Physicians’ perceptions and attitudes toward clinical pharmacy services in urban general hospitals in China

Getting time and building trust: unveiling the systemic, relational, and personal factors influencing clinical pharmacy service implementation in South Africa, a qualitative study

BACKGROUND

While multidisciplinary teams with clinical pharmacists improve medication use and outcomes, their integration in South Africa faces limitations. A lack of dedicated positions and healthcare professionals' misunderstanding restrict ward activities and hinder full collaboration, limiting their potential to optimize patient care. This study addresses a gap by exploring how perceived healthcare professionals' understanding of clinical pharmacists' roles impacts their motivation and service implementation. Understanding these dynamics, particularly in resource-constrained settings, is crucial for optimizing integration and healthcare delivery.

METHODS

Adopting a constructivist approach, this qualitative study was conducted using focus group discussions. Through purposive sampling clinical pharmacists were recruited across South Africa's public healthcare sector. A semi-structured guide based on previous findings explored how the perceived understanding around clinical pharmacy impacts service delivery and work motivation. Transcripts were analyzed using thematic analysis, guided by the Self-Determination Theory framework. Thematic analysis employed an inductive approach, following an initial preliminary analysis of open and selective coding to develop a coding framework.

RESULTS

Clinical pharmacists (n = 16) reported various challenges impacting service implementation and motivation. Two main themes were identified: (1) Time: Dedicated ward time is crucial for both the proper implementation of clinical services, as well as the clinical pharmacists' motivation; and (2) Trust: Clinical pharmacists experience a lack of trust amongst healthcare professionals in the value of clinical pharmacy services. The themes illustrated mechanisms at work at three levels: systemic (lack of dedicated positions), inter-relational (healthcare professional's misconceptions), and personal (thwarted autonomy).

CONCLUSIONS

Systemic challenges, like the absence of official positions present the biggest obstacle, affecting support, scope of practice, and healthcare professional interactions. While systemic changes are crucial for full integration of clinical pharmacists, in resource-constrained settings fostering autonomous motivation is equally important. This study emphasizes the need for a multi-faceted approach, including policy changes, international collaboration, interprofessional education, and interventions to empower clinical pharmacists for proactive service delivery. By addressing these interconnected challenges, healthcare systems can leverage the full potential of clinical pharmacists, ultimately improving healthcare delivery and patient outcomes.

Yemeni Physicians' Attitudes and Perceived Barriers Toward Ward-Based Clinical Pharmacist in Hospital Settings

Background

Clinical pharmacy services (CPSs) are still in their infancy in Yemen. Furthermore, pharmacists are not members of a multidisciplinary healthcare team, so their responsibilities are limited to drug dispensing and marketing. This study examines physicians' attitudes and perceived obstacles regarding the inclusion of clinical pharmacists in hospital medical wards.

Methods

A descriptive observational study was carried out using a validated, self-administered bilingual questionnaire. The study's questionnaire was conducted among physicians in three leading hospitals. Those hospitals were at the forefront of establishing clinical pharmacy units and embracing clinical pharmacy services. Data were analyzed using descriptive statistics.

Results

Sixty-five responses were included. Our data results indicated that physicians believed the most important contributions for clinical pharmacists to improve patient care were "attending medical rounds", followed by "order review". About 75% of physicians showed positive attitudes toward the clinical pharmacist role. However, more than 70% of physicians believed that clinical pharmacists should leave patient care to other healthcare professionals and focus on drug products. Not enough clinical pharmacist staff working in the health center was considered the top perceived barrier (83.1%), followed by "clinical pharmacist responsibilities were not clearly defined" and "clinical pharmacist recommendations are not properly documented".

Conclusion

Strategies to expand clinical pharmacy services in Yemen should focus on several key areas. Protocols must be established to clearly outline the collaboration between clinical pharmacists and physicians. Additionally, fostering inter-professional relationships is crucial to overcoming resistance and increasing awareness and understanding of CPS adoption among healthcare team members.

What is impacting clinical pharmacists' participation in an interprofessional ward round: a thematic analysis of a national survey

The ward round (WR) is an important opportunity for interprofessional interaction and communication enabling optimal patient care. Pharmacists' participation in the interprofessional WR can reduce adverse drug events and improve medication appropriateness and communication. WR participation by clinical pharmacists in Australia is currently limited. This study aims to explore what is impacting clinical pharmacists' participation in WRs in Australian hospitals. A self-administered, anonymous national survey of Australian clinical pharmacists was conducted. This study describes the outcomes from qualitative questions which were analyzed thematically in NVivo-2020 according to Braun and Clarke's techniques. Five themes were constructed: "Clinical pharmacy service structure", "Ward round structure", "Pharmacist's capabilities", "Culture" and "Value". A culture supportive of pharmacist's contribution with a consistent WR structure and flexible delivery of clinical pharmacy services enabled pharmacists' participation in WR. Being physically "absent" from the WR due to workload, workflow, and self-perception of the need for extensive clinical knowledge can limit opportunities for pharmacists to proactively contribute to medicines decision-making with physicians to improve patient care outcomes. Bidirectional communication between the interprofessional team and the pharmacist, where there is a co-construction of each individual's role in the WR facilitates consistent and inter-dependent collaborations for effective medication management.

Doctor of pharmacy as a career option: a cross-sectional study exploring PharmD students and practitioners expectations in Jordan

OBJECTIVE

This study aimed to (1) investigate the expectations and preferences of PharmD students and practitioners regarding their role in the health care system, and (2) to contrast those expectations and preferences of PharmD practitioners with real-life practice in Jordan.

METHODS

Two cross-sectional descriptive questionnaires were used to collect data from PharmD students and PharmD practitioners in Jordan. A total number of 330 students and 280 practitioners were interviewed. The responses to all questions were encoded, entered, and summarized as frequencies and percentages or as means and standard deviations. Comparisons between groups were performed using Chi-square test. A p-value of < 0.05 was considered significant.

RESULTS

Both PharmD students and practitioners chose working as a clinical pharmacist in a hospital as their first-choice job. However, their second and third jobs choices were significantly different as practitioners opted for income as a main criterion for job selection. Interestingly, salary expectations by PharmD students were significantly higher than the reality as reported by PharmD practitioners. Both students and practitioners placed the work environment as the highest priority criterion for making a work choice on the work environment. In general, both students and practitioners agree on the ideal roles of PharmD graduate with the issues of prescribing and compounding responsibilities being the ones with the highest disparity between practitioners and students. Significant differences were found between the student's and practitioner's perceptions of the ideal role of a PharmD in and the current professional practice in Jordan.

CONCLUSION

Job preferences and salary expectations differ significantly between students and practitioners. Professional orientation of PharmD. students should be implemented to minimize misconceptions of their job nature, availability, and compensations. The fact that students do not prefer to work in a community pharmacy should be addressed by educational institutions and professional organizations. The prescribing and compounding responsibilities of pharmacists should be also emphasized in the curricula of pharmacy schools and worked in by professional organization to achieve optimal implementation in real-life practice.

Exploring the training of pharmacists oriented to the demands for clinical pharmacy services: from the perspective of physicians

BACKGROUND

To evaluate physicians' perceptions, experiences and expectations of clinical pharmacists in China from the perspective of physicians' demands, to improve the training of pharmacists.

METHODS

A cross-sectional survey involving physicians (except for primary physicians) was conducted from July to August 2019 in China. Using a field questionnaire, this study gathered data on descriptive information about the respondents and their perceptions, experiences and expectations of clinical pharmacists. Data were analysed descriptively using frequencies, percentages and mean. Several subgroup analyses using Chi-square tests were conducted to identify physicians' demands for clinical pharmacists in China.

RESULTS

A total of 1376 physicians from secondary and tertiary hospitals in China (response rate = 92%) participated. The majority of the respondents were comfortable with clinical pharmacists providing education to patients (59.09%) and detecting and preventing prescription errors (60.17%), but they appeared uncomfortable when asked about clinical pharmacists suggesting the use of prescription medications to patients (15.71%). Most respondents agreed that clinical pharmacists are a reliable source of general drug information (81.84%) instead of clinical drug information (79.58%). The majority of the respondents expected clinical pharmacists to be knowledgeable drug therapy experts (95.56%) and to educate their patients about the safe and appropriate use of medications (95.56%).

CONCLUSION

Physicians' perceptions and experiences were positively associated with the frequency of their interaction with clinical pharmacists. They had high expectations of clinical pharmacists as knowledgeable drug therapy experts. Corresponding policies and measures are needed to improve the education and training system of clinical pharmacists in China.

Understanding of healthcare professionals towards the roles and competencies of clinical pharmacists in South Africa

BACKGROUND

Incorporating clinical pharmacists in collaborative medical teams results in better patient treatment and health outcomes. In addition, the understanding of other healthcare professionals (HCPs) towards the role of clinical pharmacists can either facilitate or hinder the implementation and expansion of these services. The main distinction between pharmacists and clinical pharmacists lie in their different scope of duties. This study set out to explore other HCPs' understanding towards the role of the clinical pharmacists in South Africa, and to identify associated factors.

METHODS

An exploratory, survey-based, quantitative study was conducted. A survey assessing HCPs' understanding based on the competencies and role of a clinical pharmacist was distributed to 300 doctors, nurses, pharmacists and clinical pharmacists. An exploratory factor analysis was carried out to determine the construct validity of the measurement. Items were analysed for grouping into subscales through principal components analysis. Differences in the variable scores for gender, age, work experience and previous experience working with a clinical pharmacist were analyzed using independent t-tests. Analysis of variance was used to analyze differences in the variable scores for the different HCPs and the different departments of work in the hospital.

RESULTS

The factor analysis yielded two separate subscales, measuring HCPs' (n = 188) understanding towards the role of a clinical pharmacist, as well as the competencies of a clinical pharmacist. Doctors (85, n = 188) (p = 0.004) and nurses (76, n = 188) (p = 0.022), working in both surgical and non-surgical units, had significantly poorer understanding of the role of clinical pharmacists than clinical pharmacists (8, n = 188) and pharmacists (19, n = 188) (p = 0.028). Where specific clinical pharmacist activities were described, 5-16% of pharmacists were unsure whether an activity forms part of a clinical pharmacist's role. Over 50% of the clinical pharmacists disagreed that their role also includes pharmacist's activities, like stock procurement and control, pharmacy and administrative work, and hospital pharmacy-medication dispensing activities.

CONCLUSION

The findings highlighted the possible impact of role expectations and lack of understanding among HCPs. A standard job description with recognition from statutory bodies could promote other HCPs, as well as clinical pharmacists' understanding of their roles. Findings further suggested the need for interventions like interprofessional education opportunities, staff induction programmes and regular interprofessional meetings to foster acknowledgement of clinical pharmacy services, promoting the acceptance and growth of the profession.

Pain Physicians' Attitudes and Experiences Regarding Clinical Pharmacy Services in China: A National Cross-Sectional Survey

Purpose

Pharmacists are key members of the pain management interdisciplinary team in many developed countries. However, the implementation of clinical pharmacy services in pain management is impeded by the imbalance between the pain physicians and clinical pharmacists specializing in pain management in China. The purpose of this study was to elucidate the perceptions, expectations and current experience of Chinese pain physicians regarding clinical pharmacy services.

Patients and Methods

An anonymous, self-administered questionnaire was designed according to previously published studies with minor modifications and distributed online to 1100 pain physicians selected randomly in hospitals across all 31 provinces of mainland China in 2021. Data were analyzed using descriptive and inferential statistics.

Results

A total of 1071 valid questionnaires were included for analysis. The pain physicians were from all 31 provinces of mainland China and most of them were from tertiary hospitals holding an undergraduate degree. Among listed kinds of clinical pharmacy services, pain physicians were less comfortable with pharmacists treating minor illnesses (p < 0.001). Pain physicians' experiences with clinical pharmacy services were far less than their expectations (p < 0.001), which is in line with the results that most of pain physicians (65.9%) interacted with pharmacists at a frequency of less than once a week. Significant differences in the experiences were found among ages (p < 0.01) and among years of work experience (p < 0.05) of pain physicians. Pain physicians' expectations of pharmacists were positively correlated with their experiences with clinical pharmacy services (p < 0.001).

Conclusion

Pain physicians in China had positive perceptions and high expectations, but relatively low experiences regarding clinical pharmacy services. Expanding clinical pharmacist pain management credentialing and increasing pain physicians' exposure to clinical pharmacy services are favourable to support the interdisciplinary collaboration in pain management in China.

Perceptions of healthcare professionals and patients on the role of the pharmacist in TB management in Pakistan: A qualitative study

Background: Globally, tuberculosis (TB) is the second major cause of death from infectious diseases, particularly in developing countries. A multidisciplinary approach to the management of TB may help to curb the disease burden. Objective: The objective of this study was to outline the perceptions of healthcare professionals and patients regarding the potential role of pharmacists in TB management in Pakistan. Method: This was a large-scale qualitative study conducted at the Chest Disease Unit (CDU) of the Bahawal Victoria Hospital (BVH), Punjab, Pakistan. Data were collected through semi-structured interviews with physicians, pharmacists, and patients recruited using a mix of convenient and snowball sampling. The sample size was decided through standard saturation point criteria. All interviews were audio recorded and transcribed verbatim. The data were analyzed to draw conclusions using a thematic analysis approach. Results: Analysis of the data yielded 19 categories and seven themes. Physicians considered pharmacists qualified healthcare professionals, whereas patients considered them merely dispensers. Inventory management and dispensing of medicines were considered as major responsibilities of pharmacists. Physicians were extremely overburdened and wanted to delegate certain duties to pharmacists, subject to their prior extensive trainings. However, most of the physicians were unaware of the legal scope of pharmacy practice in Pakistan. With regard to the potential duties of pharmacists, physicians, pharmacists, and patients (patients-upon explaining the potential roles during the interview) endorsed monitoring, counseling, medicine brand selection, dose adjustment, inventory management, dispensing, and polypharmacy assessment as their potential roles. In view of all stakeholders, the rationale for integrating pharmacists in TB management included overburdened physicians, sub-standard patient care, medication safety issues, and patient dissatisfaction. The healthcare professionals highlighted that the major barriers to integrating pharmacists within the TB management system were limited interest of regulatory authorities and policy makers, followed by inadequate training and experience-driven questionable competency of pharmacists. Conclusion: The study participants acknowledged the potential role of pharmacists in TB management. However, it was emphasized that healthcare policy makers should devise strategies to overcome the underlying barriers before assigning medicine-related clinical roles to pharmacists.

Implementation and Evaluation of Clinical Pharmacy Services on Improving Quality of Prescribing in Geriatric Inpatients in Vietnam: An Example in a Low-Resources Setting

Purpose

Geriatric inpatients generally have a high risk of drug-related problems (DRP) in prescribing following hospital admission, which are likely to cause negative clinical consequences. This is particularly evident in developing countries such as Vietnam. Therefore, clinical pharmacy service (CPS) aims to identify and resolve these DRPs to improve the quality use of medicines in the older population following hospital admission.

Patients and Methods

The study was conducted as a prospective, single-center study implemented at a general public hospital in Hanoi. Patients aged ≥60 years with at least three chronic diseases admitted to the Internal Medicine Department between August 2020 and December 2020 were eligible to be enrolled. A well-trained clinical pharmacist provided a structured CPS to identify any DRP in prescribing for each patient in the study. Clinical pharmacist interventions were then proposed to the attending physicians and documented in the DRP reporting system.

Results

A total of 255 DRP were identified in 185 patients during the study period. The most frequent types of DRP were underuse (21.2%), dose too high (12.2%), and contraindication (11.8%). There was a very high rate of approval and uptake by the physicians regarding the interventions proposed by the clinical pharmacist (82.4% fully accepted and 12.5% partially accepted). Of the interventions, 73.4% were clinically relevant (pADE score ≥0.1). In general, 9 out of 10 physicians agreed that CPS has significant benefits for both patients and physicians.

Conclusion

Improving clinical pharmacy services can potentially have a positive impact on the quality of prescribing in elderly inpatients. These services should officially be implemented to optimize the quality use of medicines in this population group in Vietnam.

Factors influencing the degree of physician-pharmacists collaboration within governmental hospitals of Jigjiga Town, Somali National Regional State, Ethiopia, 2020

BACKGROUND

Collaboration is the way to deliver the desired health outcome for the patients or service users in the healthcare. Inter-professional collaboration can improve medication safety, patient outcome and minimize healthcare costs. This study aimed to explore the degree of collaboration and factors influencing collaboration between physicians and pharmacists within the public hospitals of Jigjiga town, Somali National Regional State, Ethiopia, 2020.

METHODS

A cross-sectional study qualitative was conducted among 149 participants in the two governmental hospitals of the Jigjiga town with a response rate of 79.87%. The collaborative working relationship model and the physician-pharmacist collaborative instrument with three main exchange domains (trustworthiness, role specification, and relationship initiation) and collaborative care items were used. An independent sample t-test was used to compute the differences of the mean scores of physician-pharmacist collaborative instrument domains and collaborative care. Separate multiple regression was employed to assess factors influencing collaborative care for pharmacists and physicians.

RESULTS

This study showed that pharmacists reported higher mean of collaborative care (10.66 ± 4.75) than physicians (9.17 ± 3.92). The multiple regression indicated that area of practice influence both professionals' collaborative practice. A significant association between collaborative care and the two PPCI domains (trustworthiness and relationship initiation for the physicians; role specification and relationship initiation for pharmacists) was established.

CONCLUSIONS

The study showed that the collaboration between the physicians and pharmacists was sub-optimal and the exchange variables had a significant influence on their collaboration.

RECOMMENDATION

Physicians and pharmacists need to exert more efforts to enhance this collaboration. Further qualitative study might be needed to search for factors affecting, barriers and how to develop collaborative practice.

Perceptions, Expectations, and Experience of Physicians About Pharmacists and Pharmaceutical Care Services in Pakistan: Findings and Implications

Background: Optimal collaboration between pharmacists and other healthcare professionals such as physicians is integral in implementing pharmaceutical care. However, there are concerns regarding the role of pharmacists, especially among low- and middle-income countries. This study explored the perceptions, expectations, and experience of physicians working in various hospital settings of Punjab, Pakistan, about pharmacists and their roles. Methods: A self-administered questionnaire consisting of four sections was administered from October to December 2020. Descriptive and inferential statistics such as Kruskal-Wallis and Mann-Whitney tests were used for data analysis using SPSS. Results: Six hundred and seventy-eight physicians participated in this study with a response rate of 77.9%. Most of the physicians reported minimal to no interaction with pharmacists (n = 521, 76.8%). However, more than three-quarters of physicians (n = 660, 97.3%) accepted pharmacists as evidence-based sources of drug information. In addition, many physicians (n = 574, 84.7%) strongly agreed that pharmacists should attend patient care rounds to respond promptly to questions related to patient medication. A limited number of physicians (n = 124, 18.3%) assumed that pharmacists were advising their patients regarding the judicial use of their drugs. Median expectation and experience score had a significant association with age, experience, and education of physicians (P < 0.05). Conclusions: The perception of physicians was positive toward certain roles of pharmacists, coupled with high expectations. However, their experience was low, with most of the activities of pharmacists due to inadequate interprofessional coordination.

Factors influencing the implementation of clinical pharmacy services on paediatric patient care in hospital settings

OBJECTIVES

This systematic review (SR) was undertaken to identify and summarise any factors which influence the implementation of paediatric clinical pharmacy service (CPS) from service users' perspectives in hospital settings.

METHODS

Literature search from EMBASE, MEDLINE, Web of Science (Core Collection), Cochrane Library, Scopus and CINAHL databases were performed in order to identify any relevant peer-reviewed quantitative and qualitative studies from inception until October 2019 by following the inclusion criteria. Boolean search operators were used which consisted of service, patient subgroup and attribute domains. Studies were screened independently and included studies were quality assessed using Mixed Methods Appraisal Tool. The study was reported against the 'Enhancing Transparency in Reporting the Synthesis of Qualitative Research' statement.

RESULTS

4199 citations were screened by title and abstract and 6 of 32 full publications screened were included. There were two studies that were graded as 'high' in quality, with four graded as 'moderate'. The analysis has led to the identification of seven factors categorised in five predetermined overarching themes. These were: other healthcare professionals' attitudes and acceptance; availability of clinical pharmacist on ward or outpatient settings; using drug-related knowledge to perform clinical activities; resources for service provision and coverage; involvement in a multidisciplinary team; training in the highly specialised areas and development of communication skills.

CONCLUSION

Evidence for paediatric CPS was sparse in comparison to a similar SR conducted in the adult population. An extensive knowledge gap within this area of practice has therefore been identified. Nevertheless, majority of the factors identified were viewed as facilitators which enabled a successful implementation of CPS in paediatrics. Further research is needed to identify more factors and exploration of these would be necessary in order to provide a strong foundation for strategic planning for paediatric CPS implementation and development.

Sierra Leonean doctors' perceptions and expectations of the role of pharmacists in hospitals: a national cross-sectional survey

Background The effective implementation of pharmaceutical care requires pharmacists' collaboration with other healthcare providers, especially doctors. However, doctor's perceptions and expectations may not be in line with the tasks and responsibilities of pharmacists. Objectives We aim to explore doctors' expectations and perceptions of pharmacists while working together in a multi-disciplinary team in Sierra Leone. Setting Twelve public hospitals in Sierra Leone. Method A national cross-sectional survey was conducted between July and September 2018. Anonymous self-administered questionnaires were distributed to all doctors at randomly selected public hospitals. Data were analyzed in Excel and SPSS using descriptive and inferential statistics, and a p > 0.05 was taken as statistically significant. Main outcome measure Doctors' perceptions and expectations towards pharmacists role in patient care. Results A total of 119 out of 150 questionnaires were returned. Doctors hold a mixed perception of pharmacists. The majority of medical doctors believed that pharmacists are vital (n = 98; 82.4%) as they provide services that foster better patients outcomes (n = 78; 65.6%). However, about half (n = 58; 48.8%) expressed uncertainty or perceived pharmacists as incompetent in providing clinical pharmacy services. Our findings also showed a large proportion of doctors expect pharmacists to review medication order (n = 110; 92.4%) for appropriateness and monitoring patients' response to therapy and possible adverse drug effects (n = 112; 92.2%). M ore than three quarters (n = 104, 87.4%) were in favour of collaborating with pharmacists in the process of developing patients' treatment plans. Doctors (n = 116; 97.5%) were of the view that doctor-pharmacist collaborations can be improved by developing trust relationships through dialogue. No demographic characteristics were independently associated with doubt in pharmacist clinical competence. Conclusion Reservations regarding pharmacists' clinical competency still prevail amongst medical doctors. Conversely, they view pharmacists as crucial players in the healthcare delivery system in Sierra Leone. Doctors also have high expectations of pharmacists in terms of contributing to better patient outcomes and therefore wish to collaborate. Possible interventions to settle doctors' discontent regarding pharmacists may include fostering interprofessional training, practice, and constructive dialogue.

Degree of physician-pharmacist collaboration and influencing factors in a teaching specialized hospital in Ethiopia

Several studies have found that physician-pharmacist collaboration improves medication therapy outcomes. This study aimed to measure the degree of physician-pharmacist collaboration in Ethiopia, to identify associated factors, and to determine barriers to their collaboration. A cross-sectional study was conducted among 299 health professionals (246 physicians and 53 pharmacists) in Tikur Anbessa Specialized Hospital, Ethiopia. The Collaborative Working Relationship Model and the Physician-Pharmacist Collaborative Instrument (PPCI) with three main exchange characteristics (trustworthiness, role specification, and relationship initiation), and collaborative care items were used. Barriers to collaboration and areas that need further collaboration were assessed. Multiple regression was used to assess influencing factors. This study revealed that, in Ethiopia, physicians had higher PPCI mean scores on collaborative care items (4.22 ± 1.35) compared to pharmacists (3.25 ± 0.86). Areas of practice and relationship initiation were the two influencing factors for collaboration among pharmacists. But for physicians, age, areas of practice, educational qualification, role specification, and trustworthiness were the factors associated with collaboration. Lack of face-to-face communication and fragmentation of care were the common barriers. However, the vast majority of members of both professions believed that collaboration should be developed in their future practice. Their current collaboration seems suboptimal, and exchange characteristics, which reflect interactions between the practitioners, had a significant influence on their collaboration in addition to other factors.

Perceptions and expectations of health care providers towards clinical pharmacy services at a tertiary cancer centre in Qatar

BACKGROUND

Clinical pharmacy services started in 2009 at the National Center for Cancer Care and Research, Qatar. Clinical pharmacy services was established to provide comprehensive prescription of drug management and support, and consulting services to build clinically efficient and cost-effective pharmacy program.

AIM

To determine perceptions and expectations of healthcare providers toward the clinical pharmacy services at the National Center for Cancer Care and Research.

METHODS

A cross-sectional survey of healthcare providers was conducted from January to May 2018. A self-administered electronic/paper survey containing four domains assessing healthcare providers' perceptions and expectations towards clinical pharmacy services, perceived barriers to clinical pharmacist role and suggested area for improvement was sent to 375 healthcare providers including physicians, operational pharmacists, nurses and dietitians.

RESULTS

The response rate was 112/375. Most of the healthcare providers (74%) perceived the increasing interest in clinical pharmacy services. Also, they expected (1) providing consultations regarding appropriate medication choices (82%); (2) providing information about medication availability and shortages (82%); (3) assisting in the prescribing of cost-effective drugs by providing pharmacogenomics information routinely (75%) and (4) Participating actively in research activities (74%). Overall, healthcare providers have a high level of trust in the clinical pharmacists' abilities (P < 0.01). Nurses were less appreciative (P < 0.002) of the positive role of clinical pharmacists in direct patient care as compared to both physicians and pharmacists (64.2%, 90% and 95.7%, respectively).

CONCLUSION

This study revealed a positive attitude towards the role of clinical pharmacists by healthcare providers at National Center for Cancer Care and Research. However, there is an area of improvement by empowering with privilege and staffing, elevating the awareness and expansion in the ambulatory care settings.

Attitude and Perception of Physicians and Nurses Toward the Role of Clinical Pharmacists in Riyadh, Saudi Arabia: A Qualitative Study

Clinical pharmacists are responsible for guiding pharmacotherapy and ensuring medication safety along with other health-care providers. This study highlighted barriers that physicians and nurses encounter when interacting with clinical pharmacists. Twenty-seven physicians and nurses were randomly invited to participate in focus-group discussions. Five focus-group discussions were recorded and then transcribed, and the transcripts were reviewed and coded. Three major themes were identified, which were the role of clinical pharmacists, interprofessional communication, and competency. The greatest challenge reported in this study was lack of consistent understanding of the role of clinical pharmacists which to some extent caused communication deficiencies and affected the level of involvement with multidisciplinary teams. Despite that, majority of the participants perceived pharmacists as beneficial in optimizing pharmacotherapy and improving quality of care. Clinical pharmacy services are perceived positively in impacting quality of care as expressed by majority of the study participants. However, there is a lack of common understanding of the role of clinical pharmacists by other health-care providers.

Perceptions and expectations of health care providers towards clinical pharmacy services in a mental health hospital in Qatar

BACKGROUND

With the growing burden of mental disorders, pharmacists are ideally positioned to play an important role in supporting people with a mental illness. However, the value of clinical pharmacists within mental health remains unrecognized by other healthcare professionals.

AIMS

The purpose of this study was to explore the perceptions and expectations of mental health professionals on the provision of clinical pharmacy services (CPS) at a psychiatric hospital.

METHODS

A cross-sectional, self-administered, online survey was administered to physicians and nurses working at a psychiatric hospital. Five-point likert scales were used to measure participant's perceptions and expectations about the CPS provided. Descriptive and inferential statistical analysis were undertaken.

RESULTS

Both physicians and nurses reported positive perceptions regarding the CPS provided at the hospital, although physicians agreement with positive statements was higher than those reported by nurses (mean likert scale score 4.76 and 4.45, respectively). There was a statistically significant positive association between participants' years of experience and agreeing that clinical pharmacy services are essential for achieving hospital accreditation (χ2 = 13.11, φ = 0.41, p = 0.04). A statistically significant positive association was noted between the physicians' current position and agreeing that pharmacists assist physicians in selecting more cost effective medication regimens (χ2 = 16.55, φ = 0.62, p = 0.04).

CONCLUSION

Physicians and nurses have mostly positive perceptions and expectations from clinical pharmacists at the psychiatric hospital. However, traditional clinical pharmacy services were more favorably viewed than those associated with advanced clinical roles such as prescribing and pharmacist-led medication management clinics.

Drug therapy problems identification by clinical pharmacists in a private hospital in Kuwait

OBJECTIVES

To report the types and frequency of drug therapy problems (DTPs) identified and the physician acceptance of the clinical pharmacist interventions in a private hospital in Kuwait.

METHODS

A retrospective cross-sectional study was conducted on 3500 patients admitted to the hospital between December 2010 and April 2013. A structured approach was used to identify DTPs and recommend interventions. Data were analyzed using MAXQDA version 11.

KEY FINDINGS

A total of 670 DTPs were identified and recommendations were proposed to treating physicians for each DTP. Overdosage was the most frequently identified drug therapy problem (30.8%), followed by low dosage (17.6%), unnecessary drug therapy (17.3%), need for additional drug therapy (11.6%), and need for different drug product (11.6%). The drug classes most frequently involved were anti-infectives (36.9%), analgesics (25.2%), and gastrointestinal agents (15.5%). More than two-third of the interventions (67.5%) were accepted and implemented by physicians. The most frequently accepted interventions were related to nonadherence, adverse drug reaction, monitoring parameters, inappropriate dosage, and need for additional drug therapy.

CONCLUSION

The current findings expand the existing body of data by reporting on pharmacist recommendations of identified DTPs and importantly, their high rate of acceptance and implementation by the treating physician. These results could serve as a springboard to support further development and implementation of clinical pharmacy services in other healthcare settings in Kuwait.

Physicians' perspectives on clinical pharmacy services in Northern Sweden: a qualitative study

BACKGROUND

In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy services (CPSs) in hospital settings have not been widely implemented and regional differences exist in the uptake of these services. Physicians' attitudes toward CPSs and collaborating with clinical pharmacists may facilitate or hinder the implementation and expansion of the CPSs and the role of the clinical pharmacist in hospital wards. The aim of this study was to explore physicians' perceptions regarding CPSs performed at hospital wards in Northern Sweden.

METHODS

Face-to-face semi-structured interviews were conducted with a purposive sample of nine physicians who had previously worked with clinical pharmacists between November 2014 and January 2015. Interviews were digitally recorded, transcribed and analysed using a constant comparison method.

RESULTS

Different themes emerged regarding physicians' views of clinical pharmacy; two main interlinked themes were service factors and pharmacist factors. The service was valued and described in a positive way by all physicians. It was seen as an opportunity for them to learn more about pharmacological treatment and also an opportunity to discuss patient medication treatment in detail. Physicians considered that CPSs could improve patient outcomes and they valued continuity and the ability to build a trusting relationship with the pharmacists over time. However, there was a lack of awareness of the CPSs. All physicians knew that one of the pharmacist's roles is to conduct medication reviews, but most of them were only able to describe a few elements of what this service encompasses. Pharmacists were described as "drug experts" and their recommendations were perceived as clinically relevant. Physicians wanted CPSs to continue and to be implemented in other wards.

CONCLUSIONS

All physicians were positive regarding CPSs and were satisfied with the collaboration with the clinical pharmacists. These findings are important for further implementation and expansion of CPSs, particularly in Northern Sweden.

Differences and similarities in clinical pharmacy practice in China and the United States: a narrative review

The clinical pharmacy practice provided by pharmacists aims to improve the rational use of medication and enhance the quality of life of patients. Although clinical pharmacy in the USA has been developing for almost 60 years, it began in China only in 2005. Despite this, rapid development in clinical pharmacy has been achieved under the support of China's Ministry of Health. This article aims to compare the differences between, and similarities of, clinical pharmacy practice in China and the USA.

Problems, interventions, and their outcomes during the routine work of hospital pharmacists in Bosnia and Herzegovina

Background In the last 30 years, activities of hospital pharmacists have gone through significant changes. Pharmacists are increasingly involved in patient care. Objectives To explore drug-related and logistic problems, interventions, and their outcomes during routine everyday work of hospital pharmacists. Setting Institute for physical medicine and rehabilitation, Banja Luka, Bosnia and Herzegovina. Methods In the period of January 2013-October 2015 a prospective observational study was performed. Medical doctors, nurses, therapists, and patients addressed pharmacists, face-to-face or by telephone, with drug-related problems (DRPs) and/or logistic issues. Main outcome measure Type of DRP or logistic issue, intervention, outcome, initiator and time spent for solving the problem were documented for each consultation. Results Out of 1515 interventions, 48.8% were aimed at solving DRPs. The most common DRPs were the recommendation of a drug or dose and need for additional information about drugs. Drug price and supply were the most prevalent logistic issues. DRPs were more frequently initiated by medical doctors and required more time to solve the problem compared to logistic issues (Mann-Whitney U test, p ≤ 0.001, respectively). The acceptance rate of interventions to solve DRPs (83.7%) was lower compared to logistic issues (95.2%; p ≤ 0.001). Conclusions Hospital pharmacists were faced with an approximately equal number of DRPs and logistic issues during their routine everyday work. The overall acceptance rate of pharmacists' interventions was high, and the results of our study indicate that there is a need for more involvement of hospital pharmacists in Bosnia and Herzegovina in clinical activities. Impact on practice.

[Clinical pharmacy: Evaluation of physician's satisfactions and expectations in a French regional hospital]

INTRODUCTION

The purpose of the study was to evaluate physician's satisfaction with the clinical pharmacy activities in a French regional hospital.

METHODS

Data were collected by face-to-face interviews carried out by a public health intern with physicians from 14 different departments of medicine and surgery. A specifically designed questionnaire was used for this study. This contained 18 closed-ended questions, 3 open-ended questions and 6 questions relating to the multidisciplinary analysis of prescriptions of elderly patients.

RESULTS

The questionnaire was proposed to 78 physicians, of which 62 replied (participation rate of 79%). Thirty-seven percent were interns (23/62), 19% were assistants (12/62) and 44% were senior physicians (27/62). Clinical pharmacy satisfaction levels were generally very high. In regard to clinical skills, 87% of the physicians were satisfied with pharmacists' competencies and 91% by the pertinence of transmitted information. Ninety-five percent of the physicians were also satisfied by the logistical aspect and the relationship with pharmacists (reactivity, availability and communication). Analysis of the open-ended questions showed that physicians were in favour of the increased presence of clinical pharmacists on the wards.

CONCLUSIONS

This study shows a high level of physician satisfaction in relation to the clinical pharmacy activities in our hospital, and should be viewed as a strong endorsement of the work of the clinical pharmacy. This study highlights some areas of improvement such as increase presence of the clinical pharmacists on the wards. In order to assess periodically our activity, this study must be repeated in the future.

Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study

OBJECTIVES

Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively.

DESIGN

Cross-sectional questionnaire study.

SETTING

The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China.

PARTICIPANTS

416 hospital pharmacists (292 (70.2%) female) entered and completed the study.

PRIMARY AND SECONDARY OUTCOME MEASURES

Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs.

RESULTS

The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs.

CONCLUSIONS

The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour.

Attitude and satisfaction of health care providers towards clinical pharmacy services in Ethiopia: A post-deployment survey

Background

Clinical pharmacy service has evolved steadily over the past few decades and is contributing to the ‘patient care journey’ at all stages. The service improves safety and effectiveness of medicines, thereby avoiding medication errors. As part of this global shift in pharmacy education and practice, Ethiopian Universities revamped the undergraduate pharmacy curriculum and the first graduates came out in July 2013. These graduates were immediately deployed in public hospital settings, with the ultimate aim of providing clinical pharmacy services. As such an initiative is new to the Ethiopian pharmacy sector, there is a need to do assessment of the health care providers’ perception and satisfaction towards the service.

Methods

A cross-sectional survey using self-administered questionnaire was conducted in six regions and one-city administration of the country. Physicians, Health officers and Nurses working along with the new pharmacy graduates formed the study population. A total of 650 healthcare professionals participated in the study. Data were entered, cleaned and analyzed using appropriate statistical tools.

Results

Majority of the health care providers agreed that clinical pharmacy service could have a significant contribution to the patient care. A large proportion of them (70–90 %) had a positive attitude, although there appeared to be some differences across professions. About 50 % of the professionals were of the opinion that patient care should be left to the health care providers and pharmacists should concentrate on drug products. In addition, the same proportion of respondents said that the setup in their respective hospital was appropriate for provision of clinical pharmacy service. Multivariable analysis indicated that attitude of the health care providers was significantly associated with year of experience.

Conclusions

A large proportion of the health care providers had positive attitude towards the service, although the extent of the service was below their expectation. Hence, efforts should be in place to organize continuous professional training for pharmacists and awareness creation forums for other healthcare professionals.