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Clinical Pharmacy and Its Relationship to Clinical Research
Published in Gary M. Matoren, The Clinical Research Process in the Pharmaceutical Industry, 2020
William F. McGhan, Glen L. Stimmel, Gary M. Matoren
It is important to define what is meant by the term "clinical pharmacy." While some use the term to refer to the "patient orientation" sweeping the pharmacy profession as a whole, others use the term to refer to pharmacists with specialized knowledge and skills not common to all licensed pharmacists. While patient orientation should be the standard of practice for all pharmacists, clinical pharmacy best describes those pharmacists with "unique clinical skills." In the United States, there are now hundreds of clinical pharmacists with specific responsibilities that cannot be performed by the majority of pharmacists: drug therapy selection; dosage calculation based upon pharmacokinetic parameters; interpretation of laboratory tests and physical assessment used to evaluate drug response and adverse effects; and primary patient care [3,4]. Rather than being a divisive concept, recognition of these specialty practitioners points to the diversity and strength of the profession.
The sector's heritage
Published in Nigel Starey, Health and Social Care in the Digital World, 2020
The development of clinical pharmacy services, such as those in hospitals where pharmacists are intimately involved with the provision and supervision of medicines, has been gradually developing in the primary care sector. Pharmaceutical advisers to health authorities have usually been hospital pharmacists with training in clinical pharmacy and are aware of the potential for community pharmacists to develop this role in the primary care sector. The rapid growth in the drug budgets of the NHS (£6.2 billion in 1999/2000) is an important driver towards the development of effective medicines management in the community. The implications for the future of the profession of pharmacy are profound. No longer simply the dispenser of prescriptions and the first point of contact for advice on minor ailments, perhaps in the future the pharmacist may be the manager of medicines in primary care teams, the prescriber of medication where licensed and competent, and even the controller of the medicine budget of the primary care organisation.
Government Pharmacy
Published in William N. Kelly, Pharmacy, 2018
The Clinical Center pharmacy has inpatient and outpatient services, a manufacturing facility, and a full analytical section to support investigators in their research. Clinical pharmacy specialists, supported by other pharmacists, provide a full range of services, including therapeutic drug monitoring and review, protocol adherence monitoring, and institutional review board membership. In 2017, there were 85 pharmacists working in the NIH center and hospital.12
Risk management of medication errors: a novel conceptual framework
Published in Expert Opinion on Pharmacotherapy, 2023
Richard Despott, Janet Sultana, Liberato Camilleri, Janis Vella Szij, Anthony Serracino Inglott
The risk assessment identifies critical control points for each step within the pharmacotherapeutic process, and therefore provides an objective basis for healthcare service providers to focus clinical governance initiatives in ways that are most effective for improving patient safety outcomes: Strengthening decision support measures for prescribers, primarily integrated medical information systems, and medication review by clinical pharmacists.Improving standards of clinical pharmacy practice including screening and prioritization of ‘at risk’ patient groups and continuing education programs for prevention of medication errors.Standardization of treatment processes, in-line quality control checks including unit dose systems, performance-based staff ratios and training on medical devices and safety practices.
Polypharmacy, potentially inappropriate prescribing and medication complexity in Turkish older patients in the community pharmacy setting
Published in Acta Clinica Belgica, 2022
Zeynep Sayın, Mesut Sancar, Yasin Özen, Betul Okuyan
A structured form was used by a clinical pharmacist to collect the following data: age, sex, number of education years, weight, height, comorbidities, history of hospitalization during the last 6 months, and variables to calculate the Fracture Risk Assessment Tool (FRAX®) [17] (such as previous fracture, parent fractured hip, smoking, secondary osteoporosis, and femoral neck bone mineral density if available). The clinical pharmacists in Turkey take part in academic research. The Turkish community pharmacists could participate in post-graduate education and in continuing professional education on clinical pharmacy and pharmaceutical care. No defined pharmaceutical care services (including detecting PIPs) were available for older patients in Turkey during the conduct of the present study. The prescriptions and all medications including over-the-counter (OTC) medications were recorded during the patient interview.
Optimizing pharmacotherapy on geriatric hospital units in Belgium – a national survey
Published in Acta Clinica Belgica, 2022
Julie Hias, Lorenz Van der Linden, Karolien Walgraeve, Jean-Claude Lemper, Laura Hellemans, Isabel Spriet, Jos Tournoy
Furthermore, medication reviews performed by a multidisciplinary team can effectively and safely improve drug use in older adults [6,22,25,26]. Yet, in Belgium less than half (42%) installed a multidisciplinary team to perform these activities. Literature supports the involvement of a clinical pharmacist as part of such a team to further improve medication use and clinical outcome. Most clinical pharmacy programs included one or a combination of the following interventions: medication reconciliation on admission and discharge, medication review based on implicit and/or explicit criteria and discharge counseling [6,20–23,26,27]. Importantly, we should take into account the current state of available evidence. On the one hand, studies that specifically examined the effect of pharmacist-led interventions in geriatric inpatients, were almost exclusively designed to detect differences in drug use and not in hard clinical outcomes such as readmission rates [6,20–23,26,27]. On the other hand, studies that were effectively powered to detect the impact of a clinical pharmacy program on e.g. readmission rate, did not specifically enroll patients admitted to the geriatric unit. Importantly, Gillespie et al., Ravn Nielsen et al. and Pellegrin et al. showed a reduction in (drug-related) readmissions for elderly inpatients [28–30]. The uptake of clinical pharmacy programs on Belgian geriatric units is however rather limited, as only 24% of hospitals have a graduated clinical pharmacist allocated to their geriatric unit(s).