[Improvement in the training of pharmacists at the pharmaceutical departments of medical schools (a model of skilled pharmacist)].
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Education, Pharmacy↗
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Factors associated with successful integration of pharmacists into residential aged care teams: A qualitative study.
BACKGROUND: Australia's Aged Care Onsite Pharmacist program aims to support quality use of medicines in residential aged care homes. This is a novel role introduced into existing teams in a complex environment. Factors associated with successful integration since implementation are currently unknown. AIM: This study aims to explore the perspectives of pharmacists and other stakeholders within aged care homes regarding successful integration of the novel aged care pharmacist service into healthcare teams. METHODS: A qualitative approach, using interpretive descriptive methodology, was used to explore perspectives. Semi-structured focus groups and interviews with pharmacists, nursing and care staff, allied health professionals, general practitioners, residents, and family members were undertaken. Data were collected via Zoom™, audio- and video-recorded, and transcribed verbatim. Two researchers undertook inductive thematic analysis to identify key themes. RESULTS: 30 participants across focus groups, focus-group interviews, interviews, and member-checking processes contributed. An overarching theme of proactivity and showing a genuine interest in others underpinned three key themes. Theme 1: Pharmacists needed to be seen, through physical presence and availability, as well as developing a distinct identity. Theme 2: Pharmacists needed to build trust, through collaboration in real time and demonstrating value. Theme 3: Pharmacists needed to develop an understanding of the aged care home environment, including social and contextual norms, as well as procedures, routines and roles. DISCUSSION: This research complements existing understandings of interprofessional collaboration and teamwork amongst healthcare professionals. Themes were interlinked; we used a sensitising framework, social cognitive theory, to present and explain the findings and interactions that can support pharmacist integration into existing teams. Aged care services should structure onboarding to prioritise early visibility, clarify roles and organisational needs, and foster in-person collaboration. Pharmacists should demonstrate proactivity and an authentic interest in all staff, residents and families.
Humans↗
Community pharmacists' perspectives on resupplying and prescribing contraceptives: a descriptive qualitative study in Australia.
OBJECTIVES: Australia has commenced implementing contraceptive resupply and prescribing by community pharmacists to improve equity in method access. This study aimed to investigate pharmacist's acceptability of hormonal contraceptive resupply and prescribing. METHODS: Participants were recruited via convenience sampling and had provided contraceptive counseling consistent with the ALLIANCE intervention (i.e. structured, patient-centered, effectiveness-based care) to women seeking the emergency contraceptive pill or presenting prescriptions for medical abortion medicines. This qualitative descriptive study was embedded within the ALLIANCE trial, whose process evaluation included semi-structured interviews with pharmacist participants. The interview guide, containing questions on pharmacists' views of the resupply and prescribing service, was reviewed by the ALLIANCE Trial Chief Investigators and piloted in June 2024 with the SPHERE Pharmacy Advisory Circle. Thirteen questions were developed using the Theoretical Framework of Acceptability (TFA). Two researchers conducted line-by-line coding using an iteratively refined codebook, with codes mapped to TFA constructs to examine operationalization in pharmacists' delivery of hormonal contraception. KEY FINDINGS: Although pharmacists (n = 24) perceived that the service could be cost- and time-saving to patients, they raised concerns of unintentionally removing general practitioner (GP)-led monitoring of patients and overstepping GPs' roles. While pharmacists felt confident in their expertise and generally supported the service, they expressed hesitation about initiating contraceptive prescriptions, for which they felt further training and access to comprehensive medical records were required. Additional barriers included increased workload pressures, lack of reimbursement, and inadequate staffing. CONCLUSIONS: Overall, providing a resupply service appears to be acceptable to community pharmacists because it relies on the GP's initial assessment but prescribing less so. However, evaluation is needed post-implementation to explore sustainability, feasibility, and long-term impact on patient outcomes.
contraception↗
Pharmacist as team leader for total parenteral nutrition therapy.
A total parenteral nutrition program in a 635-bed private nonteaching institution which uses the pharmacist as team leader is described. To initiate TPN therapy, the attending physician writes a request for a consulation with the pharmacist. Prior to initiation of TPN therapy, the pharmacist reviews the chart, conducts a physical and nutritional assessment of the patient, orders any laboratory tests needed for further assessment of the patient and uses these results to classify the patient's nutritional status. The pharmacist then writes all TPN-related orders, including orders for laboratory tests and nursing care. Communications between the pharmacist and the attending physician concerning the progress of the patient and TPN changes are conducted orally on rounds and via chart notes. The number of patients receiving TPN therapy has increased each year--from six patients during 1976, to 19 patients during 1977 and 54 in 1978. Of the two preventable complications that developed in these 79 patients, both were quickly resolved by the pharmacist. Physicians who, in the past, opted not to place patients on TPN because of lack knowledge or lack of a TPN consultant, now rely on the pharmacist for this service.
Florida↗
Pharmacists' knowledge and attitudes regarding monitoring the behaviors of children with learning disabilities.
The attitudes and knowledge of pharmacists in Nebraska regarding children's learning disabilities were surveyed by questionnaire. One hundred thirty-three pharmacists responded. The results were analyzed according to type of practice (community, chain and hospital) and age (20--30 years, 31--40 years, 41--50 years, and 51 years and over). The results indicate that pharmacists are being asked about learning disabilities. Overall, 53% of the pharmacists responding had been asked about learning disabilities by parents, physicians, teachers or others. No significant interactions were found between the type of practice and age, and no significant main effect for type of practice was found in the ANOVA results for knowledge scores or attitude scores. Even though there were no differences owing to age in pharmacists' knowledge of learning disabilities, age was found to have a significant effect on attitudes toward increased pharmacist involvement in monitoring behaviors of learning-disabled children; the younger groups had a more positive attitude. The pharmacist seems to have the knowledge and attitudes required to become more actively involved in monitoring the medications and behaviors of children with learning disabilities.
Adult↗
Pharmacist-managed patient assessment and medication refill clinic.
The effectiveness of a pharmacist in determining the appropriateness of prescription renewal for patients appearing at a hospital-based refill clinic was investigated. In part 1, data were collected on the clinic as it traditionally functioned with staff physicians evaluating the patients. In parts 2 and 3, data were collected with the pharmacist assuming the assessment function. In part 2, a physician reviewed the pharmacist's decisions before the patient left. In part 3, the pharmacist functioned without supervision and the physician reviewed patient records retrospectively. Physician agreement with the pharmacist's decisions was the primary criterion for determining effectiveness, and was found to be 99% in part 2, for a total of 105 patients. In part 3, physician agreement remained at the 99% level for a total of 106 patients. Patient waiting time was about the same in each part of the study because of clinic procedures beyond the pharmacist's control. A pharmacist can be cost-effective in this role if the task is combined with regular pharmaceutical functions.
Cost-Benefit Analysis↗
A systematic literature review of cultural concepts taught by pharmacist preceptors during pharmacy student experiential placements.
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.
Humans↗
Effectiveness of a specially trained pharmacist in a rural community mental health center.
Pharmacists having training in psychopharmacology and psychiatry are being specially trained to function in community mental health centers as a resource in psychopharmacology and to provide direct care to patients. Management information data over a 3-year period from eight rural mental health clinics indicate that these pharmacists can successfully maintain large numbers of stabilized psychiatric patients within their communities. The cost of a pharmacist's services is, conservatively, one-half that of a psychiatrist's services. A followup study of the stabilized and active aftercare outpatients in the 10-county rural area in which the 8 clinics are located revealed that those patients who received all their direct care from the pharmacist were functioning at a slightly healthier level than the other aftercare patients. The pharmacist's patients indicated that they were at least as satisfied with their care as were the aftercare patients who received care from other mental health professionals. If the results of this study can be generalized to other community mental health centers in rural areas, a pharmacist can provide services effectively when psychiatrists are inaccessible or unavailable or when funds for mental health professionals are limited.
Aftercare↗
Harvey A.K. Whitney lecture. The patient's pharmacist.
The concept of the patient's pharmacist, the clinical pharmacist who directs his efforts to the individual patient with prospective and concurrent drug use review, is discussed. A patient's pharmacist is familiar with the patient's medical and social history and his present health problems, and ensures that the patient's drug therapy is appropriate at all times. His knowledge base includes an understanding of the clinical use and actions of drugs, pharmacokinetics, optimum clinical response expected from drug therapy, monitoring and evaluating clinical response and communication skills for medication counseling. The patient information the pharmacist needs is discussed in detail. The pharmacist should record his patient care activities in the medical record; this record can serve as a basis for evaluating the pharmacist's activities.
Drug Information Services↗
Clinical toxicology consultation by pharmacists.
The functions of pharmacists in a clinical toxicology consultation service are described. Pharmacists provided three basic services in conjunction with poisonings treated by the emergency department of a children's hospital: (1) assisted with obtaining the history and assessment of the toxicologic proglems, (2) recommended a plan for rational management, and (3) discussed poison prevention with the parents of the victims. Pharmacists were consulted for 189 poisoning cases over a six-month period; 80% of the cases were attended at the bedside and the remainder were monitored by telephone. Drugs were involved in 58% of the patient exposures. Median time for the pharmacist to reach the emergency room after the patient's arrival was 5 to 10 minutes. Physicians and nurses rated the pharmacists' contributions favorably. These results suggest that pharmacists can play an important role in clinical toxicology.
Adolescent↗
Pharmacist monitoring of parenteral nutrition: clinical and cost effectiveness.
The effect of pharmacist involvement in total parenteral nutrient (TPN) therapy on patient outcome and cost of therapy was studied. Data from 26 patients who received standard TPN solutions without pharmacist monitoring (Group 1) were compared with those from 26 patients whose TPN therapy was individualized (by use of a minicomputer) and monitored by a pharmacist (Group 2). Six patients from each group who were 35 days of age or younger and who received TPN as the only caloric source for 8 to 20 days were compared for clinical response. Mean duration of TPN therapy increased form 12.3 +/- 9 days for Group 1 to 14.8 +/- 12 days for Group 2, and the TPN use rate for Group 2 was 31% above that for group 1. The mean daily charge for TPN was greater for Group 1 ($72.00) than for Group 2 ($50.18). The pharmacy's mean cost per course of TPN for Group 2 was $44.10 less than that for Group 1. The mean weight gain in Group 1 was significantly less (4 g/day) than that in Group 2 (17 g/day) (p less than 0.05) (for the six patients per group compared). Pharmacist monitoring of TPN reduced the pharmacy's costs and patient charges for TPN and improved the patients' clinical responses to TPN.
Child, Preschool↗
Pharmacist management of anticoagulant therapy in ambulant patients.
The development, operation, patient management protocol and teaching activities of a pharmacist-managed anticoagulant clinic for ambulatory patients are described. Pharmaceutical services provided in the ambulatory clinic include (1) contribution to the problem-oriented medical record; (2) patient education; (3) therapeutic response monitoring; (4) drug information; (5) drug distribution; and (6) inservice education. A pharmacist completes a medication history on initial visit; assesses and adjusts anticoagulant therapy based on physical examination, detection of adverse drug reactions and laboratory test results; schedules return clinic visits; provides patient education; and records, in the patient's medical record, the assessment and results of treatment. Treatment adjustments made by the pharmacist are based on an oral anticoagulant protocol and reviewed by the clinic cardiologist. The clinic serves as a teaching site for undergraduate pharmacy students, Doctor of Pharmacy students and hospital pharmacy residents. The anticoagulant clinic gives the pharmacist a unique opportunity to provide comprehensive pharmaceutical services, to establish effective, long-term professional relationships with ambulant patients and their families, and to foster interdisciplinary health team activities.
Anticoagulants↗
Evaluation of pharmacist management of streptococcal throat infections in a health maintenance organization.
A program within a health maintenance organization in which pharmacists were delegated the responsibility of treating and managing adult patients whose throat culture results were positive for group A, beta-hemolytic Streptococcus was evaluated. Results of 50 patients who received diagnostic throat cultures and treatment from internists, physician's assistants and nurse practitioners were compared with results of 58 patients treated and managed by pharmacists who followed procedures defined by physicians. Six hypotheses were tested with respect to the pharmacy program: (1) provider time is saved; (2) the time between throat culture and therapy initiation is shortened; (3) there are fewer return sick visits; (4) there are more reculture follow-up visits; (5) the medication regimen which exhibits a higher rate of cure (oral vs injection) is used more often; and (6) cost savings are realized. Hypotheses 1, 2 and 6 were supported by the results, 3 and 4 were possibly supported, and 5 was not testable. Pharmacists appeared to be as effective as the other practitioners in the management and treatment of streptococcal sore throat.
Adult↗
Patient package inserts and the pharmacist's responsibility.
Patient package insert regulations by the Food and Drug Administration are discussed, emphasizing the pharmacist's responsibility. The possible criminal and civil liability problems the pharmacist may face under the regulations are considered. Legal implications of alternatives to using PPIs provided by the manufacturer are presented. The prudent pharmacist will examine the alternatives, weighing the administrative, clinical and legal implications of the various approaches.
Legislation, Drug↗
Effect of a pharmacist-led mHealth app on adherence, quality of life, and glycaemic control in diabetes: A multicentre RCT.
AIMS: To evaluate whether CareAide®, a pharmacist-driven mHealth application, improves medication adherence, health-related quality of life (HRQoL), and glycaemic control in diabetes mellitus using structural equation modelling. METHODS: Pre-specified secondary analysis of the type 2 diabetes mellitus cohort from a 6-month multicentre open-label randomised controlled trial (N = 663) across three Malaysian hospitals. Adherence was assessed by MMAS-8 (subjective) and Proportion of Days Covered (PDC; pharmacy-verified). HRQoL was measured by AQoL-6D and EQ-5D-5 L. Structural equation modelling (SEM), Necessary Condition Analysis, and Importance-Performance Map Analysis (cIPMA) were applied. RESULTS: CareAide® produced large adherence gains (MMAS-8: 7.31 vs 5.55, d = 1.64; PDC ≥ 80%: 81.6% vs 33.0%; both p < 0.001). Early 3-month adherence was the strongest predictor of sustained 6-month adherence in both models (β std = 0.567 and 0.688; p < 0.001). AQoL-6D utility improved significantly (0.669 vs 0.618; d = 0.353, p < 0.001), driven by coping (d = 0.447) and relationships (d = 0.254) domains. HRQoL did not mediate adherence; gains were a direct independent benefit. The intervention effect on HbA1c was not statistically significant in the PDC-based SEM model (β =  - 0.333, p = 0.065); a group difference was, however, supported by baseline-adjusted ANCOVA (β =  - 0.41%, p = 0.002), and the complete-case comparison was non-significant (p = 0.153), so glycaemic findings warrant cautious interpretation. cIPMA identified the intervention as the primary optimisation target. CONCLUSIONS: CareAide® significantly improves medication adherence and psychosocial quality of life. Evidence for glycaemic benefit came from baseline-adjusted analysis (ANCOVA), though findings should be interpreted with caution given incomplete HbA1c data at one site. The first three months are the most critical period for pharmacist support. In this dataset, PDC appeared more sensitive than MMAS-8 to the HbA1c signal within 6 months, but this finding requires confirmation in longer studies with more complete HbA1c data. TRIAL REGISTRATION: ClinicalTrials.gov NCT06068309.
Aged↗
Fluphenazine outpatient clinics: a pharmacist's role.
Twenty-five schizophrenic outpatients were treated in a pharmacist-administered fluphenazine decanoate clinic for periods of up to 1 year. These patients had a significantly lower rehospitalization rate, a decrease in medication related side effects, and showed improvement in functional capacity. The results suggest that a pharmacist can be clinically beneficial to schizophrenic outpatients and may help to reduce the cost of treatment programs.
Adult↗
Strategy for increasing the demand for clinical pharmacists.
A strategy for increasing the demand for clinical pharmaceutical services in hospitals is described. The strategy consists of three steps: (1) Show that the overall quality of drug prescribing affects patient outcomes not only in a negative way but also in a positive manner; i.e., appropriate prescribing speeds recovery and minimizes the need for more expensive types of care; (2) show that the pharmacist can detect poor quality prescribing; and (3) show that after detecting poor quality prescribing, the clinical pharmacist can effectively intervene in the prescribing process to reduce inappropriate prescribing and improve patient outcomes.
Drug Prescriptions↗
Pharmacists expand their roles through clinical services.
This article highlights various educational forums that were held at the 13th annual Midyear Clinical Meeting of the American Society of Hospital Pharmacists. Among the areas covered by the article are justification for clinical pharmacy services, administrative considerations in a drug utilization review program, and the expanding role of the pharmacist in the emergency department.
Congresses as Topic↗