Factors influencing the implementation of clinical pharmacy services for hospitalized patients: A mixed-methods systematic review

Onozato, Thelma; Cruz, Carla Francisca dos Santos; Farre, Anny Giselly Milhome da Costa; Silvestre, Carina Carvalho; Silva, Rafaella de Oliveira Santos; Júnior, Genival Araújo dos Santos; Lyra, Divaldo Pereira de

doi:10.1016/j.sapharm.2019.06.018

Cited by 30 publications

(23 citation statements)

References 79 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Onozato and colleagues highlighted the importance of both administrative and political support in the implementation of clinical pharmacy services within health care institutions. 25 Unfortunately, clinical pharmacists seem to be trapped in a catch-22 situation: While individual clinical pharmacists can and want to deliver pharmaceutical care to patients, this lack of support hampers their ability to do so. On the other hand, without being able to demonstrate the need for their presence in direct patient care, clinical pharmacists lose the opportunity to gain said support.…”

Section: Discussionmentioning

confidence: 99%

“To be or not to be in the ward”: The impact of COVID‐19 on the role of hospital‐based clinical pharmacists—A qualitative study

Cheong

2020

J Am Coll Clin Pharm

View full text Add to dashboard Cite

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has significantly affected health care systems around the world. In many hospitals and health care facilities, services and health care workers have been reorganized and restructured to meet the demands of the pandemic. The impact of the pandemic on hospital-based clinical pharmacists and their ability to deliver pharmaceutical care is currently unknown. Objective: This study aimed to explore the impact of the COVID-19 pandemic on hospital-based clinical pharmacists working in Malaysia and the implications on how clinical pharmacy is perceived as a health care service. Methods: A qualitative study was designed to meet the research objectives. Nineteen hospital-based clinical pharmacists consented and participated in one-on-one, semi-structured interviews. The interviews were transcribed and analyzed using an iterative thematic analysis approach. Results: The experiences and views of the participants were reported. Three main themes were developed: "Reassignment and other changes in clinical pharmacist roles," "Adapting clinical pharmacy services to COVID-19," and "The need for clinical pharmacists in the ward." The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment. Despite this, clinical pharmacists continued to support patient care in hospitals through the use of technology. The withdrawal of clinical pharmacy services, however, raises concern that the role of clinical pharmacists is still poorly recognized. Conclusion: Clinical pharmacists in hospitals continue to support patient care despite the disruption caused by the COVID-19 pandemic. Greater support and recognition of their role is required in order to empower and enhance their ability to deliver pharmaceutical care. K E Y W O R D S clinical pharmacists, coronavirus, hospital pharmacy services Around the world, health care systems have been significantly impacted by the coronavirus disease 2019 (COVID-19) pandemic. Health care facilities have been forced to restructure their services and systems in order to prioritize infection control and manage COVID-19 patients. 1 There have been reports of health care workers being reassigned to areas deemed more essential,

show abstract

Section: Discussionmentioning

confidence: 99%

“To be or not to be in the ward”: The impact of COVID‐19 on the role of hospital‐based clinical pharmacists—A qualitative study

Cheong

2020

J Am Coll Clin Pharm

View full text Add to dashboard Cite

show abstract

“…The factors identi ed in the study were classi ed by two researchers (KSSR and SCS), according to the Apoteca framework, which comprises the following domains: "attitudinal", "political", "technical", and "administrative". This conceptual framework emerged from systematic observation and immersion of our research group (LEPFS, UFS) in the implementation of CPS in various settings within the Brazilian Health System [20,21]. The aforementioned domains are de ned as follows:…”

Section: Discussionmentioning

confidence: 99%

“…The implementation process will be based on the Methodology of Problematization with Maguerez Arc in association with the Apoteca framework [20,21]. This methodology has ve steps: observation of reality, key points, theorizing, solution hypotheses, and application to reality [22,23].…”

Section: Study Context and Settingmentioning

confidence: 99%

Which factors may influence the implementation of drug dispensing in community pharmacies? A qualitative study

Cerqueira-Santos

Rocha

Araújo

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Implementation of clinical pharmacy services, such as drug dispensing, is a complex process. It is necessary to understand the challenges associated with this practice from the perspective of the actors involved to help ensure optimal service provision. Thus, this study aimed to understand the factors that may influence the implementation of drug dispensing in community pharmacies, according to the perceptions of pharmacists. Methods: This qualitative study was based on semi-structured, face-to-face interviews. The participants were pharmacists who worked in a chain of community pharmacies in Brazil, selected based on their direct participation in the implementation process. The interview recordings were transcribed full verbatim and were independently analyzed using thematic analysis, followed by consensus meetings between researchers. The factors identified by the participants were classified according to the Apoteca framework. This study was approved by the Committee of Ethics in Research and all participants signed an informed consent form. Results: We conducted 18 interviews, with 47 factors that may influence the implementation of drug dispensing in community pharmacies being identified. These factors were allocated to seven categories: support from community pharmacy chain (4), pharmacy infrastructure (11), characteristics of the pharmacy, medicines and other health products (4), pharmacist (16), dispensing work process (2), pharmacy team (2), and patient (8). The classification of factors according to the Apoteca framework allocated most of them to administrative (14) and technical (14) domains, followed by attitudinal (13) and political (5) domains. Conclusions: This study identified several factors that can influence the implementation of drug dispensing and classified them according to the domains of the Apoteca framework, highlighting the multifactorial nature of the implementation process. The results of this study can guide the planning of strategies aimed at providing efficient drug dispensing in community pharmacies.

show abstract

“…The solution hypotheses were divided into four groups: political interventions (referring to the characteristic of influencing individuals or groups); administrative interventions (related to the organization and management process); technical interventions (referring to the development of skills and knowledge necessary for the development of CPS); and attitudinal interventions (related to behaviour, action or reaction, motivated by a feeling, or opinion for a particular fact or person) based on the Apoteca framework 47,48 . All the selected solution hypotheses were agreed upon the members of the implementation team, pharmacists and managers.…”

Section: Methodsmentioning

confidence: 99%

“…The application of the interventions to reality began at different times and persisted throughout the CPS implementation process. The interventions were based on the Apoteca framework, which presents four domains: Attitudinal, POlitical, TEChnical and Administrative (APOTECA) 47,48 . The interventions were described as follows: Political (this domain is related to the relationships within a group or organization that allow particular individuals or groups to influence others).…”

Section: Methodsmentioning

confidence: 99%

Implementation of clinical pharmacy services using problematization with Maguerez Arc: A quasi‐experimental before‐after study

Júnior

Silva

Onozato

et al. 2020

Evaluation Clinical Practice

Self Cite

View full text Add to dashboard Cite

Rationale, aims, and objectives The growth of clinical pharmacy services (CPS) has positively impacted clinical, economic, and humanistic health outcomes. However, detailed studies on the process of implementing CPS in healthcare systems are incipient. Thus, the present study aimed to evaluate the CPS implementation in certain public health units in a metropolis in northeast Brazil. Methods A quasi‐experimental before‐and‐after study was carried out in Recife City, from July 2015 to March 2016. The study was carried out using the Methodology of Problematization with Maguerez Arc and was divided into: initial evaluation (before), planning, interventions, and preliminary evaluation (after). The participants were pharmacists, patients, health professionals, and local health managers. Descriptive statistics were used to report data. The statistical significance of the comparison between variables was evaluated using the Wilcoxon test (95% CI; P ≤ .05). Results Initial evaluation: Identified incipient CPS, a lack of structure and work process of pharmacists. Planning: Sixteen brainstorming meetings were held with the different actors resulting in a strategic plan. Intervention: Twenty‐two political‐administrative meetings were held with managers and health teams and 768 hours of theoretical and practical training with mentoring for pharmacists. Preliminary evaluation: Structure indicators presented a statistically significant difference, differently from the process indicators. Pharmacists attended 842 patients and performed 1465 pharmaceutical consultations in 6 months. Regarding the outcome indicators, it was possible to identify changes in the clinical status of the most prevalent diseases among those patients who attended three pharmaceutical consultations. Conclusions It was possible to evaluate the CPS implementation in certain public health units in a metropolis in Brazil, through the Methodology of Problematization with Maguerez Arc. This methodology may be part of models for future implementations of CPS in health systems.

show abstract

Factors influencing the implementation of clinical pharmacy services for hospitalized patients: A mixed-methods systematic review

Cited by 30 publications

References 79 publications

“To be or not to be in the ward”: The impact of COVID‐19 on the role of hospital‐based clinical pharmacists—A qualitative study

“To be or not to be in the ward”: The impact of COVID‐19 on the role of hospital‐based clinical pharmacists—A qualitative study

Which factors may influence the implementation of drug dispensing in community pharmacies? A qualitative study

Implementation of clinical pharmacy services using problematization with Maguerez Arc: A quasi‐experimental before‐after study

Contact Info

Product

Resources

About