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1.
Clinical pharmacist recommendations in daily interdisciplinary ward rounds at a psychiatric hospital: a retrospective pre-post study on drug-related problems focused in somatic comorbidities
Matej Štuhec, Anteja Gorjan Gazdag, Zala Čuk, Robert Oravecz, Borjanka Batinic, 2024, original scientific article

Abstract: Objective: One potential strategy to address inadequate screening for somatic comorbidities among patients with mental disorders is to integrate a clinical pharmacist into the inpatient team for daily interdisciplinary ward rounds. This approach remains under-researched in psychiatric hospitals. This study aimed to evaluate the impact of a clinical pharmacist on drug-related problems (DRPs) during daily ward rounds within an interdisciplinary team in a psychiatric hospital. Methods: A retrospective observational pre-post study was conducted at the Ormož Psychiatric Hospital in Slovenia, including patients treated between 2019 and 2020, during which clinical pharmacists offered recommendations during daily ward rounds. The primary outcomes assessed the difference in the total number of DRPs observed at the time of hospital discharge compared to previous stage, as well as the recommendations and their continuation rate after three months. The secondary outcomes evaluated adherence to treatment guidelines. Results: The study included 186 patients (mean age: 58.1 years, SD=17.0). During ward rounds, 280 recommendations related to DRPs were conducted (1.5 recommendations per patient). Regarding the nature of DRPs, 154 (55.0%) were identified as expressed DRPs, while 127 (45.0%) were deemed potential DRPs. Following pharmacist recommendations, 133 (86.4%) of the expressed DRPs were successfully resolved. The majority of DRPs pertained to treatment effectiveness (N=179, 63.9%), followed by unnecessary treatments (N=86, 30.7%) and patient safety (N=15, 5.4%). Initially, the acceptance rate of recommendations was 88.9% (N=249) at discharge, declining to 63.2% (N=177) three months after discharge. The acceptance rate for somatic conditions at discharge was 87.8% (N=122), declining to 59.0% (N=82) three months after discharge. Adherence to treatment guidelines for somatic comorbidities increased (p < 0.05). Conclusions: The results indicate that this approach led to fewer DRPs, a high rate of acceptance, and better adherence to treatment guidelines. This is the first retrospective pre-post study in the European Union to include this collaboration in daily rounds at psychiatric hospitals, focusing on somatic comorbidities. However, the study also has significant limitations, such as its non-randomized design and short monitoring period, which should be addressed in future research.
Keywords: psychiatry, clinical pharmacy, hospital, ward rounds, drug-related problem
Published in DKUM: 07.01.2025; Views: 0; Downloads: 4
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2.
Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital
Matej Štuhec, Valentina Tement, 2021, original scientific article

Abstract: Clinical pharmacists have not yet become an integral part of interdisciplinary ward rounds in most psychiatric hospitals across the European Union. This retrospective observational pre-post study examined the impact of clinical pharmacist recommendations in an interdisciplinary medical team during psychiatric hospital rounding. The study included all patients in a Slovenian psychiatric hospital who were hospitalized 2019-2020. The clinical pharmacist made 315 recommendations for a total of 224 participants (average age M = 59.4, median = 56). Psychiatrists accepted 295 (93.7%) of the recommendations. After the recommendations, the number of expressed and potential drug-related problems decreased in 166 (93.8%) and 129 (93.8%) interventions, respectively. Three months after discharge, 222 accepted recommendations were continued (70.5%). The most common recommendations were related to antipsychotics (19.4%, N = 61) followed by antidepressants (16.8%, N = 53). Including a clinical pharmacist in the interdisciplinary ward rounds at a psychiatric hospital reduced the number of expressed and potential drug-related problems with a very high recommendation acceptance rate. These results are the first in Central Europe to explore the benefits of including a clinical pharmacist in ward rounding.
Keywords: clinical pharmacist, clinical pharmacy, psychiatry
Published in DKUM: 10.12.2024; Views: 0; Downloads: 2
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3.
Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes
Kamila Urbańczyk, Sonja Guntschnig, Vasilis Antoniadis, Slaven Falamić, Tijana Kovacevic, Marta Kurczewska-Michalak, Branislava Miljković, Anna Olearova, Inese Sviestina, Attila Szucs, Matej Štuhec, 2023, review article

Abstract: Clinical pharmacy as an area of practice, education and research started developing around the 1960s when pharmacists across the globe gradually identified the need to focus more on ensuring the appropriate use of medicines to improve patient outcomes rather than being engaged in manufacturing and supply. Since that time numerous studies have shown the positive impact of clinical pharmacy services (CPS). The need for wider adoption of CPS worldwide becomes urgent, as the global population ages, and the prevalence of polypharmacy as well as shortage of healthcare professionals is rising. At the same time, there is great pressure to provide both high-quality and cost-effective health services. All these challenges urgently require the adoption of a new paradigm of healthcare system architecture. One of the most appropriate answers to these challenges is to increase the utilization of the potential of highly educated and skilled professionals widely available in these countries, i.e., pharmacists, who are well positioned to prevent and manage drug-related problems together with ensuring safe and effective use of medications with further care relating to medication adherence. Unfortunately, CPS are still underdeveloped and underutilized in some parts of Europe, namely, in most of the Central and Eastern European (CEE) countries. This paper reviews current situation of CPS development in CEE countries and the prospects for the future of CPS in that region.
Keywords: clinical pharmacy, cost-effective treatment, drug safety, drug utilization, health policy, medication adherence, medication errors, polypharmacy
Published in DKUM: 27.05.2024; Views: 190; Downloads: 15
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4.
Clinical pharmacy services in mental health in Europe : a commentary paper of the European Society of Clinical Pharmacy Special Interest Group on Mental Health
Matej Štuhec, Martina Hahn, I. Taskova, I. Bayraktar, I. Fitzgerald, L. Molitschnig, A. Tatarević, N. Lindner, L. Agnoletto, Filipa Alves da Costa, 2023, review article

Abstract: A large proportion of the world's disease burden is attributable to mental illnesses. Although effective interventions are available, many patients still have limited access to evidence-based treatments. Aside from access, treatment gaps, including inappropriate medication selection and monitoring, are also routinely recognised. Mental health clinical pharmacists can help address these gaps and enable patients to receive optimised pharmaceutical care, particularly appropriate medication selection and monitoring. The European Society of Clinical Pharmacy (ESCP) Special Interest Group on Mental Health was established to improve standardised service provision in mental health settings across Europe. The Special Interest Group identified significant barriers (predominantly associated with reimbursement and position within the multidisciplinary team) to effective pharmaceutical care amongst those with mental illnesses. This commentary presents recommendations to address these gaps through improved mental health clinical pharmacy service provision.
Keywords: clinical pharmacist interventions, clinical pharmacy in mental health, European society of clinical pharmacy, mental illnesses and pharmacy, pharmaceutical services in mental health, polypharmacy and clinical pharmacy, psychotropics and clinical pharmacy
Published in DKUM: 15.04.2024; Views: 214; Downloads: 5
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5.
Overview of this issue: "clinical pharmacy impacting mental health delivery and outcomes"
Martina Hahn, Matej Štuhec, Filipa Alves da Costa, 2023, preface, editorial, afterword

Keywords: clinical pharmacy, mental health care
Published in DKUM: 15.04.2024; Views: 205; Downloads: 9
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