The Implementation of Clinical Pharmacy services in healthcare organizations; Concept, Benefits, facilitators, and barriers

Healthcare and drug expenditures are increasing worldwide due to the increase in the ages of the population, chronic diseases, and polypharmacy. Increasing numbers of drugs used by the elderly, increasing the cost of new pharmacotherapies, increases the pressure on health care organizations to identify and implement cost control measures. Reducing improperly prescribed drugs saves money on drug expenditures, reduces adverse drug reactions that result in prolonged hospitalization, as reducing patient stay is the key to cost savings. Many health care systems have adopted clinical pharmacy services into their standards of care and policy agendas. The concept of clinical pharmacy varies between countries, many professional and policy research organizations have attempted to define clinical pharmacy. in the united states and according to the American College of Clinical Pharmacy (ACCP), clinical pharmacy is the science and practice of rational drug use and it is a health discipline that regulates drug way, providing patient care that promotes the prevention of disease and improving health. In the United Kingdom, the clinical pharmacy association has defined clinical pharmacy as the knowledge, skills, attitudes required by pharmacists to contribute to patient care. Clinical pharmacists work in collaboration with the patient and other healthcare providers, in designing, implementing, and monitoring a therapeutic plan. Clinical pharmacists must be part of the decision-making process regarding drug therapy in healthcare organizations to improve patients' outcomes and increase drug safety and effectiveness. Clinical pharmacists can work in hospital pharmacies and many healthcare, settings including hospital outpatients' clinics, emergency departments, physician offices, community-based clinics, nursing homes, and managed care organizations. There is a difference between countries in the application of pharmaceutical activities. Traditional pharmacy practices are still more applied than advanced practice such as tracking therapeutic goals, creating, documenting, and monitoring care plans. Services provided by clinical pharmacists vary between countries such as providing homecare for chronic patients in Australia, and it is expanding to prescribing and vaccinating in other countries. The levels of clinical pharmacy provision also vary between countries in this article I will take the Turkish and Palestinian case.  In Turkey, the education of clinical pharmacy has started at Marmara university by restructuring education into more patient-oriented. From 2002 many clinical pharmacy programs related to the field of clinical pharmacy were organized by the Turkish pharmacist association. In Palestine since 2016, the Palestinian ministry of health started to hire doctors of pharmacy graduate and pharmacists with a master degree in a clinical pharmacy under the job description of clinical pharmacist in hospitals and another ministry of health facilities and they started to take their role and their numbers are increasing each year with the clear and effective role. Important developments in the United States of America have shaped and influenced the field of clinical pharmacy. As a result of the developments achieved, the clinical pharmacy has turned into a more patient-centered concept with the addition of pharmaceutical care to the service definitions. Besides, many factors such as the participation of hospital pharmacists in visits and inpatient services, the development of drug information centers, and the provision of unit dose services in hospitals have contributed to the transformation of clinical pharmacy into a patient-oriented concept. To measure the scope of pharmaceutical care service among pharmacists, it is essential to ensure that pharmacists have a good understanding of the concept of pharmaceutical care. Many factors affect clinical pharmacy and pharmaceutical care practices. These factors are stated in the literature and can be classified as barriers/inhibitors or facilitators/influencers/enhancers. Barriers have often been associated with healthcare networks, healthcare staff, pharmacists, the administration process, or patients. Barriers in clinical pharmacy and pharmaceutical care practices; lack of policies, administrative and organizational deficiencies, lack of time, hospital pharmacists' workload related to drug preparation and distribution, lack of clinical skill, lack of knowledge, lack of staff, former pharmacists who are not trained in clinical issues, lack adequate technology, lack of economic incentives, lack of documentation system, lack of dedicated consulting space, or inappropriate pharmacy setup, physicians and other health professionals not providing enough support for pharmacists. Also, the lack of structural protective measures for medication errors is considered an obstacle to clinical pharmacy provision. Facilitators are associated with the implementation process of either the local healthcare network, the healthcare team, pharmacists, or clinical pharmacy services. Among the factors affecting clinical pharmacy and pharmaceutical care practices; Having a clear mission and organizational structure for pharmaceutical care and a clear job description for pharmaceutical care jobs and procedures, in addition to the traditional pharmacy activities delegation, having a well-defined authority and responsibility for hospital pharmacists, motivation of hospital pharmacists to achieve high performance in both clinical and communication Having the right number of knowledgeable, well-educated, skilled pharmacists with dose calculation skills. The vast majority of physicians believe that pharmacists are a reliable source of information and can contribute to the clinical care of the patient, the acceptance rate of pharmacist’s interventions by physicians is increasing worldwide in many studies from different hospital wards at different stages from prescribing, during patients follow up, until patients discharge.  Many Interventional studies that aim to measure the outcomes of clinical pharmacist interventions implementation have shown that clinical pharmacist interventions have a positive effect on economic, clinical, and therapeutic outcomes by reducing drug-related problems, increasing drug safety, reducing morbidity, and improving human outcomes.

Conference Title

7th World Conference on Health Sciences (HSCI 2020)

Conference Country

Russia

Conference Date

Sept. 13, 2020 - Sept. 15, 2020

Conference Sponsor

Christian University St. Petersburg, Russia

Additional Info

Conference Website