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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 42454

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Special Issue Editor

Prof. Dr. Tinne Dilles

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Guest Editor

Centre for Research and Innovation in Care, NuPhaC, University of Antwerp, 2000 Antwerp, Belgium
Interests: patient safety; pharmaceutical care; interprofessional care; implementation science

Special Issue Information

Dear Colleagues,

Medicines administration is an important part of the treatment of many patients. Achieving a therapy tailored to individual patients, with a maximum of therapeutic effects and a minimum of adverse effects, can be challenging. It requires significant efforts by patients, informal caregivers, interprofessional teams of healthcare providers, and the healthcare system. It also involves respectful agreements of all stakeholders on responsibilities throughout the complex process of pharmaceutical care.

On 11 March 2020, the Council of Europe adopted a new resolution [1] on pharmaceutical care, i.e., the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient’s quality of life [2]. The resolution focuses on how pharmaceutical care can be implemented for the benefit of patients and health services.

From the resolution, several challenges and opportunities can be derived to optimise pharmaceutical care through an interprofessional and patient-centred approach. Steps considered in the process are: 1) assessment of patient’s medication and health status; 2) identification and prioritisation of medication-related problems; 3) selection of interventions and formulation of a pharmaceutical care plan; 4) patient agreement, implementation and monitoring; and 5) patient follow-up.

This Special Issue of the International Journal of Environmental Research and Public Health is devoted to making a substantial contribution to the implementation of pharmaceutical care for the benefit of patients and health services. We welcome manuscripts within this scope, based on varied healthcare settings, patient populations or healthcare professions. We encourage translational research that tests new approaches incorporating person-centred design or technology support or considering implementation strategies.

The Council of Europe Resolution CM/Res(2020)3 on implementation of pharmaceutical care for the benefit of patients and health services https://search.coe.int/cm/pages/result_details.aspx?objectid=09000016809cdf26 (Accessed on 30 October 2020)
Hepler C.D. and Strand L.M., Opportunities and Responsibilities in Pharmaceutical Care, American Journal of Hospital Pharmacy 1990; 47, 533–543.

Prof. Dr. Tinne Dilles
Guest Editor

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Keywords

Pharmaceutical care
Medicines optimisation
Medication review
Medication reconciliation
Medication adherence
Medication (self-)management
Responsibilities/ Role’s in pharmaceutical care
Drug monitoring
Medication-related problems
Polypharmacy
Interprofessional pharmaceutical care
Patient centred pharmaceutical care
Implementation of pharmaceutical care within the health system
Medication Safety

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Published Papers (10 papers)

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Research

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14 pages, 352 KiB

Open AccessArticle

Pharmacist Intention to Provide Medication Therapy Management Services in Saudi Arabia: A Study Using the Theory of Planned Behaviour

by Ahmed M. Alshehri, Omar S. Alenazi, Salman A. Almutairi, Ali Z. Alali, Yasser S. Almogbel, Rana E. Alonazi, Hind A. Alkhelaifi, Waleed M. Alshehri and Faisal A. Alsehli

Int. J. Environ. Res. Public Health 2022, 19(9), 5279; https://doi.org/10.3390/ijerph19095279 - 26 Apr 2022

Cited by 10 | Viewed by 2701

Abstract

Medication therapy management (MTM) is provided by pharmacists and other healthcare providers, improves patient health status, and increases the collaboration of MTM providers with others. However, little is known about pharmacists’ intention to provide MTM services in Saudi Arabia. This study aimed to predict the pharmacists’ willingness in this nation to commit to providing MTM services there. This study used a cross-sectional questionnaire based on the theory of planned behaviour (TPB). The survey was distributed to 149 pharmacists working in hospital and community pharmacies. It included items measuring pharmacist attitudes, intentions, subjective norms, perceived behavioural control, knowledge about the provision of MTM services, and other sociodemographic and pharmacy practice-related items. The pharmacists had a positive attitude towards MTM services (mean = 6.15 ± 1.12) and strong intention (mean = 6.09 ± 1.15), highly perceived social pressure to provide those services (mean = 5.42 ± 1.03), strongly perceived control over providing those services (mean = 4.98 ± 1.05), and had good MTM knowledge (mean = 5.03 ± 1.00). Pharmacists who completed a pharmacy residency programme and had good knowledge of MTM services and a positive attitude towards them usually strongly intended to provide MTM services. Thus, encouraging pharmacists to complete pharmacy residency programmes and educating them about the importance and provision of MTM services will enhance their motivation to provide them. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

13 pages, 2333 KiB

Open AccessArticle

Polish Pharmacy Students’ Readiness, Qualifications, Competences, Relevance, Motivation and Effectiveness to Promote Health in Community Pharmacies

by Dorota Raczkiewicz, Bartosz Kobuszewski, Beata Sarecka-Hujar, Adrianna Pawełczak-Barszczowska and Iwona Bojar

Int. J. Environ. Res. Public Health 2021, 18(24), 13227; https://doi.org/10.3390/ijerph182413227 - 15 Dec 2021

Cited by 3 | Viewed by 2480

Abstract

Background: One of the parts of the broadly understood pharmaceutical care is health promotion. Therefore, the study aimed to find out how pharmacy students in Poland assess their own readiness to promote health in pharmacies and their own qualifications, competences, relevance, motivation and effectiveness of health promotion in pharmacies. Methods: The study conducted in 2019 comprised 206 pharmacy students from Poland. The authors’ survey questionnaire had two parts: Readiness to promote health in pharmacies; and Qualifications, competences, relevance, motivation and effectiveness of health promotion in pharmacies. Results: The students assessed the system solutions regarding health promotion as insufficient. The highest assessment was given to their own readiness to promote health. In between those was assessment of readiness to promote health by pharmacists as an occupational group. Readiness to promote health at a workplace in a pharmacy was assessed higher than in a local community. The students gave the highest assessments to the relevance and motivation to promote health, and the lowest to their own competences to promote health. In between those, their qualifications and effectiveness to health promotion in pharmacies. were assessed. Conclusions: Pharmacy students consider themselves ready and motivated to promote health, that is of a great importance in their opinion, and they could potentially play an important role in improving the health care of patients. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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9 pages, 350 KiB

Open AccessArticle

Geriatric Depression and Inappropriate Medication: Benefits of Interprofessional Team Cooperation in Nursing Homes

by Hana Vankova, Iva Holmerova and Ladislav Volicer

Int. J. Environ. Res. Public Health 2021, 18(23), 12438; https://doi.org/10.3390/ijerph182312438 - 26 Nov 2021

Cited by 4 | Viewed by 1858

Abstract

An investigation of inappropriate medication use in treatment of depressivity in institutionalized older adults, based on a nurse-led evaluation of functional status and depressive symptoms in nursing home residents. Methods: A cross-sectional multicenter study was performed using records from 1087 residents cared for in fifteen nursing homes (NHs) in the Czech Republic. Inclusion criteria were being a permanent resident of one of the facilities, being 60 years of age or older, having a Geriatric Depression Scale score of 6 or more, and having a Mini Mental State examination score 10 or more. The final sample for analysis included 317 depressed NH residents. Results: 52 percent of NH residents with depressivity had no antidepressant treatment. Benzodiazepines were the only medication in 16 percent of depressed residents, and were added to antidepressant treatment in 18 percent of residents. Benzodiazepine users had significantly higher GDS scores compared to non-users (p = 0.007). Conclusion: More than half of depressed NH residents remained without antidepressant treatment. Residents inappropriately treated with benzodiazepines were more depressed than residents treated with antidepressants only, or even not treated at all. Cooperation of the interprofessional team in the screening of depressive symptoms has the potential to improve the quality of care. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

12 pages, 646 KiB

Open AccessArticle

Artificial Intelligence for Identifying the Prevention of Medication Incidents Causing Serious or Moderate Harm: An Analysis Using Incident Reporters’ Views

by Marja Härkänen, Kaisa Haatainen, Katri Vehviläinen-Julkunen and Merja Miettinen

Int. J. Environ. Res. Public Health 2021, 18(17), 9206; https://doi.org/10.3390/ijerph18179206 - 31 Aug 2021

Cited by 5 | Viewed by 2732

Abstract

The purpose of this study was to describe incident reporters’ views identified by artificial intelligence concerning the prevention of medication incidents that were assessed, causing serious or moderate harm to patients. The information identified the most important risk management areas in these medication incidents. This was a retrospective record review using medication-related incident reports from one university hospital in Finland between January 2017 and December 2019 (n = 3496). Of these, incidents that caused serious or moderate harm to patients (n = 137) were analysed using artificial intelligence. Artificial intelligence classified reporters’ views on preventing incidents under the following main categories: (1) treatment, (2) working, (3) practices, and (4) setting and multiple sub-categories. The following risk management areas were identified: (1) verification, documentation and up-to-date drug doses, drug lists and other medication information, (2) carefulness and accuracy in managing medications, (3) ensuring the flow of information and communication regarding medication information and safeguarding continuity of patient care, (4) availability, update and compliance with instructions and guidelines, (5) multi-professional cooperation, and (6) adequate human resources, competence and suitable workload. Artificial intelligence was found to be useful and effective to classifying text-based data, such as the free text of incident reports. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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26 pages, 7187 KiB

Open AccessArticle

The NUPHAC-EU Framework for Nurses’ Role in Interprofessional Pharmaceutical Care: Cross-Sectional Evaluation in Europe

by Elyne De Baetselier, Bart Van Rompaey, Nienke E. Dijkstra, Carolien G. Sino, Kevin Akerman, Luis M. Batalha, Maria I. D. Fernandez, Izabela Filov, Vigdis A. Grøndahl, Jana Heczkova, Ann Karin Helgesen, Sarah Keeley, Petros Kolovos, Gero Langer, Sabina Ličen, Manuel Lillo-Crespo, Alba Malara, Hana Padyšáková, Mirko Prosen, Dorina Pusztai, Bence Raposa, Jorge Riquelme-Galindo, Jana Rottková, Francesco Talarico, Styliani Tziaferi and Tinne Dilles Show full author list Hide full author list

Int. J. Environ. Res. Public Health 2021, 18(15), 7862; https://doi.org/10.3390/ijerph18157862 - 25 Jul 2021

Cited by 5 | Viewed by 3695

Abstract

Clear role descriptions promote the quality of interprofessional collaboration. Currently, it is unclear to what extent healthcare professionals consider pharmaceutical care (PC) activities to be nurses’ responsibility in order to obtain best care quality. This study aimed to create and evaluate a framework describing potential nursing tasks in PC and to investigate nurses’ level of responsibility. A framework of PC tasks and contextual factors was developed based on literature review and previous DeMoPhaC project results. Tasks and context were cross-sectionally evaluated using an online survey in 14 European countries. A total of 923 nurses, 240 physicians and 199 pharmacists responded. The majority would consider nurses responsible for tasks within: medication self-management (86–97%), patient education (85–96%), medication safety (83–95%), monitoring adherence (82–97%), care coordination (82–95%), and drug monitoring (78–96%). The most prevalent level of responsibility was ‘with shared responsibility’. Prescription management tasks were considered to be nurses’ responsibility by 48–81% of the professionals. All contextual factors were indicated as being relevant for nurses’ role in PC by at least 74% of the participants. No task nor contextual factor was removed from the framework after evaluation. This framework can be used to enable healthcare professionals to openly discuss allocation of specific (shared) responsibilities and tasks. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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15 pages, 734 KiB

Open AccessArticle

Assessing Medication Adherence Barriers to Short-Term Oral Antibiotic Treatment in Primary Care—Development and Validation of a Self-Report Questionnaire (BIOTICA)

by Melanie Haag, Kurt E. Hersberger and Isabelle Arnet

Int. J. Environ. Res. Public Health 2021, 18(15), 7768; https://doi.org/10.3390/ijerph18157768 - 22 Jul 2021

Cited by 10 | Viewed by 3095

Abstract

Background: Pharmacists are increasingly involved in strategies to fight antimicrobial resistance by ensuring optimised antibiotic (AB) use, including adherence support. Successful adherence interventions should be tailored to patients’ barriers and validated instruments are needed. This study aimed to identify adherence barriers to AB treatment, develop a self-report questionnaire, and validate it in outpatients. Method: Adherence barriers were identified through a systematic literature search and focus group discussion. Unmodifiable and irrelevant barriers were excluded from further processing. A validation study assessed the questionnaire’s internal reliability and construct validity by comparing the questionnaire’s score with electronically monitored adherence data. Results: A 15-item questionnaire was created. Overall, 68 patients were included in the construct validation analysis (60.3% female). The mean consecutive taking adherence was 88% and the most frequently reported barriers were “worries about side-effects” (37%) and “having swallowing difficulties” (19%). Three items were excluded from the questionnaire, which was supported by an increase of Cronbach’s alpha (0.69 to 0.70). The 12-item version’s score correlated significantly with medication adherence rate (r = −0.34, p < 0.01). Conclusion: The self-report questionnaire is a reliable and valid tool to pre-emptively assess adherence barriers in outpatients prescribed ABs. In the future, appropriate adherence interventions can be matched to barriers and tested in a pilot intervention study. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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16 pages, 876 KiB

Open AccessArticle

What Happens after Hospital Discharge? Deficiencies in Medication Management Encountered by Geriatric Patients with Polypharmacy

by Laura Mortelmans, Elyne De Baetselier, Eva Goossens and Tinne Dilles

Int. J. Environ. Res. Public Health 2021, 18(13), 7031; https://doi.org/10.3390/ijerph18137031 - 30 Jun 2021

Cited by 14 | Viewed by 4344

Abstract

This study aimed to describe post-discharge medication self-management by geriatric patients with polypharmacy, to describe the problems encountered and to determine the related factors. In a multicenter study from November 2019 to March 2020, data were collected at hospital discharge and two to five days post-discharge. Geriatric patients with polypharmacy were questioned about medication management using a combination of validated (MedMaIDE) and self-developed questionnaires. Of 400 participants, 70% did self-manage medication post-discharge. Patients had a mean of four different deficiencies in post-discharge medication management (SD 2.17, range 0–10). Knowledge-related deficiencies were most common. The number of medicines and the in-hospital provision of medication management by nurses were significant predictors of post-discharge medication management deficiencies. In addition to deficiencies in knowledge, medication-taking ability and obtaining medication, non-adherence and disrupted continuity of medication self-management were common in geriatric patients with polypharmacy post-discharge. Improvements in in-hospital preparation could avoid medication self-management problems at home. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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Review

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20 pages, 1035 KiB

Open AccessReview

The Particularities of Pharmaceutical Care in Improving Public Health Service during the COVID-19 Pandemic

by Steliana Ghibu, Anca Maria Juncan, Luca Liviu Rus, Adina Frum, Carmen Maximiliana Dobrea, Adriana Aurelia Chiş, Felicia Gabriela Gligor and Claudiu Morgovan

Int. J. Environ. Res. Public Health 2021, 18(18), 9776; https://doi.org/10.3390/ijerph18189776 - 16 Sep 2021

Cited by 16 | Viewed by 5854

Abstract

Nowadays, humanity is confronted with one of the most difficult challenges. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was identified for the first time in Hubei, China in December 2019 and produced the COVID-19 pandemic, a devastating disease that led to many complications and deaths. The authorities and the global healthcare system have been alerted regarding the prevention and treatment of this pathology. Even though worldwide quarantine was declared, health care professionals, including pharmacists, have been at the frontline in this war. Since the beginning of the pandemic, the authorities relied on the involvement of the community, hospital, or clinical pharmacists in offering support to the entire population. Also, the authorities implemented measures for emergency authorization of the vaccines, or the drugs used in COVID-19 treatment. In order to facilitate the population’s access to healthcare services, the authorities have established regulations regarding, the extension of prescriptions by pharmacists, working hours, prevention of shortages and price-increase, drive-thru services, etc. However, several countries have taken financial measures to support the pharmacies’ activity. At the same time, pharmaceutical associations elaborated guidelines for the protection of pharmacists and patients alike. Additionally, the pharmacies have come to support the health system and patients by adapting pharmaceutical care to the new needs like preparation and supply of disinfectants, patient care, information, and counseling, especially to COVID-19 patients, as well as the implementation of home drugs-delivery systems. The important roles played by pharmacists were to perform COVID-19 tests and further vaccines, as well as to combat the abundance of misinformation and fake news. The clinical and hospital pharmacy services have also been adapted. Strengthening the role of the pharmacist in the medical team was important for the purpose of providing correct and complete information regarding drugs used in the COVID-19 pathology. In all these activities, pharmacists needed creativity and professionalism, but also the support of pharmacy owners and managers. With this crisis, pharmaceutical care has entered a new phase, demonstrating the ability of pharmacists to be competent and accessible providers of public health. Based on this information, we conducted a narrative review whose purpose was to identify the impact of the authorities’ decisions on pharmaceutical practice, the involvement of professional associations, and the responsibilities of the pharmacy owners and management. On the other hand, we performed a global assessment on the pharmaceutical care services provided by community pharmacists as well as by clinical or hospital pharmacists during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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32 pages, 598 KiB

Open AccessReview

Psychiatry in the Digital Age: A Blessing or a Curse?

by Carl B. Roth, Andreas Papassotiropoulos, Annette B. Brühl, Undine E. Lang and Christian G. Huber

Int. J. Environ. Res. Public Health 2021, 18(16), 8302; https://doi.org/10.3390/ijerph18168302 - 5 Aug 2021

Cited by 14 | Viewed by 6643

Abstract

Social distancing and the shortage of healthcare professionals during the COVID-19 pandemic, the impact of population aging on the healthcare system, as well as the rapid pace of digital innovation are catalyzing the development and implementation of new technologies and digital services in psychiatry. Is this transformation a blessing or a curse for psychiatry? To answer this question, we conducted a literature review covering a broad range of new technologies and eHealth services, including telepsychiatry; computer-, internet-, and app-based cognitive behavioral therapy; virtual reality; digital applied games; a digital medicine system; omics; neuroimaging; machine learning; precision psychiatry; clinical decision support; electronic health records; physician charting; digital language translators; and online mental health resources for patients. We found that eHealth services provide effective, scalable, and cost-efficient options for the treatment of people with limited or no access to mental health care. This review highlights innovative technologies spearheading the way to more effective and safer treatments. We identified artificially intelligent tools that relieve physicians from routine tasks, allowing them to focus on collaborative doctor–patient relationships. The transformation of traditional clinics into digital ones is outlined, and the challenges associated with the successful deployment of digitalization in psychiatry are highlighted. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

11 pages, 748 KiB

Open AccessReview

Nurses and Pharmaceutical Care: Interprofessional, Evidence-Based Working to Improve Patient Care and Outcomes

by Tinne Dilles, Jana Heczkova, Styliani Tziaferi, Ann Karin Helgesen, Vigdis Abrahamsen Grøndahl, Bart Van Rompaey, Carolien G. Sino and Sue Jordan

Int. J. Environ. Res. Public Health 2021, 18(11), 5973; https://doi.org/10.3390/ijerph18115973 - 2 Jun 2021

Cited by 8 | Viewed by 7037

Abstract

Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective. Despite the consensus that interprofessional collaboration is essential, in clinical practice, research, education and policy-making challenges are often not addressed interprofessionally. This paper concludes with specific advises to move towards the implementation of more interprofessional, evidence-based pharmaceutical care. Full article

(This article belongs to the Special Issue Opportunities and Responsibilities in Pharmaceutical Care)

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