Community-acquired pneumonia(CAP)in adults(≥18 years old)is the most common infectious disease encountered in emergency departments.Its clinical complexity and the need for prompt treatment decisions pose significant...Community-acquired pneumonia(CAP)in adults(≥18 years old)is the most common infectious disease encountered in emergency departments.Its clinical complexity and the need for prompt treatment decisions pose significant challenges for patient management.The physician-pharmacist collaborative management(PPCM)model,which optimizes drug therapy regimens through collaboration between physicians and clinical pharmacists,has demonstrated strong clinical value in practice.However,the lack of standardized national guidelines for the application of the PPCM model in emergency departments in China has hampered its widespread adoption.This guideline is developed based on evidence-based medicine and clinical practice experience,with a focus on the application of the PPCM model in the management of CAP in emergency settings.It outlines the significance of the PPCM model,its applicable scenarios,the respective roles of emergency physicians and clinical pharmacists,and its practical implementation in the antimicrobial treatment of CAP patients.In addition,the guideline proposes standardized implementation processes and clinical pathways.By promoting the PPCM model,the expert panel aims to standardize the use of antimicrobial agents in the emergency treatment of CAP,reduce the risk of antimicrobial resistance,and improve patient outcomes.展开更多
Objectives:Emotional exhaustion among healthcare professionals,particularly pharmacists,significantly impacts their well-being and efficacy in patient care.Understanding the psychological mechanisms contributing to em...Objectives:Emotional exhaustion among healthcare professionals,particularly pharmacists,significantly impacts their well-being and efficacy in patient care.Understanding the psychological mechanisms contributing to emotional exhaustion is essential for developing effective interventions.The present research sought to investigate the potential mediating roles of rumination and coping strategies(adaptive and maladaptive)in the relationship between perceived stress and emotional exhaustion among pharmacists.Methods:A cross-sectional survey was carried out between September 2023 and January 2024 involving 576 pharmacists working in public hospitals in Punjab who met the inclusion criteria and actively participated in the study.We employed the Perceived Stress Scale,the Ruminative Response Scale,the Brief Coping Orientation to Problems Experienced Inventory(COPE),and the Oldenburg Burnout Inventory(OLBI)to assess the hypothesized study model.Path analysis was employed to test the hypothesized mediation model,incorporating simple and chain mediation processes.Results:The findings provided empirical evidence supporting a positive association between perceived stress and emotional exhaustion.Rumination significantlymediated this relationship.Further,both adaptive andmaladaptive coping strategieswere found tomediate this relationship,withmaladaptive coping demonstrating amore substantial impact.Conclusion:The chainmediation model demonstrated that rumination and coping strategies(both maladaptive and adaptive)significantly mediate the relationship between perceived stress and emotional exhaustion among pharmacists.Specifically,rumination was found to be a key mediator,with maladaptive coping strategies having a more substantial impact.These findings provide a deeper understanding of the psychological mechanisms contributing to emotional exhaustion in the pharmacy profession.展开更多
Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria sti...Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria still grapples with wide acceptance,key translational research and implementation of PM.This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.Methods:A cross‐sectional study was conducted in selected tertiary hospitals across the country.A 21‐item semi‐structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25.Descriptive statistics were used to summarize the data.A chi‐square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.Results:A total of 167 hospital pharmacists participated in the study.A high proportion of the participants are familiar with artificial intelligence(91.75%),Pharmacogenomics(84.5%),and precision medicine(61%).Overall,38.9%of the pharmacists had a good knowledge while 13.2%had a poor knowledge of PM and associated terms.The level of knowledge did not correlate significantly with gender(X^(2)=3.21,p=0.201),age(X^(2)=5,p=0.27),marital status(X^(2)=3.21,p=0.201),and professional level(X^(2)=6.85,p=0.144).The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine(49%)while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.Conclusions:There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria.Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM.Also,more research aimed at translating PM knowledge into clinical practice is recommended.展开更多
Objective:The evolving landscape of healthcare delivery emphasizes the importance of collaborative relationships between healthcare professionals.Community pharmacists and nurses,though traditionally occupying distinc...Objective:The evolving landscape of healthcare delivery emphasizes the importance of collaborative relationships between healthcare professionals.Community pharmacists and nurses,though traditionally occupying distinct roles,are increasingly working together to provide comprehensive,patient-centered care.Methods:This review explores the collaborative relationship between community pharmacists and nurses,focusing on their unique contributions to chronic disease management,patient education,and medication adherence.The article analyzes existing literature and highlights key interdisciplinary strategies that enhance patient outcomes.Results:By integrating their expertise,pharmacists and nurses can improve health outcomes by addressing both the physical and psychosocial needs of patients.Their collaboration enhances the effectiveness of chronic disease management,promotes early interventions,minimizes medication errors,and fosters improved patient adherence to treatment plans.Conclusions:The findings underscore the need for structured,proactive collaboration models that go beyond independent roles to foster a truly synergistic healthcare environment.Strengthening these interdisciplinary partnerships is crucial for achieving more efficient,holistic,and timely healthcare delivery.展开更多
Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical p...Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical pharmacy,and promote the high-quality development of clinical pharmacy in primary hospitals.Methods:Developing a target management model,adopting a wide coverage work model of“1+1+N”(that is,1 clinical pharmacist,1 resident clinical department,and N contracted clinical departments).According to the SMART principle,various work assessment indicators were quantified.This involved setting clear work goals,diversifying work methods,personalizing work methods,standardizing workflows,and using numerical assessment indicators.Regular supervision,inspection,feedback,and improvement mechanisms were implemented.Results:The implementation of the target management model has made the work effectiveness of clinical pharmacists visualized.There were more than 200 annual consultations and multidisciplinary team(MDT)cases,with an opinion adoption rate of 90.2%and a patient improvement rate of 80.6%.More than 1500 rational drug use interventions were conducted,with a suggestion adoption rate of 83.5%.In terms of pharmaceutical indicators control.The intensity of antibacterial drug use in 2024(without CMI adjustment)was 30.07 DDDs,significantly lower than the 2023 value of 33.54 DDDs,and also significantly lower than the provincial average(32.87 DDDs)and the average for hospitals of the same level(32.49 DDDs).The daily usage of intravenous infusion per bed for hospitalized patients was 2.09,a decrease from 2.15 in 2023,significantly lower than the provincial average of 2.71 and the average of 2.56 in hospitals of the same level.The amount of the second batch of national key monitoring drugs accounts for the value was 6.48%,significantly lower than the provincial average of 8.27%and the same level hospital average of 8.82%.In terms of chronic disease pharmaceutical management,taking the pharmaceutical management of patients with chronic heart failure as an example,the usage rates of renin-aldosterone-angiotensin-system inhibitors(RAAS inhibitors)and beta-blockers for heart failure in the management group were 87.88%and 80.81%,respectively,significantly higher-1 than those in the control group(62.22%and 65.56%).Heart rate in the management group(69.54±10.68 times·min-1)was significantly lower than in the control group(80.04±17.68 times·min)(P<0.001).The low-density lipoprotein cholesterol(1.69±0.57 mmol·L-1)was significantly lower than the control group(1.95±0.77 mmol·L-1)(P<0.001),and the 1-year readmission rate was 47.47%,significantly lower than the control group 56.67%.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)Score was(44.20±10.78),significantly lower than the control group(55.89±11.48)(P<0.001),indicating a significant improvement in the patient’s quality of life.Conclusions:The targeted management model for clinical pharmacists can effectively enhance communication and collaboration between clinical pharmacists and clinicians,improve the work efficiency and service quality of clinical pharmacists in primary hospitals,promote the work of clinical pharmacy towards standardization and scientificization,boost the high-quality development of pharmacy in primary hospitals,and also provide new ideas and methods for the management of clinical pharmacists in other primary hospitals.展开更多
The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy ...The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.展开更多
The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to unders...The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to understand how community pharmacists see their role in end-of-life home care in France,and to analyze their experiences of this care.An online questionnaire was distributed to community pharmacists working in France between December 2022 and March 2023.Of the 136 respondents to the questionnaire,87%had accompanied at least one patient at the end of life in the 3 months preceding the survey.Therapeutic education(88%of respondents),psychological support for caregivers(85%of respondents),securing treatment(82%of respondents)and monitoring therapeutic compliance(80%of respondents)are the behaviors validated by the greatest number of participants.The majority of professionals surveyed had a positive overall experience of managing patients at the end of life.These results pave the way for pharmacists to better support end-of-life patients at home.展开更多
The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opi...The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opioid overdoses. Pharmacists play an important role in the accessibility and education of naloxone in both the community and health system settings. Recent efforts, such as co-dispensing naloxone with opioid prescriptions, naloxone training programs, and approval of naloxone to be over-the-counter, have been implemented in hopes to better control the opioid epidemic. Despite the efforts to make naloxone more accessible, there are still some barriers to overcome such as lack of training, cost, stigma, and patient refusal. This review aims to explore the contributions pharmacists have made thus far and define the barriers that still have to be resolved.展开更多
Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no prop...Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.展开更多
This study focuses on seating arrangement and interpersonal distance as important aspects of nonverbal communication and aims to elucidate the optimal distance and angle between pharmacist and patient through an analy...This study focuses on seating arrangement and interpersonal distance as important aspects of nonverbal communication and aims to elucidate the optimal distance and angle between pharmacist and patient through an analysis based on the subjective evaluation of the patient and the objective evaluation of eye movements. Seven female simulated patients and one male and one female pharmacist cooperated as patients and pharmacists, respectively. The medication teaching scenes were set up with three pharmacist placements (face-to-face at 50 cm and 70 cm, 90-degree at 70 cm) and three hospital rooms (0-degree, 45-degree, 90-degree). Pupil diameter, blink rate, saccades, and fixation rate of the patient at each of these locations were measured using a Tobii Pro Glass 2. The patient’s subjective evaluation at each placement was also investigated using the conversation scale, which assesses the optimal distance for conversation. The results for the pharmacy setting revealed that pupils were significantly more mydriatic at the 50 cm point than at the other points. The results for the hospital room setting showed the greatest mydriasis at the 0-degree point. The result of the 50 cm point for the pharmacy setting and the 0-degree point for the hospital room setting was similar to that of the subjective evaluation. When the likelihood of saccades occurrence in the hospital room setting was compared, saccades were found to be most likely to occur when medication instructions were given to patients at the 0-degree point. We believe that using pupil diameter for interpersonal distance, and saccades for angle will enable more accurate determinations of the optimal distance and angle between pharmacist and patient. The results of the present study suggest that the 70 cm face-to-face point in the pharmacy and the 45-degree point in the ward may be suitable for medication instruction.展开更多
A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and ...A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and the trainee providing hospitals are all very high,among which the satisfaction of the training hospital is the highest.According to the results of the questionnaire, the most important training mode in the training hospitals＇ opinion is different from that in the trainees＇ opinion.Trainees prefer more initiative,practical,and participatory training and hope to learn from the wards round process,while the training hospitals are more inclined to group discussion and teaching.It＇s necessary to increase the number of eligible training hospitals, to implement one on one mentoring strategy in hospital pharmacist training,and to increase active learning in the training program. The result of this research would help to build more effective and efficient pharmacist training programs in Chinese hospitals.展开更多
The role of pharmacists in the management of neuropsychiatric disorders is an evolving area within healthcare, driven by the need for effective treatment options for mental illnesses affecting over 50 million American...The role of pharmacists in the management of neuropsychiatric disorders is an evolving area within healthcare, driven by the need for effective treatment options for mental illnesses affecting over 50 million Americans. This review examines the critical interventions provided by pharmacists to optimize treatment in neuropsychiatric disorders, emphasizing the multi-faceted nature of their contributions within healthcare teams. Pharmacists’ interventions include medication management, adherence, patient counseling, and other methods that support the prevention of adverse events, and they are key players in enhancing mental health care through collaborative practice models. Objectives: The primary objective of this review is to evaluate the impact of pharmacist-led interventions on patient outcomes in the management of neuropsychiatric disorders, exploring their roles in various settings and collaborative environments. Background: Neuropsychiatric disorders, which span both psychiatric and neurologic conditions, require comprehensive and integrated care approaches. Pharmacists are increasingly involved in medication management, patient education, and adherence strategies essential for managing these disorders effectively. Methods: A literature review was conducted to analyze studies examining pharmacist-led interventions in neuropsychiatric care, including adherence programs, medication reconciliation, adverse event monitoring, and pharmacogenomic applications. Articles were selected based on their focus on pharmacist interventions in community, hospital, and interdisciplinary settings. Results: Evidence suggests that pharmacist-led interventions improve adherence, optimize medication management, and contribute to reducing readmissions in patients with neuropsychiatric disorders. Key findings highlight the success of interventions such as patient counseling, pharmacogenomic-guided therapy, and collaborative care models, demonstrating improved outcomes across various settings. Conclusions: Pharmacists play a critical role in managing neuropsychiatric disorders through comprehensive medication management, patient education, and collaboration with other healthcare providers. Their involvement is essential for safe, effective, and personalized mental health care, underscoring the need to further integrate pharmacists in mental health services.展开更多
Based on the competency model building theory, a literature review, a behavioral event interview and statistical analysis were used in this study to build a competency model for pharmacists in China. The competency mo...Based on the competency model building theory, a literature review, a behavioral event interview and statistical analysis were used in this study to build a competency model for pharmacists in China. The competency model framework for pharmacists included five dimensions of characteristics, consisting of 25 competency elements of pharmacists, such as the general competency elements that all pharmacists should possess and outstanding competency elements that community pharmacists and hospital pharmacists should possess. This newly constructed competency model for pharmacists helped develop and cultivate the abilities of future Chinese pharmacists.展开更多
Background:This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship,in addition to identifying factors influencing their perception and practices in community ...Background:This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship,in addition to identifying factors influencing their perception and practices in community pharmacy.Methods:A cross-sectional study was carried out among community pharmacists regarding antimicrobial stewardship.Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad.In total,381 participants have completed the survey.Results:The majority of the participants(85.6%)strongly agreed/agreed that“antimicrobial stewardship programs reduce the problems of antibiotic resistance”;and 85.5%of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use.In addition,high percent of community pharmacists(88.4%)strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection-control programs in the health system.The total score of perception was significantly influenced by older age groups,postgraduate degrees,and experience of 6–10 years(p<0.001).This study also showed that 65.4%of pharmacists always/often advise patients to continue the full course of antimicrobials,and 64.9%of them reported always/often considering clinical and safety parameters before dispensing antibiotics.The role of pharmacists was significantly influenced by the younger age group,females,higher degree in pharmacy,experience of 3–5 years,and medical complex pharmacy(p<0.001).Conclusion:Community pharmacists have a good perception toward antimicrobial stewardship programs,but their role is still limited.More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.展开更多
In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreov...In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreover, we analyzed the plasma concentration of vancomycin in infants in the hospital from 2013 to 2014. Simultaneously, we also discussed the necessity of regular therapeutic drug monitoring of vancomycin in infants, and the important role of clinical pharmacists was further explored. The results showed that it was necessary to routinely monitor the therapeutic drug in infants. Clinical pharmacists performed medication monitoring, which improved the effectiveness of vancomycin and prevented its adverse effects. In addition, it is a new treatment model for the participation of clinical pharmacists in the clinical treatment.展开更多
In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly sele...In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.展开更多
Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practic...Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practice. Optimal therapeutic regimen was proposed, and pharmaceutical care and health education were provided based on the condition of each patient. By providing pharmaceutical care for cancer patients with their pharmacy knowledge, clinical pharmacists specialized in oncology can not only reduce the potential risks of chemotherapy, but also take into account of other accompanying diseases, thus improving the comprehensive treatment of patients. Furthermore, it deepened the understanding of the role of clinical pharmacy practice by patients and other medical workers. Involvement of clinical pharmacist in therapeutic practice could improve the outcome of pharmacotherapy.展开更多
A series of pharmacy services of clinical pharmacists at the Wuhan Mental Health Center during the prevention and treatment of Coronavirus disease 2019(COVID-19),such as participation in the formulation of COVID-19 pr...A series of pharmacy services of clinical pharmacists at the Wuhan Mental Health Center during the prevention and treatment of Coronavirus disease 2019(COVID-19),such as participation in the formulation of COVID-19 prevention and treatment plans suitable for psychiatric departments,popular science of pharmacy,medical order review,real-time intervention,and medication education are summarized here.Due to the sudden public health incident,the service model of psychiatric clinical pharmacists should be addressed,as clinical pharmacists are an important part of the diagnosis and treatment of psychiatric diseases.Among the majors currently available in the clinical pharmacy training base curriculum,no psychiatry major has been set up in China yet;therefore,in this paper,we provide guidance in psychiatry pharmacy for those who wish to integrate clinical teams.展开更多
Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-or...Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-oriented and patient-focused care providers. However, it is still unclear how to play the role of pharmacists and carry out the related work in the new situation. Here, literature for relevant evidence was searched and summarized. Analysis results showed that there was a significant gap between pharmacy practice in China and developed countries. Evidence has supported pharmacists in their emerging role as care providers, that is available to improve the efficacy and quality of pharmaceutical care and ensure the safety of medicines for patients, but still more efforts are needed to promote new attitude toward more professional career, such as paying attention to the examination of outpatient prescription and medical orders, deeply clinical practice and individualized treatment, self-enhancement and public awareness of pharmacists. Collectively, the safety of patients can be ensured only by improving profession of pharmacists and showing the value of pharmacists. In doing so, pharmacy can develop rapidly, and pharmaceutical care with rational drug use can be realized.展开更多
To quantify drug-drug-interactions (DDIs) encountered in patients prescribed hepatitis C virus (HCV) treatment, the interventions made, and the time spent in this process.METHODSAs standard of care, a clinical pharmac...To quantify drug-drug-interactions (DDIs) encountered in patients prescribed hepatitis C virus (HCV) treatment, the interventions made, and the time spent in this process.METHODSAs standard of care, a clinical pharmacist screened for DDIs in patients prescribed direct acting antiviral (DAA) HCV treatment between November 2013 and July 2015 at the University of Colorado Hepatology Clinic. HCV regimens prescribed included ledipasvir/sofosbuvir (LDV/SOF), paritaprevir/ritonavir/ombitasvir/dasabuvir (OBV/PTV/r + DSV), simeprevir/sofosbuvir (SIM/SOF), and sofosbuvir/ribavirin (SOF/RBV). This retrospective analysis reviewed the work completed by the clinical pharmacist in order to measure the aims identified for the study. The number and type of DDIs identified were summarized with descriptive statistics.RESULTSSix hundred and sixty four patients (83.4% Caucasian, 57% male, average 56.7 years old) were identified; 369 for LDV/SOF, 48 for OBV/PTV/r + DSV, 114 for SIM/SOF, and 133 for SOF/RBV. Fifty-one point five per cent of patients were cirrhotic. Overall, 5217 medications were reviewed (7.86 medications per patient) and 781 interactions identified (1.18 interactions per patient). The number of interactions were fewest for SOF/RBV (0.17 interactions per patient) and highest for OBV/PTV/r + DSV (2.48 interactions per patient). LDV/SOF and SIM/SOF had similar number of interactions (1.28 and 1.48 interactions per patient, respectively). Gastric acid modifiers and vitamin/herbal supplements commonly caused interactions with LDV/SOF. Hypertensive agents, analgesics, and psychiatric medications frequently caused interactions with OBV/PTV/r + DSV and SIM/SOF. To manage these interactions, the pharmacists most often recommended discontinuing the medication (28.9%), increasing monitoring for toxicities (24.1%), or separating administration times (18.2%). The pharmacist chart review for each patient usually took approximately 30 min, with additional time for more complex patients.CONCLUSIONDDIs are common with HCV medications and management can require medication adjustments and increased monitoring. An interdisciplinary team including a clinical pharmacist can optimize patient care.展开更多
基金supported by Sanming Project of Medicine in Shenzhen(No.SZZYSM202411012)Beijing Clinical Key Specialty Project(2023).
文摘Community-acquired pneumonia(CAP)in adults(≥18 years old)is the most common infectious disease encountered in emergency departments.Its clinical complexity and the need for prompt treatment decisions pose significant challenges for patient management.The physician-pharmacist collaborative management(PPCM)model,which optimizes drug therapy regimens through collaboration between physicians and clinical pharmacists,has demonstrated strong clinical value in practice.However,the lack of standardized national guidelines for the application of the PPCM model in emergency departments in China has hampered its widespread adoption.This guideline is developed based on evidence-based medicine and clinical practice experience,with a focus on the application of the PPCM model in the management of CAP in emergency settings.It outlines the significance of the PPCM model,its applicable scenarios,the respective roles of emergency physicians and clinical pharmacists,and its practical implementation in the antimicrobial treatment of CAP patients.In addition,the guideline proposes standardized implementation processes and clinical pathways.By promoting the PPCM model,the expert panel aims to standardize the use of antimicrobial agents in the emergency treatment of CAP,reduce the risk of antimicrobial resistance,and improve patient outcomes.
基金supported by Social Policy Grant through Nazarbayev University,Kazakhstan.
文摘Objectives:Emotional exhaustion among healthcare professionals,particularly pharmacists,significantly impacts their well-being and efficacy in patient care.Understanding the psychological mechanisms contributing to emotional exhaustion is essential for developing effective interventions.The present research sought to investigate the potential mediating roles of rumination and coping strategies(adaptive and maladaptive)in the relationship between perceived stress and emotional exhaustion among pharmacists.Methods:A cross-sectional survey was carried out between September 2023 and January 2024 involving 576 pharmacists working in public hospitals in Punjab who met the inclusion criteria and actively participated in the study.We employed the Perceived Stress Scale,the Ruminative Response Scale,the Brief Coping Orientation to Problems Experienced Inventory(COPE),and the Oldenburg Burnout Inventory(OLBI)to assess the hypothesized study model.Path analysis was employed to test the hypothesized mediation model,incorporating simple and chain mediation processes.Results:The findings provided empirical evidence supporting a positive association between perceived stress and emotional exhaustion.Rumination significantlymediated this relationship.Further,both adaptive andmaladaptive coping strategieswere found tomediate this relationship,withmaladaptive coping demonstrating amore substantial impact.Conclusion:The chainmediation model demonstrated that rumination and coping strategies(both maladaptive and adaptive)significantly mediate the relationship between perceived stress and emotional exhaustion among pharmacists.Specifically,rumination was found to be a key mediator,with maladaptive coping strategies having a more substantial impact.These findings provide a deeper understanding of the psychological mechanisms contributing to emotional exhaustion in the pharmacy profession.
文摘Background:Precision medicine(PM)has taken center stage in healthcare since the completion of the genomic project.Developed countries have gradually integrated PM into mainstream patient management.However,Nigeria still grapples with wide acceptance,key translational research and implementation of PM.This study sought to explore the knowledge and attitude of PM among pharmacists as key stakeholders in the healthcare team.Methods:A cross‐sectional study was conducted in selected tertiary hospitals across the country.A 21‐item semi‐structured questionnaire was administered by hybrid online and physical methods and the results analyzed with Statistical Package for the Social Sciences Version 25.Descriptive statistics were used to summarize the data.A chi‐square test was employed to determine the association of knowledge of PM and the sociodemographic characteristics of the study population.Results:A total of 167 hospital pharmacists participated in the study.A high proportion of the participants are familiar with artificial intelligence(91.75%),Pharmacogenomics(84.5%),and precision medicine(61%).Overall,38.9%of the pharmacists had a good knowledge while 13.2%had a poor knowledge of PM and associated terms.The level of knowledge did not correlate significantly with gender(X^(2)=3.21,p=0.201),age(X^(2)=5,p=0.27),marital status(X^(2)=3.21,p=0.201),and professional level(X^(2)=6.85,p=0.144).The most important value of precision medicine to hospital pharmacists is the ability to minimize the impact of disease through preventive medicine(49%)while a large portion are pursuing and or actively planning to pursue additional education in precision medicine.Conclusions:There is a highly positive attitude toward the prospect of PM among hospital pharmacists in Nigeria.Education modules in this field are highly recommended as most do not have a holistic knowledge of terms used in PM.Also,more research aimed at translating PM knowledge into clinical practice is recommended.
文摘Objective:The evolving landscape of healthcare delivery emphasizes the importance of collaborative relationships between healthcare professionals.Community pharmacists and nurses,though traditionally occupying distinct roles,are increasingly working together to provide comprehensive,patient-centered care.Methods:This review explores the collaborative relationship between community pharmacists and nurses,focusing on their unique contributions to chronic disease management,patient education,and medication adherence.The article analyzes existing literature and highlights key interdisciplinary strategies that enhance patient outcomes.Results:By integrating their expertise,pharmacists and nurses can improve health outcomes by addressing both the physical and psychosocial needs of patients.Their collaboration enhances the effectiveness of chronic disease management,promotes early interventions,minimizes medication errors,and fosters improved patient adherence to treatment plans.Conclusions:The findings underscore the need for structured,proactive collaboration models that go beyond independent roles to foster a truly synergistic healthcare environment.Strengthening these interdisciplinary partnerships is crucial for achieving more efficient,holistic,and timely healthcare delivery.
文摘Objective:To explore the target management model for clinical pharmacists in primary hospitals facing current shortages of clinical pharmacists,in order to improve the work efficiency and service quality of clinical pharmacy,and promote the high-quality development of clinical pharmacy in primary hospitals.Methods:Developing a target management model,adopting a wide coverage work model of“1+1+N”(that is,1 clinical pharmacist,1 resident clinical department,and N contracted clinical departments).According to the SMART principle,various work assessment indicators were quantified.This involved setting clear work goals,diversifying work methods,personalizing work methods,standardizing workflows,and using numerical assessment indicators.Regular supervision,inspection,feedback,and improvement mechanisms were implemented.Results:The implementation of the target management model has made the work effectiveness of clinical pharmacists visualized.There were more than 200 annual consultations and multidisciplinary team(MDT)cases,with an opinion adoption rate of 90.2%and a patient improvement rate of 80.6%.More than 1500 rational drug use interventions were conducted,with a suggestion adoption rate of 83.5%.In terms of pharmaceutical indicators control.The intensity of antibacterial drug use in 2024(without CMI adjustment)was 30.07 DDDs,significantly lower than the 2023 value of 33.54 DDDs,and also significantly lower than the provincial average(32.87 DDDs)and the average for hospitals of the same level(32.49 DDDs).The daily usage of intravenous infusion per bed for hospitalized patients was 2.09,a decrease from 2.15 in 2023,significantly lower than the provincial average of 2.71 and the average of 2.56 in hospitals of the same level.The amount of the second batch of national key monitoring drugs accounts for the value was 6.48%,significantly lower than the provincial average of 8.27%and the same level hospital average of 8.82%.In terms of chronic disease pharmaceutical management,taking the pharmaceutical management of patients with chronic heart failure as an example,the usage rates of renin-aldosterone-angiotensin-system inhibitors(RAAS inhibitors)and beta-blockers for heart failure in the management group were 87.88%and 80.81%,respectively,significantly higher-1 than those in the control group(62.22%and 65.56%).Heart rate in the management group(69.54±10.68 times·min-1)was significantly lower than in the control group(80.04±17.68 times·min)(P<0.001).The low-density lipoprotein cholesterol(1.69±0.57 mmol·L-1)was significantly lower than the control group(1.95±0.77 mmol·L-1)(P<0.001),and the 1-year readmission rate was 47.47%,significantly lower than the control group 56.67%.The Minnesota Living with Heart Failure Questionnaire(MLHFQ)Score was(44.20±10.78),significantly lower than the control group(55.89±11.48)(P<0.001),indicating a significant improvement in the patient’s quality of life.Conclusions:The targeted management model for clinical pharmacists can effectively enhance communication and collaboration between clinical pharmacists and clinicians,improve the work efficiency and service quality of clinical pharmacists in primary hospitals,promote the work of clinical pharmacy towards standardization and scientificization,boost the high-quality development of pharmacy in primary hospitals,and also provide new ideas and methods for the management of clinical pharmacists in other primary hospitals.
文摘The aim of this study is to discipline construction in our hospital.The Delphi method was used to construct the constituent elements and specific connotations of the core competence of HCPs,and the analytic hierarchy process(AHP)was used to determine the index weight.A total of 19 experts were included,all with intermediate or higher professional titles.The positive coefficients of experts in the two rounds of consultation were all 100%.The judgment basis of experts is 0.895,the degree of familiarity is 0.842,and the coefficient of authority is 0.868.The Kendall harmony coefficients of the first,second,and third-level indicators were 0.381,0.383,and 0.320,respectively.The expert coordination degree was tested by x^(2) test,the P values were all less than 0.05,indicating that the degree of expert coordination was well.After two rounds of letter inquiry,an evaluation index system of core competence of HCPs with professional accomplishment,theoretical knowledge,basic skills,professional skills,and professional development ability as the main framework was formed,including 5 first-level indicators,18 second-level indicators,and 62 third-level indicators.Based on the Delphi and AHP methods,the index system of HCPs'core competence established has high authority and scientificity,to provide the theoretical basis for the standardized training and comprehensive evaluation of HCPs.
基金Cetteétude aétéréalisée grâce au soutien financier de la Fondation de France (numéro d’engagement 00101618).
文摘The need for home palliative care is increasing in allWestern countries.Community pharmacists are local professionals whose role in end-of-life care at home remains poorly understood.The aim of this study is to understand how community pharmacists see their role in end-of-life home care in France,and to analyze their experiences of this care.An online questionnaire was distributed to community pharmacists working in France between December 2022 and March 2023.Of the 136 respondents to the questionnaire,87%had accompanied at least one patient at the end of life in the 3 months preceding the survey.Therapeutic education(88%of respondents),psychological support for caregivers(85%of respondents),securing treatment(82%of respondents)and monitoring therapeutic compliance(80%of respondents)are the behaviors validated by the greatest number of participants.The majority of professionals surveyed had a positive overall experience of managing patients at the end of life.These results pave the way for pharmacists to better support end-of-life patients at home.
文摘The opioid epidemic in the United States continues to take the lives of many individuals, with overdoses continuing to rise every year. Naloxone is an opioid antagonist that is efficacious in temporarily reversing opioid overdoses. Pharmacists play an important role in the accessibility and education of naloxone in both the community and health system settings. Recent efforts, such as co-dispensing naloxone with opioid prescriptions, naloxone training programs, and approval of naloxone to be over-the-counter, have been implemented in hopes to better control the opioid epidemic. Despite the efforts to make naloxone more accessible, there are still some barriers to overcome such as lack of training, cost, stigma, and patient refusal. This review aims to explore the contributions pharmacists have made thus far and define the barriers that still have to be resolved.
文摘Background: The increasing use of non-steroidal anti-inflammatory drugs (NSAIDs) both on prescription and over the counter raises a major global health concern because of the risks associated with their use if no proper guidance is given by the health care provider. This study assessed the roles of community pharmacists in screening and disseminating information about the risks associated with NSAID use in Zambia. Methodology: This was a national cross-sectional study in which a structured self-administered questionnaire was administered to 245 registered community pharmacists in Zambia. Stata/BE, version 15.1 (Stata Corporation, College Station, Texas, USA) and multivariate logistic regression model was used to determine factors associated with information dissemination about ADRs of NS-NSAIDs. Results: 231 of the 245 distributed questionnaires were returned giving a response rate of 94.3%. All (100%) participating community pharmacists claimed to have practiced dispensing NSAIDs. However, only 26 (11.0%) and 71 (30.8%) regularly screened for risk factor of selective COX-2 NSAIDS (SC2-NSAIDS) and non-selective NSAIDS (NS-NSAIDs) respectively. Information dissemination on adverse drug reactions (ADRs) of SC2-NSAIDS was regularly provided by only 22 (9.5%) of pharmacists while that of NS-NSAIDs was regularly provided by 49 (21.2%). In the multivariate logistic regression model, being the owner of a pharmacy (AOR: 5.4, CI: 1.84 - 16.4) was significantly associated with information dissemination about ADRs of NS-NSAIDs while an hour increase in the working hours per day (AOR: 0.9, CI: 0.64 - 0.95) was associated with less likelihood of information dissemination. Conclusion: Pharmacists working in community pharmacies in Zambia did not regularly screen and disseminate information about the risks associated with NSAID use. Therefore, pharmacists should be able to screen and monitor patients at risk and be aware of the majority of risk factors while dispensing NSAIDs to minimize the associated complications.
文摘This study focuses on seating arrangement and interpersonal distance as important aspects of nonverbal communication and aims to elucidate the optimal distance and angle between pharmacist and patient through an analysis based on the subjective evaluation of the patient and the objective evaluation of eye movements. Seven female simulated patients and one male and one female pharmacist cooperated as patients and pharmacists, respectively. The medication teaching scenes were set up with three pharmacist placements (face-to-face at 50 cm and 70 cm, 90-degree at 70 cm) and three hospital rooms (0-degree, 45-degree, 90-degree). Pupil diameter, blink rate, saccades, and fixation rate of the patient at each of these locations were measured using a Tobii Pro Glass 2. The patient’s subjective evaluation at each placement was also investigated using the conversation scale, which assesses the optimal distance for conversation. The results for the pharmacy setting revealed that pupils were significantly more mydriatic at the 50 cm point than at the other points. The results for the hospital room setting showed the greatest mydriasis at the 0-degree point. The result of the 50 cm point for the pharmacy setting and the 0-degree point for the hospital room setting was similar to that of the subjective evaluation. When the likelihood of saccades occurrence in the hospital room setting was compared, saccades were found to be most likely to occur when medication instructions were given to patients at the 0-degree point. We believe that using pupil diameter for interpersonal distance, and saccades for angle will enable more accurate determinations of the optimal distance and angle between pharmacist and patient. The results of the present study suggest that the 70 cm face-to-face point in the pharmacy and the 45-degree point in the ward may be suitable for medication instruction.
文摘A total of 626 questionnaires were collected and analyzed to study the current status of Clinical Pharmacist Pilot Training（CPPT）in Chinese hospitals.The training satisfaction of the training hospitals,trainees,and the trainee providing hospitals are all very high,among which the satisfaction of the training hospital is the highest.According to the results of the questionnaire, the most important training mode in the training hospitals＇ opinion is different from that in the trainees＇ opinion.Trainees prefer more initiative,practical,and participatory training and hope to learn from the wards round process,while the training hospitals are more inclined to group discussion and teaching.It＇s necessary to increase the number of eligible training hospitals, to implement one on one mentoring strategy in hospital pharmacist training,and to increase active learning in the training program. The result of this research would help to build more effective and efficient pharmacist training programs in Chinese hospitals.
文摘The role of pharmacists in the management of neuropsychiatric disorders is an evolving area within healthcare, driven by the need for effective treatment options for mental illnesses affecting over 50 million Americans. This review examines the critical interventions provided by pharmacists to optimize treatment in neuropsychiatric disorders, emphasizing the multi-faceted nature of their contributions within healthcare teams. Pharmacists’ interventions include medication management, adherence, patient counseling, and other methods that support the prevention of adverse events, and they are key players in enhancing mental health care through collaborative practice models. Objectives: The primary objective of this review is to evaluate the impact of pharmacist-led interventions on patient outcomes in the management of neuropsychiatric disorders, exploring their roles in various settings and collaborative environments. Background: Neuropsychiatric disorders, which span both psychiatric and neurologic conditions, require comprehensive and integrated care approaches. Pharmacists are increasingly involved in medication management, patient education, and adherence strategies essential for managing these disorders effectively. Methods: A literature review was conducted to analyze studies examining pharmacist-led interventions in neuropsychiatric care, including adherence programs, medication reconciliation, adverse event monitoring, and pharmacogenomic applications. Articles were selected based on their focus on pharmacist interventions in community, hospital, and interdisciplinary settings. Results: Evidence suggests that pharmacist-led interventions improve adherence, optimize medication management, and contribute to reducing readmissions in patients with neuropsychiatric disorders. Key findings highlight the success of interventions such as patient counseling, pharmacogenomic-guided therapy, and collaborative care models, demonstrating improved outcomes across various settings. Conclusions: Pharmacists play a critical role in managing neuropsychiatric disorders through comprehensive medication management, patient education, and collaboration with other healthcare providers. Their involvement is essential for safe, effective, and personalized mental health care, underscoring the need to further integrate pharmacists in mental health services.
文摘Based on the competency model building theory, a literature review, a behavioral event interview and statistical analysis were used in this study to build a competency model for pharmacists in China. The competency model framework for pharmacists included five dimensions of characteristics, consisting of 25 competency elements of pharmacists, such as the general competency elements that all pharmacists should possess and outstanding competency elements that community pharmacists and hospital pharmacists should possess. This newly constructed competency model for pharmacists helped develop and cultivate the abilities of future Chinese pharmacists.
文摘Background:This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship,in addition to identifying factors influencing their perception and practices in community pharmacy.Methods:A cross-sectional study was carried out among community pharmacists regarding antimicrobial stewardship.Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad.In total,381 participants have completed the survey.Results:The majority of the participants(85.6%)strongly agreed/agreed that“antimicrobial stewardship programs reduce the problems of antibiotic resistance”;and 85.5%of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use.In addition,high percent of community pharmacists(88.4%)strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection-control programs in the health system.The total score of perception was significantly influenced by older age groups,postgraduate degrees,and experience of 6–10 years(p<0.001).This study also showed that 65.4%of pharmacists always/often advise patients to continue the full course of antimicrobials,and 64.9%of them reported always/often considering clinical and safety parameters before dispensing antibiotics.The role of pharmacists was significantly influenced by the younger age group,females,higher degree in pharmacy,experience of 3–5 years,and medical complex pharmacy(p<0.001).Conclusion:Community pharmacists have a good perception toward antimicrobial stewardship programs,but their role is still limited.More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.
基金Shanghai Outstanding Young University Teachers Research and Special Funds(Grant No.ZZjdyx13089)Science and Technology Commission of Shanghai Municipality Grants(Grant No.12DZ1930404)
文摘In the present study, clinical pharmacists monitored the blood concentration of vancomycin in children in the Infant Ward from 2013 to 2014, and the drug dose was adjusted according to its plasma concentration. Moreover, we analyzed the plasma concentration of vancomycin in infants in the hospital from 2013 to 2014. Simultaneously, we also discussed the necessity of regular therapeutic drug monitoring of vancomycin in infants, and the important role of clinical pharmacists was further explored. The results showed that it was necessary to routinely monitor the therapeutic drug in infants. Clinical pharmacists performed medication monitoring, which improved the effectiveness of vancomycin and prevented its adverse effects. In addition, it is a new treatment model for the participation of clinical pharmacists in the clinical treatment.
文摘In the present study, we aimed to evaluate the intervention effect of prophylactic antibiotic use in thyroid surgery in a large hospital. From 2004 to 2012, 70 patients who underwent thyroid surgery were randomly selected each year. The quality of surgical antibiotic prophylaxis （SAP） was assessed each year in terms of antibiotic ratio, choice, duration, timing, combination, route of administration and so on. The result showed that the SAP ratio was 100% from 2004 to 2010. With our intervention, this SAP ratio was decreased to 45.7% in 2011, and it reached 2.9% in 2012. The AUD was consistently greater than 38 before 2010, while it rapidly declined to 1 in 2012. The number of DDDs per 100 operations was decreased from 431 to 3 after the intervention. The average cost of antibiotic drugs per patient was RMB 350.65 in 2010, whereas it was decreased to RMB 18.51 in 2012. The average duration of hospitalization showed no difference during the intervention. This study indicated that implementation of a multi-disciplinary protocol and clinical pharmacist interventions could improve the rational use of SAP.
基金Zhejiang Provincial Program for the Cultivation of High-level Innovative Health Talents(Grant No.2010-190-4)
文摘Clinical pharmacists specialized in oncology contributed to the safe and effective chemotherapy treatment for advanced esophageal carcinoma patients complicated with hypertension by participating in medication practice. Optimal therapeutic regimen was proposed, and pharmaceutical care and health education were provided based on the condition of each patient. By providing pharmaceutical care for cancer patients with their pharmacy knowledge, clinical pharmacists specialized in oncology can not only reduce the potential risks of chemotherapy, but also take into account of other accompanying diseases, thus improving the comprehensive treatment of patients. Furthermore, it deepened the understanding of the role of clinical pharmacy practice by patients and other medical workers. Involvement of clinical pharmacist in therapeutic practice could improve the outcome of pharmacotherapy.
基金Projects supported by National Natural Science Foundation of China(Project Number 81771445).
文摘A series of pharmacy services of clinical pharmacists at the Wuhan Mental Health Center during the prevention and treatment of Coronavirus disease 2019(COVID-19),such as participation in the formulation of COVID-19 prevention and treatment plans suitable for psychiatric departments,popular science of pharmacy,medical order review,real-time intervention,and medication education are summarized here.Due to the sudden public health incident,the service model of psychiatric clinical pharmacists should be addressed,as clinical pharmacists are an important part of the diagnosis and treatment of psychiatric diseases.Among the majors currently available in the clinical pharmacy training base curriculum,no psychiatry major has been set up in China yet;therefore,in this paper,we provide guidance in psychiatry pharmacy for those who wish to integrate clinical teams.
文摘Zero addition of drugs is an important aspect of medication reformation in the whole country, which is the end of the era of medicine. The role of pharmacists is changing from being medication dispensers to outcome-oriented and patient-focused care providers. However, it is still unclear how to play the role of pharmacists and carry out the related work in the new situation. Here, literature for relevant evidence was searched and summarized. Analysis results showed that there was a significant gap between pharmacy practice in China and developed countries. Evidence has supported pharmacists in their emerging role as care providers, that is available to improve the efficacy and quality of pharmaceutical care and ensure the safety of medicines for patients, but still more efforts are needed to promote new attitude toward more professional career, such as paying attention to the examination of outpatient prescription and medical orders, deeply clinical practice and individualized treatment, self-enhancement and public awareness of pharmacists. Collectively, the safety of patients can be ensured only by improving profession of pharmacists and showing the value of pharmacists. In doing so, pharmacy can develop rapidly, and pharmaceutical care with rational drug use can be realized.
文摘To quantify drug-drug-interactions (DDIs) encountered in patients prescribed hepatitis C virus (HCV) treatment, the interventions made, and the time spent in this process.METHODSAs standard of care, a clinical pharmacist screened for DDIs in patients prescribed direct acting antiviral (DAA) HCV treatment between November 2013 and July 2015 at the University of Colorado Hepatology Clinic. HCV regimens prescribed included ledipasvir/sofosbuvir (LDV/SOF), paritaprevir/ritonavir/ombitasvir/dasabuvir (OBV/PTV/r + DSV), simeprevir/sofosbuvir (SIM/SOF), and sofosbuvir/ribavirin (SOF/RBV). This retrospective analysis reviewed the work completed by the clinical pharmacist in order to measure the aims identified for the study. The number and type of DDIs identified were summarized with descriptive statistics.RESULTSSix hundred and sixty four patients (83.4% Caucasian, 57% male, average 56.7 years old) were identified; 369 for LDV/SOF, 48 for OBV/PTV/r + DSV, 114 for SIM/SOF, and 133 for SOF/RBV. Fifty-one point five per cent of patients were cirrhotic. Overall, 5217 medications were reviewed (7.86 medications per patient) and 781 interactions identified (1.18 interactions per patient). The number of interactions were fewest for SOF/RBV (0.17 interactions per patient) and highest for OBV/PTV/r + DSV (2.48 interactions per patient). LDV/SOF and SIM/SOF had similar number of interactions (1.28 and 1.48 interactions per patient, respectively). Gastric acid modifiers and vitamin/herbal supplements commonly caused interactions with LDV/SOF. Hypertensive agents, analgesics, and psychiatric medications frequently caused interactions with OBV/PTV/r + DSV and SIM/SOF. To manage these interactions, the pharmacists most often recommended discontinuing the medication (28.9%), increasing monitoring for toxicities (24.1%), or separating administration times (18.2%). The pharmacist chart review for each patient usually took approximately 30 min, with additional time for more complex patients.CONCLUSIONDDIs are common with HCV medications and management can require medication adjustments and increased monitoring. An interdisciplinary team including a clinical pharmacist can optimize patient care.
