Pharmacists’ role in transgender healthcare: A scoping review

BackgroundTransgender patients have unique healthcare needs, providing pharmacists with the opportunity to play an important role in transgender care through addressing the healthcare disparities observed in this patient group.ObjectiveThis scoping review aimed to explore the role of pharmacists in transgender healthcare.MethodsSix databases were searched from inception: Emcare, Informit, MEDLINE (Ovid), PubMed, Scopus, and Web of Science. The first author performed screening and data extraction in consensus with co-authors. Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) was utilised to report this review. Themes related to the role of pharmacists in transgender healthcare were identified.ResultsA total of 356 studies were identified; however, only 15 studies, all from the USA met the selection criteria and were included in this review. Study types included empirical research, practice reports and opinion pieces such as commentaries, editorials, and reports. Pharmacists were found to practise in two different care settings: community and interdisciplinary clinics, performing various roles in transgender healthcare, including patient education and counselling, management of cross-sex hormonal therapy, patient advocacy and provision of preventative care. They were also responsible for the provision of culturally sensitive care in an inclusive and welcoming environment. Although pharmacists considered their role important, they lacked confidence in their knowledge to provide appropriate care to this patient group.ConclusionThis review has highlighted that there is a need for education in transgender care for both pharmacists and pharmacy students, so that they are both confident and comfortable to play a meaningful role in transgender care. Pharmacists’ involvement in addressing the health disparities experienced will contribute to improving the overall health outcomes for this group.     

Infectious diseases pharmacy practice,education, and research in Saudi Arabia: A review and future perspectives by the Infectious Diseases Pharmacy Specialty Network at the Saudi Society of Clinical Pharmacy

BackgroundInfectious diseases (ID) pharmacy is one of the rapidly evolving clinical pharmacy specialties in the Kingdom of Saudi Arabia (KSA). There are gaps in the literature on ID pharmacy status in KSA. This review aimed to provide an update on the current status of several areas related to ID pharmacy in KSA, including practice, education, and research, and make pertinent recommendations for future development to achieve the KSA Vision, 2030, KSA Vision, 2030.MethodsThis review was developed by a group of ID pharmacists working in different sectors under the umbrella of the ID Pharmacy Specialty Network (PSN) of the Saudi Society of Clinical Pharmacy (SSCP). The authors evaluated domains related to ID pharmacy in KSA and searched the literature for relevant articles. Based on the experts' assessment of the current gaps and challenges, recommendations were made for future improvement.ResultsSeveral aspects of ID pharmacy in KSA were evaluated, including history and development, antimicrobial resistance (AMR), antimicrobial stewardship programs (ASP), roles of ID pharmacists, ID pharmacy education, and research. The biggest challenges include AMR, the varying levels of ASP implementation, and the low number of ID-trained pharmacists, especially in non-major cities. Several recommendations for improvement were discussed.ConclusionInfectious diseases pharmacy has sustained remarkable progress in KSA in several areas. However, more efforts are needed to increase ASP implementation, increase the number of ID-trained pharmacists, and encourage ID pharmacists in publishing and participating in practice guidelines, which will eventually help achieve the KSA Vision, 2030, KSA Vision, 2030.     

Community pharmacy interventions to improve antibiotic stewardship and implications for pharmacy education: A narrative overview

BackgroundAntibiotic resistance is one of the world's most pressing public health problems, resulting in over 23,000 deaths per year. One of the main contributing factors to antimicrobial resistance is antibiotic misuse and overuse. Community pharmacists can play a role in reducing antibiotic resistance, since they are one of the most accessible healthcare professionals.ObjectiveThe purpose of this paper is to describe community pharmacy interventions and strategies to reduce antibiotic misuse and overuse and to discuss the implications for pharmacy training.MethodsA narrative overview strategy was employed to identify papers on antibiotic stewardship and the role of the community pharmacist. Our review examined potential stewardship strategies and interventions within community pharmacy practice that provide opportunities for pharmacists to engage or lead in the reduction of antimicrobial resistance.ResultsWe describe five promising community pharmacist-led intervention strategies: Collaborative Practice Agreements (CPAs), point-of-care (POC) testing, patient consultations, academic detailing and serving as an advocate for patients and other healthcare providersConclusionsThis review highlights topics that may warrant increased attention in pharmacy school curricula. Pharmacy schools may want to consider modifying their curricula to address the shifts in practice of the community pharmacist – emphasizing the expanded role of the pharmacist in patient care and public health issues such as outpatient antibiotic stewardship.     

Informing a collaborative-care model for delivering medication assisted treatment for opioid dependence (MATOD): An analysis of pharmacist,prescriber and patient perceptions

BackgroundDemand for medication assisted treatment for opioid dependence (MATOD) in Australia exceeds capacity, particularly in rural and regional areas. There is increasing recognition that community pharmacists are well-positioned to take on expanded roles in MATOD delivery, however there has been limited Australian research exploring attitudes of pharmacists, prescribers, and patients to collaborative models of care.Objective(s)This study aimed to better understand enablers and barriers to a collaborative model for MATOD, to inform implementation in regions where increases in treatment capacity are urgently needed.MethodsSemi-structured telephone interviews were conducted with pharmacists (n = 11), prescribers (n = 6), and patients (n = 8) recruited from the Frankston-Mornington Peninsula region in Victoria, Australia, where transport and access to services have impacts on health care utilisation. The COM-B model was used to explore perceptions of pharmacists’ capability, opportunity, and motivations for delivering collaborative care.ResultsThere was strong motivation among healthcare professionals to participate in a collaborative model of care, with the main perceived benefits including improvements in accessibility, convenience, and continuity of care, and leverage of pharmacists’ high level of patient engagement. Key barriers identified by both pharmacists and prescribers included a perceived lack of pharmacist skills in some areas (capability) and resources (opportunity) to deliver collaborative care in a community pharmacy setting. Established relationships between all stakeholders (social opportunity) and communication between pharmacists and prescribers were identified as facilitators. Barriers and facilitators aligned with seven key areas: skills, confidence, relationships, patient selection, protocols, communication and resources.ConclusionsFindings informed the development of a collaborative model that was individualised, protocol based, and supported by training and clear processes.Project impactThis study identifies specific barriers and facilitators to a pharmacist-prescriber collaborative model of care for MATOD. The resulting model will be tested in a hybrid implementation-effectiveness trial in the Frankston-Mornington Peninsula region.     

Framework to enable pharmacist access to health care data using Blockchain technology and artificial intelligence

BackgroundDecentralization and authentication are embedded in blockchain technology, which utilizes artificial intelligence (AI) to ensure seamless sharing of data among different health care providers while safeguarding data privacy. Although community pharmacists are highly accessible to patients and possess robust clinical knowledge, they are limited in the clinical services they can provide owing to their lack of access to patient health records. We proposed a blockchain- and AI-based conceptual framework by performing a scoping review of successful blockchain integration in health systems.ObjectiveTo formulate a conceptual framework based on a scoping review to improve access to health care data in the community pharmacy setting through the adoption of blockchain technology and AI.MethodsWe performed a scoping review of literature based on Preferred Reporting Items for Systematic reviews and Meta-Analyses review criteria to identify the specific areas where blockchain can be implemented in health systems. We utilized the Pharmacists’ Patient Care Process (PPCP) to identify 2 critical areas for blockchain integration that can support community pharmacists to access patient electronic health records and implement patient-specific information in clinical decision-making.ResultsWe included 7 articles out of 70 articles in our final review. The 2 areas in the PPCP identified for the use of blockchain on the basis of the literature review were “Assess” and “Implement.” Our proposed model involves pharmacists using AI and blockchain technology to comprehensively assess any concerns with the prescribed medication through access to laboratory results for patients and then implement a plan based on a comprehensive assessment of the patient’s health record.ConclusionsUtilizing blockchain to securely share health data with community pharmacies has the potential to improve patient outcomes, optimize medication safety, and amplify pharmacists’ roles in patient care. Future research should focus on implementing the model in the real-world settings.     

Impact of a health literacy assignment on student pharmacist learning

BackgroundThe average American adult reads at the 8th grade level while most written health information materials, including medication guides, are written at the 12th grade level. To assist students with health literacy-sensitive communication, pharmacy schools should incorporate educational activities addressing health literacy competencies.ObjectivesThe objectives of this study were to evaluate the impact of a health literacy assignment on student pharmacists' perceptions of: 1) learning about health literacy; 2) ability to write health literacy level-appropriate patient education material; and 3) the use of these skills in future pharmacy practice.MethodsThird professional year student pharmacists were asked to rewrite a patient medication information sheet at the 5th grade reading level, altering it from the 12th grade level. Following assignment completion, students responded to a 4-item open-ended questionnaire on what they learned from the activity, what information components were the most difficult to rewrite and reason for the difficulty, key strategies to accomplish the assignment, and their perception of the impact this assignment had on their future practice. Content analysis of the reflections was performed using QSR NVivo to identify themes grounded in the students' responses.ResultsReflections were completed in 2009 (n = 159) and 2010 (n = 144), for a total of 303 completed reflections. Predominant themes included greater understanding about the challenges, importance, and methods of health literacy level-appropriate communication and greater awareness of the role of pharmacists in presenting information clearly to patients.ConclusionsStudents indicated the activity increased their understanding of the complexity of patient information, the educational needs of patients, and the importance of providing information that is understandable. Student pharmacists learned methods of effective communication with patients and should be better prepared to communicate in a health literacy-level appropriate manner.     

A scoping review of health professional curricula: Implications for developing integration in pharmacy

BackgroundIntegrated health professions curricula aim to produce graduates who are capable of meeting current and future healthcare needs. This is reflected in pharmacy education where integration is increasingly advocated by pharmacy regulators as the perceived optimal way of preparing students for registration as pharmacists. There is, however, no definition of integration. Integration can be described according to a model of horizontal, vertical or spiral integration. It can also be described by the themes used to integrate, such as a systems-based approach or by integrative teaching and learning approaches. The level of integration can also be described.ObjectiveThis scoping review aimed to explore health professions education literature to inform the optimal design of integrated pharmacy curricula. This review asks: what is meant by integration in health professions curricula?MethodsThe Arksey and O'Malley scoping review framework was utilised. Ovid MEDLINE, EMBASE, Scopus, Web of Science and ERIC were searched. Models of integration, themes for integration, integrative teaching and learning approaches, and level of integration were defined and supported data extraction.ResultsThere were 9696 records screened and of these 137 were included. The majority of studies (n = 88) described horizontal integration. Systems-based teaching (n = 56) was the most common theme reported. Various integrative teaching and learning approaches were described, including experiential (n = 43), case-based (n = 42) and problem-based (n = 38) learning. The majority of the curricula could be classified as levels 5–7 on Harden's ladder (n = 102). Perception outcomes were reported for 81 studies, and only 3 reported outcomes beyond perception. Reported outcomes were generally positive and included knowledge gains and increased motivation.ConclusionsThere is a need for integration to be explicitly defined by curriculum developers and researchers. Attention should be given to describing the model, theme, teaching and learning approach and level of integration. There remains a lack of evidence for integration.     

Towards defining and supporting pharmacists' professional role associated with traditional and complementary medicines – A systematic literature review

BackgroundA review conducted in 2015 reported community pharmacists are willing to adopt a professional role in counselling consumers about the appropriate and safe use of traditional and complementary medicines (T&CM) but faced multiple barriers in doing so; including the role being poorly defined. This current review aimed to update and extend these findings, by identifying studies published since 2015 that reported on pharmacists across any setting.MethodsEligible studies published between January 01, 2016 and December 31, 2021 were identified across six databases (PubMed, Scopus, Web of Science, EMBASE, ScienceDirect and MEDLINE). A grounded theory approach was used to thematically synthesize the data extracted.FindingsA total 64 studies representing pharmacists across 30 countries were included for review. Study designs varied including cross-sectional surveys (n = 36), qualitative studies (n = 14), and pseudo-patient studies (n = 3). Eight studies reported on practice and/or bioethical responsibilities and 19 studies reported on factors that would enable pharmacists to fulfill these responsibilities, while 37 studies reported about both.ConclusionThese findings indicate research about pharmacists’ responsibilities associated with T&CM is evolving from gap analysis towards research that is proactive in advocating for change in multiple areas. These findings can be used to inform a consensus discussion among pharmacists and key stakeholders regarding a set of professional responsibilities that would serve in the development of: a clearly defined role and associated practice standards, and competency requirements that inform educational learning objectives for inclusion in undergraduate, post-graduate and continuing professional pharmacy education.