Advertisement

The impact of clinical pharmacy services in Nepal in the context of current health policy: a systematic review

  • Reyaj Mikrani
  • Muhammad Naveed
  • Aman Mikrani
  • Sufia Yasmeen
  • MD. Akabar
  • Zhou XiaohuiEmail author
Original Article

Abstract

Aim

The necessity of clinical pharmacy services is increasing globally, and their provision is the upcoming direction of hospital pharmacists. The aim of this review was focused on the impact of clinical pharmacy services in the Nepalese healthcare setup.

Subjects and methods

The English-language databases of Web of Science, PubMed, ScienceDirect, and Cochrane Library were searched using the following keywords: ‘pharmacy’, ‘clinical pharmacy’, pharmaceutical services’, ‘pharmacists’, pharmaceutical care’, ‘pharmacy practice’, ‘hospital pharmacy’, ‘pharmaceutical interventions’, and ‘Nepal’. Eligibility for inclusion, risk of bias assessment, and data extraction from the included studies were determined by two authors, and a narrative synthesis was conducted.

Results

This review contained a total of 14 published articles. The included studies involved the counseling and educating of patients, working as a member of the healthcare team, detecting prescribing errors, suggesting clinicians or nurses, reviewing prescriptions on the ward, giving training and monitoring of the implementation of policies, etc. The outcome of these interventions showed a reduction in the direct healthcare cost, excessive use of medicines, and prescription errors, as well as improvement in the drug utilization pattern, knowledge, as well as satisfaction of patients.

Conclusion

In order to implement and enhance clinical pharmacy services, governmental, educational, and administrative support may be needed.

Keywords

Clinical pharmacy Clinical pharmacist Hospital pharmacy Pharmaceutical care Pharmaceutical services Nepal 

Notes

Acknowledgements

The authors greatly acknowledge Dr. Muhammad Abbas (School of Life Sciences, Nanjing University, People’s Republic of China) for his guidance and insightful comments on this manuscript. The lead author (Reyaj Mikrani) is thankful to the China Scholarship Council (CSC) for its generous financial support for him to study in China.

Funding

This work was supported by the National Natural Science Foundation of China (grant numbers 30973003 and 30901993) and the Administration of Traditional Chinese Medicine of Jiangsu Province (grant number LZ11093).

Compliance with ethical standards

Ethics approval and consent to participate

Not applicable.

Conflict of interest

The authors declare that they have no conflicting interests.

Supplementary material

10389_2019_1042_MOESM1_ESM.docx (85 kb)
ESM 1 (DOCX 84 kb)

References

  1. Ansari M, Rao BS, Koju R, Shakya R (2005) Impact of pharmaceutical intervention on inhalation technique. Kathmandu Univ J Sci Eng Technol 1:1–8Google Scholar
  2. Bista D, Saha A, Mishra P, Palaian S, Shankar PR (2009) Impact of educational intervention on the pattern and incidence of potential drug–drug interactions in Nepal. Pharm Pract (Granada) 7:242–247CrossRefGoogle Scholar
  3. De Rijdt T, Willems L, Simoens S (2008) Economic effects of clinical pharmacy interventions: a literature review. Am J Health Syst Pharm 65:1161–1172.  https://doi.org/10.2146/ajhp070506 CrossRefPubMedGoogle Scholar
  4. Dingding C, Abbas M (2017) A critical review; the quest of clinical pharmacist in Pakistan government hospital, references USA and China hospital setting, to salvage the public health problems like diabetes. J Basic Clin Pharm 8:1–6CrossRefGoogle Scholar
  5. Ghimirey A, Sapkota B, Shrestha S, Basnet N, Shankar PR, Sapkota S (2013) Evaluation of pharmacist counseling in improving knowledge, attitude, and practice in chronic kidney disease patients. SAGE Open Med 1:2050312113516111.  https://doi.org/10.1177/2050312113516111 CrossRefPubMedPubMedCentralGoogle Scholar
  6. Hepler CD, Strand LM (1990) Opportunities and responsibilities in pharmaceutical care. Am J Health Syst Pharm 47:533–543CrossRefGoogle Scholar
  7. Higgins JPT, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions. The Cochrane CollaborationGoogle Scholar
  8. Holloway KA, Gautam BR, Reeves BC (2001) The effects of different kinds of user fee on prescribing costs in rural Nepal. Health Policy Plan 16:421–427CrossRefPubMedGoogle Scholar
  9. Holloway KA, Karkee S, Tamang A, Gurung YB, Pradhan R, Reeves BC (2008) The effect of user fees on prescribing quality in rural Nepal: two controlled pre-post studies to compare a fee per drug unit vs. a fee per drug item. Trop Med Int Health 13:541–547.  https://doi.org/10.1111/j.1365-3156.2008.02032.x CrossRefPubMedGoogle Scholar
  10. Isetts BJ, Schondelmeyer SW, Heaton AH, Wadd WB, Hardie NA, Artz MB (2006) Effects of collaborative drug therapy management on patients’ perceptions of care and health-related quality of life. Res Social Adm Pharm 2:129–142CrossRefPubMedGoogle Scholar
  11. Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL (2006) Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med 166:955–964CrossRefPubMedGoogle Scholar
  12. Kafle KK, Shrestha N, Karkee SB, Prasad RR, Bhuju GB, Das PL (2005) Intervention studies on rational use of drugs in public and private sector in Nepal. Nepal Med Coll J 7:47–50PubMedGoogle Scholar
  13. Kafle KK, Bhuju GB, Karkee SB, Prasad RR, Shrestha N, Shrestha AD, Das PL, Chataut BD, Daud M (2009) An intervention improving prescribing practices and monitoring drugs availability in a district. Nepal Med Coll J 11:217–221PubMedGoogle Scholar
  14. Khan GM, Badri P, Parbati T, Anita D, Atul A, Deepak P, Dipendra R, Himal B, Kabita G, Nirmala K (2016) Intervention on inhalation technique of rotahaler in patients with chronic obstructive pulmonary disease and asthma. Asian J Pharm Sci 11:81–82.  https://doi.org/10.1016/j.ajps.2015.11.112 CrossRefGoogle Scholar
  15. Li J, Li Z (2018) Differences and similarities in clinical pharmacy practice in China and the United States: a narrative review. Eur J Hosp Pharm 25:2–5.  https://doi.org/10.1136/ejhpharm-2016-001195 CrossRefGoogle Scholar
  16. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 339:b2700.  https://doi.org/10.1136/bmj.b2700 CrossRefPubMedPubMedCentralGoogle Scholar
  17. Penm J, Li Y, Zhai S, Hu Y, Chaar B, Moles R (2014) The impact of clinical pharmacy services in China on the quality use of medicines: a systematic review in context of China’s current healthcare reform. Health Policy Plan 29:849–872.  https://doi.org/10.1093/heapol/czt067 CrossRefPubMedGoogle Scholar
  18. Perez A, Doloresco F, Hoffman JM, Meek PD, Touchette DR, Vermeulen LC, Schumock GT (2009) Economic evaluations of clinical pharmacy services: 2001–2005. Pharmacotherapy 29:128CrossRefPubMedGoogle Scholar
  19. Pickard AS, Hung S-Y (2006) An update on evidence of clinical pharmacy services’ impact on health-related quality of life. Ann Pharmacother 40:1623–1634.  https://doi.org/10.1345/aph.1G653 CrossRefPubMedGoogle Scholar
  20. Poudel RS, Shrestha S, Khatiwada D, Thapa S, Prajapati A, Thapa L, Baral R (2015) Prescription errors and pharmacist’s intervention at outpatient pharmacies of two teaching hospitals of central Nepal. World J Pharm Sci 3:448–452Google Scholar
  21. Poudel RS, Piryani RM, Shrestha S, Prajapati A (2016) Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal. Integr Pharm Res Pract 6:7–13.  https://doi.org/10.2147/IPRP.S119202 CrossRefPubMedPubMedCentralGoogle Scholar
  22. Ranjit E (2016) Pharmacy practice in Nepal. Can J Hosp Pharm 69:493–500PubMedPubMedCentralGoogle Scholar
  23. Rauniar GP, Das BP, Manandhar TR, Bhattacharya SK (2014) Effectiveness of an educational feedback intervention on drug prescribing in dental practice. Kathmandu Univ Med J 10:30–35.  https://doi.org/10.3126/kumj.v10i4.10991 CrossRefGoogle Scholar
  24. Schumock GT, Butler MG, Meek PD, Vermeulen LC, Arondekar BV, Bauman JL (2003) Evidence of the economic benefit of clinical pharmacy services: 1996–2000. Pharmacotherapy 23:113–132CrossRefPubMedGoogle Scholar
  25. Sharma S, Bhuvan KC, Alrasheedy AA, Kaundinnyayana A, Khanal A (2014) Impact of community pharmacy-based educational intervention on patients with hypertension in Western Nepal. Australas Med J 7:304–313.  https://doi.org/10.4066/AMJ.2014.2133 CrossRefPubMedPubMedCentralGoogle Scholar
  26. Shrestha N, Samir KC, Baltussen R, Kafle KK, Bishai D, Niessen L (2006) Practical approach to lung health in Nepal: better prescribing and reduction of cost. Trop Med Int Health 11:765–772.  https://doi.org/10.1111/j.1365-3156.2006.01599.x CrossRefPubMedGoogle Scholar
  27. Strand LM, Cipolle RJ, Morley PC, Frakes MJ (2004) The impact of pharmaceutical care practice on the practitioner and the patient in the ambulatory practice setting: twenty-five years of experience. Curr Pharm Des 10:3987–4001CrossRefPubMedGoogle Scholar
  28. Upadhyay DK, Ibrahim MIM, Mishra P, Alurkar VM (2015) A non-clinical randomised controlled trial to assess the impact of pharmaceutical care intervention on satisfaction level of newly diagnosed diabetes mellitus patients in a tertiary care teaching hospital in Nepal. BMC Health Serv Res 15:57.  https://doi.org/10.1186/s12913-015-0715-5 CrossRefPubMedPubMedCentralGoogle Scholar
  29. Upadhyay DK, Ibrahim MIM, Mishra P, Alurkar VM, Ansari M (2016) Does pharmacist-supervised intervention through pharmaceutical care program influence direct healthcare cost burden of newly diagnosed diabetics in a tertiary care teaching hospital in Nepal: a non-clinical randomised controlled trial approach. Daru 24:6.  https://doi.org/10.1186/s40199-016-0145-x CrossRefPubMedPubMedCentralGoogle Scholar
  30. Viktil KK, Blix HS (2008) The impact of clinical pharmacists on drug-related problems and clinical outcomes. Basic Clin Pharmacol Toxicol 102:275–280.  https://doi.org/10.1111/j.1742-7843.2007.00206.x CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Clinical Pharmacy, School of Basic Medicine and Clinical PharmacyChina Pharmaceutical UniversityNanjingPeople’s Republic of China
  2. 2.Department of Clinical Pharmacology, School of PharmacyNanjing Medical UniversityNanjingPeople’s Republic of China
  3. 3.Department of Finance, College of Economics and ManagementNanjing University of Aeronautics and AstronauticsNanjingPeople’s Republic of China
  4. 4.Department of Pharmaceutics, School of PharmacyChina Pharmaceutical UniversityNanjingPeople’s Republic of China
  5. 5.Department of Cardiothoracic SurgeryZhongda Hospital affiliated to Southeast UniversityNanjingPeople’s Republic of China
  6. 6.Department of Heart SurgeryNanjing Shuiximen HospitalNanjingPeople’s Republic of China

Personalised recommendations