1. Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospitalMatej Štuhec, Valentina Tement, 2021, izvirni znanstveni članek Opis: 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.
Ključne besede: clinical pharmacist, clinical pharmacy, psychiatry
Objavljeno v DKUM: 10.12.2024; Ogledov: 0; Prenosov: 2
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2. Clinical pharmacist interventions in ambulatory psychogeriatric patients with excessive polypharmacyMatej Štuhec, Kaja Zorjan, 2022, izvirni znanstveni članek Opis: Psychogeriatric primary care patients are frequently treated with excessive polypharmacy (≥ 10 medications), leading to complications and increased costs. Such cases are rarely included in treatment guidelines and randomized controlled trials. This paper evaluates the impact of clinical pharmacist medication reviews on the quality of pharmacotherapy in primary care psychogeriatric patients with excessive polypharmacy. The retrospective observational multicentric pre-post study included patients (aged 65 or above) treated with at least one psychotropic and ten or more medications. Clinical pharmacists' recommendations were retrieved from medication review forms for the period 2012-2014. The study outcome measures were the number of medications, potentially inappropriate medications in the elderly (PIMs), potential drug-drug interactions which should be avoided (pXDDIs), and adherence to treatment guidelines. The study included 246 patients receiving 3294 medications, of which 14.6% were psychotropics. The clinical pharmacists proposed 374 interventions in psychopharmacotherapy. The general practitioners accepted 45.2% of them (169). Accepting clinical pharmacist recommendations reduced the total number of medications by 7.5% from 13.4 to 12.4 per patient (p < 0.05), the total number of prescribed PIMs by 21.8% from 312 to 244 (p < 0.05), the number of pXDDIs by 54.9% from 71 to 31 (p < 0.05) and also improved treatment guidelines adherence for antidepressants and antipsychotics (p < 0.05). Clinical pharmacist interventions significantly improved the quality of psychopharmacotherapy by reducing the total number of medications, PIMs, and pXDDIs. Accepting clinical pharmacist interventions led to better treatment guidelines adherence.
Ključne besede: polypharmacy, elderly patients, clinical pharmacist, medications, drug-drug interactions, psychopharmacotherapy
Objavljeno v DKUM: 05.07.2024; Ogledov: 101; Prenosov: 9
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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 outcomesKamila Urbańczyk, Sonja Guntschnig, Vasilis Antoniadis, Slaven Falamić, Tijana Kovacevic, Marta Kurczewska-Michalak, Branislava Miljković, Anna Olearova, Inese Sviestina, Attila Szucs, Matej Štuhec, 2023, pregledni znanstveni članek Opis: 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.
Ključne besede: clinical pharmacy, cost-effective treatment, drug safety, drug utilization, health policy, medication adherence, medication errors, polypharmacy
Objavljeno v DKUM: 27.05.2024; Ogledov: 190; Prenosov: 11
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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 HealthMatej Štuhec, Martina Hahn, I. Taskova, I. Bayraktar, I. Fitzgerald, L. Molitschnig, A. Tatarević, N. Lindner, L. Agnoletto, Filipa Alves da Costa, 2023, pregledni znanstveni članek Opis: 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.
Ključne besede: 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
Objavljeno v DKUM: 15.04.2024; Ogledov: 214; Prenosov: 4
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