The impact of clinical pharmacy services in Nepal in the context of current health policy: a systematic review
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.
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.
In order to implement and enhance clinical pharmacy services, governmental, educational, and administrative support may be needed.
KeywordsClinical pharmacy Clinical pharmacist Hospital pharmacy Pharmaceutical care Pharmaceutical services Nepal
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.
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
Conflict of interest
The authors declare that they have no conflicting interests.
- 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
- 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
- Higgins JPT, Green S (eds) (2011) Cochrane handbook for systematic reviews of interventions. The Cochrane CollaborationGoogle Scholar
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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