Clinical Pharmacy Activities: We Know What to Do, but for Whom Should We Do It?

Slavik, Richard S; LeBras, Marlys; Gorman, Sean K

doi:10.4212/cjhp.v69i2.1549

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Clinical activities in pharmacies involve pharmacists providing patient care to optimize medication therapy and to promote health, wellness, and disease prevention [1]. Among such activities are the identification, prevention, and resolution of drug-related problems (DRPs) [2,3]. A DRP is defined as an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes [4].…”

Section: Introductionmentioning

confidence: 99%

Clinical Pharmacy Activities Documented (ClinPhADoc): Development, Reliability and Acceptability of a Documentation Tool for Community Pharmacists

et al. 2019

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Documentation of community pharmacists’ clinical activities, such as the identification and management of drug-related problems (DRPs), is recommended. However, documentation is not systematic in Swiss community pharmacies, and relevant information about DRPs, such as consequences or involved partners, is frequently missing. This study aims to evaluate the interrater and test-retest reliability, appropriateness and acceptability of the Clinical Pharmacy Activities Documented (ClinPhADoc) tool. Ten community pharmacists participated in the study. Interrater reliability coefficients were computed using 24 standardized cases. One month later, test-retest reliability was assessed using 10 standardized cases. To assess the appropriateness, pharmacists were asked to document clinical activities in their own practice using ClinPhADoc. Acceptability was assessed by an online satisfaction survey. Kappa coefficients showing a moderate level of agreement (>0.40) were observed for interrater and test-retest reliability. Pharmacists were able to document 131 clinical activities. The good level of acceptability and brief documentation time (fewer than seven minutes) indicate that ClinPhADoc is well-suited to the community pharmacy setting. To optimize the tool, pharmacists proposed developing an electronic version. These results support the reliability and acceptance of the ClinPhADoc tool.

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Section: Introductionmentioning

confidence: 99%

Clinical Pharmacy Activities Documented (ClinPhADoc): Development, Reliability and Acceptability of a Documentation Tool for Community Pharmacists

et al. 2019

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“…[1][2][3] Clinical pharmacists can prioritize the care they provide and add value by making evidence-based pharmacotherapy interventions for patients with priority diseases. 4 Two randomized controlled trials showed that hospital pharmacists providing comprehensive proactive clinical care and identifying and resolving drug therapy problems (DTPs) for patients with priority disease states can improve the overall quality of drug therapy, thereby reducing emergency department visits, hospital visits, drug-related readmissions, hospital readmissions, and total cost of care. 5,6 Most importantly, these trials confirmed that pharmacist-resolved DTPs are a useful process measure in continuous quality improvement projects to evaluate clinical pharmacy services, and represent an acceptable surrogate marker for predicting clinical and economic outcomes.…”

Section: Introductionmentioning

confidence: 99%

Contribution of Pharmacy Practice Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study

Slavik

Khullar

Gorman

et al. 2019

CJHP

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ABSTRACT Background: Canadian pharmacy practice residency programs promote development of key competencies for direct patient care resulting in resolution of drug therapy problems (DTPs), which is 1 of 8 national clinical pharmacy key performance indicators. There are no Canadian data on the contribution of residents to resolution of DTPs, including DTPs for priority diseases covered in disease-state education modules (PD-DTPs) or quality indicator DTPs (QI-DPTs), as assessed through application of evidence-based interventions proven to reduce morbidity, mortality, or health resource utilization. Objective: To describe the contribution of pharmacy practice residents to direct patient care using 3 process-of-care measures: resident-resolved DTPs, PD-DTPs, and QI-DTPs. Methods: This prospective, observational single-group study was conducted across 5 rotation sites within the authors’ health authority from September 2, 2013, to June 13, 2014. The primary outcome was number of DTPs resolved. The secondary outcomes were number of PD-DTPs resolved; number of QI-DTPs resolved; numbers of DTPs, PD-DTPs, and QI-DTPs resolved over time; and residents’ satisfaction with electronic tracking of resolved DTPs (in terms of training, usability, efficiency, and time requirements). Results: Four residents completed a total of twenty-one 4-week rotations and resolved a total of 1201 DTPs. Of these, 620 (52%) were PD-DTPs and 479 (40%) were QI-DTPs. Overall, the number of interventions increased for rotations 1–3, decreased for rotations 4 and 5, and increased again for rotation 6. The median score for all questions in all domains of the satisfaction survey was 4 out of 5 (“agree”). Conclusions: Pharmacy practice residents were resolving DTPs, PD-DTPs, and QI-DTPs for patients and were contributing significantly to direct patient care. On the basis of literature evidence, the number and type of interventions observed in this study would be expected to improve clinical and health economic outcomes for patients.RÉSUMÉ Contexte : Les programmes de résidence canadiens en pratique pharma-ceutique encouragent le développement de compétences clés relatives aux soins directs offerts aux patients. Ces compétences entraîneront la résolu-tion des problèmes de pharmacothérapie (DTP), l’un des huit indicateurs clés nationaux de rendement relatifs à la pharmacie clinique. Il n’existe pas de données canadiennes portant sur la contribution des résidents à la résolution des problèmes de pharmacothérapie, notamment ceux relatifs aux maladies prioritaires (PD-DTP) couverts dans les modules d’éducation sur les problèmes de santé, ou les indicateurs de qualité des DTP (QI-DPT), évalués au moyen d’interventions fondées sur des données scientifiques dont il a été prouvé qu’elles réduisaient la morbidité, la mortalité ou l’utilisation des ressources sanitaires. Dans une étude, les intervenants avaient des opinions divergentes concernant la contribution des résidents à la résolution des DTP, des PD-DTP et des QI-DTP. Objectif : Décrire la contribution des résidents dans le cadre de la pratique pharmaceutique des soins directs offerts aux patients à l’aide de trois mesures spécifiques du processus des soins : DTP, PD-DTP et QI-DTP résolus par les résidents. Méthodes : Cette étude prospective par observation portant sur un seul groupe a été menée dans cinq sites de rotation compris dans la sphère d’autorité sanitaire des auteurs, du 2 septembre 2013 au 13 juin 2014. Le résultat principal était le nombre de DTP résolus. Les résultats sec-ondaires étaient les suivants : nombre de PD-DTP résolus; nombre de QI-DTP résolus; nombre de DTP, de PD-DTP et de QI-DTP résolus avec le temps; et la satisfaction des résidents à l’égard du suivi électronique de leurs DTP résolus (en termes de formation, de facilité d’utilisation, d’efficacité et d’exigences en matière de temps). Résultats : Quatre résidents ont effectué un total de 21 rotations de quatre semaines et ont résolu 1201 DTP. De ceux-ci, 620 (52 %) étaient des PD-DTP et 479 (40 %), des QI-DTP. Les interventions générales ont augmenté de la 1re à la 3e rotation; elles ont diminué à la 4e et à la 5e rotation; elles ont à nouveau augmenté à la 6e rotation. Le score moyen de toutes les questions posées dans l’enquête de satisfaction, tous domaines confondus, était de 4 sur 5 (ou « d’accord »).Conclusions : Les résidents en pratique pharmaceutique résolvaient les DTP, les PD-DTP et les QI-DTP des patients et contribuaient de manière significative aux soins directs aux patients. Sur base de la documentation, on pourrait s’attendre à ce que le nombre et le type d’interventions observées dans cette étude améliorent les résultats cliniques et sanitaires des patients.

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“…However, the patient to pharmacist ratio for patients with renal disease can impede a pharmacist from identifying and resolving all DTPs for all patients in a timely manner. Taking into account the complexity of renal patients in terms of their medical conditions and medication regimens, the renal pharmacist's efforts need to be focused on performing priority activities that will provide the greatest value to the patient and the health system . Quality indicators are commonly used in health care to track performance and identify areas for improvement and manage improvement activities .…”

Section: Introductionmentioning

confidence: 99%

“…Quality indicators are commonly used in health care to track performance and identify areas for improvement and manage improvement activities . They can also assist pharmacists in identifying priority patients for whom they should provide interventions …”

Section: Introductionmentioning

confidence: 99%

Development of intervention-related quality indicators for renal clinical pharmacists using a modified Delphi approach

Boutin

Nevers

Gorman

et al. 2018

International Journal of Pharmacy Practice

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Clinical Pharmacy Activities: We Know What to Do, but for Whom Should We Do It?

Abstract: -

Cited by 3 publications

References 8 publications

Clinical Pharmacy Activities Documented (ClinPhADoc): Development, Reliability and Acceptability of a Documentation Tool for Community Pharmacists

Clinical Pharmacy Activities Documented (ClinPhADoc): Development, Reliability and Acceptability of a Documentation Tool for Community Pharmacists

Contribution of Pharmacy Practice Residents to Resolution of Drug Therapy Problems for Patients: RES-DTP Study

Development of intervention-related quality indicators for renal clinical pharmacists using a modified Delphi approach

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