Aspects Of Pharmaceutical Care Research Articles

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

ObjectivesThe study aimed to determine how eHealth was adopted in pharmaceutical care (PC), the outcome reported and the contextual factors.DesignSystematic literature review in accordance with the Preferred Reporting Items for...

Pharmaceutical care and telemedicine during COVID-19: A cross-sectional study based on pharmacy students, pharmacists, and physicians in Jordan

Lack of access to the patient medical record (90.6%) was the major barrier for the integration of pharmaceutical care into practice. The majority of participants (93.0%) encouraged creating a website that provides pharmaceutical care. Furthermore, 45.1% would pay for such a service if present. Moreover, the majority (89.8%) agreed that creating a comprehensive database for patients’ data will help in decreasing medical errors. Among the four aspects of pharmaceutical care (technical, psychosocial, communication and administrative) that were assessed for students and pharmacist’s, general weakness in all aspects was noticed. This study highlights that absence of proper documentation of patient medical information raises the risk of medical problems and is considered the most documented barrier for the integration of pharmaceutical care. This emphasizes the future role of telemedicine and the availability of a specialized website and database repository that stores patient’s information to ensure the continuity of care even during pandemics.

Núcleo de atenção farmacêutica: vivências e práticas junto à comunidade

Este artigo apresenta as atividades desenvolvidas e os resultados obtidos pelo Núcleo de Atenção Farmacêutica da Universidade Federal de Alfenas (UNIFAL-MG) nos anos de 2016 a 2017. O Núcleo de Atenção Farmacêutica da UNIFAL é um componente extracurricular para o curso de Farmácia, indispensável à consolidação dos conhecimentos adquiridos durante o curso. Com o farmacêutico atuando nas diversas vertentes da Atenção Farmacêutica, este projeto visa abranger pesquisa, ensino e extensão nesta área, incentivar o trabalho em equipe, promover atividades de ensino curricular e extracurricular, bem como orientar os pacientes quanto ao uso racional dos medicamentos a fim de promover a saúde. O projeto realiza reuniões semanais com discussões de casos clínicos, campanhas educativas para a população e comunidade acadêmica com aferição de parâmetros bioquímicos e fisiológicos, palestras educativas, seminários, eventos científicos como o Simpósio Internacional de Atenção Farmacêutica, Estudos Dirigidos em Atenção Farmacêutica (EDAF), acompanhamento farmacoterapêutico de pacientes portadores de doenças crônicas.

Pharmaceutical care in Kuwait: hospital pharmacists' perspectives.

Pharmaceutical care practice has been championed as the primary mission of the pharmacy profession, but its implementation has been suboptimal in many developing countries including Kuwait. Pharmacists must have sufficient knowledge, skills, and positive attitudes to practise pharmaceutical care, and barriers in the pharmacy practice model must be overcome before pharmaceutical care can be broadly implemented in a given healthcare system. To investigate hospital pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care, and the barriers to its implementation in Kuwait. Six general hospitals, eight specialized hospitals and seven specialized health centers in Kuwait. A descriptive, cross-sectional survey was distributed to all pharmacists working in the governmental hospitals in Kuwait (385 pharmacists). Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (standard deviations) were calculated and compared using statistical package for social sciences, version 20. Statistical significance was accepted at a p value of <0.05. Pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care competencies, and the barriers to its implementation in Kuwait. Completed surveys were received from 250 (64.9%) of the 385 pharmacists. Pharmacists expressed overall positive attitudes towards pharmaceutical care. They felt well prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Pharmacists with more practice experience expressed significantly more positive attitudes towards pharmaceutical care (p = 0.001) and they felt better prepared to provide pharmaceutical care competencies (p < 0.001) than those with less experience as practitioners. The respondents agreed/strongly agreed that the most significant barriers to the integration of pharmaceutical care into practice were lack of private counseling areas or inappropriate pharmacy layout (87.6%), organizational obstacles (81.6%), inadequate staff (79.6%), and lack of pharmacist time and adequate technology (76.0%). Hospital pharmacists in Kuwait advocate implementation of pharmaceutical care while also appreciating the organizational, technical and professional barriers to its widespread adoption. Collaborative efforts between health authorities and educational institutions, and the integration of innovative approaches in pharmacy management and education could overcome these barriers and achieve the transition towards pharmaceutical care practice.

Pharmaceutical care education in Kuwait: pharmacy students' perspectives.

Pharmaceutical care is defined as the responsible provision of medication therapy to achieve definite outcomes that improve patients' quality of life. Pharmacy education should equip students with the knowledge, skills, and attitudes they need to practise pharmaceutical care competently. To investigate pharmacy students' attitudes towards pharmaceutical care, perceptions of their preparedness to perform pharmaceutical care competencies, opinions about the importance of the various pharmaceutical care activities, and the barriers to its implementation in Kuwait. A descriptive, cross-sectional survey of pharmacy students (n=126) was conducted at Faculty of Pharmacy, Kuwait University. Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (SD) were calculated and compared using SPSS, version 19. Statistical significance was accepted at a p value of 0.05 or lower. The response rate was 99.2%. Pharmacy students expressed overall positive attitudes towards pharmaceutical care. They felt prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Perceived pharmaceutical care competencies grew as students progressed through the curriculum. The students also appreciated the importance of the various pharmaceutical care competencies. They agreed/strongly agreed that the major barriers to the integration of pharmaceutical care into practice were lack of private counseling areas or inappropriate pharmacy layout (95.2%), lack of pharmacist time (83.3%), organizational obstacles (82.6%), and pharmacists' physical separation from patient care areas (82.6%). Pharmacy students' attitudes and perceived preparedness can serve as needs assessment tools to guide curricular change and improvement. Student pharmacists at Kuwait University understand and advocate implementation of pharmaceutical care while also recognizing the barriers to its widespread adoption. The education and training provided at Kuwait University Faculty of Pharmacy is designed to develop students to be the change agents who can advance pharmacist-provided direct patient care.

An evaluation of the psychometric properties of the Purdue Pharmacist Directive Guidance Scale using SPSS and R software packages

BackgroundThe Purdue Pharmacist Directive Guidance (PPDG) Scale was developed to assess patients’ perceptions of the level of pharmacist-provided (1) instruction and (2) feedback and goal-setting—2 aspects of pharmaceutical care. Calculations of its psychometric properties stemming from SPSS and R were similar, but distinct differences were apparent. ObjectiveUsing SPSS and R software packages, researchers aimed to examine the construct validity of the PPDG using a higher order factoring procedure; in tandem, McDonald's omega and Cronbach's alpha were calculated as means of reliability analyses. MethodsNinety-nine patients with either type I or type II diabetes, aged 18 years or older, able to read and write English, and who could provide written-informed consent participated in the study. Data were collected in 8 community pharmacies in New Mexico. Using R, (1) a principal axis factor analysis with promax (oblique) rotation was conducted, (2) a Schmid-Leiman transformation was attained, and (3) McDonald's omega and Cronbach's alpha were computed. Using SPSS, subscale findings were validated by conducting a principal axis factor analysis with promax rotation; strict parallels and Cronbach's alpha reliabilities were calculated. ResultsMcDonald's omega and Cronbach's alpha were robust, with coefficients greater than 0.90; principal axis factor analysis with promax rotation revealed construct similarities with an overall general factor emerging from R. ConclusionsFurther subjecting the PPDG to rigorous psychometric testing revealed stronger quantitative support of the overall general factor of directive guidance and subscales of instruction and feedback and goal-setting.

Provision of pharmaceutical care by community pharmacists: a comparison across Europe

To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Response rates ranged from 10-71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even though different aspects of pharmaceutical care were implemented to different extents across Europe, it was noted that the lowest scores were consistently achieved in the direct patient care dimension (particularly those related to documentation, patient assessment and implementation of therapeutic objectives and monitoring plans) followed by performance evaluation and evaluation of patient satisfaction. Pharmacists who dispensed higher daily numbers of prescriptions in Ireland, Germany and Switzerland had significantly higher total BPCS scores. In addition, pharmacists in England and Ireland who were supported in their place of work by other pharmacists scored significantly higher on referral and consultation and had a higher overall provision of pharmaceutical care. The present findings suggest that the provision of pharmaceutical care in community pharmacy is still limited within Europe. Pharmacists were routinely engaged in general activities such as patient record screening but were infrequently involved in patient centred professional activities such as the implementation of therapeutic objectives and monitoring plans, or in self-evaluation of performance.

Pharmacy and pharmacists' perceptions of pharmaceutical care in Kazakhstan

Abstract Objectives To investigate the perceived importance that pharmacists in Kazakhstan place on the various activities involved in the delivery of pharmaceutical care, using the modified Behavioural Pharmaceutical Care Scale (BPCS) questionnaire. Method The questionnaire consisting of 3 dimensions and 14 domains was translated into Russian and back-translated into English for verification. The Russian version was mailed to a sample of 510 randomly selected pharmacists throughout all the regions of Kazakhstan. Pharmacists were asked to score the importance of each pharmaceutical care activity contained in the modified BPCS Scale on a six-point Likert scale ranging from 0 to 5. Key findings The overall score for the questionnaire, which illustrated the importance pharmacists attributed to the various aspects of pharmaceutical care, ranged from 46 to 170, with a mean score of 119.2. The highest scored dimension was that of instrumental activities, obtaining 76.7% of the maximum achievable score, while the direct patient care activities dimension obtained the lowest score. The competency improvement domain obtained the highest score and hence was perceived to be the most important pharmaceutical care activity. Younger pharmacists, however, obtained significantly lower scores (P &amp;lt; 0.05 Kruskal—Wallis) in the domains of prescription validation, evaluation of patient satisfaction, and competency improvement, perceiving these instrumental activities to be of lesser importance. Conclusion Pharmacists in Kazakhstan need to become better acquainted with pharmaceutical care and the current international extended practice of pharmacy. This needs to be addressed at both a basic and continuing education stage as well as at national pharmaceutical policy level.

Provision of pharmaceutical care to patients with limited English proficiency

A study was conducted to evaluate the current practices of pharmacists in ambulatory care clinics in communicating with and providing pharmaceutical care to patients who have limited English proficiency. Semistructured surveys were used to gather data from 16 pharmacists and 8 physicians from 15 ambulatory care clinics in metropolitan Toronto. The survey examined pharmacists' knowledge about the linguistic services, policies, and guidelines in their ambulatory care practice settings; the strategies that pharmacists and physicians use to communicate with patients with limited English proficiency; the challenges pharmacists face when providing pharmaceutical care to those patients; the drug-related problems observed by pharmacists and physicians; and how pharmacists and physicians can collaborate to resolve medication issues for those patients. Many pharmacists (69%) were unaware of existing institutional policies for communicating with patients with limited English proficiency. Language interpretation services in clinics were nonstandardized and did not always reflect practitioners' preferences. All aspects of pharmaceutical care were reported to be difficult to accomplish in patients with limited English proficiency. Pharmacists and physicians identified similar drug-related problems, with nonadherence being the most commonly observed drug-related problem. Strategies suggested by pharmacists and physicians to improve communication with patients involved proactively identifying language needs of patients before appointments, having translated medication information available and using trained language interpreters. Pharmacists at 15 ambulatory care clinics reported difficulty communicating with and providing pharmaceutical care to patients with limited English proficiency. Strategies suggested by pharmacists and physicians to enhance communication with those patients may help improve the quality of pharmaceutical care delivered.

病棟薬剤師の介入による処方薬剤数，薬剤費および副作用発現頻度の減少

The major requirement for the hospital pharmacist is the practice of good pharmaceutical care. In this study, we examined the content of such pharmaceutical care and whether the average number of drugs, drug costs and the incidence of adverse drug events was reduced by the presence of the pharmacist in the neurology ward of Nagoya Daini Red Cross Hospital. We also considered ways of improving the function of clinical pharmacists in the future.The number of the clinical pharmacy practices for the month of September 2000 was 762 broken down into dispensing of drugs, consultation with patients and other clinical pharmacy practices, with 198, 338 and 226 practices each, respectively. The greatest proportion of other clinical pharmacy practices involved supplying drug information, with advice on prescription changes and amending prescriptions coming next. The number of the clinical pharmacy practices increased from 762 in 2000 to 893 in 2003, with practices covering a broad range of functions, all needing specialist pharmaceutical knowledge. Over this period, the average number of drugs in prescriptions, drug costs and incidence of adverse drug events decreased, which resulted from pharmacists ensuring that drugs were used properly by amending prescriptions.A major goal of clinical pharmacists is to ensure that drugs are used properly and this can be achieved through their active involvement in all aspects of pharmaceutical care as an active member of the health care team. Their role should not be limited to instructing patients on how to take drugs.

The provision of pharmaceutical care in Denmark: a cross-sectional survey.

Pharmaceutical care was a concept initially defined in the early 1990s. It had its roots within clinical pharmacy, in the USA. In Denmark, pharmaceutical care has been part of the professional standards of practice for community pharmacy since 1995. The objective of the present study was to investigate the provision of pharmaceutical care in community practice in Denmark. A focus of the study was the estimation of the frequency of medicine-related problem identification and the process of problem management in the Danish pharmacies. A cross-sectional questionnaire-based survey of all Danish community pharmacies was conducted (n = 288). The variables included: detection and identification of medicine-related problems, goal-setting for solving medicine-related problems, and documentation of efforts to solve these. The response rate was 75.7%. A non-respondent analysis was performed. On average three medicine-related problems per pharmacy were found within the working week prior to the survey. For two-thirds of those cases the type of problem involved was identified. For the other third, goals had been set to resolve the problem. Minimal documentation of these activities was reported. The primary collaborators in problem management were general practitioners and patients. Pharmaceutical care, in its fullest sense, as defined in policy documents in Denmark, was not evident in practice. While some aspects of pharmaceutical care were being performed, almost no documentation of efforts was taking place in community pharmacy.

The importance that community pharmacists in Malta place on the introduction of pharmaceutical care.

The results from a study to assess the importance Maltese pharmacists placed on various aspects of pharmaceutical care and their willingness to provide such care are reported. A modified version of the Behavioural Pharmaceutical Care Scale (BPCS) questionnaire (consisting of three dimensions and 14 domains) was mailed to the 198 privately owned community pharmacies in Malta. A total of 99 questionnaires were returned following two reminder telephone calls. Pharmacists were asked to score the importance of each pharmaceutical care activity contained in the modified BPCS on a 6 point Likert scale ranging from 0 to 5. The overall score for the questionnaire, which illustrated the importance pharmacists attributed to various aspects of pharmaceutical care, ranged from 90 to 170 with a mean score of 134.8. There was little difference recorded between the scores for the three dimensions. The Referral and Consultation domain recorded a slightly higher score than the other two domains. Younger pharmacists obtained significantly higher scores (p < 0.05; Kruskal-Wallis test) in the Verification of Patient Understanding domain. Approximately 72% of respondents indicated that they were willing to provide pharmaceutical care, but remarked that a number of issues e.g. reimbursement, qualified support staff, GP-pharmacist co-operation, had to be addressed. A series of strategic steps are needed to help pharmacists resolve these issues before pharmaceutical care programmes could be offered by Maltese community pharmacists.

Pharmaceutical care in The Netherlands. History, definition and projects.

The evolving concept of Pharmaceutical Care knows different interpretations in different countries. In the Netherlands community pharmacists already perform several functions which may be part of the Pharmaceutical Care concept. The Dutch concept of Pharmaceutical Care is tested in the TOM and OMA-projects. Patients recognise the educational, aspects of Pharmaceutical Care and in general are content about the provision thereof.