Why Nomenclature for Pharmacist-Led Interventions Matters: Conquering the State of Confusion

Mapping the concept of health care integration: A lexicographic analysis of scientific literature

BACKGROUND

Systems fragmentation is a major challenge for an efficient organization, integration being a potential solution also proposed in health care field, including pharmacy as a player. However, the use of different terms and definitions in the literature hinders the comparison of different integration initiatives.

OBJECTIVE

To identify and map the terms used in scientific literature regarding integration in health care and to characterize each emerging topic.

METHODS

A lexicographic analysis of the integration of healthcare systems literature indexed in PubMed was conducted. Ten different systematic searches, four using only Medical Subject Headings (MeSH) and six using text words, were conducted in March 2023. Journal scattering was analyzed following Bradford's distribution using the Leimkuhler model. An overall text corpus was created with titles and abstracts of all the records retrieved. The corpus was lemmatized, and the most used bigrams were tokenized as single strings. To perform a topic modeling, the lemmatized corpus text was analyzed using IRaMuTeQ, producing descending hierarchic classification and a correspondence analysis. The 50 words with higher chi-square statistics in each class were considered as representative of the class.

RESULTS

A total of 42,479 articles published from 1943 to 2023 in 4469 different journals were retrieved. The MeSH "Delivery of Health Care, Integrated", created in the 1996 MeSH update, was the most productive retrieving 33.7 % of the total articles but also retrieving 22.6 % of articles not retrieved in any other search. The text word "Integration" appeared in 15,357 (36.2 %) records. The lexicographic analysis resulted in 7 classes, named as: Evidence and implementation, Quantitative research, Professional education, Qualitative research, Governance and leadership, Clinical research, and Financial resources. Association between the classes and the searches or the text-words used ranged from moderate to weak demonstrating the lack of a standard pattern of use of terms in literature regarding healthcare integration.

CONCLUSIONS

The term "integration" and the MeSH "Delivery of Health Care, Integrated" are the most used to represent the concept of integration in healthcare and should be the preferred terms in the literature.

Role of a Pharmacist in Postdischarge Care for Patients With Kidney Disease: A Scoping Review

OBJECTIVE

The objective was to explore and describe the role of pharmacists in providing postdischarge care to patients with kidney disease.

DATA SOURCES

PubMed, Embase (Elsevier), CINAHL (Ebscohost), Web of Science Core Collection, and Scopus were searched on January 30, 2023. Publication date limits were not included. Search terms were identified based on 3 concepts: kidney disease, pharmacy services, and patient discharge. Experimental, quasi-experimental, observational, and qualitative studies, or study protocols, describing the pharmacist's role in providing postdischarge care for patients with kidney disease, excluding kidney transplant recipients, were eligible.

STUDY SELECTION AND DATA EXTRACTION

Six unique interventions were described in 10 studies meeting inclusion criteria.

DATA SYNTHESIS

Four interventions targeted patients with acute kidney injury (AKI) during hospitalization and 2 evaluated patients with pre-existing chronic kidney disease. Pharmacists were a multidisciplinary care team (MDCT) member in 5 interventions and were the sole provider in 1. Roles commonly identified include medication review, medication reconciliation, medication action plan formation, kidney function assessment, drug dose adjustments, and disease education. Some studies showed improvements in diagnostic coding, laboratory monitoring, medication therapy problem (MTP) resolution, and patient education; prevention of hospital readmission was inconsistent. Limitations include lack of standardized reporting of kidney disease, transitions of care processes, and differences in outcomes evaluated.

RELEVANCE TO PATIENT CARE AND CLINICAL PRACTICE

This review identifies potential roles of a pharmacist as part of a postdischarge MDCT for patients with varying degrees of kidney disease.

CONCLUSIONS

The pharmacist's role in providing postdischarge care to patients with kidney disease is inconsistent. Multidisciplinary care teams including a pharmacist provided consistent identification and resolution of MTPs, improved patient education, and increased self-awareness of diagnosis.

Confusing terminology used in the abbreviation of pharmacy journal names

The lack of commonly agreed terminology in pharmacy field is highly prevalent and may have influence on the relevance and robustness of the area, especially how others see pharmacy literature. Potential consequences of this poor perception of pharmacy field by the National Library of Medicine (NLM) could be the omission of several pharmacy-related Medical Subject Headings (MeSH) or the low indexing rate of pharmacy practice journals in MEDLINE. Journal name abbreviation, under the responsibility of the NLM, is the unambiguous way to identify a journal in bibliographic references and catalogs. The present study investigated the consistency of pharmacy journal abbreviations in the NLM Catalog. For the 290 journals containing any word with the root pharm in their names, a consistent procedure for NLM title abbreviations was found for 27 of the words in journal names but not for the abbreviation "Pharm", which represented several words with very different meanings: pharmaceutical, pharmaceutics, pharmacists, and pharmacy. The use by the NLM of different abbreviation for pharmaceutical and pharmaceutics would increase journal identification clarity.