Public and Patients by Pharmacists in the Era of COVID-19: An Evidence-Based Review and Practical Recommendations

Purpose: Currently, managing the public and patients during the COVID-19 pandemic is constituting a health care challenge worldwide. Patient-oriented management is of crucial importance to promote emergency preparedness and response. This study aims to formulate an integrated pharmacist management strategy of the public and patients and to provide evidence-based and practical references. Methods: Evidence-based review and practical analysis were utilized. First, PubMed, EMBASE and Chinese database were searched. Studies about patient management in major public health emergencies were included. Second, the Chinese experience of patient management was analyzed and identified. Finally, combining evidence-based and practical analysis, the pharmacist management strategy of the public and patients was researched and summarized. Results: Regarding the home quarantine period, pharmacist management services should include medication guidance, guidance on risk monitoring, sanitation measures education, health management guidance and psychological support. Regarding the outpatient visit period, pharmacists should participate in the control of in-hospital infections and provide physician-pharmacist joint clinic services, pharmacy clinic services, medication therapy management, medication consultation services, drug supply guarantee and drug dispensing services. Regarding the hospitalization period, pharmacist management services should include monitoring and evaluating the safety and efficacy of medications, providing strengthened care for special populations and other pharmaceutical care. For non-hospitalized or discharged patients, pharmacist management services should include formulating medication materials and establishing pharmacy management files for discharged patients. Conclusion: An evidence-based, patient-centered and entire-process-integrated pharmacist management strategy of the public and patients is established, which remedies the gaps in the existing patient management and can be implemented to support pharmacists' contributions to COVID-19 pandemic control.

Reintroduction of Post-Baccalaureate Doctor of Pharmacy (PharmD, Post-Bac) Program in Nepal: Exploration of the Obstacles and Solutions to Move Forward

This commentary article highlights the status of clinical pharmacy education in Nepal, explores the challenges and solutions in sustainably reintroducing Post-Baccalaureate Doctor of Pharmacy (PharmD, Post-Bac) in Nepal, as was previously launched by Kathmandu University (KU) Department of Pharmacy in 2010, and suggests a few prospects forward. Clinical pharmacy practice has remained on the sidelines and subordinate to physicians in Nepal. KU launched the PharmD (Post-Bac.) as a postgraduate program to establish the professional identity of clinical pharmacists in the country. However, despite unremitting efforts, the program did not thrive long and held since 2014. This paper aimed to explore challenges that remained at the forefront of the program and provide possible solutions for its reintroduction. The KU produced three batches of PharmD Post-Bac. graduates and now the revival of the program is crucial. Undoubtedly, a well-trained clinical preceptor can bring significant changes in the quality and competency of the PharmD graduates. Advocacy programs to foster the role of clinical pharmacists in the patient care services and revisiting of Bachelor of Pharmacy (BPharm) curriculum to complement the necessity of the PharmD program are needed. The non-sustenance of the PharmD program is emblematic of the dire mosaic that the clinical pharmacists are facing while delivering patient-oriented services in the country. Hence, strategies need to be formulated for the revival and sustainability of the program.

A comprehensive review on global contributions and recognition of pharmacy professionals amidst COVID-19 pandemic: moving from present to future

BACKGROUND

COVID-19, a respiratory tract infection caused by SARS-CoV-2, is a burning question worldwide as it gives rise to a pandemic situation. No specific medications are still recommended for COVID-19; however, healthcare support is crucial for ameliorating the disease condition. Pharmacists are the frontline fighters who are responsible for providing healthcare support to the COVID-19 infected patients around the world. This review endeavored to briefly rationalize the contributions of several pharmacy professionals in diverse fields along with their collaborative efforts and dedication regarding their limitations during the COVID-19 situation and view the prospects of pharmaceutical care services in the post-pandemic period.

MAIN BODY OF THE ABSTRACT

Online databases were utilized to search for scholarly articles and organizational websites, to sum up the information about the contemporary and expanded role of pharmacists. Key articles were retrieved from Google Scholar, PubMed, and Science Direct databases using terms: "COVID-19," "novel coronavirus," "community," "industrial," "hospital," "clinical," "recognition," "obstacles," "collaboration," "SARS-CoV-2," "healthcare," and "outbreak" in combination with "pharmacist." The articles were included from the inception of the pandemic to January 25, 2021. The current review found pharmacist's global contributions and involvements with other professionals to provide healthcare services amidst COVID-19. This included testing of suspects, providing medical information, psycho-social support, debunking myths, mitigating drug shortage events, telemedicine, e-prescription, infection control, and controlling the drug supply chain. In many countries, pharmacists' activities were much appreciated but in some countries, they were not properly acknowledged for their contributions amidst COVID-19 outbreak. They played additional roles such as participating in the antimicrobial stewardship team, improving value-added services, conducting clinical data analysis to suppress the outspread of the SARS-CoV-2.

SHORT CONCLUSION

During the COVID-19 pandemic while the whole world is fighting against an invisible virus, the pharmacists are the earnest hero to serve their responsibilities along with additional activities. They need to be prepared and collaborate with other healthcare professionals further to meet the challenges of post-pandemic circumstances.

Knowledge, awareness and preparedness regarding coronavirus disease 2019 pandemic among community pharmacy practitioners working in Kathmandu, Nepal: A pilot study

Good knowledge, awareness and preparedness regarding coronavirus disease 2019, among community pharmacy practitioners (CPPs), will enable them to provide correct information and support to patients, convey instructions from the public health authorities and protect their own health.

Objective

The aim of this study was to determine knowledge, awareness and preparedness regarding coronavirus disease 2019 among CPPs working in Kathmandu, Nepal.

Methods

A cross-sectional study was conducted using a convenience sampling method from 10 February to 25 March 2020. Data were analysed descriptively, and one-sample independent t-test and one-way analysis of variance were used to compare scores among different subgroups of respondents (p < 0.05). Post hoc analyses (following analysis of variance) were done using the Bonferroni test.

Results

A total of 81 CPPs participated. Mean ± standard deviation age was 26.70 ± 5.29 years. Majority of the respondents were male (64.2%). Many CPPs (40.7%) had work experience between 1 and 5 years. Almost half (45.7%) had an educational qualification of Diploma in Pharmacy. Significant differences in knowledge (p = 0.022) and preparedness (p < 0.001) were found among individuals with differing levels of work experience. Similarly, a significant difference was found between knowledge-preparedness and work experience (p = 0.022 and p < 0.001), location of pharmacy (p < 0.001) and educational qualification (p = 0.031). Awareness (p < 0.001) and preparedness scores (p = 0.049) were different among community pharmacies with the different number of medicines available.

Conclusion

Knowledge was found to be higher in CPPs with a work experience of more than 5 years. CPPs working at larger community pharmacies were more aware and prepared. CPPs' knowledge, awareness and preparedness should be evaluated more widely and strengthened.

Choice of Food: A Preventive Measure during Covid-19 Outbreak

As the Covid-19 pandemic has affected communities around the globe, people are facing the fear of being infected by it. It is believed that Coronavirus disease 2019 is directly associated to an individual’s immune response, with no documented research evidence found yet. But, Covid-19 is genetically similar to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV), therefore the same immune response is expected for Covid-191. It has also been found that individuals having weaker immune functions are more suspected to infect and have a high fatality rate2. Preventive measures such as good personal hygiene, wearing a mask, avoiding crowded places and sick individuals, practicing quarantine, and proper choice of food can help an individual to be safe from the risk of current COVID-19 infection. Research findings state that nutrition influences immune strength thereby protecting our body from the attack of pathogens3. Increasing intake of a nutritious diet can help to enhance the immune system and makes an individual less susceptible to diseases, which is also considered as a key factor for the prevention of viral infection like COVID-19. Therefore, the incorporation of foods rich in nutrients that boosts our immunity is one of the possible essential preventive measures to fight with this global crisis.