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PurposeAn initiative to implement patient-centered medication labeling at 4 pharmacies within a publicly funded safety-net healthcare system is described.SummaryMedication nonadherence negatively affects patient outcomes and safety. Nonadherence has been attributed to poor understanding of instructions on medication labels. Research has demonstrated that patient-centered labeling (PCL) can improve adherence and produce safer medication-taking practices. As part of a mixed-methods study by a safety-net health system, audits of nearly 9,000 prescription labels generated at 4 pharmacy sites, as well as interviews with 6 stakeholder informants, were conducted to determine PCL adoption rates and factors contributing to success. Descriptive statistics were used to analyze audit data; constructs of the Consolidated Framework for Implementation Research were used to analyze interview data. Among the 4 sites, 3 pharmacies successfully converted more than 85% of audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions and inadequate real-time data on conversion rates. Interviewees perceived that leadership and policy directives promoted PCL conversion efforts. Successful pharmacies used adaptable software, had closer communication networks with prescribers, and/or used automation to facilitate PCL conversion.ConclusionThree pharmacies successfully converted more than 85% of labels for audited prescriptions to a PCL format; 1 pharmacy converted less than 25% of prescriptions. Barriers to implementation included pharmacists' reluctance to modify prescriber instructions, inadequate real-time data on conversation rates, and lack of customizable software to automate changes.

Purpose: To provide pharmacy leaders and clinicians with the basic principles of a training method called job instruction (JI) and its application within pharmacy as a strategy to teach routine pharmacy work. Summary: Job instruction is a reliable way to teach a person to quickly learn how to perform a work standard correctly, safely, and efficiently. Job instruction is a proven and successful technique for improving time to train, productivity, employee turnover and quality of work. In healthcare, JI training is not well-known or widely utilized. Job Instruction was the strategy of choice to stabilize the variable training practices within The University of Kansas Health System pharmacy enterprise, and a prospective, single center, multi-cohort study was conducted to study its impact. Conclusion: The preliminary results of this study provide initial insight into the applicability of job instruction in pharmacy. The study indicated the benefits of JI training within different teams to standardize training practices, decrease error and safety event rates, and increase satisfaction of team members with on-the-job training. The results of this study will be used to further analyze and optimize training practices in The University of Kansas Health System pharmacy enterprise. [ABSTRACT FROM AUTHOR]

What Is Known and Objective: Immune‐mediated inflammatory diseases (IMIDs) are a group of chronic and highly disabling diseases. The objective is to evaluate the satisfaction with the health care received by patients with the most prevalent IMIDs in Spain: inflammatory bowel disease (IBD), psoriasis (Ps) psoriatic arthritis (PsA), rheumatoid arthritis (RA) and spondyloarthropathies (SpAs), and to determine the factors that influence patient satisfaction. Methods: This was an observational, cross‐sectional, multicentre study in a real‐world evidence context conducted in the Pharmacy Service in four hospital centres of the Community of Madrid that belong to the National Health System. The study included adult patients diagnosed with an IMID who had attended the Pharmacy Service at least three times. The patients were grouped according to the main IMID. Health care satisfaction was evaluated using the chronic patient experience assessment (IEXPAC) questionnaire. The responses to IEXPAC are grouped into three factors: productive interactions, new relational model and patient self‐management, with a total score from 0 (worst) to 10 (best experience). Health‐related quality of life (HRQoL) was also evaluated using the EQ‐5D‐5L questionnaire, and pharmacological adherence was evaluated through the Morisky‐Green test. Results and Discussion: A total of 578 patients were analysed (IBD = 25.3%; Ps = 19.7%; SpAs = 18.7%; RA = 18.5%; PsA = 17.8%). The mean age (SD) was 49.8 (12.3) years and 50.7% were male. The average score (SD) for the total IEXPAC sample was 6.6 (1.9). RA was the IMID with the lowest score, at 5.83 (2.0), significantly lower than the scores of Ps (SD) [7.01 (1.7); p = 0.003], IBD [6.83 (1, 9); p = 0.012] and SpAs [6.80 (1.6); p = 0.001]. Productive interactions (SD) [8.5 (1.8)] and patient self‐management (SD) [7.3 (2.3)] were the factors with the highest scores, and the new relational model had the lowest score (SD) [3.2 (2.7)]. Male gender, a longer time interval between medication administrations and a higher HRQoL were correlated with better patient satisfaction. Current biological therapy (according to the Anatomical Chemical classification system) also had a significant influence; patients treated with tumour necrosis factor inhibitors and interleukin inhibitors showed greater satisfaction than those treated with selective immunosuppressants. What Is New and Conclusion: The IEXPAC results show high general satisfaction with care quality reported by patients with IMIDs treated in the Pharmacy Service. However, there are areas of improvement in care quality specially health professional–patient communication, such as increasing access to information, and promoting and facilitating relationships with patients in similar conditions. [ABSTRACT FROM AUTHOR]

The article discusses the development of pharmacy services in hospitals at home (HaH) or acute hospital care at homes in the U.S. and around the world. Other topics include the results of studies showing benefits of HAH like reduced overall medical costs and 30-day readmissions and improved continuity of care, and the areas for consideration when developing HAH models like medication safety, clinical pharmacy services, and medication dispensing.

The study aims to evaluate outpatient satisfaction (OS) with health insurance drug dispensing at the central hospital in Vietnam and to explore the influential factors. A cross-sectional survey was conducted on adult outpatients via an adjusted SERVQUAL questionnaire. The questionnaire's internal consistency (Cronbach alpha) and construct validity (exploratory factor analysis) were considered. The difference between groups was solved using a t-test or ANOVA-test. The multiple-regression analysis determined the influence levels of each factor. A p-value less than 0.05 was statistically significant. A total of 210 participants participated, with most being over 55 years old, female, with a high school education, and freelancers. The mean general satisfaction score was 3.42 (SD = 0.79). The reliability obtained the highest satisfaction score, and the guarantee was the lowest. The final questionnaire, including five factors (reliability, responsiveness, assurance, sympathy, and tangible) with 26 observational variables, had an internal consistency reliability and construct validity. These five factors had a statistically significant correlation and influence on the general satisfaction of the outpatients. The reliability factor had the strongest influence, and assurance had the weakest. Training staff about communication, counseling, and consolidating the facilities are the core solutions for increasing OS. [ABSTRACT FROM AUTHOR]

Objective: To assess the public perception of the role of hospital pharmacists, their satisfaction with the pharmacy service provided, and the factors associated with their perception and satisfaction., Methods: A cross-sectional, questionnaire survey was conducted on adults older than 18 years who utilized public pharmacy services. A self-developed, validated questionnaire consisting of three parts was used, i.e., demographic data, perception, and satisfaction. The questionnaire was tested in a pilot study of 50 study participants and demonstrated good reliability results of 0.900 for the perception section and 0.836 for the satisfaction section. Therefore, all items were used in the final questionnaire., Key Findings: Four hundred and seventy-nine completed questionnaires were collected with a response rate of 91.6%. The Cronbach's α for perception and satisfaction scores were 0.938 and 0.841, respectively. The median total score for public perception was 83 (interquartile range [IQR]: 15), whereas the median total score for public satisfaction was 38 (IQR: 33). The level of public perception was significantly associated with the age groups (P = .009), ethnic groups (P < .001), respondents' locality groups (P < .001), the level of education achieved group (P = .017), and the income groups (P = .006). Satisfaction was not significantly associated with any sociodemographic factors., Conclusions: This study has found that the general public had a favorable perception of the role of hospital pharmacists, and they were generally satisfied with the pharmacy service provided., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: The development of community-based health insurance (CBHI) was driven by the need to provide economic protection for the poor against unexpected healthcare expenses. This can lead to increased patient satisfaction with their overall care. Maintaining high levels of client satisfaction with pharmacy services is crucial for effectively treating patients with psychiatric disorders. Therefore, the purpose of this study was to assess the impact of pharmacy services on psychiatry patient satisfaction among users of CBHI in the psychiatric setting., Methods: A multicenter cross-sectional study was conducted at the psychiatric clinics with a systematic random sampling technique between December 2023 and May 2024. A structured interview questionnaire was used to gather data. Both bivariate and multivariate analysis were employed. In multivariate analysis, variables having a p -value of < 0.05 were deemed statistically significant., Result: A total of 420 participants were enrolled with a response rate of 99.5%. Overall, 261 (62.1%) of the patients reported being satisfied with the pharmacy service. However, a significant number of patients expressed dissatisfaction with certain aspects of the service, such as pharmacist counseling on medication side effects (43.1%), medication interactions (36.9%), and labeling and dispensing of medicines (42.4%). According to the study, living in an urban area [AOR = 2.0; 95% CI (1.25, 3.2); P = 0.04], being between the ages of 18-35 and 36-44 [AOR = 2.7, 95% CI (1.38, 5.3), p = 0.04] and [AOR = 3.3, 95% CI (1.6, 5.7), p = 0.001] respectively. First and second visits to the institution [AOR = 2.2; 95% CI (1.15, 4.4); P = 0.01] and [AOR = 1.9; 95% CI (1.13, 3.3); P = 0.01] respectively. Having two psychiatric disorders [AOR = 1.8, 95% CI (1.07, 3.07), p = 0.02] and all drug availability [AOR = 1.5, 95% CI (1.3, 3.43), p = 0.02], were positively associated with psychiatry patient pharmacy service satisfaction., Conclusion: In this study, the users of CBHI psychiatric patients were generally satisfied with the pharmacy service. Additionally, being urban residency age (18-44 years), first and second visits to the institution, having two psychiatric disorders and all drug availability were found to have a significant impact on psychiatric patient pharmacy services satisfaction., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Chanie, Atalay, Alemayehu, Wube Bayleyegn, Tadesse, Fentahun, Wassie, Tesfaye and Geremew.)

Objectives: To evaluate health-related quality of life perceived by patients with the most prevalent immune-mediated inflammatory diseases in Spain: inflammatory bowel disease (IBD), psoriasis (Ps), psoriatic arthritis (AP), rheumatoid arthritis (RA), and spondyloarthropathies (SpAs), and to determine the factors that influence patient quality of life., Methods: The SACVINFA study (SA = satisfaction, CV = quality of life, IN = immune-mediated, FA = pharmacy) consisted of an observational study conducted in 4 hospitals in the Community of Madrid. A cross-sectional analysis was made of adult patients diagnosed with an immune-mediated inflammatory disease who attended the Pharmacy Service. Quality of life was assessed using the EQ-5D-5L questionnaire (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) and specific questionnaires: SIBDQ-9, DLQI, PsAQoL, QoL-RA and ASQoL., Results: A total of 578 patients were analyzed (inflammatory bowel disease = 25.3%; psoriasis = 19.7%; spondyloarthropathies = 18.7%; rheumatoid arthritis = 18.5%; psoriatic arthritis = 17.8%). The mean age (SD) was 49.8 (12.3) years and 50.7% were male. The average score (SD) for the global EQ-5D- 5 L was 0.771 (0.2) and the mean (SD) visual analogue scale score was 71.5 (20.0). Type of immune-mediated inflammatory diseases was associated with differences in quality of life showing psoriasis and inflammatory bowel disease higher values of EQ-5D-5L than psoriatic arthritis, rheumatoid arthritis and spondyloarthropathies, p < 0,05 in all comparisons. Patients with RA, IBD, and Ps achieved 70% of the maximum score, while patients with PsA and SpAs did not reach 50% of the maximum possible score. Female gender, a state of moderate/severe disease severity, an older age and a higher number of previous treatments were correlated with worse quality of life. Conversely, persistence to current treatment correlated with better quality of life., Conclusions: Patients with immune-mediated inflammatory diseases have markedly affected quality of life, mainly in the pain/discomfort dimension, especially in those immune-mediated inflammatory diseases with a rheumatological component., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To describe the process of implementing a traceability and safe manufacturing system in the clean room of a pharmacy service to increase patient safety, in accordance with current legislation., Methods: The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterised in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardised work procedures, and quality controls., Results: A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardised work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition, 17 were high risk, 327 medium risk, and 32 low risk, and 13 quality controls., Conclusions: The computerization of the production process has allowed the implementation of a traceability and secure manufacturing system in a controlled environment in accordance with current legislation., Competing Interests: Declaration of competing interest None declared., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: To describe the process of implementing a traceability and safe drug manufacturing system in the clean room of a Pharmacy Service to increase patient safety, in accordance with current legislation., Methods: The process was carried out between September 2021 and July 2022. The software program integrated all the recommended stages of the manufacturing process outlined in the "Good Practices Guide for Medication Preparation in Pharmacy Services" (GBPP). The following sections were parameterized in the software program: personnel, facilities, equipment, starting materials, packaging materials, standardized work procedures, and quality controls., Results: A total of 50 users, 4 elaboration areas and 113 equipments were included. 435 components were parameterized (195 raw materials and 240 pharmaceutical specialties), 54 packaging materials, 376 standardized work procedures (123 of them corresponding to sterile medicines and 253 to non-sterile medicines, of which 52 non-sterile were dangerous), in addition 17 were high risk, 327 medium risk, 32 low risk, and 13 quality controls., Conclusions: The computerization of the production process has allowed the implementation of a traceability and secure drug manufacturing system in a controlled environment in accordance with current legislation., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

The pharmacist is an important link between doctor and patient. To optimise patient care, it is essential that expectations of doctors and patients regarding pharmacy services are met. Hence the objective of this study was to assess the satisfaction levels of doctors and patients on pharmacy services currently provided, and their expectations from pharmacy services. This cross sectional study was conducted in selected clinics of a university based teaching hospital. Questionnaires developed in-house by referring previously published resources, content validated by a group of experts, and face validated through a pilot study were used. Doctors and patients of chronic disease clinics were selected for the study. All doctors involved in prescribing for more than six months, and patients or their regular care givers attending clinics for more than one year were included. Mentally incapacitated patients were excluded. An interviewee administered questionnaire was distributed to doctors and an interviewer administered questionnaire was used for patients. Exploratory factor analysis (EFA) (principal component analysis with Varimax rotation) was conducted to divide variables of the questionnaires into reliable components. Response rate of doctors was 82.3%. Among them 59.6% (50/84) doctors said that they have a good relationship with pharmacists, and 89.3% (75/84) expected communication with pharmacists more often. EFA for doctors' perceptions resulted in four components. A statistically significant difference was observed between doctors' expectation (95.9% - 81/84) and current practice (22.6% - 19/84) on communicating medication issues (p<0.001). A total of 380 patients participated. EFA for patients' perceptions resulted in ten components. The majority considered pharmacists as an integral part of the healthcare system (98.7% - 375/380) and experts in medication (84.7% - 322/380). They further perceived that dispensed medications are safe (82.9% - 315/380) and of good quality (76.3% - 290/380). Further 95.5% (363/380) were satisfied with dispensing label information. A statistically significant difference was found between the expectations (93% - 353/380) and satisfaction levels (86.5% - 329/380) of patients on pharmacy services (p=0.003). According to findings, both doctors and patients held a positive perception on pharmacy services and pharmacists, but the statistically significant gap reported between expectations and current level of pharmacy service, highlighting both the potential and scope for service improvement. [ABSTRACT FROM AUTHOR]

The article discusses the development of a strategic plan by a pediatric clinical pharmacy team to manage the COVID-19 pandemic. Topics mentioned include the goals and objectives of strategic plan, a description of data gathering process and strengths, weakness, opportunities, and threats analysis, and the factors that contributed to the success of strategic planning.

Purpose Discharge prescriptions represent an important aspect of care for patients seen in the emergency department (ED) setting and are used by providers to continue therapy for acute illness once patients leave the ED or to prevent future exacerbations of chronic conditions. The success of an ED discharge and the medications prescribed rely on patient compliance. Compliance depends on patients' ability to obtain prescriptions, which can be hindered by limited access to pharmacies and cost. Summary In order to address issues traditionally associated with medication noncompliance, a discharge pharmacy was implemented within a busy urban ED. The pharmacy began processing prescriptions on December 18, 2019, using a formulary aimed towards providing commonly prescribed and high-risk medications. The pharmacy accepts insurance plans in addition to utilizing 340B Drug Pricing Program pricing to offer affordable medications to patients. During the first year of operation 10,230 prescriptions were filled for 5,703 patients, representing 13% of all patients discharged during that time. Of the prescriptions filled, 35.4% were for products considered high-risk medications, including epinephrine auto-injectors, insulin, and antibiotics. Over 50% of these high-risk medications were provided to patients through reduced cash pricing. Pharmacist interventions were made on 4.3% of prescriptions to address incorrect dosing, avoid use of inappropriate antibiotics, and recommend alternative therapies. Conclusion The implementation of a discharge pharmacy within the ED allowed over 5,700 patients to be discharged with medications and represents a potential solution to issues surrounding medication noncompliance. Similar initiatives have the opportunity to improve medication access for a larger ED population. [ABSTRACT FROM AUTHOR]

Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures and clearly defined responsibilities, may facilitate and increase the use of PGx in clinical practice. Over 140 patient cases from an observational study in Switzerland formed the basis for the design and refinement of a pharmacist-led pharmacogenetics testing and counselling service (PGx service) in an interprofessional setting. Herein, we defined a six-step approach, including: (1) patient referral; (2) pre-test-counselling; (3) PGx testing; (4) medication review; (5) counselling; (6) follow-up. The six-step approach supports the importance of an interprofessional collaboration and the role of pharmacists in PGx testing and counselling across healthcare settings. [ABSTRACT FROM AUTHOR]

Purpose: Assess whether full-scale simulation exercises improved hospital pharmacies' disaster preparedness.Methods: Swiss hospital pharmacies performed successive full-scale simulation exercises at least four months apart. An interprofessional team created two scenarios, each representing credible regional-scale disasters involving approximately fifty casualties (a major road accident and a terrorist attack). Four exercise assessors used appraisal forms to evaluate participants' actions and responses during the simulation (rating them using five-point Likert scales).Results: Four hospital pharmacies performed two full-scale simulation exercises each. Differences between exercises one and two were observed. On average, the four hospitals accomplished 69% ± 6% of the actions expected of them during exercise one. The mean rate of expected actions accomplished increased to 84% ± 7% (p < 0.005) during exercise two. Moreover, the average quality of actions improved from 3.0/5 to 3.6/5 (p = 0.01), and the time required to gather a crisis management team drastically decreased between simulations (from 23 to 5 min). The main challenges were communication (reformulation) and crisis management. Simulation exercise number one resulted in three hospital pharmacies creating disaster action plans and the fourth improving its already existing plan.Conclusion: This study highlighted the value of carrying out full-scale disaster simulations for hospital pharmacies as they improved overall institutional preparedness and increased staff awareness. The number of expected actions accomplished increased significantly. In the future, large-scale studies and concept dissemination are warranted. [ABSTRACT FROM AUTHOR]

BackgroundAntimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable. Antimicrobial stewardship programs (ASPs) have been advocated to improve antimicrobial utilization, but program implementation is variable.ObjectiveTo determine associations between ASPs and facility characteristics, and inpatient antimicrobial utilization measures in the Veterans Affairs (VA) system in 2012.DesignIn 2012, VA administered a survey on antimicrobial stewardship practices to designated ASP contacts at VA acute care hospitals. From the survey, we identified 34 variables across 3 domains (evidence, organizational context, and facilitation) that were assessed using multivariable least absolute shrinkage and selection operator regression against 4 antimicrobial utilization measures from 2012: aggregate acute care antimicrobial use, antimicrobial use in patients with non-infectious primary discharge diagnoses, missed opportunities to convert from parenteral to oral antimicrobial therapy, and double anaerobic coverage.SettingAll 130 VA facilities with acute care services.ResultsVariables associated with at least 3 favorable changes in antimicrobial utilization included presence of postgraduate physician/pharmacy training programs, number of antimicrobial-specific order sets, frequency of systematic de-escalation review, presence of pharmacists and/or infectious diseases (ID) attendings on acute care ward teams, and formal ID training of the lead ASP pharmacist. Variables associated with 2 unfavorable measures included bed size, the level of engagement with VA Antimicrobial Stewardship Task Force online resources, and utilization of antimicrobial stop orders.ConclusionsFormalization of ASP processes and presence of pharmacy and ID expertise are associated with favorable utilization. Systematic de-escalation review and order set establishment may be high-yield interventions. Journal of Hospital Medicine 2017;12:301-309.

Pharmacists' admission medication histories (AMHs) are known to reduce adverse drug events (ADEs). Pharmacist-supervised pharmacy technicians (PSPTs) have also been used in this role. Nonetheless, few studies estimate the costs of utilizing PSPTs to obtain AMHs. We used time and motion methodology to study the time and cost required for pharmacists and PSPTs to obtain AMHs for patients at high risk for ADEs. Pharmacists and PSPTs required 58.5 (95% confidence interval [CI], 46.9-70.1) and 79.4 (95% CI, 59.1-99.8) minutes per patient, respectively (P = 0.14). PSPT-obtained AMHs also required 26.0 (95% CI, 14.9-37.1) minutes of pharmacist supervision per patient. Based on 2015 US Bureau of Labor Statistics wage data, we estimated the cost of having pharmacists and PSPTs obtain AMHs to be $55.91 (95% CI, 44.9-67.0) and $45.00 (95% CI, 29.7-60.4), respectively, which included pharmacist supervisory cost, per patient (P = 0.32). Thus, we found no statistically significant difference in time or cost between the two provider types. Journal of Hospital Medicine 2017;12:180-183.

Objective: Given the global uncertainty faced due to the Covid-19 pandemic, health services were forced to adjust inventory management and purchase projections. This publication aims to describe the strategies taken and their impact on the supply chain indicators by the pharmacy service in the management of drug purchases during the pandemic to expose the importance of pharmacist in charge of the supply chain. Methods: This observational study describes the drug purchasing system in a general hospital and the strategies used to manage drug supply. The actions proposed by the pharmacy department are listed chronologically related to inventory issues and purchasing decisions. The accuracy of the purchase forecast was evaluated by calculating indicators such as the mean absolute standard deviation (MAD) and the variance of the forecast error (MSE). Inventory days and inventory turnover indicators were also compared in pre-pandemic and pre-pandemic periods. Findings: In general, the forecast error given by MAD and MSE tended to decrease. Specifically, from the 82 drug categories, during the pandemic period, this indicator decreased in 72 (88%), increased in 9 (11%), and remained the same in only 1 (1%) of the categories. In financial terms, comparing the 2018–2019 and 2020–2021 periods, a favorable result was obtained when evaluating the inventory turnover indicators, which decreased by 0.01 points and the days of inventory increased on average by two days. Conclusions: The implementation and use of these indicators prevented drug shortages, reducing inventory forecast errors. A pharmacist with knowledge in inventory management allows managing a process of continuous improvement and tactics for efficient inventory management without neglecting the benefit to patients or the economic profitability of the service. There were limitations since digital operating systems do not generate centralized or organized data for this type of analysis.

The use of Complementary Alternative Medicine (CAM) in patients with cancer is increasing. CAM is associated with potential toxicity and drug interactions, particularly with chemotherapy. Here, we report a case of cytolysis and hepatic cholestasis in a patient who was self-medicated with a mushroom powder-based alternative therapy containing Agaricus blazei Murril (ABM) during cancer treatment.A 43-year-old woman with metastatic colorectal cancer and hepatic metastases was admitted to our hospital for intravenous chemotherapy. Markers of hepatic grade 3 cytolysis and cholestasis were identified during the pretreatment consultation. The baseline results were within normal limits.The chemotherapy was immediately canceled, and further tests were performed. After the investigation, the patient reported taking three mushroom powder-based capsules per day since November 2023. The dietary supplement contained ABM and Hericium erinaceus (HE) powder. After Pharmaceutical analysis, treatment with the supplement was discontinued, and the patient has not resumed. The changes in liver function were also favorable.In our case, given the improvement in liver function after CAM discontinuation, hepatic cytolysis appeared to be linked to ABM consumption despite the patient's liver metastases. Pharmaceutical analysis of CAM is essential to ensure the safety and optimization of cancer treatments. Patients should also communicate their CAMs to healthcare professionals and be aware of the consequences of consuming these dietary supplements. Finally, collaboration between pharmaceutical teams and oncologists is essential for optimal management of cancer patients. [ABSTRACT FROM AUTHOR]

Introduction: Standard of care after an acute myocardial infarction (AMI) includes high‐intensity statin therapy to lower the risk of future cardiovascular events. However, the use of high‐intensity statins post‐AMI remains suboptimal, presenting an opportunity for clinical pharmacist services to improve clinical care. Objective: To evaluate the impact of a cardiology clinical pharmacist intervention upon the rate of high‐intensity statins issued at hospital discharge after AMI. Methods: This was a single‐center, pre‐post study that included patients 18 to 75 years of age who were discharged from one investigative site with a primary diagnosis of AMI (as determined by ICD‐10 codes) between July 2019 to December 2020. The primary outcome was the proportion of patients prescribed high‐intensity statins, defined as atorvastatin 40 to 80 mg or rosuvastatin 20 to 40 mg daily, at discharge pre and postimplementation of a cardiology clinical pharmacist intervention. Patients were stratified into two groups for comparison: pre‐ (07/01/2019‐3/31/2020) and post‐ (04/01/2020‐12/31/2020) intervention, for which the latter included cardiology pharmacist‐driven communication and documentation via the electronic health record. Results: A total of 418 patients were included: 223 (53.3%) preintervention and 195 (46.7%) postintervention. The overall cohort was approximately two‐thirds men and 90% Caucasian, with a mean ± SD age of 61.4 ± 9.7 years; the pre and postintervention groups were similar in terms of demographics. The rate of high‐intensity statin prescribing at discharge improved from 83.0% preintervention to 95.4% postintervention (P <.0001). A total of 9.9%, 1.8%, and 5.4% of patients in the preintervention group received moderate‐intensity, low‐intensity, or no statin at discharge, respectively, lowering to 3.1%, 1.0%, and 0.5% postintervention. Conclusion: There was a statistically significant increase in the rate of high‐intensity statin prescribing post‐AMI after the implementation of targeted cardiology clinical pharmacist services. [ABSTRACT FROM AUTHOR]

Issue addressed: Australian pharmacists are increasingly moving towards the provision of patient‐centred professional pharmacy services for chronic disease management. Some of these services are targeted towards improving patients' health and wellbeing through the facilitation of patient‐driven health behaviour change. This paper investigates whether the provision of behaviour change interventions by Australian pharmacists is adequately underpinned by the current competency framework. Methods: The foundation and behaviour change competences within each of the domains in the generic health behaviour change competency framework (GHBC‐CF), was mapped to the Australian pharmacist competency framework. Results: Although the Australian competency framework underpins most of the foundation and behaviour change competences of the GHB‐CF required to undertake low‐intensity interventions, for medium to high‐intensity interventions four specific task‐related competences need to be addressed. These are F12 'Ability to recognise barriers to and facilitators of implementing interventions', BC4 'ability to agree on goals for the intervention', BC5 'capacity to implement behaviour change models in a flexible but coherent manner' and BC6 'capacity to select and skilfully apply most appropriate intervention method'. Conclusion: Additional training is necessary if pharmacists aspire to provide behaviour change interventions for chronic disease management, in particular those that are complex as they involve changes to multiple health behaviours. So what?: The identification of these gaps is critical and can potentially be addressed in postgraduate training programs and as pharmacy curricula are updated. [ABSTRACT FROM AUTHOR]

Coronavirus disease-2019 (COVID-19) is one of the greatest pandemics of modern times. More than one hundred eleven million global deaths have already been associated with COVID-19. The incidence of COVID-19 as well as morbidity and mortality due to COVID-19 have increased in lowincome countries (LICs). COVID-19 has further weakened health systems in LICs, that are already distressed by inadequate funding, lack of human resources, and poor infrastructure and service delivery. Despite the resource crunch, hospital LICs have been instrumental in treating COVID-19 patients. Pharmacists working in hospitals play an indispensable role in providing pharmaceutical services for infection prevention and control. This study discusses the contribution of hospital pharmacists and the challenges faced by them for treating COVID-19 patients in LICs before the COVID-19 vaccine roll-out. [ABSTRACT FROM AUTHOR]

Background Despite several international studies demonstrating that ward-based pharmacists improve medication quality, ward pharmacists are not generally established in German hospitals. Aim We assessed the effect of a ward-based clinical pharmacist on the medication quality of geriatric inpatients in a German university hospital. Method The before-after study with a historic control group was conducted on the geriatric ward. During the control phase, patients received standard care without the involvement of a pharmacist. The intervention consisted of a clinical pharmacist providing pharmaceutical care from admission to discharge. Medication quality was measured on admission and discharge using the Medication Appropriateness Index (MAI). A linear regression analysis was conducted to calculate the influence of the intervention on the MAI. Results Patients in the intervention group (n = 152, mean 83 years) were older and took more drugs at admission compared to the control group (n = 159, 81 years). For both groups, the MAI per patient improved significantly from admission to discharge. Although the intervention did not influence the summated MAI score per patient, the intervention significantly reduced the MAI criteria Dosage (p = 0.006), Correct Directions (p = 0.016) and Practical Directions (p = 0.004) as well as the proportion of overall inappropriate MAI ratings (at least 1 of 9 criteria inappropriate) (p = 0.015). Conclusion Although medication quality was already high in the control group, a ward-based clinical pharmacist could contribute meaningfully to the medication quality on an acute geriatric ward. [ABSTRACT FROM AUTHOR]

Manal Al-Zaidan,1 Mohamed Izham Mohamed Ibrahim,2 Mohamed Ghaith Al-Kuwari,3 Azza Mustafa Mohammed,3 Mansoor Nawaz Mohammed,4 Samya Al Abdulla5 1Pharmacy Department, Primary Health Care Corporation, Doha, Qatar; 2College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 3Directorate of Strategy Planning and Health Intelligence, Primary Health Care Corporation, Doha, Qatar; 4Clinical Information Systems Department, Primary Health Care Corporation, Doha, Qatar; 5Directorate of Operations, Primary Health Care Corporation, Doha, QatarCorrespondence: Manal Al-ZaidanDirector of Pharmacy, P.O. Box 26555, Doha, QatarTel + 974 40271103Email malzaidan@phcc.gov.qaAbstract: The COVID-19 pandemic has strained health care systems around the world. Pharmacists have made substantial contributions to the health care operations during the COVID-19 response. The Pharmacy Department at Qatar Primary Health Care Corporation (PHCC) acted proactively to ensure that all patients received their medications and their refilled prescriptions in time and without any disruption. The Medication Home Delivery Service was introduced and implemented for all Qatar residents to prevent unnecessary visits to health centers, minimize the spread of COVID-19 to vulnerable populations, especially those with multiple comorbidities, and protect health care workers from exposure to the virus. Moreover, several other precautionary measures were taken by the PHCC to ensure uninterrupted access to health care, including moving to a virtual health care delivery model. As of September 2020, the service had served around 64,213 patients since its launch in March 2020. In total, 70,357 medications were delivered and 69,092 (98.2%) medication packages were delivered successfully to patients, with an average of 450.8 medication packages delivered per month. Despite various challenges, the PHCC is considering continuing the Medication Home Delivery Service in the long term to continue with a more effective and efficient service for patients during the coming months and years.Keywords: COVID-19, pandemic, pharmacy service, medication home delivery, PHCC, Qatar

Mònica Andreu-March,1 Margarita Aguas Compaired,1,2 Montserrat Pons Busom,1,2 Eduardo L Mariño,1 Pilar Modamio1 1Clinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, 08028, Spain; 2Pharmacy Service, University Hospital Sagrat Cor, Barcelona, 08029, SpainCorrespondence: Pilar ModamioClinical Pharmacy and Pharmaceutical Care Unit, Department of Pharmacy and Pharmaceutical Technology and Physical Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Av. Joan XXIII, 27-31, Barcelona, 08028, SpainTel/Fax +34 934024544Email pmodamio@ub.eduPurpose: The main objective was to develop and validate a “Hospital Outpatients’ Information Needs Questionnaire” (HOINQ). Secondly, to identify patients’ preferred sources of information. Finally, to establish differences depending on the disease, as well as between sociodemographic and clinical variables.Patients and Methods: This is a transversal study based on a questionnaire. All adult hospital outpatients’ who collected their medication at the Pharmacy Service were consecutively recruited, regardless of their diagnosis time, treatment or disease. The Spanish version of the internationally validated European Organization for Research and Treatment Cancer Quality of Life Questionnaire (EORTC QLQ-25) aimed at oncology patients was used as the starting point. In order to be applicable on new target population, it was crucial to make several changes and ensure that it complies with the validity, viability and reliability criteria. The questionnaire prepared for validation was then obtained by a literature review (face validity), submitting the EORTC QLQ-25 to an expert committee (content validity), by piloting (viability) and Cronbach’s alpha statistical analysis (reliability). Once the questionnaire was completed, Cronbach’s alpha of the final study (reliability) and factor analysis (construct validity) were performed. Then, pertinent modifications were applied to obtain the HOINQ.Results: A total of 153 outpatients filled the questionnaire, which was widely accepted and required 5– 10 min to complete. Cronbach’s alpha coefficients met criteria > 0.7. Three factors were established by factor analysis: aspects about the disease, pharmacological and no-pharmacological treatment and satisfaction and perception of the information received. Participants felt satisfied (41– 52%) with the information amount, quality and usefulness, although 1 out of 3 stated wanting to know more about the different information areas. Younger patients (P-value < 0.05) and those who had been attending the Pharmacy Service for a longer time span (P-value < 0.01) reported receiving more information. On a 0 to 7 scale, medical specialists (mean = 6.28, SD = 1.38) followed by the rest of health care professionals (mean = 4.23– 4.63, SD = 2.25– 2.29) were selected as the preferred sources of information. HIV patients reported being more informed, while those with rheumatoid arthritis felt less informed (P-value < 0.05).Conclusion: The HOINQ was developed. It is a self-completed questionnaire, composed of three blocks: the 16-item information needs questionnaire, demographic and clinical variables, and patients’ preferred sources of information. It is an easy tool to use and replicate, both for patients and professionals.Keywords: information needs, outpatients, pharmacy service, questionnaire validation

Objective: The objective of this study was to assess the results of applying Lean Methodology in the design of a standardized medication storage model in hospitalization departments.Method: Descriptive and retrospective study conducted between September 2017 and January 2019 in a tertiary level hospital. The Pharmacy Service led the creation of a multidisciplinary team. Lean Methodology was used to establish the components and organization and identification criteria that made up the standardized medication storage model. The stocks of each hospitalization department were reviewed and quantified, the final amount of stock needed was agreed with the supervisor of each department, and the economic impact of the implementation of the standardized medication model was assessed. A questionnaire was designed and sent to nursing staff to determine their level of satisfaction with the new model.Results: The standardized medication storage model was scaled up to 20 nursing departments, leading to an overall reduction of 56.72% in the number of pharmaceutical dosage forms available (5,688 vs 2,462). The number of high-risk drugs was reduced by 40.73% (631 vs 374). This elimination of wastage achieved a saving of €25,357.98. A total of 58 nurses returned the questionnaires (20.70% of the total): 22.40% worked a fixed shift and 77.60% worked a rotating shift. The mean score on overall satisfaction was 5.79 ± 3.61 (scores ranged from 1 to 10).Conclusions: The application of Lean Methodology is very useful for the management of medication stocks in hospitalization departments. The implementation of a standardized medication storage model leads to economic savings and a marked reduction in the number of active ingredients and high-risk medications. The nursing staff were satisfied with the implementation of the model, suggesting that we should continue to pursue this effective line of action.

Hussien Kebede,1 Tessema Tsehay,2 Mogesie Necho,3 Yosef Zenebe3 1Department of Adult Health Nursing, School of Nursing and Midwifery, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia; 3Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Mogesie NechoDepartment of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaEmail nechomoges2014@gmail.comBackground: Satisfaction of patients is a key measure of quality pharmacy service delivery. However, the traditional way of drug inventory and dispensing practice by professionals negatively affects the satisfaction of patients. Hence, assessment of satisfaction level is an important tool to identify gaps in pharmacy service delivery and works for its improvement.Objective: To determine the level of patients’ satisfaction towards outpatient pharmacy service and contributing factors at Dessie Town Public Hospitals, South Wollo, North-east Ethiopia, 2020.Methods: We implement a facility-based cross-sectional survey on 414 patients over the age of 18 years from the outpatient pharmacy service of Dessie town public hospitals. The study was done from February to June 2020 through a systematic random sampling method and face-to-face pharmacy exit interview using the Self Reporting Questionnaire-17. We used Epi-data version 3.1 for data entry and SPSS-21 software for analysis. We assessed the strength of association in the binary logistic regression with odds ratio and declare statistical significance with p-value < 0.05.Results: Among the total patients participated, 246 (59.4%) were satisfied towards outpatient pharmacy services. In this finding, comfortability of waiting area [AOR=1.87; 95% CI, (1.13, 4.18)], frequency of visit [AOR=2.4; 95% CI, (1.19, 4.80)], and payment status [AOR=2.90; 95% CI, (1.21, 6.95)] showed a positive association towards satisfaction. On the other hand, age (28– 37 years) [AOR=0.16; 95% CI, (0.08– 0.34)], number of drug dispensed [AOR=0.3; 95% CI, 0.13– 0.41] and medication availability [AOR=0.44; 95% CI, (0.26, 0.71)] showed a negative association with patient satisfaction.Conclusion and Recommendations: The findings of the current study revealed that patients’ satisfaction towards outpatient pharmacy services provided by public Hospitals at Dessie town was low. Hence, hospitals need to take attention to and consider the identified gaps like improving the availability of drugs, comfortability of waiting area, payment status, and the number of drugs dispensed, and the frequency of visits.Keywords: patients’ satisfaction, pharmacy service, Dessie

Background: In public health emergencies, such as the COVID-19 pandemic, the work strategies of clinical pharmacists need to be modified according to the rapid spread of the disease, where information and resources are constantly changing. The aim of this study was to describe the role of clinical pharmacists in the COVID-19 pandemic by the implementation of clinical practice guidelines. Methods: This was a prospective study from September 2020 to March 2021 in a COVID-19 center hospital. A clinical pharmacist visited patients in the ICU and internal ward three times per week and delivered Comprehensive Medication Management (CMM) on a consultation paper in patient’s files. In October 2021, a consensus regarding the improvement of the rational use of COVID-19 medications and their costs was developed. The high-cost medications were selected based on the hospital information system to evaluate direct medical costs from the provider’s perspective. Results: During six months, in addition to pharmacotherapy consultation for 193 patients, pharmacotherapy evaluation was done 903 times for COVID-19 patients and their medication was also assessed. After implementation of the updated COVID-19 protocol in the hospital, the use of main drugs reduced by 8.950.328.786 IRR equivalent to 21,317 USD based on reference currency within two months. Conclusion: The participation of a clinical pharmacist in a COVID-19 center by the implementation of pharmacotherapy guidelines and comprehensive medication management may lead to cost reduction and improved drug safety.

Over the past decade, the Department of Veterans Affairs (VA) Pharmacy Benefits Management Services (PBM) has enhanced its formulary management activities and added programs to ensure that the national drug plan continues to meet the pharmacy needs of veterans and to promote safe and appropriate drug therapy in the face of rising medication expenditures. This article describes the broad range of services provided by the VA PBM that work in partnership to deliver a high-quality and sustainable pharmacy benefit for veterans. In support of formulary management, VA PBM pharmacists prepare extensive clinical guidance documents (e.g., drug monographs and criteria for use) that are used by physicians and pharmacists with operational and clinical oversight of the VA national formulary. The VA PBM has utilized various contracting techniques and continually evaluates drug utilization data to identify opportunities for potential savings. Remarkably, since before 2004, the average acquisition cost for a 1-month supply of medication has remained fairly stable at approximately $13-$15. Two new VA PBM programs are the VA Center for Medication Safety (VA MedSAFE) and the Clinical Pharmacy Practice Office (CPPO). VA MedSAFE is a comprehensive pharmacovigilance program focused on the detection, assessment, and prevention of adverse drug events, and CPPO is dedicated to improving safe and appropriate medication use by supporting and expanding clinical pharmacy practice. Moving forward, the VA PBM will consider new initiatives to stay at the forefront of providing quality care while maintaining economic viability.DisclosuresNo outside funding supported this research. This work was supported by VA Pharmacy Benefits Management Services (VA PBM), Hines, Illinois, and VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania. Glassman is co-director of the VA Center for Medication Safety, which is part of the VA PBM. He is also part of the Medical Advisory Panel for the VA PMB. All other authors are employed by the VA PBM. The views expressed in this article are those of the authors, and no official endorsement by the U.S. Department of Veteran Affairs or the U.S. government is intended or should be inferred. Study concept and design were contributed by Valentino, Cunningham, Good, Aspinall, and Sales. Calabrese and Ourth took the lead in data collection, along with Good, Cunningham, Aspinall, Sales, Burk, Moore, Neuhauser, and Golterman. Data interpretation was performed by Burk, Newhauser, and Golterman, along with Glassman, Calabrese, Moore, and Ourth. The manuscript was written by Aspinall and Sales, along with Burk, Newhauser, Golterman, Ourth, and Cunningham. Good, Glassman, and Moore revised the manuscript, along with Calabrese, Valentino, and Aspinall.

BackgroundAll Department of Veterans Affairs Medical Centers (VAMCs) operate under a single national drug formulary, yet substantial variation in prescribing and spending exists across facilities. Local management of the national formulary may differ across VAMCs and may be one cause of this variation.ObjectiveTo characterize variation in the management of nonformulary medication requests and pharmacy and therapeutics (P&T) committee member perceptions of the formulary environment at VAMCs nationwide.MethodsWe performed an online survey of the chief of pharmacy and an additional staff pharmacist and physician on the P&T committee at all VAMCs. Respondents were asked questions regarding criteria for use for nonformulary medications, specific procedures for ordering nonformulary medications in general and specific lipid-lowering and diabetes agents, the appeals process, and the formulary environment at their VAMCs. We compared responses across facilities and between chiefs of pharmacy, pharmacists, and physicians.ResultsA total of 212 chief pharmacists (n = 80), staff pharmacists (n = 78), and physicians (n = 54) responded, for an overall response rate of 49%. In total, 107/143 (75%) different VAMCs were represented. The majority of VAMCs reported adhering to national criteria for use, with 38 (36%) being very adherent and 69 (65%) being mostly adherent. There was substantial variation between VAMCs regarding how nonformulary drugs were ordered, evaluated, and appealed. The nonformulary lipid-lowering drugs ezetimibe, rosuvastatin, and atorvastatin were viewable to providers in the order entry screen at 67 (63%), 67 (63%), and 64 (60%) VAMCs, respectively. The nonformulary diabetes medication pioglitazone was only viewable at 58 (55%) VAMCs. In the remaining VAMCs, providers could not order these nonformulary drugs through the normal order-entry process. For questions about the formulary environment, physician respondent perceptions differed from those of staff pharmacists and chief pharmacists. Compared with pharmacy chiefs and staff pharmacists, physicians were less likely to agree that providers at their VAMC prescribed too many nonformulary medications (47% and 44% vs. 12%, P < 0.001), more likely to agree that providers must jump through too many hoops to prescribe nonformulary medication (5% and 3% vs. 25%, P < 0.001), and more likely to agree that providers make an effort to convert new patients from nonformulary to formulary lipid-lowering (65% and 73% vs. 94%, P

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Abstract Background Novel Coronavirus is a global pandemic affecting all walks of life and it significantly changed the health system practices. Pharmacists are at the front line and have long been involved in combating this public health emergency. Therefore, the study was aimed to explore pharmacy preparedness and response to prevent and control coronavirus disease 2019 (COVID-19). Methods A qualitative study was conducted in six pharmacies in Aksum, Ethiopia in May, 2020. We conducted six in-depth interviews with purposively selected key informants. Direct observation measures were made to assess the activities made in the medicine retail outlets for the prevention and control of the pandemic. Interview data were audio-recorded, translated and transcribed verbatim. Thematic analysis was employed to analyze the data and OpenCode version 4.02 software was used to facilitate the data analysis. Results The thematic analysis has resulted in seven major themes. Good preparedness measures were undertaken to control and prevent COVID-19. Study informants had good knowledge about the pandemic disease and reported they had used different resource materials to update themselves. Preparing of alcohol-based hand-rub, availing finished sanitizers and alcohol, and advising clients to maintain physical distancing were the major counseling information being delivered to prevent the disease. Some tendencies of irrational drug use and false claims of COVID-19 were observed at the beginning of the pandemic. Interview informants had reported they were working with relevant stakeholders and appropriate patient education and support were given to combat the pandemic. Conclusion The study revealed necessary pharmacy services has been rendered to all clients. However, availability of drugs and medical supplies were scarce which negatively affected the optimal delivery of pharmacy services. The government and other responsible bodies should work together to solve such problems and contain the pandemic.

Objective: To determine the impact of the implementation of an influenza vaccination campaign in a hospital pharmacy service on patients who are starting or receiving treatment with biological therapies. Method: A 15-month quasi-experimental study of patients starting or receiving treatment with biological therapies. Between October and December 2016 and October and December 2017, we compared influenza vaccination rates, the incidence of influenza in the study population, the direct impact of the vaccination campaign on the patient, the effect of the campaign on vaccination rates, and the results of the satisfaction survey. Results: A total of 188 patients participated in the study. Of the patients who had not been vaccinated in the 2016/2017 campaign, 72.6% were vaccinated (p < 0.000) during the 2017/2018 campaign. No statistically significant differences were found between the 2016/2017 and 2017/2018 campaign (p = 0.636) in the percentage of patients who contracted flu after receiving the vaccine. In total, 99.5% thought that the campaign was a good initiative, and 50.5% reported that their decision to be vaccinated was influenced by the fact that the campaign was led by the hospital pharmacy service. Conclusions: The implementation of the influenza vaccination campaign in the hospital pharmacy service achieved led to a marked increase in vaccination rates. This result underlines the key role played by the hospital pharmacy service in achieving this level of success.

Abstract Objective Investigation of polypharmacy in patients with type 2 diabetes revealed that medications administered according to the patient’s symptoms and complaints strongly contributed to polypharmacy. We explored the effects of clinical ward pharmacy service, which evaluated the need for symptomatic treatment, therefore minimizing polypharmacy by reducing inappropriate medications. Results The number of drugs (hospitalization vs. discharge: 9 [1–17] vs. 7 [1–16], P

In pharmaceutical care, patients' perceptions of drug information provided by pharmacists are vital for assessing pharmaceutical services at community health centers (in Indonesian known as Puskesmas ). The aim of this study was to determine the alignment between patients' expectations and experiences of drug information services by pharmacists at Puskesmas in Indonesia. This multicenter cross-sectional study utilized a validated questionnaire among outpatient patients aged 18 years and above across all 47 Puskesmas in Makassar, Indonesia. A total of 622 respondents were interviewed between September to December 2023. Significant gaps were observed between patients' expectations and experiences regarding all the drug information aspects such as quantity (median: 4 vs 3, p <0.001), drug effects (median: 4 vs 3, p <0.001), dosage form (median: 3 vs 3, p <0.001), proper administration (median: 4 vs 4, p <0.001), side effects (median: 4 vs 2, p <0.001), storage (median: 3 vs 2, p <0.001), drug-drug interactions (median: 4 vs 2, p <0.001), drug-food interactions (median: 4 vs 2, p <0.001), handling missed dose (median: 3 vs 2, p <0.001), managing accidental overdoses (median: 4 vs 2, p <0.001), history of drug use (median: 3 vs 2, p <0.001), co-medications (median: 3 vs 2, p <0.001), and previous drug allergies (median: 3 vs 2, p <0.001). Sociodemographic factors influencing patients' need for drug information services encompass age, sex, educational attainment, comorbidities, family size, number of visits, monthly income, and occupation. The quality of drug information services at Puskesmas in Indonesia still requires optimization and customization to meet the specific needs of patients, taking into account their sociodemographic characteristics., Competing Interests: The authors declare that there is no conflict of interest., (© 2024 The Author(s).)

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, Guía de entrevista telemática en atención farmacéutica, as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, "Guía de entrevista telemática en atención farmacéutica," as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care., (Copyright © 2024 Sociedad Española de Farmacia Hospitalaria (S.E.F.H). Publicado por Elsevier España, S.L.U. All rights reserved.)

This commentary shares the experience of a hospital pharmacy department in providing healthcare services during the COVID-19 outbreak in Malaysia. During this pandemic, the medication delivery system is redesigned to minimize contact among patients and the health care providers. Also, the remote medication monitoring system was implemented to deliver pharmaceutical care for inpatients. Communication technology was used to assist the pharmacist in medication counseling. QR codes to access videos demonstrating the use of devices were made available for patients. Pharmacists were also tasked with the procurement of personal protective equipment and medications needed requiring special approval from the Ministry of Health. [ABSTRACT FROM AUTHOR]

Objectives: (1)To compare Part D plan switching for users and nonusers of a pharmacy-led Medicare Part D consultation service and (2) to evaluate the effect of service use on chronic medication adherence. Methods: This was a longitudinal study, occurring in one independently owned community pharmacy in Iowa. Medicare Part D beneficiaries who used the service were compared to nonusers. Dispensing data were used to compare planswitching and the effect of service use on chronic medication adherence between service users and nonusers. Proportion of days covered (PDC) was used to evaluate medication adherence. Results: In the 2017 and 2018 plan year, 79 and 138 Medicare beneficiaries used the service, respectively. These individuals were compared to 849 Medicare beneficiaries and a random sample of 101 beneficiaries in respective years. The respective switching rates for service users in 2018 and 2019 plan year were 43% and 15.9%, compared to 4% switching rates in both years for nonusers. Using the Medicare Part D consultation yielded a statistically significant positive effect on switching in both plan years (P values <.05) and a statistically significant positive effect on PDC between years (P value <.05). Conclusion: The use of a pharmacist-led Medicare Part D consultation resulted in increased plan switching and improved chronic medication adherence. [ABSTRACT FROM AUTHOR]

This commentary shares the experience of a hospital pharmacy department in providing healthcare services during the COVID-19 outbreak in Malaysia. During this pandemic, the medication delivery system is redesigned to minimize contact among patients and the health care providers. Also, the remote medication monitoring system was implemented to deliver pharmaceutical care for inpatients. Communication technology was used to assist the pharmacist in medication counseling. QR codes to access videos demonstrating the use of devices were made available for patients. Pharmacists were also tasked with the procurement of personal protective equipment and medications needed requiring special approval from the Ministry of Health.

Purpose Highly effective coronavirus disease 2019 (COVID-19) vaccines have brought hope for ending the pandemic. Unprecedented mass vaccination started first among healthcare workers. The aim of this report is to describe key strategies undertaken by a large hospital pharmacy department to meet the challenges of preparing a large quantity of COVID-19 vaccine doses in a short period of time. Summary MedStar Washington Hospital Center (MWHC) was in the first group of hospitals in Washington, DC, to receive Pfizer-BioNTech vaccine in December 2020. The pharmacy department faced challenges including stringent vaccine storage requirements, a need for specific equipment and workflow, limited funding, and staffing constraints. The pharmacy department's senior leaders defined pharmacy responsibilities, budgeted for equipment, participated in vaccination center design, and instructed pharmacy informatics personnel. The vaccine coordinators were appointed to oversee all vaccination-related operations. An ultra–low temperature freezer was installed 2 weeks before arrival of the first shipment of vaccine. All pharmacy order entry tools and operating procedures were standardized, and staff training and schedules were finalized by December 15. The first dose of the vaccine was administered on December 16 at the vaccination center. Pharmacy staff members dispensed the vaccine doses and monitored patients. By January 6, 2021, MWHC had vaccinated 3,812 employees with their first vaccine dose, with an average of 228 doses administered daily. Conclusion Key strategies such as systemic coordination, early preparation, detailed planning, operating procedure development, and staff education and engagement proved successful in facilitating preparation of thousands of COVID-19 vaccine doses for hospital employees within a short period of time. [ABSTRACT FROM AUTHOR]

Background: Implementation outcomes serve as progress and success indicators of the implementation process. They are also key antecedents to achieving the more traditional clinical outcomes typically associated with a service. Despite their importance, there are few implementation outcomes measures with appropriate psychometric properties, none of which have yet been adapted for medication optimization services.Objectives: This study aims to develop and validate the Implementation Outcomes Questionnaire (IOQ) to assess implementation of medication optimization services, starting with Comprehensive Medication Management (CMM). The resulting IOQ is a 40-item self-report instrument for six implementation outcomes, including adoption, acceptability, feasibility, appropriateness, penetration, and sustainability.Methods: A three-phase approach was used to develop and validate the IOQ. Development of the instrument, Phase I, was informed by a targeted search of existing implementation outcomes measures in other fields, a review of suitableoptions options by an expert panel, and item adaptation. To assess content validity, Phase II, an internal vetting process was conducted using an adapted version of Rubio and colleagues' methodology. Evidence of reliability and construct validity, Phase III, was obtained through a pilot test with 167 pharmacists within 78 different care settings.Results: Overall, the results supported the reliability and validity (both content and construct) of the IOQ, with further psychometric testing needed for adoption. The items' relevance, clarity, and alignment with each implementation concept were high, except for Penetration. As a result, the Penetration items were refined for further use. Best-fit models were identified for each outcome based on the MCFA analyses, thereby providing insights into the factor structures and interpretation for each measure. Cronbach' alphas indicated good internal consistency.Conclusions: This questionnaire is the first of its kind tailored to medication optimization services, starting with CMM. Access to this survey should facilitate measurement of implementation outcomes, thereby increasing the likelihood of achieving the desired clinical outcomes. [ABSTRACT FROM AUTHOR]

As medication experts, clinical pharmacists play an active and dynamic role in a medication shortage response. Supplementing existing guidelines with an actionable framework of discrete activities to support effective medication shortage responses can expand the scope of pharmacy practice and improve patient care. Dissemination of best practices and illustrative, networked examples from health systems can support the adoption of innovative solutions. In this descriptive report, we document the translation of published shortage mitigation guidelines into system success through broad pharmacist engagement and the adaption and implementation of targeted strategies. The profound, wide‐reaching medication shortages that accompanied the coronavirus disease 2019 (COVID‐19) pandemic are used to highlight coordinated but distinct practices and how they have been combined to expand the influence of the pharmacy enterprise. [ABSTRACT FROM AUTHOR]

Background: The clinical pharmacy service to the ward was established in 2005 in Malaysia, as the number of pharmacists working in the public service sector began to grow. Yet, there has been little local research done on reporting the range of work activities of clinical pharmacists and the amount of time that they spent on their work activities. Objective: This study aimed to identify the range of work activities of clinical pharmacists by observation and to estimate the proportion of time spent on different work activities by using the work sampling technique. Methods: The time spent by clinical pharmacists on various activities was measured using the work sampling technique over 30 working days. The work activities of clinical pharmacists were pre-identified and customized into an activity checklist. Two observers were placed at the study site and took turns recording the activities performed by the clinical pharmacists by following a randomly generated observation schedule. Results: 1,455 observations were made on five clinical pharmacists with a total of 3493 events recorded. Overall, clinical pharmacists spent 78.8% (n=2751) of their time providing clinical services whereas 12.3% (n=433) of their time was spent on non-clinical activities. They were found to be idle from work for 8.9% of the time. There was no difference in bed occupancy rate in the study site regardless of the presence of the observer (p=0.384). Clinical pharmacists were found to report a higher average daily cumulative work unit of 9.8 (SD=4.3) when under observation compared to an average daily cumulative work unit of 6.5 (SD=4.6) when no observer was present (p=0.005). Conclusions: The results revealed that clinical pharmacists spent a significant amount of time on non-clinical work. Their responsibilities with non-clinical work should be properly taken care of so they can allocate more time to providing patient care. [ABSTRACT FROM AUTHOR]

Objective: Increased risk of infection following hyperglycemia has been reported in hospitalized patients. Sliding-scale insulin protocol is an out-of-date method; therefore, it is necessary to examine new approaches in this regard. This study aimed to evaluate the efficacy of sliding-scale protocol versus basal-bolus insulin protocol, which supervised by clinical pharmacists in an infectious disease ward. Methods: In this prospective randomized clinical trial, 90 hyperglycemic patients who hospitalized in Loghman Hakim Hospital Infectious Disease Ward (Tehran, Iran) were randomized into two groups: sliding-scale insulin protocol (the control group) and the basal-bolus protocol groups that were under supervision clinical pharmacists. Some demographic, laboratory, and clinical variables, as well as patient's blood glucose were measured four times daily. Findings: The results indicated significant improvement among the patients in the intervention group. General indicators including fever, blood glucose level, the duration of hospitalization, incidence of hypoglycemia, days to achieve normal blood glucose, and leukocyte count improved in intervention group. Conclusion: According to this study, basal-bolus insulin protocol, which supervised by clinical pharmacy service, showed better blood glucose control and infection remission compared to the sliding-scale protocol.

Genetic predisposition is one factor influencing interindividual drug response. Pharmacogenetic information can be used to guide the selection and dosing of certain drugs. However, the implementation of pharmacogenetics (PGx) in clinical practice remains challenging. Defining a formal structure, as well as concrete procedures and clearly defined responsibilities, may facilitate and increase the use of PGx in clinical practice. Over 140 patient cases from an observational study in Switzerland formed the basis for the design and refinement of a pharmacist-led pharmacogenetics testing and counselling service (PGx service) in an interprofessional setting. Herein, we defined a six-step approach, including: (1) patient referral; (2) pre-test-counselling; (3) PGx testing; (4) medication review; (5) counselling; (6) follow-up. The six-step approach supports the importance of an interprofessional collaboration and the role of pharmacists in PGx testing and counselling across healthcare settings.

Introduction: Clinical pharmacy is considered an integral discipline in the health care system for optimizing therapy and reducing drug-related problems. The objective of this study was to evaluate the impact of clinical pharmacists in optimizing management in a medical oncology service. Methods: A prospective study was conducted at King Hussein Cancer Center between July 2019 and September 2019 of patients admitted to the medical oncology service. The impact of clinical pharmacists was measured by evaluating their interventions, defined as actions that were expected to result in a change in patient management. Data were collected daily by routine review of patients' profiles and by recording clinical pharmacists' interventions. The data collected were baseline characteristics of patients, numbers and types of clinical pharmacists' interventions, their significance, medications involved, and rate of acceptance of clinical pharmacists' interventions by physicians. The significance of each intervention was assessed by two clinical pharmacists on a Hatoum scale. Physicians' acceptance was assessed by whether the recommendations were implemented. Results: During the study period, 748 patients were included, of whom 605 required a total of 1683 clinical interventions. The mean age was 56.3 years (±15.5 SD). Of the interventions, 39% resulted in initiation of a drug and 25% in drug discontinuations. The drug group most commonly associated with clinical pharmacists' interventions was antibiotics (26.5%). Physicians accepted 98% of the clinical pharmacists' interventions, and 92.4% of the interventions brought care to a more appropriate level and were considered significant. Conclusion: Most patients in the medical oncology service required clinical pharmacists' interventions, as demonstrated by the high number of significant clinical pharmacists' interventions. Studies should be conducted to follow up these findings with respect to patient outcomes and cost savings. [ABSTRACT FROM AUTHOR]

Background: The "Pharmacy Technician and Assistant Role Redesign within Australian Hospitals Project" outcomes were released in November 2016. Aim: To assess pharmacy staff attitudes towards expanded hospital pharmacy technician (HPT) roles in a Victorian metropolitan teaching hospital. Method: An electronic questionnaire circulated to all pharmacists, interns and HPTs remained open for 4 weeks during September 2018. Questions focused on three key domains: HPT involvement in final accuracy checking of inpatient supplies and manufactured items, drugs of addiction (DA) management and clinical support roles. The hospital's Office for Research deemed the study a quality improvement activity. Results: The questionnaire was undertaken by 61 of 122 (50%) pharmacy staff. Fewer than 10% of respondents believed that HPTs are adequately used in current practice. Final accuracy checking technicians for inpatient medication supplies was supported by 82% of respondents. HPTs signing entries into dispensary DA registers for discharge and outpatient prescriptions was supported by 81% of respondents. Best possible medication history taking conducted by an HPT was supported by 52% of respondents, but support differed between pharmacists and HPTs, with 38 and 92% supportive, respectively (p < 0.01). Forty percent of respondents supported HPT involvement in patient medication counselling. Key themes identified from qualitative data included: the need for clarification of legal and indemnity issues, training and credentialing and professional attributes for expanded HPT roles. Conclusion: These findings are informing HPT role expansion within the pharmacy department and have identified potential barriers to change. Such findings may be useful to pharmacy departments undertaking similar role redesign work. [ABSTRACT FROM AUTHOR]