The cost burden is high for systemic fungal infections. Additional attention should be given to the 55% with fungal disease and other comorbid diagnoses.
BackgroundThe roles of pharmacists in patient care have expanded from the traditional tasks of dispensing medications and providing basic medication counseling to working with other health professionals and the public. Multiple reviews have evaluated the impact of pharmacist-provided patient care on health-related outcomes. Prior reviews have primarily focused on in-patient settings. This systematic review focuses on services provided by outpatient pharmacists in community or ambulatory care settings. This is an update of the Cochrane review published in 2000.
ObjectivesTo examine the e ect of outpatient pharmacists' non-dispensing roles on patient and health professional outcomes.
Search methodsThis review has been split into two phases. For Phase I, we searched the Cochrane E ective Practice and Organisation of Care (EPOC) Group
This tool allows for efficient and rapid screening of patients at risk of DRPs in preparation for the ward round. It helps CPs to prioritize their medication reviews and to optimize their workload.
Over the years, the number of studies and quality of methodology has increased. The most frequently observed outcomes with a positive impact were appropriateness of prescribing and cost savings. The vast majority of studies used multiple interventions, in conjunction with pharmacists' recommendations to physicians. Coupled with the use of practice guidelines or educational strategies, these interventions demonstrated a positive impact on economic or clinical outcomes. However, the data are still sparse and sometimes contradictory; therefore, further studies with randomized controlled designs are needed.
One possible explanation for the lack of effect of the intervention is that high-risk patients in the control group received a similar intervention from other health care professionals. We suggest that telephone follow-up be coordinated among health professionals.
Even though interdisciplinary interventions aiming at rationalizing antibiotic use could not diminish the duration of treatments, their costs or the length of stay, they proved useful to control the progression of these parameters.
The recent explosion in the conduct of multi-site and multinational research has created complexities in the assignment of authorship that challenge investigators who publish the results of their research. The practice of using "guest" and "ghost" authors is common. These issues of complexity and inequity received international attention in 1997 when, in order to ensure equity, accountability, and transparency of authorship, the concept of assigning contributors and guarantors was first proposed by Rennie and colleagues. 1 The concept has since been embraced by leading medical journals.Because of expanding opportunities within the profession of pharmacy, issues of authorship will become commonplace. Yet many pharmacists receive no formal education about issues inherent in this aspect of the publication process. From 1998-2000, the Department of Pharmacy at our institution conducted a multi-site randomized trial. The primary investigators were committed to ensuring that all investigators were appropriately recognized for their contributions and adopted the concept of contributorship to ensure this equity as one of our outcomes. By application of the contributorship concept, and through a formal and systematic process, we arrived at an equitable assignment of authorship for our resulting publication. We describe our experience in the following case study.
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