Pharmacy Services Research Articles

Utilization of Lean Six Sigma and the DMAIC process on oral treatment regimen entry and consent to improve patient care and mitigate practice risk.

281 Background: Oral medication (chemo/hormone) volumes in oncology treatment selection will continue to increase year over year. In 22’, oral meds accounted for the largest market share in dollars at 51% vs IV treatment at 49%. Oral medication volume is projected to increase by proliferation and utilization, though revenues may decrease due to decreasing drug margins. Medication regimen consent is a critical part of specialty pharmacy accreditation through one of the national accrediting organizations. This accreditation is vital to meeting the requirements and maintaining contracts with pharmacy benefit managers (PBMs) and specialty-focused pharmacy services administrative organizations (PSAO). Without improved and continued consent compliance, OHC was at a significant risk of losing the ability to provide care for this impacted patient population, thus resulting in increased risk of financial toxicity. PBMs and accreditations require quality components be completed to maintain the ability to run a specialty oncology pharmacy. When a new oral prescription is written, the oral must be 1.) entered as a regimen and not a single script-only in the EHR and 2.) must have a completed teaching visit and legal consent. Methods: Following the DMAIC (define, measure, analyze, implement and control) process, OHC’s Lean Team deployed Lean Six Sigma strategies and tools in PY23’ to bridge the gap to goal for both oral medication risk areas. OHC followed the lean methodology A3 process using DMAIC, deployed implementation strategies and curated data analytic reports to ensure oral medications were entered as regimens vs script-only, that teaching/consents were completed, and that the control phase maintained a steady state. Results: In 23’, OHC providers accurately prescribed in the EHR a new oral chemo/hormone at 98% (1037/1055) accuracy vs 22’ at 69% (586/845). Additionally, OHC achieved a 93% (986/1055) teach/consent compliance rate vs 22’ at 59% (499/845). With mitigation of compliance risk (est. at 12,114,000), OHC ensured no loss of pharmacy accreditation and contracts. Increased oral medication teaching visits capture rate increased (n=399) resulting in $114,000 additional return on investment in calendar year 23’. Conclusions: Utilizing Lean Six Sigma tools and the DMAIC process, OHC was able to implement strategies to meet both measure goals in one performance year, resulting in improved patient care, organizational risk mitigation, and sustainable profitability. The results have been maintained in the control phase of PY24’. Lean Six Sigma and the DMAIC process are vital to organization success. Tactics deployed have proven to be reproducible and scalable to other projects. Measure PY2022 PY2023 Goal Oral Medication Regimen NCCN Entry vs Script-only 69% (586/845) 98% (1037/1055) 90% Oral Medication Regimen Teach/Consent 59% (499/845) 93% (986/1055) 93%

Maximizing Patient Safety in Al-Diwaniya Private Pharmacies: An Exploratory Review of the Various Physiological Disorders Where Field Pharmacists are Central to Treatment and Management

The community pharmacist is unique among health care providers in that he or she interacts with a wide variety of people every day, giving them enough opportunities to raise patients' levels of self-awareness and provide guidance toward healthier lifestyle choices. This project detailed the duties of several authorized committees and administrations, some of which were excellent and others of which were subpar. There has to be more work done by community pharmacists to help improve health care, but integrated care where they provide clinical pharmacy services while dispensing may make a big difference. From December 2021 until the end of May 2022, online surveys were conducted. The pharmacists' understanding of patient safety culture was evaluated using a community pharmacy questionnaire. The results showed that of all the areas examined, patient counseling had the greatest level of positive awareness (23–59%), and yet only 18% of pharmacists regularly educate patients of important information about their new prescriptions, which is a very low response rate.

Key stakeholder perspectives on delivery of vaccination services in Quebec community pharmacies

Key stakeholder perspectives on delivery of vaccination services in Quebec community pharmacies

Relationship between Pharmacists' Emotional Intelligence and Job Performance: A Cross-Sectional Study in Saudi Arabia.

Pharmacists' job performance is crucial for improving pharmacy services. The purpose of this study was to evaluate the association of emotional intelligence with the job performance of pharmacists in Saudi Arabia. Using social media platforms, we disseminated an online questionnaire to pharmacists licensed to practice in Saudi Arabia between June and July 2022. The questionnaire was filled out by 352 pharmacists. The majority of the participants were women (60.5%) and working as community pharmacists (55.7%). On self-reported emotional intelligence and job performance scales, the respondents scored an average of 5.5 ± 0.9 (out of 7) and 4.0 ± 0.6 (out of 5), respectively. Multiple linear regression analyses revealed that emotional intelligence had a significant relationship with job performance (β = 0.43, p < 0.001). In conclusion, the findings indicated that emotional intelligence may influence the job performance of pharmacists in Saudi Arabia. As the primary objective of every organization is to accomplish the best possible performance, prioritizing emotional intelligence is important. Further research is needed to identify the impact of emotional intelligence on work performance, which could potentially enhance clinical outcomes for patients.

A Review of Studies on HIV Pre-Exposure Prophylaxis in Community Pharmacies in States with Restrictive Pharmacist Prescription Authority in the United States.

A systemic literature review was conducted to identify the primary literature that involved community pharmacy service and PrEP conducted in states that do not have expanded pharmacist prescriptive authority between 2000 to 2024. Ten publications were identified, describing nine studies, including four interview and survey studies, three intervention reports, and two ongoing clinical trials. None of these studies have a control group. Most pharmacists provide PrEP services in the community through a collaborative practice agreement with a primary care provider. Future clinical studies with randomized controlled designs are required to test novel strategies in the education and implementation of pharmacy-led PrEP services in a community pharmacy setting to increase PrEP access.

Development of an innovative clinical pharmacy service in a urology surgical unit: a new initiative from Qatar.

To provide an insight into the role of a clinical pharmacy initiative in a surgical urology unit through evaluating the nature, significance, associated medications, and acceptance rate of pharmacist interventions. A cross-sectional study was carried out at the Ambulatory Care Center (ACC), Doha, Qatar. Data related to clinical pharmacist interventions and associated rationale were classified according to the nature of the intervention using an adapted classification system. The assessment of the severity followed the National Patient Safety Agency (NPSA) Risk Matrix. Linear regression, Kruskal-Wallis, and post-hoc analyses were performed to determine the association between patient-related and medication-related characteristics on pharmacist interventions. A total of 3284 interventions (on 1486 patients) were analysed. Most patients (n = 1105; 74.4%) had 1-2 interventions. Age and gender showed a positive linear correlation with the number of interventions per patient (p < 0.01). Majority of interventions were related to pharmacological strategy (n = 1858; 56.6%) and quantity of drug (n = 821; 25%). Additional drug therapy (n = 748; 22.78%) was the most common subcategory followed by optimum dose/frequency (n = 691; 21.04%) and discontinuation of medications (n = 352, 10.72%). Anti-infectives were the most identified drug category (n = 798, 55.1%). Most interventions (59.4%) were of moderate significance; patients with moderate interventions were found to be older compared to patients with minor interventions (p = 0.032). Prescribers' acceptance rate was high (>90%), with a notable increase of 6.6% from 2021 to 2023. This study showed that the clinical pharmacy service in the urology surgical field was a fruitful initiative. The clinical pharmacist's role has expanded to include not only therapeutic optimisation while ensuring medication safety across the continuum of perioperative care but also the identification and management of untreated health problems. The dynamic and complexity of the urology patient population challenge clinical pharmacists; however, the practice concepts remain the same as in any other clinical setting.

Influence of the Quality of Pharmacy Services and Non-Pharmacy on the Decision to Redeem the Prescription and Its Impact on Retreatment of General Outpatient at Pasar Minggu Hospital

The study examines the influence of pharmaceutical and non-pharmaceutical service quality on prescription redemption decisions and subsequent re-treatment decisions among general outpatients at Pasar Minggu Regional Hospital. The hospital has faced challenges, including a decline in outpatient visits and filled prescriptions, affecting its revenue during the 2022-2023 period. Patient perceptions of the pharmacy services significantly impact their decision to return for further medical care. The research aims to assess both direct and indirect effects of service quality on prescription redemption and re-treatment decisions. The study employs a verification approach with a cross-sectional design, using accidental sampling to survey 342 general outpatients between October 2023 and February 2024. Data were analyzed descriptively and inferentially using SEM PLS 3.0, encompassing both outer and inner model analyses through PLS Algorithm, Bootstrapping, and Blindfolding techniques. The findings reveal that the quality of pharmaceutical and non-pharmaceutical services significantly influences the decision to redeem a prescription (P = 0.000). Moreover, non-pharmaceutical service quality and the decision to redeem a prescription significantly affect the decision to re-medicate (P = 0.002 and 0.000, respectively). However, pharmaceutical service quality alone does not positively impact repeat treatment (P = 0.041). Both service variables have a significant indirect effect on re-treatment decisions through the mediating role of prescription redemption (P = 0.000).

Two-Spirit Peoples’ experiences accessing and receiving care from community pharmacies

Background: Two-Spirit Peoples face unique challenges in accessing and receiving health care in Canada due to health services, including community pharmacy services, being built on hetero- and cis-normative models that impede appropriate care for this group. Currently, there is limited published information on Two-Spirit Peoples’ experiences accessing and receiving care in community pharmacy settings. Methods: To address the lack of published information, 21 Two-Spirit individuals shared their experiences in a focus group setting. Four different focus groups were held across Canada, including 1 in Saskatoon, Vancouver, Edmonton, and Toronto. Informed by Indigenous methodologies, data were recorded via audio recording and notetaking, and the audio was transcribed and then analyzed for themes using the Voice-Centred Relational Method. Results: Three major structural systems that affect the experiences of Two-Spirit Peoples in community pharmacies were identified: 1) white supremacy, 2) capitalism, and 3) heteronormativity. These 3 systemic issues presented themselves via racism, homophobia, transphobia, pharmacists’ lack of knowledge about Two-Spirit individuals and their health and lack of time spent educating or building relationships with Two-Spirit Peoples. Participants provided suggestions for how community pharmacists can better serve the Two-Spirit community, such as using inclusive language, adding pronouns and preferred names to patient files, increasing knowledge about Two-Spirit health and advocating for Two-Spirit Peoples. Discussion: The results suggest that dismantling current structures and ideologies in community pharmacy and society are required to overcome the identified issues. Conclusion: Two-Spirit Peoples face barriers when it comes to accessing and receiving care in community pharmacies, resulting in many Two-Spirit individuals avoiding health care to save themselves from unsafe and uncomfortable interactions. Pre- and postlicensure pharmacy education about Two-Spirit Peoples is required to improve Two-Spirit Peoples’ experiences accessing and receiving care in community pharmacies.

User experiences of selfcare interventions for sexual and reproductive health services in community pharmacies in Rwanda: A qualitative study

ABSTRACT Self-care interventions for sexual and reproductive health (SRH) empower individuals to autonomously access services, reducing their reliance on traditional healthcare settings. However, there is limited knowledge about community pharmacy-based SRH services in Rwanda. Therefore, this study aims to explore the experiences of community pharmacy-based SRH users and inform strategies to enhance service delivery effectiveness. This study employed a qualitative research approach employing a phenomenological design. Semi-structured in-depth interviews were conducted with 22 participants from 1st June 2023 to 20th March 2024, in 5 Districts of Rwanda. Participants were recruited using purposive sampling methods. The interviews were recorded, transcribed, and imported into NVivo 11 software for further analysis. Users of pharmacy-based SRH products intended for self-care interventions reported positive experiences. Three main themes emerged from the interviews: community pharmacies ensured the utmost confidentiality, provided fast service delivery with minimal procedures, and expressed user satisfaction with friendly communication. Users of community pharmacy-based SRH services intended for self-care use reported positive experiences with community pharmacies. They received the needed confidentiality, faster service delivery, and friendly communication with community pharmacists. There is a pressing need for close collaboration among the public, private, and stakeholders to empower citizens over their SRH.

Assessment of the public perception of the hospital pharmacist and their satisfaction level with the pharmacy services provided in a developing country: a cross-sectional survey in Malaysia.

To assess the public perception of the role of hospital pharmacists, their satisfaction with the pharmacy service provided, and the factors associated with their perception and satisfaction. A cross-sectional, questionnaire survey was conducted on adults older than 18 years who utilized public pharmacy services. A self-developed, validated questionnaire consisting of three parts was used, i.e., demographic data, perception, and satisfaction. The questionnaire was tested in a pilot study of 50 study participants and demonstrated good reliability results of 0.900 for the perception section and 0.836 for the satisfaction section. Therefore, all items were used in the final questionnaire. Four hundred and seventy-nine completed questionnaires were collected with a response rate of 91.6%. The Cronbach's α for perception and satisfaction scores were0.938 and 0.841, respectively. The median total score for public perception was 83 (interquartile range [IQR]: 15), whereas the median total score for public satisfaction was 38 (IQR: 33). The level of public perception was significantly associated with the age groups (P = .009), ethnic groups (P < .001), respondents' locality groups (P < .001), the level of education achieved group (P = .017), and the income groups (P = .006). Satisfaction was not significantly associated with any sociodemographic factors. This study has found that the general public had a favorable perception of the role of hospital pharmacists, and they were generally satisfied with the pharmacy service provided.

Antecedents of Patient Satisfaction with Outpatient Pharmacy Services on Patient Well-Being and Hospital Image

Antecedents of Patient Satisfaction with Outpatient Pharmacy Services on Patient Well-Being and Hospital Image

The burden of acute eye conditions on different healthcare providers in Wales: a retrospective population-based study

Objective &amp; ApproachDemand for urgent eyecare exponentially outstrips public healthcare capacity in the United Kingdom. Such eye conditions, and related vision impairment, affect the lives of people everywhere. We aimed to quantify the burden of urgent eyecare on primary- and community-care providers in a national population using data produced by General Practitioner, Accident and Emergency, pharmacy and optometry services. A secondary aim was to characterise some drivers of this burden. We analysed data from the Secure Anonymised Information Linkage Databank (linked), Eye Health Examination Wales Service (unlinked) and Common Ailments Scheme (unlinked) during 2017-2018 to quantify burden. We applied generalised linear modelling and logistic regression to understand drivers. ResultsOf 365,044 episodes of care during the study, GPs and A&amp;E managed 46.2% (168,877) and 1.4% (5,122) respectively while optometrists and pharmacists managed 51.8% (116,868) and 0.6% (2,635). Older females and infants of both sexes were more likely to use GP prescribing services, while adolescent and middle-aged males were more likely to visit A&amp;E. GP prescribing burden was driven partially by economic deprivation, access to local services, and overall community health. Season, day of the week, and time of day were predictors of burden for GP and A&amp;E services. Conclusion &amp; ImplicationsAcute eyecare continues to place considerable burden on primary care services in Wales, particularly in urban areas with greater deprivation. This is likely to increase with an ageing population. With ongoing pathway development to better utilise community care, there may be scope to change this trajectory.

Knowledge and Perception of Pharmacy Students toward Telepharmacy Education in Saudi Arabia.

Telepharmacy education should be incorporated into the curricula due to its beneficial effects on students, providing pharmacy services during their practice. Therefore, this study aims to explore the knowledge and perceptions of pharmacy students regarding the integration of telepharmacy services into their education curriculum in Saudi Arabia. A cross-sectional study was conducted using an online survey from 1 June to 30 September 2023, among pharmacy students from five universities in Saudi Arabia. The questionnaire was divided into three sections, and descriptive statistics and a generalized linear model were used for analysis. A total of 523 pharmacy students participated. Approximately half of the students were aware of telepharmacy, and only one-quarter had studied it as part of their curriculum. Students believed that telepharmacy education should cover communication, reimbursement, and training for virtual patient interactions. There was a significant positive correlation (p < 0.0001) between the knowledge and perception scores. In addition, students who had heard about telepharmacy before and those with a "somewhat" confidence level showed a significantly positive correlation with knowledge scores (p = 0.01). In conclusion, perception scores, students who had heard of telepharmacy, and those with a "somewhat" confidence level were all positively correlated with pharmacy students' understanding of telepharmacy. This study underscores the importance of integrating telepharmacy education and practical training into pharmacy curricula to prepare future pharmacists for the evolving healthcare landscape.

Exploring pharmacists' attitude, willingness and barriers to provide extended community pharmacy services: Implications for improved pharmacy services.

This study aimed to evaluate pharmacists' attitude and willingness to provide extended community pharmacy services (ECPS), the barriers to ECPS, and the factors associated with attitude and willingness to implement ECPS. In this cross-sectional study, a validated, self-administered questionnaire was distributed online to community pharmacists across the United Arab Emirates between September and November 2023. In addition to sociodemographic data, the questionnaire evaluated attitudes toward ECPS, willingness to provide ECPS, and barriers to its implementation. Binary logistic regression was conducted to explore the factors associated with attitude and willingness to implement ECPS. The study included 409 pharmacists. Over half of the participants reported below the median attitude (58.7%) and willingness (59.4%) scores. Female pharmacists had a lower attitude towards ECPS (OR = 0.425, 95%CI: 0.242-0.747). Higher number of daily prescriptions (OR = 1.066, 95%CI: 1.029-1.105) and being a Pharm D graduate (OR = 2.664, 95%CI: 1.439-4.932) were associated with higher willingness to provide ECPS, while an increased number of employed pharmacists (OR = 0.518, 95%CI: 0.397-0.676) was associated with a lower willingness (OR = 0.049, 95%CI: 0.004-0.660). Patients' preoccupation (76.5%), lack of specific training (76.3%), lack of clinical problem-solving skills (74.6%) and lack of a private consultation room (74.6%) were the most commonly reported barriers to ECPS. Community pharmacists demonstrated unsatisfactory levels of attitude and willingness towards ECPS provision. Therefore, providing training and education programs that enhance pharmacists' perception and willingness to implement ECPS and emphasize improving clinical problem-solving skills, as well as setting up specific private consultation rooms, is deemed necessary. Female pharmacy graduates, pharmacists dispensing fewer daily prescriptions, and those working with a higher number of employed pharmacists should be specifically targeted when implementing these strategies.

Enhanced Pharmacy Service Delivery Through a Pharmacy Information System at a Medical Center: A Case Study.

A pharmacy information system (PIS) is a crucial tool for preventing errors and enhancing patient safety. This study aims to assess the influence of a PIS on workflow and medication errors (MEs) within the pharmacy department of a medical city in Saudi Arabia. The analysis encompasses an evaluation of the current workflow within pharmacy modules (in-patient, out-patient, and clinical pharmacy modules) and an exploration of associated challenges and inefficiencies. The study employed both qualitative and quantitative methodologies, incorporating structured interview techniques and the review of system records, such as logs, incident reports, and ME databases. Respondents recognized the benefits of the PIS, including the management of high-quality real-time data (26%), reduction of MEs (25%), acceleration of healthcare practices (23%), and absence of space-time constraints (14%). The study highlighted the role of PIS in addressing medication stock control and shortage issues, thereby improving overall medication availability. Furthermore, PIS significantly enhanced safety (93.3%), efficiency (80%), reliability, accuracy, ease of use (56.7%, 56.7%), and cost-effectiveness (53.7%). Following the implementation of the PIS, there was an increase in ME reporting, indicating improved error detection and management. The research revealed an increase in ME reporting rates in hospitals after PIS installation, attributed to improved medication management processes resulting in higher detection rates. As healthcare facilities increasingly embrace electronic medical records, the understanding of patient care quality will be significantly impacted. Consequently, further research is warranted to explore the role of PIS in reporting, detecting, analyzing, and mitigating MEs, as well as their influence on the work environment to promote a secure and efficient patient journey.

A cross-sectional survey exploring organizational readiness to implement community pharmacy-based opioid counseling and naloxone services in rural versus urban settings in Alabama

BackgroundRural US regions experience lower naloxone dispensing rates compared to urban counterparts, particularly in Alabama. In light of this, strategies to enhance opioid counseling and naloxone services (OCN) in rural community pharmacies are critical. However, organizational readiness to implement OCN in rural versus urban contexts where resource networks may differ is not well understood. ObjectivesThe purpose of this study was to explore organizational readiness and identify factors associated with implementation of OCN in rural versus urban Alabama community pharmacies. MethodsAlabama community pharmacists and technicians were recruited to participate in an anonymous online cross-sectional survey via email. The survey instrument was adapted from the Organizational Readiness to Change Assessment (ORCA). Primary outcome measures included 3 overarching ORCA domains (Evidence, Context, and Facilitation) with 19 subscales regarding OCN implementation readiness, measured via 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree). Secondarily, pharmacy OCN implementation status (implementer, non-implementer, or in-development) was measured via multiple-choice (1-item). Differences in mean domain and subscale scores between rural and urban pharmacies were evaluated using Mann-Whitney U tests and influential factors affecting OCN implementation status were assessed via logistic regression (alpha = 0.05). ResultsOf 171 respondents, the majority were pharmacists (78.6 %) in urban locations (57.1 %). Mean[SD] clinical experience evidence (Evidence) (3.98[0.69] vs 3.74[0.71]; p = 0.029), staff culture (Context) (4.04[0.66] vs 3.85[0.76]; p = 0.047), service measurement goals (Context) (3.92[0.77] vs 3.66[0.79]; p = 0.034), and senior management characteristics (Facilitation) (3.87[0.72] vs 3.71[0.66]; p = 0.045) subscales were higher in urban versus rural pharmacies. Notably, 66.7 % of pharmacies were current OCN implementers, and pharmacies with higher ORCA context domain scores had 3.230 greater odds of implementing or being in the process of developing OCN (95 % CI = 1.116–9.350; p = 0.031). ConclusionOrganizational readiness to implement OCN was higher among urban versus rural pharmacies in terms of perceived strength of clinical evidence, staff culture, service measurement goals, and senior management characteristics. Future research may leverage key contextual factors to enhance OCN implementation.

Implementation of a pharmacist-guided pharmacogenomics dosing service at a rural NCI-designated comprehensive cancer center.

The goal of pharmacogenetic testing is to identify genetic variants with significant implications on drug safety and efficacy. Several professional organizations and institutions have demonstrated the value of pharmacist involvement in the implementation of pharmacogenomic services. Therefore, we aimed to establish a pharmacist-guided model for interpretation of pharmacogenetic results for all oncology patients seen at the Dartmouth Cancer Center (DCC) in Lebanon, NH. A pilot of a pharmacist-guided pharmacogenomics dosing service was implemented at the DCC. Pharmacy services included review of results from a next generation sequencing panel for DPYD, TPMT, NUDT15, and UGT1A1 variants. The pharmacist wrote a note in the electronic health record (EHR) detailing actionable drug-gene interactions and drug-dosing guidance, which was then routed to the treating oncologist. Outcomes collected included highlighting actionable mutations and defining pharmacist interventions. In addition, time spent formulating and documenting patient-specific drug-dosing recommendations was collected. From February 2024 through May 2024, a total of 71 patients with pharmacogenetic results, provided by the clinical molecular laboratory at Dartmouth Health, were reviewed by the pharmacist. The majority of patients tested were diagnosed with a malignancy of gastrointestinal origin. Twenty-one patients were found to have actionable variants in at least one of the four genes evaluated, and five of the 21 identified patients had active treatment plans for which dose changes were then implemented. Implementation of a pharmacist-guided pharmacogenomics based dosing service aided in optimizing drug therapy and has positioned Dartmouth Health for further expansion of pharmacogenomics and personalized patient care.

Perceptions, Expectations, Reality, and Public Confidence Regarding the Role of Pharmacists in Pharmacy Services in Bandung

Background: The shifting from the old paradigm to the new paradigm with the philosophy of pharmaceutical care demands pharmacists to enhance the quality of pharmaceutical services. However, this role has not been optimally fulfilled, especially in the community setting.Objectives: This study aimed to identify the perceptions and expectations, the gap between expectations and reality, and public confidence as well as to analyze the relationship between sociodemographic factors and the perceptions, expectations, and public confidence in Bandung City regarding the role of pharmacists in pharmaceutical services.Methods: A cross-sectional study was conducted using a validated survey instrument with 440 respondents in Bandung, West Java, from March to April 2023. The survey data were analyzed descriptively and through inferential statistics.Results: The analysis showed that 58.41% of the community had a positive perception, 56.82% had high expectations, the average gap between expectations and reality was 14.04%, and more than 51.36% had a high level of public confidence in pharmacists. Sociodemographic factors influencing perceptions were age and the highest level of education (p = 0.005; p = 0.003), factors influencing public confidence were age, the highest level of education, residence address according to ID card (KTP), and occupation (p &lt; 0.001; p = 0.034; p = 0.001; p = 0.001), and the factor influencing expectations was the residence address according to ID card (KTP) (p = 0.043). A correlation was found between the dimensions of perceptions, expectations, and public confidence.Conclusion: Most participants held a positive perception, had high expectations, and shown high confidence in the pharmacist's position, despite the existence of a disparity between expectations and the actual provision of pharmacy services. The elements of perception, expectations, and confidence are interrelated.

Medication Adherence and Health Outcomes: A Public Health Perspective

Medicine is a two-edged sword: while it can treat a patient's illness, when applied carelessly, it also has the potential to do more harm than good. Ensuring that patients receive appropriate medication for their clinical condition at the appropriate time, by the appropriate channel, and in the appropriate doses should be the top priority for any healthcare system. Polypharmacy can be helpful because numerous morbidities are common, but it can also have unintended harmful effects. The co-morbidity-polypharmacy score uses the patient's physiological age rather than their chronological age to predict how their therapy will turn out. Any departure from the medication's intended therapeutic impact may be regarded as a drug-related issue. The purpose of this study was to examine the effects of clinical pharmacist interventions on drug-related issues in prescriptions for polypharmacy as well as the cost-benefit analysis of clinical pharmacy services. The particular goals were to recognise and address drug-related issues, find out how well health care providers received clinical pharmacist interventions, analyse the cost-benefit of clinical pharmacy services, and create and suggest a clinical pharmacists intervention form to standardise and record drug-related issues.

Pharmaceutical Care in Chronic Coronary Artery Disease Management

Individuals who suffer from Acute Coronary Artery Disease (CAD) frequently experience related issues, either because of the illness itself or as a side effect. Despite the existence of established criteria, Drug-Related Problems (DRPs) are more likely to arise, which impairs therapy outcomes and overburden patients. The purpose of this study is to assess clinical pharmacist-initiated medication optimisation in ACS patients. In order to optimise pharmacotherapy and the patient care process, a comprehensive clinical pharmacy service was created and deployed for the management of acute coronary syndrome (ACS-CPS). The service activities were prototyped under four primary themes. Our research showed the proactive role of clinical chemists in starting and offering services such as transition care, medication reconciliation, medication optimisation, and evidence-based drug information and interventions