Patient Medication Counseling Research Articles

Applications of SGLT2 inhibitors beyond glycaemic control.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors were initially developed for their glucose-lowering effects and have shown a modest glycaemic benefit in people with type 2 diabetes mellitus (T2DM). In the past decade, a series of large, robust clinical trials of these therapies have demonstrated striking beneficial effects for various care goals, transforming the chronic disease therapeutic landscape. Cardiovascular safety studies in people with T2DM demonstrated that SGLT2 inhibitors reduce cardiovascular death and hospitalization for heart failure. Subsequent trials in participants with heart failure with reduced or preserved left ventricular ejection fraction demonstrated that SGLT2 inhibitors have beneficial effects on heart failure outcomes. In dedicated kidney outcome studies, SGLT2 inhibitors reduced the incidence of kidney failure among participants with or without diabetes. Post hoc analyses have suggested a range of other benefits of these drugs in conditions as diverse as metabolic dysfunction-associated steatotic liver disease, kidney stone prevention and anaemia. SGLT2 inhibitors have a generally favourable adverse effect profile, although patient selection and medication counselling remain important. Concerted efforts are needed to better integrate these agents into routine care and support long-term medication adherence to close the gap between clinical trial outcomes and those achieved in the real world.

The impact of burnout on over-the-counter counseling: a survey of community pharmacists in Vietnam

Abstract Background In many countries, self-medication is, in fact, the main service provided, exhausting pharmacist time and increasing their workload. However, there are currently no reports describing the impact of burnout on patient medication counseling. Objectives This study was conducted to determine the influence of burnout on over-the-counter (OTC) medication counseling services in Vietnam. Methods A cross-sectional study was conducted in community pharmacies across four districts in Can Tho City, Vietnam, between April and May 2023. Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), comprising three subscales: emotional exhaustion (EE; 9 items), depersonalization (DP; 5 items), and personal accomplishment (PA; 8 items). OTC medication counseling activities were evaluated using 12 questions. Results Of the 385 participants recruited, 22.3% reported high work intensity as a common factor contributing to burnout. Pharmacists with burnout had significantly lower medication counseling scores than those without burnout (mean = 4.35 vs. mean = 4.55, P = 0.005). Of the 12 OTC medication counseling activities, 6 activities, including inquiring about the recent medications used by the patient (P = 0.044), discouraging long-term medication use (P = 0.021), warning about the possibility of self-misdiagnosis (P < 0.001), warning about the possibility of the patient choosing the wrong treatment method (P = 0.001), providing advice on improving health (P = 0.005), and inquiring about allergies in the patient (P < 0.001), had significantly lower scores in pharmacists with burnout. Conclusions There was a significant negative association between burnout and medication counseling activities. Increasing staff numbers may be a useful solution for reducing work intensity, as this factor is reported to contribute the most to burnout among current pharmacists.

Non-virtual simulation training and patient simulation existing for pharmacy students: A scoping review

Background: Simulation training enhances non-technical skills and patient safety in pharmacy education, fostering healthcare knowledge and interprofessional collaboration. These training programmes are crucial for instructing pharmacy students in establishing therapeutic and interprofessional relationships with patients and healthcare providers. The objective of this scoping review was to examine not only the simulation training activities currently available to pharmacy students but also their effectiveness and then to identify areas in non-technical skills that still need to be taught. Methods: A scoping review focused on “simulation training” and “pharmacy students” was conducted, excluding virtual simulation. Initial searches in Scopus, MEDLINE and ERIC were performed on June 6, 2020, with a follow-up on February 25, 2022. Both English and French articles were considered, guided by PRISMA-ScR. Results: From 812 initial papers, 140 met inclusion criteria, revealing two simulation modalities: simulated patient and hybrid. Hybrid modality facilitated interprofessional simulation. Simulation training in patient communication, medication counselling and interprofessional education was seen to have the most impact on students. Conclusion: Simulation training was found to be an efficient method of teaching non-technical skills such as communication, medication counselling and interprofessional collaboration for patient-centred care and interprofessional exchanges in pharmacy education programmes.

Gross Hematuria Associated with Anticoagulants and Antiplatelet Drugs: Analysis of Current Treatment Standards and Relevance of Co-medication and Pharmacological Interactions

BackgroundAnticoagulants and antiplatelet drugs are risk factors for gross hematuria (GH). Moreover, co-medication and drug-drug interactions (DDIs) may influence GH and its clinical course. ObjectiveTo investigate the relationship between GH and administration of oral anticoagulants and antiplatelet drugs. Design, setting, and participantsHospitalized patients with GH in an academic tertiary reference center were included. The use of individual compounds and DDIs were recorded and correlated to relevant clinical outcome factors. Outcome measurements and statistical analysisThe association between GH, DDIs, and clinical outcome parameters was analyzed using χ2 and Kruskal-Wallis tests. DDIs were systematically evaluated using a previously published calculator. Results and limitationsA total of 189 patients with GH were eligible for the study. Of these, 76.2% took anticoagulants or antiplatelet drugs. The mean hospitalization duration was 4.7 d. The mean bladder irrigation duration was 3.1 d and the mean volume of irrigation fluid used was 22.8 l. Overall, 30.7% of patients had a pre-existing genitourinary malignancy. DDIs were observed in 31.9% of cases. The irrigation duration (p = 0.01) and volume of irrigation fluid (p = 0.05) were significantly associated with the use of anticoagulants or antiplatelet drugs. Specific DDI patterns were not predictive of clinical outcome. ConclusionsMedication with anticoagulants or antiplatelet drugs has a significant impact on GH and its clinical course. DDIs are a relevant issue and may lead to adverse clinical events or greater drug toxicity. Critical evaluation of medication and interdisciplinary counseling for patients with GH and urinary tract disease are recommended. Patient summaryDrugs taken to reduce the risk of blood clotting can increase the risk of blood in the urine (called hematuria) and medical expenses for treatment. Drug–drug interactions are a relevant issue, especially in elderly patients and those with other medical conditions who are taking several drugs. Thoughtful discussion of individual risk profiles for hematuria and medication is therefore recommended.

An initial reliability analysis of a patient counseling rubric to objectively measure student pharmacist performance

Current literature outlines the documented need for improved communication during patient medication counseling. Although many tools exist, there needs to be a national standardized tool that complies with federal and state law, to objectively measure student pharmacist performance during patient counseling in the community pharmacy setting. The primary objective of this study is to perform an initial analysis of the internal consistency reliability of a patient medication counseling rubric designed with an Indian Health Services theoretical framework. Secondary objectives include measuring changes in student performance over the time of the study. The 18-item rubric was developed to objectively measure student pharmacist performance during patient medication counseling sessions in a 21-h Introductory Pharmacy Practice Experience (IPPE) course. The community-pharmacy-based IPPE patient counseling course evaluates students' communication skills and patient-centered counseling techniques in live and simulated patient counseling sessions. Three pharmacist evaluators assessed a total of 247 student counseling sessions. The rubric's internal consistency reliability was analyzed, and student performance improvement was observed within the course. Students' performance was evaluated as “meets expectations” in most live and simulated sessions. However, an independent groups t-test showed that the mean performance score for the live counseling sessions (2.59, SD = 0.29) was higher (p < 0.001) than that for the simulated counseling sessions (2.35, SD = 0.35). Students' performance in the course improved over three weeks [Week 1: mean (SD) = 2.29 (0.32), Week 2: mean (SD) = 2.44 (0.33), Week 3: mean (SD) = 2.62 (0.29); p < 0.001]. A Tukey-Kramer comparison post hoc test found a significant increase in the mean performance scores between weeks (p < 0.05). The overall internal consistency reliability of the counseling rubric was determined acceptable, with a Cronbach's alpha of 0.75. Further study is required, including the assessment of inter-rater reliability, factor analysis, variable analysis, and use in other states with patient confirmation testing necessary to validate the rubric for use with student pharmacists in the community pharmacy setting.

Students’ Perceived Counseling Behavior and Feedback on a University-led Patient Medication Counseling Program Implemented in a Tertiary Government Hospital

Students’ Perceived Counseling Behavior and Feedback on a University-led Patient Medication Counseling Program Implemented in a Tertiary Government Hospital

Patient medication counselling in community pharmacy: evaluation of the quality and content

BackgroundPatient medication counselling (PMC) is a pharmaceutical care service targeted at optimizing patient drug use, safety and improving treatment outcomes. This study assessed the content and quality of PMC from the community pharmacists’ (CPs) and pharmacy customers’ (PCs) perspectives.MethodsA cross-sectional questionnaire-guided survey was conducted in Ibadan, Nigeria, among 125 CPs and 612 PCs. The 35-counselling items validated United States Pharmacopeia Medication Counselling Behaviour Guideline scale with 10-point graded responses (1 = poor to 10 = excellent) was used. Self-reported medication counselling information content provided by CPs and received by PCs was assessed and expressed in median and interquartile ranges. The quality of PMC was evaluated and graded as poor (1–29.9%), unsatisfactory (30–59.9%), satisfactory (60–79.9%) and excellent (80–100%). Associations between demographic variables and overall quality of counselling were determined with Mann–Whitney U and Kruskal–Wallis tests at p < 0.05.ResultsThe response rate was 92.5% and 97.6% for PCs and CPs, respectively. The PCs’ opinions on the individual content of the PMC provided by the CPs were significantly different from the pharmacists’ self-report (p < 0.05). Some of the PMC content included how to take the medicine PC = 6.00 (2.00) vs CP = 8.00 (2.00), information on possible side effects PC = 6.00 (2.00) vs CP = 8.00 (2.00), taking history of allergies and other medications PC = 6.00 (6.00) vs CP = 7.00 (1.00), and how to incorporate drug regimen into daily routine PC = 5.00 (6.00) vs CP = 8.00 (3.00). The quality of PMC purportedly provided by CPs and received by the PCs was satisfactory (75%) and unsatisfactory (55%), respectively. The quality of communication counselling offered by CPs trained in Nigeria (Mean rank = 62.49) was higher than those trained outside Nigeria (Mean rank = 26.40), U = 228.00, p = 0.024. The PC’s age, marital status, and highest educational qualification were significantly associated with their opinion on the quality of counselling received.ConclusionsBoth the community pharmacists and pharmacy customers reported the provision of patient medication counselling on side effects, drug usage, medication history and allergies among others. However, the quality of counselling provided by the pharmacists was satisfactory, but the quality of counselling received by the pharmacy customers was unsatisfactory. Pharmacists may need to engage pharmacy customers more during medication counselling.

Evaluation of the Patient Medication Counseling Services in the Philippine General Hospital Using the CIPP Model

Objectives. The patient medication counseling (PMC) services at Philippine General Hospital (PGH) started 21 years ago. While several changes have been incorporated into the program, no formal evaluation has been conducted to date. The objective of this evaluation was to assess the relevance, usefulness, responsiveness, acceptability, efficiency, impact, and sustainability of the service using the context, input, process (CIPP) model of Stufflebeam.&#x0D; Methods. The study utilized a mixed-methods study design. Interviews and surveys were conducted on pharmacist-counselors, a purposive sample of doctors, nurses, and other stakeholders. A review of records from the Department of Pharmacy of UP College of Pharmacy (UPCP) and PGH, such as patient and student satisfaction surveys and monthly reports of counseled patients served from 2015 to 2019, was conducted. The results were analyzed using descriptive statistics for quantitative data and content analysis for qualitative data.&#x0D; Results. Context evaluation revealed that the establishment of PMC resulted from informal interactions with hospitalized patients due to incorrect use of prescription medicines. Correct information was envisioned to address the irresponsible use of medicines. The input evaluation revealed that only 24% (N=75) of the pharmacists are involved in PMC, which comprise only 10% of their workload. There was also a lack of comprehensive training for counseling and insufficient physical facilities. The process evaluation identified lack of time (94%) as a significant limiting factor for the involvement of pharmacists in PMC. The interns became an additional workforce for the service, but scheduling and the consistent availability of both students and faculty-preceptors were experienced. The product evaluation revealed positive perceptions among the pharmacists, faculty, and student interns. From the patient satisfaction survey records of 5,071 patients counseled, 98 to 100% expressed high service satisfaction, and 100% were likely to recommend PMC to other patients. The pharmacists, interns, and faculty-preceptors suggested that PMC improved their confidence, communication skills, and decision-making.&#x0D; Conclusion. The PMC service is relevant and valuable to ensure patients' rational and quality use of medicines. As a value-added service to existing hospital pharmacy services, it serves as a venue for enhancing soft skills among pharmacists and students alike. However, physical and human resources and current processes need to be upgraded to improve efficiency, ensure sustainability, and expand service coverage to more patients.

Perceptions of hospital pharmacists and pharmacy technicians towards expanding roles for hospital pharmacy technicians: a cross‐sectional survey

AbstractBackgroundThe “Pharmacy Technician and Assistant Role Redesign within Australian Hospitals Project” outcomes were released in November 2016.AimTo assess pharmacy staff attitudes towards expanded hospital pharmacy technician (HPT) roles in a Victorian metropolitan teaching hospital.MethodAn electronic questionnaire circulated to all pharmacists, interns and HPTs remained open for 4 weeks during September 2018. Questions focused on three key domains: HPT involvement in final accuracy checking of inpatient supplies and manufactured items, drugs of addiction (DA) management and clinical support roles. The hospital's Office for Research deemed the study a quality improvement activity.ResultsThe questionnaire was undertaken by 61 of 122 (50%) pharmacy staff. Fewer than 10% of respondents believed that HPTs are adequately used in current practice. Final accuracy checking technicians for inpatient medication supplies was supported by 82% of respondents. HPTs signing entries into dispensary DA registers for discharge and outpatient prescriptions was supported by 81% of respondents. Best possible medication history taking conducted by an HPT was supported by 52% of respondents, but support differed between pharmacists and HPTs, with 38 and 92% supportive, respectively (p &lt; 0.01). Forty percent of respondents supported HPT involvement in patient medication counselling. Key themes identified from qualitative data included: the need for clarification of legal and indemnity issues, training and credentialing and professional attributes for expanded HPT roles.ConclusionThese findings are informing HPT role expansion within the pharmacy department and have identified potential barriers to change. Such findings may be useful to pharmacy departments undertaking similar role redesign work.

Pharmacist-led Medication Counseling for Patients Undergoing Hemodialysis: A Path to Better Adherence.

Objective: The primary objective was to assess the satisfaction of patients undergoing hemodialysis regarding counseling services provided by pharmacists. The secondary objectives were to compare the effect of years on dialysis and the presence of comorbidities on patient satisfaction. Methods: A total of 138 patients were included in the study, and all demographic and clinical variables were retrieved from the dialysis unit records of King Abdulaziz Medical City over a period of 4 months from July to October 2015. Chi-square test and Fisher’s exact test were used for group comparisons at a significance level of 0.05. Results: Most patients aged between 51 and 75 years and had been on dialysis for 1 to 5 years; 94.9% of them had comorbidities. The overall satisfaction of patients toward pharmacy services was excellent (77.5%), and approximately 38.4% of patients thought that pharmacists were providing clear information about their prescribed medications. In addition, 55.8% of the patients did not know that hemodialysis could affect the efficacy of their medications. Conclusions: Patients undergoing hemodialysis were somewhat satisfied with the counseling provided by the pharmacist. Moreover, there is a need for educational programs for patients undergoing hemodialysis that would increase awareness among hospital pharmacists to improve patients’ medication knowledge.

Creation and validation of a semi-quantitative instrument to assess the confidence of pharmacists in medication consultation for patients with depression: The Pharmacists' Confidence scale about Medication Consultation for Depressive patients (PCMCD)

Objectives:To develop a semi-quantitative instrument to assess pharmacists’ confidence in medication counseling for patients with depression, The Pharmacists’ Confidence scale about Medication Consultation for Depressive patients (PCMCD), and investigated its validity.Methods:Following discussions with practicing pharmacists, we developed a 12-item questionnaire to assess pharmacists’ confidence in medication counseling for patients with depression. We launched web-based cross-sectional survey during November and December 2018 to 77 pharmacists employed at drug chain stores in Kansai area. Factor analysis was performed to evaluate the configuration concept validity. The least-squares method was used for factor extraction, and the resulting factors were subjected to direct oblimin rotation, with a factor loading cut-off of 0.4. To assess internal consistency, Cronbach’s alpha values were calculated for each of the extracted factors (subscales). A multiple regression analysis was performed using simultaneous forced entry, with the scores obtained for each subscale as dependent variables and responder attributes as independent variables in order to investigate the factors associated with each subscale.Results:During the factor analysis procedure, four questions were excluded by the cut-off rule. Eventually, a model with three subscales was identified, with a cumulative sum of squared loadings being 61.9%. The subscales were termed “relationship building,” “comprehension of condition,” and “information provision” based on the nature of the questions relevant for each of them. The Cronbach’s alpha values for these subscales were 0.92, 0.73, and 0.72, respectively. The average inter-item correlation was 0.378. In addition, multiple regression analysis revealed that there were significant correlations between pharmacist career and both relationship building and information provision.Conclusions:The PCMCD model demonstrated a satisfactory construct validity and internal consistency. This model will provide an excellent tool for assessing pharmacists’ confidence in depression care.

Impact of Pharmacist Counselling on Medication Adherence among Elderly Patients on Antihypertensive Therapy in a Tertiary Care Hospital of Nepal

Background: Poor adherence (compliance) is common with antihypertensive medications among elderly patients. As the elderly people are prone to multiple comorbidities, they are at higher risk of polypharmacy and therefore may present with a higher risk of non-adherence to medications compared to the younger population. The study was conducted to investigate the impact of pharmacist counseling on medication adherence among elderly hypertensive patients.&#x0D; Methods: The elderly hypertensive patients who visited the out-patient department at Chitwan Medical College (CMC) between August to November 2018. The face-to-face interview was conducted among 332 elderly hypertensive patients, selected with the purposive sampling technique. A paired t-test was used to show the difference between pre-test and post-test medication adherence.&#x0D; Results: It was found that 13.85% of patients were poor adherent and 86.14% low adherent in the intervention and the control group. The major reason for non-adherence was found to be carelessness about taking medicine (97%). The adherence score for intervention group changed from 1.60±0.83 to 3.95±0.56 (p-value &lt; 0.001) while in the control group the average score before and after follow up was 1.48±0.77 and 1.51±0.80 (p=0.373) respectively. Blood pressure status improved in the intervention group than the control group (p&lt;0.001). Polypharmacy was 27.71%, 15.66% of whom experienced adverse drug reactions.&#x0D; Conclusion: The patient medication counseling had a good impact on hypertensive patients. All factors of the Morisky Green Levine adherence scale improved after counseling and motivation. Pharmacist-led counseling improved medication adherence among elderly hypertensive patients.

Healthcare Professional's Perception of Pharmacist's Relationship and Counseling Skills in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2018,7,4,11-16.DOI:10.5530/ijpcs.2018.7.4Published:November 2018Type:Research ArticleAuthors:Yousef Ahmed Alomi, Sarah Abdullah Al-Hathlool, Maryam Ibrahim Almulhim, Amal Ali Alashaq, Yousef Aboshalaf, and Mytham Al-Ethan Author(s) affiliations:Yousef Ahmed Alomi1,* , Sarah Abdullah Al-Hathlool2, Maryam Ibrahim Almulhim2, Amal Ali Alashaq2, Yousef Aboshalaf3, Mytham Al-Ethan4 1The Past General Manager of General Administration of Pharmaceutical Care, The Past Head, National Clinical pharmacy and pharmacy practice, The Past Head, Pharmacy R and D Administration, Ministry of Health, Riyadh, SAUDI ARABIA. 2Clinical Pharmacy Staff, Ministry of Health, Riyadh, SAUDI ARABIA. 3Head of Pharmacy Services, King Fahad Hospital, Alhasa Medical Affairs, Ministry of Health, SAUDI ARABIA. 4Assistant head of Pharmacy Services, King Fahad Hospital, Alhasa Medical Affairs, Ministry of Health, SAUDI ARABIA. Abstract:Purpose: To explore the healthcare provider’s perception of pharmacist’s relationship, communication, and counseling skills in Saudi Arabia. Methods: This is a 4-month crosssectional survey of the healthcare professional’s perception of the pharmacist. The survey consisted of two parts: first part gathers demographic information and the second part contains 49 questions divided into four domains. (1) the first domain captures data regarding the healthcare provider’s general perception about the pharmacist; (2) the second domain captures data regarding the healthcare professional’s perception of pharmaceutical services; (3) the third domain was regarding the healthcare professional’s perception of visiting ambulatory care; and (4) the fourth domain captures the data regarding the healthcare professional’s perception of pharmacist’s relationship and counseling skills. All healthcare professionals responded to the 5-point Likert response scale system. The survey was distributed through social media to more than 1000 healthcare professionals across the Kingdom of Saudi Arabia. Because the survey was in an electronic format, we were able to analyze and discuss the four domains with respect to the healthcare professional’s perception of pharmacist’s relationship and counseling skills through the Survey Monkey system. Results: A total of 170 healthcare providers responded to our survey. Of all the responders, 129 (75.9%) were females and 41 (24.1%) were males. Most of the healthcare providers were pharmacists (81 (47.65%)), others (33 (19.41%)), nurses (27 (15.88%)), and physicians (23 (13.53%)). Most of the healthcare providers (143 (87.2%)) spent less than 16 minutes waiting for the medication from the pharmacy. The average score of the healthcare professional’s perception of the pharmacist’s communication and relationship skills was around (3.41). The highest score with respect to the pharmacist’s and patient’s relationship was obtained for the following statements: “The pharmacist politely delivers the medication” (3.96) and “The pharmacist answers questions in an excellent manner” (3.67). The average score of healthcare professional’s perceptions of pharmacists with medication counseling skills was around (3.42). Highest scores were obtained for the following statements: “All the medications received were packed” (4.28) and “The patient understands what the pharmacist was saying” (4.14). The highest score with respect to the patient’s relationship with the drug information center was obtained for the statement: “The pharmacist answers patient’s questions through drug information center of the hospital over 24/7” (3.44) and “Poisonous cases first contact the national drug information center or any other hospital drug information center any time through MOH hotline 937 service over 24/7” (3.37). Conclusion: The results of this survey revealed that healthcare professionals had an acceptable perception of the pharmacist with respect to communication and patient counseling skills. The healthcare professional’s privacy, easy contact with the pharmacist, and drug-related problems information improve the p Keywords:Counseling skills, Healthcare professional, Ministry of Health, Perception, Pharmacist, Relationship, Saudi ArabiaView:PDF (377.48 KB) PDFClick here to download the PDF file. Images Healthcare provider’s perception regarding pharmacist’s patient medication counseling skills

Oncology Pharmacist’s Role and Impact on the Multidisciplinary Patient-Centre Practice of Oncology Clinic in Public Hospitals

Oncology pharmacy service was developed and integrated into the multidisciplinary team of oncology clinic in 2013 at the United Christian Hospital aiming to enhance the holistic patient-centre practice of the clinic through the optimization of the safety and efficacy of anti-cancer treatment. This review aims to describe the role and impact of oncology pharmacists (OPs) in clinical setting to optimize anti-cancer treatment for cancer patients in a multidisciplinary care approach. From selection, prescribing, procurement to monitoring and patient education, OPs significantly contribute to the safety and effective use of anti-neoplastics in any circumstances. OPs provide professional advices to oncologists in choosing the appropriate anti-cancer agents for specific cancer and designing personalized anti-cancer treatment according to patients’ fitness and appropriateness for chemotherapy. Parenteral and oral chemotherapeutic agents carry heightened risk of causing significant patient harm when they are used in errors. Thus, OPs also develop standardized chemotherapy orders and ensure the final dose is appropriate in terms of both hematological and non-hematological responses and tolerability. Moreover, OPs play an important role in procuring anti-cancer drugs and sourcing alternative drug choices that will deliver similar clinical outcomes. In addition, OPs also assure the clinical integrity of anti-cancer drugs for full anti-neoplastic activity and safe administration of these drugs by nursing staff to minimize potential occupational risk. Most importantly, OPs play a vital role in providing direct patient care functions such as drug therapy monitoring and management (e.g. ensure that patients receive sufficient pre-medications for administration of anti-cancer drugs), and medication counseling for patients and their carers to better understand their anti-cancer treatment. The positive impact of integrating OPs into the multidisciplinary patient-center practice of oncology clinic includes (1) reduction in potentially life-threatening medication incidents and cancer drug administration errors in public hospitals; (2) collaboration with oncologists to select the most suitable cancer drug regimens for patients; (3) prevention of potential occupational risk to the healthcare professionals who handle cancer drugs; and (4) provision of optimal therapy treatment, monitoring and counseling to patients to reduce side effects and hospital readmission. The professional drug knowledge of OPs adds value to the multidisciplinary team in oncology clinics and the growth of OPs into effective direct patient care in oncology clinics should be encouraged to optimize medication-related outcomes.

Family Planning and Rheumatoid Arthritis.

Patients with rheumatoid arthritis (RA) have special family planning considerations that require close coordination with health care providers. While this article focuses on issues inherent to female patients given their potential for pregnancy, we will review pertinent issues related to medication counseling for male patients. Some women with RA may experience subfertility. Disease activity may decrease for some, but not all pregnant women with RA. Preterm birth is more common among women with RA than among healthy women, which may be explained, in part, by disease activity and/or use of certain medications. Contraception is safe for women with RA. RA is a chronic, female-predominant inflammatory disease that may affect women and men during their reproductive years. We describe some of these considerations herein and focus on strategies to help providers to clarify and support their patients' reproductive goals.

Development and validation of a scale to measure the quality of patient medication counseling using Rasch model.

Objective:The purpose of this study is to develop and validate the psychometric properties of a scale for measuring the quality of patient medication counseling by using the Rasch model.Methods:In this study, the scale was developed based on the literature review. It consisted of 31 items across five subscales: introduction, problem identification, content, behavior, and conclusion. A convenient sample of community pharmacists was recruited from four major cities in Vietnam: Hanoi, Da Nang, Ho Chi Minh, and Can Tho. Data collection was conducted from June 10 to October 30, 2017. A Rasch analysis for polytomous data was performed to assess the suitability of the item and the reliability of the scale.Results:The research results showed that all items had a positive point-measure correlation coefficient between 0.47 and 0.77. All items had infit and outfit values in the optimal range between 0.5 and 1.5 except for D5, but its value was within acceptable range. Differential item function analysis indicated that all items had no DIF, except for items B4 and E4 containing moderate magnitude of DIF. Response category statistics found that there was a gradual increase in difficulty level from category 1 to 5 and no presence of reversal. Infit and outfit statistics of these categories were also considered good, with their values close to 1. The test result of the item characteristic curve and the person-item map showed that there were some overlapping items. Their appearance, however, might play an important role in measuring different aspects of construct. The overall scale reliability index (0.97) was high and the overall scale separation index (6.11) was good.Conclusions:The developed scale satisfied the requirements of the Rasch model. The scale is a useful tool that could be used to measure the quality of patient medication counseling among community pharmacists.

SCREENING OF DRUG RELATED PROBLEMS IN HIV PATIENTS RECEIVING ANTI RETROVIRAL THERAPY

Aim: The main aim of the study is prospective screening of drug related problems in ART receiving patients at RIMS Kadapa. Objectives: The key objectives of the study include To identify various drug related problems using various domains as per PCNE (Pharmaceutical care network Europe). To identify the most common ART regimen causing DRP. Methodology: A prospective observational study conducted for a period of six months november2015-april 2016. The data was collected by using Patient Data Collection Form, PCNE classification V5.01, Drug interaction form, ADR form. The collected data was analysed for age and gender distribution, distribution of patients based on co morbidities, patients with and without DRPs based on type of ART regimen used, distribution of problems, causes for different problems, interventions suggested for different problems then outcome of interventions were calculated. Results: A total of 125 patients 104 members experienced DRPs with ART regimens, which accounts 63(60.57%) males and 41(39.42%) females. Out of 104 patients 59 members experienced DRPs with ZLN regimen. In those patients the main DRPs were adverse drug reactions, drug use problems and drug interactions. The main causes for those problems were Pharmacokinetic problems incl. Ageing/ deterioration in organ function and interactions (C1.4), manifest side effect no other cause (C1.8) as per PCNE scheme V5.01. The various interventions suggested for those problems were Patient (medication) counselling (I2.1), Instructions for use changed to......(I3.4), new drug started(I3.6). the outcomes for suggested interventions were problems( Rashes, muscle pain, vomiting, nausea, headache, cough, abdominal pain.....etc.) totally solved(O1.0) and problems (Neutropenia, anaemia, hyper pigmentation of skin & nails, ear impairment, severe anaemia, finger paralysis, blurred vision.....etc.) were partially solved(O2.0). Conclusion: Our study concludes adverse drug reactions with ART are high in problems domain as per PCNE, which can be decreased by identifying DRPs in early stages of drug therapy, prescribing other drugs cautiously in HIV patients. Majority of DRPs can be decreased by improving patient-physician relationships and patient-pharmacist relationships. For better outcomes patient counselling can be considered as a better interventional tool which will improve adherence and decrease DRPs in HIV patients. Keywords: Pharmaceutical Care Network Europe, Drug related problems, Anti retro viral therapyÂ

Provision of Patient Medication Counseling Service In A Tertiary-Care Eye Hospital In Bandung: A Gap Analysis of Patient’s Need, Standard and Service Provider Resources

Many studies showed that counseling can improve patient adherence and reduce medication-related problems leading to reach an optimal outcome therapy. The aims of this study were to identify patient’s need, healthcare professional’s support, pharmacist’s readiness and step to be taken to meet standard for implementing patient medication counseling service. Questionnaires has been given to hospitalized-patient to identify the patient’s need and to healthcare professionals in recognizing their supports, followed by survey of pharmacist’s readiness. Gap analysis was then carried out to identify the additional resources to be provided for conducting the service. About 103 patients were enrolled and eager for drug counseling to be implemented with pharmacist as healthcare counselor. Approximately 46 nurses and 25 active-medical-doctors were participated and giving their support for pharmacist to provide the service; and pharmacists are ready to conduct patient medication counseling with minor adjustment. Gap analysis concluded that additional resources should be furnished, e.g. information module consist of standard information needed by the patient, standard operational procedure, and updated literatures. Due to lack of pharmacist, counseling service only be delivered to patient who has a complex antibiotic regimen therapy. Our data showed that patient medication counseling service in this center could be quickly implemented.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling

BackgroundMedication counselling opportunities are key times for pharmacists and patients to discuss medications and patients’ concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication.ObjectiveTo invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling.DesignThis was a theory‐based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling.Setting and participantsRecruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists’ practice sites were prescribed at least three medications to manage chronic disease(s).Main outcome measuresThe extent to which pharmacists accommodate, or not, to patients’ conversational needs based on accommodative behaviour described within CAT strategies.ResultsTwelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients’ conversational needs. Non‐accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda‐setting phase. Multiple strategy use resulted in communication patterns such as “information‐reassurance‐rationale” sandwiches.Discussion and conclusionsMost pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists’ communication could be improved at the initial agenda‐setting phase by asking open‐ended questions to invite patients’ input and allow patients to identify any medication‐related concerns or issues.

National Survey of Drug Information Centers Practice in Saudi Arabia: Drug Monitoring and Patient Counseling at Ministry of Health Hospitals

Objective: To explore the National Survey of Drug Information Centers practice in Saudi Arabia: Drug Monitoring and Patient Counseling at Ministry of Health Hospitals.Methods: It is a cross-sectional four months national survey of Drug Information Services at Ministry of Health. It contained ten domains with 181 questions designed by the authors. It derived from Internal Pharmaceutical Federation (FIP), American Society of Health-System Pharmacists best practice guidelines. This survey distributed to forty hospital pharmacies that run drug information services. In this study, the domain Drug Monitoring and Patient Counseling System explored and analyzed. It consisted of eight questions about the written policy and procedure and application methods for Drug Monitoring and Patient Counseling system in the drug information centers. All analysis is done through survey monkey system.Results: The survey distributed to forty-five of hospitals, the response rate, was 40 (88.88%) hospitals. Of those; the highest percentages of implementation of adverse reaction monitoring was ADR reporting forms are available did not exist in 3 (7.5%) hospitals while 29(72.5%) of hospitals 100% applied the elements. The highest scores of implementation of the medications errors program were Definition of a significant medication error, the time frame for reporting and reporting format did not exist in 3 (7.5%) hospitals while 27 (67.5%) of hospitals 100% applied the elements. The highest percentages of implementation of patient counseling were the Proper storage of the medication did not exist in 6 (15%) hospitals while only 20 (50%) of hospitals 100% applied the elements.Conclusion: There was a real application of drug monitoring and patient medication counseling system in drug information centers practice. Continues keep up with these levels is required with regular investigation of network drug information centers at Ministry of Health hospitals is preferable.