Evolving role of clinical pharmacists in assessment of clinical and modern health care services
DOI:
https://doi.org/10.18203/2319-2003.ijbcp20251849Keywords:
Patient counselling, Adverse drug reactions, Medication compliance, Drug safetyAbstract
Clinical pharmacy is a pharmacy profession in which clinical pharmacists as health care professionals helps and provide direct patient care with the medications. Clinical pharmacists work in many settings, including hospitals, clinics, long-term care facilities, and community pharmacies. Clinical pharmacists work directly with patients in a variety of ways. They utilise their understanding of pharmaceuticals (including dose, drug interactions, side effects, cost-effectiveness, and so on) to assess if a medication plan is appropriate for their patients. Patient education and counselling on effective pharmaceutical usage are critical components of pharmacists' increasingly important duties. Pharmacists can detect and address any drug-related issues during counselling, as well as offer information that enhances patients' treatment compliance and raises the standard of care. Pharmacists have a critical role in detecting, identifying, preventing, and managing adverse drug reactions. Pharmacists play a crucial role in reporting adverse drug reactions (ADRs), which can lead to product withdrawal or label modifications. Clinical pharmacist can improve medication review, identify drug-related issues, provide treatment suggestions, and promote medication compliance. Pharmacists can also help enhance drug safety by working with other healthcare providers to create patient-centered medication management regimens. In this position, chemists can analyse prescription histories, identify potential drug-related issues, and provide recommendations to optimise medication management.
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References
Burke JM, Miller WA, Spencer AP, Crank CW, Adkins L, Bertch KE, et al. American College of Clinical Pharmacy. Clinical pharmacist competencies. Pharmacotherapy. 2008;28(6):806-15. DOI: https://doi.org/10.1592/phco.28.6.806
Thomas D, editor. Clinical pharmacy education, practice and research: clinical pharmacy, drug information, pharmacovigilance, pharmacoeconomics and clinical research. Elsevier. 2018. DOI: https://doi.org/10.1016/B978-0-12-814276-9.00015-5
Viswanathan M, Kahwati LC, Golin CE, Blalock SJ, Coker-Schwimmer E, Posey R, et al. Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis. JAMA Int Med. 2015;175(1):76-87. DOI: https://doi.org/10.1001/jamainternmed.2014.5841
Ali R, Wazaify M. Prescription and Nonprescription Drug Misuse and Abuse in Jordan: A 15-Year Community Pharmacy Analysis. Substance Use Misuse. 2025;1:70. DOI: https://doi.org/10.1080/10826084.2025.2505771
McKenzie C. ACCP Global Conference on Clinical Pharmacy. 2018.
Greer N, Bolduc J, Geurkink E, Rector T, Olson K, Koeller E, et al. Pharmacist-led chronic disease management: a systematic review of effectiveness and harms compared with usual care. Ann Int Med. 2016;165(1):30-40. DOI: https://doi.org/10.7326/M15-3058
Tong EY, Roman C, Mitra B, Yip G, Gibbs H, Newnham H, et al. Partnered pharmacist charting on admission in the General Medical and Emergency Short‐stay Unit–a cluster‐randomised controlled trial in patients with complex medication regimens. J Clin Pharm Therap. 2016;41(4):414-8. DOI: https://doi.org/10.1111/jcpt.12405
Hohl CM, Partovi N, Ghement I, Wickham ME, McGrail K, Reddekopp LN, et al. Impact of early in-hospital medication review by clinical pharmacists on health services utilization. PloS one. 2017;12(2):170495. DOI: https://doi.org/10.1371/journal.pone.0170495
Lau ET, Tan SH, Antwertinger YJ, Hall T, Nissen LM. Counseling interactions between patients living with persistent pain and pharmacists in Australia: are we on the same page. J Pain Res. 2019;3:2441-55. DOI: https://doi.org/10.2147/JPR.S199017
Palaian S, Chhetri AK, Prabhu M, Rajan S, Shankar P. Role of pharmacist in counseling diabetes patients. Internet J Pharmacol. 2005;4(1):234 DOI: https://doi.org/10.5580/105
Palaian S, Prabhu M, Shankar PR. Patient counseling by pharmacist-a focus on chronic illness. Pak J Pharm Sci. 2006;19(1):65-72.
Villako P, Volmer D, Raal AI. Factors influencing purchase of and counselling about prescription and OTC medicines at community pharmacies in Tallinn, Estonia. Acta Pol Pharm. 2012;69(2):335-40.
Kelly DV, Young S, Phillips L, Clark D. Patient attitudes regarding the role of the pharmacist and interest in expanded pharmacist services. Canadian Pharmacists J/Revue des Pharmaciens du Canada. 2014;147(4):239-47. DOI: https://doi.org/10.1177/1715163514535731
Wintzingerode F, Göbel UB, Stackebrandt E. Determination of microbial diversity in environmental samples: pitfalls of PCR-based rRNA analysis. FEMS Microbiol Rev. 1997;21(3):213-29. DOI: https://doi.org/10.1111/j.1574-6976.1997.tb00351.x
Sudulaguntla A, Baby E, Philip FM, John LM. A review article on effective patient counseling. Res Rev J Pharm Sci. 2018;9:12-7.
Raynor DK. Patient compliance: the pharmacist's role. International J Pharm Prac. 1992;1(3):126-35. DOI: https://doi.org/10.1111/j.2042-7174.1992.tb00554.x
Steiner JF, Earnest MA. The language of medication-taking. Ann Int Med. 2000;132(11):926-30. DOI: https://doi.org/10.7326/0003-4819-132-11-200006060-00026
Vermeire E, Hearnshaw H, Van Royen P, Denekens J. Patient adherence to treatment: three decades of research. A comprehensive review. J Clin Pharm Therap. 2001;26(5):331-42. DOI: https://doi.org/10.1046/j.1365-2710.2001.00363.x
Rudd P, Byyny RL, Zachary V, LoVerde ME, Mitchell WD, Titus C, Marshall G. Pill count measures of compliance in a drug trial: variability and suitability. American J Hypert. 1988;1(3):309-12. DOI: https://doi.org/10.1093/ajh/1.3.309
Pullar T, Kumar S, Tindall H, Feely M. Time to stop counting the tablets. Clin Pharmacol Therap. 1989;46(2):163-8. DOI: https://doi.org/10.1038/clpt.1989.121
Cramer JA, Mattson RH, Prevey ML, Scheyer RD, Ouellette VL. How often is medication taken as prescribed: a novel assessment technique. JAMA. 1989;261(22):3273-7. DOI: https://doi.org/10.1001/jama.1989.03420220087032
Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med. 2003;163(17):2014-8.
Bushra R, Baloch SA, Jabeen A, Bano N, Aslam N. Adverse drug reactions (ADRS): factors and role of pharmacist in their prevention. J Ayub Med Coll Abbottabad. 2015;27(3):702-6.
Sriram S, Ghasemi A, Rajeswari R, Devi M, Balasubramanian R, Ravi T. Prevalence of adverse drug reactions at a private tertiary care hospital in south India. J of Res Med Sci. 2011;16(1):16-25.
Zolezzi M, Parsotam N. Adverse drug reaction reporting in New Zealand: implications for pharmacists. Therap Clin Risk Man. 2005;1(3):181–8.
Howard RL, Avery AJ, Howard PD, Partridge M. Investigation into the reasons for preventable drug related admissions to a medical admissions unit: observational study. Qual Safe Health Care. 2020;12(4):280–5. DOI: https://doi.org/10.1136/qhc.12.4.280
Murphy BM, Frigo LC. Development, implementation, and results of a successful multidisciplinary adverse drug reaction reporting program in a university teaching hospital. Hospital Pharm. 1993;28(12):1199–240.
Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Int Med. 2003;163(17):2014-8. DOI: https://doi.org/10.1001/archinte.163.17.2014
Alhameed AF, Khansa SA, Hasan H, Ismail S, Aseeri M. Bridging the gap between theory and practice; the active role of inpatient pharmacists in therapeutic drug monitoring. Pharmacy. 2019;7(1):20. DOI: https://doi.org/10.3390/pharmacy7010020
Kang JS, Lee MH. Overview of therapeutic drug monitoring. The Korean J Int Med. 2009;24(1):17. DOI: https://doi.org/10.3904/kjim.2009.24.1.1
Jurado LV, Steelman JD. The role of the pharmacist in the intensive care unit. Crit Nurs. 2013;36(4):407–14. DOI: https://doi.org/10.1097/CNQ.0b013e3182a11057
Kheir N, Awaisu A, Gad H, Elazzazy S, Jibril F, Gajam M. Clinical pharmacokinetics: perceptions of hospital pharmacists in Qatar about how it was taught and how it is applied. Int J Clin Pharm. 2015;37:1180-7. DOI: https://doi.org/10.1007/s11096-015-0183-3
Cuvelier E, Robert L, Musy E, Rousseliere C, Marcilly R, Gautier S, Odou P, Beuscart JB, Décaudin B. The clinical pharmacist’s role in enhancing the relevance of a clinical decision support system. Int J Med Inform. 2021;155:104568. DOI: https://doi.org/10.1016/j.ijmedinf.2021.104568
American Society of Health-System Pharmacists. ASHP statement on the pharmacist’s role in clinical pharmacokinetic monitoring. Am J Health-Syst Pharm. 1998;55(16):1726-7. DOI: https://doi.org/10.1093/ajhp/55.16.1726
Chauhan N, Moin S, Pandey A, Mittal A, Bajaj U. Indian aspects of drug information resources and impact of drug information centre on community. J Advan Pharma Technol Res. 2013;4(2):84-93. DOI: https://doi.org/10.4103/2231-4040.111524
Wongpoowarak P, Phengchuai C, Rattanachamit P, Kaewmanee M, Konsuparp S, Wongpoowarak W, et al. Evaluation of Drug Information Service. Science, Engine Health Stud. 2010;3:8-14.
Patel H, Adepu R, Sapthagiri R, Gurumurthy P. Drugs and therapeutic information service provided by clinical pharmacists for an improved patient care: an experience from a tertiary care teaching hospital. Asian J Pharma Clin Res. 2015;8(6):175-8. DOI: https://doi.org/10.5530/ijopp.8.3.6
Leili M, Nikvarz N. Evaluating the role of clinical pharmacist in the detection and reduction of medication errors in a specialized burn unit. Burns. 2023;49(3):646-54. DOI: https://doi.org/10.1016/j.burns.2022.04.013
Reddy KS. A study on role of clinical pharmacist in identification and prevention of medication errors at a tertiary care hospital. Indian J Pharm Pract. 2018;11(4):199. DOI: https://doi.org/10.5530/ijopp.11.4.41
Venkatesh P. Review on the clinical pharmacist's role in reducing medication errors. Asian Journal of Hospital Pharmacy. 2022;3:5-8.
Nissen L. Current status of pharmacist influences on prescribing of medicines. American J Health Sys Pharm. 2009;66(3):29-34. DOI: https://doi.org/10.2146/ajhp080607
Nester TM, Hale LS. Effectiveness of a pharmacist-acquired medication history in promoting patient safety. American journal of health-system pharmacy. J American Soc Health-System Pharma. 2002;59(22):2221–5. DOI: https://doi.org/10.1093/ajhp/59.22.2221
Yarboough PC. Pharmaceutical care and disease state management. In Shargel L, Mutnick AH, Souney PF, Swanson LN (Eds.): Comprehensive Pharmacy Review, Sixth Edition. Philadelphia, Lippincott Williams & Wilkins. 2007.
Bond CA, Raehl CL. Clinical pharmacy services, pharmacy staffing, and adverse drug reactions in United States hospitals. Pharmacotherapy. 2006;26(6):735–47. DOI: https://doi.org/10.1592/phco.26.6.735
American Society of Health-System Pharmacists. ASHP guidelines on the provision of medication information by pharmacists. Am J Health-Syst Pharm. 1996;53:1843-5. DOI: https://doi.org/10.1093/ajhp/53.15.1843
Pilnick A. Patient counselling by pharmacists: four approaches to the delivery of counselling sequences and their interactional reception. Social Sci Med. 2002;56(4):835-49. DOI: https://doi.org/10.1016/S0277-9536(02)00082-5
Chagas MO, Mendonça LT, Rebustini F, Noll M, Carvalho QDP, Hernandes JC, et al. Instruments to assess the role of the clinical pharmacist: a systematic review. System Rev. 2022;11(1):175. DOI: https://doi.org/10.1186/s13643-022-02031-1