AN EFFECTIVE CLINICAL PHARMACIST COMMUNICATION MAY BUILT PATIENT TRUST ON PHARMACIST OVER OTHER HEALTHCARE PROVIDERS: EVIDENCE BASED PRACTICEHTML Full Text
AN EFFECTIVE CLINICAL PHARMACIST COMMUNICATION MAY BUILT PATIENT TRUST ON PHARMACIST OVER OTHER HEALTHCARE PROVIDERS: EVIDENCE BASED PRACTICE
Maria Ayub*, Somia Gul, Nusrat Afzal and Asma Eraj
Faculty of Pharmacy, Jinnah University for Women, Karachi, Pakistan
ABSTRACT: Clinical pharmacists are integral part of patient healthcare team. They tend to serve as key element in patient care provide quality of care to reduce ADR (adverse drug reactions),improve patient compliance, effective drug cost and make role of pharmacist evident in healthcare sector and society. For the purpose of evaluating patient outcome failure from treatment, a retrospective study conducted where clinical pharmacist were directed to pay their role in evaluating mechanism behind failure of treatment. About 300 patients from different healthcare sector were included particularly of with chronic illness and those reported with poor compliance. They disclose many horrible facts and identify mechanism in poor response of therapy. By special counseling in separate area by clinical pharmacist patient reveals many fact in failure about 31% due to improper counseling, 61% undesirable taste, 5% ADR,41% due to psychological burden of long treatment and only 11% were receiving psychological treatment with 59% were not satisfied with physician response. After introduction of clinical pharmacist, there is a remarkable improvement in outcome of treatment with patient trust built on pharmacist as they believe on clinical pharmacist as integral part of their health care provider and clinical pharmacist achieved their target 40% enhancement in patient hope for their life.
Pharmacist role, Patient care, Healthcare system, Clinical Pharmacist role, quality of care
INTRODUCTION: Clinical pharmacist tend to serve as an integral part of healthcare sector by incorporating effective role in reducing medication error in wards dealing with infection and critical care which reflects positive impact of pharmacist regarding prevention of medication error 1. pharmacist involvement at healthcare centers proved dedicated role in clinical time and in minimizing medication related discrepancies and clinical pharmacist involvement proved gradual decline in medication error, proper discharge record regarding medications and understanding about their medication in outpatients. 2-3
They proved their dedicated role in critical units by providing quality of services 4 chronic disease 5-7 like diabetes and life threatening diseases 8-9 and by built up relationship with trust 10 to reduce drug cost 11 by facing challenging task 12 and by reducing their duration of stay in hospital 13 and by collaborative role with physician based on scientific evidence and pharmacy care planes 14-17.
Various studies support role of clinical pharmacy in reducing economical burden with improvement in outcomes.18-24 In such studies they demonstrated role of services of clinical pharmacy in diverse healthcare settings inclusive of critical care, ambulatory care, old and deliberate peoples, psychological therapeutic compliance, economical burdens and quality of healthcare issues and useful interventions 25-28. Currently two medicinal institutes emphasized that safe utilization of medication can made possible by inclusion of pharmacist by important interventions in critical areas, safe delivery of drug in collaboration with physician and pharmacist 29-30. Current studies showed 30% raise in percentage of pharmacist round in hospital with growing rate day by day 31.Various literature reviews support efficient role of clinical pharmacist in improving the health quality in inpatient care system proposed by institute of medicine in significance of clinical pharmacist role in patient setting 32 by advancing patient care, clinical pharmacist must be fundamental part of hospitalized patient care team, one study reveals services provided by clinical pharmacy showed improvement in cost of drug, medications error with decline in mortality rate 33-35. Clinical pharmacist role distinguish remarkably from usually common classical pharmacists in such manner that they imparts their distinctive role in collaboration directly with health care practitioners and patients and not only related to drug dispensing. Most of clinical pharmacists have been trained in specialties areas of oncology, psychology, pharmacotherapy, nutrition with residencies 36.
The objective of the study is to revolutionized globally with emerging role of clinical pharmacist in view of that fact that clinical pharmacist are integral part of healthcare team and serve as important tool in patient care with trust over other health care providers.
This retrospective study was conducted from July 2014 to Dec 2014 in major healthcare centers of Karachi particularly of patients with chronic & immune compromised diseases. Study design was conducted on 300 patients (n = 300) with well demonstrated and efficient role of clinical pharmacist towards patients care. All patients were always receiving medications with proper counseling from pharmacy and ambulatory care was being ever supported by pharmacy.
Retrospective study comprised of two important sessions, first was extra communication of clinical pharmacist with patients in separate especial built area of pharmacy to communicate well with patients about their experience with medications and compliance associated with their life saving medications to treat chronic illness. Second part was profound interaction of clinical pharmacist with consultants at ICU and how clinical pharmacist built their role over other healthcare provider with scientific evidence based knowledge of research.
Results & Statistical Analysis:
During patient interaction with clinical pharmacist disclose many horrible facts about all of which physicians were not aware. Most of the patients with blood disorders of chronic illness reported that they don’t take medications because of non-compliance, unpleasurable test and adverse effect and psychological stress associated with this drug. They have no idea that how these drugs were essential in extending life expectancy and how they may save their life. They had lost hope for life and they didn’t share this important fact with physician and how this all procedure may painful for them to take medications and treatment for life time
Clinical pharmacist were directed to pay extra attention in patient counseling and try to find out failure of results of treatment from long time and why physician couldn’t yet able to achieve target benefit to increase their life expectancy. Most of patients reported complaint associated with ADR and physicians failed to encounter such problems had ultimately lost their adherence with long term medications. Fig. 1 & Table reveals some facts of failure of achieving target with their medication to treat their chronic illness.
FIG.1: BASIS OF FAILURE OUTPUT OF TREATMENT FROM PATIENTS
After finding basis of failure of treatment, they designed study to achieve their target and responsibility purely governed by clinical pharmacist that they will prove how they are important in healthcare sector to save patient life. After proper counseling and effective communication clinical pharmacist suggested other options to take medications and how re-adherence of medication is necessary to increase life expectancy. Effective communication proved to be only way to aware patients about importance of their medication and by the suggestion of clinical they shifted to other route of administration to raise compliance also proved beneficial and patient back to their treatment and ultimately they did faith over clinical pharmacist that they are only person in healthcare sector who can understand our problems.
|Reason of Failure||Percentage|
|Adverse reaction cases||58%|
|Psychological burden due to long term treatment||41%|
|Lose of hope||85%|
|Unsatisfactory response from physician||59%|
Interesting part of study was that patient wait for meeting with clinical pharmacist to communicate with them as they had built their trust over pharmacist. Fig. 2 shows level of success in sixth month after effective role of clinical pharmacist. After successful communication of clinical pharmacist with patients, they also pay their attention at intensive care unit to built effective communication with physicians to find out the possible mechanism of ineffective utilization of drugs and found that due to sound knowledge of drugs clinical pharmacist may serve as useful key element in patient healthcare particularly of patient with chronic illness.
FIG. 2: LEVEL OF SUCCESS AFTER EFFECTIVE CLINICAL PHARMACIST ROLE
Clinical pharmacist also achieved target to communicate well with physician just for being providing quality of care to patient and serve as key part of effective healthcare provider. By the scientific research and evidences they tried to put their effort in reducing adverse drug reaction and minimize the incidence of drug interaction and provide cost effective formulary for hospital with quality care. This effective role of clinical pharmacists was well appreciated by physicians and other healthcare team at intensive care unit. Fig. 3 explained an effective clinical pharmacist role can be helpful in increasing quality of health.
FIG.3: EFFECTIVE ROLE OF CLINICAL PHARMACIST
DISCUSSION: Prevalence of immunodeficient patients have increased markedly in last two decades as a resultant of lose in immunity either may be as a progression of disease or due to foreign agent that make prone to body for development of opportunistic infection. Patient with chronic illness require special care because of weak immune system and serious adverse reaction associated with life saving drugs, as they put their life on risk seriously due to reduction in compliance day by day as a result of non-adherence with treatment.
Pharmacist are the integral part of healthcare team they provide patient care by reducing medication error, by evaluating failure of treatment, by dispense drug safely especially narcotic analgesic , and prove their role essential for health society 37-39. Traditionally the prescribing of drug and rational goal therapy responsibility is governed by physician only but current studies showed clinical pharmacist are also integral part of healthcare system with well demonstrated role in patient compliance, drug related ADR and patient lost of hope due to their chronic illness by their proper counseling by pharmacist. With amelioration in current era of cure of serious illness, collaborative role of healthcare team is necessary with special consideration in view of the fact to achieve useful outcome in patient with serious illness and to reduce economical burden.
This studies showed that Clinical Pharmacist may serve as integral part in building of effective healthcare team with well interesting finding that patient do more trust on pharmacist compared to other healthcare providers. They assume that clinical pharmacist was the only key person that can understand their problem and helpful in solving their psychological burden associated with their chronic illness and long term use of medications.
Pharmacist intervention made at intensive care unit also showed gradual decline in medication error and consultation of pharmacist proved to be economic in cost of drug. However, inclusion of pharmacist in patient care with other healthcare provider at intensive care unit showed reduction in adverse reaction and also acknowledge by physician readily 40.
Current study is conducted to evaluate the basis of failure of treatment in patient with chronic illness. Incorporation of clinical pharmacist in collaboration with other healthcare team may play a dynamic role in improving quality of health.
CONCLUSION: Clinical pharmacists are integral part of healthcare sector, imparts effective role in patient care, in collaboration with other member of health care team. They tend to serve as key element in achieving successful outcome of treatment by effective communication, by built trust and by effective counseling with patient. A pharmacist intervention with physician during round is useful tool in minimizing ADR and cost effectiveness. Further research is necessary to make role of clinical pharmacist evident in healthcare sector and society towards patient care.
More detail study with research is needed to compute the evident role of pharmacist to healthcare sector to isolate the worth of pharmacist in healthcare system.
ACKNOWLEDGMENT: Authors wish to acknowledge Rabia Arshad (pharmacist) for her help and support in this study.
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How to cite this article:
Ayub M, Gul S, Afzal N and Eraj A: An effective clinical pharmacist communication may built patient trust on pharmacist over other healthcare providers: evidence based practice. Int J Pharm Sci Res 2015; 6(10): 4442-47.doi: 10.13040/IJPSR.0975-8232.6(10).4442-47.
All © 2013 are reserved by International Journal of Pharmaceutical Sciences and Research. This Journal licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 3.0 Unported License.
Maria Ayub*, Somia Gul, Nusrat Afzal and Asma Eraj
Faculty of Pharmacy, Jinnah University for Women, Karachi, Pakistan
09 April, 2015
24 May, 2015
29 July, 2015
01 October, 2015