Clinical pharmacy practice in an outpatient clinic.
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A simple, low-cost manual data retrieval system, which provides selective access to all patient cases monitored by pharmacists, is described. The system uses notched cards which are coded by clinical descriptors. The codes are based on a modification of the International Calssification of Diseases, Adapted, disease-diagnosis coding system. This multiple entry system is flexible and can be easily converted to a computer-based system.
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It is suggested that nursing homes, as opposed to hospitals, provide the pharmacist with one of the best opportunities to practice clinical pharmacy. Restraining forces to clinical pharmacy include the reluctance of other health professionals to accept the pharmacist in clinical roles, and inadequate reimbursement for monitoring services. These restraining forces are less prevalent in nursing homes. Further, the great reliance on drug therapy in nursing homes, coupled with regulations requiring the pharmacist to assume a drug monitoring role, create a favorable atmosphere for clinical pharmacy practice. The importance of documenting the benefits of clinical pharmacy service is discussed.
Clinical pharmacy is discussed in terms of its historical basis, current status and future trends. Topics covered include the origins and current scope of clinical pharmacy practice, controversial issues in clinical pharmacy practice and education, and the quest for quality in clinical pharmacy practice.
Literature reports of the contributions of clinical pharmacists to patient care are reviewed. The topics covered are: clinical pharmacist functions in the drug use process, specific clinical activities of clinical pharmacists, and specialty areas of clinical pharmacy practice. It is concluded that more research needs to be done on the effectiveness and legal basis of clinical pharmacy services, and that adequate methods of payment for clinical pharmacy services must be developed.
A step-by-step approach is outlined for obtaining third-party reimbursement for clinical pharmacy services separate from dispensing fees. The program is based on a patient-care philosophy rather than a cost-conscious philosophy. The steps in implementation of the program were: (1) a total commitment to the patient's health, (2) identification of patient needs that require clinical pharmacy expertise, (3) development of a patient training program, (4) presentation of a written proposal to the hospital administration, (5) presentation of the proposal to third-party agencies, (6) initiation of charges for the services, and (7) preparation of reports on the progress of the program. Third-party reimbursement covers pharmacist instruction of home therapy patients receiving antihemophilic factor, cytarabine, parenteral nutrition, calcitonin-salmon and injectable analgesics. Financial data based on one year's experience with the program show that savings far outweight the charges.
BACKGROUND: The global transition toward patient-centered pharmaceutical care has exposed structural disparities in ASEAN pharmacy workforce training and deployment. This review examines four research questions: how pharmacy education systems and accreditation standards differ across Indonesia, Malaysia, Thailand, the Philippines, and Singapore (collectively, the ASEAN-5); the extent to which pre-registration education influences clinical service scope and professional confidence; how education reform and regulatory change have shaped pharmacist clinical roles; and what barriers and enablers exist for regional qualification harmonization. METHODS: A systematic literature review following PRISMA 2020 was conducted. Searches of PubMed/MEDLINE and Scopus, supplemented by grey literature, were completed in May 2026. Of 78 unique records screened, 46 studies published between 2005 and 2026 met inclusion criteria. Quality appraisal used an adapted Mixed Methods Appraisal Tool; synthesis employed narrative thematic analysis. RESULTS: The five countries represent four structurally distinct pharmacy education architectures: Thailand's standardized six-year Doctor of Pharmacy with dual specialization tracks; four-year Bachelor of Pharmacy programmes in Malaysia and the Philippines with institutional variation; Indonesia's clinically underdeveloped system despite rapid expansion; and Singapore's four-year Bachelor of Pharmacy followed by a nationally mandated one-year pre-registration pathway. Evidence links deeper clinical training to broader practice scope, higher confidence, and improved patient outcomes. Reform produced uneven results: Thailand's PharmD transition improved clinical recognition but exposed deployment paradoxes; Singapore achieved the strongest training-to-practice alignment; Indonesia's health insurance reforms were not absorbed by an underprepared workforce; the Philippines lacks a national competency framework. No binding mutual recognition arrangement was identified; divergent qualification structures, incompatible accreditation systems, and an asymmetric evidence base remain the primary barriers. DISCUSSION: These findings indicate that clinical service scope is bounded less by national policy ambition than by the depth and clinical orientation of the pre-registration education that precedes it, and that credentialing reforms which outpace a health system's capacity to absorb new clinical roles, or the reverse, do not by themselves translate into expanded practice. CONCLUSIONS: Pharmacy education across the ASEAN-5 remains nationally distinct and clinically uneven. Clinical service scope is directly bounded by pre-registration education quality. No country has fully closed the education-practice gap. Regional harmonization requires national-level educational reform as a prerequisite.
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The development and operation of a pharmacy-based clinic providing specialized services to noncompliant patients is described. Physicians refer patients who are not complying with their medication regimens to the pharmacy. The pharmacist interviews the patient to determine the reasons for noncompliant behavior and to reinforce the need for taking medications as directed. Special packaging, such as unit-of-use, may be used to encourage compliance. Medication calendars also are employed. The program has yet to be evaluated fully, but it is concluded that the compliance clinic has permitted the growth of comprehensive pharmacy practice.
The needs for clinical pharmacy services in mental health facilities have been identified, and a general, applicable role model description, which already is in practice across the country, has been given. Examples of implementation methods for institutions and for ambulatory care facilities have been described. Many pharmacists, particularly more recent graduates, already possess the skills necessary to provide clinical services in mental health facilities. These developments signal an end to the developmental phase of clinical mental health pharmacy practice and a beginning to the implementation phase of clinical mental health pharmacy practice.
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BACKGROUND: Cultural concepts such as cultural intelligence, awareness, competency and safety are essential in guiding culturally responsive care in health professional practice. Pharmacist preceptors play a pivotal role in sharing both clinical and cultural safe practice with pharmacy students. Culturally responsive care can contribute to achieving health equity, which is especially important for Indigenous communities. AIM: To review literature on cultural concepts in pharmacist preceptorship practices, and how these concepts are taught and communicated to pharmacy students during experiential learning. METHOD: The systematic review followed the PRISMA 2020 guideline. Scopus, PubMed, and Google Scholar were used to identify articles specific to pharmacist preceptors and pharmacy students published between 2015 and 2025, and available in English. RESULTS: Three full-text articles met the inclusion criteria. Major themes and subthemes were identified; pharmacist preceptors lacked preparedness to teach cultural concepts, resulting in variability in preceptors' understanding of cultural concepts and confidence in fulfilling preceptor responsibilities, underutilised structured frameworks to guide students' learning, challenges with preceptorship due to limited resources and support, and the influence of preceptorship on student learning, which impacted students' learning and competency. CONCLUSION: Pharmacy students had minimal exposure to culturally informed pharmacist preceptorship. It is likely that pharmacist preceptors require country-specific educational resources to support culturally safe preceptorship. Future research is required to substantiate these findings, and to guide culturally responsive practice and promote equitable health outcomes in diverse populations.
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