Pharmacy Group Research Articles

A qualitative, theory-based exploration of facilitators and barriers for implementation of pharmacist prescribing in chronic kidney disease.

While there is an accumulation of evidence that pharmacist prescribing is safe and effective, there is a lack of research on processes of implementation into practice, particularly for patients with complex clinical conditions such as chronic kidney disease (CKD). The aim was to explore the facilitators and barriers to the implementation of pharmacist prescribing for patients with CKD in the United Kingdom (UK). Semi-structured interviews were conducted with UK Renal Pharmacy Group members who were independent prescribers. The Consolidated Framework for Implementation Research (CFIR) underpinned the interview schedule. Interviews were recorded, transcribed, and independently coded by two researchers. A thematic approach was used for analysis, with data generation continuing until saturation of themes. Ethical approval was granted. Data saturation was achieved following 14 interviews. Most interviewees were female (n = 11), all had secondary care as their main practice setting, and were highly experienced prescribers with 8 having 11 or more years of prescribing practice. Interviewees were positive regarding the development of their prescribing practice. Facilitators and barriers emerged across all 5 of the CFIR domains. Key facilitators were aspects of inner setting (e.g., organisational support and communication) while key barriers were also related to inner setting, specifically the need for adequate structural and financial resources. This theory-based study has illuminated the facilitators and barriers for the implementation of pharmacist prescribing in CKD. There is a need to consider the resources required for implementation of prescribing practice at an early stage of planning and development.

Digital screens in community pharmacy for public health messaging; a mixed-methods study.

An independent evaluation was undertaken to investigate the perceived impact of installing digital screens in a group of community pharmacies as an approach to provide public health messaging. Community pharmacy staff were interviewed prior to screen installation to investigate experience and perceptions of conventional public health campaigns using written materials. Staff were interviewed after the digital screen installation to investigate their opinions of the installation and its impact on public health delivery in the pharmacy. Patients and public representatives were recruited to visit the pharmacies and asked to complete a survey about what they observed and thought about the public health messaging. Interviews were transcribed verbatim and thematically analysed. Surveys consisted of open, closed, and rating questions. The results of which were descriptively analysed. Community pharmacy staff found paper-based campaigns work-intensive and created paper wastage. The digital screen installation was received positively by pharmacy staff and patient, and public representatives found them eye-catching and engaging. Staff were unable to report any conversations with members of the public triggered by the screens, but the patient and public volunteers were able to recall some of the health messages. Digital messaging is common practice and digital screens are already in use in areas where patients and the public have conventionally been in attendance, e.g. GP surgeries. Digital screens in community pharmacy for public health messaging could be considered an inevitable progression for public health messaging given concerns about wastage and up-to-date information. The impact, however, on triggering healthier choices and lifestyles requires further investigation.

Medical abortion in Ghana: A non-randomized, non-inferiority study of access through pharmacies compared with clinics

ObjectivesTo compare self-reported clinical outcomes following medical abortion with mifepristone and misoprostol sourced from either a pharmacy or health clinic. Study designWe conducted a prospective, non-randomized, non-inferiority cohort study across four regions in Ghana, from high-volume pharmacies and health clinics. Participants seeking medical abortion (less than nine weeks’ gestation) who met usual medical abortion eligibility criteria were recruited. Data collection included baseline surveys, follow-up phone interviews, and self-reported assessments of medical abortion outcomes. The study aimed to enroll 2000 medical abortion users (1000 from each source). ResultsComplete outcome data was available and analyzed from 1958 participants (of 2208 enrolled), with the adjusted risk difference of need for additional treatment to complete the abortion indicating non-inferiority of the pharmacy group compared to the clinic group [−2.3% (95% CI −5.3% to 0.7%)]. Both groups reported low rates of additional treatment (4.9%) and adhered similarly to the abortion regimen. Secondary outcomes showed no significant differences, with moderate acceptability in both groups (65.4% pharmacy, 52.3% facility). Adverse outcomes were rare: one ectopic pregnancy, one blood transfusion and no deaths or other major complications were reported. ConclusionsAccessing medical abortion pills directly from pharmacies without prior consultation from a provider demonstrated non-inferior self-reported clinical outcomes compared to seeking care from health clinics. The findings align with the growing global evidence supporting the safety and effectiveness of medical abortion self-care. ImplicationsThis study contributes data which support future registration of over-the-counter use of medical abortion drugs up to nine weeks’ gestation. Such measures could expand options for safe abortion care, especially in regions where unsafe abortion poses a substantial maternal health risk. Trial registrationClinicalTrials.gov (NCT03727308).

Dispensation of outpatient hospital medicines by hospital only versus hospital-community pharmacies collaboration: a cross-sectional study and survey of patient's satisfaction.

To describe the experience of a dispensing model of outpatient hospital medicines (OHM) via collaboration of hospital and community pharmacies, and to explore patient satisfaction with the strategy as compared with the hospital pharmacy only service. Patient satisfaction is an important component of the quality of health care. A new model of dispensing OHM was conducted in the Outpatients Unit of the Service of Hospital Pharmacy of Hospital del Mar, in Barcelona, Spain. Participants were patients on stable chronic treatment with clinical or social fragility, immunocompromised patients, and those whose residence was located at a distance from the hospital that justified drug delivery through the community pharmacy. A cross sectional study was done using an ad hoc 14-item questionnaire collecting demographic data, duration of treatment, usual mode of collecting medication, and the degree of satisfaction regarding waiting time for the collection of medication, attention received by professionals, information received on treatment, and confidentiality. The study population included a total of 4,057 patients (66.8% men) with a mean age of 53 (15.5) years, of whom 1,286 responded, with a response rate of 31.7%. Variables significantly associated with response to the survey were age over 44 years, particularly the age segment of 55-64 years (odds ratio [OR] 2.51) and receiving OHM via the community pharmacy (OR 12.76). Patients in the community pharmacy group (n = 927) as compared with those in the hospital pharmacy group (n = 359) showed significantly higher percentages of 'satisfied' and 'very satisfied' (p < 0.001) in the waiting time for the collection of OHM (88.1% vs. 66%), attention received by professionals (92.5% vs. 86.1%), and information received on treatment (79.4% vs. 77.4%). In relation to confidentiality, results obtained were similar in both pharmacy settings. Dispensing OHM through the community pharmacy was a strategy associated with greater patient satisfaction as compared with OHM collection at the hospital pharmacy service, with greater accessibility, mainly due to close distance to the patient's home. The participation of community pharmacists could further optimize the care received by patients undergoing OHM treatment.

Pharmacy and Genomic Medicine: A UK-wide survey of pharmacy staff assessing their prior education, confidence and educational needs

Abstract Introduction Pharmacy teams are key in helping patients to get the most from genomic medicine.1,2 However, genomics has only recently been included in undergraduate curricula, and it has been suggested that all healthcare professionals could benefit from education in pharmacogenomics2. We surveyed pharmacy staff to gather information on previous education, current practice and future educational needs in genomics and pharmacogenomics. Aim This survey aimed to establish existing levels of education and confidence in genomics and pharmacogenomics in pharmacy staff working in any role, in any sector, across the UK, and to investigate respondents’ preferences in delivery of genomic education. Methods The survey was based on a 2021 survey of genomic knowledge among medical staff by Health Education England (HEE)3, and amended to reflect pharmacy roles and practice following discussion with pharmacy leads from the 7 NHS Genomic Medicine Service Alliances in England, and from Scotland, Wales and Northern Ireland. SmartSurvey software was used to host the survey, with data held securely. The survey was open between 1st March and 16th May 2022, and was publicised via pharmacy groups including the Royal Pharmaceutical Society, National Pharmacy Association, Local Pharmaceutical Committees, chief pharmacists networks in primary and secondary care, and social media. This work was assessed using the NHS Health Research Authority Research screening tool and judged as ‘not research’; therefore ethical approval was not required. Results 1,552 responses were received from pharmacists, pharmacy technicians, dispensers and other pharmacy staff across the UK; 68% of responses were from England, 13% from Scotland, 10% from Northern Ireland and 9% from Wales. The majority of responses (69%) were from Pharmacists, with 24% from Pharmacy Technicians and 4% from Pharmacy support workers. Only 13% of respondents had received any formal training in genomics. Most respondents felt unprepared to use genomic testing in their practice; just 8% of pharmacists (including trainees), and 1% of pharmacy technicians (including trainees) felt prepared. However, 65% of respondents thought that genomics would change their practice within the next 5 years, and over 70% of pharmacists, and 56% of pharmacy technicians, could envisage ordering, advising on, or counselling patients on genomic testing in the future after appropriate training. 29% of respondents (mainly pharmacy managers) did not currently see patients and therefore might not train personally in genomics. Discussion/Conclusion This work suggests that pharmacy teams are likely to require educational support to embrace the opportunities of genomic medicine. High survey engagement suggested that respondents were keen to make their voices heard. Pharmacists appeared more confident in their ability to advise patients on genomics than Technicians, however both groups seemed keen to receive training. One limitation is that respondents were likely interested in genomics; those with no interest may not have completed the survey. Additionally, pharmacy managers who do not see patients might not train personally in genomics, but may influence strategy for pharmacy genomics service development and delivery. National bodies should capitalise on enthusiasm across the sector to help drive pharmacy genomics services forward through education and training.

Desarrollo de una aplicación informática de ayuda al soporte nutricional especializado integrado en la historia clínica electrónica

ObjectivesTo develop an integrated computer software application for specialized nutritional support, integrated in the electronic clinical record, which detects automatically and early those undernourished patients or at risk of developing undernourishment, determining points of opportunity for improvement and evaluation of the results. MethodsThe quality standards published by the Nutrition Work Group of the Spanish Society of Hospital Pharmacy (SEFH) and the recommendations by the Pharmacy Group of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) have been taken into account. According to these quality standards, the nutritional support has to include the following healthcare stages or sub-processes: nutritional screening, nutritional assessment, plan for nutritional care, prescription, preparation and administration. ResultsThis software allows to conduct, in an automated way, a specific nutritional assessment for those patients with nutritional risk, implementing, if necessary, a nutritional treatment plan, conducting follow-up and traceability of outcomes derived from the implementation of improvement actions, and quantifying to what extent our practice is close to the established standard. ConclusionsThis software allows to standardize the specialized nutritional support from a multidisciplinary point of view, introducing the concept of quality control per processes, and including patient as the main customer.

Quality assurance standards and their use in the preparation of parenteral systemic anticancer therapy products in healthcare establishments: a scoping review

ObjectivesThe use of parenteral systemic anticancer therapy (SACT) has led to improved cancer survival. A quality assurance (QA) system of the aseptic compounding process is necessary to ensure safe and...

Classification of antineoplastic drug-induced tissue damage: a Consensus of the Spanish Oncology Pharmacy Group

ObjectiveTo reach at an expert consensus, using the Delphi method, for classifying the tissue-damaging potential of antineoplastic drugs, in order to facilitate the decision-making process in the event of extravasations. MethodThe panel of expert evaluators was made up of seven pharmacists belonging to the working group on extravasations. Other member served as coordinator. The likelihood of tissue damage was reviewed on the basis of eight reference documents. Four categories of drugs were established: vesicant (V); high risk irritant (HRI); low risk irritant (LRI) and non-irritant (NI). Two rounds of surveys were performed. The drugs with an agreement of less than 70% after the two rounds were discussed non-anonymously by the group. For each of the rounds the following was analysed: median of the degree of consensus and the interquartile range (IQR25–75), degree of agreement by tissue damage category, and percentage of antineoplastics reaching a degree of consensus of over 85% and of 100%. Drugs whose classification differed in the various reference documents were assessed separately. SPSS v23.0 statistical software was used. ResultsSeventy-one antineoplastics were evaluated. In the first round, the median for degree of consensus was 100.0% (IQR25–75: 71.4–100.0%). In the second round, the median was 100.0% (IQR25–75: 85.7–100.0%). The percentage of antineoplastics with a consensus of 85.7% or above increased from 66.7% to 85.9% in the second round. For the 30 antineoplastics whose values differed in the reference documents, the degree of agreement increased from 71.4% (IQR25–75: 571–87.7%) to 100.0% (IQR25–75: 85.7–100.0%) in the second round. The percentage of antineoplastics with a consensus of 85.7% or above increased from 40.0% to 76.7%. Four antineoplastics had a degree of agreement of less than 70.0%. The final classification of drugs per category, was: 17 vesicants; 15 HRI; 13 LRI; and 26 NI. The final degree of consensus was 85.7% or above for 90.1% of antineoplastics, and 100.0% for 74.6% of the same. ConclusionsIn this area of scarce evidence and high variability, the Delphi method allows for consensus in classifying tissue damage risk, thus making it easier to reach clinical decisions. In approximately 90% of the antineoplastics, the degree of consensus reached by the expert panel was 85% or above. In 74% of the antineoplastics, it was 100%. This provides solid ground for management decisions.

Community pharmacist’s preparedness to provide patient-centred care in Saudi Arabia

BackgroundCommunity pharmacy practice in Saudi Arabia is evolving and needs to be at par with the developed world. Community pharmacists can play a vital role in bridging gaps in the delivery of healthcare services by providing patient-centred care to patients and contributing toward the healthcare transformation plan of vision 2030 of Saudi Arabia. The present study is aimed at evaluating the knowledge, attitude, and practices of community pharmacists in delivering patient-centred care services. MethodA nationwide cross-sectional survey using a validated and pre-tested 27-item self-reported questionnaire was conducted amongst 301 (86.4% male, 13/6% female) community pharmacists from all regions of Saudi Arabia. Both descriptive and inferential analysis was employed using the SPSS version, with 0.05 as the level of significance. ResultsCommunity pharmacists from chain pharmacy groups, female gender and staff community pharmacists had statistically better overall practice standards, knowledge, and attitude to conduct patient-centred care services (p less than 0.01). The majority of community pharmacists would expect extra remuneration and participation in structured professional skills development programs to provide patient-centred care efficiently. Inaccessibility of patient data from healthcare facilities, the unavailability of informative literature, and administrative workload were among the barriers cited in delivering patient-centred care. ConclusionThe study findings show that community pharmacists could play a significant role in providing patient-centred care and contribute to the achievement of the healthcare reform agenda of Saudi Arabia. However, some obstacles must be overcome before this practice can be shifted, including the introduction of a formalized continuing professional development program, financial incentives, and a decrease in the administrative burden on pharmacists. The results of this study may help policymakers in Saudi Arabia better comprehend the country’s existing approach to community pharmacy practice.

A prospective, comparative study of clinical outcomes following clinic-based versus self-use of medical abortion

BackgroundTo determine whether clinical outcomes differ among women accessing a combined medical abortion regimen from a health clinic when compared with those accessing it from a pharmacy.MethodsWe conducted a multicentre,...

UK prescribing practice of anticoagulants in patients with chronic kidney disease: a nephrology and haematology-based survey

A survey to gain insight into anticoagulant prescribing practice in the setting of chronic kidney disease (CKD) across the UK was disseminated via renal and haematology networks. Areas of anticoagulant use included patients with venous thromboembolism (VTE), requiring thromboprophylaxis for VTE, Atrial Fibrillation (AF) and nephrotic syndrome.An online-survey was disseminated via British Haematology Society, UK Kidney Association, and Renal Pharmacy Group over a five month period. All responses were voluntary and anonymous.Among 117 responses there were 49 nephrology doctors, 47 renal pharmacists and 20 haematology clinicians. A specialist multidisciplinary team to discuss the specific anticoagulant management of these patients was only available to 3% (4/117) respondents. Renal function estimate used for anticoagulant dosing was mainly Cockcroft-Gault for pharmacists and haematology but lab-based estimates were used by nephrology doctors. Therapeutic dose of Low Molecular Weight Heparin was mostly likely to be reduced by one-third when used for VTE treatment, with the majority of units undertaking anti-Xa monitoring in CKD stage 5 and dialysis. Direct-acting Oral Anticoagulants are being used in patients with nephrotic syndrome, those with CKD stage 5 and on dialysis for VTE and AF in the absence of license in these indications.This survey highlighted the significant differences between anticoagulant prescribing in CKD between two professional specialties and marked variation between centres in anticoagulant management strategies employed for these patients. With gaps still existing in the evidence base and answers to these not expected within the next few years, development of a best-practice guideline would be warranted to support clinicians in this field.

Pharmacists should be able to refer patients directly to secondary care for skin conditions, says APPG chair

Pharmacists should have the ability to refer patients directly to secondary care for dermatological conditions, the chair of the All-Party Pharmacy Group (APPG) has said. Speaking to The Pharmaceutical Journal on 16 February 2023, Taiwo Owatemi, who is also an MP for Coventry North West and a trained pharmacist, said that community pharmacists “should be […]

Constructs of the Collaboration between Hospital and Community Pharmacists: Findings from Community Pharmacist Perspective Using Multivariate Analysis and Structural Equation Modeling

Collaborations between hospital and community pharmacists play a key role in ensuring consistent continuation of pharmacotherapy within official medical care plans designed to promote community-based healthcare. A previous study conducted by the authors clarified the constructs of collaboration between the hospital and community pharmacists from the hospital pharmacist's perspective. In this study, a similar questionnaire was used to survey a group of pharmacies with 424 outlets nationwide, and 244 responses were collected. Factor analysis from the community pharmacists' perspective extracted five latent factors comprising 18 variables, and structural equation modeling yielded a model with a high goodness-of-fit. In the latter model, variables representing "Organizational climate" and "Basic policy on collaboration" formed the foundation of the collaboration between hospital and community pharmacists, while variables representing "Understanding of healthcare policy", "Resources for collaboration", and "Community support systems" represented concepts that flexibly compensated for fluctuations in medical policy. These trends were similar to those of the constructs previously indicated by hospital pharmacists. We performed multiple regression analysis and structural equation modeling to confirm the impact of the inclusion of "Need for collaboration" as a dependent variable on the proposed constructs of hospital-community pharmacist collaboration using different analytical methods. Our results indicated that "Organizational climate", "Basic policy on collaboration", and "Community support systems" affected the "Need for collaboration". Our findings indicate that future studies are needed to confirm and clarify the causal relationships demonstrated by the constructs of hospital-community pharmacist collaboration seen within the current study.

’It stayed there, front and centre’: perspectives on community pharmacy’s contribution to front-line healthcare services during the COVID-19 pandemic in Northern Ireland

ObjectivesTo explore community pharmacists and key stakeholders’ perspectives and reflections on the community pharmacy workforce’s preparedness for, and response to, COVID-19, including lessons for future public health crises.Design, setting and...

Association of Supply Source with Continence Product and Care Satisfaction in Patients with Urinary Incontinence.

PurposeWe aimed to examine how supply source affects satisfaction with continence products and care among individuals with urinary incontinence (UI). Supply source was compared among pharmacies, national suppliers, and shops. The secondary aim was to compare participant characteristics between the three groups.Patients and MethodsA survey questionnaire was distributed via social media between April and June 2020. This included the international consultation on incontinence questionnaire (ICIQ) UI short form (ICIQ-UI-SF), the ICIQ-PadPROM, and the ICIQ-LUTSqol, together with questions about respondent characteristics and satisfaction with continence products.ResultsOf the 1045 respondents, 706 fully completed and 339 partially completed the survey. Among these, 322 (45.6%), 199 (28.1%), and 185 (26.2%) made purchases from shops, national suppliers, and pharmacies, respectively. The mean ICIQ-UI-SF sum scores were comparable for the pharmacy (13.3 ± 3.7) and national supplier (13.8 ± 3.5) groups, but were significantly lower for the shop group (12.0 ± 3.3). Mean sum scores for satisfaction with continence products and satisfaction with continence care were also significantly lower in the shop group (7.9 ± 2.6 and 6.4 ± 2.7, respectively) compared with the pharmacy (9.1 ± 2.7 and 7.9 ± 2.6, respectively) and national supplier (9.3 ± 2.6 and 8.1 ± 3.0, respectively) groups. There were no statistically significant differences in the ICIQ-PadPROM and ICIQ-LUTSqol scores. Respondents’ characteristics were similar, apart from the significantly lower number of males in the shop group.ConclusionSatisfaction with continence products and continence care is lower for people with UI who purchase materials from a shop than from a pharmacy or national supplier.

The rise of telepharmacy services during the COVID-19 pandemic: A comprehensive assessment of services in the United Arab Emirates.

Objective:The study aimed to explore changes in community pharmacies’ processes in response to the pandemic in the United Arab Emirates (UAE) and factors affecting the adoption of these changes.Method:A cross-sectional study was conducted using a self-administered questionnaire that was distributed to licensed community pharmacists in the UAE. The survey used to collect information on the type of telepharmacy services and related topics such as constraints and supports. The evaluation of services was done for three periods: before, during and after lockdown.Results:The number of completed surveys was 391. The majority of the participants were under 35 years old (79.5%), female (65.0%), with a bachelor’s degree (82.6%), and working in a pharmacy group (70.6%). Pharmacies provided the services by phone (95.6%) and/or messaging applications (80.0%) such as WhatsApp and Messenger. The community pharmacies provided a variety of services using telepharmacy tools such as managing of mild diseases, dispensing and delivering prescribed and OTC medications, general health information, and services for patients with chronic disease. The main factors that had significant effects on several telepharmacy services were pharmacies’ type (group/chain vs. individual) and the number of pharmacists in the pharmacy (p < 0.05). Lack of time, training and financial support were the main barriers associated with telepharmacy services among individual pharmacies.Conclusion:Telepharmacy supported the work of community pharmacies during the COVID-19 pandemic by facilitating the provision of pharmaceutical services. Although the occurrence of several financial and technical problems, it appeared less frequently in pharmacy chains with a large number of pharmacists.

Retroactive application of the EPIS framework to promote future implementation success in community pharmacy clinical interventions

BackgroundThe assessment of the implementation process of a clinical intervention in a community pharmacy setting can reveal useful insights for future implementation efforts. ObjectiveWe aimed to examine the implementation of a community pharmacist-led prospective registry and practice tool (RxING, Epidemiology Research Coordinating Center and the University of Alberta) designed to reduce cardiovascular risk among patients with diabetes and to assess how the participating pharmacists could be supported at each of these stages. MethodsSemistructured interviews were conducted developed using the Exploration, Preparation, Implementation, Sustainment (EPIS) framework. The EPIS framework was used to evaluate the implementation of an online, guideline-driven tool (RxING tool) designed to help pharmacists implement and document the care of patients with diabetes by a group of community pharmacies located in Alberta, Canada. ResultsIn relation to the preparation phase, responses focused more on suitability of the work environments and less on workflow adjustment. With regard to the implementation stage, participants mentioned that often the pharmacy manager or owner received the training to operate the RxING tool, complicating their ability to engage in regular patient recruitment and follow-up. Most pharmacies did not have specific goals relating to patient recruitment and retention. Concerns hindering sustainability of the evidence-based practice centered around the time-consuming online documentation process and patient retention. Finally, innovation factors identified from the pharmacists’ responses were related to patient recruitment and streamlining the documentation process. ConclusionsThis study identified 17 key recommendations that should be considered when designing and implementing future community pharmacy-led projects. In particular, providing assistance and training to pharmacies on-site, specific planning for program roll-out, identifying participating staff who have the time to engage with the program, and troubleshooting how to best integrate programs in normal workflow processes are some key recommendations.

Antineoplastic extravasation management: Consensus of the Spanish Oncology Pharmacy Group (GEDEFO).

Antineoplastic extravasation management: Consensus of the Spanish Oncology Pharmacy Group (GEDEFO).

Research Policy on Case-control and Cohort Study Design in Pharmaceutical Care

International Journal of Pharmacology and Clinical Sciences,2022,11,1,25-30.DOI:10.5530/ijpcs.2022.11.6Published:April 2022Type:Review ArticleAuthors:Yousef Ahmed Alomi, Amal Hassan Al-Najjar, Maha Hussein Almadany, Fakhar Al-Ayoubi, Ghudair Tashan Alanazi, and Abeer Hussin Almasoudi Author(s) affiliations:Yousef Ahmed Alomi*, BSc. Pharm, MSc. Clin Pharm, BCPS, BCNSP, DiBA, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor, and Data Analyst, Riyadh, SAUDI ARABIA. Amal Hassan Al-Najjar, BSc, MSc, Drug and Poison Information Center, Security Forces Hospitals, Riyadh, SAUDI ARABIA. Maha Hussein Almadany, Bsc. Pharm. Health Care Quality Management Professional Diploma (HCQM), Pharmacy Quality Department, King Salman bin Abdulaziz Medical City, Al Madina Al Monwarah, SAUDI ARABIA. Fakhar Al-Ayoubi, Bsc. Pharm. Msc. Pharm Adjunct Assistant Professor, Clinical Pharmacist, Coronary Care Units, President, Cardio Clinical Pharmacy Group, General Secretary of Saudi Heart Failure Group, Saudi Heart Association, King Saud University Medical City, Riyadh, SAUDI ARABIA. Ghudair Tashan Alanazi, BSc. Pharm, Pharm.D, MSc. Clin Pharm, Diploma of Epid. Critical care clinical pharmacist, Internal medicine clinical pharmacist, MOH, Hafrbatin, SAUDI ARABIA. Abeer Hussin Almasoudi, Bsc. Pharm Director, Administration of Research and Studies, Ministry of Health, Tabuk, SAUDI ARABIA. Abstract:Objectives: This study explores the Research Policy of Case-Control and Cohort Study Design in Pharmacy Practice as a new initiative in Saudi Arabia. Methods: This article is a narrative review of pharmacy research. Litterateur researched specific research policies and procedures in pharmacy practice using a variety of databases, including PubMed, Medline, and Google Scholar. The period covered for the search is from the 1960s to October 2021. The terms used are in the English language and encompasses narrative reviews, systemic reviews, meta-analyses, and guidelines. The search term includes all hospital and community pharmacy-related services. Besides, there are national and international guidelines for conducting general research in hospital practice. The pharmacy research committee was formed and comprised numerous expert members, including clinical pharmacists, pharmacists specializing in drug information, and clinical research specialists. A member drafted the policy’s guidelines, which were then reviewed and corrected by another member. The research specialist made the third revision. The subject emphasizes the Pharmacy Research Policy for the Case-Control and Cohort Study Model. Results: The Pharmacy Research policy for the Case-Control and Cohort Study Design in pharmaceutical care services consisted of several components, including the advantages and disadvantages of Case-Control and Cohort Study Design and the steps involved in conducting Case-Control research, and the steps involved in conducting Cohort Study research in pharmacy practice. Conclusion: The pharmacy research policy for the Case-Control and Cohort Study Design is a new initiative as part of the pharmaceutical care services. The pharmacy policy on Case-Control and Cohort Studies aims to improve pharmacists’ research abilities in healthcare institutions. Additionally, the new tools for documenting and validating adverse drug reactions. Therefore, the Case-Control and Cohort Study research policies in pharmacy are recommended for implementation in Saudi Arabia. Keywords:Case-Control, Cohort Study, Pharmacy, Policy, Research, Saudi ArabiaView:PDF (318.91 KB) PDFClick here to download the PDF file. Images Research Policy on Case-control and Cohort Study Design in Pharmaceutical Care

Implementation and evaluation of social determinants of health practice models within community pharmacy

BackgroundWhile community pharmacies are an ideal setting for social needs screening and referral programs, information on social risk assessment within pharmacy practice is limited. ObjectivesOur primary objective was to describe 2 social determinant of health (SDOH) practice models implemented within community pharmacies. The secondary objective was to evaluate implementation practices utilizing the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. Practice descriptionTwo pharmacy groups participated in a 3-month study, one in New York (9 pharmacies) and another in Missouri (1 pharmacy). The New York pharmacies implemented an SDOH specialist practice model, in which pharmacy staff members facilitate the program. The Missouri pharmacy implemented a community health worker (CHW) model by cross training their technicians. Each pharmacy developed their program using the Community Pharmacy Enhanced Services Network Care Model. Practice innovationBoth programs expanded the technician role to take on additional responsibilities. The SDOH specialist model partnered with a local independent practice association to create a social needs referral program using a technology platform for closed-loop communication. All workflow steps of the self-contained CHW program were completed within the pharmacy, placing additional responsibility on the CHW and pharmacy staff. Evaluation methodsRE-AIM framework dimensions of Reach, Effectiveness, and Adoption. ResultsSocial challenges were identified in 49 of 76 (65%) generated SDOH screenings. The most prevalent social needs reported were affordability of daily needs (33%) and health care system navigation (15%). While most pharmacy staff indicated that workflow steps were clearly defined, assessments and referral tools were identified as potential gaps. While approximately 50% of pharmacy staff were comfortable with their assigned roles and in addressing SDOH challenges, physical and mental health concerns required additional education for intervention. ConclusionThe successful implementation of community pharmacy SDOH programs connected patients with local resources. Community pharmacies are ideally positioned to expand their public health footprint through SDOH interactions that consequently improve patient care.