Accreditation Standards of Clinical Pharmacy Education in Three Leading Countries

Accreditation Standards of Clinical Pharmacy Education in Three Leading Countrie

Improvement of knowledge, attitude and perception of healthcare workers about ADR, a pre- and post-clinical pharmacists' interventional study

Purpose: Healthcare workers have a main role in detection, assessment and spontaneous reporting of adverse drug reactions (ADRs), and improvement of their related knowledge, attitude and perception is essential. The goal of this study was evaluation of clinical pharmacists' interventions in improvement of knowledge, attitude and perception of healthcare workers about ADRs in a teaching referral hospital, Tehran, Iran. Method: Changes in knowledge, attitude and perception of healthcare workers of Imam teaching hospital about ADRs were evaluated before and after clinical pharmacists' interventions including workshops, meetings and presentations. Results: From the 100 participated subjects, 82 of them completed the study. 51 of the health workers have been aware of the Iranian Pharmacovigilance Center at the ministry of health before intervention and after that all the participants knew this centre. About awareness and detection of ADRs in patients, 69 (84.1) healthcare workers recognised at least one, and following interventions, it was improved to 73 (89). Only seven (8.5) subjects have reported ADRs in before intervention phase that were increased significantly to 18 (22) after intervention. Conclusion: Clinical pharmacists' interventions were successful in improvement of healthcare workers' knowledge, attitude and perception about ADRs and spontaneous reporting in our hospital

Costs of hospital admission on primary immunodeficiency diseases

Background Primary immunodeficiency diseases (PID) are heterogeneous group of inherited disorders mainly characterized by recurrent infections leading to several times hospital admissions. The economic impact of PID is a challenging issue; therefore, this study was designed to determine the medical costs of hospitalizations in this group of patients as an indicator of the direct cost of these diseases. Methods One hundred and ten children with PID hospitalized in the Children’s Medical Center Hospital, Tehran, Iran were included in this study during Jan 2011 and Jan 2012. All direct costs during the admission period were calculated, using the hospital information system. Results Medical cost was $7.090 per patient per admission. Among them, about 1.580$ belong to drug consuming during hospitalization. Anti-infective drugs for systemic use were the most cost-consuming group of drugs, followed by alimentary tract and metabolism and blood and blood forming organs agents. Investigation of anti-infective group internally showed that immune sera and immunoglobulin and antiviral agents for systemic use consisting the most important medication for PID patients during hospital admission. Conclusion Although the results of economic evaluations in a region cannot necessarily be applied to other regions, having an overall estimation of hospital admission costs and types of drugs used during admission could be helpful in health policy system

Clinical Pharmacists: Practitioners Who Are Essential Members to Enhance Pharmaceutical Care During Covid-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged health systems to find innovative ways of delivering patient care. Pharmaceutical care and team-based care which include the patient along with their other healthcare providers are designed to promote health, prevent disease, and ensure safe and effective use of medicine which is an essential component for fighting against COVID-19 pandemic (1). Clinical pharmacy is defined as “a health science discipline in which pharmacists provide patient care that optimizes medication therapy and promotes health, wellness, and disease prevention” and "embraces the philosophy of pharmaceutical care”(2) Clinical pharmacists (CPs) are practitioners with advanced education and training, providing direct patient care and comprehensive medication management for both patients and health-care providers, they also perform pharmaceutical care to ensure patients' safe and effective medication use. (3) However, in case of public health emergencies, such as COVID-19 pandemic, the strategies of CPs need to be remodeled to face with rapid spread of the disease, and lack of evidence-based information. CPs activities can promote the rational use of drugs (RUDs) to reduce the rate of side effects, drug costs and optimize patient outcome by selecting the most appropriate medication, dosage form, route of administration, and appropriate monitoring.(4) Roles of pharmacist to enhance pharmaceutical care during COVID-19 pandemic can be characterized as fallow:   • Pharmacotherapy evaluation: By assessment of the patients in routine visits, the pharmacotherapy recommendations can be given based on medication review, data from medical documents, and interview with the physicians, and the patient. • Preparation of hospital treatment protocols: Providing updates on the latest evidence to guide health care team regarding COVID-19 management. • Establishment of evidence-based medicine and guidelines: By contribution to improve pharmaceutical policies and decision-making process. • Providing education on pharmacotherapy of COVID-19 for healthcare professionals: through pharmacotherapy classes, face to face education and utilization of virtual space. • Establishment of drug registration research and clinical trials: pharmaceutical scientists, clinicians and pharmacists are actively conducting registered studies to explore effective treatment options. (figure1) CPs can collaborate with other healthcare providers to apply their knowledge and pharmacological expertise to manage pharmacotherapy challenges in COVID-19 patients and actualize pharmacists’ value and responsibility through the pandemic (4). Clinical pharmacy services aimed improving the quality use of medicines which could lead to better patient outcomes and reducing health care costs.(1) The implementation of RUD is a reasonable opportunity for CPs to make a significant impact on patient management, reducing healthcare costs, since they have the expertise to identify, resolve, and prevent medication errors and DRPs.(5) Notably, COVID-19 treatment protocols are rapidly changing, CPs should constantly keep their scientific information up to date so that they could play an active role in the pandemic. We need to implement creative methods to deal with this little known disease. Employment of CPs can affect the proper use of financial resources which is particularly important for developing countries. Finally, the role of a CPs is not only being an academic leader to develop practice guidance and recommendations, but also a practitioner of pharmacy services who is at the frontline of fighting against COVID-19 to ensure the rational use of drugs during the pandemic. Involvement of CPs in the healthcare setting should not be overlooked in the pandemic, since it is a pragmatic step to improve safe and effective use of medication

Vascular Microthrombosis Associated with Increased Interleukin-6. A Severe Acute Respiratory Distress Syndrome in COVID-19 Patients Treated with Tocilizumab

Thrombosis is an important pathology in the deterioration of COVID-19 patient [...

Burnout, Depression, and Anxiety in Teaching Professors of an Educational Hospital of Tehran University of Medical Sciences

Introduction: Burnout is prevalent in several physicians that may undermine the progress nad performance of physicians, reduced accessibility of patients to physicians, and patients’ safety. This study endeavored to determine burnout, anxiety, and depression in the specialists and attending physicians of one of the educational hospitals of Tehran University of Medical Sciences. Methods: This cross-sectional study conducted in the academic year 2018. One-hundred twenty-three physicians filled the Malach Burnout Inventory (MBI) questionnaire, Hospital Anxiety, and Depression Survey (HADS) questionnaires. Results: Forty-four physicians (35.8%) had some levels of burnout. Severe Emotional Exhaustion (EE) was seen in 18 physicians (14.6%). Likewise, severe Depersonalization (DP) in 12 physicians (9.8%), and severe dysfunction in Personal Accomplishment (PA) were seen in 33 physicians (26.8%). Four physicians (3%) had an abnormal level of anxiety, and 32 subjects (26%) were in the borderline zone. Four (3.2%) had abnormal depression, and 12 subjects (9.8%) had a borderline depression. There was a significant relationship between attending teacher type (i.e., educational, research, or treatment) and dysfunction of personal accomplishment (X2 = 12.24, p = 0.02). Moreover, anxiety was higher in non-married physicians (p = 0.046); anxiety was higher in part-time physicians as well (p = 0.03). Conclusion: Findings revealed that burnout is an essential issue in attending physicians of educational hospitals. Identifying and managing burnout and its adverse effects could eliminate further health complications for the physicians and under-treating patients

Pharmacokinetic study of mycophenolic acid in Iranian kidney transplant patients

<p><strong>Background:</strong> The purpose of this study was to characterize the pharmacokinetic parameters of mycophenolic acid (MPA) in Iranian kidney transplant patients.</p> <p><strong>Methods:</strong> Plasma MPA concentration of mycophenolate mofetile (MMF) 1 gram two times a day was measured in 21 Iranian kidney transplant recipients receiving treatment. Patients who entered the study had been transplanted for more than 3 months and their drug level was supposed to be at steady state. MMF concentration was measured with high-performance liquid chromatography (HPLC).</p> <p><strong>Results: </strong>The plasma MPA concentration-time curve was characterized by an early sharp peak at about 1 hour postdose. The mean Area Under Curve (AUC), Cmax and Tmax were 47.0±18.3 µg.h/ml, 18.6±8.5 µg/ml and 1.0±0.5 hours respectively.</p> <p><strong>Conclusion:</strong> The plasma MPA concentration-time curve pattern of Iranian patients was similar and consistent with previously reported profiles in other populations taking the same dose.</p> <strong>Keywords:</strong> Mycophenolate mofetil, Mycophenolic acid, Pharmacokinetics, Area Under Curve, Kidney transplantatio

Costs of hospital admission on primary immunodeficiency diseases

<b>Background</b>\ud \ud <i>Primary immunodeficiency diseases</i> (PID) are heterogeneous group of inherited disorders mainly characterized by recurrent infections leading to several times hospital admissions. The economic impact of PID is a challenging issue; therefore, this study was designed to determine the medical costs of hospitalizations in this group of patients as an indicator of the direct cost of these diseases.\ud \ud <b>Methods</b>\ud \ud One hundred and ten children with PID hospitalized in the Children’s Medical Center Hospital, Tehran, Iran were included in this study during Jan 2011 and Jan 2012. All direct costs during the admission period were calculated, using the hospital information system.\ud \ud <b>Results</b>\ud \ud Medical cost was $7.090 per patient per admission. Among them, about 1.580$ belong to drug consuming during hospitalization. Anti-infective drugs for systemic use were the most cost-consuming group of drugs, followed by alimentary tract and metabolism and blood and blood forming organs agents. Investigation of anti-infective group internally showed that immune sera and immunoglobulin and antiviral agents for systemic use consisting the most important medication for PID patients during hospital admission.\ud \ud <b>Conclusion</b>\ud \ud Although the results of economic evaluations in a region cannot necessarily be applied to other regions, having an overall estimation of hospital admission costs and types of drugs used during admission could be helpful in health policy system