The impact of clinical pharmacy services in Nepal in the context of current health policy: a systematic review

Mikrani, Reyaj; Naveed, Muhammad; Mikrani, Aman; Yasmeen, Sufia; Akabar,; Zhou, Xiaohui

doi:10.1007/s10389-019-01042-y

Cited by 6 publications

(12 citation statements)

References 24 publications

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“…These transferrable skills are linked with providing individual care, optimization of therapy and improving health outcomes. A recent systematic review from Nepal reported that a clinical pharmacy service reduced direct health-care costs, unnecessary use of medications, prescription errors, and improvement in drug utilization pattern and patients’ satisfaction 40. However, this review is subjected to a major limitation of sample size, short follow-up time, inadequate randomization and lack of control groups.…”

Section: Discussionmentioning

confidence: 99%

<p>Undergraduate pharmacy students’ attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal</p>

Baral¹,

Parajuli²,

Shrestha³

et al. 2019

IPRP

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Background: Pharmaceutical care (PC) has a significant impact on optimizing pharmacotherapy and improving patients’ quality of life. We aimed to determine the attitudes and perceived barriers of final year pharmacy undergraduates towards provision of PC services in Nepal. Methods: A cross-sectional study was conducted among 232 students using a 13-item-standard PC attitude survey (PCAS) questionnaire and 12-itemed PC barrier questionnaires. Mann–Whitney U test and Kruskal–Wallis tests were used to measure the median difference between groups, at alpha=0.05, and Spearman’s rho test was used to measure the strength of the correlation. Results: Majority of students were self-motivated in undertaking the current pharmacy education (178, 76.7%) and had no previous incomplete grades that could delay their graduation (177, 76.3%). Over 80% of students had a positive attitude toward all items of PCAS (agreed and strongly agreed) except for two items. Whereas, 61 (26.3%) disagreed and strongly disagreed that providing PC takes too much time and effort. The major barriers perceived were inadequate PC training (176, 75.9%), inadequate drug information resources in the pharmacy (170, 73.3%), and lack of access to patient medical records in the pharmacy (165, 71.1%). A significant relationship was noticed between positive attitude towards PC and three factors; source of motivation, current employment in pharmacy job, and incomplete grades delaying graduation. Age factor was significant but negatively correlated with the scores of positive attitudes namely “I would like to perform PC as a pharmacist practitioner”, “Providing PC is professionally rewarding” and “I feel that the PC is the right direction for the provision to be headed”. Conclusion: Nepalese undergraduate pharmacy students had positive attitudes toward PC. Exercising proper pharmacy practice regulations and educational efforts to overcome the perceived barriers may lead to better delivery of PC.

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Section: Discussionmentioning

confidence: 99%

<p>Undergraduate pharmacy students’ attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal</p>

Baral¹,

Parajuli²,

Shrestha³

et al. 2019

IPRP

View full text Add to dashboard Cite

show abstract

“…Twelve reviews focused on pharmacists and clinical pharmacist involvement in the treatment process ( 13 , 17 , 32 , 41 , 59 – 66 ). Five reviews presented leadership or managerial manners interventions ( 12 , 56 , 67 – 69 ). The remaining 12 reviews stated process interventions ( 9 , 12 , 32 , 34 , 67 , 70 – 76 ), and two reviews focused on smart pumps impact ( 32 , 77 ) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Five reviews presented leadership or managerial manners interventions ( 12 , 56 , 67 – 69 ). The remaining 12 reviews stated process interventions ( 9 , 12 , 32 , 34 , 67 , 70 – 76 ), and two reviews focused on smart pumps impact ( 32 , 77 ) ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…For example, the most significant results were noted for computerized provider order entry in 96% error interception and 90% reduction of medication errors ( 41 , 44 ). There was evidence that leadership or managerial manners intervention could effectively and significantly reduce medication errors ( 12 , 56 , 67 – 69 ). For example, redesign of diabetes prescribing charts incorporating prescribing guidelines, diabetes prescription error management pathway, and mandatory e-learning reduced insulin prescription errors from 65 to 2% ( 67 ) ( Table 2 , Supplementary Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…For example, pharmacists' participation in medical treatment leads to a 43% reduction in prescribing errors and a 27% reduction in overall medication errors ( 63 , 64 ). Most reviews on process interventions had also shown that such intervention could effectively and significantly reduce medication errors ( 9 , 12 , 34 , 67 , 70 – 74 ), with only a few ( 32 , 75 , 76 , 78 ) presenting only some evidence of medication error reduction. For example, double-checking reduce medication error from 2.98 to 2.12 per 1,000 medication administered and dispensing error from 9.8 to 6 ( 73 ).…”

Section: Resultsmentioning

confidence: 99%

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Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews

2022

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Background and aimImproving health care quality and ensuring patient safety is impossible without addressing medical errors that adversely affect patient outcomes. Therefore, it is essential to correctly estimate the incidence rates and implement the most appropriate solutions to control and reduce medical errors. We identified such interventions.MethodsWe conducted a systematic review of systematic reviews by searching four databases (PubMed, Scopus, Ovid Medline, and Embase) until January 2021 to elicit interventions that have the potential to decrease medical errors. Two reviewers independently conducted data extraction and analyses.ResultsSeventysix systematic review papers were included in the study. We identified eight types of interventions based on medical error type classification: overall medical error, medication error, diagnostic error, patients fall, healthcare-associated infections, transfusion and testing errors, surgical error, and patient suicide. Most studies focused on medication error (66%) and were conducted in hospital settings (74%).ConclusionsDespite a plethora of suggested interventions, patient safety has not significantly improved. Therefore, policymakers need to focus more on the implementation considerations of selected interventions.

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A nationwide exploratory survey assessing perception, practice, and barriers toward pharmaceutical care provision among hospital pharmacists in Nepal

Shrestha

Palaian

Sapkota

et al. 2022

Sci Rep

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Pharmaceutical care (PC) services reduce medication errors, improve the use of medicines, and optimize the cost of treatment. It can detect medication-related problems and improve patient medication adherence. However, PC services are not commonly provided in hospital pharmacies in Nepal. Therefore, the present study was done to determine the situation of PC in hospital pharmacies and explore the perception, practice, and barriers (and their determinants) encountered by hospital pharmacists while providing PC. A descriptive online cross-sectional study was conducted from 25th March to 25th October 2021 among pharmacists with a bachelor’s degree and above working in hospital pharmacies using non-probability quota sampling. The questionnaire in English addressed perception and practice regarding PC, and barriers encountered and were validated by experts and pre-tested among 23 pharmacists. Descriptive statistics were used to describe the data. Kendall’s correlation was used to explore the correlations among various perception and practice constructs. The scores were also compared among subgroups of respondents using the Mann–Whitney test for subgroups with two categories and Kruskal–Wallis test for greater than two categories. A total of 144 pharmacists participated in the study. Majority of the participants were male, between 22 and 31 years of age, and had work experience between 10 and 20 years. Over 50% had received no training in PC. The perception scores were higher among those with more work experience and the practice scores among those who had received PC training. Participants agreed that there were significant barriers to providing PC, including lack of support from other professionals, lack of demand from patients, absence of guidelines, inadequate training, lack of skills in communication, lack of compensation, problems with access to the patient medical record, lack of remuneration, and problems with accessing objective medicine information sources. A correlation was noted between certain perceptions and practice-related constructs. Hospital pharmacists who participated had a positive perception and practice providing PC. However, PC was not commonly practised in hospital pharmacies. Significant barriers were identified in providing PC. Further studies, especially in the eastern and western provinces, are required. Similar studies may be considered in community pharmacies.

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The impact of clinical pharmacy services in Nepal in the context of current health policy: a systematic review

Cited by 6 publications

References 24 publications

<p>Undergraduate pharmacy students’ attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal</p>

<p>Undergraduate pharmacy students’ attitudes and perceived barriers toward provision of pharmaceutical care: a multi-institutional study in Nepal</p>

Interventions to reduce the incidence of medical error and its financial burden in health care systems: A systematic review of systematic reviews

A nationwide exploratory survey assessing perception, practice, and barriers toward pharmaceutical care provision among hospital pharmacists in Nepal

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