Pharmacist clinical interventions: Five years' experience of an efficient, low-cost, and future-proofed tool

Development and validation of a feasible questionnaire to assess pharmacists' attitudes to documenting and classifying pharmaceutical interventions in hospital settings

BACKGROUND

Significant efforts have been directed towards systematically documenting and classifying pharmacist interventions (PIs), generating relevant data for professionals' practice and improving the quality of patient care and health outcomes. However, the paucity of PI evaluation tools hinders data generation, harmonisation and sensible application.

AIM

This study aimed to develop and validate a comprehensive questionnaire to assess pharmacists' opinions and practices concerning documenting and classifying PIs in Portuguese hospital settings.

METHOD

The tool development underwent face, content, construct validity procedures and scale reliability calculations grounded in the attitudinal framework. An exploration of the instrument dimensionally was accomplished through factor analysis. Face validity, content validity, construct validity and scale reliability were the selected validation parameters.

RESULT

A 37-item scale was developed comprising an initial sociodemographic section (8 items) and three explanatory attitudinal-based domains: Cognitive (6 items), Behavioural (14 items), and Affective (9 items). The scale showed adequate overall psychometric properties. Within the Affective domain, factor analysis revealed three latent explanatory factors: Process (4 items), Outcome (3 items) and Satisfaction (2 items).

CONCLUSION

This newly developed tool can contribute to assessing pharmacists' perspectives and routines in documenting and classifying PIs within hospital environments.

One Year Evaluation of Pharmacist Medication Charting Service in a Principal Referral Women and Newborn Hospital

Background: Accuracy of medication charts on admission to hospital has previously shown that inadvertent omission of therapy was the most common discrepancy, accounting for 40% to 60% of errors. Partnered Pharmacist Medication Charting (PPMC) has shown to reduce medicationrelated problems. Objective: The aim of this study was to evaluate the implementation of Pharmacist Medication Charting (PMC), a derivative of PPMC, in a maternity and gynecological hospital. The occurrence of medication omission identified by the pharmacists was assessed and the pharmacist interventions involving PMC analyzed. Methods: The pharmacist interventions documented from 1st July 2022 to 30th June, 2023 were evaluated using PowerBI for data and trends on the Medication-Related Problems (MRPs) identified, occurrence of PMC, common medications charted by the pharmacists and the pharmacist recommendation and action following the identification of MRPs. Results: A total of 4898 pharmacy interventions was documented in the 12-month period. Of the total interventions documented, 1321 (26.97%) were related to pharmacist medication charting. Of all the interventions related to PMC, 53.29% involved pharmacists charting medications for the continuation or initiation of over-the-counter medications, 13.32% involved pharmacist partnered charting of Prescription Only Medications and Controlled Medications with medical staff, and 33.3% were referred to a credentialled pharmacist for PMC service. With regards to action taken following interventions involving PMC, 1065 (80.62%) were resolved following PMC. Common medications charted by the pharmacists include: macrogol and docusate laxatives (288), pregnancy multivitamin containing iron, iodine and folate (169), colecalciferol (133), iron (127), asthma inhaler (99), paracetamol and ibuprofen (88), nicotine (38), calcium (29), folic acid (26), and pantoprazole (15). Conclusion: Our study demonstrated that hospital pharmacists contribute to the reduction of MRPs, and PMC enables pharmacist to address prescribing omission and conditions untreated in the hospital. This study also reflects skills enhancement in practice for clinical pharmacists and resulted in successful implementation of PMC.

A health integrated platform for pharmacy clinical intervention data management and intelligent visual analytics and reporting

Objective

Our initiative aimed to improve the system used to capture pharmacist clinical interventions to better support staff to document, manage and identify trends in medication-related problems (MRPs). The aim of the study was to develop an electronic tool which is easily accessible by most electronic devices with secure data storage and access.

Methods

A REDCap® database was designed for documentation of pharmacy clinical interventions. Information documented can be retrieved in real-time and can be integrated to Microsoft Power BI® for real-time data visualisation. The dashboards were customised to display useful information including pharmacy clinical intervention details, common MRPs, common medications involved available to users at real time.

Results

A total of 4343 interventions were documented from July 2022 to March 2023. The most common MRPs were omission of regular medications 876 (20.17%), condition untreated 722(16.62%), and contraindications apparent 451 (10.38%). The most common medications involved include iron 244 (5.62%), enoxaparin 231 (5.32%), macrogol laxatives 208 (4.79%), multivitamin 206 (4.74%), colecalciferol 179(4.12%), tramadol 156 (3.59%).

Conclusion

This study demonstrated the significance of integration of health application tools of REDcap and Power BI in the data management and intelligent visual analytics and reporting.

Small patients, big challenges: navigating pediatric drug manipulations to prevent medication errors - a comprehensive review

INTRODUCTION

Medication errors during drug manipulations in pediatric care pose significant challenges to patient safety and optimal medication management. Epidemiological studies have revealed a high prevalenceof medication errors throughout the medication process. Due to the lack of age-appropriate dosage forms, medication manipulation is common in pediatric drug administration. The consequences of these manipulations on drug efficacy and safety could be devastating, highlighting the need for evidence-based guidelines and standardized compounding practices.

AREAS COVERED

This review focuses on examining medication errors in pediatric care and delving into the manipulation of medicinal products.

EXPERT OPINION

The observed prevalence of medication errors and manipulations underscores the importance of addressing these issues to enhance patient safety and improve medication outcomes in pediatric care. Overall, the development of age-appropriate formulations and the dissemination of comprehensive clinical guidelines are essential steps toward improving medication safety and minimizing manipulations in pediatric healthcare settings.

A computer architecture based on disruptive information technologies for drug management in hospitals

The drug management currently carried out in hospitals is inadequate due to several factors, such as processes carried out manually, the lack of visibility of the hospital supply chain, the lack of standardized identification of medicines, inefficient stock management, an inability to follow the traceability of medicines, and poor data exploitation. Disruptive information technologies could be used to develop and implement a drug management system in hospitals that is innovative in all its phases and allows these problems to be overcome. However, there are no examples in the literature that show how these technologies can be used and combined for efficient drug management in hospitals. To help solve this research gap in the literature, this article proposes a computer architecture for the whole drug management process in hospitals that uses and combines different disruptive computer technologies such as blockchain, radio frequency identification (RFID), quick response code (QR), Internet of Things (IoT), artificial intelligence and big data, for data capture, data storage and data exploitation throughout the whole drug management process, from the moment the drug enters the hospital until it is dispensed and eliminated.