Pharmaceutical Care To Patients Research Articles

Analysis of pharmaceutical care in patients with psoriatic arthritis using statutory health insurance data.

Psoriatic arthritis (PsA) is an inflammatory joint disease. Despite numerous health care research studies, there is hardly any data regarding the current state of pharmaceutical care of PsA patients in Germany. Based on a systematic literature search and routine administrative data from the Rhineland/Hamburg (statutory) health insurance fund ("Allgemeine Ortskrankenkasse", AOK), the present study provides an up-to-date overview of pharmaceutical care of German PsA patients. Selected were those in- and outpatients who - in the first or second quarter of 2014 - had been coded as having the diagnosis of psoriatic arthritis (L40.5+) according to the International Classification of Diseases (ICD-10-GM version 2015). On the basis of this "predefined cohort", drug prescription data was subsequently analyzed for a five-year period (January 1, 2010 to December 31, 2014). Overall, 3,205 AOK-insured individuals (45% male, 55% female) were diagnosed with PsA. Mean age was 58.9 years; 53.7 % of PsA patients received systemic treatment. Nonsteroidal antiinflammatory drugs (NSAIDs) were the most frequently prescribed agents, followed by corticosteroids. Among patients on systemic treatment, 72.1% were treated with disease-modifying antirheumatic drugs (DMARDs); 20.9% with a combination of DMARDs and biologics. Not only does pharmacological treatment of PsA have to ensure adequate patient care aimed at preventing disease progression, it also has to be approached with economic responsibility.

Prioritization of diseases for the development of a pharmaceutical care service model in South Korea using the analytic hierarchy process .

Drug therapy plays a critical role in most chronic diseases. Effectiveness of pharmaceutical care services in the improvement of clinical, social, or economic outcomes has been scientifically proven through numerous studies. In South Korea, to optimize and standardize pharmaceutical care for patients with chronic metabolic diseases, the development of a pharmaceutical care service model is needed. To determine the priority of diseases in developing pharmaceutical care service models, analytic hierarchny process (AHP)analysis was used. A survey questionnaire standardized with detailed evaluation areas and an index, to ensure sufficient understanding and identical standards of evaluators, was designed. It was prepared for pair-wise comparisons of individual criteria of candidate diseases. Medical specialists and pharmacists who have clinical experience and expertise in chronic metabolic diseases or at least 10 years of experience in pharmacy practice were recruited. They responded to a survey consisting of nine sections by using the pair-wise comparison method. A total of seven candidate diseases were selected for prioritization. Diabetes mellitus was given the highest score of 0.2695, cardiovascular disease (0.2598) being the next, followed by chronic kidney disease (0.2000), and cerebrovascular diseases (0.1087). The criteria were weighted as follows: disease characteristics (0.4964), patient-oriented care (0.3649), and improvement in services (0.1386). Diabetes, cardiovascular diseases, and chronic kidney disease were found to have high priority in developing a pharmaceutical care service model in South Korea. In the future, further research for the development and application of pharmaceutical care services models for different types of diseases is required. .

The Use of Traditional Herbal Medicines Amongst South Asian Diasporic Communities in the UK.

Migrant South Asian communities in the UK have brought with them their own traditional forms of medicine, yet little is known about their current use of herbal medicines (HMs) in the UK. The aim of the study was to explore the origins, use and transmission of knowledge of traditional HMs used by diasporic South Asian communities in the UK. A researcher-administered questionnaire was used for data collection (n=192). An opportunity sampling technique was used to recruit participants across several locations in Birmingham and Leicester. Two thirds of participants (n=126) stated they used HMs to maintain their health and to treat various health conditions such as digestive problems, skin conditions and diabetes. Almost 2000 actively used HMs were documented including 123 plant species that were identified. Participants imported HMs from abroad as well as sourcing them locally and even growing some of their own plants. Up to 82% (n=87) of participants who took prescription medicines did not tell their healthcare professionals about any HMs they consumed; this raises concerns about people's knowledge of herb-drug interactions, compliance and effect on prescribed medicine regimens. Similar studies to explore the use of HMs by other ethnic groups are imperative to help optimise pharmaceutical care of patients. Copyright © 2017 John Wiley & Sons, Ltd.

Interdisciplinary Care Team with Pharmacist in a Community-based HIV Clinic

BackgroundHuman immunodeficiency virus (HIV) infection presents a significant burden, especially in the Washington, DC area. Literature is limited in describing the role of pharmacists in the outpatient clinic setting to provide patient-centered pharmaceutical care for patients with HIV. ObjectiveOur study aims to describe an interdisciplinary HIV care model including a clinical pharmacist at a community-based transcultural clinic in the Washington, DC area, and to describe the role of the pharmacist as indicated by an association between non-adherence to antiretroviral therapy (ART) and an ART regimen change. MethodsUsing the electronic health record at the clinic from May 2011 through July 2013, 53 patients were identified who were referred to the clinical pharmacist. ResultsThe average age of the patients with HIV was 46.57 years in the clinic. About 28% of patients had documented non-adherence to ART and 30% of patients had one or more ART regimen changes during the study period. Medication non-adherence was a significant predictor of ART regimen change (ORadj 8.44; 95% CI 1.91–37.29). Substance use was a strong predictor of ART regimen change (ORunadj 3.47; 95% CI 1.02–11.81), but the relationship disappeared in the multivariate analysis. ConclusionsA strong association between pharmacist's evaluation of non-adherence to ART and a regimen change was demonstrated and the role of the pharmacist as the interdisciplinary team member was described. A follow-up study should be made to assess the services provided by the pharmacist on clinical, economic, and humanistic outcomes in the community-based clinical setting.

Impact of clinical pharmacist intervention in anticoagulation clinic in Sudan.

Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care. Setting This study was conducted in Ahmed Gasim cardiac surgery and renal transplant center warfarin clinic. Methods One hundred thirty-five patients were randomly selected from adult patients on warfarin therapy The history of INR records, and adverse effects for the past year, were recorded. Then patients' warfarin dose adjustments according to INR, was done by the clinical pharmacist for one year. Patients received continuous verbal education and written information about warfarin. Main outcome measure The primary outcome for this study was the INR control, while the secondary outcomes were the bleeding events and hospitalization due to warfarin. Results After the clinical pharmacist intervention there was significant (P<0.01) improvement in INR control and a significant (P<0.05) reduction in incidence of bleeding after clinical pharmacist intervention. Hospitalization due to warfarin related complications (bleeding, high INR, low INR) was also significantly (P<0.001) reduced. Conclusion Clinical pharmacists intervention in warfarin therapy improve INR control, reduce bleeding and hospitalization due to warfarin complications.

Opinions of pharmacists and herbalists on herbal medicine use and receiving herbal medicine education in Jordan

Purpose: To explore the beliefs of herbalists and community pharmacists on receiving educational courses in herbal medicine (HM) use by patients at pharmacy schools.Methods: This cross-sectional study was conducted in 2014. Herbalists (n = 48) and pharmacists (n = 163) were randomly recruited into the study. Demographic data, beliefs on HM use by patients, and willingness to attend educational courses were collected using a validated questionnaire and one-onone interviews.Results: The majority of the herbalists (n = 37, 77.1 %) believed that HMs are highly used in Jordan as alternative or add-on therapy to conventional medications, and the majority (n = 39, 81.3 %) reported that they need to be educated on HM use by a professional organization. More than 80 % of the pharmacists believed that they need to be experts on HM use and should apply pharmaceutical care for patients buying registered HMs at their pharmacies; a significantly higher proportion of female pharmacists (p = 0.04) agreed with this concept compared to male pharmacists.Conclusion: Both herbalists and pharmacists showed interest in attending educational courses on HM use at pharmacy schools to improve their ability to serve their patients.Keywords: Herbalists, Community pharmacists, Herbal medicine, Pharmaceutical care

Изучение мнения фармацевтических работников об организации медицинской и лекарственной помощи больным с хроническими заболеваниями кожи и подкожной клетчатки на примере Тульской области

Diseases of the skin and subcutaneous tissue account for 3.8% in the structure of total morbidity. Tula region is among the five leaders in the diseases of skin and subcutaneous tissue in the Central Federal District. This study was examined a medical and pharmaceutical care to patients with chronic diseases of the skin and subcutaneous tissue. Pharmacists give expert assessment of the situation. In the Tula region 40 pharmacists and pharmacy staff were interviewed because they have direct contact with pharmacy visitors. Chronic skin disease was examined on the example of psoriasis, eczema and atopic dermatitis. These diseases are characterized by a prolonged course, with periods of recurrence and remission. Chronic diseases of the skin and subcutaneous tissue significantly reduce the quality of life of patients and are accompanied by long-term medication. Patients with these diseases are frequent visitors to pharmacies, so it is important to study the opinions of specialists with pharmaceutical education on the organization of medical and pharmaceutical care for patients with atopic dermatitis, psoriasis, and eczema.

Optimization of the pharmaceutical care system for diabetes patients using modern pharmaceutical informatics methodology

Aim. Implementation of pharmaceutical informatics methods in the system of pharmaceutical care for diabetes patients in Ukraine. Methods. System method was used for the analysis of status and reforming the pharmaceutical care for patients with diabetes; program-oriented management at informatization project realization; pharmaceutical informatics in the creation of computer pharmaceutical knowledge bases; methods of data synthesis and summarizing. Results. System analysis of the basic directions of reforming the pharmaceutical care for patients with diabetes in Ukraine was carried out. Ways of it’s of optimization were processed: establishment of specialized pharmacies with implementation of modern information technologies and special postgraduate education for pharmacists. Structure and information providing of computer knowledge base “Pharmaceutical care for patients with diabetes” was substantiated. Conclusion. Based on the regional project “Informatization of prescription antidiabetic drugs circulation in Ukraine” realization, the necessity of establishment of specialized pharmacies providing pharmaceutical care for patients with diabetes was substantiated. Ways for optimization of postgraduate education for pharmacists of the specialized pharmacies by implementation of special thematic improvement cycles were proceed. Computer knowledge base as an effective tool for optimization of pharmaceutical care for patients with diabetes was realized

Pharmacist-involved care for patients with heart failure and acute coronary syndrome: a systematic review with qualitative and quantitative meta-analysis.

Many trials have indicated that interventions by pharmacists resulted in beneficial outcomes with positive effects on cardiovascular diseases. The interventions through pharmacist-involved pharmaceutical care in patients with heart failure (HF) and acute coronary syndrome (ACS) were reviewed systemically and examined. A systematic literature search was conducted to identify relevant articles describing pharmacist interventions in HF and ACS. Most studies were evaluated qualitatively, and the strength of evidence was graded according to the Agency for Healthcare Research and Quality (AHRQ) guidelines. Some of the studies were also assessed by a meta-analysis. A total of 26 studies containing data on 9415 patients were identified. For all studies, the strength of the body of evidence was reviewed and graded, and 14 studies among them were meta-analysed. The evidence was not strong enough to determine the effects of pharmaceutical care on major and patient-centred outcomes, except the prescription rates of angiotensin-converting-enzyme inhibitors (ACEI) with a high strength of evidence. In the meta-analysis, all-cause hospitalization [odds ratio (OR), 0·74; 95% confidence interval (CI), 0·58-0·94] was reduced and the prescription rates of angiotensin-converting-enzyme inhibitors (ACEI; OR 1·43; 95% CI, 1·07-1·91) and beta-blockers (OR 1·92; 95% CI, 1·24-2·96) were significantly higher in the pharmaceutical care group compared with the usual care group. All-cause hospitalization showed improvement in the pharmaceutical care group. However, the strength of evidence for the majority of outcomes with pharmaceutical care, except direct performance measures such as prescription rates, was either insufficient or low. This could be explained by the presence of imprecision and inconsistency derived from the diversity of pharmaceutical care, the heterogeneity of patient populations or clinical settings. Moreover, it may indicate the necessity for homogeneous applicable criteria for assessment. A standardized consensus of the guidelines for pharmaceutical care service should be considered to improve homogeneity.

Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

ІНФОРМАЦІЙНО-ОРГАНІЗАЦІЙНЕ ЗАБЕЗПЕЧЕННЯ ФАРМАЦЕВТИЧНОЇ ДОПОМОГИ ХВОРИХ НА ЕПІЛЕПСІЮ

&lt;p&gt;&lt;strong&gt;INFORMATIONAL-ORGANIZATIONAL PROVIDING OF PHARMACEUTICAL CARE FOR PATIENTS WITH EPILEPSY&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Y.O.Hrynkiv, O.B.Blavatska, M.O. Lozynska&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Danylo Galytskyj Lviv National Medical University, Lviv&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Summary:&lt;/strong&gt; The analysis of information on antiepileptic medicines (AEM) in standardized clinical protocols of medical care for patients with epilepsy, State Medicinal Formulary (SMF) of Ukraine 6th and draft 7th editions and comparison of information about AEM in these sources with the State Register of Medicines. It was found that currently registered AEM arsenal (14 INN) is mentioned in the main text of these sources of information and standardized clinical protocols of primary, emergency, secondary and tertiary medical care for patients with epilepsy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Keywords:&lt;/strong&gt; Antiepileptic Medicines (AEM), State Medicinal Formulary (SMF), State Register of Medicines (SRM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction.&lt;/strong&gt; About 50 million people worldwide have epilepsy, nearly 80% of them live in developing countries. Epilepsy responds the treatment about 70% of cases, yet about three fourths of affected people in developing countries do not get the treatment they need. Epilepsy and epileptic syndromes is one of the most widespread and socially significant diseases of the nervous system. The prevalence of epilepsy in the general population in most European countries is 80-230 cases per 100 thousand people. In Ukraine in average of 50-73 persons per 100 thousand suffer from it. According to majority epidemiological studies conducted in our country and abroad, today an increase of the part of epilepsy in the general structure of nervous system diseases from 0.5 to 0.8-1.2%.&lt;/p&gt;&lt;p&gt;The purpose of this study is to analyze standardized clinical protocols of medical care for patients with epilepsy (Ministry of Health of Ukraine order № 276 from 17.04.2014), State Formulary of Ukraine 6th edition (approved by the Ministry of Health of Ukraine order № 252 from 08.04.2014), draft of 7th edition of the State Formulary, and compare information about AEM in these sources with the State Register of medicines of Ukraine.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods.&lt;/strong&gt; To achieve the goals and objectives methods of information retrieval, comparative analysis, synthesis, system, target-oriented were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results and discussion&lt;/strong&gt;. By the latest official data of Ministry of Health (2012) there are about 100,000 patients with epilepsy in Ukraine, but this figure taking into account the statistical average of global prevalence of the disease, most likely is understated. In connection with the providing of medical care for patients with epilepsy by neurologists and psychiatrists, respectively, due to the double coding and registration of clinical expertise and epidemiology, statistics data are fundamentally incorrect and need a new regulation.&lt;/p&gt;&lt;p&gt;According to the analyzed sources one can say that standardized clinical protocol of primary, emergency, secondary (specialized) and tertiary (highpecialized) medical care "Epilepsy in Adults" contains the largest number of AEM, which can be used, but not all of them are registered in Ukraine and exist in State Formulary. Eslikarbazepin (registered in Ukraine under the brand name "Eksaliyef" from July 2012.) is the only currently registered in Ukraine AEM not included in the list of medicines that can be purchased with state funds.&lt;/p&gt;&lt;p&gt;Almost all of these medicines are prescribed on the ordinary prescription forms F-1 and do not stand in the subject-quantifiable accounting (except phenobarbital: the F-3 form, SQA), which increases the physical availability of antiepileptic drugs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions.&lt;/strong&gt; Arsenal of AEM currently registered in Ukraine generally corresponds with the standardized clinical protocol of primary, emergency, secondary (specialized) and tertiary (highspecialized) medical care for patients with epilepsy; adopted Clinical guideline on epilepsy and State Formulary 6th edition. 93% AEM, which are currently registered in Ukraine can be purchased by public funds, which gives patients the opportunity to receive adequate and appropriate treatment.&lt;/p&gt;

Provision of pharmaceutical care in patients with limited English proficiency: Preliminary findings.

Objective:Overcoming language and cultural barriers is becoming ever challenging for pharmacists as the patient population grows more ethnically diverse. To evaluate the current practices used by the pharmacists for communicating with patients with limited English proficiency (LEP) and to assess pharmacists’ knowledge of, attitude toward, and satisfaction with accessing available services for supporting LEPs patients within their current practice settings.Methods:Semi-structured interviews were conducted with five pharmacists employed in pharmacies representing multiple practice settings Queensland, Australia. Thematic analysis was primarily informed by the general inductive approach. NVivo software (QSR International Pty Ltd.) was used to manage the data.Findings:Three interlinked themes emerged from the analysis of interview data: (1) Barriers to the provision of pharmaceutical care, (2) Strategies employed in dealing with LEP patients, and (3) Lack of knowledge about existing services. Pharmacists recognized their lack of skills in communicating with LEP patients to have potential negative consequences for the patient and discussed these in terms of uncertainty around eliciting patient information and the patient's understanding of their instructions and or advice. Current strategies were inconsistent and challenging for LEP patient care. While the use of informal interpreters was common, a significant degree of uncertainty surrounded their actual competency in conveying the core message.Conclusion:The present study highlights a significant gap in the provision of pharmaceutical care in patients with LEP. Strategies are needed to facilitate quality use of medicines among this patient group.

Pharmaceutical care for patients with anti-tuberculosis drug induced liver injury

Pharmaceutical care for patients with anti-tuberculosis drug induced liver injury

ASSESSMENT OF QUALITY OF RENDERING PALLIATIVE CARE TO THE ONCOLOGY PATIENTS

The analysis of prevalence of cancer in the world, in Russia and on the territory of the Samara Region. The results of analysis of neglect of oncological diseases in the Samara region; the results of regression analysis of growth of oncological diseases are presented. The organization of rendering palliative care in the Samara Region is studied and assessment of provision of palliative patients with berths is carried out. The estimate of provision of patients with malignant neoplasms with drugs for pain management. Factors that reduce the quality of rendering of medical assistance to the oncology patients are revealed. Directions of improving the quality of pharmaceutical care of patients with cancer are suggested.

IS4-1 - Pharmaceutical Care for Patients Receiving Cancer Treatment

The role of the Pharmacist in providing pharmaceutical care for oncology patients is dynamically changing. In the United States, the profession of Pharmacy has grown dramatically over the past decade. The Pharmacist's degree has changed from a Bachelor of Science to an entry level Doctor of Pharmacy. Graduates are flooding into the Hospital, Academic, and Ambulatory Clinic settings. As a result, postDoctoral training is becoming more common. In order to provide pharmaceutical care for patients receiving cancer treatment two years of postdoctoral training is recommended. Following postdoctoral specialty training, Oncology Specialty Pharmacists must continue to learn and read literature daily in order to keep up with the fast paced Oncology environment. Furthermore, Pharmacists are encouraged to take their board exams to become board certified in oncology pharmacy (BCOP). Oncology Pharmacist Specialists are involved in designing, monitoring, and changing chemotherapy for patients. They also play a prominent role in medical rounds in the day to day care of patients receiving chemotherapy. This entails formulating supportive care treatment plans for chemotherapy induced toxicities, infections, and their underlying comorbidities such as hypertension, diabetes, dyslipidemia, etc. Providing education is paramount to pharmaceutical care. Patients are educated by a Pharmacist on their chemotherapy regimen and their supportive care medications. Pharmacists also provide education to their Attending Physicians, fellows, residents, and students. Lastly, Oncology Pharmacists indirectly impact patients through clinical research, institutional guideline implementation, chemotherapy orderset building, and reporting of safety events.

IS4-4 - Clinical Pharmacy Services and Research for Lymphoma Patients at an Asian Cancer Center

At the National Cancer Centre Singapore, which is currently the largest ambulatory cancer center that provides patient services to more than 70% of cancer patients in the country, clinical pharmacists have taken upon responsibilities to provide direct pharmaceutical care for patients caring under the lymphoma team since 2006. Given the complexities and intricacies of chemotherapy treatments, clinical pharmacists are part of the team to ensure cancer supportive care is fully optimized among patients receiving treatment. In addition, clinical pharmacists play a pivotal role in guiding cost-effective and safe prescribing. In collaboration with the oncologists on the medical team, clinical pharmacists are also involved in conducting collaborative research in order to optimize the delivery of pharmaceutical care. These dedicated services and research activities conducted by clinical pharmacists, as well as the overall impact to patient care, will be discussed within the seminar.

Enhancing collaborative pharmaceutical care for patients with chronic kidney disease: survey of community pharmacists.

The Kidney Care Clinic at Sunnybrook Health Sciences Centre provides multidisciplinary care for patients with stage 4 or 5 chronic kidney disease. These patients are at high risk of drug therapy problems. Clinic pharmacists review medications and provide recommendations at each visit, but potential gaps in care exist between clinic visits. Community pharmacists are ideally situated to identify and resolve drug therapy problems between visits. To determine community pharmacists' confidence in managing care for patients with chronic kidney disease; to identify opportunities for improving collaboration between clinic and community pharmacists; and to determine the key clinical information that community pharmacists would use when caring for these patients. An anonymous survey was sent by mail and electronically to community pharmacies that were providing prescription medications for clinic patients. A total of 318 surveys were sent to 96 pharmacies. Data analysis was based on descriptive statistics, including frequencies, ranges, and measures of central tendency. Fifty-one completed surveys were returned (response rate 16%). Thirty-five (69%) of the responding pharmacists were not aware or were unsure that a patient from the Kidney Care Clinic was a client of their pharmacy. Forty-six (90%) were confident in providing counselling about medications used to manage chronic kidney disease, and 32 (63%) indicated confidence in recommending drug dosing changes based on kidney function. Forty-five (88%) of the pharmacists indicated a willingness to play a greater role in reviewing medications for patients with chronic kidney disease, and all agreed that they would benefit from education about the complications of this disease and their management. Clinical information ranked most useful included an updated medication list with indications and details regarding recent medication changes. Community pharmacists indicated willingness to have greater involvement in the care of patients with chronic kidney disease. The survey results revealed a need to increase awareness of clinic patients among community providers. Participants were receptive to continuing education, and initial efforts should focus on dosing adjustments of renal drugs and the complications of chronic kidney disease. Tools for transferring clinical information must be developed.

Pharmaceutical care for patients with COPD in Belgium and views on protocol implementation.

A protocol-based pharmaceutical care program (the PHARMACOP-protocol) focusing on patient counselling during prescription filling has shown to be effective in patients with chronic obstructive pulmonary disease (COPD). However, implementation of this protocol in daily practice has not yet been studied. To describe current implementation level of the items included in the PHARMACOP-protocol in Belgian community pharmacies and to evaluate pharmacists' perspectives on the implementation of this protocol in daily practice. A cross-sectional study was conducted from April to June 2012, in randomly selected community pharmacies in Flanders. Pharmacists were questionned using structured interviews. 125 pharmacies were contacted and 80 managing pharmacists (64 %) participated. In >70 % of pharmacies, 4/7 protocol items for first prescriptions and 3/5 protocol items for follow-up prescriptions were already routinely implemented. For first and follow-up prescriptions, respectively 39 (49 %) and 34 pharmacists (43 %) stated they would need to spend at least 5 min extra to offer optimal patient counselling. Most mentioned barriers preventing protocol implementation included lack of time (80 %), no integration in pharmacy software (61 %) and too much administrative burden (58 %). Approximately 50 % of the PHARMACOP-protocol items are currently routinely provided in Belgian community pharmacies. Nearly all interviewed pharmacists are willing to implement the protocol fully or partially in daily practice.

Effectiveness of the Dader Method for pharmaceutical care in patients with bipolar I disorder: EMDADER-TAB: study protocol for a randomized controlled trial.

BackgroundBipolar I disorder (BD-I) is a chronic mental illness characterized by the presence of one or more manic episodes, or both depressive and manic episodes, usually separated by asymptomatic intervals. Pharmacists can contribute to the management of BD-I, mainly with the use of effective and safe drugs, and improve the patient’s life quality through pharmaceutical care. Some studies have shown the effect of pharmaceutical care in the achievement of therapeutic goals in different illnesses; however, to our knowledge, there is a lack of randomized controlled trials designed to assess the effect of pharmacist intervention in patients with BD. The aim of this study is to assess the effectiveness of the Dader Method for pharmaceutical care in patients with BD-I.Methods/designRandomized, controlled, prospective, single-center clinical trial with duration of 12 months will be performed to compare the effect of Dader Method of pharmaceutical care with the usual care process of patients in a psychiatric clinic. Patients diagnosed with BD-I aged between 18 and 65 years who have been discharged or referred from outpatients service of the San Juan de Dios Clinic (Antioquia, Colombia) will be included. Patients will be randomized into the intervention group who will receive pharmaceutical care provided by pharmacists working in collaboration with psychiatrists, or into the control group who will receive usual care and verbal-written counseling regarding BD. Study outcomes will be assessed at baseline and at 3, 6, 9, and 12 months after randomization. The primary outcome will be to measure the number of hospitalizations, emergency service consultations, and unscheduled outpatient visits. Effectiveness, safety, adherence, and quality of life will be assessed as secondary outcomes. Statistical analyses will be performed using two-tailed McNemar tests, Pearson chi-square tests, and Student’s t-tests; a P value <0.05 will be considered as statistically significant.DiscussionAs far as we know, this is the first randomized controlled trial to assess the effect of the Dader Method for pharmaceutical care in patients with BD-I and it could generate valuable information and recommendations about the role of pharmacists in the improvement of therapeutic goals, solution of drug-related problems, and adherence.Trial registrationRegistration number NCT01750255 on August 6, 2012. First patient randomized on 24 November 2011.

Effectiveness of pharmaceutical care for patients with chronic obstructive pulmonary disease (PHARMACOP): a randomized controlled trial.

Few well-designed randomized controlled trials have been conducted regarding the impact of community pharmacist interventions on pharmacotherapeutic monitoring of patients with chronic obstructive pulmonary disease (COPD). We assessed the effectiveness of a pharmaceutical care programme for patients with COPD. The pharmaceutical care for patients with COPD (PHARMACOP) trial is a single-blind 3 month randomized controlled trial, conducted in 170 community pharmacies in Belgium, enrolling patients prescribed daily COPD medication, aged ≥ 50 years and with a smoking history of ≥ 10 pack-years. A computer-generated randomization sequence allocated patients to an intervention group (n = 371), receiving protocol-defined pharmacist care, or a control group (n = 363), receiving usual pharmacist care (1:1 ratio, stratified by centre). Interventions focusing on inhalation technique and adherence to maintenance therapy were carried out at start of the trial and at 1 month follow-up. Primary outcomes were inhalation technique and medication adherence. Secondary outcomes were exacerbation rate, dyspnoea, COPD-specific and generic health status and smoking behaviour. From December 2010 to April 2011, 734 patients were enrolled. Forty-two patients (5.7%) were lost to follow-up. At the end of the trial, inhalation score [mean estimated difference (Δ),13.5%; 95% confidence interval (CI), 10.8-16.1; P < 0.0001] and medication adherence (Δ, 8.51%; 95% CI, 4.63-12.4; P < 0.0001) were significantly higher in the intervention group compared with the control group. In the intervention group, a significantly lower hospitalization rate was observed (9 vs. 35; rate ratio, 0.28; 95% CI, 0.12-0.64; P = 0.003). No other significant between-group differences were observed. Pragmatic pharmacist care programmes improve the pharmacotherapeutic regimen in patients with COPD and could reduce hospitalization rates.