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Peled Y, Ducharme A, Kittleson M, Bansal N, Stehlik J, Amdani S, Saeed D, Cheng R, Clarke B, Dobbels F, Farr M, Lindenfeld J, Nikolaidis L, Patel J, Acharya D, Albert D, Aslam S, Bertolotti A, Chan M, Chih S, Colvin M, Crespo-Leiro M, D'Alessandro D, Daly K, Diez-Lopez C, Dipchand A, Ensminger S, Everitt M, Fardman A, Farrero M, Feldman D, Gjelaj C, Goodwin M, Harrison K, Hsich E, Joyce E, Kato T, Kim D, Luong ML, Lyster H, Masetti M, Matos LN, Nilsson J, Noly PE, Rao V, Rolid K, Schlendorf K, Schweiger M, Spinner J, Townsend M, Tremblay-Gravel M, Urschel S, Vachiery JL, Velleca A, Waldman G, Walsh J. International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024. J Heart Lung Transplant 2024; 43:1529-1628.e54. [PMID: 39115488 DOI: 10.1016/j.healun.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 08/18/2024] Open
Abstract
The "International Society for Heart and Lung Transplantation Guidelines for the Evaluation and Care of Cardiac Transplant Candidates-2024" updates and replaces the "Listing Criteria for Heart Transplantation: International Society for Heart and Lung Transplantation Guidelines for the Care of Cardiac Transplant Candidates-2006" and the "2016 International Society for Heart Lung Transplantation Listing Criteria for Heart Transplantation: A 10-year Update." The document aims to provide tools to help integrate the numerous variables involved in evaluating patients for transplantation, emphasizing updating the collaborative treatment while waiting for a transplant. There have been significant practice-changing developments in the care of heart transplant recipients since the publication of the International Society for Heart and Lung Transplantation (ISHLT) guidelines in 2006 and the 10-year update in 2016. The changes pertain to 3 aspects of heart transplantation: (1) patient selection criteria, (2) care of selected patient populations, and (3) durable mechanical support. To address these issues, 3 task forces were assembled. Each task force was cochaired by a pediatric heart transplant physician with the specific mandate to highlight issues unique to the pediatric heart transplant population and ensure their adequate representation. This guideline was harmonized with other ISHLT guidelines published through November 2023. The 2024 ISHLT guidelines for the evaluation and care of cardiac transplant candidates provide recommendations based on contemporary scientific evidence and patient management flow diagrams. The American College of Cardiology and American Heart Association modular knowledge chunk format has been implemented, allowing guideline information to be grouped into discrete packages (or modules) of information on a disease-specific topic or management issue. Aiming to improve the quality of care for heart transplant candidates, the recommendations present an evidence-based approach.
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Affiliation(s)
- Yael Peled
- Leviev Heart & Vascular Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel.
| | - Anique Ducharme
- Deparment of Medicine, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada.
| | - Michelle Kittleson
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Neha Bansal
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Josef Stehlik
- Division of Cardiovascular Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Shahnawaz Amdani
- Department of Pediatric Cardiology, Cleveland Clinic Children's, Cleveland, Ohio, USA
| | - Diyar Saeed
- Heart Center Niederrhein, Helios Hospital Krefeld, Krefeld, Germany
| | - Richard Cheng
- Division of Cardiology, University of Washington, Seattle, WA, USA
| | - Brian Clarke
- Division of Cardiology, University of British Columbia, St Paul's Hospital, Vancouver, British Columbia, Canada
| | - Fabienne Dobbels
- Academic Centre for Nursing and Midwifery, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Maryjane Farr
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX; Parkland Health System, Dallas, TX, USA
| | - JoAnn Lindenfeld
- Division of Cardiovascular Medicine, Vanderbilt University, Nashville, TN, USA
| | | | - Jignesh Patel
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Deepak Acharya
- Division of Cardiovascular Diseases, University of Arizona Sarver Heart Center, Tucson, Arizona, USA
| | - Dimpna Albert
- Department of Paediatric Cardiology, Paediatric Heart Failure and Cardiac Transplant, Heart Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Saima Aslam
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, California, USA
| | - Alejandro Bertolotti
- Heart and Lung Transplant Service, Favaloro Foundation University Hospital, Buenos Aires, Argentina
| | - Michael Chan
- University of Alberta Hospital, Edmonton, Alberta, Canada
| | - Sharon Chih
- Heart Failure and Transplantation, Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Monica Colvin
- Department of Cardiology, University of Michigan, Ann Arbor, MI; Scientific Registry of Transplant Recipients, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
| | - Maria Crespo-Leiro
- Cardiology Department Complexo Hospitalario Universitario A Coruna (CHUAC), CIBERCV, INIBIC, UDC, La Coruna, Spain
| | - David D'Alessandro
- Massachusetts General Hospital, Boston; Harvard School of Medicine, Boston, MA, USA
| | - Kevin Daly
- Boston Children's Hospital & Harvard Medical School, Boston, MA, USA
| | - Carles Diez-Lopez
- Advanced Heart Failure and Heart Transplant Unit, Department of Cardiology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Anne Dipchand
- Division of Cardiology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | | | - Melanie Everitt
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | - Alexander Fardman
- Leviev Heart & Vascular Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel; Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Marta Farrero
- Department of Cardiology, Hospital Clínic, Barcelona, Spain
| | - David Feldman
- Newark Beth Israel Hospital & Rutgers University, Newark, NJ, USA
| | - Christiana Gjelaj
- Department of Cardiovascular and Thoracic Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Matthew Goodwin
- Division of Cardiothoracic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Kimberly Harrison
- Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eileen Hsich
- Cleveland Clinic Foundation, Division of Cardiovascular Medicine, Cleveland, OH, USA
| | - Emer Joyce
- Department of Cardiology, Mater University Hospital, Dublin, Ireland; School of Medicine, University College Dublin, Dublin, Ireland
| | - Tomoko Kato
- Department of Cardiology, International University of Health and Welfare School of Medicine, Narita, Chiba, Japan
| | - Daniel Kim
- University of Alberta & Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada
| | - Me-Linh Luong
- Division of Infectious Disease, Department of Medicine, University of Montreal Hospital Center, Montreal, Quebec, Canada
| | - Haifa Lyster
- Department of Heart and Lung Transplantation, The Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Harefield, Middlesex, UK
| | - Marco Masetti
- Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Johan Nilsson
- Department of Cardiothoracic and Vascular Surgery, Skane University Hospital, Lund, Sweden
| | | | - Vivek Rao
- Division of Cardiac Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Katrine Rolid
- Department of Cardiology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kelly Schlendorf
- Division of Cardiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Joseph Spinner
- Section of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA
| | - Madeleine Townsend
- Division of Pediatric Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada
| | - Maxime Tremblay-Gravel
- Deparment of Medicine, Montreal Heart Institute, Université?de Montréal, Montreal, Quebec, Canada
| | - Simon Urschel
- Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada
| | - Jean-Luc Vachiery
- Department of Cardiology, Cliniques Universitaires de Bruxelles, Hôpital Académique Erasme, Bruxelles, Belgium
| | - Angela Velleca
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Georgina Waldman
- Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA
| | - James Walsh
- Allied Health Research Collaborative, The Prince Charles Hospital, Brisbane; Heart Lung Institute, The Prince Charles Hospital, Brisbane, Australia
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Ding F, Ma Y, Fan W, Xu J, Pan G. Tailor-made molecular imprints for biological event intervention. Trends Biotechnol 2024; 42:1097-1111. [PMID: 38604879 DOI: 10.1016/j.tibtech.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/28/2024] [Accepted: 02/28/2024] [Indexed: 04/13/2024]
Abstract
Molecular imprints, which are crosslinked architectures containing specific molecular recognition cavities for targeting compounds, have recently transitioned from in vitro diagnosis to in vivo treatment. In current application scenarios, it has become an important topic to create new biomolecular recognition pathways through molecular imprinting, thereby inhibiting the pathogenesis and regulating the development of diseases. This review starts with a pathological analysis, mainly focusing on the corresponding artificial enzymes, enzyme inhibitors and antibody mimics with enhanced functions that are created by molecular imprinting strategies. Recent advances are highlighted in the use of molecular imprints as tailor-made nanomedicines for the prevention of three major diseases: metabolic syndrome, cancer, and bacterial/viral infections.
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Affiliation(s)
- Fan Ding
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China
| | - Yue Ma
- School of Chemistry and Chemical Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China.
| | - Wensi Fan
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China
| | - Jingjing Xu
- Department of Critical Care Medicine, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, Shanghai 200072, China.
| | - Guoqing Pan
- Institute for Advanced Materials, School of Materials Science and Engineering, Jiangsu University, Zhenjiang, Jiangsu 212013, China.
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Dixon DL, Mehta A, Moneta G. Team-Based Care to Overcome Therapeutic Inertia in PAD: A Step in the Right Direction. J Am Coll Cardiol 2024; 83:2671-2673. [PMID: 38897677 DOI: 10.1016/j.jacc.2024.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 06/21/2024]
Affiliation(s)
- Dave L Dixon
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University School of Pharmacy, Richmond, Virginia, USA; VCU Health Pauley Heart Center and Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA.
| | - Anurag Mehta
- VCU Health Pauley Heart Center and Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA. https://twitter.com/amehta_09
| | - Gregory Moneta
- Department of Vascular Surgery, Department of Surgery and Knight Cardiovascular Institute, Oregon Health and Science University, Portland, Oregon, USA
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Defieuw L, Hias J, Karapinar-Carkıt F, Forsyth P, Van der Linden LR. Empowering European hospital pharmacists in the face of heart failure. Eur J Hosp Pharm 2024; 31:287-288. [PMID: 38740548 PMCID: PMC11265546 DOI: 10.1136/ejhpharm-2023-004068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Affiliation(s)
- Lise Defieuw
- Hospital Pharmacy Department, UZ Leuven, Leuven, Flanders, Belgium
| | - Julie Hias
- Hospital Pharmacy Department, UZ Leuven, Leuven, Flanders, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Flanders, Belgium
| | - Fatma Karapinar-Carkıt
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, Limburg, The Netherlands
- CARIM School for Cardiovascular Disease, Maastricht University, Maastricht, The Netherlands
| | - Paul Forsyth
- Pharmacy, NHS Greater Glasgow and Clyde, Glasgow, Scotland, UK
| | - Lorenz Roger Van der Linden
- Hospital Pharmacy Department, UZ Leuven, Leuven, Flanders, Belgium
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Flanders, Belgium
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Kelleci Cakir B, Aydın A, Yılmaz M, Bayraktar-Ekincioglu A. Drug-related problems at the heart of cardiac surgery. Eur J Hosp Pharm 2024; 31:332-338. [PMID: 36788008 PMCID: PMC11265555 DOI: 10.1136/ejhpharm-2022-003669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/05/2023] [Indexed: 02/16/2023] Open
Abstract
OBJECTIVES Optimal perioperative success in cardiac surgery requires precise management of drug treatment. This study aimed to determine the prevalence, types and associated factors of drug-related problems (DRPs) during the entire hospital stay. METHODS A prospective observational study was conducted at the department of cardiovascular surgery in a university hospital between November 2019 and March 2020. Patients with planned elective cardiac surgery, aged ≥18 years, were included. A clinical pharmacist collaboratively reviewed medications on a daily basis and identified DRPs. RESULTS A total of 100 patients (60 male) were included; median (range) age was 62 (19-86) years, and median (IQR) length of stay in hospital was 15 (9) days. A total of 275 DRPs were identified (median (IQR) 3 (2-4)). The number of patients who had at least one DRP was 47 preoperatively, 55 in the postoperative intensive care unit, 100 in the postoperative ward, and 16 at discharge. In order to reduce bias because of the small sample size, Firth's logistic regression analysis was conducted. Statistically significant variables according to univariate analysis were included into a logistic regression model. Therefore the length of hospital stay (OR 1.14, 95% CI 1.03 to 1.26, p=0.008), living arrangements (living alone) (OR 4.24, 95% CI 1.41 to 12.73, p=0.009), number of medications at admission (OR 1.32, 95% CI 1.09 to 1.59, p=0.002), and having coronary artery bypass graft surgery (OR 2.87, 95% CI 1.07 to 7.70, p=0.03) were associated with an increased risk for DRPs in the final model. CONCLUSION Hospital stay carries an increased risk for DRPs, especially at the postoperative stage. Modifiable risk factors for DRPs can be managed by required interventions performed by a multidisciplinary healthcare team.
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Affiliation(s)
- Burcu Kelleci Cakir
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Ahmet Aydın
- Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Yılmaz
- Department of Cardiovascular Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Hatem NAH, Kubas MA, Yousuf SA, Rassam A, Mohamed Ibrahim MI. Yemeni Physicians' Attitudes and Perceived Barriers Toward Ward-Based Clinical Pharmacist in Hospital Settings. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2024; 13:69-80. [PMID: 38911015 PMCID: PMC11192290 DOI: 10.2147/iprp.s464258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/13/2024] [Indexed: 06/25/2024] Open
Abstract
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.
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Affiliation(s)
- Najmaddin A H Hatem
- Department of Clinical Pharmacy, College of Clinical Pharmacy, Hodeidah University, Al-Hudaydah, Yemen
| | - Mohammed A Kubas
- Clinical Pharmacy Department, School of Pharmacy & Medical Sciences (SPMS), Lebanese International University, Sana’a, Yemen
- Clinical Pharmacy Department, University of Science and Technology (UST) Hospital, Sana’a, Yemen
| | - Seena A Yousuf
- Social Medicine and Public Health Department, Faculty of Medicine and Health Sciences, Aden University, Aden, Yemen
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Beavers CJ, Bessada Y, Bond R, Veneman K, Barnes GD. Leveraging the Cardiovascular Team in Peripheral Artery Disease Diagnosis: A Call to Action. J Multidiscip Healthc 2024; 17:2903-2910. [PMID: 38911613 PMCID: PMC11190329 DOI: 10.2147/jmdh.s466345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/06/2024] [Indexed: 06/25/2024] Open
Abstract
Lower extremity peripheral artery disease (PAD) is a common atherosclerotic cardiovascular disease (ASCVD) involving the aortoiliac, femoropopliteal, and infrapopliteal arterial segments. PAD remains a largely underdiagnosed and undertreated condition. The ankle-brachial index (ABI) is a simple and widely available test that is key detection tool in the diagnosis of PAD and is prognostic for mortality and morbidity. The cardiovascular (CV) team is a diverse array of health care clinicians (eg, nurses, nurse practitioners, physician assistants/associates, pharmacists, podiatrists) who have the qualifications and skills to be able to recognize when patients are at risk for PAD and perform an ABI. It is critical that the healthcare community recognize the critical role the CV team could play in improving outcomes and reducing disparities for patients with PAD.
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Affiliation(s)
- Craig J Beavers
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Youssef Bessada
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Rachel Bond
- DHMG Dignity Health Medical Group, Gilbert, AZ, USA
| | - Kristen Veneman
- Elliot Vascular Surgery, Elliot Hospital, Manchester, NH, USA
| | - Geoffery D Barnes
- Frankel Cardiovascular Center, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Beavers CJ, Bhatt DL, Gotter G. Reply to 'The pharmacist ally in heart failure: Useful when involved'. Eur J Heart Fail 2024; 26:1271. [PMID: 38606515 DOI: 10.1002/ejhf.3242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 03/31/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- Craig J Beavers
- Department of Pharmacy Practice and Science, University of Kentucky College of Pharmacy, Lexington, KY, USA
| | - Deepak L Bhatt
- Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gad Gotter
- Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Heart Initiative, Durham, NC, USA
- Universite Paris Cite, INSERM UMR-S 942 (MASCOT), Paris, France
- Momentum Research, Inc, Durham, NC, USA
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9
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Salgado-Garcia C, Moreno-Ballesteros A, Guardia-Jimena P, Sanchez-de-Mora E, Rebollo-Aguirre AC, Ramirez-Navarro A, Santos-Bueno A, Jimenez-Heffernan A. Role of the clinical radiopharmacist in patient safety during myocardial perfusion imaging with vasodilator stress agents. Rev Esp Med Nucl Imagen Mol 2024; 43:84-90. [PMID: 38184070 DOI: 10.1016/j.remnie.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 11/20/2023] [Accepted: 11/23/2023] [Indexed: 01/08/2024]
Abstract
AIM To assess the radiopharmacist's role in a multidisciplinary team focused on the contraindications of regadenoson in order to ensure the safe use of pharmacologic vasodilator stress agents in patients undergoing SPECT-MPI. METHODS We ambispectively studied its safe use in 1905 patients (54.1% female, mean age: 66.6±11.7 years, range: 20-95 years). Sex, age, medical history, medications, drug allergies, and contraindications for stress testing were registered together with recommendations for the nuclear physician in charge. RESULTS Detected contraindications and corresponding recommendations were as follows: risk factors for QTc interval prolongation 7.5% - measurement of QTc interval previously to test and monitor ECG; prior stroke or TIA 4.2% - consider carotid stenosis assessment; salicylates/sulfonamides allergy 3.1% - use 99mTc-sestamibi; epilepsy or risk factors for seizures 2.4% - use of adenosine or reconsider test indication; systemic corticosteroid therapy for severe COPD 1.3% - reassessment of patient's condition; acute exacerbation of COPD 0.8% - defer test until acute episode is over; severe asthma 0.4% - do not perform test; methylxanthine ingestion 0.3% - avoid consumption previously; other 6.1% - evaluation of other contraindications. No contraindications were detected in 73.6% of patients. The test was canceled due to absolute contraindications in 2.9% of the requests. CONCLUSIONS Working in a systematic way, the radiopharmacist was able to detect a high number of issues related to regadenoson, with one out of four patients presenting some clinical contraindication. The recommendations given by the radiopharmacist were well accepted by the nuclear physicians who changed their approach contributing to increase the safety of patients referred for MPI.
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Affiliation(s)
- C Salgado-Garcia
- Radiopharmacy Unit (Department of Nuclear Medicine), Hospital Juan Ramon Jimenez, Huelva, Spain.
| | | | - P Guardia-Jimena
- Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain
| | - E Sanchez-de-Mora
- Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain
| | | | - A Ramirez-Navarro
- Radiopharmacy Unit (Department of Nuclear Medicine), Hospital Virgen de las Nieves, Granada, Spain
| | - A Santos-Bueno
- Department of Nuclear Medicine, Hospital Juan Ramon Jimenez, Huelva, Spain
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Fedkiv V, Delic J, Hollands JM, Pasciolla S, Pontiggia L, Bingham AL. Prevalence and Value of Board Certification Among Pharmacy Practice Faculty in the United States. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2024; 88:100623. [PMID: 37951575 DOI: 10.1016/j.ajpe.2023.100623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/29/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVE To determine the prevalence of board certification among pharmacy practice faculty in the United States, motivators and barriers to certification, and association between board certification and professional achievements and accomplishments that may support career advancement. METHODS In phase I, the prevalence of board-certified pharmacy practice faculty in the United States was determined by cross-referencing lists of faculty and board-certified pharmacists. In phase II, faculty were stratified by rank and invited to participate in a survey regarding professional characteristics, motivators and barriers to board certification, and professional achievements and accomplishments that may support career advancement for pharmacy practice faculty. RESULTS The prevalence of board certification among the 3276 pharmacy practice faculty was 56%. The prevalence was the highest among assistant professors (61%). A total of 746 faculty completed the survey (33% response rate). Of those respondents, 73% reported being currently certified, 23% never certified, and 4% previously certified. Overall, to be recognized as an expert in the field was identified as the most commonly perceived reason faculty obtain board certification (44%). Currently and previously certified faculty ranked the desire to be recognized as an expert in the field as the most common reason they obtained board certification (61%). There was a positive correlation between board certification and certain professional accomplishments. CONCLUSION The prevalence of board-certified pharmacy practice faculty has increased since 2011, but motivators and barriers for board certification remain similar. Board certification may support career advancement for pharmacy practice faculty.
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Affiliation(s)
- Volodymyra Fedkiv
- Saint Francis Hospital, Department of Pharmacy, Wilmington, DE, USA.
| | - Justin Delic
- Cooper University Health Care, Department of Pharmacy, Camden, NJ, USA
| | - James M Hollands
- Saint Joseph's University, Philadelphia College of Pharmacy, Department of Pharmacy Practice, Philadelphia, PA, USA
| | - Stacy Pasciolla
- Saint Joseph's University, Philadelphia College of Pharmacy, Department of Pharmacy Practice, Philadelphia, PA, USA
| | - Laura Pontiggia
- Thomas Jefferson University, College of Health Professions, Philadelphia, PA, USA
| | - Angela L Bingham
- Saint Joseph's University, Philadelphia College of Pharmacy, Department of Pharmacy Practice, Philadelphia, PA, USA
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Huang X, Estau D, Liu X, Yu Y, Qin J, Li Z. Evaluating the performance of ChatGPT in clinical pharmacy: A comparative study of ChatGPT and clinical pharmacists. Br J Clin Pharmacol 2024; 90:232-238. [PMID: 37626010 DOI: 10.1111/bcp.15896] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/01/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
AIMS To evaluate the performance of chat generative pretrained transformer (ChatGPT) in key domains of clinical pharmacy practice, including prescription review, patient medication education, adverse drug reaction (ADR) recognition, ADR causality assessment and drug counselling. METHODS Questions and clinical pharmacist's answers were collected from real clinical cases and clinical pharmacist competency assessment. ChatGPT's responses were generated by inputting the same question into the 'New Chat' box of ChatGPT Mar 23 Version. Five licensed clinical pharmacists independently rated these answers on a scale of 0 (Completely incorrect) to 10 (Completely correct). The mean scores of ChatGPT and clinical pharmacists were compared using a paired 2-tailed Student's t-test. The text content of the answers was also descriptively summarized together. RESULTS The quantitative results indicated that ChatGPT was excellent in drug counselling (ChatGPT: 8.77 vs. clinical pharmacist: 9.50, P = .0791) and weak in prescription review (5.23 vs. 9.90, P = .0089), patient medication education (6.20 vs. 9.07, P = .0032), ADR recognition (5.07 vs. 9.70, P = .0483) and ADR causality assessment (4.03 vs. 9.73, P = .023). The capabilities and limitations of ChatGPT in clinical pharmacy practice were summarized based on the completeness and accuracy of the answers. ChatGPT revealed robust retrieval, information integration and dialogue capabilities. It lacked medicine-specific datasets as well as the ability for handling advanced reasoning and complex instructions. CONCLUSIONS While ChatGPT holds promise in clinical pharmacy practice as a supplementary tool, the ability of ChatGPT to handle complex problems needs further improvement and refinement.
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Affiliation(s)
- Xiaoru Huang
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
| | - Dannya Estau
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
| | - Xuening Liu
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
| | - Yang Yu
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
| | - Jiguang Qin
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
| | - Zijian Li
- Department of Pharmacy, Peking University Third Hospital, Beijing, China
- Department of Pharmaceutical Management and Clinical Pharmacy, College of Pharmacy, Peking University, Beijing, China
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing Key Laboratory of Cardiovascular Receptors Research, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health, State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China
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12
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Krumm L, Bausewein C, Rémi C. Drug Therapy Safety in Palliative Care-Pharmaceutical Analysis of Medication Processes in Palliative Care. PHARMACY 2023; 11:160. [PMID: 37888505 PMCID: PMC10610412 DOI: 10.3390/pharmacy11050160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/28/2023] Open
Abstract
Pharmacotherapy plays a crucial role in symptom management in palliative care and is associated with risks potentially leading to drug-related problems (DRP). Pharmacists can identify DRPs and advise prescribers on optimizing drug therapy. The aim of this study was to identify DRP in a palliative care unit (PCU) and evaluate corresponding pharmaceutical interventions. A non-randomized before-and-after study in a PCU starts with a control phase, an interphase, and an intervention phase. Primary endpoint: DRP, including pharmaceutical interventions and their acceptance. The medication of all inpatients was recorded at set time points, assessed for potential and manifest DRP, and categorized. In the control phase, the ward pharmacist did not interfere with the clinical team. In the intervention phase, the pharmacist could intervene when a DRP was identified and give recommendations. During the 12-month period, 284 patients were included (control phase n = 138; intervention phase n = 146) and 1079 DRPs were identified (control phase n = 634; intervention phase n = 445). The number of DRPs/patient was significantly reduced by the pharmacist's interventions between the control and intervention phases (4 vs. 3 DRPs, p = 0.001). Overall acceptance of pharmaceutical interventions by prescribers was very high (227/256; 88%). DRPs are hardly preventable. With a clinical pharmacist as a member of the palliative care team, it is possible to reduce the number of DRPs and identify potential problems earlier.
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Affiliation(s)
- Lisa Krumm
- Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University, 81377 Munich, Germany
- Helios Dr. Horst Schmidt Hospital, 65199 Wiesbaden, Germany
| | - Claudia Bausewein
- Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University, 81377 Munich, Germany
| | - Constanze Rémi
- Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University, 81377 Munich, Germany
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13
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Suman S, Pravalika J. Beyond the Prescription Pad: Clinical Pharmacists as Integral Members of Cardiology Care Teams, A Comprehensive Review of Their Expanding Roles and Contributions. Curr Probl Cardiol 2023; 48:101880. [PMID: 37336313 DOI: 10.1016/j.cpcardiol.2023.101880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 06/13/2023] [Indexed: 06/21/2023]
Abstract
In recent years, the role of clinical pharmacists in cardiology care teams has evolved significantly. Traditionally known for their expertise in medication management, clinical pharmacists are now being recognized as integral members of interdisciplinary teams in cardiology settings. This review article aims to explore the expanding roles and contributions of clinical pharmacists in cardiac care, going beyond their traditional responsibilities. It examines their involvement in patient care, medication therapy management, collaborative decision-making, patient education, and research activities. By highlighting the value they bring to the table, this article emphasizes the need for incorporating clinical pharmacists as vital team members in cardiology care.
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Affiliation(s)
- Satyam Suman
- Department of Pharmacy Practice, Kakatiya University, Warangal, Telangana, India.
| | - Jakkula Pravalika
- Department of Pharmacy Practice, Kakatiya University, Warangal, Telangana, India
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14
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Merks P, Religioni U, Jaguszewski M, Barańska A, Neumann-Podczaska A, Kaźmierczak J, Blicharska E, Šola KF, Vaillancourt R. Patient satisfaction survey of the "Healthy Heart" pharmaceutical care service - evaluation of pharmacy labelling with pharmaceutical pictograms. BMC Health Serv Res 2023; 23:962. [PMID: 37679680 PMCID: PMC10483748 DOI: 10.1186/s12913-023-09986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/29/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Low adherence is a major challenge in healthcare worldwide, being particularly dangerous for patients with chronic diseases, such as cardiovascular diseases and heart failure, where strict adherence is essential. Non-adherence is observed in almost half of patients, and the consequences encompass a lack of therapeutic effects, health deterioration, decreased quality of life, and even death. For cardiovascular patients, the great importance of health education and pharmaceutical education can be provided within pharmaceutical care in community pharmacies. Therefore, our study aimed at evaluating the level of satisfaction with the "Healthy Heart" pharmaceutical service, in which patients received pictograms with dosage information affixed to their medication. MATERIAL AND METHODS The study was designed for patients who had been prescribed an antiplatelet medication for the first time. The patients were recruited by 577 pharmacies that took part in the study after completing a special course. Ultimately, 1590 patients were enrolled in the study. The project ran from November 2019 to January 2022. RESULTS Most of patients had a positive attitude to the "Healthy Heart" pharmaceutical service. More than 85% of the respondents were of the opinion that the pictograms facilitated the use of the medication, and 81.7% of the respondents stated that the system of labels helped in adherence. Over 66% of the respondents thought that such labels should be included in pharmacy services, and 77.92% of the participants reported that this system of labelling medications should be offered through all pharmacies. CONCLUSIONS Pharmaceutical labels in the pharmacists' everyday practice can largely improve patient adherence. These efforts, provided as part of their pharmaceutical services, can have a huge influence on optimisation of patient health outcomes.
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Affiliation(s)
- Piotr Merks
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education, Warsaw, Poland.
| | - Miłosz Jaguszewski
- First Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland
| | - Agnieszka Barańska
- Department of Medical Informatics and Statistics With E-Health Laboratory, Medical University of Lublin, 20-954, Lublin, Poland
| | | | | | - Eliza Blicharska
- Department of Pathobiochemistry and Interdisciplinary Applications of Ion Chromatograph, Medical University of Lublin, 1 Chodźki Str., 20-093, Lublin, Poland
| | - Katarina Fehir Šola
- European Association of Employed Community Pharmacist (EPhEU), Vienna, Austria
| | - Regis Vaillancourt
- Department of Pharmacology and Clinical Pharmacology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, Warsaw, Poland
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15
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Rossi LP, Granger BB, Bruckel JT, Crabbe DL, Graven LJ, Newlin KS, Streur MM, Vadiveloo MK, Walton-Moss BJ, Warden BA, Volgman AS, Lydston M. Person-Centered Models for Cardiovascular Care: A Review of the Evidence: A Scientific Statement From the American Heart Association. Circulation 2023; 148:512-542. [PMID: 37427418 DOI: 10.1161/cir.0000000000001141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Cardiovascular disease remains the leading cause of death and disability in the United States and globally. Disease burden continues to escalate despite technological advances associated with improved life expectancy and quality of life. As a result, longer life is associated with multiple chronic cardiovascular conditions. Clinical guidelines provide recommendations without considering prevalent scenarios of multimorbidity and health system complexities that affect practical adoption. The diversity of personal preferences, cultures, and lifestyles that make up one's social and environmental context is often overlooked in ongoing care planning for symptom management and health behavior support, hindering adoption and compromising patient outcomes, particularly in groups at high risk. The purpose of this scientific statement was to describe the characteristics and reported outcomes in existing person-centered care delivery models for selected cardiovascular conditions. We conducted a scoping review using Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials through Ovid, and ClinicalTrials.gov from 2010 to 2022. A range of study designs with a defined aim to systematically evaluate care delivery models for selected cardiovascular conditions were included. Models were selected on the basis of their stated use of evidence-based guidelines, clinical decision support tools, systematic evaluation processes, and inclusion of the patient's perspective in defining the plan of care. Findings reflected variation in methodological approach, outcome measures, and care processes used across models. Evidence to support optimal care delivery models remains limited by inconsistencies in approach, variation in reimbursement, and inability of health systems to meet the needs of patients with chronic, complex cardiovascular conditions.
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16
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Raat W, Truyts P, Gaillaert J, Van de Putte M, Van der Linden L, Janssens S, Vaes B, Smeets M. Community pharmacists' perceptions on multidisciplinary heart failure care: an exploratory qualitative study. BMC Health Serv Res 2023; 23:638. [PMID: 37316813 PMCID: PMC10266313 DOI: 10.1186/s12913-023-09661-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023] Open
Abstract
BACKGROUND Heart failure (HF) is an important health problem and guidelines recommend multidisciplinary management. The pharmacist is an important member of the multidisciplinary heart failure team, both in the hospital and community setting. This study aims to explore the perceptions of community pharmacists on their role in HF care. METHODS We conducted a qualitative study based on face-to-face semi-structured interviews with 13 Belgian community pharmacists between September 2020 and December 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. We structured interview content into a thematic matrix. RESULTS We identified two major themes: heart failure management and multidisciplinary management. Pharmacists feel responsible for the pharmacological and non-pharmacological management of heart failure, citing easy access and pharmacological expertise as important assets. Diagnostic uncertainty, lack of knowledge and time, disease complexity and difficulties in communication with patients and informal care providers are barriers to optimal management. General practitioners are the most important partners in multidisciplinary community heart failure management, although pharmacists perceive a lack of appreciation and cooperation and deplore communication difficulties. They feel intrinsically motivated to provide extended pharmaceutical care in HF but cite the lack of financial viability and information sharing structures as important barriers. CONCLUSION The importance of pharmacist involvement in multidisciplinary heart failure teams is undisputed by Belgian pharmacists, who cite easy access and pharmacological expertise as important assets. They point out several barriers impeding evidence-based pharmacist care for outpatients with heart failure: diagnostic uncertainty and disease complexity, lack of multidisciplinary information technology and insufficient resources. We recommend that future policy should focus on improved medical data exchanges between primary and secondary care electronic health records as well as the reinforcement of interprofessional relationships between locally affiliated pharmacists and general practitioners.
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Affiliation(s)
- Willem Raat
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, blok D bus 7001 3000, Leuven, Belgium.
| | - Pauline Truyts
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Justine Gaillaert
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | | | - Lorenz Van der Linden
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
- Pharmacy Department, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Stefan Janssens
- Department of Cardiovascular Diseases, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Bert Vaes
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, blok D bus 7001 3000, Leuven, Belgium
| | - Miek Smeets
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 7, blok D bus 7001 3000, Leuven, Belgium
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17
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Sokos G, Kido K, Panjrath G, Benton E, Page R, Patel J, Smith PJ, Korous S, Guglin M. Multidisciplinary Care in Heart Failure Services. J Card Fail 2023; 29:943-958. [PMID: 36921886 DOI: 10.1016/j.cardfail.2023.02.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 03/18/2023]
Abstract
The American College of Cardiology/American Heart Association/Heart Failure Society of American 2022 guidelines for heart failure (HF) recommend a multidisciplinary team approach for patients with HF. The multidisciplinary HF team-based approach decreases the hospitalization rate for HF and health care costs and improves adherence to self-care and the use of guideline-directed medical therapy. This article proposes the optimal multidisciplinary team structure and each team member's delineated role to achieve institutional goals and metrics for HF care. The proposed HF-specific multidisciplinary team comprises cardiologists, surgeons, advanced practice providers, clinical pharmacists, specialty nurses, dieticians, physical therapists, psychologists, social workers, immunologists, and palliative care clinicians. A standardized multidisciplinary HF team-based approach should be incorporated to optimize the structure, minimize the redundancy of clinical responsibilities among team members, and improve clinical outcomes and patient satisfaction in their HF care.
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Affiliation(s)
- George Sokos
- Department of Cardiology, West Virginia University School of Medicine, Morgantown, West Virginia
| | - Kazuhiko Kido
- Department of Clinical Pharmacy, West Virginia University School of Pharmacy, Morgantown, West Virginia.
| | - Gurusher Panjrath
- School of Medicine and Health Sciences, George Washington University, North Englewood, Maryland
| | - Emily Benton
- Department of Medicine, University of Colorado, Boulder, Colorado
| | - Robert Page
- Department of Clinical Pharmacy, at the University of Colorado Denver Skaggs School of Pharmacy, Denver, Colorado
| | - Jignesh Patel
- Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California
| | - Patrick J Smith
- Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Shelly Korous
- Advanced Heart Failure Program, Indiana University Health, Indianapolis, Indiana
| | - Maya Guglin
- Department of Medicine, Indiana University Health, Indianapolis, Indiana
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18
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Al-Badriyeh D, Kaddoura R, AlMaraghi F, Homosy A, Hail MA, El-Kassem W, Rouf PVA, Fadul A, Mahfouz A, Alyafei SA, Abushanab D. Impact of clinical pharmacist interventions on economic outcomes in a cardiology setting in Qatar. Curr Probl Cardiol 2023:101838. [PMID: 37244514 DOI: 10.1016/j.cpcardiol.2023.101838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/29/2023]
Abstract
We sought to investigate the economic impact of preventing adverse events in a cardiology setting in Qatar as an effect of the clinical pharmacist as an intervention. This is a retrospective study of interventions by clinical pharmacists within an adult cardiology setting in a public healthcare setting (i.e Hamad Medical Corporation). The study included interventions that took place in March 2018, July 15, 2018-August 15, 2018, and January 2019. The economic impact was measured via calculating the total benefit, defined as the sum of the cost savings and the cost avoidance. Sensitivity analyses were adopted to confirm the robustness of the results. The pharmacist intervened in 262 patients, resulting in 845 interventions, with appropriate therapy (58.6%) and dosing/administration (30.2%) being the most frequent categories of reported interventions. Cost savings and cost avoidance resulted in QAR-11,536 (USD-3,169) and QAR1,607,484 (USD 441,616), respectively, yielding a total benefit of QAR1,595,948 (USD438,447) per three months and QAR6,383,792 (USD1,753,789) per a year.
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Affiliation(s)
| | - Rasha Kaddoura
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Fatima AlMaraghi
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Homosy
- Department of Pharmacy, Al-Wakra Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Moza Al Hail
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | - Wessam El-Kassem
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar
| | | | - Abdalla Fadul
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Mahfouz
- Department of Pharmacy, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | | | - Dina Abushanab
- Department of Pharmacy, Hamad Bin Khalifa Medical City, Hamad Medical Corporation, Doha, Qatar.
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19
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Chen D, Wen B, Wu X, Zheng X, Zhu H, Chen X, Han D, Liu J, Liu Y, Guo J, Zhu S, Ren H, Ge W, Zhang H. Pharmacist-Driven Dosing Services and Pharmaceutical Care Increase Probability of Teicoplanin Target Concentration Attainment and Improve Clinical and Economic Outcomes in Non-Critically Ill Patients. Infect Dis Ther 2023:10.1007/s40121-023-00812-2. [PMID: 37140880 DOI: 10.1007/s40121-023-00812-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/13/2023] [Indexed: 05/05/2023] Open
Abstract
INTRODUCTION Pharmacist-driven (PD) dosing and monitoring services have been shown to improve the clinical and economic outcomes in patients treated with different antibiotics, other than teicoplanin. This study investigates the impact of PD dosing and monitoring services on the clinical and economic outcomes of non-critically ill patients receiving teicoplanin treatment. METHODS A single-center retrospective study was conducted. Patients were divided into the PD group and the non-PD (NPD) group. Primary outcomes included the achievement of target serum concentration, and a composite endpoint of all-cause mortality, intensive care unit (ICU) admission, and sepsis or septic shock development during hospitalization or within 30 days of hospital admission. The cost of teicoplanin, overall medication cost, and total cost during hospital stay were also compared. RESULTS A total of 163 patients from January to December 2019 were included and assessed. Seventy patients were assigned to the PD group and 93 to the NPD group. The PD group had a higher percentage of patients reaching the target trough concentration (54% versus 16%, p < 0.001). Around 26% of the patients in the PD group and 50% of the patients in the NPD group met the composite endpoint during their hospital stay (p = 0.002). The PD group exhibited a significantly lower incidence of sepsis or septic shock, shorter hospital stays, reduced drug costs, and lower total expenses. CONCLUSIONS Our study demonstrates that pharmacist-driven teicoplanin therapy can improve the clinical and economic outcomes for non-critically ill patients. TRIAL REGISTRATION https://www.chictr.org.cn ; identifier, ChiCTR2000033521.
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Affiliation(s)
- Dayu Chen
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
| | - Bo Wen
- Department of Burns and Plastic Surgery, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Xuanyu Wu
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Zhongshan Road 321, Nanjing, 210008, China
- Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Xinxin Zheng
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Zhongshan Road 321, Nanjing, 210008, China
| | - Huaijun Zhu
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Zhongshan Road 321, Nanjing, 210008, China
| | - Xingkai Chen
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Dan Han
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Jinchun Liu
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Yunxing Liu
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Jiayue Guo
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
- China Pharmaceutical University Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China
| | - Shaoshi Zhu
- College of Medicine, The University of Illinois, 1851 W Polk St, Chicago, IL, 60612, USA
| | - Haozhen Ren
- Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
| | - Weihong Ge
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
| | - Haixia Zhang
- Department of Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
- Nanjing Medical Center for Clinical Pharmacy, Nanjing Drum Tower Hospital the Affiliated Hospital of Nanjing University Medical School, Zhongshan Road 321, Nanjing, 210008, China.
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20
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Jasińska-Stroschein M, Waszyk-Nowaczyk M. Multidimensional Interventions on Supporting Disease Management for Hospitalized Patients with Heart Failure: The Role of Clinical and Community Pharmacists. J Clin Med 2023; 12:3037. [PMID: 37109373 PMCID: PMC10142526 DOI: 10.3390/jcm12083037] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 04/13/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on supporting disease management for hospitalized patients with heart failure (HF). The present paper reviews the effects of inpatient, discharge and/or after-discharge interventions performed on hospitalized HF patients by multidisciplinary teams, including pharmacists. METHODS articles were identified through search engines in three electronic databases following the PRISMA Protocol. Randomized controlled trials (RCTs) or non-randomized intervention studies conducted in the period 1992-2022 were included. In all studies, baseline characteristics of patients as well as study end-points were described in relation to a control group i.e., usual care and a group of subjects that received care from a clinical and/or community pharmacist, as well as other health professionals (Intervention). Study outcomes included all-cause hospital 30-day re-admission or emergency room (ER) visits, all-cause hospitalization within >30 days after discharge, specific-cause hospitalization rates, medication adherence and mortality. The secondary outcomes included adverse events and quality of life. Quality assessment was carried out using RoB 2 Risk of Bias Tool. Publication bias across studies was determined using the funnel plot and Egger's regression test. RESULTS a total of 34 protocols were included in the review, while the data from 33 trials were included in further quantitative analyses. The heterogeneity between studies was high. Pharmacist-led interventions, usually performed within interprofessional care teams, reduced the rates of 30-day all-cause hospital re-admission (odds ratio, OR = 0.78; 95% CI 0.62-0.98; p = 0.03) and all-cause hospitalization >30 days after discharge (OR = 0.73; 95% CI 0.63-0.86; p = 0.0001). Subjects hospitalized primarily due to heart failure demonstrated reduced risk of hospital admission within longer periods, i.e., from 60 to 365 days after discharge (OR = 0.64; 95% CI 0.51-0.81; p = 0.0002). The rate of all-cause hospitalization was reduced by multidimensional interventions taken by pharmacists: reviews of medicine lists and/or their reconciliation at discharge (OR = 0.63; 95% CI 0.43-0.91; p = 0.014), as well as interventions that were based mainly on patient education and counseling (OR = 0.65; 95% CI 0.49-0.88; p = 0.0047). In conclusion, given that HF patients often have complex treatment regimens and multiple comorbid conditions, our findings highlight the need for greater involvement from skilled clinical and community pharmacists in disease management.
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Affiliation(s)
| | - Magdalena Waszyk-Nowaczyk
- Pharmacy Practice Division, Chair and Department of Pharmaceutical Technology, Poznan University of Medical Sciences, 6 Grunwaldzka Street, 60-780 Poznan, Poland
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Sivakumar B, Lemonde M, Stein M, Mak S, Al-Hesayen A, Arcand J. Patient perspectives on the use of mobile apps to support heart failure management: A qualitative descriptive study. PLoS One 2023; 18:e0285659. [PMID: 37167283 PMCID: PMC10174481 DOI: 10.1371/journal.pone.0285659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/27/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Adherence to diet and medical therapies are key to improving heart failure (HF) outcomes; however, nonadherence is common. While mobile apps may be a promising way to support patients with adherence via education and monitoring, HF patient perspectives regarding the use of apps for HF management in unknown. This data is critical for these tools to be successfully developed, implemented, and adopted to optimize adherence and improve HF outcomes. OBJECTIVE To determine patients' needs, motivations, and challenges on the use of mobile apps to support HF management. METHODS A qualitative descriptive study using focus groups (n = 4,60 minutes) was conducted among HF patients from outpatient HF clinics in Toronto, Canada. The Diffusion of Innovation theory informed a ten-question interview guide. Interview transcripts were independently coded by two researchers and analyzed using content analysis. RESULTS Nineteen HF patients (65 ± 10 yrs, 12 men) identified a total of four key themes related to the use of mobile apps. The theme 'Factors impacting technology use by patients' identified motivations and challenges to app use, including access to credible information, easy and accessible user-interface. Three themes described patients' needs on the use of mobile apps to support HF management: 1) 'Providing patient support through access to information and self-monitoring', apps could provide education on HF-related content (e.g., diet, medication, symptoms); 2) 'Facilitating connection and communication', through information sharing with healthcare providers and connecting with other patients; 3) 'Patient preferences', app features such as reminders for medication, and visuals to show changes in HF symptoms were favoured. CONCLUSIONS HF patients perceive several benefits and challenges to app use for HF self-management. Capitalizing on the benefits and addressing the challenges during the app development process may maximize adoption of such tools in this patient population.
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Affiliation(s)
- Bridve Sivakumar
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
| | - Manon Lemonde
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
| | - Matthew Stein
- Ontario Tech University, Social Research Centre, Oshawa, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, Canada
- Department of Medicine, Sinai Health, Toronto, Canada
| | | | - JoAnne Arcand
- Ontario Tech University, Faculty of Health Science, Oshawa, Canada
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AlAhmad MM, ZainAlAbdin S, AlAhmad K, AlAhmad I, AbuRuz S. Value of the clinical pharmacist interventions in the application of the American College of Cardiology (ACC/AHA) 2018 guideline for cholesterol management. PLoS One 2023; 18:e0283369. [PMID: 36972252 PMCID: PMC10042341 DOI: 10.1371/journal.pone.0283369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 03/07/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVES The study aims to examine the extent to which the updated ACC/AHA management of blood cholesterol guideline (2018) is implemented in practice and to assess the value of the clinical pharmacist interventions in improving physicians' adherence the guidelines recommendations. METHODS We utilized in this study an interventional before-after design. The study was conducted on 272 adult patients who visited the study site internal medicine clinics and were candidates for statin therapy based on the 2018 ACC/AHA guidelines for cholesterol management. Adherence to guideline recommendations was measured before and after clinical pharmacists' interventions by calculating the percentage of patients receiving statin therapy as per guideline recommendation, the type and intensity (moderate or high intensity) of statin therapy used, and the need for additional non-statin therapy. RESULTS Adherence with guideline recommendations was significantly improved from 60.3% to 92.6% (X2 = 79.1, p = 0.0001) after clinical pharmacist interventions. Among patients who were on statin therapy, the percentage of those who were on proper statin intensity increased significantly from 47.6% to 94.4% (X2 = 72.5, p = 0.0001). The combination of statins with non-statin therapies such as ezetimibe and PCSK9 inhibitors increased from 8.5% to 30.6% (X2 = 95, p<0.0001) and from 0.0% to 1.6% (X2 = 6, p = 0.014), respectively. The use of other lipid-lowering agents was diminished from 14.6% to 3.2% (X2 = 19.2, p<0.0001). CONCLUSION Collaboration between physicians and clinical pharmacists is a crucial strategy to improve patients' treatment and hence, achieve better health outcomes among patients suffering from dyslipidemia.
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Affiliation(s)
- Mohammad M AlAhmad
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates
| | - Sham ZainAlAbdin
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | | | - Iqbal AlAhmad
- Czech Rehabilitation Hospital, Al Ain, United Arab Emirates
| | - Salah AbuRuz
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
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Baldewijns K, Boyne J, Rohde C, de Maesschalck L, Devillé A, Brandenburg V, De Bleser L, Derickx M, Bektas S, Brunner-La Rocca HP. What kind of patient education and self-care support do patients with heart failure receive, and by whom? Implementation of the ESC guidelines for heart failure in three European regions. Heart Lung 2023; 57:25-30. [PMID: 35994805 DOI: 10.1016/j.hrtlng.2022.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/06/2022] [Accepted: 07/28/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND In order to manage Heart Failure (HF) properly, both pharmacological and non-pharmacological interventions including patient education and self-care (SC) support are important. Appropriate health care (HC) professional support is necessary to improve patient SC-skills. However, little is known which HC-professionals deliver specific education and support in daily HF-care. OBJECTIVES To describe patient-education and SC-support as perceived by different HC-professionals in three neighboring North-West European regions: Maastricht(the Netherlands), Noorder-Kempen(Belgium), Aachen (Germany). METHODS Semi-structured interviews with cardiologists, HF-nurses and general practitioners (GPs) were performed, followed by qualitative content analysis with a five-step approach: 1) familiarization with data, 2) initial coding with an a-priori code manual, 3) structuring of data in main themes, 4) revision and recoding of initial codes and 5) synthesizing codes in main themes. RESULTS The sample consisted of 15 cardiologists, 35 GPs and 8 HF-nurses. All interviewed HC-professionals provide HF patient-education, yet, the extent differs between them. Whereas HF-nurses identify patient-education and SC-support as one of their main tasks, physicians report that they provide little education. Moreover, little patient education takes place in primary care; with almost none of the GPs reporting to educate patients about SC. GPs in region 2 refer HF-patients to their practice nurse for education and SC-support. None of the HC-professionals reported to provide patients with all key-topics for patient education and SC-support as defined by the ESC. CONCLUSION HF nurses consider patient-education and SC-support as one of their main tasks, whereas physicians pay limited attention to education. In none of the three regions, all recommended topics are addressed.
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Affiliation(s)
- Karolien Baldewijns
- Mobilab&Care, Thomasmore University of Applied Sciences, Kleinhoefstraat 4, 2440 Geel, Belgium; Maastricht University Medical Centre, Cardiology Department P. Debeyelaan 25, 6229 HX Maastricht, the Netherlands.
| | - Josiane Boyne
- Maastricht University Medical Centre, Cardiology Department P. Debeyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Carla Rohde
- Maastricht University Medical Centre, Cardiology Department P. Debeyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Lieven de Maesschalck
- Mobilab&Care, Thomasmore University of Applied Sciences, Kleinhoefstraat 4, 2440 Geel, Belgium
| | - Aleidis Devillé
- Social Work Department Thomasmore University of Applied Sciences, Kleinhoefstraat 4, 2440 Geel, Belgium
| | - Vincent Brandenburg
- UniversitätsKlinikum Aachen Pauwelsstraße 30, 52074 Aachen, Germany; Rhein-Maas Klinikum Wuerselen, Mauerfeldchen 25, 52146 Würselen, Germany
| | - Leentje De Bleser
- Nursing Department, Thomas More University College, Zandpoortvest 60, 2800 Mechelen, Belgium
| | - Mieke Derickx
- Maastricht University, Minderbroersberg 4 -6, 6221 LK Maastricht, the Netherlands
| | - Sema Bektas
- Maastricht University Medical Centre, Cardiology Department P. Debeyelaan 25, 6229 HX Maastricht, the Netherlands
| | - Hans-Peter Brunner-La Rocca
- Maastricht University Medical Centre, Cardiology Department P. Debeyelaan 25, 6229 HX Maastricht, the Netherlands; CARIM School for Cardiovascular Diseases, Universiteitssingel 50, 6229 ER Maastricht, the Netherlands
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Kellici S, Elezi G, Mihani J. Role of community pharmacists in the management of headache disorders. MAKEDONSKO FARMACEVTSKI BILTEN 2022. [DOI: 10.33320/maced.pharm.bull.2022.68.03.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Affiliation(s)
- Suela Kellici
- Department of Pharmacy, Faculty of Medicine, University of Medicine, Tirana, Dibra Street 376, 1005 Tirana, Albania
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Al-Qahtani S, Jalal Z, Paudyal V, Mahmood S, Mason J. The Role of Pharmacists in Providing Pharmaceutical Care in Primary and Secondary Prevention of Stroke: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:2315. [PMID: 36421639 PMCID: PMC9691113 DOI: 10.3390/healthcare10112315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/05/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022] Open
Abstract
Pharmacists deliver pharmaceutical care in many different healthcare settings and are well-placed to support the prevention of stroke. However, their role and impact in this area is ill-defined. This systematic review aims to explore the pharmacists’ role in stroke prevention. Nine databases were searched for studies reporting pharmacist interventions in the management of primary and secondary ischaemic stroke prevention. Study quality was evaluated through Cochrane Risk of Bias and Joanna Briggs Institute (JBI) appraisal tools where possible. A narrative review was conducted and meta-analysis performed for studies with comparable outcomes. Of the 834 initial articles, 31 met inclusion criteria. Study designs were varied and included controlled trials, observational studies, audit reports and conference abstracts. Seven studies addressed the pharmacists’ role in primary prevention and 24 in secondary prevention. Pharmacist interventions reported were diverse and often multifactorial. Overall, 20 studies reported significant improvement in outcomes. Meta-analysis showed pharmacist interventions in emergency care significantly improved the odds of achieving thrombolytic therapy door to needle (DTN) times ≤45 min, odds ratio: 2.69 (95% confidence interval (CI): 1.95−3.72); p < 0.001. The pharmacists’ role is varied and spans the stroke treatment pathway, with the potential for a positive impact on a range of health-related outcomes.
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Affiliation(s)
- Saeed Al-Qahtani
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
- School of Pharmacy, Jazan University, Jazan 45142, Saudi Arabia
| | - Zahraa Jalal
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Vibhu Paudyal
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
| | - Sajid Mahmood
- Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan
| | - Julie Mason
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Birmingham B15 2TT, UK
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Sivakumar B, Lemonde M, Stein M, Goldstein S, Mak S, Arcand J. Evaluating Health Care Provider Perspectives on the Use of Mobile Apps to Support Patients With Heart Failure Management: Qualitative Descriptive Study. JMIR Cardio 2022; 6:e40546. [PMID: 36287588 PMCID: PMC9647459 DOI: 10.2196/40546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 09/29/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nonadherence to diet and medical therapies in heart failure (HF) contributes to poor HF outcomes. Mobile apps may be a promising way to improve adherence because they increase knowledge and behavior change via education and monitoring. Well-designed apps with input from health care providers (HCPs) can lead to successful adoption of such apps in practice. However, little is known about HCPs' perspectives on the use of mobile apps to support HF management. OBJECTIVE The aim of this study is to determine HCPs' perspectives (needs, motivations, and challenges) on the use of mobile apps to support patients with HF management. METHODS A qualitative descriptive study using one-on-one semistructured interviews, informed by the diffusion of innovation theory, was conducted among HF HCPs, including cardiologists, nurses, and nurse practitioners. Transcripts were independently coded by 2 researchers and analyzed using content analysis. RESULTS The 21 HCPs (cardiologists: n=8, 38%; nurses: n=6, 29%; and nurse practitioners: n=7, 33%) identified challenges and opportunities for app adoption across 5 themes: participant-perceived factors that affect app adoption-these include patient age, technology savviness, technology access, and ease of use; improved delivery of care-apps can support remote care; collect, share, and assess health information; identify adverse events; prevent hospitalizations; and limit clinic visits; facilitating patient engagement in care-apps can provide feedback and reinforcement, facilitate connection and communication between patients and their HCPs, support monitoring, and track self-care; providing patient support through education-apps can provide HF-related information (ie, diet and medications); and participant views on app features for their patients-HCPs felt that useful apps would have reminders and alarms and participative elements (gamification, food scanner, and quizzes). CONCLUSIONS HCPs had positive views on the use of mobile apps to support patients with HF management. These findings can inform effective development and implementation strategies of HF management apps in clinical practice.
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Affiliation(s)
- Bridve Sivakumar
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Manon Lemonde
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
| | - Matthew Stein
- Social Research Centre, Ontario Tech University, Oshawa, ON, Canada
| | - Sarah Goldstein
- School of Nutrition, Faculty of Community Services, Toronto Metropolitan University, Toronto, ON, Canada
| | - Susanna Mak
- Division of Cardiology, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Medicine, Sinai Health, Toronto, ON, Canada
| | - JoAnne Arcand
- Faculty of Health Science, Ontario Tech University, Oshawa, ON, Canada
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The Impact of a Pharmacist-Led Intravenous to Oral Switch of Metronidazole: A Before-and-After Study. Antibiotics (Basel) 2022; 11:antibiotics11101303. [PMID: 36289961 PMCID: PMC9598063 DOI: 10.3390/antibiotics11101303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background. Intravenous (IV) to oral switch (IVOS) of antibiotics can reduce the length of hospitalisation, risk of IV catheter complications, and hospital costs. Pharmacists can play an instrumental role in implementing an IVOS initiative. The aim of this study is to evaluate the impact of pharmacist-led IVOS of metronidazole. (2) Method. This was an observational study conducted in a New Zealand hospital. During a 3-month intervention period, pharmacists identified patients receiving IV metronidazole; then initiated an IVOS for patients who met the criteria. The comparator groups were patients who were not switched by pharmacists in the post-intervention (post-IVOS) group, or patients treated with either IV or oral metronidazole prior to the intervention (pre-IVOS). Primary outcome measures were switch rate and duration of IV metronidazole treatment. Secondary outcome measures were readmission and/or repeat surgery within 90 days of discharge and the length of hospital stay. (3) Results. In total, 203 patients were included: 100 in the pre-IVOS and 103 in the post-IVOS groups. Pharmacists switched 63/93 (67.7%) of eligible patients to oral metronidazole in the post-IVOS period. Only 9/89 (10.1%) of IVOS eligible patients were switched in the pre-IVOS group. In the post-IVOS group, the mean duration of IV metronidazole treatment in patients switched by pharmacists was shorter than in those who were not switched by pharmacists (2.5 ± 2.8 days vs. 4.8 ± 5.9 days, p = 0.012). No significant difference was found in readmission or repeat surgery within 90 days of discharge for patients switched by pharmacists versus patients who were not switched by pharmacists. (4) Conclusion. Our data have demonstrated successful implementation of the hospital-approved pharmacist-led IVOS service.
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Li D, Dong J, Xi X, Huang G, Li W, Chen C, Liu J, Du Q, Liu S. Impact of pharmacist active consultation on clinical outcomes and quality of medical care in drug-induced liver injury inpatients in general hospital wards: A retrospective cohort study. Front Pharmacol 2022; 13:972800. [PMID: 36110542 PMCID: PMC9468675 DOI: 10.3389/fphar.2022.972800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
The utility of pharmacist consultation for drug-induced liver injury (DILI) management has not been explored. This retrospective cohort study evaluated the impact of a pharmacist active consultation (PAC) service on the management and outcome in patients with DILI. Consecutive patients meeting clinical biochemical criteria for DILI were enrolled at a tertiary teaching hospital between 1 January 2020 and 30 April 2022. The Roussel Uclaf Causality Assessment Method was used to assess causality between drug use and liver injury for each suspected DILI patient. Included patients were grouped according to whether they received PAC, and a proportional hazard model with multivariate risk adjustment, inverse probability of treatment weighting (IPTW), and propensity score matching (PSM) was used to assess DILI recovery. In the PSM cohort, the quality of medical care was compared between PAC and no PAC groups. A total of 224 patients with DILI (108 who received PAC and 116 who did not) were included in the analysis. Of these patients, 11 (10%) were classified as highly probable, 58 (54%) as probable, and 39 (36%) as possible DILI in the PAC group, while six patients (5%) were classified as highly probable, 53 (46%) as probable, and 57 (49%) as possible DILI in the no PAC group (p = 0.089). During patient recovery, PAC was associated with a ∼10% increase in the cumulative 180-day recovery rate. The PAC group had a crude hazard ratio (HR) of 1.73 [95% confidence interval (CI): 1.23–2.43, p = 0.001] for DILI 180-day recovery, which remained stable after multivariate risk adjustment (HR = 1.74, 95% CI: 1.21–2.49, p = 0.003), IPTW (HR = 1.72, 95% CI: 1.19–2.47, p = 0.003), and PSM (HR = 1.49, 95% CI: 1.01–2.23, p = 0.046). In the PSM cohort, PAC was more likely to identify suspect drugs (90% vs. 60%, p < 0.001) and lead to timely withdrawal of the medication (89% vs. 57%, p < 0.001). Thus, PAC is associated with a better quality of medical care for patients with DILI and can improve patient outcomes.
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Affiliation(s)
- Dongxuan Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- College of Pharmacy, Chongqing Medical University, Chongqing, China
| | - Jie Dong
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xin Xi
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Guili Huang
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wenjun Li
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Cheng Chen
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Liu
- Center for Medical Information and Statistics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Du
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qian Du, ; Songqing Liu,
| | - Songqing Liu
- Department of Pharmacy, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qian Du, ; Songqing Liu,
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Huynh S, Rush L, Dadalias D, Githinji D, Ta M, Poole SG, Percival M, Bell C, Warner V, Nguyen D. Time and motion study quantifying the activities of the cardiology, respiratory and geriatric clinical pharmacist. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2022. [DOI: 10.1002/jppr.1825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Simon Huynh
- Pharmacy Department Alfred Health Melbourne Australia
| | - Lily Rush
- Pharmacy Department Alfred Health Melbourne Australia
| | | | - Danson Githinji
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
| | - Melissa Ta
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
| | - Susan G. Poole
- Pharmacy Department Alfred Health Melbourne Australia
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
| | - Mia Percival
- Pharmacy Department Alfred Health Melbourne Australia
| | - Chloe Bell
- Pharmacy Department Alfred Health Melbourne Australia
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
| | - Victoria Warner
- Pharmacy Department Alfred Health Melbourne Australia
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
| | - David Nguyen
- Pharmacy Department Alfred Health Melbourne Australia
- Faculty of Pharmacy and Pharmaceutical Sciences Monash University Melbourne Australia
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Mahmoud MI, Maatoug MM, Jomaa AAAFA, Yousif M. Sudanese Medical Doctors' Perceptions, Expectations, Experiences and Perceived Barriers Towards the Roles of Clinical Pharmacists: A Cross-Sectional Study. Integr Pharm Res Pract 2022; 11:97-106. [PMID: 35879963 PMCID: PMC9307910 DOI: 10.2147/iprp.s354717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/13/2022] [Indexed: 11/26/2022]
Abstract
Purpose Interprofessional collaboration between physicians and clinical pharmacists has been shown to improve patients’ outcome by reduce medical errors, costs and patient adherence. Thus, the purpose of this study was to investigate the medical doctors’ perceptions, expectations, experiences, and perceived barriers regarding clinical pharmacists in Wad Medani. Methods A cross-sectional study was conducted at five major hospitals in Wad Medani, between April and June 2021 using a self-administered questionnaire. The questionnaire was distributed among 178 physicians. The questionnaire consists of four sections, in addition to a demographic section. These four sections measure physicians’ perceptions, expectations, experience, and perceived barriers. Results A total of 178 physicians were enrolled in the study. Physicians were comfortable with clinical pharmacists detecting and preventing prescription errors (55.1%); providing patient education (56.3%). Generally, physicians had high expectations with agreement rate of all the items ranged from 51.7% to 85.4%. Most physicians (79.8%) agreed that clinical pharmacists were a reliable source of general and clinical drug information. 64.0% and 59.0% of physicians perceive the unclear responsibility of clinical pharmacists and the lack of physicians’ experience with clinical pharmacists were barriers that can hinder clinical pharmacists’ contributions, respectively. Conclusion Physicians had positive perceptions, expectations, and experiences with clinical pharmacists, and pointed out some barriers clinical pharmacists face. It was suggested that hospitals should recruit more clinical pharmacists to cover each unit within the hospital with clear job description and provide them CPD.
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Affiliation(s)
- Mohammed Ibrahim Mahmoud
- Department of Clinical Pharmacy & Pharmacy Practice, University of Gezira, Wad Medani, Gezira State, Sudan
| | - Maha Mirghani Maatoug
- Department of Clinical Pharmacy & Pharmacy Practice, University of Gezira, Wad Medani, Gezira State, Sudan
| | | | - Mirghani Yousif
- Department of Clinical Pharmacy & Pharmacy Practice, University of Gezira, Wad Medani, Gezira State, Sudan
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Fonseca A, Lima TDM, Fernandez-Llimos F, Castel-Branco MM, Figueiredo IV. Evaluation of Cardiovascular Pharmacotherapy Guideline Adherence and Risk Factor Control in Portuguese Community Pharmacy Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19106170. [PMID: 35627707 PMCID: PMC9140328 DOI: 10.3390/ijerph19106170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
Background: Cardiovascular disease (CVD) remains the leading cause of death worldwide. Assessing the patients’ CVD risk, controlling the risk factors, and ensuring the guideline-adherent cardiovascular pharmacotherapy are crucial interventions to improve health outcomes. This study aimed to evaluate the potential of pharmacists to improve the adherence to pharmacotherapy guidelines and the achievement of risk factor goals among patients who attended a community pharmacy. Methods: We conducted a single-center cross-sectional study. We performed in-pharmacy point-of-care testing, blood pressure and anthropometric measurements, and reviewed patients’ pharmacotherapy, based on European Society of Cardiology guidelines. Results: Of the 333 patients, 63.1% were in the high/very high risk category, 91.9% showed at least two modifiable risk factors, and in 61.9% of patients the cardiovascular pharmacotherapy was non-adherent to the current guidelines, failing to reach treatment goals. The lipid-lowering therapy was the least guideline adherent, with a suboptimal use of statins. However, we found no statistically significant difference between the guideline-adherent and the non-adherent group in terms of risk factor control. The pharmacist recommended 603 interventions to adhere to the guidelines. Conclusions: Community pharmacists are able to identify opportunities to optimize cardiovascular pharmacotherapy and support the patients to achieve cardiovascular risk factor goals, based on evidence-based guidelines, contributing to the improvement of CVD management.
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Affiliation(s)
- Anabela Fonseca
- Pharmacology and Pharmaceutical Care Laboratory, Faculty of Pharmacy, University Coimbra, 3000-548 Coimbra, Portugal; (A.F.); (M.M.C.-B.); (I.V.F.)
| | - Tácio de Mendonça Lima
- Department of Pharmaceutical Sciences, Federal Rural University of Rio de Janeiro, Seropédica 23897-090, RJ, Brazil
- Correspondence:
| | - Fernando Fernandez-Llimos
- Laboratory of Pharmacology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, 4050-313 Porto, Portugal;
| | - Maria Margarida Castel-Branco
- Pharmacology and Pharmaceutical Care Laboratory, Faculty of Pharmacy, University Coimbra, 3000-548 Coimbra, Portugal; (A.F.); (M.M.C.-B.); (I.V.F.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal
| | - Isabel Vitória Figueiredo
- Pharmacology and Pharmaceutical Care Laboratory, Faculty of Pharmacy, University Coimbra, 3000-548 Coimbra, Portugal; (A.F.); (M.M.C.-B.); (I.V.F.)
- Coimbra Institute for Clinical and Biomedical Research (iCBR), 3000-548 Coimbra, Portugal
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Rattanavipanon W, Chaiyasothi T, Puchsaka P, Mungkornkaew R, Nathisuwan S, Veettil SK, Chaiyakunapruk N. Effects of Pharmacist Interventions on Cardiovascular Risk Factors and Outcomes: An Umbrella Review of Meta-analysis of Randomized Controlled Trials. Br J Clin Pharmacol 2022; 88:3064-3077. [PMID: 35174525 DOI: 10.1111/bcp.15279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 01/31/2022] [Accepted: 02/10/2022] [Indexed: 11/29/2022] Open
Abstract
AIM To grade the evidence from published meta-analyses of randomized controlled trials (RCTs) that assessed effects of pharmacist intervention on cardiovascular risk factors and cardiovascular outcomes. METHODS MEDLINE, Embase, and the Cochrane Library were searched from database inception to July 2021. Meta-analyses of RCTs were eligible. Quality of evidence were assessed by GRADE approach. RESULTS From 9,308 publications, 149 full-text articles were evaluated for eligibility, and 24 studies with 85 unique meta-analyses that assessed effects of pharmacist intervention on cardiovascular risk factors and cardiovascular outcomes. Overall, 71.7% (61/85) of unique meta-analyses showed significant impacts of pharmacist intervention. For the quality of evidence, 63.4% of meta-analyses had large heterogeneity (I2 > 50%) while 1.2%, 16.5%, 32.9% and 49.4% of meta-analyses were graded as high, moderate, low and very low quality based on GRADE approach, respectively. Among meta-analyses with moderate quality, pharmacist interventions significantly mitigated risk factors (including 6/3 mmHg reduction of blood pressure, increased the rate of lipid control, glucose control and smoking cessation (pooled OR 1.91 (1.55, 2.35), 3.11 (2.3, 4.3), and 2.3 (1.33, 3.97), respectively)) and improved medication adherence (pooled OR 1.67 (1.38, 2.02)). Furthermore, pharmacist interventions significantly reduced all-cause mortality (pooled OR 0.72 (0.58, 0.89)) and improved quality of life in patients suffering from chronic heart failure. CONCLUSION This umbrella review found convincing evidence that pharmacist intervention can provide a wide range of benefits in cardiovascular disease management, ranging from risk factor control, improvement in medication adherence and in some setting, reduction in morbidity and mortality.
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Affiliation(s)
| | - Thanaputt Chaiyasothi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Srinakharinwirot University, Nakhon Nayok, Thailand
| | | | - Rachata Mungkornkaew
- Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Ubon Ratchathani, Thailand
| | - Surakit Nathisuwan
- Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Sajesh K Veettil
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, United States of America
| | - Nathorn Chaiyakunapruk
- Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, United States of America
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Yousef B, Abudleek M, Adam M, Ahmed K. Doctors' attitude and satisfaction toward clinical pharmacists' role at omdurman military hospital: A descriptive cross-sectional study. MATRIX SCIENCE MEDICA 2022. [DOI: 10.4103/mtsm.mtsm_22_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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34
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Chelghoum M, Khitri W, Kadouri F, Chaouche K. A pilot study to assess the need for new hospital pharmaceutical services in Algerian patients and physicians’ perspective. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmab042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Objectives
The objective of this study was to assess the needs for pharmaceutical services from the perspectives of physicians and patients in the hospital setting and to contribute to the implementation of new hospital pharmacy activities.
Methods
A cross-sectional descriptive study was carried out among the doctors and patients encountered in hospital departments in Sidi Bel Abbès (Algeria); each service was evaluated using a Likert scale. Associated characteristics with an important need were evaluated by univariate analysis and binary logistic regression.
Key findings
All pharmaceutical services were important to the patients, particularly providing treatment advice and therapeutic education. Women presented an important need for insurance of the availability of pharmaceutical products (P = 0.02) and lifestyle and dietetic information (P = 0.05). High frequency of taking medication was associated with an important need for information about drug interactions (P = 0.005). Patient-oriented pharmaceutical services were not important to the physicians who considered drug information and therapeutic education to be the most important need.
Conclusions
To implement patient-centred services, it is important to improve the contact between pharmacists and physicians and to provide information about pharmaceutical services that can benefit patients. Implementation of new practices in university hospital is more feasible than in public health facilities.
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Affiliation(s)
- Mustapha Chelghoum
- Faculty of Medicine of Sidi Bel Abbes, University of Djillali Liabes, Sidi Bel Abbes, Algeria
| | - Walid Khitri
- Faculty of Medicine, University of Oran 1, Oran, Algeria
| | - Feriel Kadouri
- Faculty of Medicine of Sidi Bel Abbes, University of Djillali Liabes, Sidi Bel Abbes, Algeria
| | - Khedra Chaouche
- Faculty of Medicine of Sidi Bel Abbes, University of Djillali Liabes, Sidi Bel Abbes, Algeria
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35
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Östbring MJ, Eriksson T, Petersson G, Hellström L. Effects of a pharmaceutical care intervention on clinical outcomes and patient adherence in coronary heart disease: the MIMeRiC randomized controlled trial. BMC Cardiovasc Disord 2021; 21:367. [PMID: 34334142 PMCID: PMC8327441 DOI: 10.1186/s12872-021-02178-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/23/2021] [Indexed: 01/22/2023] Open
Abstract
Background In the treatment of coronary heart disease, secondary prevention goals are still often unmet and poor adherence to prescribed drugs has been suggested as one of the reasons. We aimed to investigate whether pharmaceutical care by a pharmacist at the cardiology clinic trained in motivational interviewing improves clinical outcomes and patient adherence. Methods This was a prospective, randomized, controlled, outcomes-blinded trial designed to compare pharmaceutical care follow-up with standard care. After standard follow-up at the cardiology clinic, patients in the intervention group were seen by a clinical pharmacist two to five times as required over seven months. Pharmacists were trained to use motivational interviewing in the consultations and they tailored their support to each patient’s clinical needs and beliefs about medicines. The primary study end-point was the proportion of patients who reached the treatment goal for low-density lipoprotein cholesterol by 12 months after discharge. The key secondary outcome was patient adherence to lipid-lowering therapy at 15 months after discharge, and other secondary outcomes were the effects on patient adherence to other preventive drugs, systolic blood pressure, disease-specific quality of life, and healthcare use. Results 316 patients were included. The proportion of patients who reached the target for low-density lipoprotein cholesterol were 37.0% in the intervention group and 44.2% in the control group (P = .263). More intervention than control patients were adherent to cholesterol-lowering drugs (88 vs 77%; P = .033) and aspirin (97 vs 91%; P = .036) but not to beta-blocking agents or renin–angiotensin–aldosterone system inhibitors. Conclusions Our intervention had no positive effects on risk factors for CHD, but it increased patient adherence. Further investigation of the intervention process is needed to explore the difference in results between patient adherence and medication effects. Longer follow-up of healthcare use and mortality will determine if the increased adherence per se eventually will have a meaningful effect on patient health. Trial registration: ClinicalTrials.gov NCT02102503, 03/04/2014 retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12872-021-02178-0.
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Affiliation(s)
- Malin Johansson Östbring
- eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden. .,Pharmaceutical Department, Region Kalmar County, Building 2, floor 2, County Council Hospital, 391 85, Kalmar, Sweden.
| | - Tommy Eriksson
- Department of Biomedical Science, and Biofilm - Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Göran Petersson
- eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden
| | - Lina Hellström
- eHealth Institute, Department of Medicine and Optometry, Linnaeus University, Kalmar, Sweden.,Pharmaceutical Department, Region Kalmar County, Building 2, floor 2, County Council Hospital, 391 85, Kalmar, Sweden
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36
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Benge C, Pouliot J, Muldowney JAS. Evaluation of a Clinical Pharmacist Specialist Transition of Care Pathway to Manage Heart Failure Readmissions During a Provider Shortage. J Pharm Pract 2021; 35:929-939. [PMID: 34060365 DOI: 10.1177/08971900211017484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Evidence supports scheduling early follow-up after heart failure (HF) hospitalization with a provider capable of managing hypervolemia. Often this service is provided by cardiologists or specialty nurse practitioners. Continuity or "familiar" providers may be better positioned to identify decompensating HF in patients who have advanced HF and/or multiple complicating medical problems. The objective of this study was to evaluate whether a clinical pharmacy specialist (CPS) service, covering the role of a "familiar" provider in an advanced HF specialty clinic (AHFC) during a staffing shortage, may prevent readmission metrics from worsening. METHODS We evaluated the entire, eligible concurrent cohorts, representing 175 AHFC-CPS and 273 control patient-admissions, respectively. Study- and disease-specific predictors for readmission were assessed. A matched cohort of 202 patient-admissions (101 AHFC-CPS:101 NO-CPS) were evaluated. RESULTS Subjects were predominantly white, elderly males. While overall "clinic [performance] profiling" outcomes for readmissions (p = 0.43) and mortality (p = 0.66) did not statistically differ between the AHFC-CPS and NO-CPS groups, an imbalance in severity of illness persisted. A survival curve and analysis were constructed, and the hazard ratio for all-cause mortality was 0.69 (p = 0.033). CONCLUSIONS This retrospective project supports the premise that AHFC-CPS intervention may be a suitable alternative to maintain the volume status for AHFC patients during a staffing short-fall. More work needs to be done to determine intervention effect size, predictors for readmission, specifically in advanced cardiovascular disease, and to evaluate CPS opportunities in the provision of independent HF care, particularly for patients with advanced HF.
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Affiliation(s)
- Cassandra Benge
- 20106VA Tennessee Valley Healthcare System, Nashville, TN, USA
| | - Jonathon Pouliot
- 5707Lipscomb University College of Pharmacy and Health Sciences, Nashville, TN, USA
| | - James A S Muldowney
- 20106VA Tennessee Valley Healthcare System, Nashville, TN, USA.,Vanderbilt University Medical Center, Nashville, TN, USA
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37
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Warden BA, Steiner J, Camacho A, Nguyen K, Purnell JQ, Barton Duell P, Craigan C, Osborn D, Fazio S. Optimizing sodium-glucose co-transporter 2 inhibitor use in patients with heart failure with reduced ejection fraction: A collaborative clinical practice statement. Am J Prev Cardiol 2021; 6:100183. [PMID: 34327503 PMCID: PMC8315663 DOI: 10.1016/j.ajpc.2021.100183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/29/2021] [Accepted: 04/04/2021] [Indexed: 12/11/2022] Open
Abstract
Heart failure with reduced ejection fraction (HFrEF) is a debilitating disease that is associated with substantial morbidity, mortality, and societal costs. The past three decades have brought about significant advancements in the pharmacologic management of HFrEF, and a corresponding reduction in morbidity and mortality. However, the progress to improve clinical outcomes in real-world settings has stalled in recent years, largely due to underutilization of guideline directed medical therapies (GDMT). The discovery of significant cardio-renal protection from sodium-glucose co-transporter 2 inhibitors (SGLT2i) has ushered in a new treatment paradigm for HFrEF management with SGLT2i therapy becoming an essential component of GDMT. Our Preventive Cardiology and Heart Failure services have established an innovative, multi-disciplinary, collaborative protocol to optimize management of cardiovascular risk factors and facilitation SGLT2i use in patients with HFrEF. The goal of this collaboration is to enhance utilization and safety of SGLT2i for HFrEF management by circumventing medication access issues, the major obstacle to therapy initiation. Within this protocol, our heart failure providers identify patients for the addition of SGLT2i to a background of heart failure GDMT. The patient is then referred to preventive cardiology where the team performs a comprehensive cardiovascular risk assessment, optimizes cardiovascular risk factors, and initiates SGLT2i with an emphasis on medication access, cost minimization, and mitigation of potential side effects. The heart failure team assumes responsibility for modification of heart failure-based therapies, and the preventive team manages diabetes, lipid, and metabolic-based therapies. The patient is followed by both cardiology services in a structured fashion, comparing outcome measures at regular intervals and utilizing our patient registry and bio-repository. This clinical practice statement provides a detailed evidentiary review on the cardiovascular and renal benefits of SGLT2i, outlines the rational for creation of a collaborative protocol, details a structured program that may serve as a template for enhanced heart failure management in other health systems, and addresses challenges encountered and recommendations for use.
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Affiliation(s)
- Bruce A. Warden
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Johannes Steiner
- Heart Failure and Heart Transplantation, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Albert Camacho
- Heart Failure and Heart Transplantation, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Khoa Nguyen
- Cardiology Fellow, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Jonathan Q Purnell
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - P. Barton Duell
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Courtney Craigan
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Diane Osborn
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
| | - Sergio Fazio
- Center for Preventive Cardiology, Knight Cardiovascular Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239 USA
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38
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Shukkoor AA, George NE, Radhakrishnan S, Velusamy S, Kaliappan T, Gopalan R, Anandan P, Palanimuthu R, Balasubramanian VR. Impact of Clinical Audit on Adherence to the Guidelines Directed Medical Therapy in Patients Admitted with Heart Failure. Curr Drug Saf 2021; 15:117-123. [PMID: 32156240 DOI: 10.2174/1574886315666200310114528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 12/19/2019] [Accepted: 02/24/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The adoption of guideline recommendations of pharmacotherapy to improve the clinical course of Heart Failure (HF) remains below par. Our objective is to evaluate the impact of clinical audit on adherence to the Guideline-Directed Medical Therapy (GDMT) in patients admitted with acute heart failure with reduced ejection fraction (EF). METHODS A prospective interventional study was conducted over a period of 12 months from June 2018 to May 2019 in all patients admitted with acute heart failure with reduced ejection fraction. The discharge prescriptions of patients who met the inclusion criteria were audited for appropriateness in the usage of neurohormonal blockers and Ivabradine, by a clinical pharmacist on a monthly basis. Audit results were presented to the practicing physicians every month and feedback was given. RESULTS Discharge prescriptions of 716 patients who presented with HF were audited for the reasonable or unreasonable omission of neurohormonal blocking drugs. The first-month audit revealed that the unreasonable omission of Angiotensin-Converting Enzyme Inhibitors/ Angiotensin Receptor Blockers/ Angiotensin Receptor Neprilisin Inhibitors ( ACEI/ARB/ARNI), Betablockers and Mineralocorticoid Receptor Antagonists (MRA) were 24.5%, 13.1%, and 9.09% respectively, which reduced to nil at the end of the study period (p=0.00). Initiation of Ivabradine before prescribing or achieving the target dose of Betablocker was noted in 38.18% of patients in the first month, which was also reduced to nil (p=0.00) at the end of the study. CONCLUSION This study reveals that periodic clinical audit improves adherence to GDMT in patients admitted with heart failure with reduced ejection fraction.
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Affiliation(s)
| | - Nimmy E George
- Department of Cardiology, PSG Hospitals, Tamilnadu, India
| | | | - Sivakumar Velusamy
- Department of Pharmacy Practice, PSG College of Pharmacy, Tamil Nadu, India
| | - Tamilarasu Kaliappan
- Department of Cardiology, PSG Institute of Medical Science and Research, Tamil Nadu, India
| | - Rajendiran Gopalan
- Department of Cardiology, PSG Institute of Medical Science and Research, Tamil Nadu, India
| | - Premkrishna Anandan
- Department of Cardiology, PSG Institute of Medical Science and Research, Tamil Nadu, India
| | - Ramasamy Palanimuthu
- Department of Cardiology, PSG Institute of Medical Science and Research, Tamil Nadu, India
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Yuen T, Zhang H, Bonin RP. Pharmacists' knowledge, experiences and perceptions of treatments for attention-deficit/hyperactivity disorder. Can Pharm J (Ott) 2021; 154:110-119. [PMID: 33868522 DOI: 10.1177/1715163520981397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that begins in childhood and often persists into adulthood. ADHD increases the risk of various negative impacts, and pharmacists are well positioned to address these issues in the community. Objectives This survey study aims to first identify pharmacists' ADHD knowledge gaps and experience with ADHD management and to second assess their preferences for continuing education and their experience with sleep-related issues in ADHD. Methods A survey was sent to Part A Ontario pharmacists with active licenses who opted in to receive research-related emails (n = 6022). Descriptive statistics were used to analyze survey data, while free-form answers were pooled and evaluated for common themes and trends. Results A total of 238 complete responses were received. The average self-reported ADHD knowledge was 5.8 ± 1.96 on a 10-point scale. There was no correlation between the number of years of practice as a pharmacist, the number of working hours per week or the location of practice on pharmacists' self-reported knowledge scores. There was a significant difference in self-reported knowledge of ADHD between pharmacists who were not aware of the Canadian ADHD Resource Alliance (CADDRA) guidelines (5.1 ± 2.1) and those who refer to it for standard of care (7.1 ± 1.5). Almost all pharmacists (95%) indicated they could benefit from additional ADHD education, with a strong preference for "online continuing education modules" (81%). The majority of responders considered psychostimulant ADHD medication as the major possible contributor to sleep disturbances (47%) in ADHD, highlighting a need for further education on the inconclusive link between ADHD medication effects on sleep. Conclusion The study results raise the concern that pharmacists may require additional ADHD education but also show the lack of awareness of available resources, such as the CADDRA guidelines. Can Pharm J (Ott) 2021;154:xx-xx.
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Affiliation(s)
- Terence Yuen
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
| | - Hantao Zhang
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
| | - Robert P Bonin
- Leslie Dan Faculty of Pharmacy (Yuen, Zhang, Bonin), University of Toronto, Toronto.,Purdue Pharma (Canada) (Yuen), Pickering.,University of Toronto Centre for the Study of Pain (Bonin), Toronto, Ontario
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40
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Rahhal A, Mahfouz A, Al‐Amri M, Aljundi A, Khir F, Hamid Y, Alyafei S, Arabi AR. Impact of discharge education by clinical pharmacists on patients' adherence to post‐percutaneous coronary intervention medications: A retrospective cohort study using real‐world data. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alaa Rahhal
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Ahmed Mahfouz
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Maha Al‐Amri
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Amer Aljundi
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Fadi Khir
- Internal Medicine Department Hamad General Hospital, Hamad Medical Corporation Doha Qatar
| | - Yousra Hamid
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Sumaya Alyafei
- Pharmacy Department Heart Hospital, Hamad Medical Corporation Doha Qatar
| | - Abdul Rahman Arabi
- Cardiology Department Heart Hospital, Hamad Medical Corporation Doha Qatar
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41
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Auditing the scope of antithrombotic care in iPACT (International Pharmacists for Anticoagulation Care Taskforce) represented countries. Res Social Adm Pharm 2021; 17:1764-1769. [PMID: 33579613 DOI: 10.1016/j.sapharm.2021.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/10/2021] [Accepted: 01/18/2021] [Indexed: 11/23/2022]
Abstract
Countries strive to find suitable solutions to offer health services to their populations. Pharmacist-led services are a possible solution to supplement the care offer with a clear advantage of proximity, with demonstrated expertise in medication use. This paper aims to audit the scope of antithrombotic care services available; and to describe the arrangements adopted for meeting the needs of the population. A multi-stage project involved the development of the list of services, generated during a face-to-face expert meeting; the definition of each service by literature search; and their clustering into three main groups (general, specific and support); resulting in an online audit of each service's availability, the settings where the service was available and the possible providers. The audit was distributed to a taskforce devoted to antithrombotic care representing 22 countries, with response obtained for all. Most reported general services were Transfer of care and Comprehensive Medication Review. Among specific services, Point-of-care testing for INR and renal function and Patient Education on antithrombotic care (antiplatelets and anticoagulants) were the most frequent. Interprofessional Education as a support service was very common, but the use of the Choosing Wisely initiative to inform evidence-based decisions was still limited. There was wide diversity found in arrangements for the provision of services to support patients taking antithrombotic medication, albeit specific services were reported in over half the surveyed countries.
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42
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Alkoudmani R, Hassali MA, Allela OQBA, Elkalmi R, Al-Essa RK. Acceptance of Pharmacist’s Extended Roles by other Healthcare Providers in the Arab Region: Review Article. ARCHIVES OF PHARMACY PRACTICE 2021. [DOI: 10.51847/iho5cje9vn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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43
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Liu Q, Zhu X, Shen M, Wu J, Chen S, Wang Z, Yu W, Shi J, Huang J, Wang Z. Community Pharmacist Services for Hypertensive Patients: A Novel Practice in Shanghai, China. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2021; 58:469580211020874. [PMID: 34078162 PMCID: PMC8182196 DOI: 10.1177/00469580211020874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 04/18/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022]
Abstract
For Chinese community pharmacists, there is a lack of guidance before and after the drug treatment process for community residents. This study aimed to investigate community pharmacists' role in hypertension management. One hundred ninety-six hypertensive patients were randomly selected from the studied community. For patients in the intervention group, monthly meetings were scheduled with a community pharmacist. Patients in the non-intervention group received standard care from their physicians. In the intervention group, the percentage using information from pharmacists increased significantly, from 54.3% to 94.2% (P < .05). Awareness of self-management was also enhanced, with community self-management group attendance increasing from 53.4% to 77.7% (P < .05), but the non-intervention group did not change significantly. Hypertensive patients' beliefs about community pharmacists also improved significantly. Hypertension status also showed a significant improvement, whereas for participants without intervention, it worsened over time. In addition to increasing knowledge regarding drug use, care provided by community pharmacists can also significantly improve blood pressure status. For those who did not receive intervention, a disproportionate level of health deterioration could be seen.
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Affiliation(s)
- Qian Liu
- Tongji University, Shanghai,
China
| | - Xiaoyan Zhu
- Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Mei Shen
- Shanghai Ouyang Road Community Health
Service Center, Shanghai, China
| | - Jianping Wu
- Shanghai Ouyang Road Community Health
Service Center, Shanghai, China
| | - Shuqin Chen
- Shanghai Ouyang Road Community Health
Service Center, Shanghai, China
| | | | - Wenya Yu
- Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Jianwei Shi
- Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Jiaoling Huang
- Shanghai Jiao Tong University School of
Medicine, Shanghai, China
| | - Zhaoxin Wang
- Shanghai Jiao Tong University School of
Medicine, Shanghai, China
- Southern Medical University, Guangdong,
China
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44
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Hasen G, Negeso B. Patients Satisfaction with Pharmaceutical Care and Associated Factors in the Southwestern Ethiopia. Patient Prefer Adherence 2021; 15:2155-2163. [PMID: 34584408 PMCID: PMC8464365 DOI: 10.2147/ppa.s332489] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/07/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND An evaluation of patient satisfaction with service provided in the health care system has been globally recognized as the measure of health care service quality. However, there is a lack of research findings that indicate patient satisfaction with newly implemented patient-oriented pharmaceutical care (PC) service provided by clinical pharmacists in Ethiopia. Therefore, the current study is aimed to determine the level of patient satisfaction and associated factors with PC service provided by clinical pharmacists in the Southwestern Ethiopia. METHODOLOGY A facility-based cross-sectional study design was employed among patients admitted to Medical wards in Jimma University Medical Center (JUMC) (n=219) from May to June 2021. The pretested interviewer-administered questionnaire containing structured questions on a 5-point Likert scale was appropriately completed and returned for statistical analysis. For the analysis of data, Statistical Package for Social Sciences (SPSS) was used. The associations between status of patient satisfaction and predictors were determined at 5% (p<0.05) level of significance by employing multivariate logistic regression. RESULTS The current study revealed that more than half (56%) of the respondents were satisfied with clinical pharmacy service. From 30% of drug therapy problems (DTPs) reported, non-adherence was the most prevalent (11.4%), while the dose being too low and adverse effects (0.9%) were the least reported. Moreover, the assignment particular clinical pharmacist (AOR: 2.091, 95% CI: 1.028, 4.255), previous admission (AOR: 0.459, 95% CI: 0.244, 0.86), number of medications taken per day (AOR: 1.929, 95% CI: 1.996, 3.739) and length of hospital stay (AOR: 2.236, 95% CI: 1.124, 4.446) were significantly associated with patient satisfaction. CONCLUSION The present study revealed that patient satisfaction towards PC was low. Lack of specific clinical pharmacist assignment, previous history of admission, number of medications taken per day and length of hospital stay are revealed as the major factors affecting the level of satisfaction. In addition, current findings implicate that clinical pharmacist collaboration with a multidisciplinary team is essential to increase patient satisfaction.
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Affiliation(s)
- Gemmechu Hasen
- Jimma University, Institute of Health, School of Pharmacy, Jimma, Oromia, Ethiopia
- Jimma University Laboratory Drug Quality (JuLaDQ), Jimma, Oromia, Ethiopia
- Correspondence: Gemmechu Hasen Jimma University, P.O.Box: 378, Jimma, Oromia, Ethiopia Email
| | - Bedaso Negeso
- Jimma University, Institute of Health, School of Pharmacy, Jimma, Oromia, Ethiopia
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45
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Schwier NC. Pharmacists’ Role in the Management of Acute and Recurrent Pericarditis: Inpatient and Outpatient Perspectives. J Pharm Pract 2020; 33:838-845. [DOI: 10.1177/0897190019857404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Pharmacists are qualified to provide valued care to patients inflicted with cardiovascular-related disorders. Although the role of pharmacists regarding the care of patients with cardiovascular disease has been previously described, there is currently no literature describing the role of pharmacists in the management of patients with pericarditis, specifically in patients with viral or idiopathic etiologies of pericarditis. Much of the management of idiopathic pericarditis, whether acute or recurrent, is a combination of pharmacotherapy, consisting of aspirin, nonsteroidal anti-inflammatory therapies, colchicine, corticosteroids, and/or immunotherapies. Therefore, pharmacists in any practice setting (ie, inpatient or outpatient) have the opportunity to provide an integral role in ensuring adherence to guideline-based care related to the management of acute or recurrent idiopathic pericarditis, optimizing patients’ use of pharmacotherapy, preventing adverse drug events such as drug–drug and drug–disease interactions, resolving managed care-related issues, providing care transitions activities that emphasize medication reconciliation and patient education, and evaluating the cost-effectiveness of the pharmacotherapies used to treat acute and recurrent idiopathic pericarditis. This review describes the role of pharmacists in the management of acute and recurrent idiopathic pericarditis within the inpatient and outpatient practice settings, with an emphasis on specialty practice areas, such as the emergency department, intensive care and medicine units within the hospital, ambulatory care–based practices, community pharmacy, and managed care pharmacy.
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Affiliation(s)
- Nicholas C. Schwier
- PGY-2 Cardiology Pharmacy Residency Program Director, Department of Pharmacy: Clinical and Administrative Sciences, College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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46
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Shi X, Geng G, Hua J, Cui M, Xiao Y, Xie J. Development of an informational support questionnaire of transitional care for aged patients with chronic disease. BMJ Open 2020; 10:e036573. [PMID: 33203624 PMCID: PMC7674111 DOI: 10.1136/bmjopen-2019-036573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES We developed an informational support questionnaire of transitional care (ISQTC) for aged patients with chronic disease and investigated its reliability and validity. SETTING This study was conducted in three large general hospitals in Nantong, Jiangsu Province, China. PARTICIPANTS A total of 130 aged patients with chronic diseases, admitted into outpatient and inpatient departments from three hospitals in China, participated in the study. The inclusion criteria were: (1) patients must provide consent to participate; (2) being 60 years and above; (3) being diagnosed with at least one chronic disease and hospitalised more than two times within the last 1 year; (4) being able to listen, speak, read and write. The exclusion criteria were: (1) refusing to participate; (2) language expression and communication barriers (and having no caregiver to assist in participation); (3) being in intensive care or long-term hospitalisation. PRIMARY AND SECONDARY OUTCOME MEASURES The developed questionnaire was validated and tested for reliability. The content validity of the questionnaire was determined through experts' interviews and Delphi expert consultation, and the structure validity of the questionnaire was determined by performing exploratory factor analysis. The coefficient of reliability of the questionnaire was measured using Cronbach's alpha. RESULTS Through Delphi expert consultation and exploratory factor analysis, the questionnaire was reduced from four dimensions and 12 items to three dimensions and 11 items. A total of 130 patients responded to the questionnaire. The alpha coefficient was 0.747. CONCLUSION The ISQTC is a reliable and valid instrument for evaluating aged patients with chronic disease in transitional care. TRIAL REGISTRATION DETAILS ChiCTR1900020923. The trial was registered on 22 January 2019.
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Affiliation(s)
- Xiaoliu Shi
- School of Medical, Nantong University, Nantong, Jiangsu, China
| | - Guiling Geng
- School of Medical, Nantong University, Nantong, Jiangsu, China
| | - Jianing Hua
- School of Medical, Nantong University, Nantong, Jiangsu, China
| | - Min Cui
- School of Medical, Nantong University, Nantong, Jiangsu, China
| | - Yuhua Xiao
- Affiliated Hospital of Nantong University, Nantong, China
| | - Juan Xie
- Department of Information Management, Affiliated Hospital of Nantong University, Nantong, China
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47
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Parihar V, Katz L, Siyam MA, Rogers A, Patterson L, Zacharias R. Mandatory pharmacist-led education session for patients seeking medical cannabis. Pharm Pract (Granada) 2020; 18:2088. [PMID: 33343771 PMCID: PMC7732211 DOI: 10.18549/pharmpract.2020.4.2088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/15/2020] [Indexed: 11/21/2022] Open
Abstract
Objective: The primary objectives of this pre-post session study, was to evaluate the impact of a pharmacist-led education session on the perceived benefits and safety of cannabis among patients with chronic pain, as well as determine the influence of pharmacist education on the selection of safer cannabis products and dosage forms for medical use among patients. Methods: A retrospective analysis of completed pre-post session questionnaires was conducted among chronic pain patients attending a mandatory education session led by a pharmacist, prior to being authorized cannabis in clinic. All questionnaire data was analyzed using SPSS v. 25. Demographic and sample characteristics were reviewed using univariate analyses. Chi-Square tests were employed to determine if the group-based education significantly affected knowledge, perception of efficacy and safety of cannabis. Results: Of the 260 session participants, 203 completed pre-post session questionnaires. After the session, a majority of current cannabis users (33.8%) and cannabis naïve/past users (56.9%) reported they would use a low THC product in the future, and a majority of current users (54.5%) would use a high CBD product in the future. After education, participants were more likely to report cannabis as having the potential for addiction (chi-square =42.6, p <0.0001) and harm (chi-square =34.0, p <0.0001). Conclusions: Pharmacist counselling and education has the potential to influence patient selection and use of cannabis, from more harmful to safer products, as well as moderate the potential perceived benefits of use.
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Affiliation(s)
- Vikas Parihar
- BSc(Pharm), PharmD. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Anesthesia, McMaster University. Hamilton, ON (Canada).
| | - Laura Katz
- PhD, CPsych. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Psychology, Neuroscience and Behavior, McMaster University. Hamilton, ON (Canada).
| | - Mahmoud A Siyam
- BSc. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & School of Pharmacy, University of Waterloo. Waterloo, ON (Canada).
| | - Anna Rogers
- BSc(Pharm). Michael G. DeGroote Pain Clinic, Hamilton Health Sciences. Hamilton, ON (Canada).
| | - Lisa Patterson
- BA. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences. Hamilton, ON (Canada).
| | - Ramesh Zacharias
- MD, FRSC, DAAPM, CMD. Michael G. DeGroote Pain Clinic, Hamilton Health Sciences, & Department of Anesthesia, McMaster University. Hamilton, ON (Canada).
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48
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Strand MA, DiPietro Mager NA, Hall L, Martin SL, Sarpong DF. Pharmacy Contributions to Improved Population Health: Expanding the Public Health Roundtable. Prev Chronic Dis 2020; 17:E113. [PMID: 32975507 PMCID: PMC7553224 DOI: 10.5888/pcd17.200350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Affiliation(s)
- Mark A Strand
- School of Pharmacy, College of Health Professions, North Dakota State University, 118K Sudro Hall, Fargo, ND 58101.
| | | | - Lori Hall
- Division of Strategic National Stockpile, Office of the Assistant Secretary for Preparedness and Response, Atlanta, Georgia
| | - Sarah Levin Martin
- Department of Community Health, University of Maine at Farmington, Farmington, Maine
| | - Daniel F Sarpong
- Center for Minority Health and Health Disparities Research and Education, College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana
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49
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Freudenberg DL, Covington LP, Young RB, Lopez ND, Patel MV, MacLaughlin EJ. Impact of a Pharmacist-Driven Protocol to Improve Guideline-Concordant Prescribing of Diabetes Medications in Patients With Atherosclerotic Cardiovascular Disease: A Pilot Study. J Pharm Pract 2020; 35:80-85. [PMID: 32938319 DOI: 10.1177/0897190020958245] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
PURPOSE To determine whether a pharmacist-driven protocol improves guideline-concordant prescribing of diabetes medications in patients with atherosclerotic cardiovascular disease (ASCVD). METHODS A retrospective pre- and post-intervention study was conducted at a university-based family medicine clinic. A pharmacist-driven protocol was implemented which involved the creation of an algorithm recommending specific diabetes medications in patients with ASCVD. An in-service presentation reviewing the algorithm and process for referral of eligible patients to an appointment with a clinical pharmacist was delivered to providers. Clinical pharmacist appointments focus was on improving diabetes management and initiating cardiovascular risk-reducing medications if appropriate. RESULTS A total of 234 patients were screened, and 108 met inclusion criteria. Upon completion of patient outreach, 34% were scheduled with a pharmacist. Forty-three percent of patients (16 of 37) attended the appointment. Of those, 31% were initiated on an evidence-based regimen indicated for diabetes and ASCVD. In comparing pre- to post-implementation of the pharmacist-driven protocol, the rate of guideline-concordant prescribing increased by 48% (3.8% to 5.6%). CONCLUSION Implementation of a pharmacist-driven protocol can increase guideline-concordant prescribing. However, further exploration of patient- and system-level barriers is necessary to implement such a program more broadly.
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Affiliation(s)
- Dakota L Freudenberg
- Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA
| | - Les P Covington
- Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA.,Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, USA
| | - Rodney B Young
- Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA.,Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, USA
| | - Nicole D Lopez
- Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, USA
| | - Miti V Patel
- Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA
| | - Eric J MacLaughlin
- Texas Tech University Health Sciences Center Jerry H. Hodge School of Pharmacy, Amarillo, TX, USA.,Texas Tech University Health Sciences Center School of Medicine, Amarillo, TX, USA
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50
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El Hadidi S, Rosano G, Tamargo J, Agewall S, Drexel H, Kaski JC, Niessner A, Lewis BS, Coats AJS. Potentially Inappropriate Prescriptions in Heart Failure with Reduced Ejection Fraction (PIP-HFrEF). EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 8:187-210. [PMID: 32941594 DOI: 10.1093/ehjcvp/pvaa108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/12/2020] [Accepted: 09/04/2020] [Indexed: 12/13/2022]
Abstract
Heart failure (HF) is a chronic debilitating and potentially life-threatening condition. Heart Failure patients are usually at high risk of polypharmacy and consequently, potentially inappropriate prescribing leading to poor clinical outcomes. Based on the published literature, a comprehensive HF-specific prescribing review tool is compiled to avoid medications that may cause HF or harm HF patients and to optimize the prescribing practice of HF guideline-directed medical therapies. Recommendations are made in line with the last versions of ESC guidelines, ESC position papers, scientific evidence, and experts' opinions.
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Affiliation(s)
- Seif El Hadidi
- Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, New Cairo, Egypt
| | - Giuseppe Rosano
- Department of Medical Sciences, IRCCS San Raffaele Pisana, Rome, Italy.,Cardiovascular Clinical Academic Group, St George's Hospitals NHS Trust University of London, London, UK
| | - Juan Tamargo
- Department of Pharmacology, School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón, CIBERCV, Madrid, Spain
| | - Stefan Agewall
- Department of Cardiology, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Sciences, University of Oslo, Oslo, Norway
| | - Heinz Drexel
- VIVIT Institute, Landeskrankenhaus Feldkirch, Austria
| | - Juan Carlos Kaski
- Molecular and Clinical Sciences Research Institute, St George's, University of London
| | - Alexander Niessner
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria
| | - Basil S Lewis
- Lady Davis Carmel Medical Center and the Ruth and Bruce Rappaport School of Medicine, Technion-IIT, Haifa, Israel
| | - Andrew J S Coats
- Centre of Clinical and Experimental Medicine, IRCCS San Raffaele Pisana, Rome, Italy
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