Implementation Of Pharmaceutical Care Research Articles

Analysis of clinical outcomes in older individuals who received pharmaceutical care and posthospital discharge follow-up.

Previous evidence underscores the need to assess potential clinical outcomes resulting from pharmaceutical care interventions and to monitor patient's progress to evaluate their clinical evolution, which is crucial for bolstering the relevance of implementing pharmaceutical care in healthcare services. To conduct an in-depth analysis of pharmaceutical care practices in a geriatric ward and monitor the clinical outcomes of older people served. This interventionist study was conducted in the geriatrics ward of a Brazilian university hospital. The research intervention occurred between January and May 2022, with a follow-up conducted for up to 90 days after patients' hospital discharge. Older patients in the geriatrics ward received pharmaceutical care, including medication reconciliation, medication review,and pharmacotherapeutic follow-up, aimed at identifying and resolving drug-related problems (DRPs). The clinical relevance of DRPs and pharmaceutical recommendations was evaluated. Additionally, analyses were conducted on mortality and rehospitalization outcomes in older patients at 30, 60,and 90 days following initial hospital discharge. Of the patients evaluated, a significant 88.3% exhibited at least one DRP (with an average of 2.6 ± 1.9 DRPs per patient), with the majority classified as need/indication problems (38.9%). The acceptance rate of pharmaceutical recommendations was 80.9%, with the majority categorized as very significant relevance (60.4%). DRPs were predominantly of serious clinical relevance (50.9%). In patients whose clinical indicators could be monitored, 95.5% showed some clinical response (in vital signs, laboratory testsand/or clinical status evolution) potentially related to resolved DRPs. Association analysis revealed that a higher number of medications in use before hospitalization correlated with a greater identification of DRPs during hospitalization (p = 0.03). At hospital discharge, 23.6% of patients were no longer using polypharmacy. In total, 16 patients (26.7%) died during the study period. Among patients who did not die during hospitalization (n = 54), 20 patients (37%) experienced rehospitalizations within 90 days following discharge. This study facilitated the consolidation of pharmaceutical care implementation in a geriatric ward. We conducted identification, evaluation,and proposed evidence-based solutions, as well as monitored cases for outcome analysis. It is anticipated that this methodology will inspire future research and the implementation of pharmaceutical care-related services.

Medication use review as a service for pharmaceutical care: Conditions for implementation in pharmacy practice


 
 
 Pharmaceutical care is an aggregated pharmaceutical service based on an innovative approach towards the patient’s pharmacotherapy process. It was introduced into the Polish pharmaceutical law system in 2008, but it was not until the end of 2020 that the list of activities included in this innovative health service was clarified. The delayed initiation of pharmaceutical care means that implementation procedures are lacking, making it difficult to fully implement it into pharmacy practice. The initiating service for pharmaceutical care in pharmacy practice is the medication use review (MUR), which, combined with the pharmacotherapy assessment, has the task of detecting and solving patients’ drug-related problems and thus ensuring safety in the pharmacotherapy process. Such important objectives for medication use review face organisational barriers that make its effective implementation difficult and practically impossible, limiting the scope of pharmaceutical care to the consultative aspect in practice. The aim of the article is to present the implementation conditions of medication use reviews in Polish pharmacy practice, which helped to identify the conditions for effective implementation of pharmaceutical care. Achieving the research objectives requires the use of a variety of research methods. To identify the conditions for effective implementation of medication use reviews, the method of analysis of legal acts was used. Apart from that, the analysis of literature and the method of examination of documents were also implemented, which made it possible to determine whether the Polish pharmaceutical law system creates conditions for effective provision of this service in pharmacy practice. The method of observation (the mystery shopper) was also used to indicate the territorial (subjective scope) scope of the provision of medication use review and to identify barriers to their implementation in Polish organisational and legal realities. All the methods applied made it possible to determine to what extent pharmacist shortages in the pharmacy limit the implementation process. The results of the study were subjected to statistical analysis.
 
 

Hospital pharmacists’ knowledge, attitudes and practice of pharmaceutical care and the barriers for its implementation at the hospital setting

ObjectiveTo assess hospital pharmacists' understanding of pharmaceutical care and their attitudes regarding the adoption of the patient-centered model, as well as investigate Jordan's current state of pharmaceutical care implementation and the associated barriers. MethodsA validated survey was distributed to hospital pharmacists in different major tertiary hospitals in Jordan. The study questionnaire contained five sections to assess sociodemographic characteristics, pharmacists’ understanding of pharmaceutical care, attitudes towards pharmaceutical care, potential barriers that may limit the delivery of pharmaceutical care, and the extent of pharmaceutical care implementation in the hospital setting. ResultsThe survey was completed by 152 hospital pharmacists. Participants in this study demonstrated adequate levels of knowledge about pharmaceutical care (Mean = 9.36 out of 11, SD = 1.23) and expressed favorable perceptions of pharmaceutical care (mean = 3.77 out of 5; SD = 0.7). Although more than one-third of the pharmacists practiced pharmaceutical care, the study revealed a number of impediments to the delivery of pharmacological care services. Regression analysis revealed that age (P < 0.05) and years of experience (P < 0.05) were significant predictors of knowledge, while age (P < 0.05), gender (P < 0.05), the graduation university (governmental vs. private) (P < 0.05), and years of experience (P < 0.05) were significant predictors of attitude. Furthermore, Doctor of Pharmacy degree holders had fewer barriers to pharmaceutical care implementation but were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.01 and P < 0.05 respectively). Pharmacists with a Master's degree or higher in pharmacy were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.05). Pharmacists working in the Ministry of Health and the Royal Medical Services experienced more barriers than those working in teaching hospitals (P < 0.05). ConclusionsAlthough the current study indicated high knowledge and perceptions regarding pharmaceutical care among hospital pharmacists, the provision of pharmaceutical care is not widely practiced in Jordan. Moreover, several barriers to the practice of pharmaceutical care were identified, highlighting the need for effective strategies to be put in place to overcome these obstacles. These strategies should include increasing the number of pharmacy staff, resolving timing issues, providing adequate financial initiatives, improving communication skills, changing the layout of pharmacies to include a private counseling room, developing specific policies that support the role of the pharmacist in patient care, and providing effective training and continuing professional education programs.

Evaluating the role of intern pharmacists in pharmaceutical care in hospitals in Uganda.

In Uganda, there is limited adoption of pharmaceutical care in hospitals due to pharmacist shortages and limited collaboration among healthcare professionals. Intern pharmacists are deployed annually to assist in patient care to address pharmacist shortages. Evaluate intern pharmacist's extent of involvement in pharmaceutical care activities, assess facilitators and barriers, and explore healthcare professionals' perceptions, attitudes, and opinions on implementation of pharmaceutical care. A mixed-method concurrent study was carried out for four months. We conducted an online survey among 107 intern pharmacists from 26 hospitals, including National Referral, Regional Referral, Private Not-For-Profit, and General hospitals; predictors of extent of involvement were identified using linear regression models, using STATA 14. 24 key informants (nurses, prescribers, pharmacists) from five hospitals were interviewed; themes were developed using a deductive thematic analysis approach. Intern pharmacists had a median (Interquartile range[IQR]) age of 25 years (25-27) and 74.7% were male. About half (54.1%) of key informants were female and had a median (IQR) of 10 years (4.0-15.5) of professional experience. Interns focused on patient counseling, lacked documentation, and showed positive attitudes, and knowledge. Key informants supported implementation, but prescribers expressed dissatisfaction with interns' performance. Enhancing pharmacy internship and training through developing policies and guidelines on pharmaceutical care practice, improving working conditions, and mentorship can address gaps impeding pharmaceutical care implementation by intern pharmacists.

Council of Europe Resolution on the Implementation of Pharmaceutical Care-A Step Forward in Enhancing the Appropriate Use of Medicines and Patient-Centred Care.

Pharmaceutical care was proposed to address morbidity and mortality associated with medicine-related problems. It utilises the pharmacist's expertise in medicines, their relationship with the patient and cooperation with other healthcare professionals to optimise the use of medicines. The European Directorate for the Quality of Medicines & HealthCare (EDQM), part of the Council of Europe, found significant variation in the acceptance of pharmaceutical care and in the implementation of pharmaceutical care in Europe. A multidisciplinary group was established to draft a statement of principles and recommendations concerning pharmaceutical care. Through face-to-face meetings, circulation of draft texts and informal consultation with stakeholders, the group produced a resolution. On 11 March 2020, the resolution was adopted by the Committee of Ministers of the Council of Europe. It explains pharmaceutical care and illustrates pharmacists' contribution to medicine optimisation in different care settings. Pharmaceutical care's value to health services and its place in health policy were emphasised by addressing the risks and harms from suboptimal use of medicines. Pharmaceutical care can improve medicine use, promote rational use of healthcare resources and reduce inequalities in healthcare by realigning the roles and responsibilities of pharmacists and healthcare professionals. EDQM will promote and advocate for the implementation of pharmaceutical care by enacting practice Resolution CM/Res(2020)3.

The study of the state of awareness of pharmaceutical workers regarding coronavirus disease (COVID-19)

Aim. To analyze and summarize the results of a questionnaire on the state of awareness of pharmaceutical workers in the Western regions of Ukraine about the coronavirus disease (COVID-19). Materials and methods. The results of a survey of pharmacy managers, pharmacists and interns working in pharmacies in 8 regions of the Western area of Ukraine were used. The survey of respondents lasted 12 months: December 2021 – December 2022. A special questionnaire was developed to determine the level of knowledge about the coronavirus disease (COVID-19) caused by the SARS-CoV-2 coronavirus. Results and discussion. With the beginning of the full-scale invasion of the Russian Federation, COVID-19 practically disappeared from the information space and ceased to be an urgent issue for Ukrainians. However, in recent weeks, the Ministry of Health has recorded an increase in the number of hospitalizations due to the coronavirus disease. During the period of martial law and the coronavirus disease pandemic (COVID-19), the pharmacy is the most accessible healthcare institution for the population and ranks first in terms of the number of citizens’ requests for symptoms, methods of treatment and prevention of SARS-CoV-2, therefore, the awareness of pharmacists – practitioners about COVID-19 is very important to provide complete and high-quality pharmaceutical care to patients. A review of the specialized scientific literature over the past 5 years confirmed the lack of studies on the level of awareness of pharmaceutical workers about the symptoms, methods of diagnosis, treatment and prevention of the main diseases that are widespread in the Western regions of Ukraine. With the help of a questionnaire, we conducted an expert assessment of the level of knowledge of pharmacy managers, pharmacists and interns working in pharmacy institutions in 8 regions of the Western area of Ukraine regarding the main symptoms, methods of diagnosis, treatment and prevention of uncomplicated forms of the coronavirus disease (COVID-19). After analyzing the answers of the respondents, it can be assumed that pharmaceutical workers know the main manifestations of the coronavirus disease (COVID-19) and are oriented towards the threatening indicators of the patient’s condition. It causes concern that some respondents incorrectly determine the reasons for prescribing antibacterial therapy to a patient, which can lead to incorrect recommendations and advice during the implementation of pharmaceutical care, however, the introduction of electronic prescriptions for dispensing antimicrobial drugs and information and educational work with pharmaceutical workers should correct the situation. Conclusions. In our opinion, it is promising to conduct further research to improve the level of knowledge and competencies of pharmaceutical workers during their specialization courses and thematic improvement in the system of continuous professional development

Indonesia Facing Challenges of Pharmaceutical Care Implementation in Community Pharmacies: A Legal Perspective

Pharmaceutical Care (PC) is a kind of interactive comprehensive service offered by the pharmacist to the patient, in which the pharmacist's physical presence is expected when providing pharmaceutical services to the patients at the pharmacy. However, pharmacists still prioritized internal management over interacting directly with patients. The objective of this research is to glance at the legal challenges of PC implementation in Indonesian community pharmacies. The normative juridical research method has been used, with a conceptual and legal approach. PC implementation in community pharmacies experiences major-level, mid-level, and minor-level challenges. PC standards in pharmacies are legally stated in Regulation of the Minister of Health of the Republic of Indonesia No. 73 of 2016, but there are still conflicts between pharmaceutical management and PC implementation. In the incident of a medication error, the pharmacist as the person responsible for PC in the pharmacy, is legally responsible. Pharmacists who do not meet PC standards in community pharmacies encounter administrative, civil, and criminal consequences.

The Impact of Pharmaceutical Care Implementation on The Incidence of Drug-Related Problem and Clinical Outcome of Hypertension Patients at Puskesmas Lubuk Pakam in 2021

&#x0D; &#x0D; &#x0D; &#x0D; The role of pharmacists in the implementation of pharmaceutical care has been shown to improve the outcome of therapy in hypertension patients in various countries. This study aimed to implement pharmaceutical care for hypertension patients and determine its impact on the incidence of drug-related problems (DRPs) and clinical outcomes of hypertension patients in Puskesmas Lubuk Pakam. This study used a comparative experimental method before and after the intervention of 73 hypertension patients in March-August 2021. Identification of the of DRPs was using the PCNE V9.00 standard and blood pressure values were obtained from direct examination of patients. Data were analyzed using the Wilcoxon Signed-Rank test. The results showed that the average DRPs incidence was significantly reduced after the intervention (observation, interview, and education) on the hypertension patients. The average blood pressure before intervention was 154.38 ± 16.20 mmHg and after intervention became 144.04 ± 15.94 mmHg (p value = 0.000). Based on the results of the study, it can be concluded that the application of pharmaceutical care can reduce the incidence of DRPs and improve clinical outcomes in hypertension patients in Puskesmas Lubuk Pakam.&#x0D; &#x0D; &#x0D; &#x0D;

Study of preferences of patients with diabetes regard to pharmaceutical services

Pharmacies are a component of the healthcare. Pharmaceutical care and pharmaceutical services improve disease control, quality of patients life and reduce of the burden on healthcare. The implementation of pharmaceutical care and pharmaceutical services for patients with diabetes according to the standards of the GPP is relevant for the domestic pharmacy. Therefore, it is advisable to determine the preferences of patients with diabetes because they have their own needs for treatment and control.&#x0D; The purpose of the study was to study the views of patients with diabetes regarding to function of pharmacies, pharmaceutical services and determine their preferences.&#x0D; The survey of patients with diabetes by the questionnaire method was carried out. Relevant questionnaires of 510 patients with type 1 and type 2 diabetes were included in the study.&#x0D; The results of the survey showed that the majority of patients with diabetes would like to be served in a specialized pharmacy that specializes in drugs and medical products for diabetes. On the basis of the study, the preferences of patients with diabetes regarding to the activities of pharmacies were determined: availability of a wide rang of product; loyalty program for special products related to diabetes, additional services and pharmaceutical consultations. The majority of those interviewed noted that they need a pharmacist's consultation on taking medications. This type of service requires training of pharmacists in diabetes in order to provide pharmaceutical care at an appropriate level. Pharmaceutical services which patients with diabetes need were identificated. There are: testing of blood glucose, cholesterol, blood pressure, weight check, calculation of body mass index and interpretation of results. The creation of a «diabetes self-management school» based on pharmacies will improve the availability of education for patients with diabetes. It is necessary to study the demand directly in the area of the pharmacy before introduction this type of service. It is important to implement systematic special events in pharmacies for the World Diabetes Day. Thes is appropriated for the general population, but also for patients with diabetes. From the point of view of patients with diabetes during this event, they are interested in: consultation of an endocrinologist and nutritionist; blood glucose test; test of diabetes risk; information materials about diabetes.&#x0D; The results of the survey can be prospectively used to improve the service of patients with diabetes and provide for their needs.

Polish Patients' Needs and Opinions about the Implementation of Pharmaceutical Care in Diabetes.

The study aimed to get to know patients' opinions on implementing pharmaceutical care for diabetic patients in a community pharmacy to prevent and effectively and holistically approach the treatment of people with diabetes. It was based on an authorial survey form and conducted from August to October 2021 in a community pharmacy in Poznan, Poland. A total of 131 pharmacy patients over 18 years were included in the study. Results showed that the vast majority of patients confirmed their interest in pharmaceutical care in diabetes conducted by pharmacists. Moreover, 79.4% of respondents would like to benefit from medicines use review, while 87.0% confirmed an interest in the 'New Drug' service, with diabetic patients being particularly interested in this (p = 0.2447). Most respondents were also interested in education on how to use a glucose meter, administer insulin and use a lancing device. In addition, the study showed patients' insufficient knowledge about risk factors and prevention of diabetes with the need for patient education. As the source of funding, 91.7% of diabetic patients indicated the National Health Fund. Given that such a service has not been implemented in Poland yet, this study may support established teams at the Supreme Pharmaceutical Chamber or the Ministry of Health in introducing such new services.

Building a draft national strategy for implementation of pharmaceutical care in patients with chronic diseases in Republic of North Macedonia

Building a draft national strategy for implementation of pharmaceutical care in patients with chronic diseases in Republic of North Macedonia

Current views of community and hospital pharmacists on pharmaceutical care services in the United Arab Emirates: A mixed methodological study.

Background: The profession of pharmacy has evolved significantly in recent years in terms of professional service delivery. The aim of this study was to explore the current views of pharmacists in the United Arab Emirates (UAE) on pharmaceutical care services and the nature of barriers encountered in practice using qualitative and quantitative assessment methods. Methods: A cross-sectional study was conducted among hospital and community pharmacists (n = 305) between March and May 2021, using qualitative and quantitative assessment methods. In the qualitative phase, 15 interviews were conducted to explore five main criteria: patient information, inadequate patient counseling, prescribing errors prevention and identifying drug-related problems, lack of participation in health awareness programs, and barriers to pharmaceutical care implementation. In the quantitative phase, 305 consenting pharmacists completed a questionnaire on seven criteria: demographic profile, pharmacist-physician interaction, patient counseling assessment, patient reports of adverse drug events, pharmacist participation in health awareness programs, perceptions of reducing prescribing errors and identifying drug-related problems, and barriers to appropriate pharmaceutical care implementation. Results: The results of both the qualitative and quantitative phases of the study revealed that pharmacists' influence on practice in the UAE is limited due to many factors, mainly lack of time and patients' ignorance of the pharmacist's role in the medical field. The mean responses regarding pharmacists' approach to patient counseling and patients' knowledge of pharmacists' role in managing adverse drug reactions were 77.1% and 59.7%, respectively. Active participation in health awareness programs was 64.8%. The mean positive response of participants in reducing prescribing errors and recognizing drug-related problems was 9.2%. Pharmacists' age and number of years in practice were the most important factors influencing the pharmaceutical care services implementation. Conclusion: The study has shown the need to shed light on the proper implementation of pharmaceutical care while maintaining a trusting relationship with physicians.

Pharmaceutical Care Practices among Hospital Pharmacists in a State in Nigeria

Pharmaceutical care is a patient centered, outcome-oriented practice, requiring collaboration between the pharmacist, other care givers and the patient. In Nigeria, pharmacy practice is still majorly product based. Implementation of pharmaceutical care in hospitals in Nigeria since its introduction several years ago has remained erratic. This study evaluated practice of pharmaceutical care among hospital pharmacists in Delta State. This was a prospective study using a structured, pretested and self-administered questionnaire to 55 hospital and administrative pharmacists that gathered in Asaba in July 2018 for the quarterly meeting of their Association. The four-part Questionnaire evaluated demographics of respondents, pharmaceutical care practices carried out, reasons for not implementing pharmaceutical care and suggestions on how pharmaceutical care can be implemented in their various hospitals. Data obtained were analyzed using SPSS Version 22. Descriptive and chi square statistics were obtained. A P value of less than 0.05 was considered statistically significant. 55 questionnaires were distributed, 50 were returned, giving a response rate of 90.9%. Majority (40.0%) were aged 20-29 years; there were more males (52.0%) than females. Majority (56.0%) were married, about one quarter (24.0%) were in practice for 1-5 years. More than half (58.0%) were sole holders of Bachelor of Pharmacy degree. Majority (66.0%) were practicing at the Federal Medical Centre, Asaba. Pharmaceutical care practices carried out included monitoring patient response to therapy (58.0%), identification of errors in patient prescriptions (88.0%), interventions to correct detected errors (86.0%), documentation of pharmaceutical care activities (72.0%), medication review with physicians (54.0%), participation in pharmacists ward rounds (16.0%). However, only 4.0% of respondents counselled patients during interventions to rectify drug therapy problems. Among factors responsible for non-implementation of pharmaceutical care were lack of collaboration (20.0%) lack of space (6.0%), non-acceptance by physicians and nurses and lack of personnel were 10.0% each. Association between location of practice and monitoring improvement in patient response was statistically significant (c2 =23.112, P = 0.003). Practice of pharmaceutical care among pharmacists that converged for the quarterly meeting was average. There is need for pharmacists to improve in the area of monitoring patient’s response to pharmacotherapy as well as sharpen their counselling skills so that they can render effective drug information services to patients and other healthcare providers.

Barriers to Practice of Pharmaceutical Care in a Tertiary Hospital in Nigeria

Pharmaceutical care continues to gain worldwide acceptance since its introduction over two decades ago. In Nigeria, a variety of forces is slowing down the implementation of pharmaceutical care in healthcare institutions. This study was carried out to determine the barriers to implementation of pharmaceutical care in a tertiary hospital in Nigeria. These were achieved through the use of a prospective, cross-sectional study using a structured, pretested and self-administered questionnaire to 55 hospital pharmacists in Asaba in July 2018. The four-part Questionnaire evaluated demographics of respondents, knowledge of and reasons for not implementing pharmaceutical care and willingness to practice pharmaceutical care if perceived barriers were removed. Data obtained were analyzed using SPSS Version 22. Descriptive and chi square statistics were obtained. A P-value of less than 0.05 was considered statistically significant. A total of 55 questionnaires were administered to hospital pharmacists practicing at the Federal Medical Centre, Asaba, in 2018. Fifty questionnaires were returned, giving a response rate of 90.9%. Majority (80.0%) were aged 21-30 years, there were more females (56.0%) than males, most were single (74.0%), a third (34.0%) were holders of the Doctor of Pharmacy degree, nearly half (42.0%) were in practice for less than one year. Barriers identified were difficulty in accessing patients clinical and laboratory data, lack of acceptance by physicians and nurses, lack of space, inadequate number of pharmacists, pharmaceutical care is not feasible without financial incentives, pharmaceutical care required too much time, lack of clinical knowledge, Pharmaceutical care required too much effort, and lack of communication skills. Analysis of sex versus respondents was significant for those who felt pharmaceutical care was not feasible without financial incentives. (c2 = 12.236, *P = 0.022) with female respondents taking the lead (56.0%). This study revealed barriers that are militating against the practice of pharmaceutical care in the study area. Concerted efforts to address these challenges that will involve the management of the hospital, update lectures, attitudinal change by pharmacists and introduction of remuneration for additional services rendered by pharmacists are recommended.

Polypharmacy among elderly patients in Poland: prevalence, predisposing factors, and management strategies.

The world's elderly population is growing dramatically. Pharmacotherapy in seniors is particularly challenging due to changes in metabolism, multimorbidity, and a great interest in nonprescription drugs. We aimed to provide up‑to‑datedata on pharmacotherapy in the geriatric population of Poland, to determine factors predisposing to polypharmacy and excessive polypharmacy, and to identify seniors who are most likely to require multidisciplinary interventions in the field of pharmacotherapy. We analyzed the use of all prescription and nonprescription drugs taken within 2 weeks preceding the study in a representative national sample of 3014 home‑dwelling seniors aged over 65 years. The variables of age, sex, place of residence, level of education, and multimorbidity were considered. Poststratification was used to balance the sample structure to match the Polish population of 2017. Consumption of at least 1 drug was reported by 90.7% of the participants, and the mean number of drugs used was 5.01 (95% CI, 4.87-5.15). At least 1 nonprescription drug was used by 44.2% of the respondents, with a mean number of 0.52 (95% CI, 0.49-0.55). More than 5 drugs were taken by 53.5% of the entire population, while the use of more than 10 drugs was reported by 8.7% of the respondents, with multimorbidity as the most predisposing factor. Single‑pill combinations accounted for 27.2% of medications. The high prevalence of polypharmacy resulting from multimorbidity confirms the need for the implementation of combined medical and pharmaceutical care of the geriatric patients.

Elements of good pharmaceutical practice in the implementation of pharmaceutical care for patients with diabetes during the martial law

During the martial law, the role of pharmacists increases, but they must be educated for such activities. It will ensure pharmaceutical care according to Good Pharmacy Practice. Currently, there are no developed standards for the provision of pharmaceutical care to patients with diabetes mellitus (DM) during the martial law.&#x0D; The purpose of the work is to analyze the legislative changes that took place in the pharmaceutical provision for diabetes patients during the martial law. Recommendations for pharmacists to provide pharmaceutical care to diabetes patients in humanitarian disasters have been developed.&#x0D; The regulatory framework of Ukraine for the provision of diabetes patients and international recommendations for the provision of pharmaceutical assistance to diabetes patients during humanitarian disasters. Content analysis, bibliosemantic, analytical, generalizing analyzes were used.&#x0D; To prevent the consequences of humanitarian disasters for people with diabetes, there must be universal access to insulin, other essential drugs and diagnostics for monitoring of blood glucose level and blood pressure in the conditions of humanitatian crises. The peculiarities of the pharmaceutical supply of patients with diabetes during the martial law have been established. Patients with diabetes in Ukraine can receive insulin and other tableted sugar-reducing drugs in pharmacies, which are reimbursed by medical guarantee program (free of charge or with copayment by the patient), or patients can receive insulin free of charge in regional centers (hospitals) wich were received as humanitarian aid from other countries.&#x0D; The importance to use international gidiline recommendations when receiving drugs as humanitarian aid was underlined. The information about insulin, which are reimbursed now according to the ATC classification, taking into account the duration of action of insulin, has been analyzed and summarized. This information is important for practical use by pharmacists who dispenses insulin according to the newly introduced order (by classification of duration of action of insulin).&#x0D; During the martial law, the role of pharmaceutical workers increases. Recommendations for pharmacists have been developed on the basis of international recommendations and the results of scientific research. These recommendations are appropriate for pharmaceutical care to diabetes patients according to Good Pharmacy Practice during the martial law.

Current views of community and hospital pharmacists on pharmaceutical care services in the United Arab Emirates: A mixed methodological study.

Background: The profession of pharmacy has evolved significantly in recent years in terms of professional service delivery. The aim of this study was to explore the current views of pharmacists in the United Arab Emirates (UAE) on pharmaceutical care services and the nature of barriers encountered in practice using qualitative and quantitative assessment methods. Methods: A cross-sectional study was conducted among hospital and community pharmacists (n = 305) between March and May 2021, using qualitative and quantitative assessment methods. In the qualitative phase, 15 interviews were conducted to explore five main criteria: patient information, inadequate patient counseling, prescribing errors prevention and identifying drug-related problems, lack of participation in health awareness programs, and barriers to pharmaceutical care implementation. In the quantitative phase, 305 consenting pharmacists completed a questionnaire on seven criteria: demographic profile, pharmacist-physician interaction, patient counseling assessment, patient reports of adverse drug events, pharmacist participation in health awareness programs, perceptions of reducing prescribing errors and identifying drug-related problems, and barriers to appropriate pharmaceutical care implementation. Results: The results of both the qualitative and quantitative phases of the study revealed that pharmacists' influence on practice in the UAE is limited due to many factors, mainly lack of time and patients' ignorance of the pharmacist's role in the medical field. The mean responses regarding pharmacists' approach to patient counseling and patients' knowledge of pharmacists' role in managing adverse drug reactions were 77.1% and 59.7%, respectively. Active participation in health awareness programs was 64.8%. The mean positive response of participants in reducing prescribing errors and recognizing drug-related problems was 9.2%. Pharmacists' age and number of years in practice were the most important factors influencing the pharmaceutical care services implementation. Conclusion: The study has shown the need to shed light on the proper implementation of pharmaceutical care while maintaining a trusting relationship with physicians.

Polish Pharmacy Students' Attitudes toward Undergraduate Teaching and Practical Implementation of Pharmaceutical Care-A Cross Sectional Study.

It is necessary to monitor and adapt pharmacy curricula to make graduates ready to effectively meet the health needs of the society. Therefore, the aim of the study was to obtain Polish final year pharmacy students’ opinions on the activities related to pharmaceutical care (PC) andtheir perception of PC. Two questionnaires were used: one evaluating a PC regarding classes and in practice (n = 64), and the other on the assessment of existing educational solutions in the field of professional counseling (n = 118). Statistical analysis showed that the students agreed that there are not enough hours of a PC classes, since these are necessary to enable them to provide PC services in the future (R = 0.05, p = 0.0007). In previous classes, teachers’ knowledge was rated the highest on a five-point scale (4.74), and role play (3.92) and the duration of the classes (3.77) were rated the lowest. Although the students were aware of the role of a PC in the work of a pharmacist, they indicated that more extensive use of active learning methods would better prepare them for the profession. Therefore, pharmacy students’ self-efficacy survey and a curriculum renewal would be recommended in Poland.

Factors influencing the implementation of pharmaceutical care in outpatient settings: A systematic review applying the Consolidated Framework for Implementation Research

Pharmaceutical care in outpatient settings is a type of health service that has been shown to contribute to decreasing drug-related morbidity and mortality rates. However, every process of implementing a new service brings about changes and transformations in the work routine, thus posing challenges.This systematic review aims to identify barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings by applying the CFIR method, a framework based on the theory of health services, used to analyze and synthesize research data, which can direct strategies for the service to work as planned.A systematic review was conducted exploring the barriers to and facilitators for the implementation of pharmaceutical care in outpatient settings. The MEDLINE, EMBASE, CINAHL, COCHRANE, and LILACS databases were consulted.Eight studies were included: five qualitative ones, two mixed-method ones, and a quantitative one. The most frequent CFIR constructs identified were Patient Needs and Resources (n = 30, 10.75%), Knowledge and Beliefs about the Intervention (n = 31, 11.11%), Networks and Communications (n = 34, 12.19%), and Available Resources (n = 56, 20.07%). The most cited barriers were: insufficient human resources, patients' unawareness of the existence of the pharmaceutical care service, and pharmacists' resistance to changes. Facilitators included: the opportune presentation of the service to the healthcare team; the use of electronic devices for specific guidance; and the assessment of patient satisfaction.This systematic review allowed detecting key guidelines to improve the implementation process, including (1) defining an implementation method and exploring it extensively during the pre-implementation phase, (2) ensuring human and financial resources, (3) determining how the new service will interact with other existing services. More research is needed to understand how these factors can affect the implementation of clinical services.

Drug therapy safety supported by interprofessional collaboration between ICU physicians and clinical pharmacists in critical care units in Germany : Results of asurvey

Critically ill patients are particularly susceptible to adverse drug events. International studies show that pharmaceutical care has apositive impact on patient and drug therapy safety. Nationally, the integration of pharmacists into the multidisciplinary team and participation in ward rounds is required. The aim of this work is to assess the scope and extent of pharmaceutical care in intensive care units (ICU) in Germany. In aliterature and database search, 13relevant pharmaceutical activities were identified. Based on this, an online survey with 27questions on the implementation of pharmaceutical care in ICU was prepared by apanel of experts. The survey was sent to heads of German ICUs. Of the participants, 35.3% (59/167) have established regular pharmaceutical care. Drug information (89.7% [52/58]), pharmaceutical interventions with change of therapy (e.g., ward rounds; 67,2% [39/58]), regular evaluation of prescriptions (medication analysis; 65.5% [38/58]) as well as the monitoring of medication (e.g., side effects, effectiveness, costs; 63.8% [37/58]) were most frequently mentioned. The participants with pharmaceutical care (58/168) graded 7of13 but those without (104/168) only two activities as 'essential/indispensable'. Only afew ICU in Germany have already integrated ward pharmacists into the multidisciplinary team. Once apharmaceutical service has been established, agreater role/importance is assigned to several pharmaceutical activities.