Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

Júnior, Genival Araújo dos Santos; Ramos, Sheila Feitosa; Pereira, André Mascarenhas; Dosea, Aline Santana; Araújo, Elton Matos; Onozato, Thelma; Pimentel, Déborah; Lyra, Divaldo Pereira de

doi:10.1371/journal.pone.0206115

Cited by 27 publications

(26 citation statements)

References 60 publications

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“…[7][8][9][10][11] Despite the evidence, however, the implementation, funding, and staffing of clinical pharmacy services continues to face numerous challenges. [12][13][14] As such, clinical pharmacy services can be particularly sensitive to changes that affect the allocation of resources within the health care facility.…”

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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

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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 The findings indicate that in many cases, clinical pharmacy services were fully or partially withdrawn from the ward to reduce the risk of infection and to conserve the usage of personal protective equipment.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,

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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

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“…The literature based on qualitative studies that identify factors that may in uence the implementation of CPS is extensive [14,15,25,27,34] which begs the question, why carry out more studies on this topic? We believe that drug dispensing, as a basic and integrated service to health care networks, has great potential to promote the rational use of medicines and to screen patients who need additional, more complex, CPS.…”

Section: Discussionmentioning

confidence: 99%

“…Factors related to support from the community pharmacy chain were highlighted as facilitators of the implementation process. According to the literature, the support of the institution, the manager, and the supply of training, in uence the provision of CPS in different settings [15,26,27,36]. Regarding autonomy, studies have shown that this factor is in uenced by the market economy, often limiting the capacity for professionals, who are employed, to apply their own judgement when making decisions [37,38].…”

Section: Discussionmentioning

confidence: 99%

“…Factors related to pharmacists, such as knowledge, skills, and attitudes, were described by the interviewees. These competencies must form the foundation of high-quality work processes and have been widely discussed in previous studies related to the implementation of CPS [25,27,34,42]. Professions such as nursing, for example, which have well-de ned work processes, establish competencies conducive to consistent and high-quality practices [54,55].…”

Section: Discussionmentioning

confidence: 99%

“…This data collection method was chosen to include the varied experiences and perceptions of the participants. The interview guide was constructed during a brainstorming meeting between the research team (ARM, KSSR, and SCS), based on relevant literature [25,26,27] and their clinical experiences.…”

Section: Data Collectionmentioning

confidence: 99%

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

Cerqueira-Santos

Rocha

Araújo

et al. 2020

Preprint

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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.

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Implementation and evaluation of clinical pharmacy services through quality improvement in a Tertiary Hospital in Malawi

Dascanio

Nowa

Williams³

et al. 2021

J Am Coll Clin Pharm

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BackgroundClinical pharmacy services have been shown to improve patient outcomes, cost savings, and rational use of medications, yet there has been a slow transition from product‐focused to patient‐focused pharmacy practice in many low‐income countries.ObjectiveThe purpose of this study was to describe the implementation of a ward‐based clinical pharmacy program using quality improvement methods in a 1000‐bed tertiary hospital in Malawi and measure its associated impact on prescribing practices.MethodsThis was a post‐test only design with a nonequivalent control group evaluating the impact of a ward‐based clinical pharmacy program. The program was implemented in the female adult medical ward using 1‐month Plan‐Do‐Study‐Act cycles. Data were collected on the number of clinical pharmacy recommendations and acceptance rate. Outcome measures were collected in the intervention ward and a corresponding control ward and evaluated changes in prescribing habits across rational prescribing and antimicrobial prescribing. Data were collected over time and plotted on run charts. Logistic regression was used to examine differences in the trend in probability of rational prescribing and antimicrobial prescribing.ResultsOver 5 months, 321 clinical pharmacy recommendations were made and 67% were adopted by the medical team for implementation. For the intervention ward compared with the control ward, there was a significantly greater increase in probability of rational prescribing (P = .04), but no significant differences in antimicrobial prescribing (P = .48).ConclusionsThis study demonstrated a positive impact on rational prescribing as a result of ward‐based clinical pharmacy services in a low‐income country. This study can be used to inform development or improvement of clinical pharmacy services in other low‐income settings.

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Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

Cited by 27 publications

References 60 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 and evaluation of clinical pharmacy services through quality improvement in a Tertiary Hospital in Malawi

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