Scope Of Pharmacy Practice Research Articles

Setting priorities for physical examination in pharmacy education: A Delphi study.

As the scope of pharmacy practice is expanding, a growing number of pharmacists perform physical examination (PE) to gather additional information to monitor the effectiveness and safety of their patients' therapy. This professional activity calls for the development of comprehensive and valuable PE training. We sought to determine by consensus which PE tests should be given teaching priority in pharmacy education. Using existing PE literature in pharmacy, we conducted an online Delphi survey from December 2021 to April 2022 with 16 pharmacists who practise in a variety of settings and/or who are considered experts in PE. After 2 Delphi rounds, consensus was reached to either include or exclude 27 PE tests in entry-to-practice programs. One last round allowed prioritizing the agreed-upon PE tests in terms of educational needs. Clinicians agreed that measuring blood pressure is indispensable and should be given teaching priority, followed by pulse rate, weight and blood glucose measurements. Endocrine system and head and neck examinations should be included in pharmacy programs, but their clinical usefulness was considered less important. We compared our results with PE literature in other health care disciplines. We found that only a few PE tests truly influence drug therapy management, that some examinations can be quite difficult to perform accurately and that without proper training and opportunities to retrain, skill decay can lead to dangerous misinterpretations. Pharmacy programs should consider focusing on teaching PE tests supported by evidence as having an impact on drug therapy management. Can Pharm J (Ott) 2024;157:xx-xx.

Challenges and opportunities to provide immunization services: Analysis of data from a cross-sectional study on a sample of pharmacists in a developing country.

Vaccine-preventable illnesses continue to be a global health concern as immunization coverage remains below its targets. National plans emphasize on the essential role of multidisciplinary efforts and approaches to vaccination programs. Pharmacists are globally getting involved in immunization services as important members of the healthcare team. This study aimed to determine barriers, and assess challenges and possible opportunities to provide immunization in the Lebanese pharmacy practice. This was a cross-sectional study that included pharmacists from all over Lebanon, as part of a national research to assess the role of pharmacists as immunizers. All registered pharmacists in Lebanon practicing in community, hospital, or other clinical settings were considered eligible for participation. A web-based self-administered validated questionnaire, which is initially developed by the American Pharmacists Association, was adapted with permission. A total of 315 pharmacists responded to the survey. Only 23.1% declared completing an immunization training program. Over half of pharmacists (58.4%) administer vaccines to patients. A significant association between lack of support from physicians to pharmacists (adjusted odds ratio [ORa] = 2.099, 95% confidence interval [CI] = 1.290-3.414, p = 0.003) and vaccine administration was found, while cost associated with professional development and additional training (ORa = 0.533, 95% CI = 0.287-0.989, p = 0.046) was inversely associated to it. Logistic, financial, and legislative requirements as essential necessities were determined to successfully expand pharmacist-led immunization services. The major barriers and challenges to vaccine administration by pharmacists comprised a lack of physicians' support and expenses associated with professional development and additional training. Pharmacists administer more vaccination despite lack of support from physicians; whereas they administer less vaccination due to cost associated with professional development and further training. The scope of pharmacy practice in Lebanon is not well recognized by other healthcare providers and stakeholders to include immunization services.

Disparities in gender distribution within editorial boards of pharmacy journals

AbstractIntroductionSpecialties within the field of science, technology, engineering, and mathematics (STEM) have demonstrated that disparities exist within editorial boards of their respective professional journals. However, limited data of this observation exists within the scope of pharmacy practice. The purpose of this study was to evaluate the distribution of gender across editorial board members of several pharmacy journals.MethodsIn this cross‐sectional study, a total of 20 pharmacy journals were selected, using a combination of several factors including the SCImago Journal and Country Rank as of March 2019 and prominence across various organizations within the discipline. Publicly available information from the official website of each respective journal was evaluated to determine the proportion of males and females serving as members of the editorial board. An Internet search was conducted to confirm this demographic for those individuals where gender could not be determined. Descriptive statistics were used to quantify qualitative variables.ResultsData were sufficient to determine the gender of editorial members in all 20 pharmacy journals. Eight hundred and thirteen individuals were identified to serve on editorial boards, of which 326 (40%) were female, with a range of 8% to 63% per journal. Only four journals (20%) had a female editor‐in‐chief.ConclusionDisparities in gender distribution exist among editorial boards of pharmacy journals. Future efforts should focus on increasing the proportion of women serving as both members of the editorial board and as editor‐in‐chief to drive diversity, minimize implicit bias, and possibly enhance the content and quality of publications.

American College of Clinical Pharmacy Global Health Practice and Research Network's opinion paper: Pillars for global health engagement and key engagement strategies for pharmacists

AbstractThe scope of pharmacy practice in global health has expanded over the past decade creating additional education and training opportunities for students, residents and pharmacists. There has also been a shift from short‐term educational and clinical experiences to more sustainable bidirectional partnerships between high‐income countries (HICs) and low‐ to middle‐income countries (LMICs). As more institutional and individual partnerships between HICs and LMICs begin to form, it is clear that there is a lack of guidance for pharmacists on how to build meaningful, sustainable, and mutually beneficial programs. The aim of this paper is to provide guidance for pharmacists in HICs to make informed decisions on global health partnerships and identify opportunities for engagement in LMICs that yield mutually beneficial collaborations. This paper uses the foundations of global health principles to identify five pillars of global health engagement when developing partnerships: (a) sustainability, (b) shared leadership, (c) mutually beneficial partnerships, (d) local needs‐based care and (e) host‐driven experiential and didactic education. Finally, this paper highlights ways pharmacists can use the pillars as a framework to engage and support health care systems, collaborate with academic institutions, conduct research, and interface with governments to improve health policy.

A case-based learning exercise to increase students' understanding of the pharmacist's role in public health interventions for individual patients

IntroductionThe purpose of this study was to evaluate whether a public health (PH) micro-level case-based learning exercise increased pharmacy students' self-perceived understanding and confidence in their role as PH pharmacists. MethodsThree PH micro-level case-based learning exercises in community pharmacy settings were developed and integrated into the third professional year PH course. Students enrolled in the PH course from January 2012 – May 2015 completed a pre- and post-activity survey consisting of 22 statements with Likert scale responses. Survey questions were grouped into domains: perceptions of pharmacist roles (ROLES) in PH, confidence in ability to identify and address PH problems (CONF), pharmacist impact on improving PH outcomes for patients with human immunodeficiency virus (IMPACT-HIV), diabetes (IMPACT-DM), or alcoholism (IMPACT-AL), perceiving pharmacists as role models in PH (MODEL), and whether PH is beyond the scope of pharmacy practice (SCOPE). Within each domain, paired t-tests were performed on summated scores (pre- vs. post-, alpha = 0.05). ResultsBoth surveys were completed by 271 of 336 students (80.7%). Baseline scores were lowest in the CONF and MODEL domains. The activity resulted in significant changes in 21 out of 24 survey questions. Significantly higher scores were found for domains of ROLES (+1.22), CONF (+1.60), IMPACT-HIV (+0.65), IMPACT-DM (+0.42), IMPACT-AL (+0.70), and MODEL (+1.50). Cronbach's alpha ranged from 0.73 to 0.93 for each domain. ConclusionA PH case-based learning session increased students' scores on a pre- and post-activity survey regarding PH challenges at the micro-level. The activity improved students' perceptions and confidence in providing PH interventions.

Provision of pharmaceutical services in time of COVID-19 crisis: A libyan vision

Pharmaceutical services play a crucial role in any health system. Pharmacists are the main health professionals to ensure that people have access to good and safe medicines and to make certain that these medicines are used rationally. While the role of pharmacists in providing health-care services in Libya remains restricted, the scope of pharmacy practice is vast and encompasses a variety of roles and functions. Most of today's pharmacists' services are oriented toward clinical outcomes using medicines. Therefore, pharmacists are focusing on optimizing the use of medications, promoting health, wellness, and preventing diseases. Pharmaceutical services are currently being tailored to be event driven to fit the current COVID-19 pandemic crisis and to help combat this disease and its consequences. This article discusses different pharmaceutical services that can be provided by pharmacists in all practice settings, for the Libyan healthcare system and to the society in general during COVID-19 crisis.

Advancing Pharmacist Collaborative Care within Academic Health Systems.

Introduction: The scope of pharmacy practice has evolved over the last few decades to focus on the optimization of medication therapy. Despite this positive impact, the lack of reimbursement remains a significant barrier to the implementation of innovative pharmacist practice models. Summary: We describe the successful development, implementation and outcomes of three types of pharmacist collaborative care models: (1) a pharmacist with physician oversight, (2) pharmacist–interprofessional teams and (3) physician–pharmacist teams. The outcome measurement of these pharmacist care models varied from the design phase to patient volume measurement and to comprehensive quality dashboards. All of these practice models have been successfully funded by affiliated health systems or grants. Conclusions: The expansion of pharmacist services delivered by clinical faculty has several benefits to affiliated health systems: (1) significant improvements in patient care quality, (2) access to experts in specialty areas, and (3) the dissemination of outcomes with national and international recognition, increasing the visibility of the health system.

A transition from the BPharm to the PharmD degree in five selected countries.

This review focuses on the studies and opinions around issues of transition from the BPharm to the PharmD degree in the U.S., Japan, South Korea, Pakistan and Thailand.The transition to the clinically orientated PharmD degree in many countries was seen to be a means of developing the profession. However, some countries have both clinically-oriented and pharmaceutical sciences-oriented PharmD programme that are designed to meet the needs of their countries. Each country created a different process to handle the transition to an all-PharmD programme, but mostly had the process of school accreditation mandated by the regulatory bodies. The main barrier to the transition in most of the countries was the issue of educational quality. A set of indicators is needed to measure and monitor the impact/outcome of the PharmD degree.Each country has different needs due to the different contexts of health care systems and the scope of pharmacy practice. In order to increase their chances of benefiting from the new programme, academic leaders should critically assess their countries’ needs before deciding to adopt a PharmD programme.

The Position of Clinical Pharmacists in Delivering Advanced Pharmacy Practice Education and Services: Short Communication

The pharmacist’s role in health systems continues to evolve from a product focus to a patient-centered care model ensuring the safe and effective use of medications in all practice settings. The scope of pharmacy practice now includes patient-centered care with all the cognitive functions of counseling, providing drug information and monitoringdrug therapy, as well as technical aspects of pharmaceutical services, including medicines supply management. Clinical Pharmacy consist of all the services accomplished by pharmacists practicing in hospitals, community pharmacies, nursing homes, home-based care services, clinics and any other setting wherever medicines are prescribed and used. Advanced pharmacy practice should be handled and delivered by facilities where high standards of pharmaceutical care and instruction are available and preceptors and educators should be actively engaged in the delivery of high-quality pharmaceutical care, and spend a majority of their time providing pharmaceutical care in their facility.

Role of pharmacist in cardiovascular disease-related health promotion and in hypertension and dyslipidemia management: a cross-sectional study in the State of Qatar.

In Qatar, cardiovascular diseases (CVD) have recently become the leading cause of morbidity and mortality. Prevention, detection and management of CVD risk factors reduce CVD chance. The study objectives were to assess Qatar pharmacists' involvement in CVD health promotion, to identify the activities that they currently provide to patients with CVD risk factors, to describe their attitudes towards their involvement in CVD prevention and to assess their perceived barriers for provision of CVD prevention services We conducted a cross-sectional survey of community and ambulatory pharmacists in Qatar. Pharmacist characteristics, involvement in CVD-related activities along with their attitudes and perceived barriers were analysed using frequency distributions. Bivariate linear regression models were used to test for associations between CVD health promotion activity score and each variable. Variables with a P-value of 0.20 or less were included in the multivariate model. A total of 141 pharmacists completed the survey (response rate 60%). More than 70% responded with rarely or never to 6 out of the 10 CVD health promotion activities. Eighty-four per cent and 68% always or often describe to patients the appropriate time to take antihypertensive medications and the common medication adverse effects, respectively. Yet, 50% rarely or never review the medication refill history or provide adherence interventions. Lack of CVD educational materials was the top perceived barrier (55%) in addition to lack of having private counselling area (44.6%), and lack of time (38.3%). Females and community pharmacists were more involved in CVD health promotion (P = 0.046 and P = 0.017, respectively) than their counterparts. Health promotion practice increased with increasing attitudes score and decreased with increased barriers score (P = 0.012 and P = 0.001). The scope of pharmacy practice in CVD prevention is limited in Qatar. Efforts need to be exerted to increase pharmacists' involvement in CVD prevention.

What is holding pharmacists back?

Much has been written about the scope of pharmacy practice in Canada over the past decade. The benefits of pharmacists to the primary care team, in terms of both cost and patient health, are well documented, as are the reasons why community pharmacists have yet to widely adopt this new role.1-3 Barriers commonly reported by pharmacists generally involve issues of time, money, training and lack of support from patients and other health care professionals.4-6 Despite these self-perceived barriers, expectations of pharmacists continue to increase, as do support and funding, particularly in Alberta. Alberta, a worldwide leader in pharmacy practice, has given pharmacists one of the largest scopes of practice and amount of financial support in the world. Despite this, uptake of pharmacy services remains largely superficial. Pharmacists in Alberta are able to prescribe and adapt medications, administer medications by injection and develop patient care plans, but they average fewer than 2 of these services per pharmacy per day.7-9 The continued support for pharmacy services in Alberta brings into question whether the aforementioned barriers are the only issues holding back pharmacists. Indeed, evidence suggests that removing self-reported barriers is not sufficient to promote practice change.5 Rosenthal et al.10 provided a unique explanation of this poor uptake of clinical services. These authors hypothesized that pharmacists themselves are holding back practice change by undervaluing their own training and being unable to apply their knowledge in the novel ways expected from a primary care clinician. I believe that the ideas suggested by Rosenthal et al. are likely a major contributor to the lack of uptake of practice change, but I also believe that the issue comes back to a more basic problem: Many pharmacists do not perceive the necessity of change.

Scope of contemporary pharmacy practice: Roles, responsibilities, and functions of pharmacists and pharmacy technicians

ObjectiveTo provide an overview of the current context and scope of pharmacy practice, the range of professional services offered by pharmacists, and the supporting role of pharmacy technicians. Data synthesisA synopsis of the current state of pharmacy practice as it relates to the spectrum of professional roles and responsibilities, the diversity of patient populations served, the complexities of patient services provided, and various aspects of emerging pharmacy practice is provided. The current work focuses on patient care services provided by pharmacists; it does not address all possible activities of pharmacists, such as administration and general management. This is a descriptive analysis. It does not take a position regarding future changes but is intended to serve as a foundation for understanding the relationship and alignment between the profession's various mandatory and voluntary credentials and the scope of practice continuum. The key educational and credentialing standards for pharmacists and pharmacy technicians are summarized and referenced. ConclusionThe evolutions in health care and pharmacy practice are presenting many new opportunities for pharmacists to perform functions and provide services not considered as traditional roles. The profession of pharmacy is working to achieve a pervasive model and standard of care determined only by the needs of patients and populations. The Council on Credentialing in Pharmacy hopes that the material presented herein, including the framework for credentialing in pharmacy practice, will allow audiences to gain a better understanding of where pharmacy is today and what future pharmacy practice will look like.

Scope of Pharmacy Practice: Commentaries by a Pharmacist and a Physician

Scope of Pharmacy Practice: Commentaries by a Pharmacist and a Physician

Assessing the scope of pharmacy practice

Assessing the scope of pharmacy practice

Pharmacist-managed drug therapy in California hospitals

To assess the effect of state legislation expanding the scope of pharmacy practice in health-care institutions, California hospitals were surveyed in 1982 and 1986 about pharmacists' regulation of drug therapy. Questionnaires were mailed to pharmacy directors at all hospitals in the state. The survey form explained that in pharmacist-regulated drug therapy, the pharmacist, under order or authorization of the prescriber, requests laboratory tests and initiates or adjusts drug dosage to obtain the desired therapeutic response; the questions were based on this definition. The response rates were 51.4% (292 of 568) in 1982 and 56.2% (329 of 585) in 1986. For the responding hospitals of most sizes and types, the percentage having pharmacist regulation of drug therapy increased; the largest increase was in the for-profit chain hospitals. In 1986, pharmacists were involved in regulating maintenance dosages in more than half of the responding hospitals (from 52% of hospitals with 50 or fewer beds to 86% of hospitals with 400-499 beds). The responses indicated that at least 50% of patients receiving aminoglycoside or warfarin therapy or total parenteral nutrition had their maintenance dosages regulated by pharmacists. The two surveys indicate that between 1982 and 1986 pharmacists became more involved in regulating drug therapy in California hospitals.

National survey of student health pharmaceutical services--1985.

Abstract During the fall of 1985, we conducted a survey to evaluate the extent and the scope of pharmacy practice in college health institutions. We mailed self-administering questionnaires to all ACHA member institutions. Responses from 222 institutions (72.3%) showed that 41% of ACHA student health services have pharmacist-supervised drug distribution and control. Thirty-one percent of the institutions have a pharmacy and therapeutics committee. About 34% have an in-house pharmacy with a pharmacist in control. It is clear from this survey that the services of pharmacists are not generally available as part of comprehensive health care delivery in the college health setting. When pharmacists are involved, they are primarily active in the delivery of outpatient dispensing services, with a strong emphasis on the provision of drug information to patients and other health care providers.