Background:Effective pharmacist-patient communication is essential for modern pharmaceutical services, relying heavily on optimized communication strategies that are essential for ensuring treatment adherence and overcoming the unique challenges of patient care in multilingual regions. Purpose:This study investigates the perceptions, experiences, and strategies used by community pharmacists in Romania to overcome common communication barriers. Methods:The research employed an observational, descriptive, cross-sectional study design, utilizing a self-administered online questionnaire. The data was collected through an anonymous online questionnaire (N=150) administered to patients in eastern Romania. Explicit digital informed consent was obtained. Data analysis involved descriptive statistics, t-tests for independent samples, and Spearman correlation coefficient. Results:Results indicate the perception of significant barriers, notably differences in educational levels, the use of medical terminology, and time constraints. A negative and significant Spearman correlation (ρ = -0.207, p < 0.001) was found between the perceived effectiveness of communication and the need for service improvement, confirming the detrimental impact of these difficulties on the quality of pharmaceutical services. Furthermore, the average self-assessment score of 2.59 for communication training suggests a predominantly negative perception of both university and continuing education in this area. Conclusion:The conclusions highlight an urgent need to integrate culturally and linguistically adapted communication training into the education of community pharmacists. Future research should focus on developing and evaluating pilot educational programs and interventions specifically tailored for bilingual communities.
Background:This study seeks to identify and assess the severity of drug-related problems (DRPs), analyze risk factors and evaluate the impact of DRPs on the health-related quality of life (HRQoL) among elderly multimorbid inpatients with stroke in the Comprehensive Stroke Center (CSC) in China. Methods:A two-year retrospective study was conducted at a tertiary hospital among elderly multimorbid inpatients with stroke. Medication review, HRQoL assessment and stroke-associated clinical scales assessment by clinical pharmacists or the medical team. Results:An analysis of 592 patients revealed 576 DRPs. The mean age of patients was 73.64 ± 7.96 years old. 583 (55.6%) cases had at least one DRP, with an average of 1.53 ± 0.94 DRPs per patient. The most common multimorbidity pattern was co-existing hypertension and stroke (17.4%). "Drug selection, C1" emerged as the predominant cause of DRPs (54.0%; 311/576), followed by "Patient related, C7" (18.2%; 105/576). Most DRPs (79.3%, 457/576) were low severity (B-D); the remaining 20.7% (119/576) were high severity (E-H). Increased hospital length of stays (LOS) and coexisting atrial fibrillation were identified as significant factors influencing the occurrence of DRPs (p < 0.05). The quantity of DRPs showed a weak negative correlation with HRQoL scores (r = -0.291, p < 0.001), as well as moderate positive correlations with both the mRS scores (r = 0.304, p < 0.001) and the NIHSS scores (r = 0.306, p < 0.001). Conclusion:DRPs are prevalent among elderly multimorbid inpatients with stroke in CSC and are mainly caused by drug selection and patient-related problems. Prolonged hospitalization days and the presence of atrial fibrillation were identified as significant risk factors for occurrence of DRPs in elderly multimorbid inpatients with stroke. Pharmaceutical services of medication review could assist in the identification of DRPs at the CSC.
Background:The first online pharmacy (soma.com), started in the United States in 1999, a decade later, e-pharmacy industry has transformed owing to the rise of online shopping, electronic health solutions and direct-to-consumer healthcare. With over 35,000 online pharmacies worldwide, developing countries like Uganda are seeing the emergence of online pharmacy services yet there is limited data on their readiness to provide these services. We evaluated readiness to offer online pharmaceutical services in Kampala Metropolitan Area (KMA). Methods:A cross-sectional study was conducted in 272 retail pharmacies selected by proportionate stratified random sampling from Kampala, Wakiso, Mukono, and Mpigi districts of KMA. Data to assess human resource and technological readiness was collected quantitatively using a questionnaire while assessment of legal and regulatory readiness was done qualitatively using key informants (regional managers of National Drug Authority). Descriptive statistics was conducted for quantitative data and thematic analysis was done for qualitative data. Results:Majority, 222 (95%) of the pharmacies engaged in online pharmacy services offering; tele-pharmacy 189 (85%), home drug delivery 141 (64%), e-prescriptions 97 (44%), home delivery with follow-up 94 (42%), prescription reminder services 79 (36%), and online consultations 75 (34%). Only 23 (10.4%) of online pharmacies had good human resource readiness, 124 (55.9%) had good technological infrastructure readiness and only 20 (9%) had good readiness for both Technological infrastructure and Human resources. Findings also showed a lack of specific regulations and legal frameworks for online pharmacies, minimal enforcement on the quality and authenticity of products sold online, and minimal public awareness and education on online pharmacy services. Conclusion:The majority of the pharmacies in KMA practiced some online pharmacy with over half of the pharmacies having the necessary infrastructure and the majority lacking the human resource requirements for online pharmacy services.
Along with the positive development in health services and facilities, hospital pharmacy practice in Nepal has also evolved. The minimum service standards (MSS) developed by the Ministry of Health and Population of Nepal act as a structured framework to assess hospitals' readiness and capacity to deliver quality health services and consist of three significant domains: governance and management standards, clinical service management standards, and support service standards. The clinical service management standards also consist of the hospital pharmacy service standards of practice checklist. This study presents a perspective review of MSS checklists and their implications for pharmacy services, where we discuss how the MSS checklist acts as a viable tool for strengthening the hospital pharmacy practice in Nepal's primary, secondary, and tertiary hospitals. Following the MSS checklist, hospital administration, hospital leaders, hospital management committee, and the hospital pharmacy and therapeutic committee can help to develop further action plans to mitigate issues, thus resulting in 100% compliance with the checklist and quality improvement. This paper can also serve as evidence or a start-up for conducting MSS-based research at the provincial and federal levels to inform hospital pharmacy-based practices among the policy-related institutions in the coming days.
Purpose:Pharmacists ensure prescription accuracy to safeguard patient safety. Clinical decision support systems (CDSS), integrated with computerized physician order entry (CPOE), help detect medication errors and enhance care quality. Traditional homegrown CDSS (HG systems) require manual updates, while commercial CDSS offer real-time, curated drug data but come with licensing costs. To evaluate the impact and benefits of integrating a commercial CDSS with a CPOE system on clinical decision-making and pharmaceutical care in a Taiwanese medical center. Patients and Methods:This retrospective study was conducted in a 1,354-bed teaching hospital in southern Taiwan in 2022. Alerts generated by a homegrown (HG) CDSS and a commercial CDSS, both integrated with CPOE, were compared. Fifty-six trained inpatient pharmacists reviewed prescription alerts. Effective alerts were defined as those initially missed by physicians but corrected after pharmacist intervention. Alerts were categorized by clinical issue type and severity. A model incorporating the probability of adverse drug events (ADEs), extended hospital stays, and daily costs was used to estimate cost savings. A benefit-cost ratio was calculated to assess the added value of the commercial CDSS. Results:The commercial CDSS generated 357 effective alerts, and the HG system generated 251. Over 95% of pharmacist interventions were accepted by physicians. The commercial CDSS helped avoid inappropriate prescriptions, which resulted in estimated cost savings from USD 78,540 to USD 103,530 and reduced hospital stays by 470-620 days. Conclusion:Using a commercial CDSS to assist pharmacists in prescription verification provides the most real-time information and efficiently identifies inappropriate prescriptions. This reduces medical costs and avoids prolonged hospitalization owing to ADEs.
