The Canadian journal of hospital pharmacy最新文献

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A New Era for the Canadian Journal of Hospital Pharmacy: The Continuous Publication Model. 加拿大医院药学杂志》的新纪元:连续出版模式。
The Canadian journal of hospital pharmacy Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.4212/cjhp.3564
Stephen Shalansky
{"title":"A New Era for the <i>Canadian Journal of Hospital Pharmacy</i>: The Continuous Publication Model.","authors":"Stephen Shalansky","doi":"10.4212/cjhp.3564","DOIUrl":"10.4212/cjhp.3564","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 1","pages":"e3564"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Une nouvelle ère pour le Journal canadien de la pharmacie hospitalière: Le modèle de la publication continue. 加拿大医院药学杂志》的新纪元:连续出版模式。
The Canadian journal of hospital pharmacy Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.4212/cjhp.3571
Stephen Shalansky
{"title":"Une nouvelle ère pour le <i>Journal canadien de la pharmacie hospitalière</i>: Le modèle de la publication continue.","authors":"Stephen Shalansky","doi":"10.4212/cjhp.3571","DOIUrl":"10.4212/cjhp.3571","url":null,"abstract":"","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 1","pages":"e3571"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy. 等待时间目标和患者满意度反馈在减少门诊药房处方服务等待时间方面的效果。
The Canadian journal of hospital pharmacy Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.42112/cjhp.3438
Yulia Leemanza, Erna Kristin
{"title":"Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy.","authors":"Yulia Leemanza, Erna Kristin","doi":"10.42112/cjhp.3438","DOIUrl":"10.42112/cjhp.3438","url":null,"abstract":"<p><strong>Background: </strong>Long wait times for prescription services at the Outpatient Pharmacy of the Dr. OEN SOLO BARU Hospital in Indonesia have led to high numbers of complaints. In response, to decrease these wait times, the hospital undertook an intervention to determine wait time targets and provide feedback on patient satisfaction to personnel in the Outpatient Pharmacy.</p><p><strong>Objective: </strong>To measure the impact of providing wait time targets and patient satisfaction feedback to pharmacists in terms of decreasing wait times for prescription services at the Outpatient Pharmacy.</p><p><strong>Methods: </strong>This quasi-experimental research study had a single-group interrupted time-series design. Data on wait times and patient satisfaction were collected from \"waiting patients\". The study participants were 35 employees (6 pharmacists and 29 technicians), and the intervention entailed provision of wait time targets and patient satisfaction feedback to the participants every week for 5 consecutive weeks.</p><p><strong>Results: </strong>The wait times for prescription services decreased by 11.13 minutes (17%) for compounded prescriptions and by 12.70 minutes (37%) for noncompounded prescriptions. There was a significant change in average wait time for both compounded and noncompounded prescription services from week 0 to week 4 (p < 0.001). There was also a significant change in patient satisfaction from week 0 to week 4 (p < 0.001). Patient satisfaction increased significantly in conjunction with the decrease in wait times for prescription services.</p><p><strong>Conclusions: </strong>The intervention of providing wait time targets and feedback on patient satisfaction to pharmacists helped to reduce wait times for prescription services.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 1","pages":"e3438"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Describing and Comparing Patient Factors Associated with Use of Parenteral Iron before and after Implementation of an Order Set for Parenteral Iron (DECODE IRON). 描述并比较肠外铁剂订单集(DECODE IRON)实施前后与使用肠外铁剂相关的患者因素。
The Canadian journal of hospital pharmacy Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.4212/cjhp.3500
Cameron Black, Thomas Brownlee, Darren Pasay
{"title":"Describing and Comparing Patient Factors Associated with Use of Parenteral Iron before and after Implementation of an Order Set for Parenteral Iron (DECODE IRON).","authors":"Cameron Black, Thomas Brownlee, Darren Pasay","doi":"10.4212/cjhp.3500","DOIUrl":"10.4212/cjhp.3500","url":null,"abstract":"<p><strong>Background: </strong>In select clinical scenarios, IV administration of iron is suitable for management of iron deficiency anemia; however, for most patients, oral administration of iron is the mainstay of treatment. At the Red Deer Regional Hospital Centre, in Red Deer, Alberta, high utilization of IV iron has resulted in limited access to this medication for the treatment of ambulatory patients, as well as significant usage of health care resources.</p><p><strong>Objectives: </strong>The primary objective was to compare patient characteristics, specifically pretreatment laboratory test results and previous use of oral iron, among those receiving IV iron therapy in an ambulatory setting before and after implementation of an iron sucrose order set. For secondary objectives, the aforementioned groups were compared with regard to meeting the diagnostic criteria for iron deficiency anemia, with or without pretreatment oral iron or blood transfusion, and the dosing characteristics for IV iron.</p><p><strong>Methods: </strong>A retrospective electronic chart review was performed for ambulatory patients who received IV iron between January 1, 2020, and January 31, 2022.</p><p><strong>Results: </strong>A total of 436 unique treatment courses were included in the analysis. The following pretreatment laboratory results were observed before and after implementation of the iron sucrose order set: mean hemoglobin 105.8 (standard deviation [SD] 21.9) g/L versus 102.2 (SD 18.5) g/L; mean of mean corpuscular volume (MCV) 82.2 (SD 9.4) fL versus 79.2 (SD 8.9) fL; and median ferritin 7 (interquartile range [IQR] 4-12) μg/L versus 6 (IQR 4-11) μg/L. Only the difference in MCV values was statistically significant (<i>p</i> = 0.001).</p><p><strong>Conclusions: </strong>The implementation of an iron sucrose order set for ambulatory patients did not have a significant effect on pretreatment laboratory parameters among patients for whom IV iron was prescribed. Further stewardship initiatives could be beneficial in improving the appropriateness of IV iron use.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 1","pages":"e3500"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterizing Current and Optimal Involvement of Hospital Pharmacists in the Discharge Process: A Survey of Pharmacists in British Columbia. 医院药剂师参与出院流程的现状和最佳状态:不列颠哥伦比亚省药剂师调查。
The Canadian journal of hospital pharmacy Pub Date : 2024-01-10 eCollection Date: 2024-01-01 DOI: 10.4212/cjhp.3433
Kiana Rahnama, Karen Dahri, Michael Legal, Colleen Inglis
{"title":"Characterizing Current and Optimal Involvement of Hospital Pharmacists in the Discharge Process: A Survey of Pharmacists in British Columbia.","authors":"Kiana Rahnama, Karen Dahri, Michael Legal, Colleen Inglis","doi":"10.4212/cjhp.3433","DOIUrl":"10.4212/cjhp.3433","url":null,"abstract":"<p><strong>Background: </strong>Transitions of care represent a vulnerable time when patients are at increased risk of medication errors. Medication-related problems constitute one of the main contributors to hospital readmissions. Discharge interventions carried out by pharmacists have been shown to reduce hospital readmissions. Although clinical pharmacists in British Columbia are involved in discharges, their degree of involvement and the interventions they prioritize in practice have not been fully elucidated.</p><p><strong>Objectives: </strong>To characterize the current involvement of BC hospital pharmacists at the time of discharge, to identify which discharge interventions they believe should be prioritized, and who they feel should be responsible for these interventions, as well as to identify strategies to optimize the discharge process.</p><p><strong>Methods: </strong>A survey of BC hospital pharmacists was conducted in January and February 2022. The survey included questions about pharmacists' current involvement at the time of discharge, interventions required for a successful discharge, solutions for optimizing the patient discharge process, and participants' baseline characteristics.</p><p><strong>Results: </strong>The survey response rate was 20% (101/500). Pharmacists reported performing all interventions for less than 60% of their patients. Interventions such as medication reconciliation on discharge, medication education, and ensuring adherence were considered very important for a successful discharge and were considered to be best performed by pharmacists. Solutions for optimizing the discharge process included improved staffing, weekend coverage, timely notification of discharge, and prescribing by pharmacists.</p><p><strong>Conclusions: </strong>Despite the belief that most interventions listed in the survey are necessary for successful discharge, various barriers prevented pharmacists from providing them to all patients. Increased resources and expanded scope of practice for pharmacists could reduce hospital readmissions and enable broader implementation of discharge interventions.</p>","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"77 1","pages":"e3433"},"PeriodicalIF":0.0,"publicationDate":"2024-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10754396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prioritizing Quality over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit 质量优先于数量:确定最佳药剂师与病人的比例,以确保在医疗或外科单位全面直接照顾病人
The Canadian journal of hospital pharmacy Pub Date : 2023-11-08 DOI: 10.4212/cjhp.3437
Shazia Damji, Michael Legal, Karen Dahri, Nilufar Partovi, Stephen Shalansky
{"title":"Prioritizing Quality over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit","authors":"Shazia Damji, Michael Legal, Karen Dahri, Nilufar Partovi, Stephen Shalansky","doi":"10.4212/cjhp.3437","DOIUrl":"https://doi.org/10.4212/cjhp.3437","url":null,"abstract":"Background: The expanding scope of practice of hospital pharmacists has contributed to improvements in patient care; however, workload remains a barrier to the provision of optimal pharmaceutical care. Established ratios to guide clinical pharmacy staffing on medical and surgical units are lacking in Canada. Objectives: To determine the pharmacist-to-patient ratio that allows for provision of comprehensive pharmaceutical care to each patient on a medical or surgical unit and to determine which comprehensive care tasks can be delivered in settings where staffing is limited. Methods: A multiphase study was conducted in 6 hospitals. First, a modified Delphi study was conducted to define and prioritize the elements of comprehensive pharmaceutical care. Next, a work sampling study was conducted to establish the frequency of each task and the time required for completion. Finally, a workforce calculator was used to determine pharmacy staffing ratios. Results: Ten pharmacists participated in the modified Delphi study, and 31 participated in the work sampling study. A total of 15 comprehensive care tasks were identified, 7 of which were categorized as tasks to prioritize in settings where staffing is limited. The optimal staffing ratios were 1 pharmacist to 13 patients in internal medicine teaching units, 1 pharmacist to 26 patients in hospitalist or internal medicine nonteaching units, and 1 pharmacist to 14 patients in surgical units. Conclusions: The optimal staffing ratios determined in this study should enable pharmacists to provide comprehensive care to each patient. Implementing these staffing ratios could increase the consistency of clinical pharmacy services, improve patient outcomes, and improve pharmacists’ work satisfaction. Further research is required to validate these ratios in a variety of settings. Keywords: clinical pharmacy, key performance indicators, work sampling, pharmacy staffing, patient ratio, workload RÉSUMÉ Contexte : L’élargissement du champ d’exercice des pharmaciens d’hôpitaux a contribué à l’amélioration des soins aux patients; cependant, la charge de travail reste un obstacle à la prestation de soins pharmaceutiques optimaux. Il n’existe pas de ratios établis pour guider la dotation en pharmacie clinique dans les unités médicales et chirurgicales au Canada. Objectifs : Déterminer le ratio pharmacien-patient permettant de fournir des soins pharmaceutiques complets à chaque patient dans une unité médicale ou chirurgicale donnée et déterminer quelles tâches de soins complets peuvent être dispensées dans des contextes où le personnel est limité. Méthodes : Une étude multiphase a été menée dans 6 hôpitaux. Tout d’abord, une étude Delphi modifiée a été menée pour définir et hiérarchiser les éléments d’une prise en charge pharmaceutique générale. Ensuite,une étude par échantillonnage de travaux a été menée afin d’établir la fréquence de chaque tâche et le temps nécessaire pour l’accomplir. Enfin, un calculateur d’effectifs a été","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"28 47","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135392185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy 等待时间目标和患者满意度反馈在减少门诊药房处方服务等待时间中的有效性
The Canadian journal of hospital pharmacy Pub Date : 2023-11-08 DOI: 10.4212/cjhp.3438
Yulia Leemanza, Erna Kristin
{"title":"Effectiveness of Wait Time Targets and Patient Satisfaction Feedback in Decreasing Wait Times for Prescription Services in an Outpatient Pharmacy","authors":"Yulia Leemanza, Erna Kristin","doi":"10.4212/cjhp.3438","DOIUrl":"https://doi.org/10.4212/cjhp.3438","url":null,"abstract":"Background: Long wait times for prescription services at the Outpatient Pharmacy of the Dr. OEN SOLO BARU Hospital in Indonesia have led to high numbers of complaints. In response, to decrease these wait times, the hospital undertook an intervention to determine wait time targets and provide feedback on patient satisfaction to personnel in the Outpatient Pharmacy. Objective: To measure the impact of providing wait time targets and patient satisfaction feedback to pharmacists in terms of decreasing wait times for prescription services at the Outpatient Pharmacy. Methods: This quasi-experimental research study had a single-group interrupted time-series design. Data on wait times and patient satisfaction were collected from “waiting patients”. The study participants were 35 employees (6 pharmacists and 29 technicians), and the intervention entailed provision of wait time targets and patient satisfaction feedback to the participants every week for 5 consecutive weeks. Results: The wait times for prescription services decreased by 11.13 minutes (17%) for compounded prescriptions and by 12.70 minutes (37%) for noncompounded prescriptions. There was a significant change in average wait time for both compounded and noncompounded prescription services from week 0 to week 4 (p < 0.001). There was also a significant change in patient satisfaction from week 0 to week 4 (p < 0.001). Patient satisfaction increased significantly in conjunction with the decrease in wait times for prescription services. Conclusions: The intervention of providing wait time targets and feedback on patient satisfaction to pharmacists helped to reduce wait times for prescription services. Keywords: wait times, targets, patient satisfaction, feedback, PDCA (plan, do, check, act) method RÉSUMÉ Contexte : Les longs délais d’attente pour les services de délivrance de médicaments sur ordonnance à la pharmacie ambulatoire de l’Hôpital Dr. OEN SOLO BARU en Indonésie ont donné lieu à un nombre élevé de plaintes. En réponse, afin de réduire ces temps d’attente, l’hôpital a cherché à déterminer des objectifs de temps d’attente et à fournir des commentaires sur la satisfaction des patients au personnel de la pharmacie ambulatoire. Objectif : Mesurer l’incidence, sur le temps d’attente pour la délivrance de médicaments sur ordonnance à la pharmacie ambulatoire, de la remise aux pharmaciens d’objectifs de temps d’attente et de commentaires sur la satisfaction des patients. Méthodes : Cette étude de recherche quasi-expérimentale était conçue selon une série temporelle interrompue à groupe unique. Les données sur les temps d’attente et sur la satisfaction des patients ont été recueillies auprès des « patients en attente ». Au total, 35 employés (6 pharmaciens et 29 techniciens) ont participé à l’étude, et l’intervention consistaità remettre aux pharmaciens des objectifs de temps d’attente et des commentaires sur la satisfaction des patients chaque semaine pendant 5 semaines consécutives. Résultats ","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"28 41","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135392189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Switching Topical Diclofenac from Higher to Lower Strength: Financial and Clinical Evaluation 局部双氯芬酸从高强度到低强度转换:财务和临床评价
The Canadian journal of hospital pharmacy Pub Date : 2023-11-08 DOI: 10.4212/cjhp.3459
Elissa S Y Aeng, Amninder K Dhatt, Nakyung Kim, Aaron M Tejani
{"title":"Switching Topical Diclofenac from Higher to Lower Strength: Financial and Clinical Evaluation","authors":"Elissa S Y Aeng, Amninder K Dhatt, Nakyung Kim, Aaron M Tejani","doi":"10.4212/cjhp.3459","DOIUrl":"https://doi.org/10.4212/cjhp.3459","url":null,"abstract":"Background: In February 2020, the Fraser Health Authority in British Columbia introduced an automatic therapeutic interchange policy, whereby orders for any strength of topical diclofenac would be automatically interchanged to the commercially available diclofenac 2.32% gel for twice-daily administration. The new policy was intended mainly as a cost-saving measure but had the potential for clinical impacts that needed to be considered. Objectives: To evaluate the financial and clinical impact of the automatic therapeutic interchange policy for topical diclofenac. Methods: A financial evaluation and a clinical evaluation were conducted. Expenditures for topical diclofenac before and after implementation of the automatic therapeutic interchange policy were compared. To obtain information about the clinical impact of the interchange, a retrospective chart review was conducted at long-term care sites. The primary outcome was a composite of 7 components that could indicate worsening of pain in 3 prespecified scenarios. Results: The financial evaluation showed that the interchange could potentially save the health authority more than $200 000 over 12 months. The clinical evaluation showed that 25%–48% of patients met the primary outcome of worsening pain (analyzed according to 3 different scenarios) after the switch to lower-strength diclofenac, with increases in use of as-needed topical diclofenac and other analgesics being the main indicators of worsening pain. Conclusions: An automatic therapeutic interchange policy that switched orders for higher strengths of diclofenac to the 2.32% concentration resulted in large financial savings and, in most cases (52%–75% of patients), did not appear to affect pain control. Prospective studies comparing the clinical impact of higher- and lower-strength topical diclofenac products are warranted. Keywords: topical, diclofenac, pain, therapeutic interchange, dose– response relationship RÉSUMÉ Contexte : En février 2020, la Fraser Health Authority en Colombie- Britannique a introduit une politique d’échange thérapeutique automatique, selon laquelle les commandes de diclofénac topique (n’importe quelle concentration) seraient automatiquement échangées contre du diclofénac à 2,32 % (formule en gel) disponible dans le commerce pour une administration deux fois par jour. La nouvelle politique visait principalement à réduire les coûts, mais pouvait avoir une incidence clinique, qui devait être prise en compte. Objectifs : Évaluer l’impact financier et clinique de la politique d’échange thérapeutique automatique pour le diclofénac topique. Méthodes : Une évaluation financière et une évaluation clinique ont été réalisées. Les dépenses liées au diclofénac topique avant et après la mise en œuvre de la politique d’échange thérapeutique automatique ont été comparées. Pour obtenir des informations sur l’incidence clinique de l’échange, un examen rétrospectif des dossiers a été réalisé dans les sites de soins de longue durée. L","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135341501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of Multidisciplinary Heart Failure Clinic on Guideline-Directed Medical Therapy and Clinical Outcomes 多学科心力衰竭临床对指导药物治疗和临床结果的影响
The Canadian journal of hospital pharmacy Pub Date : 2023-11-08 DOI: 10.4212/cjhp.3364
Sie Sie Tan, Ahmad Hisham Shairyzah, Abdul Muizz Bin Abdul Malek, Ping Lik Chua, Lau Seng Kiong Glendon, Abdul Kahar Bin Abdul Ghapar
{"title":"Impact of Multidisciplinary Heart Failure Clinic on Guideline-Directed Medical Therapy and Clinical Outcomes","authors":"Sie Sie Tan, Ahmad Hisham Shairyzah, Abdul Muizz Bin Abdul Malek, Ping Lik Chua, Lau Seng Kiong Glendon, Abdul Kahar Bin Abdul Ghapar","doi":"10.4212/cjhp.3364","DOIUrl":"https://doi.org/10.4212/cjhp.3364","url":null,"abstract":"Background: Heart failure (HF) is associated with recurrent hospital admissions and high mortality. Guideline-directed medical therapy has been shown to improve prognosis for patients who have HF with reduced ejection fraction (HFrEF). Despite the proven benefits of guideline- directed medical therapy, its utilization is less than optimal among patients with HF in Malaysia. Objective: To determine the impact of a multidisciplinary team HF (MDT-HF) clinic on the use of guideline-directed medical therapy and patients’ clinical outcomes at 1 year. Methods: This retrospective study was conducted in a single cardiac centre in Malaysia. Patients with HFrEF who were enrolled in the MDT-HF clinic between November 2017 and June 2020 were compared with a matched control group who received the standard of care. Data were retrieved from the hospital electronic system and were analyzed using statistical software. Results: A total of 54 patients were included in each group. Patients enrolled in the MDT-HF clinic had higher usage of renin–angiotensin system blockers (54 [100%] vs 47 [87%], p < 0.001) and higher attainment of the target dose for these agents (35 [65%] vs 5 [9%], p < 0.001). At 1 year, the mean left ventricular ejection fraction (LVEF) was significantly greater in the MDT-HF group (35.7% [standard deviation 12.3%] vs 26.2% [standard deviation 8.7%], p < 0.001), and care in the MDT-HF clinic was significantly associated with better functional class, with a lower proportion of patients categorized as having New York Heart Association class III HF at 1 year (1 [2%] vs 14 [26%], p = 0.001). Patients in the MDT-HF group also had a significantly lower rate of readmission for HF (4 [7%] vs 32 [59%], p < 0.001). Conclusions: Patients who received care in the MDT-HF clinic had better use of guideline-directed medical therapy, greater improvement in LVEF, and a lower rate of readmission for HF at 1 year relative to patients who received the standard of care. Keywords: heart failure with reduced ejection fraction, target dose, multidisciplinary clinic, heart failure hospitalization, guideline-directed medical therapy RÉSUMÉ Contexte : L’insuffisance cardiaque (IC) est associée à des hospitalisations récurrentes et à une mortalité élevée. Il a été démontré qu’un traitement médical orienté par des lignes directrices améliore le pronostic des patients atteints d’insuffisance cardiaque avec fraction d’éjection réduite (ICFER). Malgré les avantages éprouvés du traitement médical orienté par des lignes directrices, son utilisation est loin d’être optimale chez les patients atteints d’IC en Malaisie. Objectif : Déterminer l’incidence d’une clinique d’IC en équipe multidisciplinaire (IC-ÉM) sur l’utilisation d’un traitement médical orienté par des lignes directrices et les résultats cliniques des patients à 1 an. Méthodes : Cette étude rétrospective a été menée dans un seul centre cardiaque en Malaisie. Les patients atteints d’ICFER inscrits à la clinique d’IC-ÉM e","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"30 40","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135390503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring the Professional Identity of Hospital Pharmacists in British Columbia 探究不列颠哥伦比亚省医院药师的职业认同
The Canadian journal of hospital pharmacy Pub Date : 2023-10-10 DOI: 10.4212/cjhp.3419
Karen Dahri, Cindy Luo, Brandy Kent, Madison Lai, Amanda Driver, Hans Haag
{"title":"Exploring the Professional Identity of Hospital Pharmacists in British Columbia","authors":"Karen Dahri, Cindy Luo, Brandy Kent, Madison Lai, Amanda Driver, Hans Haag","doi":"10.4212/cjhp.3419","DOIUrl":"https://doi.org/10.4212/cjhp.3419","url":null,"abstract":"Background: Pharmacists lack a cohesive professional identity, with only limited previous research on the formation of a professional identity for pharmacy. In particular, there is sparse information on the professional identity of pharmacists who practise in hospital settings. Objectives: To determine hospital pharmacists’ professional identity and the characteristics of an ideal pharmacist and ideal practice setting. Methods: This qualitative study used key informant interviews with semistructured questions. A maximum variation sampling strategy was used to recruit a cross-section of pharmacists from different geographic areas of British Columbia who were practising in a variety of roles. The interviews were transcribed and then analyzed thematically. Results: Nineteen pharmacists participated in the study. Seven themes pertaining to hospital pharmacists’ professional identity were generated, specifically medication expert, therapy optimizer, collaborator, educator, researcher, patient advocate, and unknown professional. Similarities were found with personas previously identified in a population of primarily community pharmacists. The ideal pharmacist was described as being a medication expert, a collaborator, and a leader. The ideal practice setting was characterized as being adequately funded and allowing pharmacists to practise to their full scope. Conclusions: Hospital pharmacists’ professional identity is based on being a medication expert who is seen as an essential member of a collaborative team. Keywords: professional identity, pharmacists, hospital practice RÉSUMÉ Contexte : Les pharmaciens manquent d’une identité professionnelle cohérente et les recherches antérieures portant sur la formation d’une identité professionnelle de la profession sont limitées. En particulier, les informations sur l’identité professionnelle des pharmaciens exerçant en milieu hospitalier sont rares. Objectif : Déterminer l’identité professionnelle des pharmaciens d’hôpitaux ainsi que les caractéristiques d’un pharmacien idéal et d’un milieu d’exercice idéal. Méthodes : Pour cette étude qualitative, des questions d’entretiensemi-structurées ont été utilisées auprès d’informateurs clés. Une stratégie d’échantillonnage à variation maximale a été utilisée pour recruter un échantillon représentatif de pharmaciens de différentes régions géographiques de la Colombie-Britannique pratiquant divers rôles. Les entretiens ont ensuite été retranscrits puis analysés par thème. Résultats : Dix-neuf pharmaciens ont participé à l’étude. Sept thèmes relatifs à l’identité professionnelle des pharmaciens d’hôpitaux se sont dessinés : expert en médicaments, optimisateur thérapeutique, collaborateur, éducateur, chercheur, défenseur des patients et professionnel méconnu. Des similitudes se sont dégagées avec des identités précédemment cernées dans une population constituée principalement de pharmaciens communautaires. Le pharmacien idéal a été décrit comme étant un expert en médica","PeriodicalId":94225,"journal":{"name":"The Canadian journal of hospital pharmacy","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136357273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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