Impact Of Clinical Pharmacist Research Articles

Impact of Clinical Pharmacists in the Inflammatory Bowel Disease Clinic.

Background: Limited evidence exists regarding pharmacist involvement and impact in inflammatory bowel disease (IBD) interdisciplinary clinic care models. The purpose is to describe pharmacist utilization in an interdisciplinary IBD clinic and evaluate clinical impact on patient quality of life. Methods: This was a retrospective cohort study comparing outcomes in patients with Crohn's disease initiated on therapy when the implementation of pharmacy services began (Early Phase) to the expansion of pharmacy services (Recent Phase). The primary outcome compared the proportion of patients referred to a pharmacist and those achieving a Harvey-Bradshaw Index (HBI) reduction of ≥3 points after therapy initiation. Results: 50 patients were included in the Early Phase and 43 patients in the Recent Phase. Utilization in pharmacy referrals increased from 48% (n = 24) in the Early Phase to 72% (n = 31) in the Recent Phase (P = 0.03). The proportion of patients achieving a HBI reduction of ≥3 points increased from 35% (n = 14) in the Early Phase to 51% (n = 18) in the Recent Phase (P = 0.23). Results also found a greater proportion of patients remaining steroid free in the Recent Phase compared to the Early Phase (50% vs 63%; P = 0.01) and C-reactive protein (CRP) improved significantly in the Recent Phase (-11) compared to (-3) in the Early Phase (P = 0.006). Conclusion: The utilization of pharmacists in an interdisciplinary IBD clinic increased and showed to impact patient care through improving symptom relief as seen by the achievement rate of the HBI score reduction, reducing steroid use after therapy initiation, and making clinically significant interventions.

The impact of clinical pharmacists’ intervention on the rational use of intravenous paracetamol vials in Baghdad Teaching Hospital: A case-control study

Paracetamol has been recognized worldwide as a safe and effective agent for relieving pain and reducing fever in many patients. This study aimed to investigate the role of clinical pharmacist interventions in the rational and appropriate use of intravenous paracetamol in surgical patients and the impact of this rational use on hospital costs. A case-control study was conducted on 794 patients (400 in the intervention group and 394 in the control group). The appropriate and rational use of the drug was compared between baseline and post-intervention in the intervention group and between the two groups. The result showed a significant reduction in dispensed IV paracetamol vials after the pharmaceutical intervention (4,151 vials recovered by the intervention), which led to a reduction in the cost (8,302 USD reduction in the total cost). There was a significant reduction in the dose of IV paracetamol, use with or without adjunctive opioid analgesics, frequency of administration, duration of intravenous paracetamol use, daily max exceeding 4 g, and concomitant use with oral paracetamol after applying the clinical pharmacist intervention. In conclusion, the clinical pharmacist plays a vital role in various aspects of healthcare; clinical pharmacist involvement positively impacts the patient’s management plan by improving the optimal and rational use of intravenous paracetamol and decreasing hospital costs.

The Prevalence and Impact of Clinical Pharmacists' Intervention on Drug-Related Problems in Patients With Chronic Kidney Disease.

Chronic kidney disease (CKD) is a global health issue of growing concern. According to projections from the Worldwide Health Observatory, it is currently one of the rapidly increasing contributors to global mortality. The prevalence of CKD and end-stage renal disease (ESRD) is increasing globally. The objective was to evaluate the prevalence and impact of clinical pharmacist intervention in resolving drug-related problems (DRPs) among patients with CKD. A single-arm, pre- and post-intervention study design was used, which was assessed to be suitable in testing for the feasibility of the implementation of an intervention in clinical practice. With this study pre- and post-intervention variables of interest were measured before and after an intervention in the same patients to evaluate the impact of clinical pharmacists on ambulatory patients with CKD. The findings of this study indicate a high prevalence of DRPs, with every patient experiencing at least one DRP. The mean DRPper patient was found to be 2.903 with STD ± 1.148. The study assessed the considerable influence of clinical pharmacist intervention on DRPs. The predominant form of DRPwas drug interaction 167 (45.1%) which was reduced to 76 (20.5%) after intervention carried out by clinical pharmacists statistically significant (p = 0.032). Another common DRP was found to be poor compliance issues in pre-interventions (n = 144 (38.9%)) and was reduced to 80 (21.6%) at post-intervention significantly (p = 0.042).Untreated indications were noticed in 137 cases (37.0%), after pharmacist intervention, this number was significantly reduced to 27 cases (7.3%), with a statistically significant difference (p = 0.004). However, it is noteworthy that medication compliance among patients in our study was unsatisfactory and fell below expectations. As a clinical pharmacist played an important role in reducing the prevalence of poor medication adherence to lower levels in these CKD outpatients. This research emphasizes the vital role of clinical pharmacists in mitigating DRPs among CKD patients, resulting in improved medication management and potentially better health outcomes.

Real-World Incidence and Severity of Hypertension Caused by Abiraterone Acetate in Patients With Metastatic Prostate Cancer.

Abiraterone acetate (AA) is used in treatment of patients with metastatic prostate cancer. Despite the survival advantage, AA is associated with hypertension due to mineralocorticoid excess syndrome. We conducted a single-center retrospective analysis to evaluate the real-world incidence and severity of AA-induced hypertension. Electronic health records were used to collect baseline characteristics and prostate cancer history. Patient data, including blood pressure at each 4 (±2)-week interval, were collected for 24 weeks after the initiation of AA therapy. The primary endpoint was the incidence and severity of AA-induced hypertension. The secondary endpoints include effect of different prednisone dosing regimens and prostate cancer types on hypertensive incidence and the impact of clinical pharmacists' involvement in managing AA-induced hypertension. A total of 142 patients who met our inclusion criteria received AA for metastatic prostate cancer, 73 (51.4%) with metastatic castration-resistant prostate cancer (mCRPC), and 69 (48.6%) with metastatic castration-sensitive prostate cancer (mCSPC). Of all, 43.7% experienced all-grade hypertension, and 28.2% experienced grade 3-4 hypertension. There was no difference in incidence of hypertension between patients receiving 5 mg of prednisone daily and those receiving 5 mg of prednisone twice daily. All-grade hypertension occurred in 39.7% of mCRPC and 47.8% of mCSPC patients (P = 0.33). Thirty-two percent of patients were actively managed by a clinical pharmacist and had an overall trend of reduced hypertension severity after 12 weeks. This single-center, retrospective cohort study found that real-world metastatic prostate cancer patients who received AA had substantially higher incidence and severity of hypertension compared with clinical trials regardless of prednisone dose. In patients with mCRPC and mCSPC, the role of prednisone dose in hypertension incidence and severity warrants further investigation. Overall, results indicate the need for closely monitoring hypertension and optimization of anti-hypertensive therapy by multidisciplinary teams in metastatic prostate cancer patients receiving AA.

The impact of clinical pharmacists’ medication reconciliation upon patients’ admission to reduce medication discrepancies in the emergency department: a prospective quasi-interventional study

BackgroundThe role of the clinical pharmacist in medication reconciliation is well established. Upon patients’ admission, the reconciliation service mainly focuses on achieving an accurate and full drug history. This will achieve the best treatment plan and reduce medication discrepancies.Upon the recent implementation of clinical pharmacy services in the emergency department at Alexandria Main University Hospital, medication reconciliation was one of the most important duties that needed to be focused on.We hypothesized that clinical pharmacists are able to achieve patients’ drug history lists with higher accuracy than emergency physicians.ResultsA total number of 161 patients were included. Age was 58.59 ± (13.78) years, number of comorbidities was 2.39 ± (1.22) and number of home medications was 4.51 ± (2.72). Clinical pharmacists’ fulfillment of patients’ drug history was significantly more accurate than the emergency physicians (75.16% and 50.3% of the total number of revised patients’ profiles respectively). The clinical pharmacists could put a written copy of the accurate patients’ drug history list in only 50.93% of the revised patients’ profiles. Five hundred eighty-five medication discrepancies were detected which represent an average of 3.63 discrepancies/medication sheet. Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for medication reconciliation and the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index were used to categorize discrepancies. Categories A, B, and C represented (66.5%), while categories D, E, and F represented (33.5%) of the total discrepancies. There was a significant direct relationship between the total number of discrepancies and both the number of comorbidities and the number of drugs administered before hospital admission.ConclusionThe clinical pharmacists are the main members of the emergency health care team. One of their fundamental services is medication reconciliation. The establishment of a complete drug history list and physicians’ discussion about the current treatment plan can obviously detect and reduce medication errors.Trial registrationNCT04395443. Registered 16 May 2020.

Evaluation of the effectiveness regarding the participation of pharmacists in perioperative blood glucose management via the iGMS: a pilot RCT

BackgroundExcellent blood glucose management is a key guarantee for successful progress of surgery. However, the impact of clinical pharmacists on blood glucose management of perioperative patients needs to be further investigated. To investigate the effectiveness regarding the participation of pharmacists in blood glucose management via the informatized glucose management system (iGMS) on perioperative patients with type 2 diabetes mellitus (T2DM).MethodsThe working mode of clinical pharmacists participating in blood glucose management of perioperative patients with diabetes was constructed. A total of 300 patients with T2DM who underwent elective surgery were recruited and divided into a clinical pharmacist management group (intervention group) of 150 patients (94 men and 56 women; mean age: 44.38 ± 14.03 years) and a control group of 150 patients (101 men and 49 women; mean age: 47.85 ± 12.26 years) between September 2019 to April 2020. The outcomes of perioperative blood glucose management, and healthcare indicators such as preoperative waiting time, total hospitalization time, postoperative infection rate and other indicators were analyzed statistically between the two groups.ResultIn the blood glucose management team of the whole hospital, the physicians, clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members, and were responsible for perioperative blood glucose management of the participants in the intervention group. All subjects had lower blood glucose after 3 days of management compared to the time of admission, and blood glucose was significantly lower in the intervention group compared to the control group (P < 0.05). As compared with the control group, subjects in intervention group demonstrated significant differences in outcome measures. The relevant parameters included preoperative blood glucose compliance rate (60.67% vs. 35.33%, P<0.05), preoperative waiting time [(5.27 ± 3.34) vs. (7.45 ± 4.38), P<0.05], length of hospitalization [(11.11 ± 4.56) vs. (14.87 ± 5.39), P<0.05], incidence of hypoglycemia (8.67% vs. 18.00%, P<0.05), incidence of hyperglycemia (32.00% vs. 62.67%, P<0.05) and postoperative infection rate (18.00% vs. 24.67%, P > 0.05).ConclusionThe involvement of clinical pharmacists in blood glucose management utilizing the iGMS can control the blood glucose level of patients with T2DM in the perioperative period more stably and effectively, thereby leading to an improvement in the quality of healthcare.

Impact of clinical pharmacist’s interventions on clinical outcomes in appropriate use of colistin: a prospective pre-post intervention study

This study aims to evaluate the clinical pharmacist’s contribution impact on the appropriate use of colistin. Our study was conducted prospectively in patients in the Internal Diseases Intensive Care Unit of Gazi University Medical Faculty Hospital for eight months. The first four months of the study were with the observation group, while the next four months were with the intervention group. The study determined how the active participation of clinical pharmacists had affected the appropriateness of colistin use. The results showed that the appropriate use of colistin was higher in the intervention group than in the observational group; furthermore, incidence of nephrotoxicity was lower. The difference between both groups was statistically significant (p < 0.001, p < 0.05), respectively. This study showed that the clinical pharmacist’s active intervention by following the patients increased the frequency and percentage of the appropriate use of colistin. This decreased the incidence of nephrotoxicity, colistin’s most important side effect.

The impact of pharmacist early active consultation (PEAC) on multidrug resistance organism treatment outcomes: A prospective historically controlled study

Background and aim: Infectious disease (ID) consultation can improve multidrug-resistant organism (MDRO) treatment outcomes. However, the impact of clinical pharmacists' ID consultation on MDRO therapy, especially early initiation, has not been reported. In this study, we try to explore the impact of the pharmacist early active consultation (PEAC) on MDRO patient management. Methods: We conducted a prospective historical controlled study based on PEAC in MDRO patients. The retrospective control group was patients hospitalized 18months before the PEAC initiation, and the prospective PEAC group was patients hospitalized 18months after the PEAC initiation. Primary endpoint was 30-day all-cause mortality. Secondary outcomes were MDRO clinical outcome, duration of antibiotic use, length of stay, antibiotic consumption and antibiotic costs. Further subgroup analysis of secondary outcomes was performed by the condition at admission, MDRO pathogenicity and MDRO clinical outcome. Results: 188 MDRO patients were included. After adjusting for potential predictors, PEAC reduced the 30-day all-cause mortality by 70% (HR 0.30, 95% CI 0.09-0.96, p = 0.042). PEAC group had clinical improvement than control group (89.47% vs. 65.59%, p < 0.001), especially in patients with non-severe clinical conditions at admission (98.41% vs. 70.18%, p < 0.001). However, no significant differences were found between groups in length of stay, antibiotics consumption, and antibiotics costs. Conclusion: Early active pharmacy ID consultation can reduce 30-day all-cause mortality and improve clinical outcomes in MDRO patients.

Impact of Clinical Pharmacist on Improving Medication Adherence among Type-2 Diabetes Mellitus Patients in Tertiary Care Teaching Hospital, Sangareddy: A Prospective - Interventional Study

According to IDF Atlas 10th edition Diabetes prevalence is increasing Globally. 537 million adults (20-79 years) are living with diabetes -1 in 10. This number is predicted to rise to 643 million by 2030 and 783 million by 2045. Medication adherence is a major universal factor influencing patient health out-comes, particularly in chronic conditions such as Diabetes. Non- adherence or Poor adherence to anti diabetic medications can cause therapeutic failure, leading to manifestation of diabetes- related complications such as retinopathy, nephropathy, neuropathy etc., reduced quality of life and increased health care costs. To forestall these, likely predictors of medication non- adherence should be assessed and addressed appropriately. The purpose of this study was therefore, to assess medication adherence among type 2 diabetes mellitus patients and to identify the patient characteristics and probable factors associated with medication non- adherence.

Impact of clinical pharmacist's educational intervention tools in enhancing public awareness and perception of antibiotic use: A randomized control trial

IntroductionIn most developing countries, antimicrobial resistance is a public threat, and insufficient knowledge of antibiotics among the public adds to it. This study aimed to determine the efficacy of the clinical pharmacist's pamphlets and video-based educational tools to address the public's knowledge, attitude, and practice gaps on antibiotic use. MethodsThis was a pre-and post-intervention cohort study of the adult population in South India who can read and understand Tamil or English. The study participants were designated into two groups-usual care group (pamphlet-based) and interventional group (video-based), with a pre-intervention assessment using a self-administered questionnaire, followed by an educational intervention by a clinical pharmacist, and finally, a post-intervention assessment after three months. ResultOf the162 respondents, the majority were female (58%), in the age group of 26–35 (30%), with intermediate education (43%) from a middle-income family. The mean score calculated for each domain among the two groups: knowledge score (Pamphlet based-Pre: 2.26 ± 1.13; post: 3.23 ± 1.02), (Video based-Pre: 2.22 ± 1.45; post: 3.95 ± 0.89), Attitude score (Pamphlet based-Pre: 2.53 ± 1.96; post: 3.23 ± 0.9), (Video based-Pre: 2.39 ± 1.81; post: 4.21 ± 1.35), Practice score (Pamphlet based-Pre: 2.19 ± 1.02; post: 4.46 ± 1.81). A significant improvement was observed in all domains of the video-based counselling group compared to the pamphlet-based (p < 0.001). ConclusionClinical pharmacists can effectively help in combating growing catastrophic AMR. Newer technologies need to be deployed in healthcare to educate the unreached. This study gives an insight into the technology-supported educational tool to provide awareness to the public effectively.

The Impacts of Clinical Pharmacists' Interventions on Clinical Significance and Cost Avoidance in a Tertiary Care University Hospital in Oman: A Retrospective Analysis.

Objectives: Pharmaceutical interventions are implicit components of the enhanced role that clinical pharmacists provide in clinical settings. We aimed to study the clinical significance and analyze the presumed cost avoidance achieved by clinical pharmacists’ interventions. Methods: A retrospective study of documented clinical pharmacists’ interventions at a tertiary care hospital in Oman was conducted between January and March 2022. The interventions were electronically recorded in the patients’ medical records as routine practice by clinical pharmacists. Data on clinical outcomes were extracted and analyzed. Cost implications were cross checked by another clinical pharmacist, and then, cost avoidance was calculated using the Rx Medi-Trend system values. Results: A total of 2032 interventions were analyzed, and 97% of them were accepted by the treating physicians. Around 30% of the accepted interventions were for antimicrobials, and the most common type was dosage adjustment (30%). Treatment efficacy was enhanced in 60% and toxicity was avoided in 22% of the interventions. The presumed cost avoided during the study period was USD 110,000 with a projected annual cost avoidance of approximately USD 440,000. Conclusion: There was an overall positive clinical and financial impact of clinical pharmacists’ interventions. Most interventions have prevented moderate or major harm with a high physician acceptance rate. Optimal documentation of the interventions is crucial for emphasizing clinical pharmacists’ value in multi-specialty hospitals.

Impact of Clinical Pharmacists on Access to Care in an Epilepsy Clinic.

Epilepsy affects about 1% of the world population and is one of the most burdensome diseases in terms of disability-adjusted life-years. The demand for neurologists and epileptologists is expected to exceed current supply by 2025. One potential strategy to increase access to epilepsy care is to utilize clinical pharmacist practitioners (CPPs) with a broad scope of practice. Appointments at the William S. Middleton Memorial Veterans Hospital (WSMVH) epilepsy clinic in Madison, Wisconsin, were reviewed to determine the percentage of appointments completed by a CPP or clinical pharmacy resident from October 2019 to May 2021. Additionally, a retrospective chart review was completed on 446 veterans to identify the types of interventions made by a CPP or clinical pharmacy resident at each appointment from October 2017 to June 2021. The CPP or clinical pharmacy resident held approximately 43% of 591 total appointments and spent a mean 27 minutes with each patient. Medication interventions occurred at 27% of 446 appointments in the retrospective chart review. Half (50.4%) of all patients seen by a CPP completed at least 1 mental health screening. The integration of a CPP WSMVH epilepsy clinic allowed for greater and more timely access to care and allowed for the epileptologists to focus their time on new consults, Epilepsy Monitoring Unit admissions, and higher acuity cases.

Perceptions of the roles and impact of clinical pharmacists by students in health-related disciplines in a Nigerian university

Background: The expanded responsibilities of pharmacists have created friction with other health professionals. This study sought to assess the perceptions of the roles and impact of clinical pharmacists by students in health-related disciplines in a Nigerian university. Methods: This was a cross-sectional survey of fifinal year students in eight health-related disciplines in the University of Nigeria Nsukka. Data were collected with a 37-item structured self-administered questionnaire and analyzed using the IBM SPSS Version 25. Pearson's Chi-Square tested the association between variables while multiple linear regression determined the predictors. Statistical signifificance was set as P&lt; 0.05. Results: Of the 790 eligible students, 463 participated. Three-fififths of the respondents had previously done Students Industrial Work Experience Scheme (SIWES)/Industrial Training (IT) in a hospital (n = 283, 61.1%). More than half of the respondents agreed that clinical pharmacists should participate in ward rounds (n = 326, 70.4%). Less than half of them (n = 184, 39.7%) agreed that clinical pharmacists should manage patients with chronic diseases. Majority of the students (n = 451, 97.4%) agreed that clinical pharmacists are necessary to the healthcare system. Overall, less than half of the respondents had a positive perception of the roles (n = 200, 43.2%) and impact (n = 195, 42.1%) of clinical pharmacists. Being in a department other than pharmacy signifificantly predicted a decrease in the positive perception of the roles (B = -4.187, P &lt; 0.001) and impact (B = -0.826, P &lt; 0.001) of clinical pharmacists. Having a pharmacist as an immediate family member increased the positive perception of the roles of clinical pharmacists (B = 0.889, P= 0.005). Undergoing SIWES/ITin a hospital (B = 0.598, P &lt; 0.001) signifificantly predicted an increase in the positive perception of the impact of clinical pharmacists. Conclusion: Less than half of the respondents had a positive perception of the roles/impact of clinical pharmacists. Interprofessional education should be encouraged.

Abstract P1-18-23: Implementation and evaluation of a shared care model between oncologists and pharmacists for advanced breast cancer patients on cyclin-dependent kinase (CDK) 4/6 inhibitors

Abstract Background: The introduction of CDK4/6 inhibitors for advanced hormone receptor positive, HER2 negative, breast cancer patients has contributed to increased ambulatory patient visits for oncologists. Oncology clinical pharmacists have training and expertise in medication management and adherence. The aim of the Medication Assessment by Pharmacist (MAP) program is to evaluate the impact of clinical pharmacists performing medication assessment follow-up visits. Methods: Metastatic breast cancer patients on a CDK4/6 inhibitor (palbociclib or ribociclib) deemed suitable for pharmacist assessment were identified by medical oncologists at British Columbia (BC) Cancer Surrey. Oncologists can book the patient for a pharmacist medication assessment appointment at alternate cycles. The clinical pharmacist uses standardized medication assessment forms, provincial protocols and toxicity management guidelines. Results: Between April 2018 to December 2019, 82 patients were initiated on a CDK 4/6 inhibitor at BC Cancer Surrey. Of these, 12 patients (14.6%) were selected for the MAP program for a total of 17 pharmacist visits. This resulted in 340 minutes of clinic time savings for physicians. Patients who underwent the MAP program were more likely to follow provincial and regional protocols for scheduling clinic visits (99%) as compared to those who did not (96%). Rates of monitoring investigations adhering to provincial protocols were similar between those in the MAP program or not (97.6% versus 97.7%). There was a 100% physician and pharmacist survey response rate with a total of 9 physicians and 9 pharmacists participating. 100% of surveyed pharmacists agreed or strongly agreed when asked whether MAP increased job satisfaction. 100% of physicians indicated that MAP reduced physician workload. Physicians and pharmacists who participated in MAP all agreed or strongly agreed when asked if patients were receptive to meeting with a pharmacist. Only 33% of physicians routinely ask about medication adherence, newly started medications or natural health supplements at each visit, as compared with 100% of pharmacists. 100% of physicians reported that they wanted to see MAP expanded to include additional oncology drugs. Conclusions: This study demonstrates that expanding the role of clinical oncology pharmacists and their integration in a shared care model with oncologists can reduce ambulatory patient visits for oncologists without compromising clinical care. Additionally, leveraging pharmacist expertise helps to enhance care by evaluating medication adherence and concurrent drug therapies. Based on this program, MAP has expanded to include additional cancer centres and other oral cancer therapies. This shared care model in the ambulatory oncology setting may be a way to help alleviate projected shortages of oncology providers. Citation Format: Angela Chan, Sylvie Labelle, Elaine Goh. Implementation and evaluation of a shared care model between oncologists and pharmacists for advanced breast cancer patients on cyclin-dependent kinase (CDK) 4/6 inhibitors [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P1-18-23.

The Impact Of Clinical Pharmacists' Interventions On Drug-Related Problems At The Military Hospital, Omdurman, Sudan

Clinical pharmacists can help to identify, solve and prevent drug-related problems (DRPs) through appropriate interventions. The objective of this retrospective study was to identify DRPs, their causes and to evaluate how the clinical pharmacists' interventions can impact on them in the medicine department at the Military Hospital, Omdurman, Sudan. A total of 100 files belonging to patients admitted between September 2018- March 2019 were analyzed in this study according to specific criteria, of which 170 Clinical pharmacists' Intervention (CPIs) were made, and 152 DRPs were identified. The most common DRP found was untreated indication (not prescribed drug but clear indication) accounting for 32.9% (n=50) of total studied cases, followed by sub-therapeutic dose 14.5% (n=22), and drug interactions 12.5% (n=19). Interventions were made by clinical pharmacists based on the type of DRP. The acceptance of intervening pharmacist suggestions was found to be 57.6% (n=98), the remaining 41.8% (n=71) of interventions were not accepted. The study highlighted that the participation of clinical pharmacists in the medical ward had a positive impact on optimization of drug therapy by reducing drug-related problems.

The Impact Of Clinical Pharmacists' Interventions On Drug-Related Problems At The Military Hospital, Omdurman, Sudan

Clinical pharmacists can help to identify, solve and prevent drug-related problems (DRPs) through appropriate interventions. The objective of this retrospective study was to identify DRPs, their causes and to evaluate how the clinical pharmacists' interventions can impact on them in the medicine department at the Military Hospital, Omdurman, Sudan. A total of 100 files belonging to patients admitted between September 2018- March 2019 were analyzed in this study according to specific criteria, of which 170 Clinical pharmacists' Intervention (CPIs) were made, and 152 DRPs were identified. The most common DRP found was untreated indication (not prescribed drug but clear indication) accounting for 32.9% (n=50) of total studied cases, followed by subtherapeutic dose 14.5% (n=22), and drug interactions 12.5% (n=19). Interventions were made by clinical pharmacists based on the type of DRP. The acceptance of intervening pharmacist suggestions was found to be 57.6% (n=98), the remaining 41.8% (n=71) of interventions were not accepted. The study highlighted that the participation of clinical pharmacists in the medical ward had a positive impact on optimization of drug therapy by reducing drug-related problems.

POSC226 Perceptions of the Roles and Impact of Clinical Pharmacists By Nigerian Students in Health-Related Disciplines

POSC226 Perceptions of the Roles and Impact of Clinical Pharmacists By Nigerian Students in Health-Related Disciplines

Implementation of a strategy for identification and monitoring of clinical outcome measures in a department of pharmacy

Abstract Purpose To describe a department of pharmacy strategy to identify and monitor outcome measures that represent the impact of clinical pharmacy services on patient outcomes. Summary Our department established the Clinical Impact Committee, with the goal of developing and maintaining an approach to demonstrate the impact of clinical pharmacists on patient care outcomes. We describe the committee’s structure, aims, and key stakeholders, inclusive of both departmental leadership and clinical pharmacist representatives across service lines. We also describe the systematic process used by the committee for identifying clinical outcome measures that are both aligned with organizational priorities and representative of pharmacists’ impact. This involved assembly of a crosswalk of clinical outcome measures that are prioritized by the organization and attributable to the work of clinical pharmacists. We found it imperative to connect pharmacists’ efforts to the priorities of the organization to demonstrate value and continue to justify pharmacy resources. Once the crosswalk of clinical outcome measures was assembled, the Clinical Impact Committee leveraged modified Delphi methodology to build consensus on the measures to prioritize. Once determined, the final outcome measures were developed into outcomes dashboards, to be monitored by the committee and leveraged by frontline pharmacists. Conclusion Our organization was successful in developing a structure, the Clinical Impact Committee, to identify, prioritize, and monitor measures that demonstrate pharmacist contributions to patient care outcomes. Further, our approach includes an intentional alignment with organizational priorities, allowing us to understand and communicate the contributions of our teams to meeting-defined organizational quality priorities.

Management of Drug-Drug Interactions among Critically Ill Patients with Chronic Kidney Disease: Impact of Clinical Pharmacist's Interventions.

ABSTRACTBackground and objectivesDrug–drug interactions (DDIs) can create a burden on prescribers to preserve patient safety. This study aimed to identify common DDIs in critically ill patients with chronic kidney disease (CKD) and to evaluate clinical pharmacist's interventions in managing DDIs among these patients.MethodsA prospective observational study was conducted from October 2018 to March 2019. The clinical pharmacist performed a medication chart review; DDIs were identified by using Lexicomp® drug interaction. Based on the occurrence of DDIs, patients were divided into group A: patients with DDI (n = 76) and group B: patients without DDI (n = 15). Clinical pharmacist's interventions were classified according to Pharmaceutical Care Network Europe. The National Coordinating Council for Medication Error Reporting and Prevention was used to categorize the severity outcomes of DDIs and the degree of patient harm.ResultsA total of 273 DDIs were identified. The majority of DDIs (63.7%) required close monitoring of the therapeutic outcome to ensure maintaining patient safety. DDIs that needed to be managed by considering therapy modification and avoiding drug combination were accounted for 17.2 and 12.8% of the most common detected interactions, respectively. Seventy-eight percent of DDIs induced no harm to patient. Clinical pharmacist provided different types of recommendations to manage detected interactions, which ranged from therapy outcome monitoring to stop DDIs. A great proportion of pharmacist's interventions (92%) were accepted by prescribers. Compared to patients with stage 3 and 4 CKD, patients with stage 5 had a significantly higher number of DDIs (stage 3 vs 5: p = 0.0019, stage 4 vs 5: p = 0.0456). The number of comorbidities (p = 0.0003) and (p <0.0001) medications were found to be significantly greater in group A.ConclusionClinical pharmacist performed important interventions in timely identifying, managing DDIs, and prevention of associated patient harms.How to cite this articleAghili M, Kasturirangan MN. Management of Drug–Drug Interactions among Critically Ill Patients with Chronic Kidney Disease: Impact of Clinical Pharmacist's Interventions. Indian J Crit Care Med 2021;25(11):1226–1231.

English

Hypertension and diabetes co-morbidity are very common chronic diseases in today&rsquo;s world. Patients with such conditions may have medication related problems. Assessment was made on the impact of clinical pharmacists&rsquo; led education and counselling in patients with co-morbid hypertension and diabetes in a hospital setting. This study was done at the medical outpatient department (OPD) of a Municipal Hospital in Tema in the Greater Accra Region of Ghana. This was an intervention study conducted in patients with co-morbid hypertension and diabetes (n=338). Patients were randomized to the case group (n=144) and the control group (n=194). Patients in the case group received the education and counselling from the clinical pharmacists&rsquo;, whilst patients in the control group had the usual care. Patients in the case group had a better knowledge (p&lt;0.0001) and adhered (p&lt;0.0001) to their medication than those in the control group. The case group had a significant reduction in body mass index (p=0.005), systolic blood pressure (p&lt;0.0001), diastolic blood pressure (p&lt;0.0001) and fasting plasma blood glucose (p&lt;0.0001). The clinical pharmacists&rsquo; led counselling and education to support the management of co-morbid hypertension and diabetes at the hospital helped improved patient outcomes. Key words: Co-morbid, diabetes, hypertension, intervention, counselling, education.