Provision Of Pharmaceutical Care Research Articles

'I think we could probably do more': an interview study to explore community pharmacists' experiences and perspectives of frailty and optimising medicines use in frail older adults.

Community pharmacists potentially have an important role to play in identification of frailty and delivery of interventions to optimise medicines use for frail older adults. However, little is known about their knowledge or views about this role. To explore community pharmacists' knowledge of frailty and assessment, experiences and contact with frail older adults, and perceptions of their role in optimising medicines use for this population. Semi-structured interviews conducted between March and December 2020 with 15 community pharmacists in Northern Ireland. Interviews were transcribed verbatim and analysed thematically. Three broad themes were generated from the data. The first, 'awareness and understanding of frailty', highlighted gaps in community pharmacists' knowledge regarding presentation and identification of frailty and their reluctance to broach potentially challenging conversations with frail older patients. Within the second theme, 'problem-solving and supporting medication use', community pharmacists felt a large part of their role was to resolve medicines-related issues for frail older adults through collaboration with other primary healthcare professionals but feedback on the outcome was often not provided upon issue resolution. The third theme, 'seizing opportunities in primary care to enhance pharmaceutical care provision for frail older adults', identified areas for further development of the community pharmacist role. This study has provided an understanding of the views and experiences of community pharmacists about frailty. Community pharmacists' knowledge deficits about frailty must be addressed and their communication skills enhanced so they may confidently initiate conversations about frailty and medicines use with older adults.

ИССЛЕДОВАНИЕ СТРУКТУРЫ ПОТРЕБЛЕНИЯ ЛЕКАРСТВЕННЫХ ПРЕПАРАТОВ У БОЛЬНЫХ БРОНХИАЛЬНОЙ АСТМОЙ В СТАЦИОНАРАХ КЫРГЫЗСКОЙ РЕСПУБЛИКИ

Bronchial asthma (BA) is one of the socially significant diseases, characterized by a high frequency of seeking medical help and mortality. The most important parameter in studies of drug consumption is the study of the structure of their use, which includes the volume of use and a number of qualitative characteristics of the use of drugs of the group being studied. Modern approaches to pharmacotherapy of asthma also include the use of drugs in combinations; such drug therapy makes it possible to control the course of asthma, which affects morbidity, mortality, quality of life and the quality of provision of pharmaceutical and medical care to the population. Aim. Study of the frequency and structure of prescription of drugs used in the pharmacotherapy of bronchial asthma. Matherials and Methods. During a retrospective pharmacoepidemiological study, 500 individual registration records of patients with bronchial asthma who were hospitalized for the period 2020 - 2023 were analyzed. in healthcare organizations of the Ministry of Health of the Kyrgyz Republic. Results. When analyzing the number of prescribed medications, it was found that in the pharmacotherapy of 500 patients with bronchial asthma in different combinations, 11 names of medications under international nonproprietary names and 26 medications under trade names were used, while the total number of prescribed medications per patient varied from 1 to 5 types of drugs in 62 different combinations. Of the combinations of salbutamol with drugs from other pharmacological groups, the leading ones were the simultaneous administration of 3 drugs: Salbutamol + Ambroxol + Theophylline; for beclomethasone, a combination of 5 drugs: Beclomethasone + Salbutamol + Ambroxol + Salbutamol + Theophylline; for salmeterol, a combination of 5 drugs: Salmeterol + Fluticacone, Salbutamol, Acetylcysteine, Salbutamol. Conclusions. A study of the structure of medications used in the hospital in the treatment of patients with bronchial asthma made it possible to establish that the largest share of drug prescriptions was for the treatment regimen Beclomethasone + Salbutamol + Ambroxol + Salbutamol + Theophylline, which was used in the treatment of 67 patients. The regimen Salbutamol + Ambroxol + Theophylline was used in the treatment of 62 patients and the prevailing treatment regimens were Salmeterol + Fluticacone, Salbutamol, Ambroxol, Theophylline and Salmeterol + Fluticacone, Salbutamol, Ambroxol, Salbutamol, Theophylline, each of which was used in the treatment of 28 patients.

Hospital pharmacists’ knowledge, attitudes and practice of pharmaceutical care and the barriers for its implementation at the hospital setting

ObjectiveTo assess hospital pharmacists' understanding of pharmaceutical care and their attitudes regarding the adoption of the patient-centered model, as well as investigate Jordan's current state of pharmaceutical care implementation and the associated barriers. MethodsA validated survey was distributed to hospital pharmacists in different major tertiary hospitals in Jordan. The study questionnaire contained five sections to assess sociodemographic characteristics, pharmacists’ understanding of pharmaceutical care, attitudes towards pharmaceutical care, potential barriers that may limit the delivery of pharmaceutical care, and the extent of pharmaceutical care implementation in the hospital setting. ResultsThe survey was completed by 152 hospital pharmacists. Participants in this study demonstrated adequate levels of knowledge about pharmaceutical care (Mean = 9.36 out of 11, SD = 1.23) and expressed favorable perceptions of pharmaceutical care (mean = 3.77 out of 5; SD = 0.7). Although more than one-third of the pharmacists practiced pharmaceutical care, the study revealed a number of impediments to the delivery of pharmacological care services. Regression analysis revealed that age (P < 0.05) and years of experience (P < 0.05) were significant predictors of knowledge, while age (P < 0.05), gender (P < 0.05), the graduation university (governmental vs. private) (P < 0.05), and years of experience (P < 0.05) were significant predictors of attitude. Furthermore, Doctor of Pharmacy degree holders had fewer barriers to pharmaceutical care implementation but were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.01 and P < 0.05 respectively). Pharmacists with a Master's degree or higher in pharmacy were more actively involved in pharmaceutical care practice than those with a Bachelor of Pharmacy degree (P < 0.05). Pharmacists working in the Ministry of Health and the Royal Medical Services experienced more barriers than those working in teaching hospitals (P < 0.05). ConclusionsAlthough the current study indicated high knowledge and perceptions regarding pharmaceutical care among hospital pharmacists, the provision of pharmaceutical care is not widely practiced in Jordan. Moreover, several barriers to the practice of pharmaceutical care were identified, highlighting the need for effective strategies to be put in place to overcome these obstacles. These strategies should include increasing the number of pharmacy staff, resolving timing issues, providing adequate financial initiatives, improving communication skills, changing the layout of pharmacies to include a private counseling room, developing specific policies that support the role of the pharmacist in patient care, and providing effective training and continuing professional education programs.

Pharmaceutical care for visually impaired patients: a qualitative study of community pharmacists' needs and professional experience.

Visual impairment is a disability that can have a significant impact on the ability to take medication safely. As a result, pharmacists must adjust their practice toprovidetargeted and adapted support for this type of patient. The aims of the present study were (1) to illustrate the usual clinical practice of community pharmacists to support the optimisation of medication use in visually impaired patients, and (2) to identify solutions to improve pharmaceutical care for visually impaired patients. Semi-structured interviews with 18 French-speaking community pharmacists were conducted via videoconference in Belgium. Participants were recruited on a voluntary basis and through a snowball method. An interview guide was developed based on literature review. Interviews were carried out until theoretical saturation of the data, recorded, transcribed verbatim and analysed using thematic analysis. Data were organised by NVivo Software. Four themes were identified: community pharmacists' training, identification of visually impaired patients by the pharmacist, communication with visually impaired patients and their proxies, and provision of appropriate pharmaceutical care. Participants stated that they had not received any training regarding visual impairment. They described that they did not always know how to recognise visually impaired patients and that communication was often difficult. This qualitative study hashighlighted a lack of knowledge and skills among community pharmacists regarding visual impairment. One possible solution could be to develop recommendations and tools to improve the care of these patients.

Study of factors influencing the occurrence of conflicts in pharmacies

The aim of the study was to investigate the factors influencing the occurrence of conflicts in pharmacies during the provision of pharmaceutical care, with the subsequent goal of optimizing the social and psychological climate within the team and improving the quality of service to the population. Materials and methods. Systematic-analytical, mathematical statistical, comparative, and sociological research methods were employed in the study. Descriptive statistics were utilized to present the obtained data. To assess the significance of individual factors, the questionnaire results were converted into corresponding component weights (Wij). Results. The study of conflicts between visitors and pharmacy employees, from the point of view of visitors, revealed several key findings. Most customers expressed dissatisfaction with the prices of medicines and medical devices (Wij = 1.00). Additionally, there were concerns about the perceived quality of the products (Wi j= 0.67), and some customers reported feeling distressed due to the unavailability of necessary medicines (Wij = 0.57). The study, conducted from the point of view of employees, focused on conflicts between employees and visitors. The findings revealed that conflicts most often arise due to dissatisfaction with the prices of medicines and medical devices (Wij = 1.00). Additionally, issues such as requests to dispense over-the-counter medicines from the list of prescription drugs (Wij = 0.70) and returning medicines to the pharmacy after purchase (Wij = 0.67) were identified as contributing factors. The analysis of factors that provoke conflicts in the pharmacy team revealed several key contributors. The most significant include the inadequate behavior of employees (Wij = 1.00), inconsistency in words, assessments, and actions of some team members with the expectations and requirements of others (Wij = 0.89), and psychological incompatibility between employees (Wij = 0.88). The study of conflicts between the administration and subordinates in the pharmacy revealed frequent occurrences linked to several factors. Most notably, conflicts were associated with an imperfect bonus system (Wij = 1.00), high workload (Wij = 0.92), and a perceived lack of career development opportunities (Wij = 0.76). Conclusions. The factors that contribute to the emergence of conflict situations in pharmacies have been identified and studied. Approaches to preventing and resolving conflicts by pharmacy employees are proposed.

Impact of Resveratrol and Pharmaceutical Care on Type 2 Diabetes Mellitus and Its Neuropathic Complication: A Randomized Placebo Controlled Clinical Trial

Background. Management of diabetic neuropathy (DN) is a challenging issue. Therefore, integration of pharmaceutical care provided by the clinical pharmacists with pharmacotherapy may provide multifaceted approach to target the management of hyperglycemia and diabetic neuropathic complication. This study aimed to evaluate the effects of resveratrol (Resv) and/or pharmaceutical care (PC) on glycemic control and amelioration of diabetes-associated neuropathic complications. Patients and Methods. A four-arm randomized placebo-controlled clinical trial assigned 120 patients from the Diabetes and Endocrinology Center in Sulaymaniyah City, Iraq. The patients were divided into four groups. The Resv group (n = 30) received 500 mg Resv capsules once daily. The Placebo group (n = 30) received placebo capsules. Resv + PC (n = 30) received Resv 500 mg capsules with PC. Placebo + PC (n = 30) received placebo capsule plus PC. The duration of the intervention was 90 days. Drug therapy problems (DTPs) have been utilized as an important domain in PC. Clinical signs, symptoms, and neuropathic abnormalities were assessed using the Michigan Neuropathy Screening Instrument (MNSI), Douleur Neuropathique 4 (DN4) questions, and nerve conduction studies (NCSs) of the lower-limb sensory and motor nerves. Results. 97 patients from all the groups completed the study. At baseline, 84% of the Resv, 87% of the Placebo, and 92% of each of Resv + PC and Placebo + PC groups, respectively, had at least one DTP. The provision of PC resulted in a dramatic reduction in the number of DTP. Resveratrol with PC significantly ameliorated hyperglycemic status, neuropathic signs, and symptoms, as evidenced by a decrease in MNSI and DN4 scores and improvement in electroneurographic parameters. Conclusion. These findings support the integration of the PC concept into a pharmacotherapy intervention; they also encourage supplementation of Resv with conventional diabetes therapy to emphasize on the importance of this herbal medicine with the provision of PC in the management of diabetes and its neuropathic complications. This trial is registered with NCT05172947.

Pharmaceutical Care in Mental Health: Pharmacists’ Barriers, Collaborations, Attitudes, and Perceptions

Background: Pharmaceutical care is an essential component of mental healthcare. Objectives: The study assessed pharmacists’ collaborations, barriers, perceptions on therapeutic relationships and attitudes toward pharmaceutical care to persons with mental illness. Methods: A questionnaire-based descriptive cross-sectional survey was conducted among 175 pharmacists in a Nigerian state via purposive sampling. Average mean score of &gt;3 (±SD) was considered positive attitude toward pharmaceutical care, and positive for respondents’ perception of pharmacists-patient relationship during consultations. Data were analyzed using SPSS version 25.0 for descriptive statistics. Results: A total of 140 (80.0%) respondents participated in the study. Access to patients’ medical records 90 (64.3%) was the major barrier to the provision of pharmaceutical care to persons with mental illness. Almost half of the study participants 69 (49.3%) desired collaboration with only general practitioners and psychiatrists. Only 44 (31.4%) had full co-operation from their desired collaborators. Average score for respondents’ attitude toward provision of pharmaceutical care to the patients, and perception of pharmacist-patient relationship were 4.5 (±0.7) and 3.8 (±0.9) respectively. Conclusions: Study participants’ attitude toward pharmaceutical care, and perception on therapeutic relationship in persons with mental disorder were positive. Lack of access to patients’ records mostly hindered provision of pharmaceutical care, and full collaboration with other mental health experts was mostly lacking. Appropriate policies are required to improve these vital components of mental healthcare for desired outcomes.

Prioritizing Quality over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit.

The expanding scope of practice of hospital pharmacists has contributed to improvements in patient care; however, workload remains a barrier to the provision of optimal pharmaceutical care. Established ratios to guide clinical pharmacy staffing on medical and surgical units are lacking in Canada. To determine the pharmacist-to-patient ratio that allows for provision of comprehensive pharmaceutical care to each patient on a medical or surgical unit and to determine which comprehensive care tasks can be delivered in settings where staffing is limited. A multiphase study was conducted in 6 hospitals. First, a modified Delphi study was conducted to define and prioritize the elements of comprehensive pharmaceutical care. Next, a work sampling study was conducted to establish the frequency of each task and the time required for completion. Finally, a workforce calculator was used to determine pharmacy staffing ratios. Ten pharmacists participated in the modified Delphi study, and 31 participated in the work sampling study. A total of 15 comprehensive care tasks were identified, 7 of which were categorized as tasks to prioritize in settings where staffing is limited. The optimal staffing ratios were 1 pharmacist to 13 patients in internal medicine teaching units, 1 pharmacist to 26 patients in hospitalist or internal medicine nonteaching units, and 1 pharmacist to 14 patients in surgical units. The optimal staffing ratios determined in this study should enable pharmacists to provide comprehensive care to each patient. Implementing these staffing ratios could increase the consistency of clinical pharmacy services, improve patient outcomes, and improve pharmacists' work satisfaction. Further research is required to validate these ratios in a variety of settings.

Emergency pharmacy workforce views and experience related to the provision of pharmaceutical care during mass gathering events: the FIFA World Cup Qatar 2022™ experience.

This study aimed to explore emergency pharmacy workforce perspectives and experiences in providing pharmaceutical care during mass gathering events (i.e., FIFA World Cup Qatar 2022™). A qualitative methodology was employed using focus groups discussions. Emergency pharmacists across Hamad Medical Corporation were invited to participate using a combination of purposive and snowball sampling. Focus groups were audio-recorded, transcribed verbatim, and validated. Inductive thematic analysis was undertaken to generate key themes and subthemes. Four focus groups were conducted which included 21 participants and generated five major themes. Whilst participants had mixed opinions in relation to their preparedness to practice during the World Cup, they perceived their experience as successful and smooth. The primary perceived facilitators were management support, mobile medical units, and high public health awareness. The main highlighted barriers were related to staff insufficiency, medications availability, and cultural and language challenges. Participants recommended pharmacist's role identification in mass gatherings, development of pharmacy action plan, and offering simulation training and pharmacy-specific training. Despite the perceived barriers, pharmacists reported positive views in relation to their experience in providing pharmaceutical care during mass gatherings. Future research should focus on the development of theory-driven action framework for pharmacy departments to adopt during mass gatherings.

Spanish Society of Hospital Pharmacy Position Statement on Telepharmacy: Recommendations for its implementation and development

The use of information and communication technologies have nowadays become part and parcel of hospital pharmacy practice. Against this background, it is hardly surprising that Telepharmacy has sparked the interest of a large number of stakeholders. In this respect, the Spanish Society of Hospital Pharmacy has developed a definition of the concept and outlined the conditions under which Telepharmacy should operate. It has also shared its institutional stance on the subject through a position statement that states that Telepharmacy is the provision of pharmaceutical care at a distance through information and communication technologies. Telepharmacy practice includes activities such as therapeutic validation, drafting of clinical documents, provision of pharmaceutical care, therapeutic follow-up, adherence monitoring, drug education and information, coordination between healthcare providers and evaluation of health outcomes. The clinical tasks performed as part of Telepharmacy practice must adhere to a standardized procedure and revolve around the patient's clinical record. Access to Telepharmacy must be provided without discrimination. The service comprises four main activities: pharmacotherapeutic follow-up; patient and caregiver-directed education and information-dissemination; coordination with healthcare providers from the same or different hospitals; and remote informed home drug delivery. Implementation of Telepharmacy requires an adjustment of human (training and capacity-building) and technological resources (validation, interoperability, confidentiality). It must also comply with the laws and regulations in force both at a regional and a national level. Telepharmacy procedures must also be adapted to the relevant ethical standards and codes of good practice. Appropriate indicators must be used to evaluate the performance of Telepharmacy and its impact on health outcomes. According to Spanish Society of Hospital Pharmacy Telepharmacy is a necessary complementary tool to provide specialized pharmaceutical care and thereby improve health outcomes and maximize patient safety and satisfaction.

PROVISION OF CLINICAL PHARMACY SERVICES THROUGH THE TELEGRAM GROUP UNDER THE CONDITIONS OF THE FULL-SCALE WAR IN UKRAINE

The research aims at studying the requirement for clinical pharmacy services offered through the activity of a Telegram group after the imposition of martial law in Ukraine.&#x0D; Materials and Methods. The staff of the Department of Healthcare Management, Pharmacotherapy and Clinical Pharmacy together with the Centre of Pharmaceutical Care and Innovations in Healthcare of Danylo Halytsky Lviv National Medical University created a "Clinical Pharmacy" group on Telegram (free of charge messenger) on March 3, 2022. The object of research is represented by the requests of the created group members. The subject of research is represented by special needs for clinical pharmacy services and the provision of pharmaceutical care after the imposition of martial law in Ukraine.&#x0D; Results and Discussion. A total of 206 participants joined the newly-created Telegram group and sent 338 requests from March 3 to June 8, 2022. Notably, 88.8% of requests were sent in March 2022. The requests involved the identification of medicines and medical products by the group administrators. Medicines and medical products were identified based on the photos of the secondary or primary packaging with labels mainly in a foreign language. The administrators answered the questions in Ukrainian. The results of the data analysis showed that 54.1% of requests were related to medicines, 16.6% to medical products, 16.6% to dietary supplements, 11.8% to cosmetic products, and 0.9% to other. The administrators of the Telegram group identified the product as medicine or attributed it to other categories when they received requests. Later, they identified the composition of active pharmaceutical ingredients, pharmacotherapeutic group and / or indications for use. The requests included narcotics and psychoactive agents, while their distribution is limited in Ukraine. The administrators also identified medicines that were not registered in Ukraine (28.4%). It may be necessary to provide more complete pharmaceutical care to ensure the rational use of them. In our opinion, the obtained results should become a part of the academic process. It should be noted that case management based on the received requests and responses to them must also be included.&#x0D; Conclusions. The obtained results prove that a part of the vital clinical pharmacy services can be provided by professional groups using free messengers in the state of emergency, namely the imposition of martial law. The provision of accurate information about drugs and medical products was prioritized among other clinical pharmacy services. We consider it relevant to enforce the development of e-clinical pharmacy, especially while implementing crisis management in Ukraine.

Exploring the pharmacist role and challenges during COVID-19 pandemic in the public healthcare setting: A qualitative study

Background: Pharmacists working in the Public Health Center (PHC) setting are at the frontline response and often have to adapt to the COVID-19 crisis. However, there is a deficit of studies examining their roles and challenges regarding providing pharmaceutical care and how they adapt to the COVID-19 situation in Indonesia. Objective: This study aims to explore the views and experiences of pharmacists in the PHC during the COVID-19 pandemic. Methods: Four Focus Group Discussions (FGDs) involving 40 PHC pharmacists working in Surabaya were conducted in May 2021. The FGDs were audio recorded, transcribed verbatim and subsequently analysed for any emerging theme. Results: Most participants viewed that the restriction of face-to-face interaction hampered the provision of pharmaceutical care in the PHC. Protective equipment and partition screens during patient visits have challenged pharmacists to communicate effectively. Services such as direct one-on-one drug information and patient counselling were still provided, often facilitated with written aids, but for a limited time, providing opportunities for pharmacists to deliver messages through WhatsApp and telephone. Conclusion: The COVID-19 pandemic significantly impacted pharmaceutical service delivery in PHC. However, it has preserved the important role of pharmacists to ensure safe and quality services, particularly with the presence of the COVID-19 vaccination programme.

Opinions and experiences on the provision of care to people with mental illnesses: a qualitative study with Doctor of Pharmacy graduates after a rotation in psychiatry.

Pharmacists are vital to optimizing therapy of people with mental illnesses. Limited knowledge, lack of confidence, and mental health-related stigma can lead to pharmacists' reluctance in the provision of pharmaceutical care to this population. Advanced pharmacy practice experiences (APPE) in mental health have been reported as valuable learning opportunities to overcome these challenges. This study aimed to explore PharmD graduates' perceived preparedness, attitudes, beliefs,and opinions on influencing factors for the provision of pharmaceutical care to people with mental illnesses after completing an APPE rotation in psychiatry. All PharmD graduates who had completed a rotation in psychiatry were invited to participate in semi-structured interviews. An interview guide was developed based on a literature review. A total of 11 PharmD graduates agreed to participate in the interviews, which were recorded, transcribed, and analysed inductively using thematic analysis and followinga phenomenological approach. Five themes were identified: Prior familiarity to mental health, opinions on the rotation, views on stigma, rotation's areas of improvement, and the positive impact of the rotation on practice. Although participants started the psychiatric rotation with low confidence and a sense of apprehension, they described their experience as unique, eye-opening, and insightful. Familiarity with mental health conditions before the rotation were perceived as a challenge to achieving full confidence in mental health care provision. For the most part, the APPE in psychiatry was viewed as a positive opportunity for enhancing the PharmD graduates' insight, knowledge, and skills for pharmaceutical care provision to people with mental illnesses.

Intelligent medication manager: developing and implementing a mobile application based on WeChat.

Background: Time and space constraints have often hindered the provision of optimal pharmaceutical care, limiting medication therapy management. Social media tools have gained significant popularity in the field of pharmaceutical care. This study aimed to develop a WeChat-based intelligent medication manager platform that facilitates online pharmaceutical care and encourages self-management. Methods: We developed a WeChat-based Internet pharmacy service platform called Xiang Medicine Guidance (XMG). Through the analysis of surveys and user access data, we evaluated the demand and utilization of the XMG platform and assessed patients' satisfaction with its services. Patients' adherence before and after the XMG platform intervention was also investigated. Results: The XMG platform was launched in November 2022, offering medication guidance, reminders, and consultation services through the WeChat mini-program. By the end of April 2023, the platform had attracted 141.2 thousand users, accumulating 571.0 thousand visits. Moreover, 1,183 clients sought online medication consultations during this period. Six months after the launch of XMG, an impressive 91.02% of users expressed their satisfaction with the platform. The medication reminders and consultations provided by XMG significantly contributed to medication adherence, with 56.02% of users categorized as having good adherence, better than the previous 47.26%. Conclusion: Through its services and features, XMG empowers patients to better manage their medications, seek professional advice, and adhere to their prescribed treatment plans. XMG has the potential to positively impact public health on a broader scale.

Barriers and facilitators experienced by migrants and refugees when accessing pharmaceutical care: A scoping review.

Pharmacists in the community are often among the first health professionals encountered by new arrivals. Their accessibility and the longevity of the relationship gives pharmacy staff unique opportunities to work with migrants and refugees to meet their health needs. While the language, cultural and health literacy barriers that cause poorer health outcomes are well documented in medical literature, there is a need to validate the barriers to accessing pharmaceutical care and to identify facilitators for efficient care in the migrant/refugee patient-pharmacy staff interaction. The purpose of this scoping review was to investigate the barriers and facilitators that migrant and refugee populations experience when accessing pharmaceutical care in host countries. A comprehensive search of Medline, Emcare on Ovid, CINAHL and SCOPUS databases, guided by the PRISMA-ScR statement, was undertaken to identify the original research published in English between 1990 and December 2021. The studies were screened based on inclusion and exclusion criteria. A total of 52 articles from around the world were included in this review. The studies revealed that the barriers to migrants and refugees accessing pharmaceutical care are well documented and include language, health literacy, unfamiliarity with health systems, and cultural beliefs and practises. Empirical evidence was less robust for facilitators, but suggested strategies included improvement of communication, medication review, community education and relationship building. While barriers experienced are known, there is a lack of evidence for facilitators for provision of pharmaceutical care to refugees and migrants and poor uptake of available tools and resources. There is a need for further research to identify facilitators that are effective in improving access to pharmaceutical care and practical for implementation by pharmacies..

Practice of pharmaceutical care by community pharmacists in response to self-medication request for a cough: a simulated client study

BackgroundCommunity pharmacy practice worldwide has been shifting from product-focused to patient-oriented. However, due to the absence of separation between prescribing and dispensing in Malaysia, community pharmacists may have limited roles in the provision of pharmaceutical care to patients with chronic diseases. Therefore, the main functions of community pharmacists in Malaysia are related to self-medication requests for minor ailments and the supply of non-prescription medications. The objective of this study was to determine the practice of pharmaceutical care by community pharmacists within the Klang Valley, Malaysia in response to self-medication requests for a cough.MethodsThis study utilised a simulated client method. A research assistant, acting as a simulated client, visited community pharmacies in the Klang Valley, Malaysia to consult the pharmacists on the treatment of a cough experienced by his father. Upon leaving the pharmacy premise, the simulated client entered the pharmacist’s responses in a data collection form which was structured based on pharmacy mnemonics for the response to symptoms, OBRA’90 on counselling elements, the five practice principles of pharmaceutical care by the American Pharmacists Association and literature review. Visits to the community pharmacies were conducted from September to October 2018.ResultsThe simulated client visited a total of 100 community pharmacies. None of these community pharmacists practised adequate patients’ data collection, with only a low proportion who practised all the components studied under medication information evaluation (13%), formulating a drug therapy plan (15%) and monitoring and modifying the plan (3%). Of the 100 community pharmacists, 98 recommended treatment but none of them provided all the counselling elements studied in implementing the drug therapy plan.ConclusionThe present study showed that community pharmacists within the Klang Valley, Malaysia were not providing adequate pharmaceutical care services to patients seeking self-medication for a cough. Such practice may compromise patient safety if inappropriate medicines or advice are given.

Study of the influence of armed conflict on the reimbursement of oral glucose lowering drugs in Ukraine

The humanitarian crisis significantly affects the provision of medical and pharmaceutical care to PWD, and makes it difficult to predict its availability and affordability. It was established that despite the military actions in Ukraine, the reimbursement system is experiencing both negative and positive trends. Negative trends are : an increase in drug prices, the amount of patient co-payments, and a decrease in the number of glucose-lowering drugs that are subject to full reimbursement. Positive trends are: an increase in the amount of reimbursement and the number of glucose-lowering drugs that are included in the system reimbursements, including at the expense of extended dosage forms. The analysis showed that the war led to the introduction of positive changes – to increase the number of glucose-lowering drugs that are subject to full compensation.

Students’ experiences and attitudes toward a newly developed simulation-based pharmaceutical care clinical rotation: A pre-post study design

PurposeThis study aims to evaluate Doctor of Pharmacy (PharmD) students’ experience with the newly developed simulation-based pharmaceutical care (PC) rotation by evaluating their knowledge and attitudes towards PC before and after the rotation. MethodsA self-administered questionnaire was distributed to sixth year PharmD students enrolled in the clinical training rotation “Comprehensive Pharmaceutical Care” during the 2020/2021 academic semesters at Jordan University of Science and Technology’s (JUST) Faculty of Pharmacy. Questionnaires were distributed before and after completing four experiential training weeks and consisted of three sections. The first section collected students’ demographic details while the second and third sections evaluated students' knowledge about, and attitudes toward PC, respectively. Descriptive statistics were used to describe and compare changes in students' knowledge and attitudes pre-and post-rotation. ResultsA total of 106 valid questionnaires were completed with a response rate of 99.07%. The rates of correct answers increased after the rotation with median total knowledge score increasing from 8 to 10 (out of 13, P value < 0.001). Significant improvements in students’ understanding of aspects relating to the concept and process of PC, and the role of clinical pharmacist in PC provision, were shown post the simulation-based clinical rotation. Similarly, their attitudes toward performing PC were either improved or emphasized. In contrast results also revealed that specific aspects of the rotation require further refinement, such as the comprehensiveness of the PC process and responsibilities in providing PC. ConclusionsPharmD students’ understanding and attitudes toward PC were either improved or emphasized after the simulation-based PC rotation. This study highlights the value of simulation as a unique instructional technique that can assist educators to develop PC competencies for pharmacy students.

Role of Clinical Pharmacy Services in Healthcare System

Clinical pharmacy services are needed into practice for better pharmacotherapy towards safe and optimal patient care. It takes into account, patient-centred orientation with specialized therapeutic knowledge, experience and judgement to assure prudent patient outcomes. Medication Reconciliation is one of the fundamental responsibilities of clinical pharmacy as it forms the basis for many different clinical pharmacy activities such as patient counselling, therapeutic drug monitoring, and detection and regulation of probable adverse drug reactions; therefore, it is the principal duty of a clinical pharmacist to approve drug orders. In many hospitals, where clinical pharmacy services are not fully established much commitment is needed for betterment and expansion of this system in contemplation of bringing out the benefits of these services for advantage of society. Clinical pharmacy mainly focuses on a patient-oriented attitude. They require regular and frequent interactions with the physicians and other health care providers which contribute to improved quality of care. The provision of pharmaceutical care can result in expanded identification of drugs and dose associated problems in admitted patients. The decision-making process for choosing economical and effective medications can be assisted by pharmacists in order to improve the standard of patient care and clinical results by ensuring that medications are chosen in accordance with local protocols and formularies. Clinical pharmacist plays a key role in the patient safety initiatives, intercepting and acting towards feasible prescribing errors. Clinical pharmacy services can serve as vital contributing factor in the betterment of health care system. Pharmacists have roles and responsibilities both as team members and as individual practitioners ensuring that patients benefit from their pharmaceutical care.

A Multi-Institutional Study of Yemeni Final Year Undergraduate Pharmacy Students' Understanding, Attitudes, and Perceived Barriers Toward Provision of Pharmaceutical Care: A Cross-Sectional Study.

Pharmaceutical care (PC) is the philosophy of the pharmacist's practice to achieve a better health-related outcome by designing, implementing and monitoring the therapeutic plans. It is in its infancy in Yemen. Hence, the study objectives were to examine the barriers to PC provision as perceived by Yemen pharmacy students and to assess their level of understanding of PC and their attitudes toward PC. A cross-sectional study was conducted among ten pharmacy colleges in Yemen, offering undergraduate pharmacy programs. A stratified sample of 518 students from the included universities were surveyed using a well-structured, validated and self-administered questionnaire. Chi-square, Mann-Whitney U, and Kruskal-Wallis tests were conducted at an alpha level of 0.05. Four hundred and seventy-five (475) participants were included (92.9% response rate). More than 17% (n=84) of participants were involved in Pharm.D program, and nearly 29.9% (n=142) preferred pharmaceutical marketing as a career after graduation. About 65% of participants recognized the purpose of PC, and pharmacists' role within PC. However, only 43.8% (n=208) knew the difference between clinical pharmacy and PC. About 82% of respondents showed very good attitudes toward PC. Pharm.D students showed higher attitudes' total scores, median (IQR): 4.3 (4.1-4.4), 4.2 (4-4.2) and 4 (3.9-4.2) for Pharm.D, bachelor of pharmacy and bachelor of clinical pharmacy respectively, (p-value = 0.032). Moreover, students who currently employed in pharmacy-related job during their study were also associated with high attitudes scores compared to unemployed students, median (IQR): 4.2 (4-4.4) and 4(3.9-4.1) respectively (p-value = 0.023). "Lack of access to the patient medical record in the pharmacy" and "inadequate (hospital and community pharmacy) internship period" were the top reported barriers with 81.5% (n=387) agreement. Although PC is in its infancy in Yemen, pharmacy students showed positive attitudes toward practicing PC. Educational institutions should exert efforts for curricular revision to improve understanding, and overcome the reported barriers in the future.