Clinical pharmacy in medical practice: the impact of detection, prevention and resolution of Drug Therapy Problems (DTPs) on patients with chronic diseases

2020 ◽  
pp. 95-107
Keyword(s):  
Drug Therapy ◽  
Chronic Diseases ◽  
Clinical Pharmacist ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Care Process ◽  
Healthcare Settings ◽  
The Impact ◽  
Drug Therapy Problems ◽  
Clinical Pharmacist Intervention

(i). Background & objective: Recently, the role of pharmacists in the healthcare settings has dramatically evolved through the application of pharmaceutical care process. However, this new role has not been fully elucidated and reflected in the Iraqi healthcare system. Therefore, the aim of this study was to evaluate the impact of clinical pharmacist intervention on the management of patients with common chronic diseases. (ii) Methods: a randomised controlled trial study was performed with 125 patients with one or more of these conditions: hypertension, hyperlipidaemia and Diabetes mellitus. They have divided into two groups i.e. intervention and non-intervention groups. (iii) Results: The results revealed that pharmacist intervention played a significantly role in the management of chronic diseases given that a significant reduction in the various clinical parameters such as blood pressure, lipid profile, HbA1c and FPG were observed among the intervention group. Apart from development of a therapeutic relationship with the patients, these results are largely amounted to the detection, prevention and resolution of a massive number of DTPs among the patients in the intervention group. (iv) interpretation & Conclusion: Clinical pharmacist intervention can play a pivotal role in the management of patients with chronic diseases. This could be extended to the other healthcare settings as well. Moreover, clinical pharmacist plays a key role in the achievement of therapeutical goals and avoiding Drug Therapy Problems (DTPs).

scholarly journals PCV122 THE IMPACT OF A CLINICAL PHARMACIST INTERVENTION ON LIPID-LOWERING IN A PRIMARY CARE SETTING

2010 ◽  
Vol 13 (7) ◽  
pp. A364
Author(s):  
N Triki ◽  
S Shani ◽  
D Rabinovich-Protter ◽  
D Mossinson ◽  
E Kokia ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Pharmacist ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pharmacist Intervention ◽  
Lipid Lowering ◽  
The Impact ◽  
Clinical Pharmacist Intervention

scholarly journals Impact of clinical pharmacist intervention in chronic obstructive pulmonary disease management

2020 ◽  
Vol 8 (11) ◽  
pp. 3944
Author(s):  
Jackin R. Moses ◽  
Neena Priyamalar E. M. ◽  
Shilpa Ravi ◽  
Raveena Pachal Balakrishnan ◽  
Rajganesh Ravichandran ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Medication Adherence ◽  
Clinical Pharmacist ◽  
Pharmacist Intervention ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Study Participants ◽  
The Impact ◽  
Improve Patient ◽  
Clinical Pharmacist Intervention

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation. In 2016, COPD is the third leading cause of death globally and is projected to increase by more than 30% in the next 10 years. The main threat to the prognosis lies in the lack of disease knowledge, poor medication adherence, and health-related quality of life. Clinical Pharmacist is a key profession to improve patient care in COPD management and literature in this regard is very limited. It is important to establish the impact of a clinical pharmacist as an indicator to improve patient outcomes. Hence the aim of this was to assess the Impact of Clinical Pharmacist Intervention in COPD management in a Tertiary care hospital.Methods: The study was conducted as a prospective and interventional. A total of 53 patients were recruited in the study. The study participants were educated by a clinical pharmacist on disease state, medications, and breathing techniques. Patients have a regular follow-up after 6 months during a scheduled visit. Questionnaires were administered to all patients at baseline and 6 months to assess their medication adherence, disease-related knowledge, and HRQoL.Results: Out of 53 study participants, the majority of COPD patients 23 (46.94%) were found to be in the elderly age group of 60-69 years. The majority of the patients were in a severe category of 48.98%. Thereafter intervention assessment of COPD related knowledge showed a 33.45% improvement. The majority of study participants showed high adherence after the intervention of 46.94 %. All aspects of the HRQoL questionnaire showed improvement after intervention. The results were statistically significant.  Conclusions: The Pharmacist-led COPD Intervention showed improvement in the three main aspects of the study. It confirms the need for healthcare systems to recognize the role of clinical pharmacists in both pharmacological therapy and non-pharmacological supportive care.

Impact of a Clinical Pharmacist Intervention Program on the Follow-up of Type-2 Diabetic Patients

2020 ◽  
pp. 001857872097388
Author(s):  
Abdel-Hameed I. Ebid ◽  
Mohamed A. Mobarez ◽  
Ramadan A. Ramadan ◽  
Mohamed A. Mahmoud
Keyword(s):  
Type 2 Diabetes ◽  
Usual Care ◽  
Clinical Pharmacist ◽  
Usual Care Group ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Care Group ◽  
Clinical Pharmacist Intervention

Aims: The primary aim of this current study was to investigate the impact of the clinical pharmacist interventions on glycemic control and other health-related clinical outcomes in patients with type 2 diabetes in Egypt. Methods: A prospective trial was conducted on 100 patients with uncontrolled type 2 diabetes admitted in the diabetes outpatient’s clinics. Patients were randomly allocated into the clinical pharmacist intervention group and usual care group. In the intervention group, the clinical pharmacist, in collaboration with the physician had their patients receive pharmaceutical care interventions. In contrast, the usual care group patients received routine care without clinical pharmacist’s interference. Results: After 6-month of follow-up, of the average HbA1c and FBG values of the patients in the clinical pharmacist intervention group (HbA1c % from 8.6 to 7.0; FBG (mg/dL) from 167.5 to 121.5) decreased significantly compared to the usual care group patients (HbA1c % from 8.1 to 7.8; FBG (mg/dL) from 157.3 to 155.9) ( P < .05). Additionally, the results indicated that mean scores of patients ‘diabetes knowledge, medication adherence, and diabetes self-care activities of the patients in the clinical pharmacist group increased significantly compared to the control group ( P < .05). Conclusions: The study demonstrated an improvement in HbA1c, FBG, and lipid profile, in addition to self-reported medication adherence, diabetes knowledge, and diabetes self-care activities in patients with type 2 diabetes who received pharmaceutical care interventions. The study outcomes support the benefits and the need to integrate clinical pharmacist interventions in the multidisciplinary healthcare team in Egypt.

scholarly journals Evaluation of the Appropriateness of Albumin Usage in a Teaching Hospital in Iran: The Impact of Clinical Pharmacist Intervention

2020 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Maede Noori ◽  
Jamshid Salamzadeh ◽  
Mohammadreza Hajiesmaeili ◽  
Omidvar Rezaeimirghaed ◽  
Omid Moradi ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Clinical Pharmacist ◽  
Guideline Implementation ◽  
Pharmacist Intervention ◽  
Demographic Parameters ◽  
Post Intervention ◽  
Intervention Phase ◽  
The Impact ◽  
Albumin Therapy ◽  
Clinical Pharmacist Intervention

Background: Albumin is a colloidal protein medication in which has a limited availability in market and it has a high cost. Albumin must be used in such approved indications as, large volume paracentesis, plasmapheresis, spontaneous bacterial peritonitis and hepato-renal syndrome. Objectives: The aim of this study was to evaluate the appropriateness of albumin utilization in a teaching hospital in Iran before and after guideline implementation. Methods: In this prospective study, a total of 100 patients were enrolled into the study in Loghman Hakim Teaching Hospital. The medical records of patients were reviewed and some information such as demographic parameters, albumin indication, albumin therapy duration, appropriateness of indication, nutrition type were recorded in pre-intervention phase. Then in post-intervention phase, albumin was administered after clinical pharmacist teaching and guideline implementation. After post-intervention period, demographic parameters, albumin indication, albumin therapy duration, appropriateness of indication were recorded again. Results: In phase 1, albumin was mostly prescribed in inappropriate indications and internist physicians were the most physicians who ordered albumin and wound healing also was the most frequent indication for albumin therapy. This improvement also was significant (P < 0.05). Data showed that albumin indication in post-intervention was different from that in the pre-intervention phase. After clinical pharmacist intervention most of indications were appropriately. Conclusions: This study demonstrated that in this hospital, albumin was prescribed inappropriately in most cases based on hospital guideline. This rate improved after clinical pharmacist intervention and resulted in significant reduction in albumin irrational utilization. It is advisable that albumin prescription must be monitored carefully by clinical pharmacists.

Pharmacist Review to Simplify Medication Regimens in a VAMC Primary Care Clinic

1996 ◽  
Vol 12 (2) ◽  
pp. 62-66 ◽  
Author(s):  
Paul V Laucka ◽  
Will B Webster ◽  
Jeffrey Kuch
Keyword(s):  
Primary Care ◽  
Clinical Pharmacist ◽  
Primary Care Clinic ◽  
Intervention Group ◽  
Pharmacist Intervention ◽  
Control Group ◽  
Care Clinic ◽  
Before And After ◽  
Clinical Pharmacist Intervention ◽  
Clinic Visits

Objective: To assess the effect of a clinical pharmacist's prospective medication review of patients receiving multiple drug therapy, using the pharmaceutical care process, as determined by the number of concurrent medications the patient is receiving before and after clinic visits. Design: Assigned groups. Setting: Outpatient primary care clinic of a tertiary healthcare Veterans Affairs (VA) medical facility. Patients: Seven hundred twenty-seven patients who had eight or more active medication orders were selected. Four hundred forty-one patients (aged 67.2 ± 10.4 y) were in the intervention group; 286 others (aged 66.6 ± 11.9 y), whose medical records were not available, were assigned to the control group and received no clinical pharmacist intervention. Intervention: Medication regimens of VA ambulatory patients with eight or more active medications were reviewed by a clinical pharmacist, and a written communication to the prescriber was attached to the medical record. Main Outcome Measures: The number of active concurrent medications before and after clinic visits was measured. Results: There was a decrease in the medications in the intervention group from an average of 12.1 ±4 to 11.5 ± 4.2 (p < 0.05). The medications in the control group rose from an average of 11.8 ± 4.44 to 12.2 ± 4 (p = NS). A decrease of 0.6 prescriptions per patient was highly significant (p < 0.05). During the study, 1,336 recommendations were made to practitioners. From this group, 41% of the recommendations were accepted, and 477 medications were discontinued, the quantity dispensed or dosage was reduced, or an alternative medication was prescribed. Conclusions: These data suggest that clinical pharmacist intervention in an ambulatory care setting can affect practitioner prescribing habits and significantly decrease the number of medications prescribed.

Effectiveness of an Ambulatory Care Clinical Pharmacist: A Controlled Trial

1993 ◽  
Vol 27 (5) ◽  
pp. 555-559 ◽  
Author(s):  
Julie D. Mason ◽  
Colleen A. Colley
Keyword(s):  
Drug Therapy ◽  
Ambulatory Care ◽  
Clinical Pharmacist ◽  
Controlled Trial ◽  
Tertiary Care ◽  
General Medicine ◽  
Cost Savings ◽  
Pharmacist Intervention ◽  
Potential Cost ◽  
Drug Therapy Problems

OBJECTIVE: To compare two general medicine clinics to determine the effectiveness of an ambulatory care clinical pharmacist in assisting recognition of drug therapy problems for physicians and decreasing drug therapy costs. DESIGN: Controlled trial SETTING: Two general medicine ambulatory care clinics associated with a large, tertiary-care teaching hospital. PATIENTS: Those with scheduled and completed appointments in the clinics during the two-week study period. METHODS: Medication profiles of patients attending clinic A (pharmacist intervention) and clinic B (no pharmacist intervention) were reviewed by the pharmacist prior to clinic appointments. Potential drug therapy problems were identified at each clinic, but interventions were performed only at clinic A. Postappointment audits determined the number of recommendations implemented at clinic A versus the number of drug therapy problems (potential interventions) recognized and addressed by clinic B physicians independently of pharmacist intervention. Potential and actual savings were extrapolated to one year from the two-week study period. RESULTS: Implementation of interventions at clinic A was greater than at clinic B (p<0.001). Drug therapy cost savings at clinic A were annualized to yield $185 per intervention. Potential cost savings of $176 724, or four times the pharmacist salary costs, is projected. CONCLUSIONS: An ambulatory care pharmacist is effective in identifying drug therapy problems, resulting in significant cost savings to the institution.

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