Research in Social & Administrative Pharmacy最新文献

Pharmacy regulation is undergoing a transformation away from prescriptive, bright-line rules toward a standard of care (SOC) framework. Unlike bright-line regulation that dictates specific tasks or thresholds, SOC regulation directs pharmacists to act within their education, training, and competence-mirroring the approach used in medicine and nursing. This model evolves naturally with scientific and clinical advancements, allowing pharmacists to implement new services without waiting for regulatory updates. States that have adopted SOC regulation, including Idaho, Iowa, and Alaska, show improved service innovation without compromising patient safety. This manuscript dispels common concerns related to SOC regulation. For example, fears that SOC is vague or permissive are unfounded; it reinforces accountability and empowers boards to sanction unsafe care based on professional judgment rather than outdated checklists. Further, SOC regulation modernizes pharmacy oversight, enabling a more responsive, evidence-based, and patient-centered practice. Adopting this model nationwide would align pharmacy with other health professions and better position pharmacists to meet contemporary healthcare needs for the betterment of patient care.

Background: Interprofessional collaborative care can be beneficial for managing chronic obstructive pulmonary disease (COPD) but may be difficult to implement in practice.

Objective: To map the evidence describing pharmacists' activities, the extent of collaboration, and the outcomes of collaborative pharmacist-physician care in individuals with COPD across healthcare settings.

Method: Scoping review according to the Arksey & O'Malley framework. A comprehensive search from January 2003 to August 2024 was conducted using Scopus, MEDLINE, Web of Science, Embase, and Google Scholar. Inductive analysis was used to organize pharmacist activities. Outcomes were organized according to the Economic, Clinical, Humanistic outcome (ECHO) model.

Results: Eighteen articles were included. Most studies originated from the USA (n = 11; 61%) and used observational research designs (n = 15; 83%) to evaluate outcomes. Studies were conducted in primary care clinics (n = 6; 33.3%), inpatient hospital wards, hospital-based outpatient clinics, and community pharmacies (n = 4 in each; 22%) and mostly involved pharmacist collaboration with family physicians and pulmonologists. The main pharmacist activities were: 1) Medication optimization (n = 16; 89%), 2) COPD monitoring (n = 18; 100%), 3) Screening and diagnosis (n = 4; 22%), and 4) Other activities (n = 12; 67%). Pharmacists were co-located with physicians in 12 studies (67%), and 8 (44.4%) studies scored high on collaboration (≥6 out of 10). Eleven studies (61%) reported 9 different clinical outcomes (e.g., COPD hospitalizations) and most studies reported improvements. Eight studies (45%) measured humanistic outcomes most commonly quality of life and symptoms using tools like the COPD assessment test (CAT) score and many studies reported no significant intervention effects. Seven studies (39%) measured economic outcomes and most reported cost savings (n = 7; 100%).

Conclusion: Pharmacists' activities, the extent of collaboration and outcomes of collaborative care varied. This information may help to support the implementation of new COPD-focused services. Further rigorously designed research is needed to explore the effect of collaborative community pharmacist-physician care in COPD management.