Clinical Pharmacists' Interventions in Chronic Care

A special issue of Pharmacy (ISSN 2226-4787). This special issue belongs to the section "Pharmacy Practice and Practice-Based Research".

Deadline for manuscript submissions: closed (30 June 2020) | Viewed by 10666

Special Issue Editors


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Guest Editor
Pharmaceutical Care, Department of Pharmaceutical Sciences, University of Basel, 4056 Basel, Switzerland
Interests: pharmaceutical care; pharmacy practice; medication management; adherence

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Guest Editor
Pharmaceutical Care Research Group, University of Basel, Basel, Switzerland
Interests: medication adherence; chronic care management; data-driven pharmaceutical care

Special Issue Information

Dear Colleagues,

Chronic conditions such as asthma, diabetes, and cardiovascular disease are today the leading cause of mortality and morbidity in the developed world. Patients may live with one or multiple chronic conditions for a substantial part of their life. The long-term management of these conditions often leads to polypharmacy, with multiple risks and a frequent perception as a burden for patients. In the care of patients with chronic conditions, interprofessional collaboration and coordination between providers are key issues. We hypothesize that involvement of clinical pharmacists in patient care may improve outcomes for patients with chronic conditions.
For this Special Issue, we welcome patient-centered research from all settings about the clinical pharmacist’s contribution to chronic care management. We look forward to receiving your contributions to advancing clinical pharmacy and achieving the triple aim of improved quality, better patient care experience, and lower costs.

Prof. Kurt E. Hersberger
Dr. Samuel Allemann
Guest Editors

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Keywords

  • Innovation in clinical pharmacy
  • Implementation of new services
  • Digital health
  • Interprofessional care
  • Collaborative care
  • Patient-centered care

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Published Papers (3 papers)

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Research

18 pages, 321 KiB  
Article
Implementation and Effectiveness of an Interprofessional Support Program for Patients with Type 2 Diabetes in Swiss Primary Care: A Study Protocol
by Noura Bawab, Joanna C. Moullin, Clémence Perraudin and Olivier Bugnon
Pharmacy 2020, 8(2), 106; https://doi.org/10.3390/pharmacy8020106 - 21 Jun 2020
Cited by 2 | Viewed by 3461
Abstract
This research protocol illustrates the use of implementation science to support the development, dissemination and integration in primary care of effective and sustainable collaborative pharmacy services for chronic care management. The objective is to evaluate the implementation and the effectiveness of a pharmacist-led [...] Read more.
This research protocol illustrates the use of implementation science to support the development, dissemination and integration in primary care of effective and sustainable collaborative pharmacy services for chronic care management. The objective is to evaluate the implementation and the effectiveness of a pharmacist-led patient support program including regular motivational interviews; medication adherence, patient-reported outcomes, and clinical outcomes monitoring; and interactions with physicians, for patients with type 2 diabetes taking at least one oral antidiabetic medication in the French-speaking part of Switzerland. This is a prospective, multi-centered, observational, cohort study using a hybrid design to assess the patient support program. The evaluation includes three levels of analysis: (1) the implementation strategies, (2) the overall implementation process, and (3) the effectiveness of the program. Qualitative and quantitative methods are used, and outcomes are assessed at each stage of the implementation process: exploration, preparation, operation, and sustainability. This research project will provide key insights into the processes of implementing patient support programs on a large scale and adapting the traditional community pharmacy practices towards the delivery of person-centered and collaborative services. Full article
(This article belongs to the Special Issue Clinical Pharmacists' Interventions in Chronic Care)
10 pages, 452 KiB  
Article
Patient Knowledge about Oral Anticoagulation Therapy Assessed during an Intermediate Medication Review in Swiss Community Pharmacies
by Corina Metaxas, Valerie Albert, Susanne Habegger, Markus Messerli, Kurt E. Hersberger and Isabelle Arnet
Pharmacy 2020, 8(2), 54; https://doi.org/10.3390/pharmacy8020054 - 28 Mar 2020
Cited by 10 | Viewed by 3526
Abstract
Background: Therapy with oral anticoagulation (OAC) can be challenging, especially in high risk groups such as chronic patients. Gaps in patient knowledge about OAC are linked to reduced effectiveness and safety of treatment. The objectives of this study were i) to assess OAC [...] Read more.
Background: Therapy with oral anticoagulation (OAC) can be challenging, especially in high risk groups such as chronic patients. Gaps in patient knowledge about OAC are linked to reduced effectiveness and safety of treatment. The objectives of this study were i) to assess OAC knowledge gathered during an intermediate medication review (MR) in patients taking vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOAC); ii) to assess OAC knowledge two weeks after the MR, and iii) to evaluate patient satisfaction with the MR service in community pharmacies. Methods: Chronic OAC patients were invited for a regular MR service in Swiss community pharmacies, the so-called “Polymedication-Check” (PMC). OAC knowledge was assessed with seven newly generated items asked face-to-face during a PMC and by telephone two weeks later. Knowledge gaps, pharmacists’ spontaneous interventions, and patient satisfaction were documented by observing pharmacy students. Treatment groups were compared. Results: Of all patients (n = 81), the number of patients with one or more knowledge gaps decreased from 66% to 31.3% after PMC (p < 0.001). NOAC patients (n = 31) had more knowledge gaps than VKA patients (n = 50; p < 0.05). Most patients (98.6%) were satisfied with the counselling provided by the pharmacists. Conclusion: The majority of chronic OAC patients shows knowledge gaps. Although spontaneous, the provision of tailored education during a PMC increased patient OAC knowledge. Full article
(This article belongs to the Special Issue Clinical Pharmacists' Interventions in Chronic Care)
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15 pages, 288 KiB  
Article
The Role of the Clinical Pharmacist in an Irish University Teaching Hospital: A Mixed-Methods Study
by Sarah Ronan, Nicola Shannon, Katie Cooke, Trish McKeon, Elaine K. Walsh, Alan Kearney and Laura J. Sahm
Pharmacy 2020, 8(1), 14; https://doi.org/10.3390/pharmacy8010014 - 30 Jan 2020
Cited by 9 | Viewed by 3236
Abstract
Medication review (MR) is a vital part of the pharmacist’s role in hospital. However, in the South Infirmary Victoria University Hospital (SIVUH), Cork, Ireland, this has not been fully implemented due to resource issues. In addition, the cost of providing this service has [...] Read more.
Medication review (MR) is a vital part of the pharmacist’s role in hospital. However, in the South Infirmary Victoria University Hospital (SIVUH), Cork, Ireland, this has not been fully implemented due to resource issues. In addition, the cost of providing this service has not been evaluated. Moreover, it is not clear how other members of the multidisciplinary team e.g., Nurses, value any interventions made as a result of the MR. This mixed methods study assessed the impact of MR in terms of (i) potential clinical harm, (ii) cost avoidance and (iii) the views of nursing staff on the role of the pharmacist. The setting is a 192-bed, voluntary, acute hospital, in the Munster region of Ireland. Study I: The pharmacist provided MR to patients conventionally once a week. Any interventions were then assessed for potential clinical harm and to calculate cost avoidance. Study II: Semi-structured interviews, guided by a topic guide were completed with 12 nurses (11 female). Thematic analysis was used to code the main themes. Main outcome measure: To estimate the cost, cost avoidance, and the net cost benefit ratio of MR provided by pharmacists. Study I: Of 128 patients who received the MR, 113 interventions were made. The estimated cost of providing the MR was €2559 (senior pharmacist). Using €1084 as the cost of an adverse drug event (ADE), the cost avoidance was calculated at €42,330. This led to a net cost benefit of €39,771 (senior pharmacist) which equated to a net cost benefit ratio of 16.5:1. Study II: The main themes were (i) perceptions of pharmacy services, (ii) the role of the pharmacist—past, present and future, and (iii) teamwork and communication. Nurses expressed a desire to have more pharmacists present on the wards. Full article
(This article belongs to the Special Issue Clinical Pharmacists' Interventions in Chronic Care)
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