In this narrative review, we trace the evolution of health care, clinical pharmacy practice, and pharmacy education in Taiwan and two Southeast Asian countries, Vietnam and Indonesia. In evaluating the current health‐care systems and progress toward health‐care reform, we review the major changes that have impacted pharmacy practice and pharmacy education in each of these countries. The lack of qualified and well‐trained pharmacists has been identified as one of the key barriers to advancement of clinical pharmacy in this region. This shortage is based on a number of factors which include having a pharmacy education system that needs reform and expansion to adequately meet the growing demands of global public health. Many initiatives from organizations such as the World Health Organization, the International Pharmaceutical Federation, and the Federation of Asian Pharmaceutical Associations have influenced the advancement of global pharmacy practice and education. Moreover, we highlight key legislative changes that have impacted clinical pharmacy development in these countries and discuss how foreign policy changes in Taiwan have increased its collaboration with foreign pharmacy schools in Vietnam and Indonesia. Understanding the history and progress of clinical pharmacy education in these countries is important to help shape future collaborations that advance pharmacy practice and improve global health.
ObjectivesThis study aimed to compare the time required and concerns raised by various perspectives of participants regarding administering subcutaneous and intravenous trastuzumab for patients with breast cancer (BC).DesignThis observational time–motion study design with mixed-methods research (cross-sectional surveys and semistructured interviews) was conducted. The time spent on preparing or administering trastuzumab by different healthcare professionals (HCPs) was recorded. The data were analysed by descriptive/inferential statistical analyses, followed by thematic analyses.SettingOutpatient and inpatient administration units of a single medical centre in Taiwan.ParticipantsThe study included patients with early-stage BC who received subcutaneous or intravenous trastuzumab (n=93), and HCPs including two attending physicians, a nurse practitioner, two pharmacists and two nurses.ResultBased on the perspectives of patients and HCPs, the subcutaneous form of trastuzumab was more efficient, less expensive and produced less discomfort in outpatient units than inpatient units. More participants preferred the subcutaneous form over the intravenous form in both outpatient and inpatient units. Pharmacists and nurse practitioners spent threefold more time on patients when preparing and administering the intravenous form in both outpatient and inpatient units. The concerns raised by patients and HCPs varied in certain aspects, including the injection skills, speed, mental distress (eg, needle phobia) and pain associated with the subcutaneous form. Almost all patients preferred receiving the subcutaneous form in outpatient units after the initial COVID-19 outbreak.ConclusionPatients with early-stage BC preferred receiving subcutaneous trastuzumab in outpatient units rather than inpatient units or the intravenous form before and after the COVID-19 outbreak. Such findings may serve as real-world evidence to facilitate better quality of care regarding administration of subcutaneous or intravenous trastuzumab in medical settings, and its feasible resolutions to balance the quality, concerns and efficiency of anticancer administration during the COVID-19 pandemic.
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