Health care at a crossroad: What will the pharmacists' role be?

Gurney, Mary K.

doi:10.1016/j.sapharm.2009.07.002

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…9,10,12 Pharmacists are also typically unfamiliar with the roles of other team members, 13 creating difficulties in collaborating successfully. [14][15][16] During the early stages, pharmacists often depend on other team members to assist in their integration, creating additional work for nurses and physicians. 17 Other frequently reported barriers include physician resistance, lack of pharmacist assertiveness, inadequate pharmacist support, lack of space and inadequate pharmacist training.…”

Section: Introductionmentioning

confidence: 99%

Guidelines for pharmacists integrating into primary care teams

et al. 2013

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PRACTICE GUIDELINESPeer-reviewed Guidelines for pharmacists integrating into primary care teams Derek Jorgenson, BSP, PharmD, FCSHP; Dan Dalton, BSc; Barbara Farrell, BScPhm, PharmD, FCSHP; Ross T. Tsuyuki, BSc(Pharm), PharmD, MSc, FCSHP, FACC; Lisa Dolovich, BScPhm, PharmD, MSc IntroductionHealth systems are moving toward a more interprofessional approach to primary care. This team-based paradigm has had a significant impact on the role of pharmacists within primary health care systems. Within the past decade, nondispensing clinical pharmacists have been integrated into many Primary Care Trusts in the United Kingdom, 1,2 primary care teams in North America 3-5 and similar practice settings around the world. 6,7 Pharmacists bring value to these teams by improving medication use through individual patient assessments and population-based interventions, providing education and drug information to other team members and implementing system-level practice enhancements. Pharmacists commonly encounter barriers to integrating into these primary care teams. For example, many experience a lack of role clarity, and other team members' expectations regarding the pharmacists' responsibilities are frequently unclear. 4,[8][9][10][11] In addition, patients often do not understand the role of the pharmacist in this setting. 9,10,12 Pharmacists are also typically unfamiliar with the roles of other team members, 13 creating difficulties in collaborating successfully.14-16 During the early stages, pharmacists often depend on other team members to assist in their integration, creating additional work for nurses and physicians.17 Other frequently reported barriers include physician resistance, lack of pharmacist assertiveness, inadequate pharmacist support, lack of space and inadequate pharmacist training. [9][10][11]13,14,[17][18][19][20][21] Many of these barriers to pharmacist integration can be minimized or avoided if pharmacists are prepared. Unfortunately, recent evidence suggests that pharmacists often continue to make the same mistakes and struggle to integrate into these teams, despite the fact that these barriers are well documented in the literature. 22 The purpose of these guidelines is to provide recommendations that will assist pharmacists to successfully integrate into existing primary care teams. MethodsA literature search was performed in OVID Books, MEDLINE, Embase and International Pharmaceutical Abstracts to identify publications related to the experiences of pharmacists in primary care teams. Additional studies were identified from bibliographical reviews of pertinent articles. Relevant articles from the search were selected for detailed review if they contained qualitative or quantitative data related to pharmacists' experiences integrating into primary care teams. Articles were excluded if they were not available in the English language. Two authors (DJ, DD) independently reviewed the relevant articles from the search and made lists of authors' conclusions about how pharmacists could have integrated bet...

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Section: Introductionmentioning

confidence: 99%

Guidelines for pharmacists integrating into primary care teams

et al. 2013

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“…In many countries, clinical pharmacists frequently encounter barriers such as undefined roles, inadequate pharmacist support and training, and as a result, are often unclear about the expectations regarding their responsibilities among team members and patients ( Assa-Eley and Kimberlin, 2005 ; Newton et al, 2007 ; Farrell et al, 2008 ; Dey et al, 2011 ; Kozminski et al, 2011 ; Berdine et al, 2012 ). Pharmacists are also typically unfamiliar with the roles of other team members during the initial period, ( Dobson et al, 2006 ), creating confusion ( Gulliver et al, 2002 ; Gurn and ey, 2009 ; Goldman et al, 2010 ) and lack of assertiveness and thus, they often rely on other team members for assistance ( Brock and Doucette, 2004 ).…”

Section: Discussionmentioning

confidence: 99%

Acceptance rate of clinical pharmacists’ recommendations—an ongoing journey for integration

Peled,

Vitzrabin,

Beit Ner

et al. 2023

Front. Pharmacol.

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Introduction: Multidisciplinary expert team collaboration in the clinical setting, which includes clinical pharmacist involvement can facilitate significant improvements in outcomes and optimize patient management by preventing drug-related problems (DRP). This type of collaboration is particularly valuable in patients with multi-morbidity and polypharmacy such as diabetic foot patients. Evidence regarding the successful integration of a new clinical pharmacist, without previous experience into a unit is still scarce. Therefore, this study aimed to describe and evaluate the actual successful integration process of the clinical pharmacist into a diabetic foot unit by measuring the change in recommendation acceptance rate over time.Methods: A prospective, exploratory treatment effectiveness study based on the recommendation acceptance rate of a new clinical pharmacist introduced into the diabetic foot unit was conducted over a 9- month period. The clinical pharmacist identified medical and drug-related problems (DRP) or any discrepancies in the prescribing and administration of medications. Each identified DRP was documented and formulated as a recommendation by the clinical pharmacist. The main outcome measure was the acceptance rate of recommendations over time.Results: A total of 86 patients, of which 67% were men, averagely aged 66.5 (SD 11.8) years were evaluated. Calculated BMI was 30.2 (SD 6.2). The average number of medical diagnoses was 8.9 (SD3.2), and 11.1 (SD 3.7) prescribed drugs for each patient. Cardiovascular disease was presented by 95% (n = 82) of the patients and 33% of them (n = 28) had uncontrolled hyperglycemia. Averagely, 3.3 (SD 1.9) DRPs were identified pre patient. The efficacy-related DRP recommendation acceptance rate increased over the study period from 37.8% in the first 4 months to 79.4% after a period of 4.75 months. Safety-related DRP recommendation acceptance rate increased from 56% to 67.6%.Conclusion: Improved clinical outcomes and optimized pharmacologic patient management may be achieved by the successful integration of a clinical pharmacist into the team. This study provides evidence of the increasing recommendation acceptance rate of integrated, pharmacist-driven comprehensive medication management in an unexperienced unit. To overcome challenges, team members should collaborate to fully integrate the clinical pharmacist into the team-based structure and utilize proper strategies to minimize and transcend barriers.

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“…33,35,37,38,[41][42][43][44] In addition, it is often mentioned that a change of mentality of both health-care professionals and patients is needed. 36 Health-care professionals will need to work more and more in multidisciplinary teams; 29,30,32,33,[40][41][42][45][46][47][48][49][50][51][52] therefore, communication needs to improve, 31,38,44,[53][54][55][56] roles and competencies need to be clarified, understood and respected, 34,39,43,44,54,57 and proper training needs to be given in order to fulfil those roles and competencies. 31,32,36,37,43,44,47,54,58,59 The patient, in turn, needs to understand the (new) role of the pharmacist and be open to building a closer relationship with ...…”

Section: Discussionmentioning

confidence: 99%

A logic model for pharmaceutical care

Moltó-Puigmartí

Vonk

Ommeren

et al. 2018

J Health Serv Res Policy

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ObjectivesTo develop a logic model for pharmaceutical care that can be used by stakeholders as a tool to support innovation and to monitor the performance of the pharmaceutical care system in the Netherlands and abroad. The ultimate aim of such a system is the responsible provision of drug therapy to improve patients’ quality of life.MethodsThe logic model for pharmaceutical care was created following a process consisting of four steps: (1) a literature review to identify what pharmaceutical care is and what elements it consists of; (2) separate interviews with 10 stakeholder organizations to discuss the results of the literature review; (3) construction of the logic model based on the findings from steps 1 and 2; and (4) separate interviews with three stakeholder organizations to discuss and fine-tune the model. This project was carried out by the National Institute for Public Health and the Environment (Rijksinstituut voor Volksgezondheid en Milieu) in the Netherlands.ResultsAccording to the proposed logic model, pharmaceutical care is care defined as: (1) patient-centred; (2) effective and safe; (3) efficient and affordable; (4) in physical, financial and timely ways; and (5) with minimal environmental impact.ConclusionThe proposed logic model provides stakeholders with a common framework for the innovation or further development of pharmaceutical care.

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Health care at a crossroad: What will the pharmacists' role be?

Cited by 3 publications

References 16 publications

Guidelines for pharmacists integrating into primary care teams

Guidelines for pharmacists integrating into primary care teams

Acceptance rate of clinical pharmacists’ recommendations—an ongoing journey for integration

A logic model for pharmaceutical care

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