Training of clinical pharmacists in psychiatric pharmacy services during the prevention and treatment of COVID-19

BackgroundPressures to open pharmacy services 7 days a week, with no financial input for these extra resources, has knock on effects that may dilute accessibility to clinical pharmacists in specialist areas.AimsThe aim of this survey was to assess opinions of the users of the current pharmacy services to PICU and the planned extended hours provision.MethodAn e-survey was sent to PIC Consultants, Advanced Nurse Practitioners, and Senior Nursing Staff following a six month period of increased clinical pharmacists time allocation to PIC. Free-text area was added to each multiple choice question.ResultsTwenty-four staff responded, 14 prescribers and 10 senior nursesPresence of PICU trained clinical pharmacist on morning ward rounds was considered essential by 19 (79%) respondents and desirable by 4 (17%). Attendance on the afternoon round was deemed essential by 14 (59%) and desirable by 8 (33%) of respondents.Comments on the benefits of pharmacists on ward rounds included:“Enabling a second professional review of the patient overall—it prevents forced direction from the consultant and the pharmacists are empowered to ask us to reconsider. Very useful to have this safety and reality check.”“Essential for the guidance of drug usage and drug chart review which improves safety, benefit of advice for use with specialist patients, best cost approach, multiple benefits.”Roles expected as routine from the clinical pharmacist included patient safety (100%), managing parenteral nutrition (80%), advice on intravenous therapy e.g. compatibility (100%), education of the multidisciplinary team (96%), management of long term medicines e.g. sedation withdrawal (83%), and therapeutic drug monitoring control (83%).Only 6 respondents felt the PICU patient would benefit from extending access to dispensary only over weekends, 11 felt that there was no benefit, and 6 respondent unsure.Provision of the pharmacy on call service which involves both supply and clinical advice, was felt sufficient to the requirements of the PICU patient by less than a third of repondents,56% feeling the current service insufficient. Comments on the on call service included.“difficult to get experienced advice on weekends”“need access to pic pharmacists officially.”“we may direct queries to the on call pharmacy staff but 9 times out of 10 theses queries are redirected to our PICU pharmacists. Our questions are answered at any time of the weekend”Ninety one percent answered positively to the final question asked about extending the current clinical pharmacy service from 5 to 7 days per week. Comments included.“PICU is a 24 hr, 7 day a week service…how we can provide adequate care to children if this valuable service is only provided 5 days a week.”ConclusionPharmacy is a valued service on PICU, where the service users support increased access and attendance on certain ward rounds by specifically PICU trained pharmacist.

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National survey of UK general practice pharmacy services

European Journal of Public Health ◽

10.1093/eurpub/ckz185.669 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

V Savickas ◽

E Foreman ◽

M Iqbal ◽

A Ladva ◽

S K Bhamra ◽

...

Keyword(s):

General Practice ◽

Care Home ◽

Care Homes ◽

Pharmacy Services ◽

Clinical Services ◽

Clinical Pharmacists ◽

Medication Waste ◽

Repeat Prescribing ◽

Medication Reviews ◽

Pharmacy Technicians

Abstract Background The Clinical Pharmacists in General Practice (CPGP) initiative aims to recruit over 2000 clinical pharmacists in general practice (GP) surgeries in England by 2020. This study aimed to explore the services delivered by all GP pharmacy professionals (GPPPs; pharmacists/pharmacy technicians) across the UK. Methods 30-item e-questionnaire was developed using SurveyMonkey platform and piloted during one-to-one cognitive interviews with GPPPs. The survey was distributed via the Primary Care Pharmacy Association, social media sites, collaborating GP organisations and via emails to participants of CPGP pilot. Three reminders were sent out 1 week apart. University ethics approval was obtained. Results Ninety-one responses were received between November 2018 and March 2019 (89% pharmacists, 52% from CPGP pilot). Participants provided an average of 9 services (95% CI 8.3-9.9). Over 90% of pharmacists delivered medication reviews and over 80% managed patients with polypharmacy. More pharmacists within than outside of the CPGP pilot managed repeat prescribing requests (70% vs. 47%, p = 0.035). Technicians took responsibility for primarily non-clinical services such as service commissioning (90%), management of safety alerts/drug recalls (80%), standard operating procedures (80%) and education & training (80%). Over 40% of GPPPs not providing care home services wished to do so by 2024. Four technicians wanted to be more involved in medication reviews. The main perceived benefits of GP pharmacy services included identifying medicines-related issues (93%), utilisation of pharmacy professionals’ skills (93%) and a reduction in medication waste (92%). Conclusions GPPPs provide a range of clinical and non-clinical services which may benefit public health at an individual and healthcare system levels. Pharmacists within the pilot are more likely to deliver repeat prescribing services. Future GP pharmacy landscape will likely include additional services to care homes. Key messages GPPPs including pharmacy technicians provide clinical and non-clinical services, appropriate to their scope of practice, to benefit patients, healthcare systems and themselves. Developing future GP pharmacy services to care homes offers further opportunities to benefit a vulnerable group of patients with long-term illnesses.

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COVID-19 preparedness: Clinical pharmacy services remote staffing in a quaternary, level I trauma and comprehensive stroke center

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa132 ◽

2020 ◽

Vol 77 (15) ◽

pp. 1250-1256

Author(s):

Sara Kjerengtroen ◽

Samuel M Wilde ◽

Gabriel V Fontaine ◽

Kevin M Forbush ◽

Charles M Van Gorder ◽

...

Keyword(s):

Clinical Pharmacy ◽

Medical Center ◽

Remote Access ◽

World Health ◽

Pharmacy Services ◽

Optimal Care ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

The World ◽

Health Organization

Abstract Purpose The rapid spread of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), has strained the resources of healthcare systems around the world. In accordance with recommendations from the World Health Organization, Centers for Disease Control and Prevention, and US Department of Defense, Intermountain Medical Center (IMED) in Murray, UT, has developed a plan to provide remote clinical pharmacy services to protect the health of pharmacy caregivers while maintaining appropriate clinical pharmacy coverage to optimally care for patients. Summary The utilization of telemedicine technology permits clinical pharmacists to readily communicate with nurses, physicians, other caregivers, and patients. We have identified strategies to allow clinical pharmacists to continue to participate in daily rounds, provide consultations under collaborative practice agreements, verify medication orders, collect medication histories, provide antimicrobial stewardship, and deliver medication education to patients from off-site locations. The pharmacy department at IMED proactively tested telemedicine technologies, defined the roles of clinical pharmacists, and identified communication strategies prior to a rapid rise in COVID-19 cases in the state of Utah. Conclusion The proactive measures described can help ensure that pharmacy caregivers have appropriate remote access and are capable of confidently using the resources. These steps allow for optimal care of hospitalized patients and promote social distancing, which may have the added benefit of decreasing the spread of SARS-CoV-2 among patients and caregivers.

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Incorporation and Impact of a Clinical Pharmacist in a Hospital-Based Neurology Clinic Treating Multiple Sclerosis Patients

International Journal of MS Care ◽

10.7224/1537-2073.2019-032 ◽

2020 ◽

pp. 0000-0000

Author(s):

Alexandria May ◽

Olivia Morgan ◽

Kristi Quairoli

Keyword(s):

Patient Care ◽

Clinical Pharmacy ◽

Clinical Pharmacist ◽

Medication Management ◽

Pharmacy Services ◽

Patient Counseling ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

Medication Access ◽

Neurology Clinic

Abstract Background: Clinical pharmacists are uniquely positioned to assist with the complexities of medication management for patients with multiple sclerosis (MS). The objective of this study is to describe clinical pharmacy services provided as well as provider satisfaction and perceived impact of incorporating a clinical pharmacist in MS patient care. Methods: This study was conducted in two parts: a retrospective chart review and provider survey conducted in an outpatient neurology clinic at an academic medical center. Between April 2017 and June 2018, electronic medical records (EMRs) of patients with documented interventions by a pharmacist were reviewed to describe clinical pharmacy services provided to MS patients. A voluntary, anonymous survey was distributed to neurology providers to evaluate provider satisfaction and perceived impact of clinical pharmacist involvement in MS patient care. Results: There were 64 patients identified during the study period with 378 documented interventions made by clinical pharmacists. Pharmacist interventions were most commonly related to facilitating medication access (N=208), pre-treatment screening (N=57), patient counseling (N=51), and providing drug information (N=43). All providers surveyed (n=9) indicated that facilitating medication access, patient counseling, and drug interaction management were moderately or very important clinical pharmacy services. Furthermore, all providers surveyed strongly agreed that pharmacist involvement decreased time to therapy initiation for patients and decreased provider time spent on medication management. Conclusions: Clinical pharmacists play an integral role in MS patient care, particularly with facilitating medication access. Prospective studies are needed to further evaluate the contribution of clinical pharmacists in the care of MS patients.

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Impact of Clinical Pharmacy Services on Patient Management in the Chemotherapy Infusion Clinics: A 5-Year Study at a Comprehensive Cancer Center

Journal of Pharmacy Practice ◽

10.1177/08971900211003446 ◽

2021 ◽

pp. 089719002110034

Author(s):

Ola K. Mashni ◽

Lama H. Nazer ◽

Haya Z. Khalil ◽

Maha I. Dalbah ◽

Haitham W. Tuffaha ◽

...

Keyword(s):

Clinical Pharmacy ◽

Patient Management ◽

Ambulatory Setting ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Pharmacy Services ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

Chemotherapy Infusion ◽

The Impact

Background: Chemotherapy requires careful dosing and monitoring and is associated with numerous adverse events. There is limited data describing the impact of clinical pharmacists in the chemotherapy ambulatory setting. Objective: This study aimed to evaluate the impact of clinical pharmacy services on patient management in the adult chemotherapy infusion clinics. Methods: This was a 5-year retrospective study that utilized the pharmacy electronic documentation system to determine the type of interventions and adverse drug events (ADEs) reported by the clinical pharmacists in the chemotherapy infusion clinics. Interventions were described based on the type of intervention and medication involved. ADEs were evaluated based on the type of ADE, the suspected medication, and the required management. Results: During the study period, 3,279 interventions and 1,445 ADEs were reported. The most common interventions involved dose adjustments (51%), followed by addition (23%) or discontinuation (21%) of prescribed medications. Carboplatin (20%) and zoledronic acid (14%) were the most common medications that required pharmacist interventions. The most common types of ADEs were hematologic (22%) and infusion-related reactions (20%). Docetaxel was the most common medication associated with ADEs (20%). Among the reported ADEs, most required adding supportive care (44%), followed by adjusting chemotherapy doses (22%). Conclusion: Clinical pharmacy services at the chemotherapy infusion clinics play an important role in optimizing the chemotherapy regimens as well as identifying and managing ADEs. Future studies should be directed to measure the impact of these services on patient outcomes as well as, physicians and pharmacy operational workload and cost savings.

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Assessment of the Clinical Pharmacists' Role by Physicians at Baghdad Hospitals

Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) ◽

10.31351/vol29iss2pp194-201 ◽

2020 ◽

Vol 29 (2) ◽

pp. 194-201

Author(s):

Ahmed H. Saihood ◽

Ali F. Hasan

Keyword(s):

Clinical Pharmacy ◽

Healthcare Professionals ◽

Personal Information ◽

Research Work ◽

Point Of View ◽

Pharmacy Services ◽

Medical Prescription ◽

Clinical Pharmacists ◽

Self Administered Questionnaire ◽

Positive Point

In Iraq, there is a limited research work exploring the clinical pharmacists' role from the point of view of other healthcare professionals. To investigate physicians' assessment of clinical pharmacy services at Baghdad hospitals, and compare junior physicians with senior physicians' point of view. The study was conducted in twelve governmental hospitals in Baghdad, Iraq. Data was collected from a sample of two hundred physicians, and through a validated, self-administered questionnaire, which comprised twenty statements in addition to a non-personal information form that precedes the questionnaire The study findings reveal a somewhat positive point of view towards clinical pharmacists' performance in Baghdad hospitals. Physicians are satisfied with clinical pharmacists' recommendations regarding their prescriptions, and their availability for consultation. However, they are dissatisfied with or unaware of the unconventional services that are not directly related to the medical prescription. Junior physicians are more appreciative of the clinical pharmacist's role than senior physicians.

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Applicability of American College of Clinical Pharmacy (ACCP) competencies to clinical pharmacy practice in Egypt

Pharmacy Practice ◽

10.18549/10.18549/pharmpract.2020.3.1951 ◽

2020 ◽

Vol 18 (3) ◽

pp. 1951

Author(s):

Mahmoud A. Elmaaty ◽

Ahmed A. Elberry ◽

Raghda R. Hussein ◽

Doaa M. Khalil ◽

Amani E. Khalifa

Keyword(s):

Population Health ◽

Clinical Pharmacy ◽

Work Experience ◽

Pharmacy Practice ◽

Direct Patient Care ◽

Pharmacy Services ◽

Practice Setting ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

Validated Questionnaire

Background: The American College of Clinical Pharmacy (ACCP) prepared clinical pharmacist competencies that have specific recommendations. Recently, many efforts to advance clinical pharmacy services in Egypt exist. The literature revealed that no country has assessed the extent of applicability of ACCP competencies in its current pharmacy practice setting. Egyptian pharmacists can provide feedback about applicability of such competencies in clinical pharmacy settings in Egypt. Objective: The objective of this study was to investigate the extent to which ACCP competencies were implemented by Egyptian clinical pharmacists and therefore evaluate development of clinical pharmacy practice in Egypt. The study also investigated factors affecting the applicability of such competencies in the current clinical pharmacy practice setting in Egypt. Methods: Four hundred and ninety-five randomly selected clinical pharmacists from several hospitals were invited to participate in a cross sectional survey using a self-administered validated questionnaire composed of 31 questions classified into six domains. This questionnaire was designed to determine the pharmacists’ perception about applicability of ACCP competencies to clinical pharmacy practice in Egypt. Results: The response rate was 64% as 317 out of 495 pharmacists completed the questionnaire. These pharmacists were categorized according to age; gender; qualifications; years of previous work experience, years since BSc. and type of hospitals they are currently working at. Analysis of data revealed the professionalism domain to have the highest percentage of acceptance among pharmacists, while the system-based care & population health domain had the lowest percentage of acceptance. Results also showed that qualifications of participants did not affect their response in three domains; “Direct Patient Care”, “Systems-based Care & Population Health” and “Continuing Professional Development” (p=0.082, 0.081, 0.060), respectively. Nevertheless, qualifications of participants did affect their response in the other three domains; “Pharmacotherapy Knowledge”, “Communication” and “Professionalism” (p<0.05). The age of pharmacists, gender, years of previous work experience, and graduation year did not affect their responses in all six domains. The type of hospital they are currently working at, though, affected their responses where, there was a highly statistically significant increase of the mean score of all domains among participants working at the NGOs/private hospitals compared to governmental hospitals (p<0.001). Conclusions: Egyptian pharmacists generally apply high percentage of ACCP competencies but the provided clinical pharmacy services need to be improved through applying the standards of best practice.

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PERCEPTIONS OF PHYSICIANS ABOUT CLINICAL PHARMACIST’S ROLE IN AL QASSIM’S HOSPITALS IN SAUDI ARABIA

Malaysian Journal of Public Health Medicine ◽

10.37268/mjphm/vol.17/no.3/art.220 ◽

2017 ◽

Vol 17 (3) ◽

pp. 109-116

Author(s):

Nahid Osman Ahmed ◽

Mahfoudh A. M. Abdulghani ◽

Sarah Fahad Alrebdi ◽

Mohammed Faez Baobaid

Keyword(s):

Clinical Pharmacy ◽

Healthcare Professionals ◽

Response Rate ◽

Pharmacy Services ◽

Medication History ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists

The objective of this study is to explore physician’s perception toward clinical pharmacy services and role of clinical pharmacists in governmental hospitals at Al-Qassim region. An observational cross-sectional survey was conducted. Results: 150 males and 39 females participated giving 75.5% (189 of 250) response rate. Physicians perceptions were found to be high (equal or more than 90% of frequency) in some clinical pharmacy services such as patients’ education and counselling, monitoring of patients’ responses to drug therapy including toxicity/side effects and provision of drug information to healthcare professionals. The physicians showed low perception (less than 76%) in the taking of patients’ medication history on admission, by clinical pharmacists. Conclusion: Physicians’ perception toward clinical pharmacy services and the role of clinical pharmacists was not found to be completely favourable. The reason of this mixed responses and to the accommodating feelings of clinical pharmacy services in clinical setting appear to relate to the state of infrastructure and environments of hospitals. The infrastructure and environments of hospitals need to be updated for an improved accommodation clinical pharmacy services.

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Impact of Introducing Clinical Pharmacy Services in A Respiratory Diseases Clinic: A Report from North Cyprus

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2019/v29i630253 ◽

2019 ◽

pp. 1-15

Author(s):

Abdikarim Mohamed Abdi ◽

Finn Rasmussen ◽

Rumeysa Demirdamar

Keyword(s):

Clinical Pharmacy ◽

Respiratory Diseases ◽

University Hospital ◽

Baseline Survey ◽

Pharmacy Services ◽

High Expectations ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

North Cyprus ◽

Classification Tool

Aims: The Implementation of Clinical Pharmacy Services (CPS) in hospitals is currently gaining attention in an effort to rationalize drug use in many developing countries. This study aims to introduce and evaluate ward-based CPS in a Respiratory Diseases clinic in North Cyprus and assess its efficacy and physician's perceptions toward the services. Study Design: A prospective interventional study. Place and Duration of Study: The study was carried out in the respiratory clinic from 01 December 2013, to 30 January 2014 at Near East University Hospital, in Nicosia, North Cyprus. Methodology: Clinical Pharmacy Services (CPS) were introduced and documented over the study period of 60 days in a tertiary university hospital. DTPs and Interventions were documented and classified using DTP classification tool obtained from previous studies, and later evaluated by an independent clinical committee for their feasibility. Physician’s attitudes and perceptions were evaluated before for and after introducing CPS's using a questionnaire tool. Results: 82.35% of the targeted physician's sample have responded to baseline survey, (n=17) majority (92%) did not have any previous interaction with clinical pharmacists, they generally well perceived and had high expectations to pharmaceutical care services in general. This further enhanced the post-implementation of CPS. 118 interventions were carried during the program, 86.6% accepted and regarded as clinically relevant. Interventions mostly related to cardiovascular agents. Add/ change/stop medications were the most common type of interventions (21%). Most common resultant outcome was to avoid adverse effects or toxicities. The intervention was significantly related to the number of drugs used (r=0,487; p=0,006), the rate of acceptance significantly was higher to services compared to DRP interventions (p<0.005). Conclusion: The introduction of CPS's lead to clinically relevant and highly accepted optimization of medicine use in different wards and clinics including respiratory diseases clinic in the case of this study, it was relatively well perceived by physicians, but also could be more valued if more optimized and practiced by talented proactive clinical pharmacists within a multidisciplinary team.

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Establishing Clinical Pharmacy Services With Prescribing Privileges in a Federally Qualified Health Center Primary Care Clinic

Journal of Pharmacy Practice ◽

10.1177/0897190017718752 ◽

2017 ◽

Vol 31 (5) ◽

pp. 434-440 ◽

Cited By ~ 2

Author(s):

Jeany K. Jun

Keyword(s):

Primary Care ◽

Family Medicine ◽

Clinical Pharmacy ◽

Primary Care Clinic ◽

Pharmacy Services ◽

Care Clinic ◽

Clinical Pharmacy Services ◽

Clinical Pharmacists ◽

Federally Qualified Health Center ◽

Ambulatory Patients

Objectives: To describe the process and cost of establishing clinical pharmacy services with prescribing privileges in a federally qualified health center (FQHC) primary care clinic. Setting: The primary care clinic was located in a low-income area of Southern California and served patients with Medicaid and Medicare. The primary care clinic had preventive medicine and family medicine physicians, a family medicine residency program, behavioral health services, and a registered dietician. Practice Innovation: New clinical pharmacy services were established at this FQHC primary care clinic. The medication assistance program was a stepping stone to establish rapport with the physicians. Credentialing and privileging was implemented for clinical pharmacists. An open protocol collaborative practice agreement was developed to allow clinical pharmacists to manage ambulatory patients. Results: From August 2014 to June 2015, the clinical pharmacist interacted with 392 patients and spent 336 hours educating patients and providing disease state management. The pharmacist also provided consults to residents and providers. Diabetic patients made up 76% of all clinical pharmacy encounters. There were 86 face-to-face clinical pharmacy appointments with the pharmacist. The average time for clinical pharmacy appointments was 77 minutes. Conclusion: By describing ways to develop rapport with providers, how to credential and privilege pharmacists, and explain resources and costs of setting up a service, the hope is that more clinical pharmacists will be able to incorporate into independent or FQHC primary care clinics for improved management of ambulatory patients.

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