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Journal of the American Pharmacists... 2021Cystic fibrosis (CF) is an autosomal recessive genetic disease requiring complex, lifelong medication regimens. Given the importance of medication in CF treatment,...
BACKGROUND
Cystic fibrosis (CF) is an autosomal recessive genetic disease requiring complex, lifelong medication regimens. Given the importance of medication in CF treatment, pharmacists are vital CF care team members in the care of people living with CF (PwCF).
OBJECTIVES
This study aimed to (1) define patients' CF medication experiences and educational needs and (2) investigate the CF outpatient clinic and community pharmacist's role in addressing patient challenges.
METHODS
A work system approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) model was used to characterize knowledge and perception of CF medication regimens, educational modalities, and pharmacist interactions for PwCF. Semistructured interviews were conducted with adults living with CF at a CF center clinic. Data analyses identified relationships between the themes in the data and 4 SEIPS work system domains: tasks, tools and technology, person, and environment.
RESULTS
Thirty PwCF interviews highlighted 4 themes regarding health care experiences: (1) medication use experience, (2) medication education needs, (3) disease experience, and (4) pharmacist and pharmacy interactions. Patients reported complex medication regimens leading to challenges with medication adherence, although the benefit of treatment was recognized. Although a high level of disease-state knowledge was identified among the participants, PwCF desired to learn about CF medication benefits and adverse effects through credible sources using multiple modalities. Many reported a benefit of pharmacist involvement in their care.
CONCLUSION
Pharmacists are well-positioned to support PwCF in adherence, medication regimen management, and medication education. Opportunities exist for growth in these supportive roles of a pharmacist in both community and outpatient clinic settings.
Topics: Adult; Cystic Fibrosis; Humans; Medication Adherence; Medication Therapy Management; Pharmaceutical Services; Pharmacists
PubMed: 33931354
DOI: 10.1016/j.japh.2021.04.006 -
Journal of the American Pharmacists... 2021To understand the perceived role and value of the clinical pharmacist in a southern Arizona concierge primary care practice (CPCP) by employees.
OBJECTIVE
To understand the perceived role and value of the clinical pharmacist in a southern Arizona concierge primary care practice (CPCP) by employees.
METHODS
Semistructured face-to-face interviews were conducted with health care team members employed by the CPCP site in December 2019 and January 2020 for this study. The interviews were audio recorded, transcribed, and thematically analyzed using an inductive approach with ATLAS.ti (version 7). A qualitative assessment was performed by 2 independent reviewers to identify the themes, which included clinical, economic, and humanistic outcomes.
RESULTS
Eleven CPCP employees were interviewed: physicians (n = 2), a nurse practitioner (n = 1), medical assistants (n = 4), and administrative staff (n = 4). The perceived role and value of the clinical pharmacist in this CPCP varied by employee position; yet, all expressed the pharmacist's positive impact on patient care. Five themes were identified. The most common pharmacist roles identified included providing medication knowledge to providers, preventing abuse of controlled substances, monitoring clinical response to medications and adverse drug events, aiding in prior authorizations, educating patients, and providing patient-centered care.
CONCLUSION
These results demonstrate that the integration of a clinical pharmacist into a CPCP can be valuable. This study highlights that the pharmacist was positively received by the physicians and staff. This further supports the value of the pharmacist as a key interprofessional health care team member. Further study is warranted to assess the longitudinal impact of pharmacists' services in a CPCP.
Topics: Arizona; Humans; Patient Care Team; Pharmacists; Primary Health Care; Professional Role
PubMed: 33478927
DOI: 10.1016/j.japh.2020.12.014 -
Yakugaku Zasshi : Journal of the... 2014In 2012, a new medical fee system was introduced for the clinical activities of hospital pharmacists responsible for in-patient pharmacotherapy monitoring in medical... (Review)
Review
In 2012, a new medical fee system was introduced for the clinical activities of hospital pharmacists responsible for in-patient pharmacotherapy monitoring in medical institutions in Japan. The new medical system demands greater efforts to provide the most suitable and safest medicine for each patient. By applying the concept of academic detailing to clinical pharmacists' roles in hospitals, I present drug use evaluation in three disease states (peptic ulcer, insomnia, and osteoporosis). To analyze these from multiple aspects, we not only need knowledge of drug monographs (clinical and adverse drug effects), but also the ability to evaluate a patient's adherence and cost-effectiveness. If we combine the idea of academic detailing with a clinical pharmacist's role, it is necessary to strengthen drug information skills, such as guideline or literature search skills and journal evaluation. Simultaneously, it is important to introduce new pharmaceutical education curriculums regarding evidence-based medicine (EBM), pharmacoeconomics, and professional communication in order to explore pharmacists' roles in the future.
Topics: Cost-Benefit Analysis; Drug Information Services; Pharmacists; Pharmacy Service, Hospital; Practice Guidelines as Topic; Prescription Drugs; Professional Role
PubMed: 24584015
DOI: 10.1248/yakushi.13-00235-3 -
American Journal of Health-system... Jun 2020The need for high-quality research during disaster responses has been well described in the literature, and such research is supported by efforts at the federal level...
PURPOSE
The need for high-quality research during disaster responses has been well described in the literature, and such research is supported by efforts at the federal level through the National Institutes of Health Disaster Research Response (DR2) Program. This article describes the fourth DR2 workshop with a specific focus on opportunities for pharmacists to get involved with disaster research efforts.
SUMMARY
Pharmacists have historically played a significant role in disaster planning and response, and there are a number of opportunities for pharmacists to bring their unique perspective, positioning, and skills to disaster research response (ie, onsite and other research on the medical and public health aspects of disasters and public health emergencies). In February 2019, the fourth DR2 workshop was held in Tucson, AZ, in conjunction with the University of Arizona College of Medicine-Tucson, the university's Mel and Enid Zuckerman College of Public Health, University of Arizona College of Pharmacy, and the university's Bio5 Institute to explore clinical and population-based research in a simulated disaster setting. This article describes the workshop and discusses several opportunities for pharmacists to design, lead, and support research efforts during disaster scenarios through involvement in research areas including clinical, operational, educational, and logistic aspects of pharmacy practice.
CONCLUSION
Due to their positioning throughout health systems, unique perspective, training, and skills, pharmacists are uniquely situated to play an important role in disaster research response.
Topics: Arizona; Disaster Planning; Disasters; Education; Humans; Pharmaceutical Services; Pharmacists; Professional Role
PubMed: 32350533
DOI: 10.1093/ajhp/zxaa093 -
PloS One 2024The pharmacist plays an essential role in identifying and managing drug-related problems. The aim of this research was to assess the costs avoided by clinical pharmacist...
BACKGROUND
The pharmacist plays an essential role in identifying and managing drug-related problems. The aim of this research was to assess the costs avoided by clinical pharmacist interventions to resolve drug-related problems.
RESEARCH DESIGN AND METHODS
Clinical pharmacists identified drug-related problems and interventions to address them in consecutive outpatients visiting internal medicine clinics at major teaching and public hospitals in Jordan from September 2012 to December 2013. The costs avoided by each intervention to address drug-related problems were collected from the literature. The collected data were used to calculate the overall cost saved and avoided by the interventions implemented to address the identified drug-related problems, adopting a Jordanian healthcare system perspective.
RESULTS
A total of 2747 patients were enrolled in the study. Diagnostic interventions, such as the need for additional diagnostic testing, were employed in 95.07% of the 13935 intervention to address the drug-related problem "Miscellaneous" which was the most frequent drug-related problems. Other common drug-related problems categories included inappropriate knowledge (n = 6972), inappropriate adherence (4447), efficacy-related drug-related problem (3395) and unnecessary drug therapy (1082). The total cost avoided over the research period was JOD 1418720 per month and total cost saved over the study period was JOD 17250.204. Drug-related problems were associated the number of prescription medications (odds ratio = 1.105; 95% confidence interval = 1.069-1.142), prescribed gastrointestinal drugs (3.485; 2.86-4.247), prescribed antimicrobials (3.326; 1.084-10.205), and prescribed musculoskeletal drugs (1.385; 1.011-1.852).
CONCLUSIONS
The study revealed that pharmacists have provided cognitive input to rationalize and optimize the medication use and prevent errors, that led to the reported projected avoided and saved expenditures via various interventions to address drug-related problems. This highlights the added economic impact to the clinical impact of drug-related problems on patients and the healthcare system. The high prevalence and cost of drug-related problems offer strong rationale for pharmacists to provide more vigilant intervention to improve patient outcomes while maintaining cost effectiveness.
Topics: Humans; Jordan; Pharmacists; Male; Female; Middle Aged; Drug-Related Side Effects and Adverse Reactions; Ambulatory Care Facilities; Aged; Adult; Cost Savings
PubMed: 38843244
DOI: 10.1371/journal.pone.0302287 -
PloS One 2020To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate... (Observational Study)
Observational Study
OBJECTIVE
To evaluate the influence of pharmacists' dispensing workload (PDW) on pharmacy services as measured by prescription suggestion rate (PSR) and dispensing error rate (DER).
METHOD
This was an observational study in northern and southern Taiwan's two largest medical centers, from 2012 to 2018. We calculated monthly PDW as number of prescriptions divided by number of pharmacist working days. We used monthly PSR and DER as outcome indicators for pharmacists' review and dispensing services, respectively. We used Poisson regression model with generalized estimation equation methods to evaluate the influence of PDW on PSR and DER.
RESULTS
The monthly mean of 463,587 (SD 32,898) prescriptions yielded mean PDW, PSR and DER of 52 (SD 3) prescriptions per pharmacist working days, 30 (SD 7) and 8 (SD 2) per 10,000 prescriptions monthly, respectively. There was significant negative impact of PDW on PSR (adjusted rate ratio, aRR: 0.9786; 95%CI: 0.9744-0.9829) and DER (aRR: 0.9567; 95%CI: 0.9477-0.9658). Stratified analyses by time periods (2012-2015 and 2016-2018) revealed the impact of PDW on PSR to be similar in both periods; but with positive association between PDW and DER in the more recent one (aRR: 1.0086, 95%CI: 1.0003-1.0169).
CONCLUSIONS
Reduced pharmacist workload was associated with re-allocation of pharmacy time to provide prescription suggestions and, more recently, decrease dispensing errors. Continuous efforts to maintain appropriate workload for pharmacists are recommended to ensure prescription quality.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists; Pharmacy Technicians; Prescriptions; Taiwan; Workload
PubMed: 32315319
DOI: 10.1371/journal.pone.0231482 -
Research in Social & Administrative... Oct 2019Interruptions constitute a key part of the communication strategy for healthcare providers, including community pharmacy personnel. Previous research in other healthcare...
BACKGROUND
Interruptions constitute a key part of the communication strategy for healthcare providers, including community pharmacy personnel. Previous research in other healthcare environments has shown that interruptions are very common and may present as patient safety hazards. One 1999 study, conducted in community pharmacy settings, found that interruptions were prevalent and associated with dispensing errors. In the last 20 years, pharmacies have expanded patient services and implemented new technology. Yet, it is unknown how these changes have affected interruption sources and frequency.
OBJECTIVE
The objective was to characterize the frequency and sources of pharmacist task interruptions that occur in community pharmacies.
METHODS
A cross-sectional qualitative study design was used to evaluate the frequency and sources of pharmacist task interruptions in Wisconsin community pharmacies. The participants included 9 pharmacists and 9 technicians working in 2 independently-owned, 2 mass merchandise, and 2 hospital/clinical-affiliated pharmacies.
RESULTS
Interruption rates ranged from 3 to 7 per hour across the 6 pharmacies. Sources of interruptions included: patients, technicians, self-initiated interruptions, technology used in the pharmacy, and a second pharmacist.
CONCLUSIONS
Interruptions are common in community pharmacies and the causes are multifactorial. Prudent management of interruptions in these work environments may involve improved technician training and better designs of pharmacy technology.
Topics: Adult; Communication; Community Pharmacy Services; Cross-Sectional Studies; Humans; Middle Aged; Pharmacists; Pharmacy Technicians; Wisconsin; Workflow; Young Adult
PubMed: 30420227
DOI: 10.1016/j.sapharm.2018.10.030 -
American Journal of Pharmaceutical... Mar 2018To show why medicinal chemistry must be a key component of the education of pharmacy students, as well as in the pharmacist's practice. Five case reports were selected... (Review)
Review
To show why medicinal chemistry must be a key component of the education of pharmacy students, as well as in the pharmacist's practice. Five case reports were selected by their clinically relevant elements of medicinal chemistry and were explained using structure-activity relationship data of the drugs involved in the case easily obtained from primary literature and in medicinal chemistry textbooks. This paper demonstrates how critical clinical decisions can be addressed using medicinal chemistry knowledge. While such knowledge may not explain all clinical decisions, medicinal chemistry concepts are essential for the education of pharmacy students to explain drug action in general and clinical decisions.
Topics: Chemistry, Pharmaceutical; Clinical Decision-Making; Curriculum; Education, Pharmacy; Educational Measurement; Humans; Pharmaceutical Preparations; Pharmaceutical Services; Pharmacists; Students, Pharmacy
PubMed: 29606703
DOI: 10.5688/ajpe6083 -
Yakugaku Zasshi : Journal of the... 2024The Education Award of the Pharmaceutical Society of Japan (PSJ) was conferred for "Contribution to pharmacy/pharmacist education through writing on organic chemistry."...
The Education Award of the Pharmaceutical Society of Japan (PSJ) was conferred for "Contribution to pharmacy/pharmacist education through writing on organic chemistry." The award-winning activities were described in three parts section 1-3. Section 1 Importance of Research and Education in Organic Chemistry: In this section, it is explained that organic chemistry serves as the fundamental basis for a wide range of natural science disciplines studied in pharmaceutical departments. It emphasizes that having a solid foundation in organic chemistry is essential for pharmacists to understand pharmaceuticals. This knowledge contributes significantly in healthcare settings such as team-based medical care (interprofessional cooperation) with physicians and nurses, as well as in interactions with patients, providing a unique contribution that other professions cannot achieve. Section 2 Two Serial Articles Written on Organic Chemistry: This part mentions two serial articles that are beneficial for pharmacists and pharmaceutical researchers. These articles aimed to broaden specialized knowledge and provide practical information, contributing to pharmaceutical education and professional training for pharmacists. Section 3 Publication of New Organic Chemistry Textbooks: In this section, the introduction of textbooks and reference books in the field of organic chemistry for pharmaceutical education is highlighted. These educational materials were published to offer valuable information to pharmaceutical students and aspiring pharmacists, enhancing their expertise. These three writing activities significantly contributed to pharmaceutical education and the improvement of the professional work of pharmacists.
Topics: Humans; Pharmacists; Education, Pharmacy; Pharmacy; Educational Status; Pharmaceutical Preparations
PubMed: 38432931
DOI: 10.1248/yakushi.23-00182 -
Pain Medicine (Malden, Mass.) Sep 2018The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This...
OBJECTIVE
The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients.
DESIGN
Focus groups.
SETTING
Patient groups were held in person, and pharmacist groups were held online.
SUBJECTS
Oregon pharmacists (N = 19, Mage = 39.0 years, range = 26-57 years, 58% female) and patients (N = 18, Mage = 60.1 years, range = 30-77 years, 71% female) with current experience dispensing or receiving opioid medications.
METHODS
Pharmacists were asked about the challenges and opportunities for opioid safety monitoring and prescription dispensing. Patients were asked about their experiences accessing care, medications, and safety information. Focus group data were analyzed by a multidisciplinary team using an immersion-crystallization approach.
RESULTS
Pharmacists and patients agreed that pharmacists are responsible for medication safety. Pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing. Patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions.
CONCLUSIONS
Feedback from both pharmacists and patient participants suggests that there is uncertainty in the degree to which pharmacists can and should confront the prescription opioid epidemic directly. Ambiguities in the pharmacist's role may be best clarified through structured training promoting enhanced between-party communication.
Topics: Adult; Aged; Analgesics, Opioid; Female; Focus Groups; Humans; Male; Middle Aged; Pharmacists; Professional Role
PubMed: 29016883
DOI: 10.1093/pm/pnx139