Specialist Pharmacist Research Articles

Smith promotes pharmacists while at CMS Innovation Center

The rollout of the Affordable Care Act (ACA) has been for many a challenge, but Marie Smith, PharmD, says a recent stint examining policy options for new health care delivery and payment models convinced her this could be a time when pharmacists are positioned for greater roles in team-based patient care.

INT-009 Efficiency of an Antifungal Stewardship Program (PROMULGA Project)

BackgroundAntifungal (AF) stewardship programs are essential, especially in large tertiary care hospitals, where many physicians prescribe very costly drugs often on an empirical or pre-emptive basis. Purpose: To assess the...

Specialist pharmacists can support hospital consultants in the community

Specialist pharmacists can support hospital consultants in the community

Oxford Academic Health Science Network Fellowship awarded to a pharmacist

Kate Masters, a specialist pharmacist, has been awarded one of only seven prestigious Fellowships from the Oxford Academic Health Science Network (AHSN). The Fellowship will involve a postgraduate MSc in evidence based healthcare at the University of Oxford and a research project sponsored by the Medicines Optimisation Network of the AHSN.

Patient Perspectives of the Role of the Community Pharmacist in the Middle East: Jordan, United Arab Emirates and Iraq

Objectives: To explore patient’s perspectives of the role of the community pharmacist in view of other health care professionals (specialist physician, general practitioner, nurse and others (e.g. herbalist)) in Jordan, UAE and Iraq. The study also investigated patient’s willingness to pay for specialized pharmaceutical care services. Methods: This study followed a single phase cross sectional survey methodology, conducted in three Middle Eastern countries. Data were collected over a period of 6 months on two consecutive years (March to May 2009 and 2010). A questionnaire was designed and validated, then completed by patients walking into community pharmacies. The source of advice (specialist physician, general practitioner, pharmacist, nurse, or herbalist) regarding patient’s medication use and medical management were investigated. Key findings: Patients visiting community pharmacies in Jordan (n = 1000), UAE (n = 1000) and Iraq (n = 968) were recruited into the study (mean age 35.9 ± 13.1, 50.6% males). Significant difference between the three countries was shown, as more patients chose the pharmacist as their primary source of advice on medication use vs. the specialist physician in Jordan (50.8% vs. 37.3%) and Iraq (41.9% vs. 36.7%) compared to UAE (38.0% vs. 40.1%), P

How pharmacists can improve the care of vulnerable patients

Specialist pharmacists discuss the issues surrounding vulnerable patient groups at the RPS annual conference.

6.0 Supporting patients on therapy

6.0 Supporting patients on therapy

The increasing role of pharmacists in antimicrobial stewardship in English hospitals

To evaluate the development of pharmacist-led antimicrobial stewardship activities in English hospitals. Distribution of an electronic questionnaire to antimicrobial pharmacists or chief pharmacists in National Health Service hospitals in England. Since a previous study, in 2005, overall numbers of specialist antimicrobial pharmacists, and their levels of experience, had increased. Over 95% of hospitals provided empirical usage guidance, antimicrobial formularies and surgical prophylaxis guidelines. Two-thirds of pharmacy departments provided antimicrobial usage reports in terms of defined daily doses at least yearly, and over 80% conducted yearly antimicrobial point prevalence studies. The vast majority of pharmacy departments indicated a willingness to supply data and audit results to a national database for benchmarking purposes. The increasing role of specialist pharmacists and general pharmacists in antibiotic stewardship in acute care in England has enabled hospitals to deliver on the antibiotic stewardship agenda, although opportunity remains to expand this role further and ensure greater multidisciplinary engagement.

Proactive clinical pharmacist interventions in critical care: effect of unit speciality and other factors

Clinical pharmacists working in critical-care areas have a beneficial effect on a range of medication-related therapies including improving medication safety, patient outcomes and reducing medicines' expenditure. However, there remains a lack of data on specific factors that affect the reason for and type of interventions made by clinical pharmacists, such as unit speciality. To compare the type of proactive medicines-related interventions made by clinical pharmacists on different critical-care units within the same institution. A retrospective evaluation of proactive clinical pharmacist recommendations, made in three separate critical-care areas. Intervention data were analysed over 18 months (general units) and 2 weeks for the cardiac and neurological units. Assessment of potential patient harm related to the medication interventions were made in the neurological and cardiac units. Overall, 5623, 211 and 156 proactive recommendations were made; on average 2.2, 3.8 and 4.6 per patient from the general, neurological and cardiac units respectively. The recommendations acceptance rate by medical staff was approximately 90% for each unit. The median potential severity of patient harm averted by the interventions were 3.6 (3; 4.2) and 4 (3.2; 4.4) for the neurological and cardiac units (P = 0.059). The reasons for, types and drug classification of the medication recommendations demonstrated some significant differences between the units. Clinical pharmacists with critical-care training make important medication recommendations across general and specialist critical-care units. The patient case mix and admitting speciality have some bearing on the types of medication interventions made. Moreover, severity of patient illness, scope of regular/routine specialist pharmacist service and support systems provided also probably affect the reason for these interventions.

An audit of paediatric ambulatory prescriptions

BackgroundImperial College Healthcare NHS Trust is made up of five hospitals over three different sites. The only paediatric service at the Hammersmith Hospital site is a paediatric ambulatory unit (PAU);...

Implementation of TTA pre-pack accreditation and training programme on paediatric wards

AimTo implement a To Take Away (TTA) pre-pack accreditation programme and recording system for paediatric nurses to facilitate the safe dispensing of TTA pre-packs from wards.MethodTo facilitate the prompt discharge...

CPC-020 Assessment of Medicines Administration in Institutionalised Patients with Dysphagia or Feeding Disorders

BackgroundDysphagia is the most common oesophageal disorder in the elderly, particularly in patients living in institutional settings, such as nursing homes. Pharmacists have an important role in patient safety by...

IBD standards highlight value of specialist pharmacists

IBD standards highlight value of specialist pharmacists

Specialist Pharmacist Training from the Viewpoint of Sports Pharmacology

When athletes consult sports outpatient or orthopedic clinics it is possible to undergo drug treatment with the medical staff having prior knowledge of that patient being an athlete. However, if athletes seek any other diagnosis and treatment as an ordinary patient, the possibility of medical staff realizing the potential for imposing a doping issue on the athlete is extremely low. As a result, if the athlete fails to provide medical staff with information regarding anti-doping regulations when receiving clinical treatment, drug treatment administered as part of medical practices could be viewed as doping, resulting in the athlete being disciplined. In order to avoid this, pharmacist should participate in training in order to be able to provide information for anti-doping purposes. It is my personal opinion that knowledge regarding anti-doping is something that should be shared by all pharmacists, as pharmacists are educated in the fields of pharmacology and pharmacokinetics during the pharmacy education process, and sports pharmacology is a part of this. However, in order for pharmacists to understand sports pharmacology, it is necessary to provide education not only on the benefits and adverse effects of pharmaceutical products, but also on the concept of banned substances. It can be considered one of the pharmacist's duties to protect athletes who purchase drugs at a pharmacy or consult medical institutions as patients. With this, I would like to propose considering the potential for introducing sports pharmacology to pharmaceutical education, and specialist pharmacist training in the sports spectrum.

PPAG 2012 Board Election Results

PPAG 2012 Board Election Results

A pharmacy led program to review anti-psychotic prescribing for people with dementia

BackgroundAnti-psychotics, prescribed to people with dementia, are associated with approximately 1,800 excess annual deaths in the UK. A key public health objective is to limit such prescribing of anti-psychotics.MethodsThis project was conducted within primary care in Medway Primary Care Trust (PCT) in the UK. There were 2 stages for the intervention. First, primary care information systems including the dementia register were searched by a pharmacy technician to identify people with dementia prescribed anti-psychotics. Second, a trained specialist pharmacist conducted targeted clinical medication reviews in people with dementia initiated on anti-psychotics by primary care, identified by the data search.ResultsData were collected from 59 practices. One hundred and sixty-one (15.3%) of 1051 people on the dementia register were receiving low-dose anti-psychotics. People with dementia living in residential homes were nearly 3.5 times more likely to receive an anti-psychotic [25.5% of care home residents (118/462) vs. 7.3% of people living at home (43/589)] than people living in their own homes (p < 0.0001; Fisher’s exact test). In 26 practices there was no-one on the dementia register receiving low-dose anti-psychotics.Of the 161 people with dementia prescribed low-dose anti-psychotics, 91 were receiving on-going treatment from local secondary care mental health services or Learning Disability Teams. Of the remaining 70 patients the anti-psychotic was either withdrawn, or the dosage was reduced, in 43 instances (61.4%) following the pharmacy-led medication review.ConclusionsIn total 15.3% of people on the dementia register were receiving a low-dose anti-psychotic. However, such data, including the recent national audit may under-estimate the usage of anti-psychotics in people with dementia. Anti-psychotics were used more commonly within care home settings. The pharmacist-led medication review successfully limited the prescribing of anti-psychotics to people with dementia.

Method to determine allocation of clinical pharmacist resources

An objective methodology to guide decisions by hospital pharmacy departments on the best use of clinical pharmacist personnel is described. To help determine the optimal deployment of state-licensed Clinical Pharmacist Specialist (CPS) staff, a task force led by the pharmacy department at University of North Carolina (UNC) Hospitals developed an objective approach to evaluating the relative need for and potential impact of CPS expertise within the medical center's many service units. After analyzing several years of patient census and medication-use data and using information from proprietary databases (Thomson Reuters) to calculate a "service-specific pharmacy intensity score" for each hospital service, the task force identified five staff-allocation metrics best suited to the medical center's service-based pharmacy coverage model. By applying the methodology, it was determined that CPS expertise was most needed in the UNC Hospitals adult medicine oncology service, the bone marrow transplant service, and the medical and neonatal intensive care units. The tool was initially used to validate the pharmacy department's existing human resource allocation and has since been used to guide budgeting for and deployment of newly added CPS positions. A novel tool to guide the application of pharmacy human resources incorporates the objective criteria of patient census, patient acuity, teaching involvement, drug expenditures, and use of high-risk medications. The tool can be used to determine the appropriate allocation and placement of clinical pharmacist resources in a service-based coverage model.

Pharmaceutical care program in a service to people with disabilities

BackgroundThe Department of Health and The Department of Labour and Welfare signed an agreement to develop a Pharmaceutical Care Program in a centre that serves 122 people with severe intellectual...

Board Certification of Pharmacist Specialists: American College of Clinical Pharmacy

Pharmacotherapy: The Journal of Human Pharmacology and Drug TherapyVolume 31, Issue 11 p. 1146-1149 Free Access Board Certification of Pharmacist Specialists: American College of Clinical Pharmacy First published: 20 January 2012 https://doi.org/10.1592/phco.31.11.1146Citations: 22AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL References 1 Council on Credentialing in Pharmacy. Scope of contemporary pharmacy practice: roles, responsibilities, and functions of pharmacists and pharmacy technicians. J Am Pharm Assoc 2010; 50: e35– 62. 2 Saseen JJ, Grady SE, Hansen LB, et al, for the American College of Clinical Pharmacy. Future clinical pharmacy practitioners should be board-certified specialists. Pharmacotherapy 2006; 26: 1816– 25. 3 Blair MM, Freitag RT, Keller DL, et al, for the American College of Clinical Pharmacy. ACCP certification affairs committee. Proposed revision to the existing specialty and specialist certification framework for pharmacy practitioners. Pharmacotherapy 2009; 29: 3– 13e. 4 American College of Clinical Pharmacy. A vision of pharmacy's future roles, responsibilities, and manpower needs in the United States. Pharmacotherapy 2000; 20: 991– 1020. 5 Murphy JE, Nappi JM American College of Clinical Pharmacy's vision of the future: postgraduate pharmacy residency training as a prerequisite for direct patient care practice. Pharmacotherapy 2006; 26: 722– 33. 6 Haase KK, Smythe MA, Orlando PL, Resman-Targoff BH, Smith LS, for the American College of Clinical Pharmacy. ACCP position statement: ensuring quality experiential education. Pharmacotherapy 2008; 28: 1548– 51. 7 Pradel FG, Palumbo FB, Flowers L, Mullins CD, Haines ST, Roffman DS. White paper: value of specialty certification in pharmacy. J Am Pharm Assoc 2004; 44: 612– 20. 8 American Society of Health-System Pharmacists. ASHP long-range vision for the pharmacy work force in hospitals and health systems. Am J Health Syst Pharm 2007; 64: 1320– 30. 9 Daughtery NE, Ryan M, Romanelli F, Smith KM. Board certification of pharmacy residency program directors. Am J Health Syst Pharm 2007; 64: 1415– 21. 10 American Society of Health-System Pharmacists. Proceedings of the pharmacy practice model summit. Am J Health Syst Pharm 2011; 68: e40– 142. 11 American Pharmacists Association. Assuring pharmacists' continuing competence in contemporary practice. Current adopted APhA policy statement 1963–2009. Adopted 1995. Available from http:www.pharmacist.comAMTemplate.cfmSectionHouse_of_Delegates&TemplateCMContentDisplay.cfm&ContenD10545. Accessed July 16, 2010. 12 Spinler SA, Bosso J, Hak L, et al. Report of the task force concerning board certification requirements for pharmacy practice faculty. Am J Pharm Educ 1997; 61: 213– 16. 13 Wells BG. Board certification and clinical faculty [editorial]. Am J Pharm Educ 1999; 63: 251. 14 Lee M, Bennett M, Chase P, et al. Final report and recommendations of the 2002 AACP task force on the role of colleges and schools in residency training. Am J Pharm Educ 2004; 66: Article S2. 15 Accreditation Council for Pharmacy Education. Accreditation standards and guidelines for the professional program in pharmacy leading to the doctor of pharmacy degree. Standard 25, guideline 25.1. Effective July 1, 2007. Citing Literature Volume31, Issue11November 2011Pages 1146-1149 ReferencesRelatedInformation

PHP56 The Emergent Role of the Specialist Pharmacist as an Important Stakeholder in Market Access

Over the last decade, specialist pharmacists across Europe have seen an emergent role in many areas of the healthcare pathway. This research examined four key domains - clinical, policy, education and research - of influence of specialist pharmacists with goal of understanding how they can impact market access of drugs. Structured interviews with 25 specialist oncology pharmacists from EU5 exploring various aspects within the four identified domains of influence. A selection of the most important roles of the specialist pharmacist by domain is presented below: Clinical: 1) Coordinate safe and timely administration of drugs and supportive treatment; 2) Coordinate outpatient supportive care focusing on management of symptoms; and 3) Help develop treatment guidelines to ensure optimal use of supportive care medications. Policy: 1) Provide formulary review for new drugs, and 2) Facilitate reimbursement for a more efficient practice. Education: 1) Educate patients and members of the HC team about drugs and their expected side effects and management, and 2) Educate members of the public about prevention strategies and recommendation for screening and early detection. Research: 1) Conduct internal treatment protocol audits to optimise patient care pathway, and 2) Participate in institutional review board for approval of clinical trials as well as scientific review and monitoring committees. A cornerstone of market access is identification of important stakeholders within a health care economy with the goal of understanding the roles they play in the care pathway. The specialist pharmacist is an often overlooked, but increasingly important stakeholder in the European health care system. The multitude of roles played by the specialist pharmacist is in itself evidence of increasing importance of the role. Pharmaceutical companies will need to engage more closely with specialist pharmacists to ensure better patient outcomes through appropriate use of drugs leading ultimately to increased market access.