Effect Of Pharmacist Intervention Research Articles

Effects of Pharmacist Interventions in a Surgical Intensive Care Unit

Effects of Pharmacist Interventions in a Surgical Intensive Care Unit

Exploring the Quality of Systematic Reviews on Pharmacist Interventions in Patients With Diabetes

To assess the reporting and methodological quality of systematic reviews and meta-analysis studies on pharmacist interventions in patients with diabetes. A comprehensive literature search was performed in MEDLINE, Scopus, and LILACS databases for systematic reviews and meta-analysis studies published from January 1990 to June 2013. The standardized search strategy included the use of MeSH terms or text words related to pharmacist interventions, diabetes, and systematic reviews. The overview included systematic reviews and meta-analysis studies published in English, Portuguese, or Spanish that evaluated the effect of pharmacist intervention on outcomes for diabetic patients. Two independent authors performed study selection, data extraction, and quality assessment with a consensus process to address disagreements. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Assessment of Multiple Systematic Reviews (AMSTAR) checklists were used to assess reporting characteristics and methodological quality, respectively. The literature search yielded 101 records of potential interest, of which 7 satisfied the inclusion criteria. The total average (SD) for PRISMA and AMSTAR scores were 17.4 (5.6) out of 27 and 6.9 (2.0) out of 11, respectively. The most frequent problems included nonregistration of study protocol, absence of a list of excluded studies, and unclear acknowledgment of conflicts of interests. The reporting and methodological quality of systematic reviews and meta-analysis studies were suboptimal, with some areas needing further improvement. It is necessary to ensure better transparency and reproducibility in the literature of clinical pharmacy services for diabetic patients.

HIV感染症診療における薬剤師介入が医療者側へもたらす効果に関する実態調査

HIV感染症診療における薬剤師介入が医療者側へもたらす効果に関する実態調査

外来がん疼痛患者におけるオピオイド鎮痛薬導入に対する薬剤師介入の効果に関する検討

外来がん疼痛患者におけるオピオイド鎮痛薬導入に対する薬剤師介入の効果に関する検討

RETRACTED ARTICLE: Evaluation of pharmaceutical care in a diabetes ward from China: a pre-and post-intervention study

To describe the development and implementation of pharmaceutical care services in a diabetes ward, and to examine the effectiveness of pharmacist interventions. Tongde hospital of Zhejiang province, a 1,200-bed South China teaching hospital, serving the local community. A single-center, 2-phase (pre-/post-intervention phase) designs was performed in the diabetes ward of a general hospital. Patients in post-intervention phase (October 2012 to December 2012) received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase (January 2012 to March 2012) received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions. Main outcome measure type and number of interventions, and medication errors assessed at the baseline and at the end of pharmaceutical care were the main outcome measures. During the 3-month study period, the clinical pharmacist made 240 interventions for 473 admitted patients; of these, 207 (86.3 %) were accepted by physicians or nurses, and dosage adjustment [n = 83, (34.6 %)] was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 (p < 0.001); medication errors, of incorrect dose or dosing interval, were markedly improved (decreased from 0.87 to 0.14; p < 0.001), the drug cost per patient day decreased from $347.15 to $309.74 (p = 0.095), and the length of diabetes ward stay did not change significantly (16.14 vs. 15.93 days; p = 0.15). The presence of the pharmacist in the diabetes ward resulted in significant reduction in medication errors and had potential drug-cost-saving effects.

Effect of pharmacist intervention on herpes zoster vaccination in community pharmacies

ObjectiveTo evaluate the effectiveness of community pharmacy–based interventions in increasing vaccination rates for the herpes zoster vaccine. DesignProspective intervention study with a pre–post design. SettingThree independent community pharmacies in Tennessee, from December 2007 to June 2008. PatientsPatients whose pharmacy profiles indicated that they were eligible for the vaccine and patients presenting to receive the vaccine at study sites. InterventionPharmacists promoted the herpes zoster vaccine through a press release published in local newspapers, a flyer accompanying each prescription dispensed at participating pharmacies, and a personalized letter mailed to patients whose pharmacy profiles indicated that they were eligible for the vaccine. Main outcome measuresComparison of vaccination rates for the herpes zoster vaccine during the control and intervention periods and patients' indication for their sources of education and influence in receiving the vaccine. ResultsVaccination rates increased from 0.37% (n = 59 of 16,121) during the control period to 1.20% (n = 193 of 16,062) during the intervention period (P < 0.0001). Cochran-Armitage trend analyses, including the months before and after the interventions, confirmed a significantly higher vaccination rate during the intervention month than other months analyzed. More patients indicated that they were educated about the herpes zoster vaccine by one of the pharmacist-driven interventions than by a physician, family/friend, or other source during the intervention period (P < 0.0001 for all comparisons). Also, more patients were influenced to receive the vaccination as a result of one of the pharmacist-driven interventions than influenced by a physician (P = 0.0260) or other source (P < 0.0001). No difference in the effectiveness of patient influence was found when the pharmacy interventions were compared with family/friends (P = 0.1025). ConclusionThree pharmacist-driven interventions were effective in increasing vaccination rates for the herpes zoster vaccine.

The Effectiveness of Pharmacist Interventions on Asthma Management

Background. In recent years, pharmacists have become more active in patient care and can demonstrate a positive impact on the outcomes of drug therapy in asthma patients. Objective. The primary objective of this systematic review was to assess the impact of asthma improvement strategies used by pharmacists. The secondary objective was to ascertain if these strategies improve the control and other direct outcomes for patients with asthma compared with no intervention. Methods. Electronic databases were searched from January 2006 to February 2012. Data abstracted from publications included publication details, participants/setting, intervention study design, outcome measures, and key findings. Results. Forty-seven studies were initially identified; 8 matched our inclusion criteria. Four were US studies and 4 were Canadian. Published studies provided evidence of the clinical effectiveness of pharmacy services in asthma interventions. The role of pharmacists in disease diagnosis, access to private area for consultation, time, and staff support were highlighted as the key barriers to asthma intervention. Reimbursement for consulting services provided a unique opportunity for pharmacists to provide direct patient care. Conclusion. The review demonstrated the contribution of pharmacy-based services to the monitoring, counseling, and educating in asthma care. The evidence supports the wider provision of asthma intervention through pharmacy services. Well-designed studies on the effectiveness of pharmacists’ interventions to improve outcomes of patients with asthma need to be performed. In addition, further research is needed regarding the contribution of pharmacy services to disease detection as part of local public health strategies.

Effect of a pharmacist intervention in Spanish community pharmacies on blood pressure control in hypertensive patients

The effect of a protocol-based pharmacist intervention on blood pressure (BP) control among treated hypertensive patients who use community pharmacies was studied. A quasi-experimental study with a control group was conducted at 13 community pharmacies in Jaén and Granada in Spain. Hypertensive patients over age 18 years who were receiving antihypertensive treatment were eligible for participation. The protocol-based intervention consisted of three components: (1) patient education about hypertension, (2) home blood pressure monitoring (HBPM), and (3) referral to a physician through personalized reports when necessary. The control group received the standard of care. BP control was assessed at the beginning and end of the study. Results Data were collected from 176 patients. In the intervention group (n = 87), significant baseline-to-endpoint reductions in systolic blood pressure (SBP) and diastolic blood pressure (DBP) were observed: 6.8 mm Hg (p < 0.001) and 2.1 mm Hg (p = 0.032), respectively. The changes in SBP and DBP in the intervention group at the end of the study were significantly greater than those in the control group (difference between adjusted mean change, 5.7 mm Hg for SBP [p = 0.001] and 2.6 mm Hg for DBP [p = 0.013]). The odds of achieving BP control in the intervention group was 2.46 times higher than in the control group (95% confidence interval, 1.15-5.24; p = 0.020). A protocol-based community pharmacist intervention in combination with HBPM significantly reduced SBP and DBP and increased the percentage of patients with controlled BP compared with patients receiving the standard of care.

Inpatient satisfaction with TCM medication counseling services provided by pharmacists

BackgroundTCM has been widely used to manage health around the world. Integrating TCM medication and western medicine into health care system is supported by WHO. The practices of integration mainly are contingent on the levels of physicians and pharmacists who have been trained in both. Integrating pharmacists into primary care practices is becoming increasingly recognized as a strategy to manage the complex medication needs. This questionnaire survey examined the satisfaction of patients with pharmacists directed interventions in TCM medication, health education and counseling services. MethodsA total of 60 inpatients receiving TCM medication integrated into conventional treatment were enrolled in the Buddhist Tzu Chi General Hospital from July 2009 to June 2010. A questionnaire was developed for evaluating general satisfaction with the provision by the pharmacist and pharmacy services. A five-point Likert rating scale was used before and after (pre-test and post-test) pharmacist interventions. Questionnaire responses were analyzed using SPSS statistical software package. ResultsThe 60 participants consisted of patients themselves (52%), family members of patients (38%) and caregivers (10%). Response rate to the survey was 100%. The majority of respondents were female (68.3%), aged between 41 and 60 years (61.7%). The pre-test/post-test changes in satisfaction with pharmacist interventions were significantly different for 8 out of the 13 items. ConclusionsRespondents were generally satisfied with pharmacist interventions as indicated by an overall average score of integrated outcomes effectiveness on pharmacist interventions greater than 4.0. Future studies on the effectiveness of pharmacist interventions should provide integrated outcome assessments.

The effect of pharmacist intervention on psychotropic prescribing through clinical medication review in a long-term care hospital in Dublin

BackgroundThe existence of psychotropic polypharmacy is well established and its detrimental effects on patients in long-term care are irrefutable. In 2009, 88% of long-term patients in the Royal Hospital Donnybrook...

The Effect of Pharmacist Intervention on Diabetes Screening Promotion and Education in a Geriatric Population

Type: Student Project

Positive effect of pharmacist intervention in diabetes management

Positive effect of pharmacist intervention in diabetes management

Influenza vaccination program for elderly outpatients

The effect of pharmacist interventions on the rate at which elderly outpatients were offered influenza vaccination was studied. Pharmacists at a university-based ambulatory-care facility reviewed the medical records of a random sample of control patients over the age of 65 who had been seen during the influenza vaccination months in 1987 or 1988 or both years. The purpose was to estimate the percentage of patients who had been documented as being offered influenza vaccination. In 1989 an intervention program was undertaken consisting of inservice presentations to the facility's nursing staff, dissemination of influenza information sheets to patients upon check-in, placement of wall posters, placement of reminders in patient charts, and institution and advertisement of a vaccination clinic. At the end of the 1989 vaccination season, the records of a random sample of intervention group patients were reviewed to determine the proportion of patients who had been offered influenza virus vaccine. Of the 280 control group patients, 47% were offered influenza vaccination during 1987 and 1988. A significantly higher proportion of the 153 intervention group patients, 71%, was offered influenza vaccine during 1989. A combination of pharmacist-initiated interventions significantly increased the number of elderly patients who were offered vaccinations during scheduled clinic visits.

Effect of pharmacist interventions on drug therapy costs in a surgical intensive-care unit

The effect of interventions by a clinical pharmacist on the cost of drug therapy in a 14-bed surgical intensive-care unit (SICU) was evaluated. The SICU pharmacist provides both distributive and clinical services from a modified satellite pharmacy five days each week. During a 13-week study period that comprised 65 days, the pharmacist documented all interventions that resulted in a discontinuation of or change in drug therapy, all nonformulary-drug requests, the detection and avoidance of problems related to drug therapy, and the enrollment of patients in investigational drug studies (for which the pharmacy department received monetary remuneration). The effect of these interventions on the costs of drug therapy was calculated using drug acquisition costs and, for i.v. preparations, the cost of the i.v. fluid and the cost of preparing and checking the product. A total of 332 interventions during the study period represented $18,030 in potential cost avoidance, which would extrapolate to an annual cost avoidance of $72,122. The majority of interventions involved discontinuations of or changes in drug therapy, most often involving antimicrobials. This pharmacist had a positive impact on the cost of drug therapy in the SICU.

Effect of pharmacist intervention on control of resistant hypertension

The effect of a pharmacist's clinical intervention on blood pressure control in ambulatory adults with resistant hypertension was studied. Twenty patients of an internal medicine clinic who had diastolic blood pressures greater than 96 mm Hg on two consecutive visits and antihypertensive regimens consisting of two or more agents were entered in the study between November 1, 1980, and February 1, 1981. After asking each patient 15 questions about hypertension and its treatment, the pharmacist counseled the patient about antihypertensive therapy, obtained a medication history, and discussed diet. The patient's blood pressure was measured, and the pharmacist evaluated the appropriateness of the patient's antihypertensive regimen (based on compliance, adverse reactions, and regimen complexity) and possible reasons for the poor response to treatment. The pharmacist then recommended drug therapy to the physician; stepped care including hydrochlorothiazide, reserpine, and hydralazine was used when possible. Patients' mean age was 56 years. Most did not know the names of their medications or understand their dosage schedules. Eight patients had severe hypertension (193/124 +/- 23/4 mm Hg), five had moderate hypertension (161/109 +/- 20/2 mm Hg), and seven had mild hypertension (171/100 +/- 29/0 mm Hg). Factors contributing to poor blood pressure control were noncompliance and adverse drug effects. After five to eight months of follow-up, mean blood pressures for patients with severe, moderate, and mild hypertension were, respectively, 140/92 +/- 23/10 mm Hg, 131/92 +/- 8/6 mm Hg, and 137/88 +/- 26/3 mm Hg; the mean for each group was significantly different from baseline. In this study, pharmacists intervened successfully with patients and physicians to enhance blood pressure control through drug therapy.

Effect of pharmacist intervention on the use of serum drug assays

The results of an investigation to (1) evaluate the use of serum drug assays (SDAs), (2) study the influence of clinical pharmacist monitoring and educational programs on SDA use, and (3) perform drug-related patient-care evaluations for the medical audit committee are reported. The components of the five-month study were a retrospective audit, education of physicians prescribing SDAs, and a concurrent reaudit. The four SDAs audited were digoxin, theophylline, gentamicin, and phenytoin. Criteria for appropriate use were defined by the audit committee and a clinical pharmacist. The criteria specified the indication for each drug, performance data, and dosage adjustments with SDA results. The clinical pharmacist presented two housestaff conferences on the appropriate use of SDAs and distributed educational materials to the attending physicians. An SDA report form was completed each time an SDA was ordered, and, whenever possible, the pharmacist met with the prescribing physician. Appropriate overall use of SDAs increased significantly (p less than 0.05). A significant improvement (p less than 0.05) was noted for each of the criteria. An estimated $2500 in patient charges was saved during the study; the cost of the clinical pharmacist's time was approximately $260. The authors concluded that clinical pharmacists, in conjunction with patient-care evaluations, can provide a cost-effective service in improving therapeutic patient monitoring based on SDA results.