Pharmacist Counseling Research Articles

A comparison of medication counseling evaluation tools utilized in colleges of pharmacy to three recognized guidance documents

IntroductionA universal tool to assess proficiency in patient counseling has not been developed. The objectives of this project were to assess current practices in evaluating patient counseling at colleges of pharmacy and compare the results with three nationally recognized reference standards: the Omnibus Budget Reconciliation Act of 1990, the American Pharmacists Association Academy of Student Pharmacists National Patient Counseling Competition Evaluation Form, and the American Society of Health-System Pharmacists Guidelines on Pharmacist Conducted Patient Education and Counseling. MethodsA cover letter and questionnaire were sent to all members of the American Association of Colleges of Pharmacy Laboratory Instructors Special Interest Group with an invitation to submit an evaluation tool. Descriptive statistics were used to examine the questionnaire items. An inductive approach was used to analyze the evaluation tools, which was completed independently by two members and then compared to build consensus to establish common content categories. ResultsFive major categories emerged with variability in content. More than 75% of tools included an introduction, almost 59% included collecting information, most included drug information (94%) and counseling points (88%), and most included verification of understanding (94%) and communication skills (94%). ConclusionAlthough there was variability, most evaluation tools incorporated aspects of all three guidance documents. A limitation of this study was that data may be subject to non-response bias, as the response rate was limited to 17.8%. Future work should focus on creating and validating a standardized evaluation tool to ultimately promote consistency among student pharmacists.

Electronic Decision Support for Management of CKD in Primary Care: A Pragmatic Randomized Trial

Most adults with chronic kidney disease (CKD) in the United States are cared for by primary care providers (PCPs). We evaluated the feasibility and preliminary effectiveness of an electronic clinical decision support system (eCDSS) within the electronic health record with or without pharmacist follow-up to improve the management of CKD in primary care. Pragmatic cluster-randomized trial. 524 adults with confirmed creatinine-based estimated glomerular filtration rates of 30 to 59mL/min/1.73m2 cared for by 80 PCPs at the University of California San Francisco. Electronic health record data were used for patient identification, intervention deployment, and outcomes ascertainment. Each PCP's eligible patients were randomly assigned as a group into 1 of 3 treatment arms: (1) usual care; (2) eCDSS: testing of creatinine, cystatin C, and urinary albumin-creatinine ratio with individually tailored guidance for PCPs on blood pressure, potassium, and proteinuria management, cardiovascular risk reduction, and patient education; or (3) eCDSS plus pharmacist counseling (eCDSS-PLUS). The primary clinical outcome was change in blood pressure over 12 months. Secondary outcomes were PCP awareness of CKD and use of angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and statin therapy. All 80 eligible PCPs participated. Meanpatient age was 70 years, 47% were nonwhite, and mean estimated glomerular filtration rate was 56±0.6mL/min/1.73m2. Among patients receiving eCDSS with or without pharmacist counseling (n=336), 178 (53%) completed laboratory measurements and 138 (41%) had laboratory measurements followed by a PCP visit with eCDSS deployment. eCDSS was opened by the PCP for 102 (74%) patients, with at least 1 suggested order signed for 83 of these 102 (81%). Changes in systolic blood pressure were-2.1±1.5mm Hg with usual care,-2.8±1.8mm Hg with eCDSS, and-1.1±1.1 with eCDSS-PLUS (P=0.7). PCP awareness of CKD was 16% with usual care, 26% with eCDSS, and 32% for eCDSS-PLUS (P=0.09). In as-treated analyses, PCP awareness of CKD was significantly greater with eCDSS and eCDSS-PLUS (73% and 69%) versus usual care (47%; P=0.002). Recruitment of smaller than intended sample size and limited uptake of the testing component of the intervention. Although we were unable to demonstrate the effectiveness of eCDSS to lower blood pressure and uptake of the eCDSS was limited by low testing rates, eCDSS use was high when laboratory measurements were available and was associated with higher PCP awareness of CKD. Grants from government (National Institutes of Health) and not-for-profit (American Heart Association) entities. Registered at ClinicalTrials.gov with study number NCT02925962.

Impact of pharmacist counseling on health-related quality of life of patients with type 2 diabetes mellitus: a cluster randomized controlled study

PurposeThe quality of life (QoL) of patients with type 2 diabetes mellitus (T2DM) is a measure of the successful outcomes of therapy. The program of management of chronic diseases “Program Pengelolaan Penyakit Kronis” (Prolanis) among patients with hypertension and T2DM is a new strategy of the Badan Penyelenggara Jaminan Sosial (BPJS), which is the Indonesian national health insurance system. Here, we analyzed the impact of pharmacist counseling interventions on health-related QoL (HRQoL) in Prolanis T2DM patients.MethodsThis cluster randomized controlled trial was designed to include two groups [control (n = 111) and intervention (n = 109) groups], and pre- and post-test procedures. The participants were Prolanis T2DM patients who attended four primary health-care centers (Puskesmas) in Makassar City, South Sulawesi, Indonesia from August 2017 to August 2018. The intervention group received systematic counseling for 6 months. The data were collected using the Bahasa Indonesia version of the European Quality of Life 5 Dimensions 5 Levels (EQ-5D-5 L) questionnaire and were analyzed using EQ-5D preference weight for each health state with the Indonesian EQ-5D-5 L value Set. Furthermore, the EQ-5D index and the EQ-5D VAS score were calculated and HbA1c levels were assessed.ResultsThe change in the EQ-5D-5 L index score (post-pre) was 0.01 in the control group and 0.04 in the intervention group (P = 0.041). The change in the VAS score was −0.07in the control group (post-pre) and 2.66 in the intervention group (P = 0.000).ConclusionPharmacist counseling may help improve the HRQoL of Prolanis T2DM patients.

Retrospective Evaluation on Patient Screening and Counseling Service on Direct-acting Antivirals Against Hepatitis C

Objective: Drug-drug interactions and risk of hepatitis B reactivation potentially affect treatment outcomes of direct-acting antivirals (DAA) against hepatitis C. A comprehensive pharmacist screening and counseling service was implemented in a Hong Kong hospital, which aims to optimize the efficacy and safety of DAA therapy while minimizing the risk of drug wastage. The objective of the service review is to explore potential roles of pharmacist in hepatitis C management.
 Design: We retrospectively evaluate all cases under service from June 2017 to September 2018.
 Main outcome measures: Outcomes measured include drug-related problems (DRP) identified, treatment discontinuation and failure rates.
 Results: There were 44 cases under provision of service, all completed therapy except 1 died from underlying disease. 25 DRPs, predominantly categorized as drug-drug interactions, were documented. The interactions commonly involved acid-lowering agents. 1 case was noted with inadvertently lengthening of treatment duration. No cases of treatment failure or hepatitis B reactivation were reported.
 Conclusion: The safety concerns and high cost of DAA have created a new challenge to healthcare providers. Comprehensive screening and counseling by pharmacists are valuable to ensure safe and effective use of DAA, hence reducing unnecessary drug wastage.

The Role and Responsibility of Clinical Pharmacists in Rheumatology Clinic: An exploratory study in Hong Kong

In Hong Kong, arthritis is the third leading chronic disorder among the older people. It could create a huge amount of burden on the health care system if patients cannot achieve good diseases control and have recurrent flare up of diseases. To maintain stable control and minimize acute flare up, medication adherence is essential. Studies revealed that drug education has the highest evidence in improving medication adherence. Pharmacists who are expert in drugs can provide counseling to arthritis patients, improving their drug adherence and disease activities. As a result, research evaluating the effectiveness of pharmacist counseling service on improving arthritis patients’ medication adherence and disease activities in Hong Kong has been initiated in a specialist out-patient clinic of a local acute hospital.
 This research aims to improve patient medication adherence and enhance medication safety. A validated Compliance Questionnaire on Rheumatology (CQR-19) is used to measure the medication adherence. From the preliminary data, over 90% of the recruited subjects are non-adherence at baseline and thus, detailed drug counseling is necessary.
 During the first visit, pharmacists will provide a 20 minutes drug counseling service to the referred patients. This includes discussion on drug administration schedule, importance of drug adherence, side effects management and pain management. Besides, pharmacists also have different roles in other aspects such as drug information and procurement. Pharmacists would assist in providing evidence-based information and recommendations to physicians and nurses for drug-related enquiries. These attempts to improve therapeutic outcomes and minimize medication errors, enhance medication safety and reduce hospitalization. Design of the multidisciplinary care model and results of this study would provide a reference for the future development of clinical pharmacist service in rheumatology.

A naturalistic observation study of medication counseling practices at retail chain pharmacies.

Objective:This study evaluated medication counseling procedures and trends at retail pharmacies in the Houston metropolitan area through a naturalistic observational study.Methods:A blinded cross-sectional observational study was conducted at retail pharmacies in the Houston metropolitan area. Data were collected by trained observers utilizing an observational log, to record various parameters that could have an impact on the duration of patient-pharmacist interaction in a naturalistic pharmacy practice setting. Additionally, indicators of counseling such as utilization of the counseling window and performance of show-and-tell were recorded. Statistical analyses included descriptive statistics, t-tests, Pearson correlations, ANOVAs, and multiple linear regressions.Results:One hundred and sixty-five interactions between patients and pharmacy staff were recorded at 45 retail pharmacies from 7 retail pharmacy chains. The counseling window was utilized in only 3 (1.81%) out of 165 observations and the show-and-tell process was observed in just 1(0.61%) interaction during this study. Mean (SD) interaction time between patient and pharmacists [159.50 (84.50)] was not statistically different (p>0.05) from the mean interaction time between patients and pharmacy technicians [139.30 (74.19)], irrespective of type of the retail chain observed. However, it was influenced by the number of patients waiting in queue. Patient wait time significantly differed by the time of the day the interaction was observed, weekends and weekdays had significantly different wait times and patient interaction times Multiple linear regression analyses indicated that, patient interaction time, pharmacy chain type, initial contact (pharmacist/technician), and time of the day, were significantly associated with patient wait time whereas patient wait time, pharmacy chain type, number of patients in queue, and number of pharmacy technician were significantly associated with interaction time.Conclusions:Our study found that the key indicators of counseling including the use of the counseling window and the show-and-tell process were absent, suggesting lack of adequate pharmacists counseling. Further studies are needed to evaluate the validity of this conclusion and the role of pharmacy services and its value towards medication use and safety.

Applying the Model for Improvement to a Student-run Quality Improvement Project in a Refugee Center: A Pilot Study.

Due to insufficient communication strategies between healthcare providers and refugees in the United States, this quality improvement project aimed to improve disparity in refugee healthcare. We chose to focus on community pharmacist counseling sessions with refugees in the city of Rochester, New York. The two refugee populations we focused on were the Burmese and Nepali. Due to illiteracy in their native language, the refugees were not receptive to a pamphlet detailing the beneficial roles a pharmacy can have in improving their health and wellbeing. We created a pictorial survey of pharmacies near a refugee center to identify the pharmacies the refugees were utilizing in the area. Once we identified these pharmacies, we created a counseling aid booklet translating common pharmacy language/terms into English, Burmese, and Nepalese languages supported by pictorial diagrams. The counseling aid booklet was evaluated by pharmacists using a satisfaction scale. Overall, the counseling aid booklet was found to be helpful for the pharmacist's daily interaction with refugee populations. Further plans for the counseling aid booklet include adding more pharmacy counseling terms for common disease states in refugee populations, making the book more inclusive of other languages, and implementation in more community pharmacies and other diverse healthcare settings.

Patient Satisfaction and Their Willingness to Pay for a Pharmacist Counseling Session in Hospital and Community Pharmacies in Saudi Healthcare Settings.

ObjectivePatient satisfaction is an indicator for quality of healthcare service and is sometimes linked to patients’ willingness to pay. Willingness to pay is an economic method for estimating patient’s inclination for a service in monetary terms. This study assessed satisfaction of patients from pharmacist counseling service and estimated their willing to pay for the same.MethodsA month-long survey was conducted in community and hospital pharmacies located in Khobar, Dammam, and Qatif cities of Saudi Arabia, using Arabic version of Patient Satisfaction Feedback (PSF) questionnaire that measured satisfaction with counseling as well as willingness-to-pay. Convenient sampling method was used, and sample size was calculated based on power analysis. Data was analyzed through SPSS version 23. Chi-square (χ2) test and logistic regression analyses were conducted to report associations between variables and, determinants of satisfaction as well as willingness to pay respectively. The study was approved by concerned ethical committee (IRB-2019-05-020).ResultsPatients (n = 531) with previous counseling experience were more likely to be satisfied [adjusted odds ratio (AOR) 5.2, p < 0.05]. Patients were more willing to pay if, they had an income above SAR 10,000 i.e., USD 2666.5 (AOR 1.78, p < 0.05), were satisfied with counseling time duration (AOR 4.5) and, were able to get counseling without difficulty (AOR 2.1, p < 0.05). Patients were more likely to be satisfied and were willing to pay if, they received required knowledge/information completely (AOR 2.5, 3.7, and p < 0.05) and found pharmacist helpful (AOR 1, 4.5, and p < 0.05). Most patients (43.9%) were satisfied with pharmacist counseling and average satisfaction rating was 7.87 ± 1.99/10.ConclusionPatients considered counseling as an important service and were satisfied from it. Less than a third of patients were willing to pay for the service. Knowledge and helpfulness of pharmacist were identified as two major determinants that could not only satisfy and but also promote willingness to pay for the service. A pharmacist with skills in pharmaceutical care and counseling could be useful in promoting the service and making it profitable for pharmacy business.

Assessment of Pharmacist Dispensing Practices and their Educational Role Toward Patients on Oral Cytotoxic Drugs Regimen in Radiation and Isotopes Center at Khartoum, Sudan

Background: Increasing use of oral cytotoxic chemotherapy among cancer patient in Sudan, rising important concern about safety practicing and using of these drugs. This study aimed to assess and demonstrate pharmacist dispensing pattern and their educational role toward patients on oral cytotoxic drugs regimen in Radiation and Isotopes Center at Khartoum (RICK). Methods: Across-sectional study was carried out at (RICK) hospital pharmacies. Data collected by using self-administered questionnaire distributed to all staff in active works (40 pharmacists) during February 2016. Results: All the participants responded to the questionnaire. The study reported variation among pharmacists when checking prescription. In which 97.4% of them checked drug name while only 76.9% calculating the dose according to the body surface area. For the patients-pharmacist counseling and it is effectiveness the study revealed that 77.5% of pharmacist providing counseling for the patient at the first visit. 75% of pharmacists counseling the drugs regimen. 28.1% of them including the drugs side effects and management. The counseling of the drugs handling and storage was registered by 65.6% of the participants. 53.1% of the pharmacists advice the patients to swallow the tablets and not crush it. The drugs interaction was counseled by 9.4% and only 2% of pharmacists counseled patients about medications teratogenicity. The finding revealed significant association between pharmacist experience and counseling practice by chi-square (p-value=0.008) while, the hospital training and staff attending has on significant association with (p-value=0.922, p-value=0.479). Conclusion: The study concluded that dispensing practice among pharmacists was main divers. Moreover, most of the pharmacists followed no standard when counseling patients and their experience becomes the main source when educating them.

EVALUATION OF RISK FACTORS FOR THE PREVALENCE OF KIDNEY FAILURE(CKD &amp; AKD) AND THE IMPACT OF CLINICAL PHARMACISTS ROLE IN IMPROVING THE MEDICATION ADHERENCE IN KIDNEY DISEASE PATIENTS OF A TERTIARY CARE TEACHING HOSPITAL

Aim : The aim of the study is to evaluate the risk factors for the prevalence of kidney failure (CKD & AKD ) and to analyse the role of clinical pharmacist in improving the medication adherence.Methodology : A prospective interventional, analytical study was done on patients admitted in Maharaja Institute Of Medical Sciences Viziayanagaram ,AP, India . Information regarding the renal disease ,stages of CKD ,age ,gender ,causative factors ,serum creatinine ,dialysis, medication adherence ,reasons for non medication adherence ,were recorded in standerdquationnarie ( Case Report Form). Results :Total 220 patients were included in this study , out of them 158(71.8%)patients were diagnosed with CKD &62 (28.1%) patients were diagnosed with AKD . Renal disease is high in male patients (63.1%) than in female patients (36.8%). Non medication adherence reasons and pharmacist counselling about medication adherence are the modifiable risk factore and got significant values in student T test (p value 0.0326 & 0.0478) using SPSS Software. Conclusion: Hypertension Is The Major Riskfactor For Developing of Kidney Failure . More Patients Are Prone To Ckd When Compared To Akd .Kidney Failure Is Mostly Observed In Men Than In Women And They Are Mostly Diagnosed With Ckd Stage 5 .Lack Of Symptoms Is The Primary Factor For Non-Medication Adherence Among People. As There Is A Clear Evidence Seen Based On Data Obtained After Performing Patient Counselling And Patient Education ,We Conclude Clinical Pharmacists Could Play A Vital Role In Improving The Medication Adherence Among Ckd & Akd Patients Which Wil Ultimately Make The Patients Free From Ckd & Akd .

Mandatory pharmacist-led education session for patients seeking medical cannabis.

Objective:The primary objectives of this pre-post session study, was to evaluate the impact of a pharmacist-led education session on the perceived benefits and safety of cannabis among patients with chronic pain, as well as determine the influence of pharmacist education on the selection of safer cannabis products and dosage forms for medical use among patients.Methods:A retrospective analysis of completed pre-post session questionnaires was conducted among chronic pain patients attending a mandatory education session led by a pharmacist, prior to being authorized cannabis in clinic. All questionnaire data was analyzed using SPSS v. 25. Demographic and sample characteristics were reviewed using univariate analyses. Chi-Square tests were employed to determine if the group-based education significantly affected knowledge, perception of efficacy and safety of cannabis.Results:Of the 260 session participants, 203 completed pre-post session questionnaires. After the session, a majority of current cannabis users (33.8%) and cannabis naïve/past users (56.9%) reported they would use a low THC product in the future, and a majority of current users (54.5%) would use a high CBD product in the future. After education, participants were more likely to report cannabis as having the potential for addiction (chi-square =42.6, p <0.0001) and harm (chi-square =34.0, p <0.0001).Conclusions:Pharmacist counselling and education has the potential to influence patient selection and use of cannabis, from more harmful to safer products, as well as moderate the potential perceived benefits of use.

Pharmacist counseling is an important factor in lowering blood pressure of hemodialysis patients with hypertension

Pharmacist counseling is an important factor in lowering blood pressure of hemodialysis patients with hypertension

Role of pharmacist's counseling on folate compliance

Background: Pregnant women's compliance with a regimen of folate supplementation is an important factor in decreasing incidence of neural tube defects (NTDs). Because effective medication counseling can be used to enhance women's compliance with folate intake, pharmacists can help ensure good pregnancy outcomes by improving women's compliance through such counseling. Objectives: To determine the effect of medication counseling delivered by pharmacists on compliance among pregnant women in Tabuk, Saudi Arabia. Materials and Methods: A cross-sectional analytical study was conducted of 360 pregnant women who attended antenatal care clinics at primary health-care centers in 2018. A well-designed questionnaire was used for data collection. The data were analyzed using descriptive statistics and the Chi-squared test. Results: About half of the study participants began consuming folic acid after becoming pregnant (55.8%) and only 28.6% reported preconceptional intake. The most common reason for noncompliance was forgetfulness (64.40%). Almost two-thirds of women knew the importance of taking folate in pregnancy to prevent NTDs (64.2%). Their main sources of knowledge about folic acid were doctors (35.8%) and pharmacists (25%). A significant association was found between regular folate intake and pharmacist counseling as a source of folate information. Conclusion: Almost half of pregnant women complied with their folate supplementation regimen. However, lower preconceptional intake was observed. Participants' level of awareness of the importance of folic acid supplementation for pregnant women, though adequate, was not sufficient to ensure good pregnancy outcomes. Pharmacists were identified as a valuable source of information about folic acid, with their provision of medication counseling significantly associated with regularity of folate intake.

A case study on geriatric patient with coronary artery disease-associated diabetic foot ulcer: A clinical pharmacist management care

A 66-year-old male patient was presented to the cardiology ward with complaints of chest pain for couple of days, breathlessness, sweating, and cough. He had complaints of loss of sensation over foot. He had past medical history of type 2 diabetes mellitus with hypertension. He had a history of ulcer with right big toe gangrene and trauma to right big toe before 20 days. Following with this condition, he developed a small ulcer. He has previous history of wound debridement. His echocardiogram detected moderate left ventricular systolic function and left ventricular ejection fraction was 38% which confirmed the presence of coronary artery disease. He underwent coronary angiogram which showed the presence of calcific coronary artery disease with triple vessel disease. The patient was diagnosed with diabetic foot ulcer with coronary artery disease. He was continuously monitored for a week and prescribed with medications. The patient was found stable and he was discharged from the hospital with advise of scheduled Physician's follow-up. The patient was forwarded to a clinical pharmacist counseling services for medication usage, foot care, wound care, lifestyle modifications' advices, physical exercise, stress management strict medication adherence, dietary intake suggestions, and disease-based information to alleviate the progress of disease complications. The medications advice by clinical pharmacist services in such complex disease association management is an imperative need in clinical practice. The clinical pharmacist intervention was proved to be an implementation to effective therapeutic outcomes in the patient.

The Effects of Clinical Pharmacist Education on Lifestyle Modifications of Postmyocardial Infarction Patients in South India: A Prospective Interventional Study

Myocardial infarction (MI) is associated with significant short-term and long-term mortality and morbidity. Secondary prevention and treatment of post-MI patients through medication and lifestyle modification is becoming an important aspect of patient care regimens. Pharmacists have a crucial role in providing these disease-prevention interventions compared with other health care professionals. The primary objective included evaluation of clinicalpharmacistinterventions at discharge and post-MI discharge follow-up to improve the secondary lifestyle modifications and medication adherence among post-MI patients. The secondary objective included the prevention of hospital readmission rates for major adverse cardiovascular events and death among post-MI patients. In this prospective interventional study comprising 160 screened patients, 154 patients were randomized according to eligibility criteria of whom 77 were enrolled in Group A (the intervention group: clinical care along with pharmacist education) and 77 in Group B (the control group: clinical care with usual counseling) (November 2017-April 2018). Two patients were lost to follow-up in both study groups. Group A patients received clinical care with pharmacist structured intervention at post-MI discharge and through telephone follow-ups, whereas Group B patients received clinical care with usual counseling at baseline. Patients in both groups were analyzed for secondary lifestyle modifications such as fasting blood sugar level; postprandial blood sugar level; blood pressure; and total cholesterol, LDL-C, HDL-C, VLDL-C, and triglyceride level; hospital readmission rates; and medication adherence at the baseline. At the end of 6 months patients in both study groups underwent follow-up. Medication adherence was analyzed using the Medication Adherence Rating Scale. Statistical analysis was carried out by using SPSS software version 17 (SPSS-IBM Inc, Armonk, NY). The mean (SD) age of the study population was 56.38 (11.68) years in Group A and 53.93 (13.26) years in Group B. Ther were more male patients than female patients in the study population. There was a statistically significant reduction in systolic and diastolic BP in Group A (P ˃ 0.0031 and P ˃ 0.0069, respectively) compared with Group B. Reduction in total cholesterol levels were observed in Group A compared with Group B (P ˃ 0.0001) patients, but there were no significant reductions found in lipid profile values, including LDL-C (P ˃ 0.0669), HDL-C (P ˃ 0.595), triglyceride (P ˃ 0.119), and VLDL-C (P ˃ 0.4215) at follow-up. Group A patients were more adherent to the medications with lower hospital readmission rates compared with Group B. Clinical pharmacist counseling improved the medication adherence and lifestyle modifications in post-MI patients with the reduction in blood glucose levels, blood pressure, and total cholesterol levels among the study population.

Dispensing errors in community pharmacies in the United Arab Emirates: investigating incidence, types, severity, and causes.

Background:Medication dispensing is a fundamental function of community pharmacies, and errors that occur during the dispensing process are a major threat to patient safety. However, to date there has been no national study of medication dispensing errors in the United Arab Emirates (UAE).Objective:The study aimed to investigate the incidence, types, clinical significance, causes and predictors of medication dispensing errors.Methods:The study was conducted in randomly selected community pharmacies (n=350) across all regions of UAE over six months using a mixed-method approach, incorporating prospective disguised observation of dispensing errors and interviews with pharmacists regarding the causes of errors. A multidisciplinary committee, which included an otolaryngologist, a general practitioner and a clinical pharmacist, evaluated the severity of errors. SPSS (Version 26) was used for data analysis.Results:The overall rate of medication dispensing errors was 6.7% (n=30912/ 464222), of which 2.6% (n=12274/464222) were prescription-related errors and 4.1% (n= 18638/464222) pharmacist counselling errors. The most common type of prescription-related errors was wrong quantity (30.0%), whereas the most common pharmacist counselling error was wrong drug (32.1%). The majority of errors were caused by medicine replaced with near expire one (24.7%) followed by look-alike/sound-alike drugs (22.3%). The majority of errors were moderate (46.8%) and minor (44.5%); 8.7% were serious errors. Predictors of medication dispensing errors were: grade A pharmacies (dispensing ≥ 60 prescriptions a day (OR 2.1; 95%CI 1.4-3.6; p=0.03) and prescriptions containing ≥4 medication orders (OR 2.5; 95%CI 1.7-4.3; p=0.01).Conclusions:Medication dispensing errors are common in the UAE and our findings can be generalised and considered as a reference to launch training programmes on safe medication dispensing practice.

Community pharmacists' attitudes, barriers, knowledge and counseling practice with regard to preconception, pregnancy and lactation.

Although preferably avoided, pregnant and lactating women often use medicines, including potentially inappropriate products. Pregnant women also commonly search for online information on medication. This underscores the need for appropriate counseling by healthcare professionals, including community pharmacists. However, little is known about pharmacists' perceptions and barriers towards this role, nor about their knowledge and counseling practice. To explore licensed pharmacists' attitudes, barriers, knowledge and counseling practice regarding pharmaceutical care during preconception, pregnancy and lactation. All pharmacists employed in 40 randomly selected pharmacies of a Belgian pharmacy chain ('Surplus Network') were asked to complete an online survey between September 2018-February 2019. The survey assessed pharmacists' attitudes and current practice regarding their role, as well as barriers and knowledge. Additionally, the 40 pharmacies were visited twice in December 2017 by simulated patients. The scenarios included a request for a pregnancy test and for an over-the-counter (OTC) product to treat pregnancy-related nausea. All 63 invited pharmacists completed the survey. For all attitude-related statements, at least 80% agreed that pharmacists should take up the presented roles. However, for only 1 in 5 statements did at least 80% report currently taking up these roles for all or most patients. Most commonly reported barriers related to difficulties identifying the woman's status (71%) and lack of education (67%). The median score for the knowledge test was 23/45 (range: 6-36). The mystery shopping showed inadequate questioning and insufficient counseling. Only in 10% of cases was folic acid intake spontaneously discussed; in 39% of cases, incorrect advice about the dispensed OTC-product was given. Pharmacists acknowledged having an important role during preconception, pregnancy and lactation, but currently do not provide pharmaceutical care in this area to most patients. Educational programs are urgently needed to improve licensed pharmacists' knowledge and counseling regarding this topic.

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.

Patient's Perception of a Pharmacist's Relationship and Counseling Skills in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2019,8,1,26-31.DOI:10.5530/ijpcs.2019.8.6Published:January 2019Type:Research ArticleAuthors:Yousef Ahmed Alomi, Sarah Abdullah Al-Hathlool, Maryam Ibrahim Almulhim, Yousef Aboshalaf, and Mytham Al-Ethan Author(s) affiliations:Yousef Ahmed Alomi1,* , Sarah Abdullah Al-Hathlool2, Maryam Ibrahim Almulhim2, Yousef Aboshalaf3, Mytham Al-Ethan4 1The Former 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, General Administration of Pharmaceutical Care, Ministry of Health, Riyadh, SAUDI ARABIA. 3Head of Pharmacy Services King Fahad Hospital, Alhasa, SAUDI ARABIA. 4Assistant Head of Pharmacy Services, King Fahad Hospital, Alhasa, SAUDI ARABIA. Abstract:Purpose: To explore the patient’s perception of a pharmacist’s relationship and counseling skills in Saudi Arabia. Methods: This is a 4-month cross-sectional survey of the patient’s perception of the pharmacist. The survey consisted of two part: the first part gathers demographic information and the second part contains 49 questions divided into four domains: (1) the first domain captures data regarding the patient’s general perception about the pharmacist; (2) the second domain captures data regarding the patient’s perception of pharmaceutical services; (3) the third domain was regarding the patient’s perception of visiting ambulatory care; and (4) the fourth domain captures the data regarding the patient’s perception of pharmacist’s relationship and counseling skills. We used the 5-point Likert response scale system to obtain responses of the participants. There were open- and close-ended questions. The survey was distributed through social media at a 500-bed general hospital in Alhassa region, at an ambulatory care pharmacy. The authors interviewed the patients with an electronic survey documentation. The survey was distributed in an electronic format. In this study, we analyzed domain four, that is, about the patient’s perception of pharmacist’s relationship and counseling skills through Survey Monkey system. Results: A total of 617 patients responded to the survey. Of them, 536 (87.7%) were Saudi and 75 (12.3%) were non-Saudi nationals. There were 457 (74.1%) female and 160 (25.9%) male responders. Most of the patients (222 (36%)) visited the pharmacy more than 10 times in the past 12 months, whereas the others (122 (19.8%)) visited the pharmacy at least 5–9 times. Most of the patients (481 (83.5%)) spent less than 11 min with the pharmacist. The average score of patient perception of a pharmacist with communication and relationship skills was 3.66. The following statements received highest scores: “the pharmacist politely delivers the medication” (4.09) and “the pharmacist answers the questions in an excellent way” (3.87). The statement with lowest score was “communication with pharmacy by phone at any time” (3.04) (Table 2). The average score of patient’s perceptions of pharmacists with medications counseling skills was 3.6. The statement with highest score was “all the medications received were packed” (4.35) and “the patient understands what the pharmacist was saying” (4.1). The statement with lowest score was “the pharmacist provides you information about the proper storage of your medication” (3.04) and “the pharmacist explains all the possible side effects” (3.12). The statements with highest scores of patient relationship with drug information centers were “the pharmacist answers patient’s question through drug information center’s hospital over 24/7” (3.44) and “poisonous cases first contact the national drug information center or any hospital drug information center any time through MOH hotline 937 over 24/7” (3.37). Conclusion: Patient’s perception toward pharmacist’s communication and counseling skills need to improve with an emphasis on patient’s privacy, contacting facilities and instructions to drug-related problems. Improvement of patient demand will raise patient’s perceptions and avoid the unnecessary additional cost. Keywords:Counselling, Ministry of Health, Perception, Pharmacist, Relationship, Saudi ArabiaView:PDF (380.64 KB) PDFClick here to download the PDF file. Images Patient perception of the pharmacist regarding his communication and relationship skills

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