1
|
Tharmalinga Sharma JJ, McMillan SS, Samaranayake NR, Waas DA, Coombes ID, Wheeler AJ. Multifaceted pharmacist-led interventions in secondary care settings between countries of various income levels: a scoping review protocol. BMJ Open 2024; 14:e083726. [PMID: 38594185 PMCID: PMC11015257 DOI: 10.1136/bmjopen-2023-083726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
INTRODUCTION Clinical pharmacy services often involve multifaceted pharmacist-led interventions. However, current pharmacy practice models vary across different countries. Despite the documented benefits of clinical pharmacy services, the characteristics of pharmacist-led interventions in different countries have not yet been adequately explored and described. Therefore, this protocol outlines the methodology for a proposed scoping review aiming to investigate various types of multifaceted pharmacist-led interventions and the outcomes used to evaluate their effectiveness within secondary care settings. Additionally, the scoping review will map the current evidence surrounding the characteristics of interventions and outcomes reported across various countries of socioeconomic status. METHODS AND ANALYSIS The scoping review will be conducted according to the JBI Methodology for Scoping Reviews and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Extension for Scoping Reviews. We will systematically search the following electronic databases: MEDLINE (Ovid), CINAHL (EbscoHost), Embase (embase.com), Scopus (scopus.com), Cochrane Library (cochranelibrary.com) and APA PsycInfo (Ovid). Additionally, the reference lists of identified reviews and included full texts will be searched for relevant papers. Grey literature sources, such as International Pharmaceutical Abstracts and the International Pharmaceutical Federation (FIP) website, will be searched. We will include primary studies published in the English language from January 2013 to December 2023, involving secondary care multifaceted pharmacist-led interventions. Two independent reviewers will screen studies against eligibility criteria and use a piloted data extraction form to extract relevant information. We will extract relevant data, complete a tabular summary from each included publication and analyse it. ETHICS AND DISSEMINATION Ethical approval is not required as we will be using data from publicly available literature sources. Findings will be disseminated in publications and presentations with relevant stakeholders. We aim to map available evidence across the breadth of studies that have reported multifaceted pharmacist-led interventions and their outcomes.
Collapse
Affiliation(s)
| | - Sara S McMillan
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Centre for Mental Health and Menzies Health Institute, Griffith University, Brisbane and Gold Coast, QLD 4111 & 4222, Australia
| | - Nithushi R Samaranayake
- Department of Pharmacy and Pharmaceutical sciences, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
| | - Dulshika A Waas
- Department of Psychiatry, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda 10250, Sri Lanka
- Colombo South Teaching Hospital, Kalubowila-Dehiwela 10350, Sri Lanka
| | - Ian D Coombes
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- School of Pharmacy, The University of Queensland, Woolloongabba, QLD 4102, Australia
- Pharmacy Department, Royal Brisbane and Women's Hospital, Herston, QLD 4029, Australia
- Collaboration of Australians and Sri Lankans for Pharmacy Practice, Education and Research (CASPPER), woolloongabba, QLD 4102, Australia
| | - Amanda J Wheeler
- School of Pharmacy and Medical Sciences, Griffith University, Gold Coast, QLD 4222, Australia
- Centre for Mental Health and Menzies Health Institute, Griffith University, Brisbane and Gold Coast, QLD 4111 & 4222, Australia
- Faculty of Health and Behavioural Sciences, University of Auckland, Auckland 1142, New Zealand
| |
Collapse
|
2
|
Hammond A, Porter R, Lynch KE, Cason TH, Passaretti P. Impact of emergency medicine clinical pharmacist practitioner-driven sepsis antibiotic interventions. Am J Emerg Med 2024; 76:24-28. [PMID: 37979228 DOI: 10.1016/j.ajem.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 11/04/2023] [Accepted: 11/07/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND The 2021 Surviving Sepsis Campaign Guidelines recommend administration of antimicrobials within the first hour of recognition of sepsis. Over the last decade, several studies have demonstrated improved time-to-antibiotic administration and antibiotic appropriateness when a pharmacist was involved in the care of patients with sepsis. To our knowledge, no studies evaluating the appropriate use of antibiotics in sepsis driven entirely by an Emergency Medicine (EM) Clinical Pharmacist Practitioner (CPP) have been published. The purpose of this study is to evaluate the impact of an EM CPP-driven protocol on antimicrobial interventions in patients with sepsis in the emergency department (ED). METHODS This was a retrospective comparison of patients with sepsis for whom antimicrobials were ordered in the ED without pharmacist intervention to patients whose antimicrobials were ordered by an EM CPP via a sepsis consult to pharmacy. An EM CPP reviewed individual patient profiles for pertinent historical admissions, culture data, and allergy profiles to guide antimicrobial selection for the suspected source of infection and entered orders under their scope of practice with formal documentation in the electronic medical record (EMR). The primary objective of this study was to compare the rates of appropriate empiric antibiotic utilization in septic patients admitted from the ED pre- and post-protocol implementation. Secondary endpoints included the following, broadening of ED-initiated empiric antibiotics on hospital admission, time-to-antibiotic administration, in-hospital mortality, Rapid Emergency Medicine Score (REMS) association with in-hospital mortality, and hospital length of stay. RESULTS A total of 144 patients were included: 80 patients prescribed antibiotics without pharmacist intervention and 64 prescribed antibiotics by an EM CPP. Appropriate empiric antibiotic selection in the ED improved from 57.5% (46/80) to 86% (55/64) with EM CPP intervention (difference 28.5%; p < 0.01). Time-to-first antibiotic administration decreased by 64 min (p < 0.01). Administration of antibiotics within 60 min, broadening of antibiotics on admission, hospital length of stay, and in-hospital mortality did not significantly differ across groups. CONCLUSIONS In this small, single-center study, an EM Clinical Pharmacist Practitioner-driven protocol for patients with sepsis in the emergency department improved the rate of appropriate empiric antimicrobial selection and time-to-antibiotic administration.
Collapse
Affiliation(s)
- Aubrie Hammond
- CaroMont Regional Medical Center, 2525 Court Dr, Gastonia, NC 28054, United States of America.
| | - Regan Porter
- CaroMont Regional Medical Center, 2525 Court Dr, Gastonia, NC 28054, United States of America
| | - Kevin E Lynch
- CaroMont Regional Medical Center, 2525 Court Dr, Gastonia, NC 28054, United States of America
| | - Taylor H Cason
- CaroMont Regional Medical Center, 2525 Court Dr, Gastonia, NC 28054, United States of America
| | - Patrick Passaretti
- CaroMont Regional Medical Center, 2525 Court Dr, Gastonia, NC 28054, United States of America
| |
Collapse
|
3
|
Liebing N, Ziehr B, Röber S, Nibbe L, Oppert M, Warnke U. [Ward-based clinical pharmacists in intensive care medicine: an economic evaluation]. Med Klin Intensivmed Notfmed 2024:10.1007/s00063-023-01102-y. [PMID: 38263495 DOI: 10.1007/s00063-023-01102-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 11/06/2023] [Accepted: 12/07/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND The positive impact of pharmaceutical care in improving medication safety is considered proven. Little is known about the economic benefit of clinical pharmaceutical services in Germany. OBJECTIVE In 2020, a pilot project was started at the Ernst von Bergmann Hospital to introduce ward-based clinical pharmacists in intensive care medicine, also in order to determine the economic benefit of the medication management offered. METHODS By a team of experienced intensive care physicians and clinical pharmacists on the basis of a consensus principle, each pharmaceutical intervention (PI) was assigned a probability score (Nesbit probability score) with which an adverse drug event (ADE) would have occurred. Assuming that each ADE results in an increased length of stay, the costs of intensive care treatment/day were used as potential savings. The model thereby combines the findings of two international publications to enable an economic analysis of pharmaceutical services. RESULTS During the study period, 177 pharmaceutical interventions were evaluated and corresponding probability scores for the occurrence of ADE were determined. From this, annual savings of € 80,000 through avoided costs were calculated. CONCLUSION In this project, the economic benefit of pharmaceutical services in intensive care medicine was proven. Ward-based clinical pharmacists are now an integral part of the intensive care treatment team at the Ernst von Bergmann Hospital.
Collapse
Affiliation(s)
- Nadja Liebing
- Apotheke, Klinikum Ernst von Bergmann gGmbH, Charlottenstr. 72, 14467, Potsdam, Deutschland
| | - Benjamin Ziehr
- Apotheke, Klinikum Ernst von Bergmann gGmbH, Charlottenstr. 72, 14467, Potsdam, Deutschland
| | - Susanne Röber
- Zentrum für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann gGmbH, Potsdam, Deutschland
| | - Lutz Nibbe
- Zentrum für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann gGmbH, Potsdam, Deutschland
| | - Michael Oppert
- Zentrum für Notfall- und Internistische Intensivmedizin, Klinikum Ernst von Bergmann gGmbH, Potsdam, Deutschland
| | - Ulrich Warnke
- Apotheke, Klinikum Ernst von Bergmann gGmbH, Charlottenstr. 72, 14467, Potsdam, Deutschland.
| |
Collapse
|
4
|
Pestka DL, Murphy D, Huynh P, Rechtzigel JA, Kjos S, Ellich LM, Kaplan AN, Taylor BC, Atwood M, Polsfuss BA, Lee JY, Ishani A. Pharmacist-driven outreach initiative to increase prescribing of sodium-glucose cotransporter-2 inhibitors in eligible VHA patients with chronic kidney disease: a study protocol. BMC Nephrol 2024; 25:14. [PMID: 38182983 PMCID: PMC10770983 DOI: 10.1186/s12882-023-03446-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/20/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Patients with chronic kidney disease (CKD) are at increased risk for multiple adverse events, several of which have been proven to be less likely with the use of sodium-glucose cotransporter-2 inhibitors (SGLT2i). As a result, guidelines now recommend SGLT2i be given to those with mild to moderate CKD and type 2 diabetes. The objective of this study is to evaluate if a pharmacist-driven SGLT2i prescribing initiative among eligible patients with CKD and diabetes within the VA could more rapidly improve the adoption of SGLT2i via a pragmatic approach aligned with learning health systems. METHODS Eligible patients will be identified through an established VA diabetes dashboard. Veterans with an odd social security number (SSN), which is effectively a random number, will be the intervention group. Those with even SSNs will serve as the control while awaiting a second iteration of the same interventional program. The intervention will be implemented in a rolling fashion across one Veterans Integrated Service Network. Our primary outcome is initiation of an SGLT2i. Secondary outcomes will include medication adherence and safety-related outcomes. DISCUSSION This project tests the impact of a pharmacist-driven medication outreach initiative as a strategy to accelerate initiation of SGLT2i. The results of this work will not only illustrate the effectiveness of this strategy for SGLT2is but may also have implications for increasing other guideline-concordant care. Furthermore, the utilization of SSNs to select Veterans for the first wave of this program has created a pseudo-randomized interventional trial supporting a pragmatic learning health system approach. TRIAL REGISTRATION ISRCTN12374636.
Collapse
Affiliation(s)
- Deborah L Pestka
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA.
| | - Daniel Murphy
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Pearl Huynh
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Jessica A Rechtzigel
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Shari Kjos
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Lisa Marie Ellich
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Adam N Kaplan
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Brent C Taylor
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Melissa Atwood
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Beth A Polsfuss
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Joseph Y Lee
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| | - Areef Ishani
- Department of Medicine, University of Minnesota, Minneapolis, MN, USA
- Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, 55417, USA
| |
Collapse
|
5
|
Sallom H, Abdi A, Halboup AM, Başgut B. Evaluation of pharmaceutical care services in the Middle East Countries: a review of studies of 2013-2020. BMC Public Health 2023; 23:1364. [PMID: 37461105 DOI: 10.1186/s12889-023-16199-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
INTRODUCTION Pharmaceutical care services (PCs) have evolved significantly over the last few decades, with a greater focus on patient's safety and proven effectiveness in a wide range of contexts. Many of the evidence supporting this technique comes from the United States, the evaluation and adoption of (PCs) which differ greatly across the globe. OBJECTIVE The goal of this study was to identify and assess the efficacy of pharmaceutical care services in various pharmaceutical aspects throughout seventeen Middle Eastern nations. METHOD The Arkesy and O'Malley technique was used to conduct a scoping review. It was conducted using PubMed/Medline, Scopus, Cochrane Library, Springer Link, Clinical Trials, and Web of Science etc. The Van Tulder Scale was utilized in randomized trials research, whereas the dawn and black checklists were used in non-randomized trials research. A descriptive and numerical analysis of selected research was done. The scope of eligible PCs, pharmaceutical implementers, study outcomes, and quality were all identified by a thematic review of research. RESULTS There were about 431,753 citations found in this study, and 129 publications were found to be eligible for inclusion after analysing more than 271 full-text papers. The study design was varied, with 43 (33.3%) RCTs and 86 (66.7%) n-RCTs. Thirty-three (25.6%) of the studies were published in 2020. Jordan, Saudi Arabia, and Turkey were home to the majority of the studies (25.6%, 16.3%, and 11.6%) respectively. Thirty-seven studies (19.7%) were concerned with resolving drug related problems (DRPs), whereas 27 (14.4%) were concerned with increasing quality of life (QOL) and 23 (12.2%) with improving drug adherence. Additionally, the research revealed that the average ratings of the activities provided to patients improved every year. CONCLUSION Studies in the Middle East continue to provide evidence supporting the positive impact of pharmaceutical care services on both hard and soft outcomes measured in most studies. Yet there was rare focus on the value of the implemented services. Thus, rigorous evaluation of the economic impact of implemented pharmaceutical care services in the Middle East and assessment of their sustainability is must.
Collapse
Affiliation(s)
- Hebah Sallom
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Cyprus, Turkey.
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, University of Science and Technology, Sana'a, Yemen.
| | - Abdikarim Abdi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Near East University, Nicosia, Cyprus, Turkey
- Department of Clinical Pharmacy, Faculty of Pharmacy, Yeditepe University, İstanbul, Turkey
| | - Abdulsalam M Halboup
- Department of Clinical Pharmacy and Practice, Faculty of Pharmacy, University of Science and Technology, Sana'a, Yemen
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Bilgen Başgut
- Department of Pharmacology, Faculty of Pharmacy, Başkent University, Ankara, Turkey
| |
Collapse
|
6
|
Gutierrez Euceda B, Ferreri SP, Armistead LT. A descriptive analysis of primary care providers' interest in clinical pharmacy services. Explor Res Clin Soc Pharm 2023; 10:100267. [PMID: 37250620 PMCID: PMC10213089 DOI: 10.1016/j.rcsop.2023.100267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/31/2023] Open
Abstract
Background Various clinical pharmacy services exist to improve the health outcomes of patients. However, there are numerous barriers to their implementation and execution, especially in outpatient settings. As pharmacists design and implement clinical pharmacy services in outpatient settings, they often do not consider the needs of providers until after service development. Objectives The purpose of this study was to assess primary care providers' (PCPs') perceptions of clinical pharmacy services and their clinical pharmacy support needs. Methods A web-based survey was distributed via email to PCPs across North Carolina (NC). Survey dissemination was completed in two phases. Data analysis consisted of mixed methods - quantitative and qualitative. Descriptive statistics were used to analyze demographic differences within each phase as well as the ranking of medication classes/disease states by providers. Qualitative data analysis through inductive coding was done to assess provider perceptions of clinical pharmacy services. Results The response rate of the survey was 19.7%. Providers with previous experience with a clinical pharmacist rated overall services as positive. 62.9% of PCPs (N = 80) provided their perception of the positive attributes (pros) of clinical pharmacy services. 53.5% of PCPs (N = 68) provided their perception of the negative attributes (cons) of clinical pharmacy services. The top three medication classes/disease states that providers indicated they would value clinical pharmacy services for were: comprehensive medication management (CMM), diabetes medication management, and anticoagulation medication management. Of the remaining areas assessed, statin and steroid management ranked the lowest. Conclusions The results from this study demonstrated that clinical pharmacy services are valued by PCPs. They also highlighted how pharmacists can best contribute to collaborative care in outpatient settings. As pharmacists, we should aim to implement the clinical pharmacy services that PCPs would value most.
Collapse
|
7
|
Ranchon F, Chanoine S, Lambert-Lacroix S, Bosson JL, Moreau-Gaudry A, Bedouch P. Development of artificial intelligence powered apps and tools for clinical pharmacy services: A systematic review. Int J Med Inform 2023; 172:104983. [PMID: 36724730 DOI: 10.1016/j.ijmedinf.2022.104983] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/15/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Artificial Intelligence (AI) offers potential opportunities to optimize clinical pharmacy services in community or hospital settings. The objective of this systematic literature review was to identify and analyse quantitative studies using or integrating AI for clinical pharmacy services. MATERIALS AND METHODS A systematic review was conducted using PubMed/Medline and Web of Science databases, including all articles published from 2000 to December 2021. Included studies had to involve pharmacists in the development or use of AI-powered apps and tools.. RESULTS 19 studies using AI for clinical pharmacy services were included in this review. 12 out of 19 articles (63.1%) were published in 2020 or 2021. Various methodologies of AI were used, mainly machine learning techniques and subsets (natural language processing and deep learning). The datasets used to train the models were mainly extracted from electronic medical records (6 studies, 32%). Among clinical pharmacy services, medication order review was the service most targeted by AI-powered apps and tools (9 studies), followed by health product dispensing (4 studies), pharmaceutical interviews and therapeutic education (2 studies). The development of these tools mainly involved hospital pharmacists (12/19 studies). DISCUSSION AND CONCLUSION The development of AI-powered apps and tools for clinical pharmacy services is just beginning. Pharmacists need to keep abreast of these developments in order to position themselves optimally while maintaining their human relationships with healthcare teams and patients. Significant efforts have to be made, in collaboration with data scientists, to better assess whether AI-powered apps and tools bring value to clinical pharmacy services in real practice.
Collapse
Affiliation(s)
- Florence Ranchon
- CNRS, TIMC UMR5525, MESP, Université Grenoble Alpes, F-38041 Grenoble, France; Hospices Civils de Lyon, Hôpital Lyon Sud, unité de pharmacie clinique oncologique, Pierre-Bénite, France; Université Lyon-1, EA 3738 CICLY, Oullins cedex F-69921, France.
| | - Sébastien Chanoine
- CNRS, TIMC UMR5525, MESP, Université Grenoble Alpes, F-38041 Grenoble, France; Pôle Pharmacie, CHU Grenoble Alpes, F-38043 Grenoble, France; Université Grenoble Alpes, Faculté de Pharmacie, F-38041 Grenoble, France
| | | | - Jean-Luc Bosson
- CNRS, TIMC UMR5525, MESP, Université Grenoble Alpes, F-38041 Grenoble, France
| | | | - Pierrick Bedouch
- CNRS, TIMC UMR5525, MESP, Université Grenoble Alpes, F-38041 Grenoble, France; Pôle Pharmacie, CHU Grenoble Alpes, F-38043 Grenoble, France; Université Grenoble Alpes, Faculté de Pharmacie, F-38041 Grenoble, France
| |
Collapse
|
8
|
Kilonzi M, Mutagonda RF, Mlyuka HJ, Mwakawanga DL, 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, OmaryMashikuMinzi, Kamuhabwa AAR. Barriers and facilitators of integration of pharmacists in the provision of clinical pharmacy services in Tanzania. BMC Prim Care 2023; 24:72. [PMID: 36932338 PMCID: PMC10021921 DOI: 10.1186/s12875-023-02026-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Collaboration between medical doctors and nurses in the provision of healthcare services has been there for decades. The concept of clinical pharmacy services as a main goal for pharmacy practice is relatively new and is yielding more positive results for healthcare providers (HCPs), patients, and the health system. This study assessed barriers and facilitators toward the integration of pharmacists in the provision of CPS in Tanzania. METHODS A qualitative study was conducted in five tertiary hospitals representing Tanzania mainland. Ten (10) focus group discussions (FGDs) with 83 HCPs and 14 in-depth interviews (IDIs) with hospital administrators in referral hospitals were conducted between August and September 2021. The experienced qualitative researchers moderated the IDIs and FGDs, and all discussions were audio-recorded. Finally, the audios were transcribed verbatim, and analysis was done using a thematic approach. RESULTS Limited skills, lack of confidence, poor communication, inferiority, and superiority behaviors among HCPs were among the mentioned barriers. Shortage of pharmacists, lack of in-job training, standard operating procedures (SOPs), and guidelines were also mentioned. The study noted the high acceptability of CPS by other HCPs, the positive perception of pharmacists, and the recognition of CPS by the Tanzania Pharmacy Act and regulation. CONCLUSION The facilitators and barriers to the integration of pharmacists in the provision of CPS lie at the individual, health facility, and health system levels. Therefore, the study recommends in-job pharmacists training, fostering teamwork among HCPs, and development of CPS SoPs, and guidelines.
Collapse
Affiliation(s)
- Manase Kilonzi
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania.
| | - Ritah F Mutagonda
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Hamu J Mlyuka
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Dorkasi L Mwakawanga
- School of Nursing, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65001, Dar Es Salaam, Tanzania
| | - Wigilya P Mikomangwa
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Wema A Kibanga
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Alphonce Ignace Marealle
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Bertha Mallya
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Deogratias Katabalo
- School of Pharmacy, the 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, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - John Mmassy
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Sungwa Kabissi
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Josephine A Balati
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - Peter Maduki
- Christian Social Services Commission (CSSC), P.O BOX 9433, Dar Es Salaam, Tanzania
| | - OmaryMashikuMinzi
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| | - Appolinary A R Kamuhabwa
- School of Pharmacy, the Muhimbili University of Health and Allied Sciences, P. O. BOX 65013, Dar Es Salaam, Tanzania
| |
Collapse
|
9
|
Richet E, Ferret L, Gaboriau L, Charpentier P, Dujardin L, Fulcrand J, Boursier A. [Use of dronabinol in the treatment of resistant neuropathic pain: Feedback from patients followed in a multidisciplinary pain center]. Ann Pharm Fr 2022:S0003-4509(22)00159-6. [PMID: 36513153 DOI: 10.1016/j.pharma.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 09/27/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Dronabinol is a drug composed of synthetic delta-9-tetrahydrocannabinol. In France, dronabinol requires a named Temporary Utilisation Authorisation (TUA), for the treatment of refractory neuropathic pain. Few data currently exist concerning its efficacy and tolerance. We present our feedback on its use for chronic pain patients, the multidisciplinary supervision and the monitoring set up by the clinical pharmacist. METHOD This retrospective monocentric study presents Patients Global Impression of Change and tolerance data from patients treated with dronabinol in a pain center between October 2020 and July 2021. We present their satisfaction towards the care process. RESULTS Nineteen patients were treated with dronabinol during the study period. - The clinical pharmacist issued 180 advices for patients and doctors. Patients reported a positive impact of the telephone follow-up carried out by the clinical pharmacist. - 75% (n=9/12) of patients who continued treatment for more than 3 months reported improvement in their health. - 74% (n=14/19) of patients had at least one adverse event, six patients needed to discontinue the treatment. DISCUSSION-CONCLUSION Dronabinol represents an alternative that can improve the quality of life of some patients suffering from refractory neuropathic pain. Nevertheless, as with any medicine, its initiation requires a rigorous evaluation of the benefit-risk balance. The close collaboration between the physician and the clinical pharmacist allows a secure management patients and makes this complex drug circuit easer.
Collapse
|
10
|
Muralidharan H, Venkatesan A, Venati R, Dhanasekaran ID, Suthahar T, Ahmed A, Salhotra A, Nair BB, Krishnan M, Rajanandh MG. Barriers of healthcare professionals in utilizing the service of drugs and poison information Centre: A cross-sectional study. Explor Res Clin Soc Pharm 2022; 6:100142. [PMID: 35586749 PMCID: PMC9108987 DOI: 10.1016/j.rcsop.2022.100142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/25/2022] [Accepted: 04/25/2022] [Indexed: 11/24/2022] Open
Abstract
Background Health care professionals (HCPs) have been using drugs and poison information centre (DIC) less frequently in recent years. The purpose of this study was to identify the barriers that inhibit HCPs from using the DIC service in a tertiary care hospital, as well as the factors that assist HCPs in using DIC more effectively. Methods A cross-sectional study was conducted among HCPs in Sri Ramachandra Institute of Higher Education and Research, Chennai. HCPs were given a semi-structured questionnaire that was developed and validated by a subject expert, a public health expert, and a clinical psychologist, and their barriers and facilitators in accessing drug information services were recorded. Findings A total of 405 HCPs responded to the survey. Among the identified barriers, the top 3 were: HCPs found it easier to use mobile internet (31%) and the department's reference library (25%) instead of contacting DIC for any drug/poison information. In addition, 17% of HCPs stated that they were too busy. The factors that may assist HCPs utilize DIC more effectively were more awareness is required to demonstrate the functionalities of DIC (24%), and a mobile application is required (23%). Conclusion Today's HCPs have easy access to a variety of drug information resources, and many prefer to do their own drug/poison research. As current generation HCPs find it more convenient to use mobile internet than contacting DIC, the creation of a mobile application for drug information service may enhance the number of questions from HCPs.
Collapse
Affiliation(s)
- Harini Muralidharan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Arthi Venkatesan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Rishitha Venati
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Indrani Devi Dhanasekaran
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Teshini Suthahar
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Abrar Ahmed
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Arushi Salhotra
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Bijisha Baburaj Nair
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Mohana Krishnan
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| | - Muhasaparur Ganesan Rajanandh
- Department of Pharmacy Practice, Sri Ramachandra Faculty of Pharmacy, Sri Ramachandra Institute of Higher Education and Research, Deemed to be University, Porur, Chennai, India
| |
Collapse
|
11
|
da Rocha C, Carlotto J, Zanis Neto J. Analysis of the interventions in antineoplastic therapy by a clinical pharmacy service at a tertiary hospital in Brazil. J Oncol Pharm Pract 2021:10781552211017650. [PMID: 34000918 DOI: 10.1177/10781552211017650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Medication errors are avoidable occurrences that can assume clinically significant dimensions and impose relevant costs to the health system, especially in the context of antineoplastic therapy. OBJECTIVE Assess the clinical significance and economic impacts of a clinical pharmaceutical service. This retrospective study consists of an analysis of pharmacy interventions and drug-related problems found in a review of electronic prescriptions referring to antineoplastic therapy of a public teaching tertiary hospital in Brazil. METHOD Retrospective descriptive study obtained from electronic records of drug-related problems and pharmaceutical interventions related to antineoplastic therapy for oncological and hematological diseases, obtained through the pharmacotherapy review service. The accepted interventions were analyzed for the financial impact generated, evaluating your direct costs. The perception of clinical significance of a random sample of interventions was ascertained by the experts' opinion, using the Delphi method. RESULTS The most frequent problem was a "lack of information to professionals" (25.06%), "problems as to the frequency and interval of doses" (22.90%), and "medication underdosing" (16.20%). Dose adjustment (31.50%) and clarifications (30.90%) were the most frequent pharmaceutical interventions. In the second round of Delphi, experts rated 77.77% of interventions as extremely significant and very significant. The main drugs reported in the interventions were cyclophosphamide, carboplatin, methotrexate, folinic acid, and monoclonal antibodies. The savings amounted to US$1,193,970.18 and involved mainly bortezomib, dactinomycin, and monoclonal antibodies. CONCLUSION Clinical pharmacy services contributed to the rational use of medicines presenting clinical significance and avoiding waste of financial resources.
Collapse
Affiliation(s)
- Camile da Rocha
- Clinical Hospital of the Federal University of Paraná, Curitiba, Brazil
| | | | | |
Collapse
|
12
|
Alshakrah MA, Steinke DT, Tully MP, Abuzour AS, Williams SD, Lewis PJ. Development of the adult complexity tool for pharmaceutical care (ACTPC) in hospital: A modified Delphi study. Res Social Adm Pharm 2021; 17:1907-1922. [PMID: 33712369 DOI: 10.1016/j.sapharm.2021.02.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Hospital pharmacists play an essential role in patient care; however, a lack of resources means pharmacists are unable to review all patients daily. Consequently, there is a demand for reliable screening tools to allocate care to patients with urgent and/or complex pharmaceutical needs. Several tools have been developed, but no broad consensus exists on the design of a screening tool to be used in the adult hospital setting. OBJECTIVE To obtain expert consensus on the design of a pharmaceutical care complexity screening tool for use on admission to hospital. METHODS Two Delphi studies were conducted: the first sought to gain consensus from experts including pharmacists, academics and physicians on the components of a pharmaceutical complexity tool, the second to achieve consensus from UK chief pharmacists and clinical service pharmacy managers on the clinical appropriateness and practicality of the tool. Tool components and Delphi statements were identified and refined from our previous systematic review, UK survey and interview study of prioritisation tools. A valid definition for consensus was used. RESULTS Over 300 components were extracted from the interview data and systematic review and then refined for inclusion in the first Delphi study. Thirty-three experts completed Delphi One and consensus was reached on 92 components. Components were grouped into demographic, clinical and medication components and condensed to 33 items, which were included in the first draft of the Adult Complexity Tool for Pharmaceutical Care (ACTPC). The tool stratified patients into highly, moderately or least complex. Forty expert panellists completed Delphi Two and consensus was reached on review frequency and experience of pharmacy practitioner at each level. These decisions were incorporated into the final version of the ACTPC. CONCLUSIONS The ACTPC is the first systematically designed and internationally agreed tool for use on medical admission to hospital. It has potential to enable the delivery of targeted patient-centred pharmaceutical care.
Collapse
Affiliation(s)
- Meshal A Alshakrah
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom; King Abdulaziz Medical City, Pharmaceutical Care Services, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
| | - Douglas T Steinke
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom.
| | - Mary P Tully
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom.
| | - Aseel S Abuzour
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom.
| | - Steven D Williams
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom; Poole Bay and Bournemouth Primary Care Network, Dorset, England.
| | - Penny J Lewis
- Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, Universityof Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, United Kingdom.
| |
Collapse
|
13
|
Varas-Doval R, Saéz-Benito L, Gastelurrutia MA, Benrimoj SI, Garcia-Cardenas V, Martinez-Martínez F. Systematic review of pragmatic randomised control trials assessing the effectiveness of professional pharmacy services in community pharmacies. BMC Health Serv Res 2021; 21:156. [PMID: 33596906 PMCID: PMC7890900 DOI: 10.1186/s12913-021-06150-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 02/03/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Implementation of Professional Pharmacy Services (PPSs) requires a demonstration of the service's impact (efficacy) and its effectiveness. Several systematic reviews and randomised controlled trials (RCT) have shown the efficacy of PPSs in patient's outcomes in community pharmacy. There is, however, a need to determine the level of evidence on the effectiveness of PPSs in daily practice by means of pragmatic trials. To identify and analyse pragmatic RCTs that measure the effectiveness of PPSs in clinical, economic and humanistic outcomes in the community pharmacy setting. METHODS A systematic search was undertaken in MEDLINE, EMBASE, the Cochrane Library and SCIELO. The search was performed on January 31, 2020. Papers were assessed against the following inclusion criteria (1) The intervention could be defined as a PPS; (2) Undertaken in a community pharmacy setting; (3) Was an original paper; (4) Reported quantitative measures of at least one health outcome indicator (ECHO model); (5) The design was considered as a pragmatic RCT, that is, it fulfilled 3 predefined attributes. External validity was analyzed with PRECIS- 2 tool. RESULTS The search strategy retrieved 1,587 papers. A total of 12 pragmatic RCTs assessing 5 different types of PPSs were included. Nine out of the 12 papers showed positive statistically significant differences in one or more of the primary outcomes (clinical, economic or humanistic) that could be associated with the following PPS: Smoking cessation, Dispensing/Adherence service, Independent prescribing and MTM. No paper reported on cost-effectiveness outcomes. CONCLUSIONS There is limited available evidence on the effectiveness of community-based PPS. Pragmatic RCTs to evaluate clinical, humanistic and economic outcomes of PPS are needed.
Collapse
Affiliation(s)
- R Varas-Doval
- Spanish General Pharmaceutical Council, Villanueva 11, 28001, Madrid, Spain.
| | - L Saéz-Benito
- Faculty of Health Sciences, San Jorge University, Villanueva de Gállego, Zaragoza, Spain.,Pharmaceutical Research Group of the University of Granada, Faculty of Pharmacy, Granada University, Granada, Spain
| | - M A Gastelurrutia
- Pharmaceutical Research Group of the University of Granada, Faculty of Pharmacy, Granada University, Granada, Spain
| | - S I Benrimoj
- Pharmaceutical Research Group of the University of Granada, Faculty of Pharmacy, Granada University, Granada, Spain
| | - V Garcia-Cardenas
- Pharmaceutical Research Group of the University of Granada, Faculty of Pharmacy, Granada University, Granada, Spain.,Graduate School of Health, Discipline of Pharmacy, University of Technology Sydney, Sydney, NSW, Australia
| | - F Martinez-Martínez
- Pharmaceutical Research Group of the University of Granada, Faculty of Pharmacy, Granada University, Granada, Spain
| |
Collapse
|
14
|
Hoffmann S, Parikh P, Bohnenberger K. Dermal Hydrofluoric Acid Toxicity Case Review: Looks Can Be Deceiving. J Emerg Nurs 2020; 47:28-32. [PMID: 33183770 DOI: 10.1016/j.jen.2020.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/04/2020] [Accepted: 08/25/2020] [Indexed: 10/23/2022]
Abstract
Hydrofluoric acid is a caustic compound found in a wide variety of items for household and industrial uses. Dermal exposures can be visually unimpressive on presentation but still have fatal complications. This case review includes a description of a patient presenting with a dermal hydrofluoric acid burn that was effectively treated with topical calcium gluconate gel. Also highlighted are the challenges faced with recognizing the severity and appropriately treating dermal hydrofluoric acid burns in the emergency department.
Collapse
|
15
|
Li Q, Qu HJ, Lv D, Yeh MK, Sun S, Li L, Liao Y. Drug-related problems among hospitalized patients with COPD in mainland China. Int J Clin Pharm 2019; 41:1507-1515. [PMID: 31705457 DOI: 10.1007/s11096-019-00913-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 09/17/2019] [Indexed: 01/10/2023]
Abstract
Background Data are lacking about the extent of drug-related problems in hospitalized patients with COPD in China. Objective Identify types and causes of drug-related problems and assess interventions performed by pharmacists. Setting Study was conducted in an academic teaching hospital in Shanghai, China. Method Between June 2017 and July 2018, 393 patients admitted to hospital for acute exacerbation of COPD hospitalized were enrolled. Patient demographics and clinical characteristics were collected. The drug-related problems and interventions were recorded and analyzed based on the Pharmaceutical Care Network Europe (PCNE)-DRP V 8.02 classification. Main outcome measures The number, types, causes, interventions, and outcomes of the problems were analyzed. Results A total of 640 DRPs, with 763 corresponding causes, were identified for 393 patients. "Treatment safety P2" was the most common type of problem (54.2%; 347/640), and the most common causes were "drug selection C1" (24.2%; 185/763), "dose selection C3" (21.5%; 164/763) and "treatment duration C4" (17.7%; 135/763). Antibiotics, corticosteroids, and proton pump inhibitors were the three primary medication classes associated with DRPs. Patients, hospitalized for more than eight days, taking ten or more drugs or having renal dysfunctions were more likely to have drug-related problems. Pharmacists totally proposed 1557 interventions to address the problems. Most interventions (91.0%; 1418/1557) were accepted, and 91.6% of the problems were solved. Conclusion The prevalence of drug-related problems among the studied COPD patients was high. Pharmacists can have an important role in addressing the problems and optimizing the safety and effectiveness of therapies for hospitalized COPD patients.
Collapse
Affiliation(s)
- Qin Li
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China
| | - Hui Jun Qu
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China
| | - Dan Lv
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China
| | - Ming-Kung Yeh
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China
| | - Shusen Sun
- Department of Pharmacy Practice, College of Pharmacy and Health Sciences, Western New England University, 1215, Wilbraham Road, Springfield, MA, 01119, USA
- Department of Pharmacy, Xiangya Hospital Central South University, Changsha, 410008, Hunan Province, People's Republic of China
- Institute for Rational and Safe Medication Practices, National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan Province, People's Republic of China
| | - Ling Li
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China.
| | - Yun Liao
- Department of Pharmacy, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, 1111 XianXia Road, Shanghai, 200336, People's Republic of China.
| |
Collapse
|
16
|
Zhu Y, Liu C, Zhang Y, Shi Q, Kong Y, Wang M, Xia X, Zhang F. Identification and resolution of drug-related problems in a tertiary hospital respiratory unit in China. Int J Clin Pharm 2019; 41:1570-1577. [PMID: 31654364 DOI: 10.1007/s11096-019-00922-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 10/09/2019] [Indexed: 12/23/2022]
Abstract
Background The prevalence of drug-related problems in patients hospitalized at respiratory care units is unknown in mainland China. Objective To identify and categorize drug-related problems in a respiratory care unit in China. Setting Respiratory care unit in a tertiary university hospital in China. Methods Clinical pharmacy services were introduced and documented during an 18-months study period. The problems were categorized using the Pharmaceutical Care Network Europe DRP classification tool V8.02. Main outcome measures Problems and causes of drug-related problems, interventions proposed, and outcome of pharmacy recommendations. Results A total of 474 patients were reviewed, 164 patients had DRPs (34.6%). Total 410 problems were identified, an average of 2.5 per patient. Treatment effectiveness was the major type of problem detected (219; 53.4%) followed by treatment safety (140; 34.1%). The most common causes of the problems were patient-related (25.8%), drug selection (24.0%), and drug use process (23.4%). Pharmacist made 773 interventions; average 1.9 per drug-related problem. A total of 96.2% of these interventions were accepted leading to solving 81.9% of the identified problems. Conclusion There is a high prevalence of drug-related problems in patients hospitalized at the respiratory unit of this clinic. Clinical pharmacists should focus on improving prescribing practice and patient counseling.
Collapse
Affiliation(s)
- Yulin Zhu
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Cheng Liu
- Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yong Zhang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
| | - Qingping Shi
- Department of Pharmacy, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Yiqiu Kong
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Muqun Wang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Xuemei Xia
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| | - Feng Zhang
- Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
| |
Collapse
|
17
|
Ramos SF, Santos Júnior GAD, Pereira AM, Dosea AS, Rocha KSS, Pimentel DMM, Lyra-Jr DPD. Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach. BMC Health Serv Res 2018; 18:632. [PMID: 30103749 PMCID: PMC6090582 DOI: 10.1186/s12913-018-3403-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/17/2018] [Indexed: 12/17/2022] Open
Abstract
Background Clinical Pharmacy Services (CPS) are a reality in many health systems around the world. However, there are few studies that discuss the facilitators and the strategies to implement CPS in healthcare systems. In this way, the objective of this study was to identify the facilitators and strategies involved in the CPS implementation process in some public health units in a metropolis in the Northeast Brazil. Methods A qualitative study was carried out with health-system pharmacists and managers who experienced the implementation of CPS. Therefore, focus groups were conducted with pharmacists, and the interviews with the managers. The discussions were carried out through semi-structured scripts and were recorded in audio and videos, after the signature of the consent form. The recordings were transcribed and analyzed independently through content analysis, followed by consensus meetings between researchers. Results Two focus groups were conducted, with an average of seven pharmacists per group, and five interviews with local health managers. Participants reported 39 facilitators who were related to the categories: local healthcare network, healthcare team, pharmacists and implementation process of the CPS. And 21 strategies attributed to the following categories: local healthcare network, pharmacists and implementation process of the CPS. Conclusions This study identified facilitators and strategies of the implementation of CPS. Most of the positive experiences were related to the clinical skills and proactive attitudes of pharmacists. These findings may support pharmacists and health managers to implement CPS in health systems. Electronic supplementary material The online version of this article (10.1186/s12913-018-3403-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Sheila Feitosa Ramos
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Genival Araujo Dos Santos Júnior
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - André Mascarenhas Pereira
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Aline Santana Dosea
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Kérilin Stancine Santos Rocha
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Déborah Mônica Machado Pimentel
- Department of Medicine, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil
| | - Divaldo Pereira de Lyra-Jr
- Laboratory of Teaching and Research in Social Pharmacy (LEPFS), Department of Pharmacy, Federal University of Sergipe, Cidade Universitária "Prof. José Aloísio Campos", Jardim Rosa Elze, São Cristóvão, Zip code: 49100-000, Brazil.
| |
Collapse
|
18
|
Díaz de León-Castañeda C, Gutiérrez-Godínez J, Colado-Velázquez JI, Toledano-Jaimes C. Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector: A case study. Res Social Adm Pharm 2018; 15:321-329. [PMID: 29731375 DOI: 10.1016/j.sapharm.2018.04.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 04/19/2018] [Accepted: 04/20/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. OBJECTIVES To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. METHODS A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. RESULTS Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. CONCLUSIONS The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision.
Collapse
Affiliation(s)
- Christian Díaz de León-Castañeda
- Consejo Nacional de Ciencia y Tecnología - Infotec, Circuito Tecnopolo Sur 112, Tecnopolo Pocitos, 20313, Aguascalientes, Ags., Mexico.
| | - Jéssica Gutiérrez-Godínez
- Hospital General "Dr. Manuel Gea González", Secretaría de Salud, Calzada de Tlalpan 4800, Tlalpan Centro I, 14080, Tlalpan, Ciudad de México, Mexico.
| | - Juventino Iii Colado-Velázquez
- Departamento de Ciencias de la Salud, Universidad Autónoma de Occidente, Boulevard Lola Beltrán s/n, 4 de Marzo, 80107, Culiacán, Sinaloa, Mexico.
| | - Cairo Toledano-Jaimes
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Avenida Universidad 1001, Chamilpa, 62210, Cuernavaca, Morelos, Mexico.
| |
Collapse
|
19
|
Bayoud T, Waheedi M, Lemay J, Awad A. Drug therapy problems identification by clinical pharmacists in a private hospital in Kuwait. Ann Pharm Fr 2018; 76:210-217. [PMID: 29475557 DOI: 10.1016/j.pharma.2018.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 01/03/2018] [Accepted: 01/04/2018] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To report the types and frequency of drug therapy problems (DTPs) identified and the physician acceptance of the clinical pharmacist interventions in a private hospital in Kuwait. METHODS A retrospective cross-sectional study was conducted on 3500 patients admitted to the hospital between December 2010 and April 2013. A structured approach was used to identify DTPs and recommend interventions. Data were analyzed using MAXQDA version 11. KEY FINDINGS A total of 670 DTPs were identified and recommendations were proposed to treating physicians for each DTP. Overdosage was the most frequently identified drug therapy problem (30.8%), followed by low dosage (17.6%), unnecessary drug therapy (17.3%), need for additional drug therapy (11.6%), and need for different drug product (11.6%). The drug classes most frequently involved were anti-infectives (36.9%), analgesics (25.2%), and gastrointestinal agents (15.5%). More than two-third of the interventions (67.5%) were accepted and implemented by physicians. The most frequently accepted interventions were related to nonadherence, adverse drug reaction, monitoring parameters, inappropriate dosage, and need for additional drug therapy. CONCLUSION The current findings expand the existing body of data by reporting on pharmacist recommendations of identified DTPs and importantly, their high rate of acceptance and implementation by the treating physician. These results could serve as a springboard to support further development and implementation of clinical pharmacy services in other healthcare settings in Kuwait.
Collapse
Affiliation(s)
- T Bayoud
- Kuwait University, P.O. Box 24923, Safat 13110, Kuwait.
| | - M Waheedi
- Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
| | - J Lemay
- Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
| | - A Awad
- Kuwait University, P.O. Box 24923, Safat 13110, Kuwait
| |
Collapse
|
20
|
Li J, Li Z. Differences and similarities in clinical pharmacy practice in China and the United States: a narrative review. Eur J Hosp Pharm 2018; 25:2-5. [PMID: 31156977 PMCID: PMC6452335 DOI: 10.1136/ejhpharm-2016-001195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/14/2017] [Accepted: 02/27/2017] [Indexed: 11/04/2022] Open
Abstract
The clinical pharmacy practice provided by pharmacists aims to improve the rational use of medication and enhance the quality of life of patients. Although clinical pharmacy in the USA has been developing for almost 60 years, it began in China only in 2005. Despite this, rapid development in clinical pharmacy has been achieved under the support of China's Ministry of Health. This article aims to compare the differences between, and similarities of, clinical pharmacy practice in China and the USA.
Collapse
Affiliation(s)
- Jing Li
- Department of Pharmacy, Children's Hospital of Fudan University, Shanghai, China
| | - Zhiping Li
- Department of Pharmacy, Children's Hospital of Fudan University, Shanghai, China
| |
Collapse
|
21
|
Bilal AI, Tilahun Z, Beedemariam G, Ayalneh B, Hailemeskel B, Engidawork E. Attitude and satisfaction of health care providers towards clinical pharmacy services in Ethiopia: A post-deployment survey. J Pharm Policy Pract 2016; 9:7. [PMID: 26962456 PMCID: PMC4784336 DOI: 10.1186/s40545-016-0058-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 03/02/2016] [Indexed: 12/03/2022] Open
Abstract
Background Clinical pharmacy service has evolved steadily over the past few decades and is contributing to the ‘patient care journey’ at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers’ perception and satisfaction towards the service. Methods A cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools. Results Majority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70–90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience. Conclusions A large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.
Collapse
Affiliation(s)
- Arebu Issa Bilal
- Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Zelalem Tilahun
- Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Gebremedhin Beedemariam
- Departement of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Belete Ayalneh
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia
| | - Bisrat Hailemeskel
- Department of Pharmacy Practice, College of Pharmacy, Howard University, Washington, DC, USA
| | - Ephrem Engidawork
- Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, P.O. Box: 1176, Addis Ababa, Ethiopia
| |
Collapse
|
22
|
Patterson BJ, Bakken BK, Doucette WR, Urmie JM, McDonough RP. Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy. Res Social Adm Pharm 2016; 13:224-232. [PMID: 26935794 DOI: 10.1016/j.sapharm.2016.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 11/18/2022]
Abstract
The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies.
Collapse
Affiliation(s)
| | | | | | - Julie M Urmie
- College of Pharmacy, University of Iowa, Iowa City, IA, USA
| | | |
Collapse
|
23
|
McCullough MB, Petrakis BA, Gillespie C, Solomon JL, Park AM, Ourth H, Morreale A, Rose AJ. Knowing the patient: A qualitative study on care-taking and the clinical pharmacist-patient relationship. Res Social Adm Pharm 2016; 12:78-90. [PMID: 26004019 DOI: 10.1016/j.sapharm.2015.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 04/17/2015] [Accepted: 04/17/2015] [Indexed: 11/21/2022]
Abstract
BACKGROUND Previous studies have found clinical pharmacists (CPs) and clinical pharmacy specialists (CPSs) in direct patient care have positive effects across various patient outcomes. However, there are also other kinds of care-taking occurring in pharmacy-run clinic appointments that produce value for patients. OBJECTIVE To identify and characterize how CPs/CPSs in direct care clinics develop and practice care-taking behaviors which advance the pharmacist-patient relationship. METHODS Semi-structured CP/CPS interviews were conducted once per year for two years (46 year 1, 50 year 2) along with direct observations of clinical pharmacy work as part of an anticoagulation improvement intervention. Participants were from Veterans Health Administration (VHA) medical centers and VHA community-based outpatient clinics in the Northeastern U.S. Interviews were transcribed verbatim and thematically analyzed using NVIVO 10 software. RESULTS It was found that CPs/CPSs practice "knowing the patient" in ways related to, but distinct from this practice in the nursing literature. For CPs/CPSs, knowing the patient occurred over time, and it produced familiarity and trust between CPs/CPs and patients. A reciprocal relationship developed in which patients came to rely on CP/CPSs for other types of assistance. Patterns of knowing the patient and being known by the patient manifested in three distinct ways: 1) identifying the patient's unmet needs, 2) explaining other medications, and 3) helping the patient navigate the system. CONCLUSION This research identifies an action, knowing the patient, whereby CPs use their knowledge of the patient to deliver individualized care. This study contributes to the developing literature on pharmacist-patient relationships and pharmacist-patient communication.
Collapse
|
24
|
Penm J, Chaar B, Rose G, Moles R. Pharmacists' influences on prescribing: validating a clinical pharmacy services survey in the Western Pacific Region. Res Social Adm Pharm 2014; 11:63-73. [PMID: 25042568 DOI: 10.1016/j.sapharm.2014.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/02/2014] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hospital pharmacists around the world are becoming increasingly involved in promoting the responsible use of medicines through clinical pharmacy services. This is reflected in the Basel Statements developed by the International Pharmaceutical Federation Hospital Pharmacy Section, particularly the theme 'Influences on Prescribing.' Some countries, particularly in Asia, are currently establishing clinical pharmacy services and would benefit from identification of facilitators. OBJECTIVES To validate a survey exploring clinical pharmacy services focusing on pharmacists' influences on prescribing, based on Basel Statements 28-31, and the factors that affect their implementation in the Western Pacific Region (WPR). METHODS Content and face validity of the survey (BS28-31) was established. This resulted in the BS28-31 consisting of 20 questions, which included a Clinical Pharmacy Services Facilitators (CPSF) scale (25 items) to measure respondents' perceptions of facilitators of clinical pharmacy services. The BS28-31 was emailed to hospital pharmacy directors in the WPR. The survey was made available in English, Japanese, Chinese, Vietnamese, Lao, Khmer, French and Mongolian. Principal components and internal consistency analyses were conducted to assess the reliability and construct validity of the CPSF scale. RESULTS The final survey was sent to a total of 2525 hospital pharmacy directors in the WPR of which 726 were returned from 31 nations yielding a response rate of 29%. Two items in the scale were removed due to low communalities (0.22 and 0.16). The resulting 23 item scale produced a parsimonious two-factor solution, divided into internal (e.g. individual pharmacist traits and pharmacy departmental structure/resources) and environmental facilitators (e.g. government support, patient and physician expectations). This two factor solution explained 51.5% of the variance. In addition, the Cronbach's α for the internal and environmental subscales were 0.94 and 0.78 respectively. CONCLUSION The BS28-31 survey was found to be a reliable and valid instrument for assessing hospital pharmacy directors' perceptions of clinical pharmacy services regarding pharmacists' influences on prescribing and their facilitators in the WPR.
Collapse
Affiliation(s)
- Jonathan Penm
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Betty Chaar
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Grenville Rose
- Aftercare, Rozelle Hospital, Church Street, Lilyfield, NSW, Australia
| | - Rebekah Moles
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia
| |
Collapse
|
25
|
Ab Rahman AF, Ahmed Abdelrahim HE, Mohamed Ibrahim MI. A survey of therapeutic drug monitoring services in Malaysia. Saudi Pharm J 2012; 21:19-24. [PMID: 23960816 DOI: 10.1016/j.jsps.2012.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 01/09/2012] [Indexed: 11/29/2022] Open
Abstract
In Malaysia, therapeutic drug monitoring (TDM) service was started in the 1980s. Since then, the number of hospitals that offer the service has increased. In this paper, we report the findings of a nationwide survey describing the practice of TDM in these hospitals. Questionnaires were mailed to 128 government hospitals. Data were collected for general characteristics of the hospitals, administrative, and laboratory activities related to TDM service. One hundred and twenty-one hospitals responded to the survey. Thirty-four hospitals (28.1%) provided the service with their own TDM laboratories, 44 hospitals (36.4%) provided the service using other hospitals' laboratories and 43 hospitals (35.5%) did not provide the service at all. TDM services were more likely to be offered in larger hospitals with various medical specialties. Since it is managed entirely by hospital pharmacists, these pharmacists assume an important role in ensuring optimum use of the TDM service.
Collapse
Affiliation(s)
- Ab Fatah Ab Rahman
- School of Pharmaceutical Sciences, Universiti Sains Malaysia Health Campus, c/o Satellite Academic Building, 16150 Kubang Kerian, Kelantan, Malaysia
| | | | | |
Collapse
|