International journal of clinical pharmacy
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Pharmacists can play an important role in identifying and instructing pulmonary patients on their inhalation techniques in their patient contacts when dispensing inhalation medication. Pharmacy dispensing data can be used to identify inappropriate drug use in asthma and chronic obstructive pulmonary disease (COPD) patients. Recent studies found beneficial effects of pharmacy care services in improving drug adherence of pulmonary patients. However, large-scale and rigorous evaluations on pharmacist-led interventions in community care settings to enhance evidence-based drug treatment in patients with asthma and COPD seems to be lacking and results from studies on pharmacist-led interventions for pharmacotherapy improvements are inconsistent. This study evaluated the effectiveness of pharmacist-led interventions on suboptimal drug use patterns with asthma or COPD medication with substantial numbers of pharmacies and patients involved. ⋯ Community pharmacists actively providing comprehensive pharmacy care could improve effective treatment in asthma and COPD patients and thereby decrease the number of prescriptions for exacerbations for these patients.
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Stroke is one of the leading causes of death and disability. Significant proportions (33 %) of stroke presentations are by patients with a previous stroke or transient ischaemic attack. Consequently, the stroke management guidelines recommend that all ischaemic stroke patients should receive three key evidence-based preventive drug therapies: antihypertensive drug therapy, a statin and an antithrombotic drug therapy (anticoagulant and/or antiplatelet). ⋯ There is a scope for improvement in implementing the stroke management guidelines when it comes to prescribing secondary preventive drug therapies using antihypertensives, antithrombotics and statins. Appropriate risk/benefit assessment is indispensable for optimal prescribing and maximizing patient outcomes, particularly in older people.
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To provide better patient care, it is very important for the physicians to be willing to accept clinical pharmacy services (CPSs). ⋯ From the perspective of improving physicians' overall attitudes, the prioritization strategy of developing CPSs in China should focus on the role of clinical pharmacists within the decision support system for medication management, thus encouraging clinical pharmacists to interact more frequently with physicians at the ward level.
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Surveillance of antimicrobial prescribing, in order to control the increase in antimicrobial resistance, is recommended by the Guidelines for Antimicrobial Stewardship in Hospitals in Ireland. ⋯ Around half of Irish hospitals do not have an antimicrobial management team in place but most hospitals have an antimicrobial prescribing policy. Most AMTs have representation by Consultants and Pharmacists, but audit and feedback of antibiotic prescribing activities is limited. Significant differences in audit activities were found between public and private hospitals, with private hospitals performing less well.