Physicians’ and Pharmacists’ Experience and Expectations of the Roles of Pharmacists: Insights into Hospital Setting in Macau

Purpose: To investigate physicians’ and pharmacists’ experience and expectations of the roles of pharmacists in hospital setting in Macau for the development of physician-pharmacist collaborative working relationship (CWR).Methods: A survey was conducted to address the research questions. The study population included the physicians and pharmacists working in hospitals in Macau. A self-administered survey was designed correspondingly to physicians and pharmacists with same series of questions, which composed of 4 parts: demographics, collaboration status, roles of pharmacist based on experience, and roles of pharmacist based on expectations.Results: Sixty six out of the 120 physician surveys and 18 out of the 30 pharmacist surveys were returned, giving a response rate of 55.00% and 60.00% respectively. 33.33% of physicians and 77.8% of pharmacists claimed they collaborated with the other professional at least once a week. The main reason for collaboration was prescription order queries. Both professionals indicated that “medication dispensing” and “identification and prevention of prescription errors” were currently the top responsibilities of pharmacists. It was anticipated by the physicians that pharmacists would remain focused on “medication dispensing” but should put in more effort. Pharmacists, on the other hand, would like to develop their role in direct patient care such as “patient counseling”.Conslusion: There were discrepancies in physicians’ and pharmacists’ expectations of the roles of pharmacists. The 6 most important responsibilities of pharmacists were determined in consultation with physicians’ opinions. Capacity building of pharmacists, communication between the two professionals and administrative co-ordinations were considered important elements in developing CWR.Keywords: Physician-pharmacist relationship, Pharmacist roles, Collaboration, Expectations

Barriers to pharmacists adopting professional responsibilities that support the appropriate and safe use of dietary supplements in the United States: Perspectives of key stakeholders.

PURPOSE:Complementary health approaches including the use of dietary supplements (DS) such as vitamin, mineral, nutritional, and herbal supplements are popular in the United States. Beyond a statement issued by the American Society of Health-System Pharmacists (ASHP) in 2004, knowledge about the role of pharmacists related to DS use is largely unknown. The objectives of this study were to identify pharmacists' and other key stakeholders' perceptions and opinions about assuming roles that ensure the appropriate and safe use of DS. METHODS:A grounded theory approach involving in-depth, semi-structured key informant audio-recorded phone interviews with 12 practicing pharmacists and 10 key stakeholders were conducted. Key themes were identified using open coding, grouping, and categorizing. RESULTS:Participants believed the majority of their patients self-select and purchase DS from a pharmacy, often in conjunction with conventional medicines, and reported concerns about the regulatory standards, efficacy, and safety of DS. Despite acknowledging their ethical and professional responsibilities regarding DS, as identified by the ASHP statement and other sources, the majority of pharmacists are not expecting their profession to adopt these in the near future because of multiple barriers. CONCLUSIONS:There is a substantial disconnect between awareness of DS use and pharmacists adopting professional responsibilities regarding DS. The barriers identified are multifaceted, indicating the need for a joint effort from key stakeholders in developing a coordinated approach to supporting pharmacists in their practice efforts to ensure the appropriate and safe use of DS

Factors Influencing the Length of Hospital Stay Among Patients with Chronic Obstructive Pulmonary Disease (COPD) in Macao Population: A Retrospective Study of Inpatient Health Record

Meng Li,1,* Kun Cheng,2,* Keisun Ku,2 Junlei Li,1 Hao Hu,1 Carolina Oi Lam Ung1 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao SAR, China; 2Internal Medicine Department, Kiang Wu Hospital, Macao SAR, China*These authors contributed equally to this workCorrespondence: Hao Hu; Carolina Oi Lam UngState Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, N22-2058, Macao SAR, ChinaTel +853 8822 8538Email [email protected]; [email protected]: This study aims to identify the effects of patient and clinical therapy factors on the length of hospital stay (LOS) for admission due to chronic obstructive pulmonary disease (COPD) in Macao.Patients and Methods: Health record of patients with COPD admitted to Kiang Wu Hospital from January 2017 to December 2019 was retrospectively analyzed. Demographic information, blood test results, clinical therapies, and LOS were described and analyzed by multivariable regression.Results: A total of 1116 admissions were included with the average LOS being 12.28 (± 9.23) days. Among them, 735 (66.6%) were male with mean age 79.42 (± 10.35) years old, 697 were current or previous smokers (62.5%), and 360 (32.2%) had 3 or more comorbidities. During hospitalization, the most common treatments received were oxygen therapy (n=991,88.8%), antibiotics (n=828,74.2%), and systemic steroids (n=596,53.4%); only 120 (10.8%) had pulmonary rehabilitation (PR) and 128 (11.5%) received noninvasive ventilation (NIV). Inhaled medications were used during nearly 95% of hospitalization cases, while 2 and 3 types of inhaled medications were used during 230 (20.6%) and 582 (52.2%) hospitalization cases, respectively. Patient factors including age (B=0.178, 95% CI:0.535– 1.072), being female (B=− 1.147, 95% CI:-0.138– 0.056), being current (B=− 0.086, 95% CI:-0.124– 0.018) or previous smoker (B=0.072, 95% CI:0.004– 0.087), having 1, 2, 3 and over 3 comorbidities (B=0.126, 95% CI:0.034– 0.147; B=0.125, 95% CI:0.031– 0.144; B=0.116, 95% CI:0.028– 0.146, B=0.090, 95% CI:0.021– 0.166) and having low hemoglobin level (B=− 0.118, 95% CI:-0.629- − 0.214) exhibited significant associations with LOS. The use of NIV (B=0.080, 95% CI:0.022– 0.138), pulmonary rehabilitation (B=0.269, 95% CI:0.212– 0.327), two and three types of inhaled medications (B=0.109, 95% CI:0.003– 0.166, B=0.255, 95% CI:0.083– 0.237) were significantly associated with longer LOS (P< 0.05).Conclusion: NIV, PR and combined inhaled medications, which are often used for AECOPD, are the main clinical therapies associated with longer LOS in Macao. Smoking cessation, early treatments of comorbidities may be crucial to avoiding AECOPD and reducing LOS and disease burden.Keywords: chronic obstructive pulmonary disease, Macao, length of hospital stay, blood test results, clinical therapy, inhaled medications, acute exacerbatio

Factors contributing to hospitalization costs for patients with COPD in China: a retrospective analysis of medical record data

Meng Li,1 Fengyan Wang,2 Rongchang Chen,2 Zhenyu Liang,2 Yumin Zhou,2 Yuqiong Yang,2 Shengqi Chen,1 Carolina Oi Lam Ung,1 Hao Hu1 1State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; 2State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou China Purpose: Hospitalization brings considerable economic pressure on COPD patients in China. A clear understanding of hospitalization costs for patients with COPD is warranted to improve treatment strategies and to control costs. Currently, investigation on factors contributing to hospitalization costs for patients with COPD in China is limited. This study aimed to measure the hospitalization costs of COPD and to determine the contributing factors. Patients and methods: Medical record data from the First Affiliated Hospital of Guangzhou Medical University from January 2016 to December 2016 were used for a retrospective analysis. Patients who were hospitalized with a diagnosis of COPD were included. Patient characteristics, medical treatment, and hospitalization costs were analyzed by descriptive statistics and multivariable regression. Results: Among the 1,943 patients included in this study, 87.85% patients were male; the mean (SD) age was 71.15 (9.79) years; 94.49% patients had comorbidities; and 82.30% patients had health insurance. Regarding medical treatment, the mean (SD) length of stay was 9.38 (7.65) days; 11.12% patients underwent surgery; 87.91% used antibiotics; and 4.53% underwent emergency treatment. For hospitalization costs, the mean (SD) of the total costs per COPD patient per admission was 24,372.75 (44,173.87) CNY (3,669.33 [6,650.38] USD), in which Western medicine fee was the biggest contributor (45.53%) followed by diagnosis fee (27.00%) and comprehensive medical fee (12.04%). Regression found that reimbursement (-0.032; 95% CI -0.046 to 0.007), length of stay (0.738; 95% CI 0.832–0.892), comorbidity (0.044; 95% CI 0.029–0.093), surgery (0.145; 95% CI 0.120–0.170), antibiotic use (0.086; 95% CI 0.060–0.107), and emergency treatment (0.121; 95% CI 0.147–0.219) were significantly (P<0.01) associated with total hospitalization costs. Conclusion: To control hospitalization costs for COPD patients in China, the significance of comorbidity, length of stay, antibiotic use, surgery, and emergency treatment suggests the importance of controlling the COPD progression and following clinical guidelines for inpatients. Interventions such as examination of pulmonary function for early detection, quality control of medical treatment, and patient education warrant further investigation. Keywords: COPD, economic burden, hospitalization costs, medical cost, multivariate regressio

Toxic peptide from Palythoa caribaeorum acting on the TRPV1 channel prevents pentylenetetrazol-induced epilepsy in zebrafish larvae

202206 bcchVersion of RecordOthersThe Science and Technology Development Fund (FDCT) of Macau SAR; University of MacauPublishe