Exploratory research in clinical and social pharmacy最新文献

{"title":"Deprescribing oral antidiabetics in elderly patients: Do electronic leaflets across the world address it?","authors":"Kitete Tunda Bunnel,&nbsp;Silvio José Elisei Carvalho Jr,&nbsp;Mariana Linhares Pereira,&nbsp;Renê Oliveira Couto,&nbsp;André Oliveira Baldoni","doi":"10.1016/j.rcsop.2024.100537","DOIUrl":"10.1016/j.rcsop.2024.100537","url":null,"abstract":"<div><div>Diabetes caused 6.7 million deaths in 2021, equating to one death every five seconds, with its global financial burden projected to rise from $1.32 trillion in 2015 to $2.12 trillion by 2030. Severe hypoglycemia necessitates interventions like deprescribing, behavioral strategies, and technology for prevention. Deprescribing aims to reduce unnecessary medication use, enhance rational prescribing, prevent prescribing cascades, and improve health outcomes in elderly patients. Evaluating electronic leaflets can support deprescribing based on patient-centered care and shared decision-making.</div></div><div><h3>Objective</h3><div>To analyze information on deprescribing in oral antidiabetic leaflets from national medicines regulatory authorities, focusing on elderly patients with type 2 diabetes.</div></div><div><h3>Methods</h3><div>This documental study analyzed electronic leaflets of oral antidiabetics from the official websites of nine Medicines Regulatory Authorities: Australia, Brazil, Canada, New Zealand, Singapore, South Africa, UK, USA, and EU, covering drugs listed in the WHO's Essential Medicines List 2023. The analysis focused on the alignment of deprescribing information with the Ontario deprescribing algorithm for oral antidiabetics developed by the Bruyère Institute in Canada.</div></div><div><h3>Results</h3><div>Out of 72 expected leaflets, 64 (88.9 %) were retrieved. Only 18 leaflets (28.1 %) explicitly discussed deprescribing oral antihyperglycemics. Hypoglycemia and drug interaction risks were addressed in 55 leaflets (85.9 %). Caution for use in patients over 65 was mentioned in 32 leaflets (50 %), and 23 leaflets (35.9 %) addressed the risks of tight glucose and HbA1c targets.</div></div><div><h3>Conclusion</h3><div>Despite a high retrieval rate, 11.1 % of leaflets were missing, and those available contained inconsistent deprescribing information. There are significant disparities in guidance across regulatory authorities. Standardized, updated leaflets that address deprescribing in frail older patients could enhance prescribers' confidence and support shared decision-making</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100537"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of pharmacist-led interventions in identifying and resolving drug related problems and potentially inappropriate prescriptions among rural patients: A pilot study","authors":"Salvador Gutiérrez-Igual ,&nbsp;Rut Lucas-Domínguez ,&nbsp;José Sendra-Lillo ,&nbsp;Alberto Martí-Rodrigo ,&nbsp;Isabel Romero Crespo ,&nbsp;M. Carmen Montesinos","doi":"10.1016/j.rcsop.2024.100536","DOIUrl":"10.1016/j.rcsop.2024.100536","url":null,"abstract":"<div><h3>Background</h3><div>Drug-related problems are a major problem that can lead to increased morbidity, mortality, and healthcare costs due to heightened medical visits, hospital readmissions, or emergency room visits. In rural areas, new tools for clinical pharmacy services, such as medication review, could decrease this problem.</div></div><div><h3>Objective</h3><div>To analyze the prevalence of clinically relevant drug-related problems (DRPs) and potentially inappropriate prescriptions (PIPs) identified by new medication review software (Revisem®) in rural pharmacies. The effectiveness of resolving DRPs and PIPs in patients who received pharmacist-led intervention (PLI) was also evaluated.</div></div><div><h3>Methods</h3><div>A prospective, multicenter, observational pilot study in 17 rural pharmacies from the Valencian region (Spain) was conducted over a period of 6 months. Revisem®, a type 1 medication review software, was developed and implemented to detect and resolve drug-related issues (DRPs and PIPs). The clinical history of 135 polymedicated patients was recorded, as well as the PLI conducted after the identification of incidences. The mean number of DRPs and PIPs before and after PLI were analyzed and compared.</div></div><div><h3>Findings</h3><div>A total of 1545 drug-related issues were detected in 135 patients (86 women). 1166 were DRPs and 379 were PIPs. Interactions were the most common incidence (43.7 %), with furosemide and omeprazole being the drugs with the highest number of significant interactions. In the before-after intervention study, the mean number of incidents detected per patient by Revisem® decreased from 9.7 ± 6.9 to 8.8 ± 6.9 (<em>p</em> &lt; 0.05) after PLI. Written reports were the most frequent means of communication between pharmacists and physicians (45.0 %). The acceptance rate of pharmacists' suggestions was 45.2 %.</div></div><div><h3>Conclusion</h3><div>The impact of pharmacist-led interventions in rural pharmacies allowed the detection of a high number of drug-related issues and significantly reduced the number of DRPs and PIPs, preventing negative health outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100536"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Professional pharmacy Services' outcomes performance measurement: A narrative review","authors":"Lígia Reis ,&nbsp;João Gregório","doi":"10.1016/j.rcsop.2024.100533","DOIUrl":"10.1016/j.rcsop.2024.100533","url":null,"abstract":"<div><h3>Background</h3><div>Professional pharmacy services are widely recognized for their role in promoting patient health and ensuring optimal medication therapy outcomes. Community pharmacies and pharmacists need to assess professional services' performance at patient level and demonstrate their value to stakeholders. To do so is important to understand which outcome performance indicators are currently being used and how added value is proven.</div></div><div><h3>Objective</h3><div>To identify performance indicators that measure patients' outcomes and demonstrate value of professional pharmacy services.</div></div><div><h3>Methods</h3><div>A narrative review was performed based on a systematic search in Pubmed and Scopus databases since year 2000. Manually search was also conducted in Google Scholar and <span><span>Google.com</span><svg><path></path></svg></span>. Inclusion criteria followed the PCC mnemonic in which Population is “community pharmacies”, Context is “pharmaceutical care, professional pharmaceutical services or pharmaceutical interventions” and Concept is “key performance indicators, or performance measures or clinical indicators”. English, Spanish or Portuguese language were accepted.</div></div><div><h3>Results</h3><div>All types of papers were included, adding up to a total of 12 papers. The publication of papers on this subject has increased in the last decade. Outcomes indicators identified were based in different frameworks, mainly linked to quality, and were clearly outlined. Disease and therapy management were the most evaluated services. Indicators were identified across 8 different domains corresponding, predominantly, to outputs rather than outcomes. Measurement is mainly conducted under the auspices of coalitions, alliances, government and payers reflecting their perspectives and based on easy-to-retrieve pharmacy data and information.</div></div><div><h3>Conclusions</h3><div>A paradigm shift is needed, so that performance indicators are based on more appropriate frameworks to measure patient level outcomes and value assignment of professional pharmacy services. By providing robust evidence of the impact of pharmacist interventions on patient outcomes, community pharmacists can advocate for the integration, expansion, and recognition of pharmacist-led services within the broader healthcare system.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100533"},"PeriodicalIF":1.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ReflACTION framework: A proposed model for implementation of clinical pharmacy services","authors":"Kérilin Stancine Santos Rocha ,&nbsp;Sabrina Cerqueira-Santos ,&nbsp;Genival Araújo dos Santos-Júnior ,&nbsp;Lincoln Marques Cavalcante-Santos ,&nbsp;Fernando de Castro Araújo-Neto ,&nbsp;Fernanda Oliveira Prado ,&nbsp;Giselle de Carvalho Brito ,&nbsp;Divaldo Pereira de Lyra-Jr.","doi":"10.1016/j.rcsop.2024.100534","DOIUrl":"10.1016/j.rcsop.2024.100534","url":null,"abstract":"<div><div>The implementation of clinical pharmacy services (CPS) has grown worldwide. However, few studies have used models and/or frameworks to facilitate the implementation process, especially in a low and middle-income countries. In addition, there are limitations in the ways that implementation frameworks are used. Therefore, this discussion aimed to propose and describe an approach using the ReflACTION framework. ReflACTION emerged from several years of systematic observation and experience of the Laboratory of Teaching and Research in Social Pharmacy (LEPFS) in implementing CPS in different settings of Brazilian health system. These experiences led the research group to systematize the implementation of CPS based on three theorical references: Paulo Freire's theoretical references, the Maguerez Arc and the Apoteca framework. The ReflACTION framework proposes five steps that starts and ends in the setting, which are: observation of reality; gathering key-points; theorization; solution hypothesis; and application to reality. All steps were carried out considering the determinants of the implementation process. For the present study, we highlight the importance of the implementation team, the involvement of stakeholders as well as their dialogue and awareness. Thus, we describe the operationalization process for each step. The ReflACTION framework can be used to describe and guide the implementation process of CPS. We expect the proposed framework may add knowledge to implementation science and, ultimately, achieve desired patient outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100534"},"PeriodicalIF":1.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent perspectives on the design, implementation, and use of the parent E-cigarette and vaping educational resource (P-EVER)","authors":"Olufunmilola Abraham ,&nbsp;Zachary Paulsen ,&nbsp;Evan Slonac ,&nbsp;Jenny Li","doi":"10.1016/j.rcsop.2024.100532","DOIUrl":"10.1016/j.rcsop.2024.100532","url":null,"abstract":"<div><h3>Background</h3><div>Adolescent use of e-cigarettes has been recognized as a significant public health concern as rates of adolescent vaping increase. As evidence of respiratory damage and other health concerns continue to emerge, educational resources for parents are critical in combating the vaping epidemic. A vaping educational tool can serve as a resource that parents of adolescents can reference to learn about e-cigarette use and how to address this topic with their families.</div></div><div><h3>Objective</h3><div>The purpose of this study was to examine parents' perspectives on the design and use of an educational infographic (Parent <em>E</em>-Cigarette and Vaping Educational Resource; P-EVER) to inform parents of adolescents and their families about e-cigarette use, risks, and quitting resources.</div></div><div><h3>Methods</h3><div>Parents who had an adolescent aged 12 to 18 years were recruited through community pharmacies in Wisconsin through recruitment fliers, emails, and word of mouth between February and June 2023. Participants reviewed the vaping educational handout in a semi-structured interview that was recorded and transcribed verbatim. Two members of the research team independently coded each transcript using NVivo software to conduct inductive thematic analysis. Bi-weekly meetings were held to refine codes, develop the master codebook, and identify prevalent themes (intercoder reliability - 0.83).</div></div><div><h3>Results</h3><div>Thirty-five parents were interviewed between February and June 2023. Four themes were identified: vaping awareness, P-EVER content and implementation, pharmacist's role, and barriers to pharmacist intervention on vaping. Participants believed the vaping educational handout was an effective resource for disseminating information to parents of adolescents. Responses highlighted the importance of providing educational resources to initiate conversations surrounding health risks to adolescents.</div></div><div><h3>Conclusion</h3><div>Pharmacists played a crucial role in successfully disseminating the P-EVER education tool to parents of adolescents. Future work is required to determine effective interventions for pharmacists and adolescents to discuss the topic of vaping awareness and safety.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100532"},"PeriodicalIF":1.8,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142538301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the social networks that contribute to diversion in hospital inpatient pharmacies: A social network analysis","authors":"Troy Francis ,&nbsp;Maaike de Vries ,&nbsp;Mark Fan ,&nbsp;Sonia Pinkney ,&nbsp;Reza Yousefi-Nooraie ,&nbsp;Mathieu Ouimet ,&nbsp;Valeria E. Rac ,&nbsp;Patricia Trbovich","doi":"10.1016/j.rcsop.2024.100530","DOIUrl":"10.1016/j.rcsop.2024.100530","url":null,"abstract":"<div><h3>Background</h3><div>Controlled substances (CS) are ‘diverted’ (stolen) from healthcare facilities via many integrated and diverse mechanisms due to a lack of safeguards. There remains a gap in understanding how healthcare workers (HCWs) leverage their social networks (e.g., their role/tasks and interactions with other roles/tasks) within the medication use process (MUP) that contribute to diversion. Social network analysis (SNA) is an analytic approach used to map and analyze social connections, which can help identify influential interdependence between HCWs and tasks susceptible to drug diversion.</div></div><div><h3>Objectives</h3><div>To map the social network structures of MUP tasks vulnerable to CS diversion in two Inpatient pharmacies and compare diversion risks by identifying influential tasks and HCWs.</div></div><div><h3>Methods</h3><div>This was an exploratory sequential mixed methods study conducted in the Inpatient pharmacies at two large hospitals in Toronto, Canada. Initial analysis used previously collected clinical observation data to identify key pharmacy roles and tasks vulnerable to CS diversion. Subsequently, a cross-sectional survey was conducted to collect demographic information on HCWs and assess their engagement in the identified vulnerable tasks. Clinical observations and survey data were used to perform two-mode SNA to identify connections between HCWs and tasks susceptible to drug diversion.</div></div><div><h3>Results</h3><div>The analysis identified different network structures across both sites but highlighted the importance of strategic Pharmacist or Technician Supervisor oversight to moderate-high vulnerability tasks. Pharmacy technicians were found to be the network's most central actors, while Pharmacists had a more supportive role on the network's periphery, providing oversight. Across both sites, there was strong connectivity between HCWs and tasks, indicating a higher level of security against potential undetected diversion.</div></div><div><h3>Conclusion</h3><div>By strategically involving Pharmacists or Technician Supervisors, diversion risk can be mitigated through cross-checking and quality control. Through identifying the network structure of each unit, hospitals can identify opportunities for future interventions to prevent diversion.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100530"},"PeriodicalIF":1.8,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and validation of an instrument to identify barriers to implementing pharmaceutical care","authors":"Luanna Gabriella Resende da Silva ,&nbsp;Rúbia Yumi Murakami Silva ,&nbsp;Mariana Linhares Pereira ,&nbsp;Maria Teresa Herdeiro ,&nbsp;André Oliveira Baldoni","doi":"10.1016/j.rcsop.2024.100529","DOIUrl":"10.1016/j.rcsop.2024.100529","url":null,"abstract":"<div><h3>Background</h3><div>Pharmaceutical Care is a professional practice in high demand for implementation in Primary Health Care within the Public Health System. Consequently, it was necessary to develop and validate an instrument to assess the obstacles to this process.</div></div><div><h3>Methods</h3><div>A methodological study was conducted in three stages: first, the questionnaire was developed based on the APOTECA framework, which includes Attitudinal, Political, Technical, and Administrative domains. Second, the content was validated using the Delphi Technique, with a content validity coefficient greater than or equal to 0.8 considered acceptable. Third, a pre-test was conducted with pharmacists working in Primary Health Care within the Public Health System. After validation, the instrument was administered to pharmacists participating in a training and support project for the implementation of Pharmaceutical Care.</div></div><div><h3>Results</h3><div>The results indicated that the instrument was validated after two rounds of evaluation, with the first round involving 33 experts achieving a total content validity coefficient of 96 %, and the second round involving 18 experts achieving a total content validity coefficient of 98 %. In the third stage, the pre-test with Primary Health Care pharmacists resulted in a total content validity coefficient of 91 %. The final version of the questionnaire, which incorporated suggestions for improvements, included 19 questions. When answered by pharmacists, the responses indicated that Technical questions were the most significant barrier to implementation, followed by Political, Attitudinal, and Administrative questions.</div></div><div><h3>Conclusion</h3><div>The validation of this instrument provides an important tool for identifying factors that hinder the implementation of Pharmaceutical Care within the Public Health System.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100529"},"PeriodicalIF":1.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploration of drug therapy related problems in a general medicine ward of a tertiary care hospital of Eastern Nepal","authors":"Rahi Bikram Thapa ,&nbsp;Prasanna Dahal ,&nbsp;Subash Karki ,&nbsp;Uttar Kumar Mainali","doi":"10.1016/j.rcsop.2024.100528","DOIUrl":"10.1016/j.rcsop.2024.100528","url":null,"abstract":"<div><h3>Background</h3><div>Inpatients are at higher risk of Drug Therapy Related Problems (DTRPs), and early identification and management of these DTRPs is crucial for optimal treatment outcomes and ensuring rational drug therapy.</div></div><div><h3>Objective</h3><div>This study aims to assess DTRPs in a general medicine ward of a tertiary care hospital in eastern Nepal.</div></div><div><h3>Methods</h3><div>A three-month prospective observational study was conducted on inpatients admitted to the general medicine ward of the hospital. Pharmacists routinely performed patient drug therapy reviews, by which suspected DTRPs were identified and recorded as per the Pharmaceutical Care Network Europe Association (PCNE) v.9.1 guidelines. Binary logistic regression analysis was used to determine the influence of predictor variables on the occurrence of DTRPs.</div></div><div><h3>Results</h3><div>A total of 301 inpatients were enrolled, out of which 233 (77.4%) had one or more DTRPs. Altogether, 528 DTRPs with an average of 2.27 ± 0.92 DTRPs per patient were identified. The primary causes of the DTRPs were drug selection (40.47%), treatment duration (16.71%), dispensing (15.75%), and dose selection (13.12%). Antimicrobials were involved in 55.18% of the DTRPs. DTRPs were more prevalent in elderly, comorbid patients, patients with longer hospital stay days, and polypharmacy, which was statistically significant (p&lt;0.05). Furthermore, multivariate binary logistic regression analysis showed that geriatric patients had a higher risk of experiencing DTRPs, with an adjusted odds ratio of 1.832 (1.021-3.286) at p-value &lt; 0.05.</div></div><div><h3>Conclusion</h3><div>DTRPs are frequently prevalent in hospital wards, emphasizing the crucial role of clinical pharmacists in identifying, resolving, and preventing DTRPs in inpatient settings for optimal treatment outcomes.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100528"},"PeriodicalIF":1.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142531953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving patient safety and access to healthcare: The role of pharmacist-managed clinics in optimizing therapeutic outcomes","authors":"Shabeer Ali Thorakkattil ,&nbsp;Sainul Abideen Parakkal ,&nbsp;K.T. Mohammed Salim ,&nbsp;Savera Arain ,&nbsp;Gopika Krishnan ,&nbsp;Hafees Madathil ,&nbsp;Ajmal Karumbaru Kuzhiyil ,&nbsp;Ammad Aslam ,&nbsp;Suhaj Abdulsalim ,&nbsp;Mahmathi Karuppannan ,&nbsp;Sathvik Belagodu Sridhar ,&nbsp;Javedh Shareef ,&nbsp;Mazhuvanchery Kesavan Unnikrishnan","doi":"10.1016/j.rcsop.2024.100527","DOIUrl":"10.1016/j.rcsop.2024.100527","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Contemporary patient care requires a multidisciplinary approach to monitoring, assessing, and managing diseases. Promoting multidisciplinary approaches encourages the purposeful participation of many healthcare professionals and harnessing their combined knowledge to provide tailored treatment plans. Pharmacists, skilled and knowledgeable professionals in medication management, drug-related problems, and disease prevention, can offer vital interventions that contribute to improved patient outcomes. Advances in healthcare and information technology have expanded pharmacists' professional roles and made them essential in healthcare. Pharmacist-managed clinics (PMCs), an innovative healthcare approach, could potentially improve patient safety, satisfaction, accessibility, and affordability to quality healthcare. Spread across the healthcare continuum, pharmacists have a well-defined role in providing comprehensive pharmaceutical care and interprofessional collaboration, further reinforcing the necessity of establishing PMCs. This narrative review aims to compile and summarize information on PMCs from PubMed, Scopus, Web of Science, and Google Scholar till December 2023. The PMC shortlist covers specialties such as cardiovascular, hematologic, endocrine, pain medicine, respiratory medicine, infectious diseases, gastrointestinal, nephrology, neurology, and oncology. Pharmacists in disease-specific PMCs have demonstrated improved treatment outcomes and access to specialty care. Additionally, based on peer-reviewed literature, the review also highlights how PMCs enhance the pharmacist's role in improving disease-specific outcomes, overall quality of care, and medication management. The inclusion criteria are randomized controlled trials, case-control studies, cohort studies, and pre-post studies involving patients from cardiology, hematology, endocrinology, pain medicine, respiratory medicine, infectious diseases, neurology, nephrology, gastroenterology, and oncology specialties, focusing on pharmacist-driven clinics, published in English, and covering any geographical location. The exclusion criteria include review articles, proposed models, commentaries, editorials, and those published in languages other than English. Our findings reveal that PMCs are underutilized globally. PMCs work better in developed countries, possibly on account of robust healthcare infrastructure, adequate healthcare budgets, availability of trained pharmacists, and supportive regulatory environments. The review found that pharmacist-led interventions, such as medication monitoring and patient education, significantly enhance therapeutic outcomes. Pharmacist Managed Clinics improve affordability and acceptability, expanding healthcare access in outpatient and inpatient settings. This review also highlights the critical need for implementing PMCs to improve healthcare delivery, particularly in providing comprehensive and accessible services in developing countries.&lt;/di","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100527"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11513600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy stakeholders' views and experiences of the credentialing of advanced or specialist pharmacist practice: A mixed methods systematic review","authors":"Evelyn Deasy ,&nbsp;Anna Seoighe ,&nbsp;Cristín Ryan ,&nbsp;Stephen Byrne ,&nbsp;Kieran Dalton","doi":"10.1016/j.rcsop.2024.100522","DOIUrl":"10.1016/j.rcsop.2024.100522","url":null,"abstract":"<div><h3>Background</h3><div>Credentialing of advanced and specialist pharmacist practice (ASPP) provides essential quality assurance for ASPP, which is significantly different to entry-level practice and is developing worldwide. Several credentialing models are in place or under development internationally. Synthesis of the views and experiences of pharmacists and other relevant stakeholders on credentialing is an important research gap.</div></div><div><h3>Objective(s)</h3><div>To determine pharmacy stakeholders' views and experiences of ASPP credentialing and to explore facilitators and barriers to credentialing implementation and uptake.</div></div><div><h3>Methods</h3><div>The Joanna Briggs Institute convergent integrated approach for mixed methods systematic reviews was followed. The review protocol was pre-registered with PROSPERO. Five electronic databases (Medline, CINAHL, Embase, Web of Science, Google Scholar) were searched from inception to August 2022 for qualitative, quantitative, or mixed methods studies that reported the views and experiences of pharmacy stakeholders on ASPP credentialing. The Mixed Methods Appraisal Tool was used to quality appraise included studies. Thematic synthesis was undertaken to analyse and integrate data from included studies. All screening and data analysis steps were performed by two reviewers independently, with additional author input where required.</div></div><div><h3>Results</h3><div>Sixty studies were included, after screening titles and abstracts (<em>n</em> = 9055) and full texts (<em>n</em> = 228). Studies represented the views of pharmacists, pharmacy managers/employers and professional/representative bodies in hospital, community pharmacy, general practice/primary care, and academic sectors, from 40 countries. Four analytical themes were generated describing the factors, including facilitators and barriers, to be considered when developing or optimising ASPP credentialing: I. Drivers of credentialing, II. Developing ASPP competence, III. Optimising credentialing implementation, and IV. Enhancing credentialing uptake.</div></div><div><h3>Conclusions</h3><div>This systematic review is the first to synthesise pharmacy stakeholders' views and experiences of ASPP credentialing. A conceptual framework highlights contextual factors, facilitators, barriers, and inter-relationships which should be considered by pharmacists, policymakers, and other key stakeholders when implementing ASPP credentialing.</div></div>","PeriodicalId":73003,"journal":{"name":"Exploratory research in clinical and social pharmacy","volume":"16 ","pages":"Article 100522"},"PeriodicalIF":1.8,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142659173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}