Clinical Pharmacist Services Research Articles

Correction to “Development and application of quality measures of clinical pharmacist services provided in inpatient/acute care settings”

Correction to “Development and application of quality measures of clinical pharmacist services provided in inpatient/acute care settings”

2304 Models of care and the role of clinical pharmacists in UK primary care for older people: findings from a scoping review

Abstract Introduction Pharmacists have traditionally worked in primary care, in the community, and with GPs. However, the role of the clinical pharmacist in primary care is evolving and there are plans to employ more clinical pharmacists in the NHS. With an ageing UK population, there is an increase in the number of people living with multiple long-term conditions, accompanied by polypharmacy, posing numerous challenges to healthcare systems. This review investigates the evidence about the varied roles and services delivered by clinical pharmacists in primary care, capturing the perspectives of health and care professionals, older adults, and their carers. Method Our scoping review followed the framework for scoping reviews in accordance with the Joanna Briggs Institute (JBI) methodology. A broad search was conducted in 2023 in CINAHL, Cochrane, Medline, SCOPUS, and Web of Science. We included articles that explored the landscape of clinical pharmacy services for older people in the UK, focusing on roles and services delivered, perceptions, and experiences. Results A total of 23 articles was included. These shed light on the multifaceted responsibilities of clinical pharmacists for older people. Stakeholder perspectives, including healthcare professionals and care home staff, emphasise the positive outcomes of clinical pharmacist involvement, from reducing other practitioners’ workloads to improving patient safety. However, communication gaps among the primary care team and those living with dementia, concerns about competence, and the need for clear role definitions of clinical pharmacists emerge as challenges. Conclusions and implications The review enhances our understanding of the clinical pharmacist service in the UK and identifies gaps in research evidence, emphasising the need for empirical studies on the experiences of older people with cognitive impairment and those from minority ethnic backgrounds. The findings can be used for policymaking, workforce planning, and healthcare provision to improve the services for older people in the UK.

Identifying ideal pharmacist‐to‐patient ratios for the successful provision of clinical pharmacy services

AbstractClinical pharmacists add significant value to the health care team and are associated with reduced hospital mortality, drug costs, length of stay, and adverse drug reactions. However, there remains a paucity of evaluative data regarding optimal clinical pharmacy practice models. Identifying optimal patient (or bed)‐to–clinical pharmacist ratios is one mechanism to assess the allocation of resources. The ACCP Task Force on Clinical Pharmacy Services was charged with developing a white paper to examine optimal ratios in different care settings, considering confounders and other factors that affect the interpretation of ratio data. The committee performed an extensive search of the pharmacy, medical, and nursing literature to identify existing data on provider‐to‐patient ratios. Recommendations on ratios are mainly from survey data or statements from various health care organizations. Many factors affect the capacity of clinical pharmacists to achieve patient care and non‐patient care responsibilities. Examples include general differences in baseline expectations; nonstandardized program performance metrics; variable hospital/practice setting types; variable patient acuity and complexity; competing priorities and other resources; industry‐wide rates of and variability in addressing burnout; inconsistent means for justifying numbers and historical corporate structures; and external endorsements and mandates. Although some areas of practice such as critical care pharmacy have more robust evidence for specific ratios, others such as pediatrics are far less clear. A clinical pharmacist ratio must be established as a starting point. This will allow for better allocation today and serve as a springboard for future determinations. Furthermore, clinical pharmacist ratios should be preserved to offer reliable patient care 365 days per year. As clinical pharmacist services shift from beneficial to essential, continuous daily patient care services must be the practice model moving forward.

Development and implementation of ambulatory care pharmacy services at an internal medicine clinic.

This report describes the step-by-step process that led to expansion of ambulatory care pharmacy services at a newly established internal medicine clinic within a patient-centered medical home in North Carolina. Implementation of clinical pharmacist services at the clinic was led by a postgraduate year 2 (PGY2) pharmacy resident and guided by the 9 steps described in the book Building a Successful Ambulatory Care Practice: A Complete Guide for Pharmacists. After a needs assessment and review of the demographics and insurance status of the clinic's target population, it was determined that pharmacist services would focus on quality measures including diabetes nephropathy screening, diabetes eye examination, blood glucose control in diabetes, discharge medication reconciliation, annual wellness visits, and medication adherence in diabetes, hypercholesterolemia, and hypertension. Clinic appointments were conducted under 3 models: a pharmacist-physician covisit model, a "floor model" of pharmacist consultation on drug information or medication management issues during medical resident sign-out sessions with supervising physicians (medical residents could also see patients along with the pharmacist at a covisit appointment), and a covisit model of stacked physician and pharmacist appointments. The pharmacist's services were expanded from 2 half-day clinic sessions per week initially to 5 or 6 half-day clinic sessions by the end of the residency year. By the fourth quarter of the first PGY2 residency year in which ambulatory care pharmacy services were provided in the clinic, the clinical and financial impact of those services justified the addition of a second full-time pharmacist to the clinic team.

Pharmaceutical Care by Clinical Pharmacists can Effectively Improve the Use of Antibacterials and Hepatoprotective Drugs during Perioperative Period in Urology Department: A Retrospective Study.

The management of medication for patients undergoing urological surgery is a subject of ongoing controversy, especially in elucidating the effect of clinical pharmacists on medication rationality. This study aims to assess the influence of clinical pharmacist service on the utilization of antibacterial and hepatoprotective drugs in urological surgery patients during the perioperative period. Patients undergoing urological surgery in our hospital from January 2020, to January 2023, were consecutively selected. The patients were divided into control group (routine procedure) and observation group (routine procedure + clinical pharmacist service). The baseline data were balanced by 1:1 propensity score matching (PSM). The t test and chi-square test were used to compare the drug use, adverse reactions, and hospitalization-related indicators between the two groups. A total of 292 patients were included, with 100 patients in each group after PSM. No significant difference was found in the baseline data between the two groups (p > 0.05). The rationality of drug use (drug type, administration time, course of treatment, and combination) in the observation group was significantly better than that in the control group (χ2 = 8.489, 10.607, 10.895, 10.666; p = 0.004, 0.001, 0.001, 0.001). The incidence of adverse reactions (6.00%) and postoperative complications (7.00%) was significantly lower (χ2 = 4.903, 5.531; p = 0.027, 0.019). The length of hospital stay and total cost were similar (p > 0.05). The use time and cost of antibacterial and hepatoprotective drugs in the observation group were lower than those in the control group (t = 2.935, 3.450, 3.243, 3.532; p = 0.004, 0.001, 0.001, 0.001). The types and rates of antibacterial and hepatoprotective drugs in the observation group were significantly lower than those in the control group (p < 0.05). Clinical pharmacist service can effectively improve the rationality of drug use in urological surgery patients and reduce adverse reactions and postoperative complications, hence its clinical promotion value.

Drug-related problems in hospitalized patients with chronic kidney diseases and clinical pharmacist interventions

BackgroundPatients with chronic kidney disease (CKD) are at high risk of drug-related problems (DRPs) because of extensive comorbidities and pharmacokinetic changes. This study aimed to identify DRPs and possible contributing factors in hospitalized patients with CKD, and evaluate the efficacy of the clinical pharmacist services in detection and intervention of DRPs in a large general hospital in Zhejiang Province, eastern China.MethodsWith the approval of the Ethics Committee, patients with CKD admitted to the nephrology ward from January to December 2020 were enrolled in this prospective study. The clinical pharmacist identified and intervened the DRPs during hospitalization. The DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) DRP classification system, and all data were statistically analyzed using Statistical Package for Social Science (SPSS) version 26.0.ResultsA total of 914 patients with CKD were included, with 463 DRPs observed among 420 (45.95%) participants; the average DRP per patient was 0.51 (standard deviation [SD], 0.60) before pharmacist intervention. Treatment safety accounted for the highest proportion of problems (43.84%), followed by treatment efficacy, accounting for 43.20%. Drug selection was the most common cause of DRPs (60.26%), and antibiotics and cardiovascular agents were the most common drugs associated with DRPs (32.84% and 28.66%, respectively). A total of 85.53% of pharmaceutical intervention recommendations were followed, and 84.23% of DRPs were completely resolved after intervention by the clinical pharmacist. The proportion of patients who experienced DRPs decreased to 7.77%, with an average of 0.08 (SD 0.28) DRPs during hospitalization after pharmacist’s intervention. Significant contributing factors for DRPs were CKD stage 4, number of comorbid diseases, number of prescribed medications, and hospitalization days in both the univariate and multivariate logistic regression models.ConclusionDRPs are common among hospitalized patients with CKD in China. CKD stage 4, the number of comorbidities, use of multiple prescription drugs, and extended length of hospital stay are contributing factors for DRPs. Even only one clinical nephrology pharmacist in the nephrology ward, clinical pharmacist can play an important role in facilitating the identification of DRPs in patients with CKD and assisting physicians resolve DRPs in this single center study in China.

The participation of clinical pharmacists in the treatment of patients with central nervous system infection can improve the effectiveness and appropriateness of anti-infective treatments: a retrospective cohort study.

Background: Central nervous system infection (CNSI) treatment in hospital neurosurgery emphasizes the importance of optimizing antimicrobial therapy. Timely and appropriate empiric antibiotic treatment is critical for managing patients with bacterial meningitis. Objectives: To evaluate the activities of clinical pharmacists in the anti-infective treatment of patients with CNSI in neurosurgery. Method: A single-center retrospective cohort study was carried out from January 2021 to March 2023 at a tertiary teaching hospital in China. The study sample included a group that received pharmacy services and a group that did not. In the pharmacy services group, the anti-infective treatment plan was led and developed by pharmacists. Pharmaceutical care, including medication therapy and all CNSI treatment regimens, was administered in daily unit rounds by pharmacists. Baseline demographics, treatment outcomes, and rational use of antibiotics were compared between the two groups, and the impact of a antimicrobial stewardship (AMS) program was evaluated. Results: Of the 306 patients assessed according to the inclusion and exclusion criteria, 151 patients were included, and 155 patients were excluded due to abnormal data and missing information on antibiotic costs or antimicrobial use. Eventually, 73 were included in the pharmacy services group and 78 in the group without pharmacist participation. The antibiotic use density (AUD) of the pharmacy services group decreased from 167.68 to 127.63 compared to the group without pharmacist participation. After the pharmacist services, the AUD for linezolid decreased from 9.15% to 5.23% and that for miscellaneous agents decreased from 17.91% to 6.72%. The pharmacy services group had better improvement (p < 0.05) and a significantly higher score for the rational use of antibiotics (p < 0.05) than the group without pharmacist participation. Conclusion: The clinical pharmacist services evaluation results demonstrated an essential role of clinical pharmacist-led AMS programs in the effective and appropriate use of anti-infective treatments in neurosurgery with patients with CNSI.

Clinical pharmacist role in improving the knowledge and outcomes in patients using isotretinoin: A randomized, controlled study

ObjectiveTo evaluate the role of a clinical pharmacist in improving knowledge and outcomes among isotretinoin users. MethodsPatients were randomly assigned to an intervention group (received education about isotretinoin by a clinical pharmacist in addition to the physician) and a control group (received routine education by the physician), then followed for three months. Patients' knowledge about isotretinoin optimal use, and side effects and their management and other outcomes were measured in both groups at baseline and at follow up after three months using a validated questionnaire. ResultsTwo-hundred and three patients completed the study; 103 were in the intervention group and 100 in the control group. The knowledge improvement between baseline score and follow-up score was greater in the intervention group (mean = 2.835 ± 1.329) compared to the control group (mean = 0.530 ± 0.784) with mean differences = −2.30495, P < 0.001. ConclusionImplementing clinical pharmacy services in dermatology clinics can positively increase patients’ level of knowledge about isotretinoin, which could reduce the severity of its side effects. Therefore, improving patients' quality of life, and improvement in acne. Practice implicationsImplementing clinical pharmacist services to patients using isotretinoin is feasible in an outpatient setting. Clinical pharmacist counseling and education improve the medication knowledge among patients who use isotretinoin.

Pharmacist ambulatory pain services for a chronic non‐cancer pain clinic: a descriptive study

AbstractBackgroundPatients presenting to specialist pain clinics are often prescribed complex and high‐risk analgesic regimens. In this setting, pharmacists can help identify at risk patients and provide valuable clinical input to improve patient outcomes.AimTo evaluate the role of a clinical pharmacist in improving the triage, assessment and management of patients presenting to ambulatory pain clinics.MethodThis descriptive study enrolled patients from two chronic noncancer pain clinics from July to December 2021. A new clinical pharmacist service was devised, which operated as telehealth one day per week. The pharmacist was responsible for accepting referrals, triaging based on clinic criteria and updating them with prescription risk factors, in line with SafeScript's traffic light system. Pharmacist clinical services included completion of medication histories, drug dose interventions and patient education. This project received departmental ethical approval from the Eastern Health Office of Research and Ethics prior to commencement (Approval No: QA21‐068).ResultsThe pharmacist assessed 253 patients and identified prescription risk factors for 68 patients; of which 11 (16%) had received opioids from ≥4 prescribers, 10 (15%) were issued a monitored prescription from ≥4 pharmacies, seven (10%) were on high‐risk drug combinations, 25 (37%) had an Oral Morphine Equivalent Daily Dose (OMEDD) of 50–100 mg, and 26 (38%) with OMEDD &gt;100 mg. The pharmacist completed 67 medication histories and provided 22 accepted drug intervention recommendations to clinic physicians, including seven recommendations for dose adjustments, six to cease a medicine and nine to start a new medicine.ConclusionThe pharmacist incorporated SafeScript in the clinics' triage processes and provided valuable clinical interventions complementing the care provided by the pain physicians and the allied health staff.

A glycemic diet improves the understanding of glycemic control in diabetes patients during their follow-up.

A glycemic diet improves the understanding of glycemic control in diabetes patients during their follow-up.

Impact of clinical pharmacist services on physicians' guideline compliance and prognosis of patients for venous thromboembolism prophylaxis in ICU.

Whether the clinical pharmacist services (CPS) improve ICU physicians' compliance with venous thromboembolism (VTE) prophylaxis guidelines remains unclear, and the impact of CPS on VTE incidence and mortality in ICU patients should also be investigated. ICU patients were assigned to a CPS group or a control group according to the medical arrangements of the day of patient admission, without any intervention. The impact of CPS on guideline compliance, VTE incidence, and mortality was assessed. A total of 338 patients were included. With CPS, ICU physicians' compliance with VTE prophylaxis guideline was improved by 7-25% (p<0.001). The incidences of VTE (9 vs. 17%, p = 0.037) and bleeding events (5 vs. 11%, p= 0.042) were both lower in the CPS group than in the control group. Multivariate Cox regression model showed that CPS was an independent risk factor for VTE events (HR = 0.438, 95% CI = 0.224-0.857, p = 0.016) and 14-day mortality (HR = 0.416, 95%CI = 0.25-0.692, p = 0.001). CPS could significantly improve ICU physician compliance with VTE prophylaxis guidelines and reduce the incidence of VTE events and mortality in ICU patients. A clinical pharmacist should be involved in the daily management of ICU patients as an important member of the clinical team.

A preliminary study to evaluate the impact of pharmaceutical care services on clinical outcome and medication adherence in type 2 diabetes mellitus patients from Ethiopian perspective.

The role of clinical pharmacist in hospital settings of Ethiopia is still new and infant. To evaluate the impact of pharmaceutical care on clinical outcome and medication adherence in type 2 diabetes mellitus (T2DM) patients. A single cantered, pre-post interventional study design was carried out by enrolling 100 uncontrolled T2DM patients from March 1-August 30, 2020. The intervention package included assessment of pharmacological and non-pharmacological needs, counselling patients in person at the clinic, and providing educational materials. Of the 100 patients initially enrolled, 87(87%) completed the follow-up and included in the final data analysis. The intervention showed a decrease in average FBG, systolic blood pressure (SBP), low density lipoprotein cholesterol (LDL-C) by 47.3 mg/dL, 22.6mmHg and 31.4mg/dL, while high density lipoprotein cholesterol (HDL-C) and estimated glomerular filtration rate (eGFR) exhibited significant increase by 13.4 mg/dL and 11.5 ml/min/1.73m2 respectively (p<0.0001). In addition, diastolic blood pressure, lipid values, kidney function parameters, and liver function parameters showed significant decrease in post intervention compared to pre-intervention (p<0.05). Medication adherence of the patients increased significantly at 6-month follow-up (p<0.001). These results also suggest the benefits of integrating clinical pharmacist services in multidisciplinary healthcare teams and diabetes management in Ethiopia.

Providers' Perceived Value of Clinical Pharmacist and Technician Services within Primary Care Clinics.

Several studies have demonstrated the benefit of clinical pharmacy services in primary care. However, studies are limited on providers' perceived value of embedded primary care pharmacy teams. The purpose of this project was to determine how primary care clinical pharmacists and technicians provide value to medical providers. Primary care providers in University of Utah health clinics where primary care clinical pharmacists are embedded were invited to participate in one-on-one, semi-structured interviews. Interview sessions were recorded, transcribed, and de-identified. The transcripts were coded and analyzed to determine common themes. Questions were on various topics, including what is of greatest value to them, pharmacy integration into care teams, provider burnout, provider happiness at work, provider workload, and provider retention in the health system. In total, 25 interviews were conducted from nine different clinics (response rates of 19.7% for providers and 81.8% for clinics). Coding revealed themes of increased job satisfaction, enhanced patient care, decreased workload and burnout, and a desire for increased access to clinical pharmacy services. The responses related to clinical pharmacists in primary care were overwhelmingly positive, and providers almost unanimously expressed the need for more pharmacy services in primary care.

Evaluation of the clinical pharmacist services at a gynaecological oncology preadmission clinic

BackgroundPharmacists working in the multidisciplinary gynaecological oncology pre-admission clinic (PAC) are involved in the perioperative assessment of patients for a comprehensive medication history and information provision regarding withholding of medications before surgery. ObjectiveTo evaluate the current services provided by pharmacists to multidisciplinary staff and patients attending the PAC. MethodsA staff and a patient feedback survey on the value and impact of PAC pharmacy services were distributed within the PAC. The impact of the PAC pharmacist was also assessed by analysing pharmacist interventions and key performance indicators documented. ResultsFifteen staff responses were recorded, 5 nursing staff, 2 midwives and 8 anaesthetists. Eighty-seven percent (n = 13) strongly agreed or agreed that pharmacists at PAC help reduce medication errors on admission. Staff strongly agreed 73% (n = 11) pharmacists obtain a more accurate medication history. Staff reported benefits in having a pharmacist at the clinic to discuss medication related questions with 87% (n = 13) strongly agreeing or agreeing with the statement. A staff overall satisfaction rating of 4.87 out of 5 was recorded. In the patient survey, respondents (n = 6) gave a 4.83 out of 5 rating in confidence in making changes to their medication and their overall satisfaction with the service provided. In reviewing data from January to June 2022, the number of patients seen by the pharmacist were 178 of 681 patients (26.1%) who attended the clinic. The most common medications involved in the pharmacist intervention include those that were advised to be withheld and those that required other changes to therapy prior to their procedure. ConclusionThe role of a PAC pharmacist can be greatly appreciated by the multidisciplinary team and patients. Pharmacist interventions and key performance indicators have demonstrated the important activities of clinical pharmacy services in the PAC in optimising patient care in medication management.

Evaluation of the effect of pharmaceutical care during inpatient treatment in a department of neurology: A retrospective study.

Common drug-related problems during neurology inpatient treatment can affect expected health results. Some interventions need to be implemented to reduce DRPs. To explore the effect of care from clinical pharmacists during inpatient treatment. Inpatients treated in the department of neurology in the Second Hospital of Shanxi Medical University between January 1 to December 31, 2019, were retrospectively included. Those who received care from the clinical pharmacist service were assigned to the pharma-care group while the other patients were assigned to the control group. From the perspective of drugs, the two groups were compared in terms of types, antimicrobial use, and key monitoring of drug use. From the perspective of patients, the two groups were compared in terms of length of stay, hospital cost, drug cost and proportion. Propensity score matching was used to balance the baseline characteristics. A total of 2684 patients were included 554 in the pharma-care group and 2130 in the control group with a median of 9 days (range, 3–30 days) hospital stay. The groups showed no significant difference in age or gender. Length of stay, the proportion of drug cost, number of adverse events, cost of antibacterial agents, use of a single antibacterial agent, and use of three or more different antibacterial agents were similar between the groups. Medicine expenses cost more in the pharma-care group. The cost and types of intensive monitoring drugs were similar, but Defined Daily Doses were lower in the control group. While clinical pharmacists may play a positive role in the pharmaceutical care of inpatients, in this study the benefits were not obvious. This may be because of the small number of clinical pharmacists in the department of neurology with narrow coverage.

Clinical Pharmacist Interventions in Intensive Care Units during Hajj

Background: Hajj pilgrimage is the largest mass gathering worldwide. The Saudi Ministry of Health (MOH) provides free medical services for all pilgrimages. In 2022, MOH incorporated clinical pharmacy services in intensive care units (ICUs) of the sacred rituals hospitals. In addition to their role in ICUs settings, they were involved in other activities related to emergency department admissions as well as conducting several educational services at the hospital level. This study aimed to describe the impact of clinical pharmacy services implementation during the Hajj season and to explore the clinical interventions delivered to ICU patients. Materials and Methods: A multicenter-retrospective, chart-review study including adult critically ill patients (&gt;14 years old) admitted to ICUs of seven sacred rituals hospitals between June 30 and July 14, 2022. Patients were excluded if they were not admitted to the ICU or admitted to an area with no assigned clinical pharmacist. Clinical interventions were categorized based on a modified version of the American Society of Health-System Pharmacists (ASHP) categorization. The study was approved by MOH Central Institutional Review Board (IRB) on September 18, 2022 (Ref. 22-41 E). Results: Clinical pharmacists performed 269 interventions for 82 patients admitted to the ICUs of participating hospitals. Each patient had a median of three interventions (interquartile range 2–5). The most common intervention was the untreated indication (n = 93; 34.5%), followed by dose adjustment (n = 60; 22.3%) and improper drug selection (n = 42; 15.6%). The ICU teams ultimately accepted all interventions. Conclusion: Incorporating clinical pharmacy services into ICU settings during Hajj season optimized patient care. The variety of provided clinical interventions shows the impact of clinical pharmacists’ presence among multidisciplinary teams. Further studies are needed to explore the economic implication of clinical pharmacist services during Hajj.

The Role of Clinical Pharmacists in Improving Quality of Care in Patients with Inflammatory Bowel Disease: An Evaluation of Patients' and Physicians' Satisfaction.

Background: Inflammatory bowel disease (IBD) is a chronic and complex disease that requires a multidisciplinary team, including clinical pharmacists, to improve the quality of care and patient outcome. This present study aimed to assess the satisfaction of patients with IBD and physicians regarding clinical pharmacist interventions in outpatient and inpatient settings. Methods: A survey-based study was performed between 1 March and 1 August 2022 in a tertiary care IBD center. Two different questionnaires were distributed among patients and physicians focusing on satisfaction with the clinical pharmacist services. Patient demographics were obtained. Descriptive statistics were used to summarize the results of the survey. Results: A total of 108 patients with IBD and 23 physicians participated in this study. Among study participants, Crohn’s disease (CD) accounted for 64.8% of the total participants, while 35.2% of patients had ulcerative colitis (UC). Regarding the patient survey, most patients were extremely satisfied with clinical pharmacists’ services, during which the majority strongly agreed or agreed that they were satisfied with the counseling session. However, five patients were unsure about the amount of time spent with the clinical pharmacist. There were no patients dissatisfied with any of the services. Finally, two physicians were not sure regarding clinical pharmacists monitoring patients’ responses in of terms of toxicity and adverse effects. Conclusions: the current study illustrates patients’ and physicians’ high satisfaction with clinical pharmacists’ services in outpatient and inpatient settings. The findings of this study as well as previous studies necessitate expanding the clinical pharmacist services in the gastroenterology field.

Medicine-related problems: A recurrent issue among residents living in nursing homes.

Aim: To examine the incidence and nature of medicine-related problems over time experienced by nursing home residents. Method: We analyzed records collected in the Reducing Medicine-Induced Deterioration and Adverse Events (ReMInDAR) trial. The trial pharmacists provided services to reduce medicine-induced deterioration and adverse reactions for residents every 8-weeks over a year. The problems identified by the pharmacists were documented in reports and subsequently classified independently by research pharmacists using the D.O.C.U.M.E.N.T system. The number and type of problems at each service and time to develop a new problem post first session were assessed. All analyses were performed using R software (Version 4.1.1). Results: The cohort was 115 nursing home residents who received 575 services. In the 12-months, a total of 673 medicine-related problems or symptom reports were identified in 112 residents. Most residents (75%) experienced a new medicine-related problem by the fourth month post the first assessment. After the first session, the proportion of residents with a new medicine-related problem or symptom report declined at each repeated pharmacy session (59% at visit 2 vs. 28% at visit 6, p < 0.01). Conclusion: Residents living in nursing homes frequently experience medicine-related problems. Our results suggest clinical pharmacist services performed every 4-months may have the potential to reduce the medicine-related problems in nursing homes.

Patient satisfaction with inpatient pharmacy services at tertiary care setting—a meta-analysis of recent literature

AbstractObjectivesThis study aimed to determine patient satisfaction with the following pharmacist-led services for inpatients in tertiary care hospitals.MethodsStudies were identified from different databases from 2012 to 2020. A total of 1910 articles were identified using the search strategies out of which 1153 were rejected based on the review of titles and abstracts. The search criteria were the roles of inpatient pharmacists and patient satisfaction with inpatient pharmacy services. Multiple keywords were used such as ‘patient satisfaction’/‘inpatient pharmacist’/‘pharmacist hospital services’/‘clinical pharmacist roles’. The quality of each study was measured using the mixed methods appraisal tool, and the same was used to evaluate the risk of bias as well.Key findingsA total of 11 cross-sectional studies were included in the evidence synthesis of this meta-analysis. Three studies tested the satisfaction of patients with inpatient counselling with a sample size of n = 742. The odd ratio (OR) was 215.33 (141.77 to 327.05) [95% confidence interval (CI)] showed a significant patient satisfaction (P = 0.00001) with the pharmacist’s inpatient counselling (I2 = 0%). Studies showed a statistically significant satisfaction of patients with discharge counselling P &amp;lt; 0.00001 and OR 55.74 (35.93 to 86.49) and heterogeneity I2 = 0%. In a total of five studies, the healthcare professional (HCP) satisfaction with pharmacist services was reported, and satisfied and unsatisfied HCPs were n = 801 and n = 362, respectively. Results showed high satisfaction (P &amp;lt; 0.00001) and OR 4.62 (95% CI, 3.89 to 5.48).ConclusionThis meta-analysis concluded that clinical pharmacist services in an inpatient setting have a significant impact on increasing patient satisfaction with their treatment. The clinical pharmacist services are not very well implemented and are limited in some hospitals, but patients who have received these services were highly satisfied and expected to receive them more often.

Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center

Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center