Integrated Pharmacy Research and Practice最新文献

Background: Pharmaceutical care (PC) has a significant impact on optimizing pharmacotherapy and improving patients' quality of life. We aimed to determine the attitudes and perceived barriers of final year pharmacy undergraduates towards provision of PC services in Nepal. Methods: A cross-sectional study was conducted among 232 students using a 13-item-standard PC attitude survey (PCAS) questionnaire and 12-itemed PC barrier questionnaires. Mann-Whitney U test and Kruskal-Wallis tests were used to measure the median difference between groups, at alpha=0.05, and Spearman's rho test was used to measure the strength of the correlation. Results: Majority of students were self-motivated in undertaking the current pharmacy education (178, 76.7%) and had no previous incomplete grades that could delay their graduation (177, 76.3%). Over 80% of students had a positive attitude toward all items of PCAS (agreed and strongly agreed) except for two items. Whereas, 61 (26.3%) disagreed and strongly disagreed that providing PC takes too much time and effort. The major barriers perceived were inadequate PC training (176, 75.9%), inadequate drug information resources in the pharmacy (170, 73.3%), and lack of access to patient medical records in the pharmacy (165, 71.1%). A significant relationship was noticed between positive attitude towards PC and three factors; source of motivation, current employment in pharmacy job, and incomplete grades delaying graduation. Age factor was significant but negatively correlated with the scores of positive attitudes namely "I would like to perform PC as a pharmacist practitioner", "Providing PC is professionally rewarding" and "I feel that the PC is the right direction for the provision to be headed". Conclusion: Nepalese undergraduate pharmacy students had positive attitudes toward PC. Exercising proper pharmacy practice regulations and educational efforts to overcome the perceived barriers may lead to better delivery of PC.

Background: Adverse drug event (ADE) errors are common and costly in health care systems across the world. Medication reconciliation is a means to decrease these medication-related injuries and increase quality of care. Research has shown that medication reconciliation accuracy and efficiency improved when pharmacists are directly involved in the process. Objective: We review studies examining how pharmacists impact the medication reconciliation process and we discuss pharmacists' future roles during the medication reconciliation process and then barriers pharmacy staff may face during this critical process. Methods: A comprehensive literature search from MEDLINE and manual searching of bibliographies was performed for the time period January 2012 through November 2018. Conclusion: Although the issue of rising costs and injury due to medication errors in our health care system are not solvable via medication reconciliation alone, it is the first and perhaps most critical piece of the medication management puzzle. As such, numerous organizations have called for pharmacists to expand their roles in the medication reconciliation process due to their expertise in medication management.

Purpose: Transitioning from being pharmacy students to pharmacists is challenging. Students need to reconcile their professional aspirations and what they have learnt with the realities of practice. A smooth transition can be hampered when they are unable to enact the role they have envisaged or if their expectations are not met. These challenges relate to professional identity. A key challenge for pharmacy educators is how best to support the professional identity formation (PIF) of pharmacy students. To assist with this challenge, we conducted a scoping review to identify factors influencing pharmacy students' PIF and pedagogical strategies to support PIF.

Methods: In September 2018, we undertook a scoping review of all contemporary research investigating pharmacy student PIF including all relevant qualitative, quantitative, theoretical, and gray literature. We searched eight databases for the review: MEDLINE, CINAHL, PsycINFO, Embase, Australian Education Index, PubMed, Scopus, and Web of Science. Literature published between January 2008 and September 2018 was reviewed and screened using inclusion/exclusion criteria. The selected articles were charted and thematically analyzed.

Results: We included 22 articles in the review. Studies generally concurred about the importance of attending to PIF throughout the whole pharmacy curriculum. Yet, those studies reporting on pharmacy students' professional identities found that students experienced challenges forming their identities. While several curriculum interventions supporting PIF have been implemented, these tended to be one-offs and there was an absence of interventions engaging key stakeholders including placement preceptors, other health professionals, and patients/consumers.

Conclusion: Supporting the formation of pharmacy students' professional identity, while recognized as an important goal for pharmacy education, requires further empirical inquiry. Pedagogical practices focused on identity formation including adopting an integrative curricular approach are required.

[This corrects the article on p. 91 in vol. 4, PMID: 29354523.].

Cardiovascular diseases (CVDs) are a leading cause of death globally. This article explores the evidence surrounding community pharmacist interventions to reduce cardiovascular events and related mortality and to improve the management of CVD risk factors. We summarize a range of systematic reviews and leading randomized controlled trials and provide critical appraisal. Major observations are that very few trials directly measure clinical outcomes, potentially owing to a range of challenges in this regard. By contrast, there is an extensive, high-quality evidence to suggest that improvements can be achieved for key CVD risk factors such as hypertension, dyslipidemia, tobacco use, and elevated hemoglobin A1c. The heterogeneity of interventions tested and considerable variation of the context under which implementation occurred suggest that caution is warranted in the interpretation of meta-analyses. It is highly important to generate evidence for pharmacist interventions in developing countries where a majority of the global CVD burden will be experienced in the near future. A growing capacity for clinical registry trials and data linkage might allow future research to collect clinical outcomes data more often.

Introduction: Cognitive impairment is a core feature and shows the highest impact on functional outcome in patients with schizophrenia. There have been no previous studies investigating the role of the pharmacist in a multidisciplinary team on cognitive outcomes in patients with schizophrenia.

Purpose: We evaluated the impact of pharmacist intervention on cognitive outcomes in patients with schizophrenia by focusing on anticholinergic discontinuation.

Patients and methods: A prospective, open-label, randomized, controlled study was conducted. Patients with schizophrenia were randomly assigned to either the pharmacist intervention or usual care groups. In the pharmacist intervention group, the pharmacist identified drug-related problems (DRPs) and provided a pharmacotherapy suggestion, while there was no intervention in the usual care group. The primary outcome was mean change from baseline of executive function by using Wisconsin Card Sorting Test (WCST) perseverative errors within the pharmacist intervention group at week 12.

Results: A total of 30 patients completed the study (13 in the pharmacist intervention group and 17 in the usual care group). WCST perseverative errors at the end of the study within the pharmacist intervention group improved significantly from baseline (P=0.003). DRPs at week 12 were reduced by 85.19% and 9.76% in the pharmacist intervention and usual care groups, respectively. The most common intervention was the discontinuation of anticholinergics in patients without extrapyramidal side effects.

Conclusion: Added-on pharmacist intervention in a multidisciplinary team could help to improve cognitive functions in patients with schizophrenia by reducing DRPs and optimizing the drug therapy regimen, especially for anticholinergic discontinuation.