A cooperation project between hospital pharmacists and general practitioners about drug interactions in clinical practice (original) (raw)
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Evaluation of the Clinical Pharmacist Role in a Health Care Team; a Comparative Approach
Indian Journal of Pharmacy Practice, 2016
Background: Clinical pharmacy services were started in 1997 in India, in contrast to developed countries where the services were started in early 1960s. However 15 years have been passed out after the introduction of clinical pharmacy in India, but still the involvement of clinical pharmacist in the health care team is negligible. Objective: To elevate the clinical pharmacist role in the health care team, to justify the liaison between health care professionals and to promote better quality of life in chronic disease patients a prospective observational and interventional study was carried out. Setting: Rajiv Gandhi Institute of Medical Sciences, an 800 bedded tertiary care teaching hospital, Kadapa, India. Main Outcome: Progression of Quality of Life in chronic disease patients. Results: 200 patients were recruited belonging to age ≥40 years; they were divided in to Observational Group (100) and Interventional Group (100). Each group consist of 25 patients for Hypertension (25), Stoke (25), Diabetes Mellitus (25) and Asthma (25). Major risk factors identified as age, obesity, cigarette smoking, hypercholesterolemia, alcohol, diet, hereditary, allergens, seasons. Laboratory levels were compared between groups with p = 0.0049 (Observational Group), p=0.0081 (Interventional Group). Significant results obtained for medication adherence in Interventional Group (p=0.0003), Knowledge, Aptitude and Practice assessment between groups yielded significant results in Interventional Group as follows in Hypertension (p=<0.0001), Diabetes Mellitus (p=<0.0001), Stroke (p=<0.0001) and Asthma (p=<0.0001). significant results were observed for Quality of Life in Interventional Group as follows Hypertension (Physical Components-p=0.0036; Mental Components-p=<0.0001), Diabetes Mellitus (Physical Components-p=0.0221; Mental Components-p=0.0014), Stroke (Physical Components-p=0.0015; Mental Components-p=0.0038) and Asthma (Physical Components-p=0.0117; Mental Components-p=0.0043). Conclusion: Clinical pharmacist role will be elevated in health care team by promoting intrinsic services to doctors, by maintaining the diplomatic liaison between health care professionals and a decent patient-pharmacist relation improves the patient's knowledge on disease and which makes their better Quality of Life.
Journal of Pharmaceutical Care & Health Systems, 2015
The current study was planned to evaluate the perception of general practitioners and pharmacists regarding the role of the pharmacist in delivering clinical services and their willingness to work and collaborate with each other. The present study was cross-sectional and conducted from July 2015 till Nov 2015. The study population comprised of pharmacists and general practitioners, who were surveyed with a 42 items questionnaire. Descriptive statistics were employed to report the response of participants to questionnaire items. The association of the profession on the responses of participants towards the role of clinical pharmacists was determined by using an Independent sample t test at p<0.05 significant level. It was good to observe that both pharmacists and general practitioners in high proportion (>90%) thought that clinical pharmacist should be a source of clinical medicines information to general practitioners such as adverse effects of medicines and selection of a medicine for a particular disease state. Pharmacists (89%) and general practitioners (70.8%) considered it undoubtedly true that involvement of clinical pharmacist in medication management would enhance relationship between general practitioners and pharmacists and >90% of them agreed that the service would improve patients' medicine-related health outcomes. General practitioners considered that pharmacists are drug information experts. Both groups were ambivalent about the government policies and did not believe that the current policies give sufficient recognition to patient care approach. The government should develop strategies to strengthen doctors-pharmacists relation, thereby enhancing the role of pharmacists in primary care.
Family Medicine & Primary Care Review, 2016
Background. Poor communication is one of the most important common factor contributing to medication errors. despite their common history, there are many intellectual and practical differences between the professions of medicine and pharmacy that eventually affects patient care and health outcomes. Objectives. the main objective of the study is to evaluate the coordination and teamwork between pharmacist and doctor to provide betterment in the care of the patient health. Material and methods. a questionnaire of 10 questions was developed each for the patient, pharmacist and doctor posted on district hospital, Moradabad (u.P.), india and data collected from the patient and medical professionals through questionnaire were analyzed for collaborative role of doctor-pharmacist with respect to patient care. the results were analyzed using graph Pad Prism 5. Results. the data obtained from the questionnaire highlights a significant effort between pharmacist and doctors. however, some patients often doubt in the skills of pharmacist for treatment outcome, but the majority of people responds positive to doctor-pharmacist role as they prove to be fruitful in removing medication errors. Conclusions. to facilitate the patient care, doctor-pharmacist alliance is necessary, desired and should be motivated as professed by the respondents. Collaboration is an important element of effective patient-focused health care delivery.
An-Evaluation-Of-Interventions-By-Clinical-Pharmacists-In-A-Tertiary-Hospital
Malaysian Journal of Pharmacy, 2021
Introduction: Problems with medication therapy are a major concern in health care because of the associated increase in morbidity, mortality and increased cost of treatment. Clinical pharmacy services are well established in developed countries such as the United States and have been reported to reduce adverse drug events, medication errors, patient's length of stay, mortality rates and costs. Clinical pharmacists proactively ensure rational medication use, avoiding medication errors at point of prescribing. They participate in ward rounds, communicate with the team in the wards, interview patients, perform medication reconciliation, provide counselling, therapeutic drug monitoring, antibiotic stewardship, discharge screening and follow ups. Any discrepancy or problems detected will be conveyed to the relevant team member for correction. Objective: To describe and evaluate the interventions performed by clinical pharmacists in a tertiary teaching hospital in Malaysia. Method: A clinical pharmacy observational retrospective study was conducted between January and December 2019. Fourteen clinical pharmacists were assigned to respective wards in the medical, surgery and intensive care units to provide pharmaceutical care. All interventions performed in the wards were documented systematically. Result: A total of 3345 interventions were recorded. The most frequent interventions were on rational drug therapy (n = 1456, 43.5%), followed by corrections made on prescription (n = 1349, 40.3%) and changes in dosage and frequency (n = 540, 16.2%). The majority of suggestions (n = 3264, 97.6%) have been accepted. Conclusion: To our knowledge, this is the first study reporting clinical pharmacist interventions in a teaching hospital in Malaysia. The involvement of clinical pharmacist in the wards contributed to the optimisation of pharmacotherapy, safety and better patients' outcomes. There was good inter-professional collaboration at the ward level.
European Journal of Hospital Pharmacy, 2012
Objectives To analyse drug-related problems (DRPs) and describe clinical pharmacists' interventions Method A prospective 22-week observational descriptive clinical pharmacists' intervention study on six different wards of an Austrian tertiary care university hospital. In-depth analysis of DRPs, performed interventions and inter-rater and intra-rater variability analysis of interventions' significance assessment was conducted. Type and frequency of DRPs, clinical pharmacists' interventions and the physicians' acceptance rate were recorded. Further outcome parameters were the clinical significance of the interventions and the proportion of those with a cost-reducing potential. Results A total of 478 DRPs were detected during 138 ward rounds. The most common DRPs related to specific therapy discussions (30.1%), organisational advice (14.2%), medical chart errors (7.7%), untreated indications (7.5%) and drug use without indication (6.9%). Clinical pharmacists provided information (42.9%), suggested the addition of new drugs (13.4%) and the adaptation of drug dosages (12.6%). Antibacterials for systemic use, antithrombotics and drugs for acid-related disorders were commonly implicated. The mean acceptance rate of interventions was 54.7%. Three out of four clinical pharmacists' interventions were rated to be significant. The inter-rater reliability analysis of clinical significance immediately and 2 weeks after study completion showed a fair to moderate agreement (Fleiss's κ 0.35, pairwise Spearman correlation coefficients between 0.5 and 0.74, all p<0.0001). One out of 20 interventions showed a cost-reducing potential. Conclusions The results highlight a positive impact of clinical pharmacy services in a continually developing environment. Although, on average, every second intervention was immediately accepted, the proportion of significant interventions was high. Clinical pharmacy services are one method of addressing evident DRPs in hospitalised patients in Austria.
Pharmacy Practice
Objectives: Disagreement between health care providers on medication-related interventions can affect clinical outcomes. We aimed to study the outcomes and significance of clinical pharmacists' interventions and evaluate the levels of agreement between different clinical pharmacists on the impact of pharmaceutical interventions. Methodology: A retrospective study was conducted at a tertiary care hospital in Oman. The study included all documented interventions by clinical pharmacists for all categories of admitted patients that met the inclusion criteria. Results: The originator clinical pharmacists interjected to improve the efficacy of treatment in (58%, n=1740) of the interventions, followed by toxicity reduction (24%). The level of agreement in the clinical significance resulted in substantial Scotts' kappa (k) between the originator and the first reviewer, the first and second reviewers, and the second reviewer and supervisor (86%; k=0.77; P<.001), (77%; k=0.63; P<.001), (84%; k=0.77; P<.001), respectively. In terms of grading of clinical significance, the originator clinical pharmacists recorded moderate significance in 50% of the interventions, followed by major (30%), not applicable (8.4%), and minor (7.3%). The level of agreement in the clinical significance resulted in substantial Scotts' k between the originator and the first reviewer, and between the second reviewer and supervisor (82%; k=0.72; P<.001), (84%; k=0.77; P<.001), respectively. The level of agreement between the first and second reviewer was fair (55%; k=0.28; p<0.001). Conclusion: Clinical pharmacists' interventions have a crucial impact on patient safety, improving efficacy and reducing toxicities. Overall, there was a substantial agreement among clinical pharmacists on the clinical significance and grading of the interventions..
1999
The pharmaceutical profession can play an important role in the changing healthcare systems as far as education and training are adequately adjusted to prepare students for their future roles. The early integration of students as a "pressure group" is important to change education. For the first time, a Student's Symposium organised by the European Pharmacy Student Association (EPSA) together with the ESCP will be held in 1999 prior to its Annual Symposium [5], The title "From Student to Clinical Pharmacist: Bridging the Gap" can further contribute to change professional understanding in the upcoming generation. National and international societies can also make pressure to change the curriculum as to integrate a high level background in pharmacotherapeutics, preparing the pharmacist for a greater involvement in the prescribing process, along with the basic underlying sciences which are a condition for the development of pharmacy as a science oriented profession. It is important that more and more practitioners are integrated in the teaching process at University level, to bring science and practice together for the best of the patient. We should not see any antagonism between clinical pharmacy, hospital pharmacy, community pharmacy and pharmaceutical care. The latter fits easily in the concept of Clinical Pharmacy which will have to integrate a growing part of the activities of community and hospital pharmacists. Clinical Pharmacy is therefore not limited to one of them but has an overlapping character which can contribute to a better understanding between the different professional categories. Moreover it is an extremely helpful concept to prepare pharmacists for an integrated healthcare system with minimal separation between hospital and ambulatory care.
Worldwide role of clinical pharmacists in optimizing patient health: A systematic review
2019
Background: In many under developed countries, role of clinical pharmacists is not well established. Whereas, world widely in developed countries pharmacists in clinical settings are playing very vital role in optimizing therapeutic regimens, minimizing drug therapy problems (DTPs) & issuance of drug safety alerts to the healthcare professional for preventing & management of Adverse drug reactions. Thus our systematic review is aimed to evaluate the role of clinical pharmacists in healthcare settings. Methodology: A comprehensive computerized literature search was carried out to find clinical research articles. Pub med, Medline, Google scholars & science direct was searched extensively. Results: Total 40 research articles were studied for the review. Irrelevant and duplicated articles were removed. Total 23 articles were selected for the systematic review. Conclusion: This systematic review concluded that clinical pharmacists have the great potential to play an active role in the ma...
Integrated Pharmacy Research and Practice, 2022
Background: Drug-drug interactions (DDIs) can cause treatment failure and serious adverse drug reactions, leading to morbidity and mortality. Due to their significant effects on the patient's health, community pharmacists (CPs) competence in detecting and preventing these interactions is essential to provide optimal health services. Thus, this study aimed to explore the performance of the CPs in situations involving the presence of potential DDIs. Methods: A cross-sectional, simulated patient study was conducted in 235 community pharmacies in the Khartoum locality. Two scenarios were used to evaluate the performance of the CPs. Ten final year B. Pharm. students were selected to act as simulated patients (SPs); they were trained for two weeks to familiarize their roles. All encounters were documented immediately after leaving the pharmacy by the SPs in the data collection form. Results: All planned SPs visits were completed, resulting in 470 visits. None of the CPs asked about the patients' medication history in both scenarios. After the SPs provided information about the drug used currently by the patient, 13.6% and 23.4% of the CPs had identified the potential DDIs in scenario 1 and scenario 2, respectively. In scenario 1, 59.4% distinguished the interaction of simvastatin with both drugs, while, in scenario 2, 74.5% recognized the interaction of warfarin with both drugs. In identifying DDIs, around half of the CPs were dependent on their knowledge or using drug interaction checker programs. The most common intervention made by the CPs was referring the patient to the prescriber (56.3% CPs in scenario 1 and 60% CPs in scenario 2). Conclusion: CPs practice in identifying and managing potential DDIs was poor. The current CPs practices need substantial improvement. Therefore, professional education and the use of software programs in community pharmacies should be encouraged.