Impact Of Pharmacists Research Articles

Impact of clinical pharmacist on home health care patients in hail region

The primary aim of this research is to assess how the involvement of clinical pharmacists can influence home health care patient’s outcomes, including medication management, adherence to prescribed therapies, and overall patient satisfaction. To achieve this, the study adopted a descriptive and quantitative approach. Data gathered through an electronic questionnaire specifically targeted at home health care patients, totaling 112 individuals, aiming to capture their experiences and perceptions regarding the contributions of clinical pharmacists to their health care. This questionnaire included questions that focus on the effectiveness, accessibility, and patient-centered care provided by clinical pharmacists. The collected data then systematically analyzed using the Statistical Package for the Social Sciences (SPSS) application, allowing for the identification of trends, correlations, and potential areas for improvement in clinical pharmacy services. The study finally concluded that.

Pharmacists in global primary healthcare systems: A comprehensive model for community health empowerment

Pharmacists play an increasingly important role in global primary healthcare systems, evolving from traditional dispensers to active participants in patient-centered care. This paper advocates for the stronger integration of pharmacists into healthcare teams to improve patient outcomes, medication adherence, and overall healthcare delivery. Through a comprehensive review, we examine the evolving role of pharmacists, the key challenges to their full integration, and the substantial opportunities they present, particularly in managing chronic diseases, providing preventative care, and enhancing patient education. We propose a model for empowering pharmacists to contribute more effectively to community health, especially in underserved areas. The paper also highlights the potential global impact of pharmacists in reducing healthcare costs, improving disease management, and promoting public health initiatives. Lastly, recommendations for future policy reforms, education enhancements, and research directions are offered to support the continued expansion of pharmacists' roles in primary healthcare systems worldwide.

Pharmacotherapy of acute ST-elevation myocardial infarction and the pharmacist's role, part 1: Patient presentation through revascularization.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Key pharmacotherapeutic modalities and considerations for the patient with ST-elevation myocardial infarction (STEMI) across the critical initial phases of care are reviewed. Despite established value in the emergency department (ED), cardiac care, and intensive care settings, there is currently little published literature describing or supporting clinical pharmacist roles in the acute management of STEMI. The high-risk period from hospital presentation through revascularization and stabilization involves complex pharmacotherapeutic decision points, many operational medication needs, and multiple layers of quality oversight. While rife with opportunities for pharmacists to optimize care, this timeframe appears inconsistently targeted by clinical pharmacy services, which may halt after ED evaluation and then resume upon postcatheterization cardiac unit admission. Herein we review the key pharmacotherapeutic modalities and considerations for the patient with STEMI across the critical initial phases of care. These include supportive therapies prior to revascularization, the host of antithrombotics involved in revascularization by percutaneous coronary intervention and/or fibrinolysis, and other periprocedural medications. Important practice guidelines and clinical resources are summarized from the clinical pharmacist perspective, and roles and responsibilities of the responding pharmacist are suggested. A companion article will extend the review to periprocedural adverse event management, key early decision-making regarding long-term risk reduction, and pharmacist involvement in institutional quality improvement efforts. We aim to support inpatient pharmacy departments in advancing clinical services for this critical patient population, and we call for further research delineating pharmacist impact on patient and institutional STEMI outcomes. Patients presenting with STEMI rapidly traverse multiple phases of care and receive a host of antithrombotic and supportive medications during acute management, presenting many important pharmacotherapeutic decision points and roles for pharmacists.

Feasibility of trauma video review for the collection of medication-related information for research and quality improvement.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Trauma video review (TVR) involves reviewing video recordings of team-based trauma response to evaluate team performance, identify improvement opportunities, and assess procedures, but the feasibility of using TVR to gather medication-related information is unknown. We aimed to assess the feasibility of using TVR for data collection of medication-related variables for research and quality improvement by comparing and describing differences between TVR and electronic medical record (EMR) review. This was an observational study of level I/II trauma patients treated between November 2022 and March 2023. Patients with video recording started within 1 minute of arrival, at least 1 medication administered, and with pharmacist participation in care were included. The number of variables able to be collected by TVR or EMR review were compared and reported in the categories of medication administration, indicators of adverse drug events (ADEs), medication errors, and communication. The numbers and types of discrepancies between data collection modalities were quantified and described. Agreement between TVR and EMR review was assessed and reported as an intraclass correlation coefficient (ICC). Twenty-five patients were included; 758 and 1,011 variables collected by TVR and EMR review, respectively. In total, 689 variables were collected by both methods, and data collection modalities matched exactly in 4 of 25 patients (16%); ICC, 0.677 (moderate level of agreement). There were 46 (6.7%) discrepancies; 84% involved communication related variables. TVR missed more variables than EMR review, mostly medication errors and inability to assess ADEs but captured more communication-related variables. TVR and EMR review together offer a greater source of medication-related information for data collection compared to either alone. EMR review collected medication administration, ADE, and medication errors variables more often than TVR and TVR was better able to collect communication-related variables. When designing studies/quality improvement efforts related to medication use during trauma resuscitation (e.g., pharmacist impact on time to administration), combined data collection modalities should be used, when available.

Transitions of Care Pharmacist Impact Following Hospitalization for Acute Myocardial Infarction.

Background: Patients admitted with acute myocardial infarction (AMI) are at high risk for morbidity and rehospitalizations. Pharmacists can play a vital role in secondary prevention by providing services such as medication reconciliation and patient education upon discharge. Objective: The purpose of this study was to evaluate the impact of a pharmacist-led transitions of care (TOC) service on readmissions in patients hospitalized with AMI. Methods: This single center, pre-post observational cohort study evaluated adults with AMI who received pharmacist TOC services compared with a historical cohort who did not. Patients were excluded if they underwent cardiac surgery during admission. The primary outcome was the difference in 90-day cardiovascular (CV)-related readmissions. Secondary outcomes included 30- and 90-day all-cause readmissions, 30-day CV-related readmissions, and patients discharged on defect-free guideline-directed medical therapy (GDMT) for AMI. Results: There were 252 patients in each cohort included. No difference was found in 90-day CV readmissions, with a rate of 10.7% in the pre-TOC group versus 9.9% in the post-TOC group (OR 0.937, 95% CI [0.493, 1.769]; P = 0.842). Patients discharged on defect-free GDMT significantly increased from 61.5% pre-TOC to 87.7% post-TOC (OR 5.424, 95% CI [3.204, 9.468]; P < 0.001). There were no significant differences found in other key secondary outcomes. Conclusion and relevance: This study did not find a significant difference in hospital readmissions after implementation of a pharmacist-led TOC service. However, the service was associated with a significant increase in patients discharged on defect-free GDMT. Further studies are needed to confirm the impact of increased GDMT on clinical outcomes.

The impact of clinical pharmacists on adherence to acute myocardial infarction guidelines: A controlled before-after Interventional study

In this controlled before-and-after interventional study, the clinical pharmacist evaluated the application of performance measures (PMs) and quality measures (QMs) in the control group and the intervention group in Al-Gurayat General Hospital (GGH) in Saudi Arabia. The total number of PMs applied in the intervention group (n = 445) was significantly higher than that in the control group (n = 407) (P-value =0.006). Considering individual PMs, only PM-4 (high-intensity statin prescription) was applied at a significantly higher frequency in the intervention group (n = 41, 82%) as compared to the control group (n = 29, 58%) (P-value = 0.009). After acceptance of 60 out of the 75 recommendations made by the clinical pharmacist for the intervention group (80% acceptance rate), the number of treatment-related problems (TRPs) left on discharge of the intervention group was significantly reduced to 15 as compared to 61 TRPs left on discharge of the control group (p &amp;lt;0.001). The clinical pharmacist-led interventions have a significant impact on ensuring adherence to PMs during the management of acute myocardial infarction (AMI) in GGH.

The Impact of Clinical Pharmacists on Cardiovascular Disease Management in Spain: A Community Pharmacy-Based Intervention Study

Background: Cardiovascular Disease (CVD) is a significant global health concern, causing 17.3 million deaths annually. In Spain, CVD accounts for 14.6% of mortality, necessitating effective management strategies. Clinical Pharmacists (CPs) have emerged as crucial players in early CVD identification and management, particularly through community pharmacies. Methods: This study enrolled 900 individuals across 55 pharmacies, with 820 meeting inclusion criteria based on existing CVD risk factors. Participants were randomly assigned to either a control group receiving standard treatment (n = 353) or an intervention group receiving enhanced guidance from CPs (n = 375). Outcomes measured included changes in CVD risk factors, blood pressure, lipid profiles, and smoking cessation over a three-month period. Results: The intervention group exhibited a statistically significant reduction in projected CVD risk, with a mean decrease of 6.42% (p &lt; 0.001). Improvements were noted in LDL cholesterol, blood pressure, and body mass index in both groups, underscoring the effectiveness of CP-led interventions. No adverse events were reported. Conclusion: CPs play a vital role in managing CVD risk factors through education, counseling, and medication management. This study highlights the effectiveness of CP interventions in community pharmacy settings, emphasizing the need for further research to evaluate long-term clinical and humanistic outcomes. Expanding the role of CPs in the healthcare system could significantly alleviate the burden of CVD in Spain.

Development and evaluation of a model to identify publications on the clinical impact of pharmacist interventions

BackgroundPharmacists are increasingly involved in patient care. Pharmacy practice research helps them identify the most clinically meaningful interventions. However, the lack of a widely accepted controlled vocabulary in this field hinders the discovery of this literature. ObjectiveTo compare the performance of a machine learning model with manual literature searches in identifying potentially relevant publications on the clinical impact of pharmacist interventions. To describe the dataset that was built. MethodsAn automated PubMed search was performed weekly starting in November 2021. Titles and abstracts were retrieved and independently evaluated by two reviewers to select potentially relevant publications on the clinical impact of pharmacists. A Cohen's kappa score was calculated. Data was collected during an 11-month period to train a machine learning model. It was evaluated prospectively during a 5-month period (predictions were collected without being shown to the reviewers). The performance of the model was compared with manual searches (positive predictive value [PPV] and sensitivity). ResultsA transformers-based model was selected. During the prospective evaluation period, 114/1631 (7 %) publications met selection criteria. If the model had been used, 1273/1631 (78 %) would not have needed review. Only 3/114 (3 %) would have been incorrectly excluded. The model showed a PPV of 0.310 and a sensitivity of 0.974. The best manual search showed a PPV of 0.046 and a sensitivity of 0.711. On December 12, 2023, the dataset contained 8607 publications, of which 544 (6 %) met the criteria. The kappa between reviewers was 0.786. The dataset and the model were used to develop a website and a newsletter to share publications (https://impactpharmacy.net). ConclusionA machine learning model was developed and performs better than manual PubMed searches to identify potentially relevant publications. It represents a considerable workload reduction. This tool can assist pharmacists and other stakeholders in finding evidence that support pharmacists' interventions.

Analysis of the impact of pharmacist initiated management of antiretroviral therapy (PIMART) on health services inputs, processes and outcomes in South Africa

Analysis of the impact of pharmacist initiated management of antiretroviral therapy (PIMART) on health services inputs, processes and outcomes in South Africa

Research productivity and citation impact of Nigerian academic pharmacists: A cross-sectional study

Research productivity and citation impact of Nigerian academic pharmacists: A cross-sectional study

Reprint of: Impact of outpatient pharmacist dispensing in an opioid use disorder clinic

BackgroundMedications for opioid use disorder are effective in reducing opioid deaths, but access can be an issue. Relocating an outpatient pharmacist for weekly buprenorphine dispensing in an outpatient clinic may facilitate coverage for buprenorphine and mitigate access and counseling barriers. ObjectivesThis study aimed to evaluate whether staffing an outpatient resident pharmacist to dispense in the buprenorphine clinic had a positive impact on (1) mean cost per prescription charged to charity care and (2) basic elements of patient satisfaction with the on-site pharmacist. MethodsPatient demographics, buprenorphine formulation, insurance type, and uncovered costs were abstracted from dispensing records in the 16 weeks before the pharmacist clinic presence and 16 weeks with the pharmacist present. The difference in insurance types across the 2 periods was tested using a chi-square test, and the mean uncovered prescription costs charged to charity care for the 2 periods was compared using an independent-samples t test. A brief survey was administered while the pharmacist was on-site to evaluate satisfaction, which was analyzed with frequencies of “yes” responses and free-text comments. ResultsA total of 38 patients received buprenorphine during both the pre- and postperiods. Once the pharmacist was on-site, more patients used Medicaid or private insurance, decreasing the mean uncovered cost per prescription from $55.00 (SD 68.7) to $36.97 (SD 60.1) (P = 0.002). Patients reported high levels of satisfaction with most reporting they were more likely to ask questions, pick up their prescriptions, and take their medicine with the pharmacist in the clinic. ConclusionsThe pharmacist successfully transitioned a portion of prescriptions previously covered by charity care to Medicaid or private insurance. This shift led to a decrease in charity care costs by $2950.20 and a reduction in the average uncovered cost per prescription. The pharmacist’s presence in the clinic seemed to reduce barriers especially related to inconvenience.

Impact of the Clinical Pharmacist in Rheumatology Practice: A Systematic Review.

This is a systematic literature review on the impact of pharmacists in rheumatology, conducted using the PubMed®, CINAHL®, Cochrane Library®, and Web of science® databases and using the PRISMA 2020 checklist. This review was conducted from 2000 to June 2024. A quality analysis was performed. The selection of articles, as well as all analyses, including quality analyses, were conducted by a pair of pharmacists with experience in rheumatology, and included 24 articles. This study highlights the growth of clinical pharmacy activities in rheumatology and the positive influence of clinical pharmacists on patient care. The implementation of such initiatives has the potential to improve medication adherence, reduce medication-related risks, and optimize associated healthcare costs. All these pharmaceutical interventions aim to make the patient care journey smoother and safer. Additionally, the diversity of available pharmaceutical services caters to the varied needs of rheumatology. Furthermore, outpatient clinical pharmacy is also explored in this field and garners interest from patients. The vast majority of studies demonstrate significant improvement in patient care with promising performance outcomes when pharmacists are involved. This review highlights the diverse range of interventions by clinical pharmacists in rheumatology, which is very promising. However, to better assess the benefits of clinical pharmacists, this activity needs further development and evaluation through controlled and randomized clinical research programs.

Impact of pharmacist managed oral epidermal growth factor receptor inhibitors.

Pharmacists are an integral part of medication management, with the positive impact of their clinical services in patient outcomes previously studied and reported in literature. The roles and responsibilities of pharmacists continue to expand, including optimizing patient medication and health outcomes related to complex oral anticancer drugs. To evaluate the impact of a pharmacist-managed oral chemotherapy clinic in patients with non-small cell lung cancer (NSCLC) taking oral epidermal growth factor receptor inhibitor (EGFRi) regimens within an integrated healthcare delivery system. This was an observational cohort study using data from Kaiser Permanente Northern and Southern California regions on adult patients who received oncology pharmacist-managed care compared to patients with usual care. Patients were newly initiated with EGFRi therapy to treat NSCLC between 2017 and 2019. The follow-up period was defined as the time from index date (first sold date of EGFRi) to December 2020 or end of membership or death, whichever occurred first. Primary outcome measures included adherence to EGFRi, frequency of imaging during drug exposure, and presence of imaging prior to treatment change. Outcomes were analyzed with Chi-square test for categorical variables, and Student's t-test or Wilcoxon rank-sum test for continuous variables. There were 613 patients in the pharmacist-managed group and 714 patients in the usual care group. Overall, the mean age was 68.2 ± 11.3 years, and 65.1% were female. In the pharmacist-managed group, there was a significantly higher mean proportion of days covered (PDC) during the first three months of therapy (0.86 ± 0.24 vs 0.82 ± 0.36, p = 0.01) and a higher percentage of patients who were adherent to EGFRi therapy (with PDC ≥0.80) during the drug exposure period (95.8% vs 92.4%, p = 0.01). The rate of computed tomography (CT) and magnetic resonance imaging (MRI) during drug exposure was higher in the pharmacist-managed group compared to the usual care group (31.8% vs 20.7%, p < 0.01) with a higher number of mean scans completed per patient (1.15 ± 2.42 vs 0.62 ± 1.63, p < 0.01) and per patient-year (2.60 ± 7.27 vs 1.58 ± 5.95, p < 0.01). Overall, 66.2% of patients had a treatment change, with a higher percentage of patients in the pharmacist-managed group who completed a CT or MRI scan prior to treatment change (36.3% vs 26.3%, p < 0.01). Additionally, the median time between the scan and treatment change was shorter for patients with pharmacist-managed care (1.8 vs 4 months, p = 0.04). Clinical pharmacy services contributed to improved adherence, higher rates of imaging, and shorter time between imaging and treatment changes in NSCLC patients who were taking EGFRi regimens.

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.

Impact of a pharmacist-led intervention on prostate cancer illness perception.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Illness perception (IP) significantly determines illness outcomes. This study determined the impact of a pharmacist educational intervention on IP in patients with prostate cancer (PCa) and predictors of IP. Using a brief IP questionnaire, an interventional study of patients with PCa was conducted in all cancer reference hospitals in one Nigerian state. After a pre-post assessment of patients' IP, descriptive and inferential statistical analyses were performed. The impact of pharmacists' intervention on IP was determined by paired-sample statistics and correlation analysis at the 95% CI. Relationships and predictors of IP were determined using Kendall's tau-b (τb), likelihood ratio, and F tests of equality of means, respectively. P < 0.05 was considered statistically significant. Pharmacists' educational intervention significantly improved IP (SEM, 0.13; r = 0.875; P < 0.0001) among the 200 participants. The analyses also showed a significant paired sample difference (2.662; SEM, 0.06; 95%CI, 2.536-2.788; t = 41.69; df = 199; P < 0.0001). All subscales of patients' IP significantly improved except for illness consequences (P = 0.173) and identity (mean [SD], 4.40 [3.730] in both pre- and postintervention assessments). Pre- and postintervention assessments showed a significant negative relationship of IP with age (τb = -110 [P = 0.040] and τb = -14 [P = 0.021], respectively), Gleason score (τb = -0.125 [P = 0.021] and τb = -0.124 [P=0.012], respectively), and age at diagnosis (τb = -0.103 [P = 0.036] post intervention). IP was significantly dependent on the drug therapy (df = 8; mean square [M] = 6.292; F = 2.825; P = 0.006), alcohol intake (df = 1; M = 9.608; F = 4.082; P = 0.045) and Gleason score (df = 9; M = 6.706; F = 3.068; P = 0.002). Patients' IP significantly improved after pharmacists' educational intervention. Predictors of IP were drug therapies, alcohol use and Gleason score. Findings can be extrapolated in clinical settings to improve treatment outcomes.

Assessment of a Geriatric Evaluation and Management in the Home (GEMITH) Service at a Quaternary Hospital: A Retrospective Observational Study.

Background: The increasing aging population in Australia has created a higher demand for specialist geriatric services within hospitals. A Geriatric Evaluation and Management in the Home (GEMITH) service was implemented at a quaternary Queensland hospital. The GEMITH service was unique as it incorporated a specialist pharmacist into the multidisciplinary team. Objective: To determine the medication safety and quality impact of the GEMITH service by evaluating the type and clinical significance of specialist pharmacist interventions. Methods: This was retrospective observational study of clinical interventions made by the GEMITH pharmacist for patients admitted to the service between October 2020 to April 2021. All pharmacist interventions were rated for their clinical significance using the Society of Hospital Pharmacists of Australia (SHPA) risk classification system. The ratings were undertaken by a panel of three pharmacists that independently assessed the interventions, coming together for final discussion. A narrative analysis of the interventions were derived through group consensus. Results: There was a total of 119 admissions to the GEMITH service, with 132 clinical interventions made by the specialist geriatric pharmacist. The majority (47%) of interventions were considered as low risk interventions, although high- (21%) and extreme-risk (2%) interventions still occurred. The most common type of intervention (32%) involved medication reconciliation. Other intervention types included monitoring recommendations, dosing interventions, and deprescribing suggestions. Conclusion: Multiple clinical interventions were made by the GEMITH pharmacist, which prevented possible and significant medication-related harm. This demonstrated the quality impact of the specialist pharmacist in improving medication safety for geriatric patients.

Establishment of a clinical pharmacist-led multiple myeloma clinic with collaborative prescribing model at the national center for cancer care and research in Qatar

BackgroundMultiple myeloma (MM) is a chronic and incurable hematologic malignancy that is prevalent among the elderly. Interprofessional patient care showed superiority over physician-only care in multiple settings, including MM. ObjectiveThe primary objective of this study was to evaluate the impact of clinical pharmacist (CP)-led clinic and CPs interventions on MM patient care. Practice descriptionReal-world analysis of ambulatory patients with MM showed that CPs were central to the optimization of therapy and adherence to treatment schedules and supportive medications. Practice innovationThe CP-led MM Clinic was established with a collaborative prescribing agreement (CPA) in 2022 at the National Center for Cancer Care and Research in Qatar and was the first of its kind in the Middle East and North Africa region. This CPA allowed CPs to issue refills for supportive medications and order required laboratory tests. Evaluation methodsData collected included the number of CP interventions, refills ordered by CPs, documentation of patient education, and medication reconciliations. The data were retrospectively collected and analyzed comparing ambulatory patients with MM treated before (2021) to those treated after the clinic implementation in 2022. ResultsThe study population comprised 22 patients. A higher number of CPs interventions were documented post-clinic than preclinic (343 vs. 76, P = 0.004), with earlier initiation of bisphosphonate post-clinic (25 vs. 206 days, P = 0.008). There were also significant improvements in the introduction of risk appropriate venous thromboembolism prophylaxis (43% vs. 6%, P = 0.001) as well as vitamin D and calcium supplementation (100% vs. 68%, P = 0.02) post-clinic. Twenty-two medication refills for supportive medications and eight prechemotherapy laboratory investigations were ordered by CPs. ConclusionThe CP-led clinic provided a timely link to care optimization for ambulatory MM patients. This innovative CPA model implemented in the clinic could potentially be applied to different cancer settings to optimize safe and effective patient care.

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.

Clinical impact and financial feasibility of remote oncology pharmacists' roles in community oncology practices.

1545 Background: The clinical and financial impact of oncology-trained pharmacists in the community oncology setting has not been well documented. The US Oncology Network has introduced a novel remote oncology pharmacist model which provides clinical services to oncology community practices to alleviate the burden on oncologists, enhance patient care, and improve workflows. Methods: Oncology-trained pharmacists remotely reviewed chemotherapy regimens across 12 community oncology practices. Pharmacists identified opportunities to modify therapy based on clinical criteria, waste reduction, and/or financial stewardship. These modifications were discussed with the treatment team or implemented in accordance with practice-approved policies. Clinical and financial metrics were tracked to assess the overall impact of the pharmacist interventions and provider time saved. Results: From January 1, 2023, through December 31, 2023, 27,938 reviews were documented for 19,962 patients. Among these reviews, the majority (14,572, 73%) required modification by the pharmacist, and many (3,005, 21%) were deemed clinically significant by the intervening pharmacist. The most common clinically significant interventions included changes to anticancer drug doses (1155, 38%), modifications to supportive care (742, 25%) and recommendations for additional monitoring (426, 14%). Across 12 practices, 63 drug-related workflow policies were implemented allowing pharmacists to autonomously auto-substitute products, order laboratory tests and adjust chemotherapy doses. These policies saved over 600 hours of physician time. Pharmacist involvement resulted in medication-related margin improvements totaling $9.3M. Practices also experienced a $4.3M reduction in the total cost of care in medication expenses. The cost of the pharmacists during this period was $1.4M, equating to a 560% return on investment compared to margin improvement. Conclusions: Community oncology practices operate within a resource-constrained model with limited access to oncology pharmacists. As invaluable members of the care team, pharmacists identified opportunities to significantly enhance clinical care by focusing on medication safety, dosing, and regimen optimization, while demonstrating a tremendous financial impact on small-scale budgets. Oncology-trained pharmacists play a vital role in alleviating care burden of the clinical team by collaboratively developing practice-approved policies and reviewing clinical orders in a high-risk patient population.

Impact of pharmacists’ training on the knowledge of pain and associated risks: results of the OPTYMED 2 study

The use of OTC analgesics is common worldwide, and the importance of the pharmacy teams is growing. Pharmacist-led medication implies that the pharmacy staff should have the necessary knowledge to deliver appropriate drugs, prevent an inappropriate drug consumption, and identify the patients in need of a medical advice. A randomized controlled study to assess the impact of training on pain knowledge and associated situations at risk among the French pharmacists and dispensers was performed. Participants were randomized into two groups receiving (n = 97) or not (n = 93) a training in the e-learning format. The training consisted of the 4 modules including the general knowledge of pain, headaches, acute musculoskeletal and chronic pain. The training modules were accompanied by the summary leaflets. The success rates were significantly higher in the trained group, with 35 % of participants reaching at least 70 % (primary endpoint) versus 2.3 % in the non-trained group. The results were not influenced by the size of the pharmacy. The knowledge improvement was more pronounced for the modules on the general knowledge of pain and headache management. For the questions associated to the risk situations, the success rates of at least 70 % were also significantly higher in the trained group The highest difference in success rates after the training was observed for the use of nonsteroidal antiinflammatory drugs during pregnancy and breastfeeding. Very low rates were obtained in both groups for the secondary headaches and the analgesic treatment adjustment in particular cases, such as chronic alcoholism or low weight. Results of this pilot study show that a training focused on pain could improve the overall knowledge of pain and suggest that it may contribute to a better pain identification, management and referral to physicians of patients at risk by the pharmacy staff in routine practice. The benefits of such a training should be assessed in a long-term prospective study, and the impact of a similar training in real-life practice remains to be evaluated.