Role Of Clinical Pharmacist Research Articles

The Pivotal Role of Clinical Pharmacist in Management of Mucormycosis

Mucormycosis, or zygomycotic or black fungus, is a fungal infection caused by a group of molds called mucoromycetes. It is the third most common invasive fungal disease after candidiasis and aspergillosis. Mainly caused by contact in the environment with fungal spores. Types of mucormycosis are Disseminated Mucormycosis, Pulmonary (lung) mucormycosis, Rhino cerebral (sinus and brain) Mucormycosis, Cutaneous (skin) Mucormycosis, Gastrointestinal Mucormycosis, Diagnosis mainly depends on biopsy, histological examination, CT scan, or MRI. Early diagnosis, complete removal of infected tissues, and early administration of active antifungal agents allow us to treat Mucormycosis by using different adjunctive therapies. In the pandemic of COVID due to exposure to various irrational and immunosuppressant's, Mucormycosis cases are in great extent, and due to this, the main role of the clinical pharmacist is to maintain drug therapy through medication therapy management, which involves drug dosing regimens and the correlation of drug therapy with other risk factors. This review highlights the indispensable role that clinical pharmacists play in the early diagnosis, treatment, and overall management of mucormycosis, with a focus on rhino-cerebral mucormycosis.

Role of clinical pharmacist in drug utilization evaluation, medication adherence and pharmacovigilance

A series of systematic, criterion-based drug evaluation known as Drug utilization review are conducted on a regular basis to ensure that medication is utilized appropriately. It’s a mean of learning more about the issues brought on by drug usage, if done properly, may help to solve the issues. Medication adherence generally refers to a patient’s ability to take prescription drugs as directed and their continued use of those drugs. The increasing body of research linking medication non adherence to unfavorable outcomes and increased healthcare cost has raised concerns among clinicians, healthcare institutions, and other stakeholders. Pharmacovigilance, in which the procedures keeping an eye on the assessing adverse medication reactions, is essential to clinical practice, public health and efficient drug regulating system. Aim of the study was wo study about the role of pharmacist in drug utilization review, medication adherence and pharmacovigilance.

Impact of pharmaceutical care for asthma patients on health-related outcomes: An umbrella review.

Recent systematic reviews suggest that pharmacists' interventions in asthma patients have a positive impact on health-related outcomes. Nevertheless, the association is not well established, and the role of clinical pharmacists is poorly represented. The aim of this overview of systematic reviews is to identify published systematic reviews assessing the impact of pharmacists' interventions on health-related outcomes measured in asthma patients. PubMed, Embase, Scopus, and Cochrane Library were searched from inception to December 2022. Systematic reviews of all study designs and settings were included. Methodological quality was assessed using AMSTAR 2. Two investigators performed study selection, quality assessment and data collection independently. Nine systematic reviews met the inclusion criteria. Methodological quality was rated as high in one, low in two, and critically low in six. Reviews included 51 primary studies reporting mainly quality of life, asthma control, lung capacity, and therapeutic adherence. Only four studies were carried out in a hospital setting and only two reviews stated the inclusion of severe asthma patients. The quality of the systematic reviews was generally low, and this was the major limitation of this overview of systematic reviews. However, solid evidence supports that pharmaceutical care improves health-related outcomes in asthma patients.

Clinical pharmacist role in smoking cessation: current and future perspective -A prospective study

Clinical pharmacist role in smoking cessation: current and future perspective -A prospective study

Current scenario and challenges of clinical pharmacists to implement pharmaceutical care in DRG/DIP payment hospitals in China: a qualitative interview study.

The Diagnosis-Related Group (DRG) or Diagnosis-Intervention Packet (DIP) payment system, now introduced in China, intends to streamline healthcare billing practices. However, its implications for clinical pharmacists, pivotal stakeholders in the healthcare system, remain inadequately explored. This study sought to assess the perceptions, challenges, and roles of clinical pharmacists in China following the introduction of the DRG or DIP payment system. Qualitative interviews were conducted among a sample of clinical pharmacists. Ten semi-structured interviews were conducted, either online or face to face. Thematic analysis was employed to identify key insights and concerns related to their professional landscape under the DRG or DIP system. Clinical pharmacists exhibited variable awareness levels about the DRG or DIP system. Their roles have undergone shifts, creating a balance between traditional responsibilities and new obligations dictated by the DRG or DIP system. Professional development, particularly concerning health economics and DRG-based or DIP-based patient care, was highlighted as a key need. There were calls for policy support at both healthcare and national levels and a revised, holistic performance assessment system. The demand for more resources, be it in training platforms or personnel, was a recurrent theme. The DRG or DIP system's introduction in China poses both opportunities and challenges for clinical pharmacists. Addressing awareness gaps, offering robust policy support, ensuring adequate resource allocation, and recognizing the evolving role of pharmacists are crucial for harmoniously integrating the DRG or DIP system into the Chinese healthcare paradigm.

Role of clinical pharmacists in multidisciplinary collaborative management of blood glucose in COVID-19 patients with hyperglycemia

BackgroundDuring the ongoing global pandemic of COVID-19, the association between hyperglycemia and COVID-19 infection has emerged as a notable concern. Therefore, finding effective methods to manage hyperglycemia in patients with COVID-19 is crucial. ObjectiveTo introduce the clinical pharmacists participating in multidisciplinary collaborative whole hospital blood glucose management mode, and to explore its effect on blood glucose control in patients with coronavirus disease 2019 infection and complicated with hyperglycemia. MethodsPatients with COVID-19 treated at Nanjing Drum Tower Hospital from December 2022 to January 2023 were assigned to routine diagnosis and treatment group and whole hospital blood glucose management group according to the blood glucose management plan received by patients. The groups were compared in regards to their adherence to management advice, blood glucose levels, fluctuation, inflammation-related indicators, medical service-related indicators, and incidence of hypoglycemia and adverse events. ResultsAfter 5 days of glucose management, both groups showed a decrease in fasting and postprandial blood glucose. Postprandial blood glucose in the whole hospital glucose management group was significantly lower than the routine group (P < 0.05). The whole hospital glucose management group showed a significant increase in compliance rate, improved inflammation-related indicators, and higher detection rates for hemoglobin and islet function (P < 0.05). Implementation rates for medical orders and treatment plans were also higher in the whole hospital group (P < 0.05). There was no significant difference in incidence of adverse events. ConclusionsMultidisciplinary blood glucose management is highly recommended for patients with COVID-19 who have hyperglycemia due to its effectiveness, standardization, safety, and improvement of inflammation indicators.

Pediatric oncology services in Nepal: A special focus on pharmacy practice.

The role of clinical pharmacists or oncology pharmacists in pediatric oncology has been established as important in anticancer regimen review, dose calculation, recommendation, chemocounseling, identification of drug-related problems, its resolution, and, prevention and monitoring of adverse drug reactions within high-income countries. With several hospitals providing pediatric oncology services in Nepal, clinical pharmacist involvement in these hospitals is very poor. Upon reviewing the reputed organization and association focused on pediatric oncology pharmacy practice, it looks imperative for Nepal to initiate clinical pharmacy services which will further help in improving patient health outcomes. As such in this commentary, we try to accentuate the pediatric oncology services and pediatric pharmacy practice within Nepal and try to pinpoint the potential areas for clinical pharmacists to focus if they intend to provide services in pediatric oncology pharmacy practice.

Can Consultation by a Clinical Pharmacist Prevent Morbidity and Mortality in Patients Undergoing Bariatric Surgery?

The purpose of this work was to investigate the effect of clinical pharmacist consultation on the long-term morbidity and mortality outcomes among patients undergoing bariatric surgery. In this retrospective cohort study, 165 bariatric patients at Herzliya Medical Center who were identified as complex cases and were consulted by a clinical pharmacist (2013-2019) were compared with a wider group of bariatric patients with chronic diseases who were recorded in the Israeli General Bariatric Registry during the same years. The primary outcomes were rates of surgical complications, re-hospitalizations, and death up to one year after surgery. The secondary outcome was the rate of re-hospitalizations in different time periods. The twelve (12)-month rate of re-hospitalization in the intervention group was 10.9% vs. 19.5% in the comparison group (p = 0.005); the rate of documented postoperative complications was 2.7% vs. 3.9% (p = 0.462), and mortality was null vs. 0.16%, respectively. As for the secondary outcomes, the rates of re-hospitalizations in the periods of 0-30, 31-90, 91-180, and 181-365 days after surgery were 1.8% vs. 5.3% (p = 0.046), 2.4% vs. 4.1% (p = 0.278), 3.6% vs. 4.8% (p = 0.476), and 7.3% vs. 9.9% (p = 0.256) in the intervention vs. comparison cohorts, respectively. In conclusion, this study demonstrates the importance and benefit of referring to a specialized clinical pharmacist around bariatric surgery for improving patient safety, especially in complex patients. This is the first study to look at the long-term effects of clinical pharmacist consultation on re-hospitalization and mortality among bariatric patients, and our encouraging outcomes should hopefully stimulate more studies to show the invaluable role of specialized clinical pharmacists.

The Role of Clinical Pharmacists in Patient-Centric Comprehensive Multiple Sclerosis Care.

Individuals with multiple sclerosis (MS) may experience a variety of visible and invisible symptoms and, as they age, comorbidities related and unrelated to their MS. This can result in a complex medication regimen that includes disease-modifying therapies, symptom management drugs, and prescriptions for other comorbid disorders. We reviewed the existing literature to discover how to optimally integrate neurology clinical pharmacists into the MS care team and how clinical pharmacists can directly support both providers and patients through their expertise in pharmacology and medication management. With approaches founded on a shared decision-making process alongside neurology providers, patients, and care partners, clinical pharmacists can help meet the complex challenges of MS care in a variety of ways. Especially within MS clinics, they are well positioned to enhance current neurology practices given their extensive training in comprehensive medication management and their ability to identify nuances in medication management to promote pharmacovigilance and patient-centered care. Neurology clinical pharmacists bring multifaceted medication management and patient counseling and education skills to the MS care team and can support the shared decision-making process by serving as an accessible resource for patients and clinicians. By building trusted partnerships between neurology providers and clinical pharmacists, MS care teams can achieve effective and efficient patient care. Future research should compare clinical and patient-reported outcomes between patients receiving standard care and those receiving multidisciplinary, pharmacist-integrated care.

Drug Therapy Problems Identified by Clinical Pharmacists at a General Surgery Ward of an Academic Referral Hospital in Jordan.

Drug therapy problems (DTPs) continuously occur in hospitalized patients. This study aims to emphasize the role of clinical pharmacists in evaluating the DTP's frequencies, causes, severity ratings, and contributing factors at a general surgery ward in Jordan. This prospective observational study was conducted at one of the major teaching and referral hospitals in Jordan. Data were collected through clinical pharmacist reviews of paper and electronic medical records as well as patient interviews. DTPs were identified using Cipolle's classification system and rated for severity on a scale of 10. Multiple linear regression was performed to identify factors contributing to DTPs. Drug classesprimarily associated with DTPs were specified. During enrollment, a total of 80 patients were recruited in this study. The mean age of the enrolled patients was 52.35 ± 14.82 years, and 49 (61.25%) of them were males. Within the study period, 192 DTPs were identified by clinical pharmacists in 87.5%of the total recruited patients. The mean number of DTPs per patient was 2.40 ± 1.83. The most common categories of DTPs were "needs additional therapy" 46 (23.96%), "unnecessary drug therapy" 45 (23.44%), and "dosage too low" 39 (20.31%). Of the total DTPs, 127 (66.15%) were rated as severe. Multiple linear regression revealed that patients' length of hospital stay and the number of current medications had a statistically significant effect on the number of DTPs identified during hospitalization. Endocrine and metabolic drugs 51 (26.56%) and cardiovascular drugs 36 (18.75%) were the most frequent classes of drugs contributing to DTPs. DTPs are common in the general surgery ward. Clinical pharmacists can provide medication reviews for surgical patients to identify DTPs and rate their severities. Detecting risk factors for DTPs and the most common drug classes associated with them can assist in decision-making relevant to reducing DTPs in the surgical ward.

Pharmaceutical interventions for drug-related problems in the neonatal intensive care unit: incidence, types, and acceptability.

Background: Drug-related problems (DRPs) are widespread in hospitalized neonates, but studies on the prevalence of DRPs in this population are limited. The presence of clinical pharmacists on multidisciplinary teams helps prevent and reduce DRPs. Aim: This investigation aimed to identify and classify the incidence of DRPs in the neonatal intensive care unit (NICU), to determine the determining factors associated with DRPs and to document clinical pharmacists' interventions, outcomes, acceptance rates and clinical significance. Method: A prospective descriptive hospital study was conducted from August to November 2023at the NICU of Children's University Hospital, Assiut University, Egypt. DRPs were classified using the Pharmaceutical Care Network of Europe (PCNE) classification V9.1. Results: Three hundred sixteen neonates were included in the study, with a mean gestational age of 34 ± 4weeks and a mean birth weight of 2.03 ± 0.85kg. A total of 1723 DRPs occurred among 283 neonates (89.6%), an average of 5.5 ± 5.1 DRPs per patient. The main types were treatment effectiveness (P1) (799, 46.4%), followed by others (P3) (469, 27.2%), and treatment safety (P2) (455, 26.4%). The leading causes were dose selection (C3) (1264, 61.9%) and "other domain" (C9) (543, 26.6%). Of the 2149 interventions introduced by pharmacists, 98.8% were accepted and 93% were accepted, and fully implemented. As a result, 92% of the DRPs were resolved. Both length of hospital stay and number of medications were significantly associated with DRPs. Conclusion: DRPs are common in the NICU; this study demonstrated the crucial role of clinical pharmacists in identifying and resolving DRPs.

The Role of Clinical Pharmacists in Antimicrobial Stewardship Programs (ASPs): A Systematic Review.

Antimicrobial resistance (AMR) is a major global health threat, increasing deaths and healthcare costs. Antimicrobial stewardship programs (ASPs) have been implemented to optimize antibiotic use and curb resistance. This systematic review aimed to summarize evidence on the role and impact of pharmacists in hospital ASPs. A comprehensive literature search was conducted across databases to identify relevant studies published from 2016 to 2023. Twenty-four studies met the inclusion criteria, comprising global observational and randomized clinical trials. Pharmacists performed various stewardship activities, including prospective audits, formulary management, de-escalation, guideline development, and education. Pharmacist-led interventions significantly improved antibiotic prescribing, reduced unnecessary antibiotic use, optimized therapy, and enhanced outcomes. Multiple studies found that pharmacist reviews decreased the time to optimal antibiotics and improved guideline compliance without affecting readmissions or revisits. De-escalation programs safely reduced antibiotic duration and length of stay. Acceptance rates for recommendations were high. Pharmacist stewardship curbed overall antibiotic use, costs, and duration across hospital departments, leading to savings. While most studies showed positive impacts, fewer detected significant changes in resistance or mortality over short periods. More research is needed, but current evidence demonstrates that pharmacists play critical roles in ASPs, leading to improved antibiotic use and patient outcomes. These findings support integrating pharmacists into stewardship activities, significantly extending programs to ambulatory settings.

Pharmaceutical Care for Premature Infants with Candida Albicans Infection of the Central Nervous System

Objective: To explore the role of clinical pharmacists in the treatment of clinical diseases by adjusting the treatment of Candida albicans infection in the central nervous system of a premature infant.&#x0D; Methods: Clinical pharmacists participated in the treatment of one premature infant with Candida albicans infection of the central nervous system, and provided drug selection suggestions based on drug safety and pharmacokinetics.&#x0D; Results: The doctor partially adopted the suggestions of clinical pharmacists, revised the medication plan, and the child received reasonable treatment.&#x0D; Conclusion: Clinical pharmacists can make full use of pharmaceutical knowledge to serve the clinic and improve the level of rational drug use.

The Role of clinical pharmacists’ interventions and prevention of medication errors in emergency departments

Clinical pharmacists play a vital role in mitigating medication errors within the high-pressure setting of emergency departments (EDs). This study underscores the significance of their interventions in elevating patient safety and reducing adverse drug events. Medication errors in the ED often stem from factors such as time constraints, incomplete patient information, and complex drug regimens. Clinical pharmacists address these challenges by conducting comprehensive medication reconciliation, assessing drug interactions, and adjusting dosages to align with each patient's specific requirements. Their presence in EDs facilitates real-time verification of medication orders, immediate correction of errors, and close collaboration with the healthcare team. Furthermore, clinical pharmacists provide invaluable drug information and education to patients and medical staff, thereby lowering the risk of inappropriate drug usage and promoting safer administration practices. Existing literature affirms that clinical pharmacist interventions in EDs lead to a notable reduction in medication errors, adverse drug events, and subsequent healthcare costs. In summary, the integration of clinical pharmacists in the ED is indispensable for augmenting patient safety, averting medication errors, and ultimately enhancing patient outcomes. Keywords: medication errors, clinical pharmacists, emergency departments, patient safety, healthcare.

The Role of Clinical Pharmacists in the Management of Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory skin condition characterized by itchy, inflamed skin that affects a significant portion of the population, particularly children, and can significantly impact quality of life. The role of clinical pharmacists in managing AD has gained prominence due to their expertise in medications, patient education, and collaborative care. This article explores the various ways clinical pharmacists contribute to the comprehensive management of AD, emphasizing patient education, medication management, and interprofessional collaboration.

Physicians’ perceptions and response to the role of clinical pharmacists in a teaching hospital in Egypt

Physicians’ perceptions and response to the role of clinical pharmacists in a teaching hospital in Egypt

Appropriateness of Surgical Antimicrobial Prophylaxis in a tertiary care hospital: A prospective observational study

Surgical site infections (SSIs) are a significant concern in global healthcare, particularly in middle and low-income countries, leading to increased hospitalizations, morbidity, mortality, and financial strain. Ranked third in the CDC's National Nosocomial Infections Surveillance System, SSIs have prompted a focus on preventive measures, notably surgical antimicrobial prophylaxis (SAP). However, SAP is often used inappropriately, contributing to the rise of Antimicrobial Resistance (AMR). Addressing this, a six-month prospective observational study was conducted in a tertiary care hospital to assess the adherence to SAP guidelines among 386 patients undergoing surgeries in various specialties. The study aimed to evaluate the appropriateness of SAP practices and identify factors leading to non-compliance. Results showed that only 58.3% of patients fully adhered to the guidelines. While 100% compliance was observed in SAP indication, lower adherence was noted in the timing of administration (97.7%), choice of SAP (85%), and duration of prophylaxis (70.2%). These findings underscore a significant gap between recommended SAP practices and actual implementation. This gap highlights the need for stronger Institutional Antimicrobial Stewardship (AMS) programs and the critical role of clinical pharmacists in regularly evaluating SAP and prescribing practices. To combat the rise of antibiotic resistance while ensuring patient safety, enhancing SAP practices in line with national and international recommendations is essential. The study advocates for more active interventions at the time of order to optimize antibiotic use, thereby addressing the challenge of compliance in SAP guidelines.

Do Future Physicians Know a Clinical Hospital Pharmacist's Capabilities?

Physicians appear to positively perceive pharmacists, but the perception of future physicians on clinical hospital pharmacists is largely unknown. By identifying medical students' perceptions, educational efforts could be developed to target areas for improvement and allow for optimal utilization of pharmacists. To identify medical students' perception of clinical pharmacists in the hospital setting. A 27-item survey that analyzed medical students' knowledge and attitudes toward clinical hospital pharmacists was sent via email to students at eight medical schools in Ohio. Survey items assessed participant's past interactions with a pharmacist (5 items), understanding of clinical pharmacists' roles and responsibilities (7 items), and current perceptions of clinical pharmacists (7 items). Quantitative data were analyzed using descriptive statistics and qualitative data using thematic analysis. There were 124 participants across 3 medical schools. Students expressed that clinical pharmacists are essential on the healthcare team to support and maintain a patient's health (Mean ± SD = 4.47 ± 0.829). They were neutral or disagreed that clinical pharmacists are qualified to diagnose a variety of conditions (Mean ± SD = 2.62 ± 1.017) and were neutral or agreed that a clinical pharmacist's role differs from a community pharmacist's role (Mean ± SD = 3.95 ± 0.659). In the qualitative analysis, medical students reported that they perceive clinical pharmacists to be medication experts (N=28, 66.7%), important members of the healthcare team (N=23, 54.8%), and useful resources for answering drug-related questions (N=15, 35.7%). Medical students reflected a positive attitude toward clinical pharmacists and affirmed the need for pharmacists to provide medication expertise in the hospital setting. However, many medical students were not fully aware of the responsibilities that a clinical pharmacist provides and could benefit from education on the scope of a pharmacist's practice.

Current practices, gaps, and opportunities on the role of clinical pharmacists in cancer pain management: Perspectives from Nepal.

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Negotiating new roles in general practice: a qualitative study of clinical pharmacists.

To address general practice workforce shortages, policy in England has supported the recruitment of 'non-medical' roles through reimbursement funding. As one of the first to receive funding, the clinical pharmacist role offers insight into the process of new role negotiation at general practice level. To identify factors influencing clinical pharmacist role negotiation at practice level, comparing the process under two different funding and employment models. Qualitative interview study with staff involved in the following schemes: 1) the national NHS England (NHSE) Clinical Pharmacists in General Practice scheme; and 2) a local clinical commissioning group-funded scheme, providing clinical pharmacist support to general practices in one area of Greater Manchester in the UK. Semi-structured interviews with purposive and snowball sampling of pharmacists, GPs, and practice staff took place. The interviews were analysed using template analysis. In total, 41 interviews were conducted. The following four factors were found to influence role negotiation: role ambiguity; competing demands and priorities; potential for (in)appropriate utilisation of clinical skills; and level of general practice control over the role. Key differences between the two funding and employment models were the level of influence GPs had in shaping the role and how adaptable pharmacists could be to practice needs. The potential for inappropriate utilisation was reported under both schemes, but most apparent under the role reimbursement, direct employment model of the NHSE scheme. This study has highlighted lessons applicable for the introduction of non-medical roles more widely in general practice. It has provided insight into the factors that can influence role negotiation at practice level and how different funding and/or employment models can impact on this process.