scholarly journals Assessment of the potential impact of resolving drug-related problems by clinical pharmacists in Japan: a retrospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Toshiya Oki ◽  
Sachi Ishii ◽  
Koya Furukawa ◽  
Aiko Shono ◽  
Manabu Akazawa
Keyword(s):  
Patient Care ◽  
Positive Impact ◽  
Anatomical Therapeutic Chemical ◽  
Hospitalized Patients ◽  
Drug Related Problems ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
Medication Reviews ◽  
Potential Impact

Abstract Background Clinical pharmacists play a role in limiting the disadvantages of pharmacotherapy for patients by detecting and resolving drug-related problems (DRPs) through medication reviews. Although their contributions to patient care have been analyzed and understood in various countries, the role of Japanese clinical pharmacists in this context remains to be clearly elucidated. Thus, in this study, we aimed to elucidate the detection of DRPs by clinical pharmacists and determine the potential impact of pharmacist interventions in Japan. Methods This study was conducted in a 273-bed hospital and targeted hospitalized patients over a period of 6 months. DRPs detected by clinical pharmacists during the study period were investigated and classified into 10 types. Furthermore, medications were categorized according to the Anatomical Therapeutic Chemical classification. A review committee consisting of two pharmacists independently reviewed the pharmacist interventions on a six-point scale (extremely significant, very significant, significant, somewhat significant, no significance, adverse significance) according to the potential impact on patient care. Results During the study period, 1711 patients (mean age: 71.2 years, 54.1% male) were included, and 2149 DRPs were detected (1.26 DRPs/patient). Pharmacists intervened in all the DRPs detected. The most common DRP was supratherapeutic dosage (19.3%), followed by untreated indication (18.1%). The most common medication classification causing DRPs was “Antiinfectives for Systemic Use” (25.1%), followed by “Alimentary Tract and Metabolism” (19.9%). Most of the pharmacist interventions (99.6%) were rated “somewhat significant” or more significant, of which 1.1% were rated “extremely significant,” and none were rated as “adverse significance.” Conclusions Our results show that in Japan, as in other countries, clinical pharmacists detect and resolve DRPs in hospitalized patients through medication review. Our findings also show that clinical pharmacists have a positive impact on patient care and suggest the need for their involvement.

scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

scholarly journals Pharmaceutical care in a school pharmacy: from consultation to resolution of drug-related problems

2019 ◽  
Vol 41 (1) ◽  
pp. 42470
Author(s):  
Amanda Thiemy Chiozzi Watanabe ◽  
Fernando Henrique Zonzini ◽  
Maurício Fumio Sybui ◽  
Angela Maria Campanha
Keyword(s):  
Pharmaceutical Care ◽  
Anatomical Therapeutic Chemical ◽  
Descriptive Analysis ◽  
State University ◽  
Drug Related Problems ◽  
Relevant Role ◽  
Professional Information ◽  
General Community

This study aimed to provide pharmaceutical care for the general community served by Pharmacy students from the Pharmacy School of the State University of Maringá [Universidade Estadual do Maringá] (UEM). Pharmacotherapeutic follow-up was performed with the identification, classification and resolution of drug-related problems (DRPs) through pharmaceutical consultations. A descriptive analysis was conducted. A total of 59 patients were interviewed; they were mostly women (75%) with average age of 63 years, and each of them was taking 8 medicines on average. The most frequently mentioned drugs were classified according to the Anatomical Therapeutic Chemical Code and related to cardiovascular system (28%), alimentary tract and metabolism (23%), and nervous system (20%). An average of 1.49 DRP per patient was detected (88), and treatment non-compliance was the most frequent DRPs found (45%). In view of this, 63 pharmaceutical interventions were carried out, with most of them (52%) being related to patient education on the treatment; approximately 20% of the patients were referred to another health professional. Information supplied by this study shows the relevant role of pharmacists face the lack of pharmacotherapeutic follow-up of polymedicated patients.

Role of clinical pharmacist in the palliative care of adults and elderly patients with cancer: A scoping review

2022 ◽  
pp. 107815522110734
Author(s):  
Julia Franco ◽  
Rafael N de Souza ◽  
Tácio de M Lima ◽  
Patricia Moriel ◽  
Marília B Visacri
Keyword(s):  
Palliative Care ◽  
Elderly Patients ◽  
Scoping Review ◽  
The United States ◽  
Eligibility Criteria ◽  
Patient Counselling ◽  
Clinical Pharmacists ◽  
Patients With Cancer ◽  
Pharmacist Interventions

Objective: We conducted this scoping review to map and summarize scientific evidence on the role of clinical pharmacists in the palliative care of adults and elderly patients with cancer. Data Sources: A literature search was performed in MEDLINE, PubMed Central, Embase, Web of Science, Scopus, and BVS/BIREME for studies published until November 22nd, 2020. Studies that reported work experiences adopted by clinical pharmacists in the palliative care of adults and elderly patients with cancer were included. Two independent authors performed study selection and data extraction. Any disagreements were resolved by discussion with the third and fourth authors. The pharmacist interventions identified in the included studies were described based on key domains in the DEPICT v.2. Data Summary: A total of 586 records were identified, of which 14 studies fully met the eligibility criteria. Most of them were conducted in the United States of America (n  =  5) and Canada (n  =  5) and described the workplace of the pharmacist in clinic/ambulatory (n  =  10). Clinical pharmacists performed several activities and provided services, highlighting medication review (n  =  12), patient and caregivers education (n  =  12), medication histories and-or medication reconciliation (n  =  6). The pharmacist interventions were mostly conducted for patients/caregivers (n  =  13), by one-on-one contact (n  =  14), and by face-to-face (n  =  13). Pharmacists were responsible mainly for change or suggestion for change in therapy (n  =  12) and patient counselling (n  =  12). Pharmacist interventions were well accepted by the clinical team. Overall, studies showed that pharmacists, within an interdisciplinary team, had significant impacts on measured outcomes. Conclusions: In recent years, there have been advances in the role of the pharmacist in palliative care of patients with cancer and there are great opportunities in this field. They play an important role in managing cancer pain and other symptoms, as well as resolving drug related problems. We encourage more research to be carried out to strengthen this field and to benefit patients with advanced cancer with higher quality of life.

Can clinical pharmacists bridge a gap between medical oncologists and patients in resource-limited oncology settings? An experience in Nepal

2018 ◽  
Vol 25 (3) ◽  
pp. 765-768 ◽  
Author(s):  
Sunil Shrestha ◽  
Sudip Shrestha ◽  
Subish Palaian
Keyword(s):  
Patient Care ◽  
Clinical Pharmacist ◽  
Human Services ◽  
Care Team ◽  
Medical Oncologist ◽  
Clinical Pharmacists ◽  
Resource Limited ◽  
Medical Oncologists ◽  
The World

The clinical pharmacist's part is emerging as a key extension to the human services care team bringing about enhanced patient care in the world. The main objective of this article is to highlight the role of clinical pharmacist in an oncology setting of Nepal. An enrollment of clinical pharmacist in an oncology hospital or in oncology settings can work as a bridge between medical oncologist and patients.

scholarly journals Role of Oncology Clinical Pharmacists in Light of the Oncology Workforce Study

2010 ◽  
Vol 6 (5) ◽  
pp. 270-272 ◽  
Author(s):  
Jolynn K. Sessions ◽  
John Valgus ◽  
Sally Yowell Barbour ◽  
Lew Iacovelli
Keyword(s):  
Patient Education ◽  
Patient Care ◽  
Nurse Practitioners ◽  
Physician Assistants ◽  
Direct Patient Care ◽  
Clinical Pharmacists

To date, the information published regarding workforce implications has focused on physicians, nurse practitioners, and physician assistants. But oncology clinical pharmacists also can assist with direct patient care and patient education activities.

scholarly journals Potential Impact of the Involvement of Clinical Pharmacists in Antimicrobial Stewardship Programs on the Incidence of Antimicrobial-Related Adverse Events in Hospitalized Patients: A Multicenter Retrospective Study

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 853
Author(s):  
Yewon Suh ◽  
Young-Mi Ah ◽  
Ha-Jin Chun ◽  
Su-Mi Lee ◽  
Hyung-sook Kim ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Antimicrobial Agents ◽  
Adverse Drug Events ◽  
Multivariate Logistic Regression Analysis ◽  
Hospitalized Patients ◽  
Teaching Hospitals ◽  
Hematologic Toxicity ◽  
Clinical Pharmacists ◽  
Tertiary Teaching ◽  
Potential Impact

Although specialized pharmacists have been suggested to be essential members of antimicrobial stewardship programs (ASPs), not all hospitals in Korea operate ASPs with pharmacists involved. We aimed to evaluate the association of involvement of clinical pharmacists as team members of multidisciplinary ASPs with the incidence of antimicrobial-related adverse drug events (ADEs). Five tertiary teaching hospitals participated in this retrospective cohort study. At each participating hospital, we randomly selected 1000 participants among patients who had received systemic antimicrobial agents for more than one day during the first quarter of 2017. We investigated five categories of antimicrobial-related ADEs: allergic reactions, hematologic toxicity, nephrotoxicity, hepatotoxicity, and antimicrobial-related diarrhea. Multivariate logistic regression analysis was used to evaluate the potential impact of pharmacist involvement in ASPs on the incidence of ADEs. A total of 1195 antimicrobial-related ADEs occurred in 618 (12.4%) of the 4995 patients included in the analysis. The overall rate of ADE occurrence was 17.4 per 1000 patient days. Hospitals operating ASPs with pharmacists showed significantly lower AE incidence proportions than other hospitals (8.9% vs. 14.7%; p < 0.001). Multidisciplinary ASPs that included clinical pharmacists reduced the risk of antimicrobial-related ADEs by 38% (adjusted odds ratio 0.62; 95% confidence interval 0.50–0.77). Our results suggest that the active involvement of clinical pharmacists in multidisciplinary ASPs may contribute to reduce the incidence of antimicrobial-related ADEs in hospitalized patients.

scholarly journals The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 89
Author(s):  
Céline Mongaret ◽  
Léa Aubert ◽  
Amélie Lestrille ◽  
Victorine Albaut ◽  
Pierre Kreit ◽  
...  
Keyword(s):  
Clinical Relevance ◽  
Positive Impact ◽  
Community Pharmacists ◽  
Primary Objective ◽  
Drug Related Problems ◽  
Health Records ◽  
Detection Rates ◽  
Problem Detection ◽  
Medication Dispensing

Community pharmacists (CPs) have traditionally had limited access to patients’ estimated glomerular filtration rate (eGFR) during the medication-dispensing process. The increasing access to shared electronic health records is making eGFR available, but the skills needed to detect and manage clinically relevant drug-related problems (DRPs) are poorly documented. The primary objective of this study was to investigate the role of CPs in the medication-dispensation process for elderly patients with renal impairment. A total of 70 CPs participated in this 6 month study. Community pharmacists asked all patients ≥65 years to bring their laboratory test values for the next medication-dispensing process. Drug-related problem detection rates were compared between CPs (prospective period) and expert pharmacists (retrospectively). The clinical relevance of each DRP was assessed by nephrologists and general practitioners using an appropriate tool. Community pharmacists recruited n = 442 patients with eGFR < 60 mL/min/1.73 m2 and detected n = 99 DRPs, whereas expert pharmacists detected n = 184 DRPs. The most frequently detected DRPs were dosage problems and contraindications. According to assessment by clinicians, CPs and expert pharmacists identified 54.0% and 84.7% of clinically relevant DRPs, respectively. This study suggests a positive impact of the systematic availability of eGFR to CPs on the detection of several DRPs with clinical relevance.

Describing the role of the hematology/oncology clinical pharmacist in health information technology

2020 ◽  
pp. 107815522090892
Author(s):  
Jennifer S Philippon ◽  
Carolyn L Kusoski ◽  
Julie M Kennerly-Shah ◽  
Janinah S Barreto
Keyword(s):  
Information Technology ◽  
Electronic Health Record ◽  
Patient Care ◽  
Health Information Technology ◽  
Health Information ◽  
Clinical Pharmacist ◽  
Health Record ◽  
Clinical Pharmacists ◽  
Electronic Health

Purpose To describe the role of hematology/oncology clinical pharmacists in health information technology as well as their perceptions of the impact of technology expansion on patient care. Methods A single-center, web-based survey was distributed to 30 hematology/oncology clinical pharmacists by email over the two-week-period of 24 September 2018 to 8 October 2018. The anonymous survey was composed of 19 questions, with varying formats including multiple choice, fill-in-the-blank, and rank order. Primary endpoints were quantification of time spent in the electronic health record and perceptions on how technology expansion has impacted the safety, quality, and efficiency of patient care. Results Twenty-seven hematology/oncology clinical pharmacists (90% response rate) completed the survey in its entirety. Respondents reported that they spend an average of 84.1% of their work day in the electronic health record. Based on a 40-h work week, clinical pharmacists indicated that they spend approximately 32.2 h each week performing direct patient care tasks in the electronic health record compared to 3.7 h on indirect patient care tasks. All respondents reported a greater utilization of technology over the last five years, and most respondents felt that patient care is safer, of better quality, and more efficient with technology expansion. The majority of respondents (81.5%) indicated that clinical pharmacists have the best understanding of the health information technology system, followed by generalist pharmacists and informatics pharmacists. Conclusion The hematology/oncology clinical pharmacist is well positioned to serve as a health information technology leader on the interdisciplinary healthcare team.

scholarly journals Evaluation of the Role and Impact of Ambulatory Clinical Pharmacists in an Academic Comprehensive Cancer Center

2020 ◽  
Vol 11 (8) ◽  
Author(s):  
Laura A. Meleis, PharmD, MS, BCPS ◽  
Mallika P. Patel, PharmD, CPP ◽  
Michael DeCoske, PharmD, BCPS ◽  
Meredith Moorman, PharmD, CPP ◽  
Paul W. Bush, PharmD, MBA, BCPS, FASHP ◽  
...  
Keyword(s):  
Patient Care ◽  
Improve Patient Care ◽  
Time Frame ◽  
Primary Objective ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Clinical Pharmacists ◽  
Pharmacist Interventions ◽  
Ambulatory Oncology ◽  
Pharmacist Services

Introduction: In recent years, there has been significant growth of ambulatory oncology pharmacy, yet there is a paucity of published studies on the clinical activities and impact of ambulatory oncology clinical pharmacists. At Duke Cancer Center, dedicated pharmacist services are embedded in specialized outpatient oncology areas. Pharmacists document their clinical and administrative activities in the electronic health record. The primary objective of this study is to quantify and assess ambulatory oncology pharmacist interventions in clinics in a large academic comprehensive cancer center. Methods: For the purposes of this single-center, retrospective, descriptive study, pharmacist interventions were collected, quantified, and described over a 6-month period from July 1 to December 31, 2015. The study evaluated the perceived contribution and impact of a pharmacist on patient care in ambulatory oncology clinics via a survey that was distributed to providers and nurses. Results: In the 6-month time period, there were 5,091 interventions spanning 3,967 patient encounters between nine ambulatory oncology clinic pharmacists. The average time per encounter in the 6-month time frame was 22.4 minutes. There were 92 respondents to the survey (61.7% response rate). Overall, responses showed that the clinical pharmacists add value to patient care and are integral members of the team. Conclusions: Although previous studies have described pharmacist activities in outpatient oncology clinics, this study showed a larger number and variety of clinical pharmacist activities in outpatient cancer clinics to improve patient care. Future directions include conducting prospective, controlled studies to link pharmacist activities to tangible outcomes.

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