The Development of an Enhanced Palliative Care Pharmacy Service during the Initial COVID-19 Surge

The Northern Health and Social Care Trust developed an enhanced palliative care pharmacy service for acute inpatients within a large hospital in Northern Ireland during the initial COVID-19 surge. By training additional staff, there was an opportunity to increase service provision, utilising palliative care pharmacy skills to undertake activities such as the symptom management of patients, appropriate management of medicines, improved access to medicines, advice for other healthcare professionals, and supporting discharge from the hospital. The data collected showed a mean of 6.8 interventions per patient, and that, irrespective of the demand resulting from the COVID-19 pandemic, the palliative care pharmacy team had a role in improving the quality of care for palliative and end-of-life patients. Subsequent data analysis also demonstrated associated cost saving and the potential for the palliative care pharmacy team to reduce the length of stay at the hospital.

THE IMPLEMENTATION OF INDONESIA HEALTH MINISTER REGULATION RELATED TO STERILIZED DISPENSING IN "X" HOSPITAL IN GIANYAR-BALI

Background: The application of Regulation of the Minister of Health Number 72 of 2016 is very important to be implemented in every Pharmacy Installation in a hospital, one of which is in the clinical pharmacy service section, namely dispensing sterile preparations to avoid the possibility of medication errors. Objective: The research aimed to find out how the implementation of Regulation of the Minister of Health Number 72 of 2016 stipulated in the basic guidelines of aseptic techniques related to space, equipment, and the implementation of dispensing sterile preparations with its practice in Hospital "X" Gianyar, Bali. Methods: This research used Sequential Explanatory design by combining quantitative and qualitative methods. Results: The results of quantitative research with a checklist found the percentage of completeness of the room and equipment by 100%, while the conformity of the practice with the guidelines of 76.48% is appropriate. The results of qualitative research with triangulation matrices that practice is by the guidelines. Conclusion: Dispensing sterile preparations at the Hospital "X" is following the basic guidelines of aseptic techniques that refer to Regulation of the Minister of Health Number 72 of 2016. Keywords: Implementation, regulation, dispensing, sterile preparations, guidelines, medication errors

Magnitude of client satisfaction and its associated factors with outpatient pharmacy service at Dubti General Hospital, Afar, North East Ethiopia: A cross sectional study

Introduction In Ethiopia the pharmacy service has had several gaps among these were low patient satisfaction, and poor availability of essential pharmaceuticals. In addition, previous studies showed variation in magnitude of client satisfaction, and there is no previous study in the study area. Therefore, the aim of the study was to determine client satisfaction with outpatient pharmacy service and associated factors among adult clients at Dubti General Hospital in Afar, Ethiopia. Methods A hospital based cross sectional study design was employed from February 1 to March 30, 2020 at Dubti General Hospital. Participants were selected by systematic random sampling method. Bivariate and multivariate binary logistic regression was computed to assess statistical association between the outcome variable, and independent variables. AOR with 95% CI were used to show statistical Significance at P <0.05. Results The overall satisfaction towards outpatient pharmacy service was 165(40.5%). Regarding associated factors, service payment insured through their workplace was positively associated with satisfaction (AOR = 3.178, 95% CI: 1.294–7.80) where as availability of some medications (AOR = 0.393, 95% CI: 0.208–0.741), unfair medication cost (AOR = 0.613, 95% CI: 0.607–0.910), and lack of organized pharmacy work flow (AOR = 0.105, 95% CI: 0.049–0.221) were negatively associated with clients’ satisfaction. Conclusion The clients’ satisfaction in this study is low that warrants immediate corrective measures. Corrective measures should be taken based on identified gaps such as improving drug availability, pharmacy work flow, and cost of medications.

The Establishment and Practice of Pharmacy Care Service Based on Internet Social Media: Telemedicine in Response to the COVID-19 Pandemic

Objective: For patients with chronic diseases requiring long-term use of medications who are quarantined at home, the management of medication therapy during the COVID-19 pandemic is a problem that pharmacists urgently need to discuss and solve. The study aims to establish and launch a telepharmacy framework to implement pharmaceutical care during the COVID-19 pandemic.Methods: To establish a remote pharmacy service model based on a medication consultation service platform under the official account of the “Beijing Pharmacists Association” on the social software WeChat app, obtain the medication consultation records from February 28 to April 27, 2020, during the worst period of the epidemic in China, and to perform a statistical analysis of the information about the patients seeking consultation, consultation process, content and follow-up results.Results: The medication consultation service system and telepharmacy service model based on social software were established in February 2020. The “Cloud Pharmacy Care” platform had 1,432 views and 66 followers and completed 39 counseling cases in 2 months. Counseling was available for patients of all ages. Of the 39 cases, 82.05% of patients were young and middle-aged. During the COVID-19 pandemic, the long-term medication usage problems of patients with chronic disease were effectively addressed using “Cloud Pharmacy Care”. In the consultation, 35 cases (89.7%) were related to the use of medicines or health products, and 4 cases (10.3%) involved disease state management and the use of supplements. The top five drug-related issues included the selection of medications, the dosage and usage of drugs, medications for special populations, medication therapy management of chronic diseases, and adverse drug reactions. All consultations were completed within 4 h, with a positive review rate of 97.4%.Conclusion: During the COVID-19 pandemic, a remote pharmacy service “Cloud Pharmacy Care” based on the social software WeChat app was quickly constructed and applied to solve the medication-related problems of patients and the public during home quarantining. The significance of the study lies in the timely and interactive consultation model helps to carry out medication therapy management for chronically ill patients and improves patients’ medication compliance, improves medical quality, and plays a positive role in promoting the popularization of safe medication knowledge.

Implementation of on-call clinical pharmacy service in an emergency department during COVID 19: New initiative in Hamad General Hospital, Qatar

Background: Throughout COVID-19, complex therapeutics and medication protocols left clinicians overwhelmed by contradicting information leading to drug-related problems (DRPs) potentially leading to ineffective pharmacotherapy and drug-related morbidity and mortality. DRPs queries are time consuming, utilize numerous resources, and require skills and experience to provide accurate answers. Quick answers are paramount in the Emergency Department (ED) especially during a pandemic period. Clinical pharmacists (CP) can identify and resolve DRPs but are only available in the ED during daytime hours. We set up an out-of-office CP service for ED DRPs. This study aimed to assess the capacity of the service to capture 100% of calls received and to measure the time taken to resolve DRP queries compared to the international standard. Methods: A dedicated ED CP on-call phone line and rota until 10 pm daily was arranged by the Hamad General Hospital Pharmacy (Doha, Qatar). Data was documented in a logbook and within the Electronic Medical Records (EMR) and analysed using predefined parameters. Results: Between March-September 2020, 133 DRPs calls were received and resolved by a CP. 38% were related to drug interaction/safety (often about medications used in COVID-19 treatment protocols), adverse drug reactions, dose-adjustments, drug allergies and drug in pregnancy. 30% were about medication administration, such as infusion rates, titration, and intravenous compatibility. Those questions were mostly from nurses. Appropriate dose selection and appropriate indication represented 21% and 11% respectively . Caller's acceptance rate to responses provided by CP was 100%. Responses were documented in the patients’ EMR. The call-history-log showed an average duration of 4.66 minutes per call which is below the average standard of 15-30 minutes. Conclusion: The availability of clinical pharmacists to provide quick, acceptable, responses to DRPs queries is crucial given the complexity and diversity of ED patients. During COVID-19, an on-call clinical pharmacy service has proven its capability to resolve DRPs and support the clinical decision-making process in a relatively short time.

Building Patient Loyalty in Pharmacy Service: A Comprehensive Model

The function of pharmacy services has been expanded becomes patient-centered care. Pharmacy services are an important part of creating provider-patient relationships which are currently a popular indicator of healthcare quality. Customer loyalty reflects a strong and positive relationship between customers and service providers The purpose of this study was to explore the mechanism of pharmacy services, patient emotions, satisfaction and trust in influencing patient loyalty. In addition, determines the mediating role of emotional factors, satisfaction and trust. A cross sectional survey has been conducted in outpatient department. The purposive sampling method were used in this study. A total of 300 respondents from six referral hospitals were interviewed. The partial least square-structural equation modelling (PLS-SEM) approach were performed to data analysis. Pharmacy service has a significant effect on positive emotions, satisfaction and trust. The satisfaction has a positive effect on trust and patient loyalty. Trust has a significant influence on patient loyalty. Positive emotions has a positive effect on patient loyalty. Furthermore, positive emotions, satisfaction and trust have a full mediating role. The satisfaction has a partial mediating effect in the relationship between pharmacy service and trust. Trust has a partial mediating effect in the relationship between satisfaction and patient loyalty. Pharmaceutical services have an indirect effect on patient loyalty. These findings emphasize the importance of the pharmaceutical services contribution in building relationships with patients.

Reduced emergency room visits and improved medication adherence of an integrated oncology pharmaceutical care practice in China

Objective We described our initial experience of a new integrated oncology phamaceutical care practice to enhance the quality of pharmacy service and patient care in Huashan hospital. Data sources: A retrospective study was performed from August 2019 to September 2020. Patients were described as integrated pharmacy service group and routine care group. Medication adherence of patients in integrated pharmacy service group was recorded by the online management system. Patient satisfaction and the cumulative incidence of emergency room (ER) and outpatient visit were evaluated between two groups. Data summary: In total, 323 patients received the integrating oncology pharmacy service. The percentage of the patients missing administration every day was reduced from 29.7% to 0.3% within a 40-day monitoring and intervention period. There was a significant difference on patient satisfaction with pharmacy service in two groups ( P < 0.05). Fewer patients in the integrated pharmacy service group visited clinic and ER compared with routine care group (33.1% vs. 59.2%; P < 0.05). Conclusions As a new practice model, the integrated program is adopted to provide patient care and ongoing monitoring for cancer patients. The practice model delivers high continuity of care for cancer patients and improves communication and collaboration between healthcare professionals and oncology patients. The practice also provides the potential of developing hospital pharmaceutical service and optimizing disease prevention and treatment strategies.