Engaging community pharmacists in quality improvement (QI): a qualitative case study of a partnership between a Higher Education Institute and Local Pharmaceutical Committees.

BACKGROUND: Quality improvement (QI) involves the use of systematic tools and methods to improve the quality of care and outcomes for patients. However, awareness and application of QI among healthcare professionals is poor and new strategies are needed to engage them in this area. OBJECTIVES: This study describes an innovative collaboration between one Higher Educational Institute (HEI) and Local Pharmaceutical Committees (LPCs) to develop a postgraduate QI module aimed to upskill community pharmacists in QI methods. The study explores pharmacist engagement with the learning and investigates the impact on their practice. METHODS: Details of the HEI-LPCs collaboration and communication with pharmacist were recorded. Focus groups were held with community pharmacists who enrolled onto the module to explore their motivation for undertaking the learning, how their knowledge of QI had changed and how they applied this learning in practice. A constructivist qualitative methodology was used to analyse the data. RESULTS: The study found that a HEI-LPC partnership was feasible in developing and delivering the QI module. Fifteen pharmacists enrolled and following its completion, eight took part in one of two focus groups. Pharmacists reported a desire to extend and acquire new skills. The HEI-LPC partnership signalled a vote of confidence that gave pharmacists reassurance to sign up for the training. Some found returning to academia challenging and reported a lack of time and organisational support. Despite this, pharmacists demonstrated an enhanced understanding of QI, were more analytical in their day-to-day problem-solving and viewed the learning as having a positive impact on their team's organisational culture with potential to improve service quality for patients. CONCLUSIONS: With the increased adoption of new pharmacist's roles and recent changes to governance associated with the COVID-19 pandemic, a HEI-LPC collaborative approach could upskill pharmacists and help them acquire skills to accommodate new working practices.

Creation and maintenance of a table for assessment of evolving evidence for COVID-19-related treatments.

PURPOSE: This report describes the development and maintenance of a table to present an assessment of evidence for treatments used in patients with coronavirus disease 2019 (COVID-19). SUMMARY: AHFS Drug Information (AHFS DI) (American Society of Health-System Pharmacists, Bethesda, MD) is ASHP's evidence-based drug compendium that contains drug monographs written for pharmacists and other healthcare professionals. The professional editorial and analytical staff of pharmacists critically evaluate published evidence to develop drug monographs for AHFS DI. In response to the global COVID-19 pandemic, these skills were applied to assess emerging evidence for COVID-19-related treatments, and the information was compiled into a new resource for pharmacists and other healthcare professionals to use at the point of care. A list of therapies was developed and prioritized based on review of scientific and public discussions on the use of these therapies in patients with COVID-19; certain therapies used for supportive care and therapies that might theoretically be harmful to patients with COVID-19 also were considered for inclusion. Potential treatments were identified, and the evidence for use in patients with COVID-19 was assessed and summarized in a table format. Information presented for each therapy included the rationale for use, summaries of clinical trials or experience, trial registry numbers, and dosage regimens. Comments on safety and efficacy, including limitations of available data, were presented along with recommendations from recognized authorities. The editorial team continued to add new therapies to the table and update existing entries as new evidence emerged. CONCLUSION: A comprehensive table that summarized available evidence for potential treatments for patients with COVID-19 was developed. The table format enabled the drug information editorial staff to provide ongoing updates as new information emerged during the pandemic.

Leveraging telecommuting pharmacists in the post-COVID-19 world.

In response to the coronavirus disease 2019 (COVID-19) pandemic, many industries, including pharmacy, rapidly expanded the use of telecommuting workers to assure business continuity and address social distancing needs. Advances in electronic health records and telepharmacy over the past 2 decades enabled pharmacy leaders to easily adapt their practice models to allow for telecommuting alternatives during the pandemic. While these changes were generally intended to be part of the short-term response, the sustained expansion of telecommuting within the pharmacy profession merits further exploration. Documented experience with telepharmacy and telehealth indicate a wide array of clinical and operational pharmacist activities that could be conducted by telecommuters. In addition, experience with telecommuters in other industries suggests potential benefits ranging from improving pharmacists' work-life balance to mitigating postpandemic financial burden. Health care organizations should consider integrating part-time telecommuter pharmacists into contemporary practice models to address other frontline issues and facilitate ongoing expansion of clinical pharmacy services to meet emerging patient needs.

Implementation of hormonal contraceptive furnishing in San Francisco community pharmacies.

BACKGROUND: In 2013, California passed Senate Bill 493, which allowed pharmacists to furnish hormonal contraceptives without a physician's prescription. Despite this expanded scope of practice, only 11% of the pharmacies reported furnishing hormonal contraception over the following 6 years. OBJECTIVES: Our study objectives were to determine the extent of hormonal contraceptive furnishing and identify the factors that led to successful implementation in San Francisco community pharmacies. METHODS: Backspace we conducted a cross-sectional survey to identify community pharmacies furnishing hormonal contraception in San Francisco. Interviews were coded inductively to identify consistent themes. Semistructured interviews with pharmacists at the locations that furnished contraception identified the factors that had led to successful implementation in local community pharmacies, as well as assessing changes in practice during the coronavirus disease (COVID-19) pandemic. RESULTS: San Francisco had 113 operational community pharmacies in April 2020. Of these, 21 locations reported that they furnished hormonal contraception (19%), and we interviewed pharmacists at 12 of those locations. We identified 3 key factors that drove implementation at the pharmacy level: administrative support, advertising, and pharmacist engagement. Additional drivers of implementation involved the nature of the community. The respondents also reported on barriers that continued to slow adoption, including consultation fees, time constraints, and patient privacy. Changes in demand for services owing to COVID-19 risks were inconsistent. CONCLUSION: Our findings suggest strategies that community pharmacies can use to expand their scope of practice and improve quality and continuity of care for patients.

Impact of Clinical Pharmacists in Inflammatory Bowel Disease Centers During the COVID-19 Pandemic.

INTRODUCTION: To characterize the clinical pharmacists' impact on caring for patients with inflammatory bowel disease during COVID-19. METHODS: A clinical pharmacist's encounters between March 17 and April 14, 2020, were audited to determine encounter frequency and indication. RESULTS: The clinical pharmacist addressed COVID-19 and inflammatory bowel disease treatment concerns with 140 patients, conducted 34 medication education and monitoring visits, reviewed 141 patients' charts and helped rescheduled 18 patients who missed their biologic infusion, transitioned 12 patients to home infusions, and assisted 5 patients with medication access. DISCUSSION: Clinical pharmacists embedded in gastroenterology practices permit for continued optimal patient care during a pandemic.

The pivotal role of pharmacists during the 2019 coronavirus pandemic.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected over 3 million people worldwide with an estimated mortality rate of 5%. Owing to the diversity of training and the variety of positions within the pharmacy department, pharmacists are uniquely positioned in the hospital setting to play a pivotal role during the pandemic. The purpose of this article is to highlight the experiences and impactful interventions made by pharmacists practicing in a community teaching hospital at the center of the COVID-19 surge in New York City. Although often underrecognized, pharmacists are well-equipped to develop treatment plans based on the evolving literature that positively affect the patient outcomes by responding to inpatient emergencies, and optimizing the medication orders to conserve and maintain a healthy supply of medications for the hospital.

Emerging from the other end: Key measures for a successful COVID-19 lockdown exit strategy and the potential contribution of pharmacists.

As the world edges towards relaxing the lockdown measures taken to control the spread of the novel coronavirus SARS-CoV-2 (COVID-19), governments have started putting in place a variety of measures to avoid a second peak in the number of infections. The implementation of and adherence to such measures will be key components of any successful lockdown exit strategy. Ranging from expanded testing and widespread use of technology to building the public's trust in the post COVID-19 world, there is a role for pharmacists to play. In this commentary, these measures and the potential contribution of pharmacists to their successful implementation are outlined and discussed.

Media's effect on shaping knowledge, awareness risk perceptions and communication practices of pandemic COVID-19 among pharmacists.

Coronavirus disease (COVID-19), an infection of the zoonotic coronavirus, is presenting a healthcare challenge around the globe. This study aims to assess the levels of disease knowledge and risk perception among pharmacists. We also recognize predictors of risk perception and perceived media roles. Methods This is a questionnaire-base cross-sectional study. The questionnaire was developed on a web-based platform and invitations were sent to pharmacists nationwide to participate in the study using social media applications. Results A total of 486 pharmacists participated in this study, where females were dominant (78.6%, n = 382). Most (40.4%, n = 198) pharmacists scored 4 out of 5 in basic disease knowledge, and more than half were able to recognize common methods of spread. Risk was highly perceived among participants, and was predicted by gender, living area, and having children (p < 0,05). Frequency of watching the media and sources of information also influenced both risk perception and perceived media roles. Conclusion Disease awareness among pharmacists, as well as risk perception must be considered for effective risk communication planning. The role of media in shaping perceptions should also be carefully studied to encourage compliance with government containment measures and engagement in preventive behaviors.

Pharmacy Emergency Preparedness and Response (PEPR): a proposed framework for expanding pharmacy professionals' roles and contributions to emergency preparedness and response during the COVID-19 pandemic and beyond.

Background: Pharmacists have long been involved in public health and emergency preparedness and response (EP&R), including through preventive measures such as screening, vaccinations, testing, medical and pharmaceutical countermeasures, as well as ensuring medication safety and access during natural disasters and pandemics. Pharmacy professionals are considered essential partners in response to the ongoing COVID-19 pandemic. Community and hospital pharmacies are expanding services and hours to provide essential services, putting pharmacists and their co-workers at the frontlines for patient care and safety to improve public health. In addition, pharmacy professionals are increasingly integrating into global, national, state and local EP&R efforts, including into interprofessional teams, such as Medical Reserve Corps (MRCs). However, lacunae exist for further integration of pharmacists into public health and safety initiatives. There are increasing opportunities and recommendations that should be expanded upon to provide improved patient care and population health interventions, and to ensure healthcare worker and public health safety. Objective: Develop a Pharmacy Emergency Preparedness and Response (PEPR) Framework and recommendations for pharmacy professional pathways towards full integration within public health EP&R efforts (such as the COVID-19 pandemic), and enhanced recognition of pharmacists' skills, roles and contributions as integral members of the interprofessional healthcare team. Methods: This paper draws on the American Society of Health-System Pharmacists (ASHP) 2003 Statement on the Role of Health-System Pharmacists in Emergency Preparedness and lessons learned from previous and current public health emergencies, such as the 2009 H1N1 pandemic and the current COVID-19 pandemic, to provide expanded guidance for pharmacists and pharmacy professionals across all practice settings in EP&R. The proposed PEPR framework also incorporates information and recommendations from The Pharmacy Organizations' Joint Policy Recommendations to Combat the COVID-19 Pandemic (March 2020), CDC-NIOSH, International Pharmaceutical Federation (FIP) Guidance, health departments and emergency preparedness guidance and resources, Boards of Pharmacy, and other pharmacy professional organizations and educational institutions. Results: Based on methods and resources utilized in developing this proposed PEPR Framework, five key focus areas were identified, as follows:1)Emergency preparedness and response2)Operations management3)Patient care and population health interventions4)Public health pharmacy education and continuing professional education5)Evaluation, research, and dissemination for impact and outcomes. Conclusion: Pharmacists and pharmacy professionals have been at the frontlines in responding to the COVID-19 pandemic. Yet, challenges remain, such as limited availability of personal protection equipment, high risk of infectious exposures inherent in healthcare professions, and legislative hurdles resulting in lack of provider status and related reimbursements. Recommendations to enhance pharmacy's scope as public health professionals involved in EP&R include targeted training and education on key framework areas and policymaking. Pharmacy professionals should further integrate with interdisciplinary public health teams. Additional research and dissemination on impacts and outcomes of EP&R can enhance recognition of pharmacy professionals' contribution and value during public health emergencies. The proposed PEPR Framework can be utilized to develop, implement, evaluate, and disseminate results in order to strengthen existing efforts and to establish new initiatives in EP&R.