Summary What is known and objectives When considering acute care settings, such as the neonatal intensive care unit (NICU), the inappropriate use of medicines poses a great risk to vulnerable babies at the start of their lives. However, there is limited published literature that explores the current medication management practices in NICUs and where the main misuse issues lie. Therefore, the purpose of this review was to give an overview of medicine use in NICUs worldwide and identify therapeutic areas requiring more targeted pharmaceutical care. Specific objectives include the following: identifying the most commonly used medicines, comparing these to the A‐PINCH (Anti‐infectives, Potassium and other electrolytes, Insulin, Narcotics and sedatives, Chemotherapy agents, Heparin and other anticoagulants), high‐risk medicines list, and determining whether there are any differences in medicine use between countries. Method Quasi‐systematic literature review. Search strategy Google Scholar, MEDLINE/PubMed, Scopus and EMBASE were searched utilizing selected MeSH terms. Results A total of 19 articles from 12 countries were reviewed. Medication use between countries was very similar with no discernible differences in types of medicines prescribed. The most commonly used medicines included gentamicin, ampicillin, caffeine, furosemide and vitamin K. The median number of medicines prescribed per patient ranged from 3 to 11, and an inverse relationship was identified between gestational age and the number of medications that were prescribed. Nine of the 20 most commonly used medicines were listed as A‐PINCH medicines, and included antibiotics, fentanyl, morphine and heparin. Inappropriate prescribing, as well as the high use of off‐label/unlicensed medicines, was highlighted as areas of practice that require consideration to improve medication safety and minimize the potential risk for medication errors. What is new and conclusion Overall, the types of medicines used in NICUs worldwide are similar, with consistent reports on the common use of antibiotics, caffeine and vitamins. However, it cannot be definitively stated that the findings of the review accurately depict current practice in NICUs, due to the limited amount of published literature available. There are several areas of concern that warrant further investigation to improve rational use of medicines in the neonatal populations, including high use of antibiotics and off‐label and unlicensed medicines.

Background Pharmacist-led care services within the hospital pharmacy setting have a significant impact on efficient drug management processes. The work of pharmacists is directly associated with the provision of drugs and medical supplies along with additional clinical, administrative, organizational and educational duties. Depending on the country, these practice roles may differ to a significant extent. Objective The aim of this research was to explore the role of the hospital pharmacist and the provision of both clinical and traditional pharmaceutical services for patients and medical staff in Polish general hospitals. Setting Hospital pharmacies from all general hospitals in Poland. Method A cross-sectional study was conducted, utilizing an anonymous questionnaire as the research instrument. Heads of hospital pharmacies were requested to participate in this study and complete the questionnaire. The survey was initially piloted to improve the research method. Main outcome measure The types of pharmaceutical services performed in Polish general hospitals. Results 166 hospital pharmacies took part in this survey. The overall response rate was 60.8 %. The total number of full-time equivalent (FTE) professionals employed within the surveyed hospital pharmacies was approximately 833. The procurement and distribution of drugs were identified as pharmaceutical services performed by most of the participants. The significant majority of pharmacists were also involved in compounding, adverse drug reaction monitoring and rational drug management services. Eleven (7 %) of the responding pharmacists had direct contact with patients and 7 (4 %) pharmacists took part in ward rounds. More precise legal regulations regarding hospital pharmacy practice were measures indicated by most pharmacists as necessary changes required in the hospital pharmacy system. Conclusion Polish hospital pharmacists provide various pharmaceutical services. Their work is closely related with direct provision of drugs. There is an observed inadequate level of clinical services provided in comparison to clinical settings in other countries.

BACKGROUND: A multidisciplinary and collaborative team network is essential in ensuring positive health outcomes for critically ill neonatal patients. OBJECTIVE: To investigate the perceptions of neonatal intensive care unit (NICU) doctors and nurses in Australia and Poland towards pharmaceutical care services in the NICU. METHOD: A cross-sectional, anonymous electronic-based survey was distributed between January and April 2017 among a sample of NICU doctors, nurses and midwives. RESULTS: A total of 77 participants from Australia and 93 from Poland completed the survey. Overall, from the perspectives of medical and nursing staff, it is apparent that clinical pharmacy practice on the NICU is more established in Australia than in Poland. Only 8.6% of Polish participants reported that a pharmacist worked directly on the NICU, in comparison with 87% of Australian participants (p < 0.001). The main roles performed by pharmacists in Polish NICUs related to the provision of medicines, whereas Australian pharmacists were highly involved in all aspects of pharmacotherapy, particularly in the clinical and education domains. CONCLUSION: Future efforts should focus on how practice is structured in each country, and what support can be implemented from educational, cultural and legislative levels to enable better pharmacist integration into the NICU therapeutic team.

Introduction There has been a significant increase in the volume of biosimilar medicines recently due to the expiries of patent protections of biologic medicines. Biosimilars are considered new medicines, and their usage in therapy is often associated with uncertainty from the perspectives of physicians, pharmacists and patients. Objectives The purpose of this study was to identify hospital pharmacist opinions towards these new medicines and investigate their usage in practice. Methods A paper-based, self-administered questionnaire was distributed to Polish hospital pharmacists. Results Biosimilars were used in 77% of surveyed hospitals, whereas originator biologics were utilised within 90% of settings. The former medicines were found to consist of less than one-third of the entire course of biological pharmacotherapy used within Polish hospitals. A total of 88% of hospital pharmacists were concerned that the new drugs were not identical with the biologic versions, 48% with their immunogenicity and 44% with other pharmacokinetic properties. The majority of respondents (87%) stated that the most important advantage of biosimilars related to decreased costs. Furthermore, according to participants, pharmacist-led substitution is not appropriate. Conclusion Due to the numerous concerns relating to the usage of biosimilars, their introduction into patient therapy requires special attention from healthcare providers. While pharmacists involved in the distribution of biosimilars are conscious of their impact in decreasing costs of therapy, they do not feel comfortable in recommending their substitution without a physician's permission. There is a need for more precise legal regulations relating to biosimilars, improved communication between physicians and pharmacists, as well as educational initiatives to improve the safe and effective usage of biosimilars.

BackgroundPalliative care requires the collaborative efforts of an interdisciplinary team, and as such a range of health professionals should be involved in supporting patients with life-threatening diseases. As a part of this therapeutic network, pharmacists at residential hospices should be thoroughly involved in care, cooperate with other medical staff and perform pharmaceutical services in order to deliver safe and efficient pharmacotherapy.AimTo provide an overview of the current state of pharmacy practice at Polish residential hospices.MethodsA cross-sectional study was applied and three types of anonymous questionnaires were developed to collect data. Hospice directors, pharmacists and physicians from all residential hospices in Poland were invited to participate.Results19 (61%) hospices collaborate with at least one pharmacist, who performs pharmaceutical services on the premises. 12 (75%) pharmacists provide advice concerning medicines and 11 (69%) are involved in various roles related to procurement, dispensing and storage of drugs, as well as creating procedures for these activities. Despite pharmacists’ great level of involvement in drug policy, most of them are not members of the therapeutic team and they do not participate in ward rounds. Furthermore, the provision of clinical pharmaceutical services forms a minority of Polish hospital pharmacy practice.ConclusionsAlthough the role of a hospice-based pharmacist is focused on the provision of drugs, it should become more clinical, that is, more patient oriented. The data obtained should be used as a source of information for implementing potential changes to palliative care pharmacy.

ObjectivesTo describe and compare the pharmaceutical services and clinical pharmacy roles performed in neonatal intensive care units (NICUs) in Australian versus Polish hospitals.MethodsA 26-item survey was distributed electronically to directors of pharmacy as well as neonatal pharmacists in hospitals in Poland and Australia. Most questions were fixed ‘agree/disagree’ answers, supplemented by open-ended questions. The survey was distributed between January and May 2017.ResultsOverall, 30 Australian pharmacists and 22 Polish pharmacists completed the survey. Significant differences were observed in the types of pharmaceutical care services provided to NICUs between Australia and Poland. A higher proportion of Australians than Poles performed clinical roles: for example, providing medication recommendations (Aus=96.6%, Pol=9.1%, P<0.001); pharmaceutical interventions to resolve drug therapy problems (Aus=93.1%, Pol=18.2%, P<0.001); and general patient medication chart review (Aus=96.6%, Pol=13.6%, P<0.001). All (100%) Polish pharmacists did not consider themselves members of the NICU team and the majority (59.1%) felt that pharmaceutical care on the NICU was practically non-existent.ConclusionFuture research should focus on bringing practice in countries such as Poland closer in line with practice in countries such as Australia.

Objectives The aim of this study was to find information about participation of hospital pharmacists in rational use of medicines at Polish university hospitals. Thus, pharmaceutical services and other tasks performed by hospital pharmacists were determined. Methods A simple questionnaire-based survey was applied. All pharmacist team managers of Polish university hospitals were invited to the study. The obtained data considered the present situation and future perspectives of the pharmacists’ role in rational use of medicines at Polish university hospitals. Results Each hospital pharmacy arranges hospital supplies of drugs and medical devices. The majority of pharmacists are involved in compounding. Also, pharmacists participate in pharmacotherapy rationalisation and monitoring of adverse drug reactions as well, as they are involved in clinical trials. Clinical activities, like participating in hospital rounds are not common Polish hospitals. Conclusions Generally, the role of hospital pharmacists is limited to performing pharmaceutical services at hospital pharmacies, and it should become more patient oriented as is observed in other countries. Similarly, they do not contribute essentially to rational use of medicines. More precise legal regulations, better postgraduate education of pharmacists may be helpful in improving this situation. Hospital pharmacy should become a significant part in medication management in Polish teaching hospitals.

Introduction. The efficient pharmacotherapy is an important part of palliative and hospice care, and requires a multidisciplinary approach to the patients. The pharmacist, as the member of the multidisciplinary therapeutic team, is responsible for performing pharmaceutical care, which provides safe and efficient treatment. The aim of the research was to conduct a comparative research about the status of palliative and hospice care and role of the pharmacist (clinical pharmacist) in Ukraine and Poland.Material and methods. It was a questionnaire survey conducted in Ukraine, as well as analysis of information sources associated with this subject. The questionnaire was developed on the basis of similar study conducted in Poland. It consisted of 15 multiple-choice questions addressed to head physicians and doctors in Ukraine. The obtained results were compared to the results of the mentioned above Polish study. Results. Eight head physicians and 22 doctors (30 questionnaires) from 13 palliative and hospice care institutions in Ukraine responded to the survey. It has been found that almost half in Ukraine (43%) believed that the pharmacist should be a mandatory member of a multidisciplinary team, because of his/her significant role in drug management in hospice. Conclusion. A multidisciplinary approach to satisfying of patients' needs in palliative and hospice care has a great significance. Results of the study testify to the importance of including the pharmacists into the multidisciplinary team.