Role Of Clinical Pharmacist Research Articles

Drug-Related Problems and Pharmacists' Interventions in Hypertensive Outpatients: A Multicenter Prospective Study in 3 Vietnamese Hospitals.

Background: Clinical pharmacists' interventions (PIs) on drug-related problems (DRPs) in Vietnamese hypertensive outpatients are limited. Objectives: The objective was to investigate the prevalence and nature of DRPs, and factors which are likely to have DRPs, types of PIs, and their acceptance rate in 3 Vietnamese hospitals. Method: A prospective interventional study was conducted over a period of 3 months in 3 hospitals (from October 2021 to March 2022). Clinical pharmacists conducted medication reviews after collecting patient information from prescriptions and patient interviewing, and then identified the DRPs and suggested PIs according to the Vi-Med tool. These DRPs and PIs were reviewed by other superior clinical pharmacists and a consensus meeting with 3 cardiologists. Results: Of 381 patients included, 344 (90.23%) experienced 1 or more DRPs. A total of 820 DRPs were identified with an average of 2.15 DRPs per patient and 415 (50.61%) were hypertension-related issues. The most common DRPs identified were "administration mode" (46.34%), "missing indication" (18.05%), "non-conformity indication" (17.80%), and "dosage" (11.95%). Comorbidity (adjusted odds ratio [AOR] = 3.985, 95% CI: 1.597-9.942, P = 0.003) was the predictor of DRPs. Clinical pharmacists provided 739 PIs and 94.45% were accepted by physicians. Conclusion: The results of this study showed that DRPs were very common in hypertensive outpatients and highlighted the role of clinical pharmacists to identify and resolve DRPs through prompt interventions.

Antiepileptic Drugs Adverse Drug Reactions and Role of Clinical Pharmacist

Aim: To identify the ADR of suspected adverse drugs to monitor, manage, and assess to improve patient health. Materials and Methods: The study type is a prospective observational study done in a tertiary care hospital at Telangana. Patients prescribed with at least one antiepileptic drug and patients with chronic diseases (SLE, renal and hepatic failure, etc.) were included in the study. Result: Sodium valproate shows relatively less adverse drug reactions (ADRs) (2.5%) when compared with other antiepileptics. Phenytoin shows the highest number of ADRs (50%), among which CNS-related ADRs, where more than 75% of were predictable clinical pharmacists can play a crucial role in the early identification and prevention of these ADRs due to Antiepileptic drugs.

The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients

Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen. Prospective, interventional, clinical study for 80 hospitalized decompensated liver cirrhosis patients was designed in two phases, an observational phase to identify drug related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and an interventional phase to increase the awareness of patients and the health care providers about those problems and to propose a proper solution for each one. The majority of drug-related problems were attributable to the Effect of drug treatment not optimal in 41.5%, Adverse drug events (possibly) occurring in 41.5 %, and Untreated symptoms or indications in 17%. Causes were Drug dose too high in 30.2%, Patient unintentionally using the drug in the wrong way in 22.6%, and Prescribed drug not available in 13.2%. Omeprazole and lactulose were the most common medications causing problems. Acceptance and full implementation were high and observed in 71.7% of pharmacist interventions while 15.1% of the intervention have no agreement. Significant numbers of Iraqi patients with decompensated liver cirrhosis have drug-related problems, and the use of proton pump inhibitors in too high dose was accountable for a large number of problems. Physicians and clinical pharmacists collaborated exceptionally well

Exploring drivers and challenges influencing antibiotic prescribing in outpatient settings and possible mitigation strategies in the United Arab Emirates: a qualitative study.

Healthcare institutions implement antimicrobial stewardship (AMS) programmes to optimize the use of antibiotics. The focus is often on inpatient rather than outpatient settings. We aimed to explore perceptions of AMS stakeholders on effective interventions for appropriate antibiotic use in outpatient settings, and the role of clinical pharmacists in the AMS multidisciplinary team. A qualitative semi-structured interview study using thematic analysis by two researchers independently. Participants that practice AMS programmes were recruited from healthcare facilities in the United Arab Emirates (UAE). Interviews were conducted face to face or online and transcribed verbatim. Four themes emerged: (i) Perceived factors leading to unnecessary or inappropriate antibiotic prescribing and their impact on patients and the community; (ii) current outpatient AMS activities and perceived barriers and facilitators for their sustainability; (iii) suggested outpatient AMS strategies to be implemented in outpatient settings; and (iv) perceived future AMS implementation barriers and suggested mitigation strategies. Several AMS interventions, together with the presence of a clinical pharmacist, may be effective in improving antibiotic use in UAE outpatient settings. Future research should investigate the most appropriate AMS strategy considering barriers and possible mitigation strategies to ensure sustainability.

Clinical pharmacist role in improving the knowledge and outcomes in patients using isotretinoin: A randomized, controlled study

ObjectiveTo evaluate the role of a clinical pharmacist in improving knowledge and outcomes among isotretinoin users. MethodsPatients were randomly assigned to an intervention group (received education about isotretinoin by a clinical pharmacist in addition to the physician) and a control group (received routine education by the physician), then followed for three months. Patients' knowledge about isotretinoin optimal use, and side effects and their management and other outcomes were measured in both groups at baseline and at follow up after three months using a validated questionnaire. ResultsTwo-hundred and three patients completed the study; 103 were in the intervention group and 100 in the control group. The knowledge improvement between baseline score and follow-up score was greater in the intervention group (mean = 2.835 ± 1.329) compared to the control group (mean = 0.530 ± 0.784) with mean differences = −2.30495, P < 0.001. ConclusionImplementing clinical pharmacy services in dermatology clinics can positively increase patients’ level of knowledge about isotretinoin, which could reduce the severity of its side effects. Therefore, improving patients' quality of life, and improvement in acne. Practice implicationsImplementing clinical pharmacist services to patients using isotretinoin is feasible in an outpatient setting. Clinical pharmacist counseling and education improve the medication knowledge among patients who use isotretinoin.

Drug Utilization Pattern and Role of Clinical Pharmacist in Medication Adherence of Stroke Patients in a Tertiary Care Hospital, South India: A Prospective Observational Study

Stroke comprises of a broad term encompassing many disorders of the blood vessels of the central nervous system that may result from either inadequate blood flow to the brain with subsequent infarction of the involved portion of the CNS or haemorrhages into the parenchyma or subarachnoid space of the CNS causing neurologic dysfunction. Stroke is one of the major cause of mortality worldwide. The objective of the study was to assess the drug utilization pattern (DUP) and to evaluate the impact of counseling on medication adherence for stroke patient admitted in the hospital. Dual antiplatelet therapy (69.4%) was mostly given over monotherapy (28.2%). CCB (28.2%) was the most commonly prescribed antihypertensive drug class and amlodipine (77.1%) was the major CCB given in this study. 96.5 prescriptions comply AHA/ASA guidelines. Unintentional reasons for nonadherence were been reported more frequently than intentional reasons prior to the counseling. The commonest reported unintentional reasons were Forgetfulness (96.0%), Confusion (80.0%) and intentional reasons are carelessness (92%), avoiding dosing schedule (78%). Medication adherence before and after counseling was compared and was found to be improved with a statistically significant (p

Physicians’ and nurses’ perceptions of the factors influencing the implementation of paediatric clinical pharmacy services in Hong Kong: a qualitative study

ObjectivesTo identify barriers and facilitators that influence the implementation of paediatric clinical pharmacy services in Hong Kong public hospitals from physicians’ and nurses’ perspectives.MethodsA qualitative study was conducted based on...

Models of care and the role of clinical pharmacists in UK primary care for older adults: A scoping review protocol.

There has been global investment of new ways of working to support workforce pressures, including investment in clinical pharmacists working in primary care by the NHS in the England. Clinical pharmacists are well suited to support older adults who have multiple long-term conditions and are on multiple medications. It is important to establish an evidence base for the role of clinical pharmacists in supporting older adults in primary care, to inform strategic and research priorities. The aim of this scoping review is to identify, map and describe existing research and policy/guidance on the role of clinical pharmacists in primary care supporting older adults, and the models of care they provide. A scoping review guided by the Joanne Briggs Institute methodology for scoping reviews, using a three-step strategy. We will search Medline, CINAHL, Scopus, EMBASE, Web of Science, PSYCHInfo, and Cochrane for English language articles, from 2015 -present day. Grey literature will be searched using Grey Matters guidelines, the Index of Grey Literature and Alternative Sources and Resources, and Google keyword searching. References of all included sources will be hand searched to identify further resources. Using the Population, Concept and Context framework for inclusion and exclusion criteria, articles will be independently screened by two reviewers. The inclusion and exclusion criteria will be refined after we become familiar with the search results, following the iterative nature of a scoping review. Data will be extracted using a data extraction tool using Microsoft Excel and presented using a narrative synthesis approach. Ethical approval is not required for this review. Review findings will be disseminated in academic conferences and used to inform subsequent qualitative research. Findings will be published and shared with relevant local and national organisations.

Barriers and facilitators of inappropriate surgical antimicrobial prophylaxis in endourological procedures: a qualitative study from Jordan

Background: Inappropriate surgical antimicrobial prophylaxis (SAP) practice increases patients’ morbidity, healthcare cost, and antimicrobial resistance. Several guidelines have been published to set guidance for SAP before endourological procedures. Such guidelines include the American Urological Association (AUA, 2019) and the European Association of Urology (EAU, 2020). Literature reported that compliance with the recommendations of these guidelines has been suboptimal.&#x0D; Aims: to investigate healthcare professionals’ (HCPs) perspectives on the barriers to international guideline adherence regarding SAP for endourological procedures and the potential strategies to optimize adherence to guidelines recommendations.&#x0D; Methodology: This study was a qualitative study based on face-to-face semi-structured interviews conducted with urologists in multiple medical centers across Jordan using a preformulated interview guide regarding barriers and facilitators to the adherence to international guidelines of preoperative SAP during endourological procedures.&#x0D; Results: Nineteen urologists were interviewed. Interviews identified many barriers influencing HCP adherence to guidelines, these included factors related to patients, HCPs, the healthcare system, or other external barriers. Also, during the interviews, HCPs suggested many strategies to enhance SAP practice which included increasing patients’ awareness about their actual need for antibiotics, providing training sessions for HCPs about appropriate SAP before endourological procedures, developing national guidelines and conducting local clinical studies, and promoting awareness of the clinical pharmacist's role. In addition to imposing national policy to control antibiotic use and prevent over-the-counter (OTC) prescriptions.&#x0D; Conclusion: Factors related to nonadherence to guidelines were determined. Such knowledge will constitute the backbone for planning appropriate antimicrobial stewardship programs that involve all stakeholders and address all those aspects to optimize SAP prescribing and reduce antibiotic misuse.

Emergency department physicians’ experiences and perceptions with medication-related work tasks and the potential role of clinical pharmacists

ABSTRACT Purpose Medication-related problems are frequent among emergency department patients. Clinical pharmacists play an important role in identifying, solving, and preventing these problems, but are not present in emergency departments worldwide. We aimed to explore how Norwegian physicians experience medication-related work tasks in emergency departments without pharmacists present, and how they perceive future introduction of a clinical pharmacist in the interprofessional team. Methods We interviewed 27 physicians in three emergency departments in Norway. Interviews were audio-recorded, transcribed, and analysed using qualitative content analysis. Results Our informants’ experience with medication-related work tasks mainly concerned medication reconciliation, and few other tasks were systematically performed to ensure medication safety. The informants were welcoming of clinical pharmacists and expressed a need and wish for assistance with compiling patient’s medication lists. Simultaneously they expressed concerns regarding e.g., responsibility sharing, priorities in the emergency department and logistics. These concerns need to be addressed before implementing the clinical pharmacist in the interprofessional team in the emergency department. Conclusions Physicians in Norwegian emergency departments welcome assistance from clinical pharmacists, but the identified professional, structural, and legislative barriers for this collaboration need to be addressed before implementation.

The impact of antimicrobial management by clinical pharmacists in obstetrics and gynecology on antimicrobial indicators, bacterial resistance and drug costs from 2011 to 2021 in China

ObjectivesThe goal of our study is to analyze the effectiveness and role of clinical pharmacists in antibiotic management through retrospective research from 2011 to 2021, depending on the current scenario of the antibiotic application in China. MethodsWe formed a team of pharmacists to carry out multifaceted intervention measures, such as forming a working group, developing a plan, establishing management rules via the pre-trial system, prescription comments, collaborating with the administrative department, implementing training and publicity, and so on. Antibiotic use was studied, bacterial drug resistance was determined, and antibiotic costs were computed. ResultsThe pharmacist intervention and rectification of inappropriate antibacterial drug orders considerably enhanced the rational use rate of antibiotics and reduced the cost of antibiotics. Antibiotic use in clean surgery decreased from 90.22% to 11.14%, the use rate of antibiotics decreased from 63.82% to 30.26%, and antibiotic use intensity decreased from 42.75DDDs to 30.04DDDs. The types, timing, and course of antibacterials used in wards were all improved to varying degrees. Bacterial drug resistance improved noticeably, with resistance of Escherichia coli to cephalosporins, ciprofloxacin and carbapenems decreased in varying degrees. The use of antibacterial drugs has decreased significantly. ConclusionsIt is feasible and effective for pharmacists in gynecology and obstetrics to control antibiotic use, which plays a positive role in promoting the safe, effective, and cost-effective use of antibiotics and serves as a valuable reference for the antibiotic management.

Artículo traducido] Atención farmacéutica y asma: protocolo de una revisión de revisiones sistemáticas

IntroductionRecent systematic reviews and meta-analyses 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, as well as severe asthma patients.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, as well as to describe key components of the interventions, the outcomes assessed and any associations between pharmacists' interventions and health-related outcomes. MethodsPubMed, Embase, Scopus and the Cochrane Library will be searched from inception to December 2022. Systematic reviews of all study designs, severity of asthma and level of care that measured health-related outcomes will be considered. Methodological quality will be assessed using A Measurement Tool to Assess Systematic Reviews 2. Two independent investigators will perform the study selection, quality assessment and data collection, any discrepancy will be solved by a third investigator. Both narrative findings and meta-analysis of primary study data included in the systematic reviews will be synthesized. If data are appropriate for quantitative synthesis, the measures of association will be expressed as the risk ratio and difference in means. DiscussionThe first results on the establishment of a multidisciplinary network for the management of asthmatic patients have shown the benefits of integrating different levels of care in disease control and morbidity reduction. Further studies showed benefits in hospital admissions, patients' basal oral corticosteroid dose, exacerbations and quality of life of asthma patients.A systematic review is the most appropriate design in order to summarize the literature and identify the evidence of the benefits of interventions performed by clinical pharmacists in asthma patients, especially those with severe uncontrolled asthma, and encourage future studies to stablish the role of clinical pharmacists in asthma units. Registration detailsSystematic review registration number: CRD42022372100.

Assessment of Comorbidities, Polypharmacy and Drug Therapy Problems Among Hypertensive Patients at a Tertiary Care Teaching Hospital

The treatment of hypertension requires special attention because of comorbid conditions and polypharmacy. A previous study found that polypharmacy was associated with a high risk of drug therapy problems (DTPs). The study aimed to analyze the correlation between comorbidity, polypharmacy and drug therapy problems in hypertensive patients. A prospective observational study was conducted among 100 hypertensive patients in Navodaya medical college hospital, Raichur for a period of three months. Classification DTPs were done using Pharmaceutical Care Network Europe V6.02. The data obtained were analyzed using univariate descriptive analysis. The result revealed that a total of 87 DTP were identified in 70 patients out of 100 study subjects. From the patients studied 53 (76%) had at least one DTP. Unnecessary drugs 30 (43%) followed by potential interactions 23 (33%) and need additional drug therapy 20 (26%) were the most common DTP identified. Similarly comorbidity was found in 69 study subjects. Independent factors which predicted the occurrence of DTPs in the study population were presence of comorbidity in 69% and polypharmacy in 75% of hypertensive patients. A significant percentage of patients being treated for hypertension experienced DTP. These DTPs were associated with poor blood pressure control. The implementation of clinical pharmacy services for all patients with hypertension is strongly recommended. The role of clinical pharmacists and physicians in monitoring drug therapy needs to be prioritized to prevent and resolve DTPs in patients with hypertension. Thus efforts that could boost compliance and minimizes substance use should be adopted.

Vancomycin prescribing and therapeutic drug monitoring: Challenges of real clinical practice.

Vancomycin prescription and monitoring guidelines have been reported to be poorly followed by various centers. Identifying barriers to compliance with vancomycin dosing and therapeutic drug monitoring guidelines (TDM) and possible ways to enhance compliance based on the healthcare providers' (HCPs) perspective. A qualitative study based on semi-structured interviews with HCP (physicians, pharmacists, and nurses) was conducted at two Jordanian Teaching Hospitals. Interviews were audio-recorded and analyzed through thematic analysis. The COREQ criteria for qualitative research were utilized to report the study findings. A total of 34 HCPs were interviewed. HCP perceived several factors as barriers to guideline recommendation compliance. Such factors included negative perception towards prescription guidelines, lack of knowledge regarding TDM guidelines, the hierarchy of medication management, work pressure, and ineffective communication among healthcare providers. Potential strategies to optimize guidelines adaptation included providing HCPs with more training and decision support tools in addition to activating the role of clinical pharmacists. The main barriers to guideline recommendations uptake were identified. Interventions should address those barriers related to the clinical environment, including enhancing interprofessional communication related to vancomycin prescription and TDM, reducing workload and providing support systems, promoting educational and training programs, in addition to adopting guidelines suitable for the local environment.

Pharmaceutical care and asthma: Protocol of an umbrella review of systematic reviews

IntroductionRecent systematic reviews and meta-analyses 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, as well as severe asthma patients.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, as well as to describe key components of the interventions, the outcomes assessed and any associations between pharmacists' interventions and health-related outcomes. MethodsPubMed, Embase, Scopus and the Cochrane Library will be searched from inception to December 2022. Systematic reviews of all study designs, severity of asthma and level of care that measured health-related outcomes will be considered. Methodological quality will be assessed using A Measurement Tool to Assess Systematic Reviews 2. Two independent investigators will perform the study selection, quality assessment and data collection, any discrepancy will be solved by a third investigator. Both narrative findings and meta-analysis of primary study data included in the systematic reviews will be synthesised. If data are appropriate for quantitative synthesis, the measures of association will be expressed as the risk ratio and difference in means. DiscussionThe first results on the establishment of a multidisciplinary network for the management of asthmatic patients have shown the benefits of integrating different levels of care in disease control and morbidity reduction. Further studies showed benefits in hospital admissions, patients' basal oral corticosteroid dose, exacerbations and quality of life of asthma patients.A systematic review is the most appropriate design in order to summarise the literature and identify the evidence of the benefits of interventions performed by clinical pharmacists in asthma patients, especially those with severe uncontrolled asthma, and encourage future studies to stablish the role of clinical pharmacists in asthma units. Registration detailsSystematic review registration number: CRD42022372100.

Evaluating the role of clinical pharmacist in the detection and reduction of medication errors in a specialized burn unit.

This study evaluated the frequency and types of medication errors and the role of clinical pharmacist in the reduction of medication errors in a burn unit. The clinical pharmacist monitored medication use process in all patients admitted to the burn unit in the 4-month interventional study. Direct observation and chart review methods were used to detect medication errors. Medication errors were classified according to the classification of American Society of Health-system Pharmacists. The seriousness of medication errors was categorized based on the National Coordinating Council for Medication Error Reporting and Prevention index. During the study, 1653 drugs were prescribed to 94 patients. Totally, 259 medication errors were identified. The rates of medication errors were 2.75 errors/patient, 0.16 errors/ordered medication, and 0.98 errors/prescription. The most common type of errors was prescribing error (61.8%) followed by dispensing error (14.7%). Regarding the seriousness of medication errors, 1.9%, 21.6%, 45.9%, 30.1%, and 0.4% of errors were in the categories B, C, D, E, and F, respectively. Antibiotics had the highest rate of errors. Of all detected medication errors, 64.5% were intercepted or corrected by the clinical pharmacist interventions. Medication errors were not rare in the burn unit. Providing clinical pharmacy services to burn patients to reduce the incidence of medication errors is highly recommended.

Antiretroviral stewardship in a tertiary academic hospital: The need for a clinical pharmacist.

South Africa has the highest prevalence of people living with HIV globally. Although antiretroviral therapy provides solutions, evidence of antiretroviral resistance emerged, requiring the application of antiretroviral-stewardship programmes to curb medication-related problems. Identify and describe antiretroviral-stewardship pharmacist interventions in an active antiretroviral-stewardship programme. HIV-positive adults admitted to medical wards at a tertiary academic hospital in South Africa. A descriptive quantitative study was performed, utilising an antiretroviral-stewardship assessment tool to determine antiretroviral-related recommendations in the treatment of HIV-positive adults. The study employed purposive sampling. Treatment charts were evaluated to identify antiretroviral-stewardship recommendations. The number of recommendations highlighted the need for a clinical pharmacist in an active antiretroviral-stewardship programme. Descriptive data analysis with Pearson correlations was employed to display the data. Medication-related problems were identified in 100% of study patients (n = 41), with an average of 2.46 interventions per patient. One-hundred-and-one medication-related problems were identified by using the antiretroviral-stewardship assessment tool. The identified problems included a lack of viral load testing (41, 100%), lack of CD4 count monitoring (15; 36.6%) and lack of prophylactic treatment against opportunistic infections (10; 24.4%). Medication-related problems included the presence of clinically significant drug-drug interactions and serious side effects, CD4 count decline despite being on antiretroviral therapy, unnecessary treatment interruptions including risk for IRIS, inappropriate antiretroviral therapy regimen, non-adherence and absence of treating tuberculosis as co-morbidity. Present study demonstrates the need of an active antiretroviral-stewardship programme's benefits. The possible role of the clinical pharmacist as active participant and leader in this programme is highlighted. Highlight the role of clinical pharmacists in antiretroviral stewardship.

Multidimensional Interventions on Supporting Disease Management for Hospitalized Patients with Heart Failure: The Role of Clinical and Community Pharmacists.

existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on supporting disease management for hospitalized patients with heart failure (HF). The present paper reviews the effects of inpatient, discharge and/or after-discharge interventions performed on hospitalized HF patients by multidisciplinary teams, including pharmacists. articles were identified through search engines in three electronic databases following the PRISMA Protocol. Randomized controlled trials (RCTs) or non-randomized intervention studies conducted in the period 1992-2022 were included. In all studies, baseline characteristics of patients as well as study end-points were described in relation to a control group i.e., usual care and a group of subjects that received care from a clinical and/or community pharmacist, as well as other health professionals (Intervention). Study outcomes included all-cause hospital 30-day re-admission or emergency room (ER) visits, all-cause hospitalization within >30 days after discharge, specific-cause hospitalization rates, medication adherence and mortality. The secondary outcomes included adverse events and quality of life. Quality assessment was carried out using RoB 2 Risk of Bias Tool. Publication bias across studies was determined using the funnel plot and Egger's regression test. a total of 34 protocols were included in the review, while the data from 33 trials were included in further quantitative analyses. The heterogeneity between studies was high. Pharmacist-led interventions, usually performed within interprofessional care teams, reduced the rates of 30-day all-cause hospital re-admission (odds ratio, OR = 0.78; 95% CI 0.62-0.98; p = 0.03) and all-cause hospitalization >30 days after discharge (OR = 0.73; 95% CI 0.63-0.86; p = 0.0001). Subjects hospitalized primarily due to heart failure demonstrated reduced risk of hospital admission within longer periods, i.e., from 60 to 365 days after discharge (OR = 0.64; 95% CI 0.51-0.81; p = 0.0002). The rate of all-cause hospitalization was reduced by multidimensional interventions taken by pharmacists: reviews of medicine lists and/or their reconciliation at discharge (OR = 0.63; 95% CI 0.43-0.91; p = 0.014), as well as interventions that were based mainly on patient education and counseling (OR = 0.65; 95% CI 0.49-0.88; p = 0.0047). In conclusion, given that HF patients often have complex treatment regimens and multiple comorbid conditions, our findings highlight the need for greater involvement from skilled clinical and community pharmacists in disease management.

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.

Cross-Sectional Survey on the Current Role of Clinical Pharmacists among Antimicrobial Stewardship Programmes in Catalonia: Much Ado about Nothing.

Antimicrobial resistance killed 1.27 million people in 2019, so urgent actions are desperately needed. Antimicrobial stewardship programmes (ASPs) are essential to optimize antimicrobial use. The objective was to acknowledge the current role of clinical pharmacists engaged in ASP activities in Catalonia. This was a cross-sectional survey shared through the Catalan Infection Control Programme (VINCat). The survey consisted of four sections and was sent by e-mail. A total of 69.0% of the centres answered. Pharmacists dedicated a median of 5.0 h per week (2.1 h/week/100 acute care beds), representing 0.15 full time equivalents. The ASP lacked information technology (IT) support, as only 16.3% of centres automatically calculated defined daily doses and days of therapy. Those with less than 15% of their time available for ASPs conducted fewer clinical activities, especially prospective audits and feedback. Those without official infectious diseases training also performed fewer clinical activities, but training was less determinant than IT support or time. Pharmacists performed interventions mostly through annotation in the medical records. Clinical pharmacists from Catalonia dedicated to ASPs present an important lack of time and IT support to perform clinical activities. Pharmacists should also improve their clinical skills and try to conduct clinical advice to prescribers, either by phone or face-to-face.