Duties Of Pharmacist Research Articles

Consensus about the duties of pharmacists in intensive care units in Chile

In 2015, the directors of the Clinical Pharmacists Division of the Chilean Society of Intensive Care Medicine (SOCHIMI) organized a collaborative work along the country to define the minimum activities and duties that a pharmacist should perform in an Intensive Care Unit in Chile, according to the Ministry of Health and SOCHIMI guidelines and recommendations. This document summarizes the agreements on three priority areas of pharmacists' duties in intensive care: a) pharmacotherapy follow-up; b) pharmacological surveillance and security management of medications, and c) data recording and documentation. The recommendations collect the experiences from Chilean pharmacists along the country and provide information and support for future consensus for other specialties.

A review of the current trends of professional activities of pharmacists in Ukraine and abroad

Aim. To analyze the current trends of professional activities of pharmacists in some foreign countries andUkraine.Materials and methods. The study was conducted based on the literature on pharmaceutical activities in some foreign countries and regulatory acts inUkraine containing provisions and wording of the rights and duties of pharmacists. The analysis of professional activity has been performed, the opinions of experts and reputable international organizations concerning the role of professional duties, powers and capabilities of pharmacists in the system of such modern relationships as pharmacist – doctor, pharmacist – society, pharmacist – consumer.Results. The expert assessment of professional pharmacists inUkraine, conclusions of the International Pharmaceutical Federation, decisions of theEuropean Court on liberalization of the rights of pharmacies’ owners, the foreign experience of the pharmacist professional activities in theUK,USA,Germany,Spain,France,Denmark, andJapan are generalized. Regulations, which reflect aspects of professional activities of pharmacists inUkraine, are presented.Conclusions. The study has shown that there is a significant empowerment of pharmacists, the growth of their status, professional independence, autonomy and responsibility in providing pharmaceutical care abroad. The professional functions of pharmacists inUkraine are limited compared with the activity of pharmacists abroad. InUkraine it is expedient to regulate the rights and duties of pharmacists taking into account the national market trends, legislative and regulatory provisions in foreign countries.

Improvement of Clinical Skills through Pharmaceutical Education and Clinical Research

Professors and teaching staff in the field of pharmaceutical sciences should devote themselves to staying abreast of relevant education and research. Similarly those in clinical pharmacies should contribute to the advancement of pharmaceutical research and the development of next generation pharmacists and pharmaceuticals. It is thought that those who work in clinical pharmacies should improve their own skills and expertise in problem-finding and -solving, i.e., "clinical skills". They should be keen to learn new standard treatments based on the latest drug information, and should try to be in a position where collecting clinical information is readily possible. In the case of pharmacists in hospitals and pharmacies, they are able to aim at improving their clinical skills simply through performing their pharmaceutical duties. On the other hand, when a pharmaceutical educator aims to improve clinical skills at a level comparable to those of clinical pharmacists, it is necessary to devote or set aside considerable time for pharmacist duties, in addition to teaching, which may result in a shortage of time for hands-on clinical practice and/or in a decline in the quality of education and research. This could be a nightmare for teaching staff in clinical pharmacy who aim to take part in such activities. Nonetheless, I believe that teaching staff in the clinical pharmacy area could improve his/her clinical skills through actively engaging in education and research. In this review, I would like to introduce topics on such possibilities from my own experiences.

Expected Duties of Pharmacists and Potential Needs of Physicians and Nurses on a Kaifukuki Rehabilitation Ward

This study investigated the required duties of pharmacists in a kaifukuki rehabilitation ward from the viewpoint of the ward physicians and nurses. A questionnaire survey was distributed to 27 facilities with kaifukuki rehabilitation wards. The questionnaire examined which duties the physicians and nurses expected from pharmacists while on the ward (4 areas, 10 items), as well as the time required for pharmacists to carry out those duties. Multivariate analysis was used to investigate which types of work took the most time for pharmacists on kaifukuki rehabilitation wards. Responses were received from 43 physicians and 184 nurses who worked on the kaifukuki rehabilitation wards of 19 facilities. The results revealed that the essential duties performed by pharmacists were the management of medical supplies, instruction on the use of self-medicating drugs at the time of introduction, and monitoring drug side effects. Furthermore, some duties, such as the distribution of medicines and changing or suggesting new drugs, required pharmacists to spend extended time on the ward. The responses indicated that physicians and nurses recognized the necessity for pharmacists to perform ward duties along with their routine work. This study shows that physicians and nurses working in kaifukuki rehabilitation wards demand proactive participation from pharmacists in appropriate medical therapy, such as instruction in the administration of medications and assessment at the time of prescription changes.

A systematic review of decided litigated cases on adverse drug events in Japan: classification of decided cases appearing in law reports

Much of the damage to health caused by drugs could be prevented by appropriate care. A well-defined duty of care and further information are required for healthcare professionals. Although there are many litigation cases to use as references, neither the extent of the duty of care nor the obligation to explain medication according to the type of drug prescribed has yet been fully established. Thus, we systematically collected decided cases of adverse drug events, and assessed the degree of the duties of care and information. Specifically, we collected decided cases in which physicians, dentists, pharmacists, nurses, or hospitals had been sued. Data were derived from Bessatsu Jurist Iryo-kago Hanrei Hyakusen, Hanrei Jihou, and Hanrei Times from 1989 to November 2013, and information on precedents in the records of the Supreme Court of Japan from 2001 to November 2013. We analyzed the cases, and assessed the following according to the type of drug: (1) standards and explanations when dealing with drugs that were critical issues in litigation, and (2) the degree of the physician's or pharmacist's duties of care and information. In total, 126 cases were collected. The number of drug categories classified was 27, and 9 were considered of practical importance. After this systematic review, we found a trend in the degree of the required level of care and information on several drugs. With respect to duties of care and information, the gap between the required level and actual practice suggests that healthcare professionals must improve their care and explanations.

Reporting of critical information in studies of pharmacists in HIV care

To evaluate manuscripts documenting HIV pharmacist interventions and assess adequacy of reporting as defined by CONSORT and STROBE criteria. PubMed, EMBASE, Cochrane Library, Web of Science, BIOSIS Previews, and PsycINFO databases were searched from inception - 1 June 2011. Studies were included if pharmacists performed an intervention to improve HIV patient care, and the study evaluated the intervention's impact. Qualitative studies, non-English language reports, abstracts and studies where the pharmacist did not intervene were excluded. Manuscripts were independently evaluated by two reviewers for the presence, absence or lack of applicability of STROBE (observational studies) or CONSORT (randomized studies) criteria, for presence or absence of description of pharmacist's duties, CD4+ cell count, HIV viral load and adherence measurement. Reviewers met to discuss the rationale behind their evaluation; a third arbiter was consulted when reviewers could not agree on a particular criterion. Twenty-two manuscripts met inclusion criteria. Observational studies of HIV pharmacists (n = 19) included 56% of applicable STROBE criteria. Randomized studies of HIV pharmacists (n = 3) adhered more closely to CONSORT reporting guidelines (average 80% of applicable criteria). Manuscripts published after 2004 more consistently evaluated pharmacist impact on HIV outcomes such as CD4+ and viral load. Thorough reporting increases the reader's ability to critically evaluate manuscripts of HIV pharmacist services. Increasing pharmacist awareness of manuscript guidelines such as CONSORT and STROBE may improve clarity of reporting in studies of HIV pharmacist interventions and clinical programmes.

Working patterns and training processes of US pharmacists in the oncology department

Objective:To introduce working patterns and training processes of US pharmacists in the oncology department.Methods:The education and assessment of Pharmacy Doctor(Pharm D)were illustrated by introducing the curriculums and examples of examination papers.The US pharmacists' working patterns and duties were uncovered through analysis of actual cases and medication history.The important roles of pharmacists were summarized through analysis of clinical trials.Results and Conclusion:A three-step pattern was clearly presented in the training system of US pharmacists.The duties of pharmacists were more elaborate and pharmacists could play important roles in pharmaceutical care.

A Simulated Hospital Pharmacy Module Using an Electronic Medical Record in a Pharmaceutical Care Skills Laboratory Course

OBJECTIVES. To implement and evaluate the effects of a simulated hospital pharmacy module using an electronic medical record on student confidence and abilities to perform hospital pharmacist duties. DESIGN. A module was developed that simulated typical hospital pharmacist tasks. Learning activities were modified based upon student feedback and instructor assessment. ASSESSMENTS. Ninety-seven percent of respondents reported full-time hospital internship experience and 72% had electronic medical record experience prior to completing the module. Mean scores on confidence with performing typical hospital pharmacist tasks significantly increased from the pre-module survey to the post-module survey from 1.5-2.9 (low comfort/confidence) to 2.0-3.4 (moderate comfort/confidence). Course assessments confirmed student achievement of covered competencies. CONCLUSIONS. A simulated hospital pharmacy module improved pharmacy students' hospital practice skills and their perceived comfort and confidence in completing the typical duties of a hospital pharmacist.

Specialist Pharmacist Training from the Viewpoint of Sports Pharmacology

When athletes consult sports outpatient or orthopedic clinics it is possible to undergo drug treatment with the medical staff having prior knowledge of that patient being an athlete. However, if athletes seek any other diagnosis and treatment as an ordinary patient, the possibility of medical staff realizing the potential for imposing a doping issue on the athlete is extremely low. As a result, if the athlete fails to provide medical staff with information regarding anti-doping regulations when receiving clinical treatment, drug treatment administered as part of medical practices could be viewed as doping, resulting in the athlete being disciplined. In order to avoid this, pharmacist should participate in training in order to be able to provide information for anti-doping purposes. It is my personal opinion that knowledge regarding anti-doping is something that should be shared by all pharmacists, as pharmacists are educated in the fields of pharmacology and pharmacokinetics during the pharmacy education process, and sports pharmacology is a part of this. However, in order for pharmacists to understand sports pharmacology, it is necessary to provide education not only on the benefits and adverse effects of pharmaceutical products, but also on the concept of banned substances. It can be considered one of the pharmacist's duties to protect athletes who purchase drugs at a pharmacy or consult medical institutions as patients. With this, I would like to propose considering the potential for introducing sports pharmacology to pharmaceutical education, and specialist pharmacist training in the sports spectrum.

La dispensation des médicaments en EHPAD : quelle place pour les pharmaciens mutualistes ?

According to articles L.5126-6-1 and L.5125-5-1A in the code of public health, pharmacists can act in two different functions in nursing homes for frail elderly: pharmacist provider and/or pharmacist referent. The issue of access to these functions remained open for mutual pharmacists. With regard to their specific applicable legal regulations, arguments do exist questioning the possibility for mutual pharmacies of entering in the organization of the nursing home pharmacy provider. In addition, it appears that mutual pharmacists could exercise the duties of pharmacist referent only in nursing homes that refer to mutual residents.

Pharmacist readiness roles for emergency preparedness

Pharmacists provide care in a variety of settings, including ambulatory care clinics, community pharmacies, home health pharmacies, and hospital pharmacies. The pharmacist’s role in disaster response is just as critical as it is in traditional settings. As the most accessible health care provider, the pharmacist plays an especially vital role when a disaster disrupts a community’s health care system. Several articles have described pharmacists’ experiences and the lessons learned in both planning and responding to disasters.1–4 In addition, pharmacy associations have recognized the responsibilities and duties of pharmacists to prepare and respond to disasters and to participate in the full range of issues related to pharmaceuticals in disaster response.5–8 While similarities exist between pharmacists’ roles and responsibilities in traditional and disaster settings, it is important to emphasize that these roles and responsibilities are not the same. The unique circumstances of and challenges presented during a crisis require the pharmacist to have specialized skills that will help him or her provide rapid and effective pharmaceutical care during a disaster.

Clinical Pharmacy in Iran: Where Do We Stand?

Since late 1960s, pharmacists in the USA and England have started a professional movement towards a more efficient presence in clinical wards of hospitals. A similar movement has started in developed European countries during the past decade. Pharmacists are convinced of the need for them to play their role as drug consultants and pharmacotherapy advisers to make decisions on drug therapy problems. Today, they are part of a number of different health care teams within which hospital pharmacy operates, such as those active in oncology, psychiatry, nutrition, critical care and pain control. In addition, pharmacists play a major role in the core hospital pharmacy team, strategy and policy-making teams as well as research and drug information teams. Undoubtedly, the clinical pharmacists main aim is to rationalize drug prescribing by doctors and drug usage by patients. Several reports have shown that an active participation of pharmacists as a member of health care teams could have a significant positive impact not only on disease management but also on reduction of health system costs as well as increasing patient satisfaction. Unfortunately, the training of pharmacists as drug consultants to other members of health care teams and patients in our country is far from satisfactory. Evidently, one of the necessary requirements to overcome this deficiency is to increase clinical knowledge and experience of pharmacy students in the course of their education. Our current “pharmacy curriculum” is unable to train pharmacists to meet the needs of our health system at both primary and secondary health care levels. It should be mentioned that other branches of pharmacy are not happy with the current situation either. It can not be denied that our pharmacists are not capable enough of taking major steps forward in our pharmaceutical industry. On the other hand, the modifications made to the definition of the duties of pharmacists, new expectations of the health system pharmacists have to live up to, new tendency of educational systems to train community-oriented health professionals the sharp acceleration in devising new methods and techniques of medical science education completely detailed and specific approaches to preventing, diagnosing and treating diseases and disorders the need for pharmacists capable of supervising clinical trials and also pharmacists able to analyze reports published about therapeutic or side effect of drugs, make it crucial for pharmacy graduates to be familiar with clinical sciences and disease management protocols as much as possible. There is a real gap between the current status of pharmacy and what it should really be. Although, our pharmacy graduates have good theoretical knowledge of medicines, however they are weak at putting pharmacological science to practical use as drug consultants to patients and health care teams. Foremost among the drawbacks of this system is an unpleasant feeling of uselessness and job dissatisfaction in pharmacy graduates, which pushes them towards irresponsibility. In conclusion, the “pharmacy curriculum” needs revising. This revised curriculum must make possible gaining of applied clinical experience for pharmacy students. It is only after receiving proper training that pharmacy students should be expected to have an interactive participation in the activities of health care teams. It is therefore utterly rational to include clinical and experimental disciplines in the “doctor of pharmacy curriculum” in order to improve knowledge, attitudes, skills and capabilities of pharmacy students, so that they can act as successful pharmaceutical care providers in both hospital and community pharmacy settings. At the same time, health and pharmaceutical systems should bring about changes in the responsibilities and authorities of pharmacists by reforming health and pharmaceutical policies. These measures will eventually minimize the present difference between pharmaceutical care in our country and that which is practiced in developed countries. Jamshid Salamzadeh, Pharm.D., PhD Assistant Professor in Clinical Pharmacy Deputy of Dean, School of Pharmacy Shaheed Beheshti University of Medical Sciences and Health Services

早期体験学習（病院見学）に対する「興味」と「満足度」に影響を及ぼす要因解析

At Gifu Pharmaceutical University,hospital visits were introduced as an early exposure program for first year students (n=144)in 2009.On conducting a questionnaire survey of students who had gone on a hospital visit (response rate 100%),the results suggested that pre-learning raised the students’interest in the hospital visit and that they were satisfied with it (2 -top ratios : 79.9% and 83.3%).We also conducted a factor analysis and covariance structure analysis to investigate a connection between“interest in hospital visit”and“level of satisfaction with hospital visit”and the learning structure.Three important factors were extracted in factor analysis of 14 questions relating to before the hospital visit:“presentation ability”,“understanding of hospital pharmacist duties”,and“basic knowledge of medicine”.Similarly,three important factors were extracted in factor analysis of 13 questions relating to after the hospital visit:“desire to be a hospital pharmacist",“active pharmacist”,and“positive attitude”.Covariance structure analysis showed that three factors:“presentation ability”,“understanding of hospital pharmacist duties”,and“basic knowledge of medicine” elicited“interest in hospital visit”.We inferred that this was linked with“hospital pharmacist desire”and“positive attitude”.We also inferred that 3 factors-“desire to be a hospital pharmacist”,“active pharmacist”,and“positive attitude”- raised the“level of satisfaction with hospital visit”.

Changes in attitudes among Japanese patients after Pharmacist Law revision

To assess changes in patients' perception of their medications and their adherence to regimens after enactment of the Japanese Pharmacist Law revision of 1997, which stipulated provision of drug information to patients as one of the principal duties of pharmacists. Setting A university hospital in Japan. Comparison of cross sectional analyses between two time periods: shortly after enactment of the Pharmacist Law revision and about a half-decade later. Patient's knowledge of the medications, anxiety level, individual beliefs regarding taking medications without anxiety, and adherence to the medication regimens. There were 141 and 151 patients who participated during each period, respectively. The proportion of non-adherent patients significantly decreased from 68.8 to 53.6% (P = 0.008). Multiple logistic regression analysis indicated that the features of the intentionally non-adherent patients have changed; they have switched from persons who lack general comprehension about the medications (P = 0.01), ones who place an importance on knowing the side effects (P = 0.04), or who place no value on mutual reliance on their doctors (P = 0.03) into persons who place no value on understanding the purpose of taking their medications (P = 0.04) or who place value on multiple items to take medications without anxiety (P = 0.03), i.e., supposedly people who prefer thinking about their drug therapy from their own point of view based on comprehension of their disease and medications. The rapid progression of drug information disclosure after enactment of the Pharmacist Law revision has likely resulted in drastic changes in patients' perception of their medications and led to improvements in medication adherence.

院外処方せん発行前後における患者・医師・看護婦の医薬分業および薬剤業務に対する評価

We conducted surveys on the opinions of patients, doctors and nurses regarding bungyo (separation of dispensing and prescribing drugs) before and after the establishment of a system of dispensing prescription drugs for outpatients. While only 25% of the patients surveyed before the establishment of the system gave a favorable opinion regarding the bungyo, about 40% of those surveyed after the establishment of the system gave a favorable opinion. On the other hand, there were no differences in the opinions of either doctors or nurses regarding bungyo in a survey conducted before and after the establishment of the system. The criterion for choosing a pharmacy by outpatients was not only convenience of location but also the quality of service offered. Although 66% of the doctors surveyed before the establishment of the system expressed concern about possible differences between their explanations to patients and those given at community pharmacies, this percentage decreased to 35% after the establishment of the system. The quality of pharmaceutical care for inpatients by pharmacists after the establishment of this system was highly evaluated by both doctors and nurses, but the evaluation of the duties of pharmacists related to the injection check system was low. The survey results indicate the need for hospital pharmacists to make further efforts to improve the quality of pharmaceutical care for inpatients.

医療人としての薬剤師業務 （６） 食後の血糖上昇に対するα‐グルコシダーゼ阻害薬の効果

医療人としての薬剤師業務 （６） 食後の血糖上昇に対するα‐グルコシダーゼ阻害薬の効果

Pharmacist faculty member in a family medicine residency program

Pharmacist involvement in a family physician residency training program is discussed. The pharmacist's duties include: (1) inpatient clinical responsibilities to the family medicine service for therapeutic decisions and drug information, (2) ongoing educational presentations to residents and faculty, (3) drug information and consultation to outpatient clinics, (4) participation in the development of standards of practice for resident training and (5) clinical education for medical students.