BackgroundClinical Pharmacy Services (CPS) are a reality in many health systems around the world. However, there are few studies that discuss the facilitators and the strategies to implement CPS in healthcare systems. In this way, the objective of this study was to identify the facilitators and strategies involved in the CPS implementation process in some public health units in a metropolis in the Northeast Brazil.MethodsA qualitative study was carried out with health-system pharmacists and managers who experienced the implementation of CPS. Therefore, focus groups were conducted with pharmacists, and the interviews with the managers. The discussions were carried out through semi-structured scripts and were recorded in audio and videos, after the signature of the consent form. The recordings were transcribed and analyzed independently through content analysis, followed by consensus meetings between researchers.ResultsTwo focus groups were conducted, with an average of seven pharmacists per group, and five interviews with local health managers. Participants reported 39 facilitators who were related to the categories: local healthcare network, healthcare team, pharmacists and implementation process of the CPS. And 21 strategies attributed to the following categories: local healthcare network, pharmacists and implementation process of the CPS.ConclusionsThis study identified facilitators and strategies of the implementation of CPS. Most of the positive experiences were related to the clinical skills and proactive attitudes of pharmacists. These findings may support pharmacists and health managers to implement CPS in health systems.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3403-4) contains supplementary material, which is available to authorized users.

BackgroundCLinical pharmacy services (CPS) are professional services provided by pharmacists, who use their skills and knowledge to take an active role in patient health. These services have expanded in health systems around the world. However, it is important to have a comprehensive understanding of factors that may hinder the implementation of CPS in health systems.ObjectiveTo identify pharmacists’ and managers’ perceptions of barriers regarding the implementation of CPS in some public health units in a metropolis in Northeast Brazil.MethodsThis is a qualitative study based on focus groups and semi-structured, face-to-face, in-depth interviews. Participants were health-system pharmacists and managers, selected based on their direct participation in the implementation process. Focus groups were carried out with the pharmacists, and interviews were carried out with managers. The audio and videos were transcribed verbatim in full, and were independently analyzed using content analysis. This study was approved by the Brazilian Committee of Ethics in Research and all participants signed informed consent forms.FindingsThere were two focus groups and five interviews. The discussions generated 240 minutes of recordings. The health-system pharmacists and managers expressed barriers were allocated into five categories to facilitate a comprehensive understanding of the implementation of CPS; these barriers were related to: the local healthcare networks, the healthcare team, the pharmacists, the implementation process, and the patients.ConclusionsThis study revealed the perceptions of barriers associated with the participants involved in the implementation of CPS in some public health units in a metropolis in Northeast Brazil. The barriers reflect the challenges to be overcome in the CPS implementation process in the health systems.

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Background. In recent years, the use of digital serious games in the education of healthcare students and professionals has been frequent. However, there are no high-level evidence studies focused on the effect of this tool in the development of patient care-related competencies in pharmacy education. Aim. To assess the effect of digital serious games on learning about patient care in pharmacy education. Methods. The Cochrane Library, ERIC, Embase, IPA, LILACS, PubMed, Scopus, and Web of Science databases were reviewed to identify relevant studies published up to October 2, 2018. Standardized and non-standardized terms including “games,” “serious games,” “pharmacy education,” “pharmacists,” and “pharmacy students” were used as search terms. The quality of the studies was assessed using validated tools. Results and Discussion. Of the 1,521 studies reviewed, seven met the eligibility criteria. Three studies were performed in the United States (42.85%). The most-frequent design studies were randomized controlled studies (n = 3; 42.85%). The number of participants ranged between 6 and 354. In most cases, game scenarios were based on simulations in which users performed the role of the pharmacist (n = 5; 71.42%). The predominant primary outcome was attitudes (n = 5; 71.42%) related to patient care. Only one study (14.27%) demonstrated significant improvements in the assessed primary outcomes. The methodology of the included studies lacked robustness. Conclusion. The effect of learning technological tools on patient care-related competencies was not significant in most of the included studies. Future studies must provide high-quality, integrated-manner evidence on the effect of digital serious games in pharmacy education (knowledge, skills, and attitudes) to facilitate the transfer of learning to real-life scenarios and changes in organizational practices.

Objective. To evaluate the effect of using a virtual patient software program to improve pharmacy students' knowledge of and attitudes toward geriatric patients. Methods. The Virtual Patient for Geriatric Education (VIPAGE) software program was used in two Bachelor of Pharmacy (BPharm) degree programs in Brazilian universities. The virtual consultations were divided into an initial evaluation, care plan, letter of referral to another professional, and evaluation of follow-up. Each weekly session lasted two hours. Students answered questionnaires before and after using the virtual patient software relating to the following: demographics, geriatric experiences, Geriatric Attitudes Scale, and the Facts on Aging Quiz. Results. Of the 128 students who completed the baseline questionnaires, 109 students also completed the second questionnaire. The mean Geriatric Attitudes Scale score before the intervention was 3.7 (SD50.8) and after was 3.9 (SD50.7). Significant improvements in Geriatric Attitudes Scale scores after using the virtual patient software were seen in students who were male, whose grandparents were still alive, or whose parents were elderly, who had frequent contact with the elderly, who did not have frequent contact with the elderly, and who did not have professional contact with the elderly. The average score on geriatrics knowledge was 44.7 (SD512.0) before completing the virtual patient consultations and 52.6 (SD511.9) after. The mean score measuring students' lack of geriatrics knowledge was 27.3 (SD515.8) before and 19.1 (SD512.8) after using the software. Conclusion. Completing virtual patient consultations using the VIPAGE software positively impacted pharmacy students' geriatrics knowledge and attitudes.

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