Open Access Open Access  Restricted Access Subscription or Fee Access

A Study and Report on Impact of Clinical Pharmacy Services Over Indian Health Care System in the Management of Chronic Disorders/Diseases in Hospital

Mekkanti Manasa Rekha, Hepzibah Noel, Rohit Chandrakant Kamble, Rinku Mathappan

Abstract


The study aims to ensure safe, effective, economic, and patient friendly with the knowledge inputs of each professional practice. With the primary and secondary objectives being: to study the role of the clinical pharmacist/doctor of pharmacy professional in the management of chronic diseases/illness, minimise medication/prescription errors, minimise/prevent adverse drug reactions, all types of drug interactions, and unnecessary healthcare costs, reducing drug-related problems and to monitor drug therapy efficiently, attain desired pharmacological effect of the drug, improve quality of life of the patients suffering from chronic conditions, provide patient counselling in a way that it helps to provide effective drug treatment in thereby improving the patient's condition, improve medication adherence, patient compliance and patient safety and therefore to provide drug or poison information services as needed. In India, chronic diseases such as cardiovascular diseases, diabetes, cancer, HIV and mental health disorders and injuries are the leading causes of death and disability. Most chronic diseases are equally prevalent in poor and rural populations and often occur together. Although a wide range of cost-effective primary and secondary prevention strategies are available, their coverage is generally low, especially in poor and rural populations. Much of the care for chronic diseases and injuries is provided in the private sector and can be very expensive. Sufficient evidence exists to warrant immediate action to scale up interventions for chronic diseases and injuries through private and public sectors; improved public health and primary health care systems are essential for the implementation of cost-effective interventions. This study enrolled 200 patients totally, out of which, 120 (sample size) patients’ prescriptions were analysed for potential drug interactions and were also selected for comparison of results of other related clinical pharmacy services. The majority of the population being males (65) and the rest being females (55) and among the study population, around 60 (132.5%) patients were geriatric, about 17 (38%) were renal impairment patients and about 13 (29.5%) were hepatic impaired patients. Out of the 45 interventions proposed, the most frequent suggestion was on substitution for 26.67% of the population and monitoring 26.67%. Out of this, 20.69% of the interventions/suggestions made were accepted and therapy was changed. Hence the prospective study was performed based on other categories which are discussed further using various software and spreadsheets to calculate the desired results and hence with the overall objective being to improve and make better the patients’ health and quality of life.

Keywords


Chronic diseases, medication/prescription errors, clinical pharmacy services, cost-effective interventions, medication adherence, patient counselling, patient compliance, patient safety, patient’s prescription

Full Text:

PDF

References


Parthasarathi G. A Textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 2. Universities Press (India) Private Limited 2012; 10.

Mohd. Rafi Bhatt, Kanchan Vohra. An article on Clinical Pharmacy. Patiala: Punjabi University. (College Website).

Simin Dashti-Khavidaki, et al. The role of clinical pharmacist to improve medication administration through enteral feeding tubes by nurses. Int J Clin Pharm. 2012; 34(5): 757–764.

Monson R, Bond CA, Schuna A. Role of The Clinical Pharmacist in Improving Drug-Therapy-Clinical Pharmacists in Outpatient Therapy. Arch Intern Med. 1981; 141(11): 1441–1444.

Dunn Steven P, et al. The role of the clinical pharmacist in the care of patients with cardiovascular disease. J Am Coll Cardiol. 2015; 66(19): 2129–2139.

Fornasier G, et al. Targeted therapies and adverse drug reactions in oncology: the role of clinical pharmacist in pharmacovigilance. Int J Clin Pharm. 2018; 40(4): 795–802.

The society of hospital pharmacist of Australia committee of specialty practice in clinical pharmacy. Practice and standards: Standards of practice for clinical pharmacy. The society of hospital pharmacist of Australia; 1996; 2–16.

Parthasarathi G, Ramesh M, Kumar JK, Madaki S. Assessment of drug-related problems and clinical pharmacists’ interventions in an Indian teaching hospital. J Pharm Pract Res. 2003, 33(4): 272–274.

Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: Updating the cost-of-illness model. J Am Pharm Assoc (Wash). 2001; 41(2): 192–9.

van den Bemt PM, Egberts TC, de Jong-van den Berg LT, Brouwers JR. Drug-related problems in hospitalised patients. Drug Saf. 2000; 22(4): 321–333.

Mohd. Rafi Bhat, Kanchan Vohra. A review article on Clinical Pharmacy Services. Patiala: Punjabi University. (College Website).

Leape LL. Preventing adverse drug events. Am J Health Syst Pharm. 1995; 52(4): 379–382.

American Society of Hospital Pharmacy. ASHP guidelines on adverse drug reaction monitoring and reporting. Am J Health Syst Pharm. 1995; 52(4): 417–419.

Handbook of resolutions and decisions of the World Health Assembly and Executive Board. Vol. 1(1948–1972). Geneva: World Health Organization; 1973.

Karch FE, Lasagna L. Toward the operational identification of adverse drug reactions. Clin Pharmacol Ther. 1977; 21(3): 247–54.

VAERS. CDC Vaccine Adverse Event Reporting System. Available Online at: https://vaers.hhs.gov/index.

US Food & Drug. Centre for Drug Evaluation and Research. Drug Interactions: What You Should Know. FDA. https://www.fda.gov/drugs/resources-you-drugs/drug-interactions-what-you-should-know

Richard Holland, James Desborough, Larry Goodyer, Sandra Hall, David Wright, Loke Yoon K. Does pharmacist-led medication review help to reduce hospital admissions and deaths in older people? A systematic review and meta-analysis. Br J Clin Pharmacol Ther. 2008; 65(3): 303–316.

Pharmaceutical Care Network Europe. Medication review definition approved. 2016 https://www.pcne.org/news/35/medication-review-definition-approved. (accessed 19 Sep 2016).

Pedersen JS, Brereton L, Newbould J, Nolte E. The puzzle of changing relationships. Does changing relationships between healthcare service users and providers improve the quality of care. London: The Health Foundation; 2013.

Eichenberger PM, Lampert ML, Kahmann IV, van Mil JW, Herzberger KE. Classification of drug-related problems with new prescriptions using a modified PCNE classification system. Pharm World Sci. 2010; 32(3): 362–72.

Ragesh G, et al. drug information services in tertiary care hospital. World J Pharm Res. 2014; 3(4).

Parthasarathi G. A textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 6 by Ramesh Adepu. Universities press (India) Private Limited; 2012; 60–61.

Subhish Petal. An article on patient counselling by Pharmacist: A focus on Chronic illness. J Pharm Sci. 2006; 19(1): 65–72. Impact factor: 1.103.

Parthasarathi G. A textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 6 by Ramesh Adepu. Universities press (India) Private Limited; 2012; 62–65.

Kumara swamy, et al. Prevalence of polypharmacy in tertiary care hospital. Int Res J Pharm. 2014; 5(10): 778–782.

Kaleemudin Mohammed, Sankham Rajendran D, Bojaraj Suresh. The role of clinical pharmacist in poison related admission in a secondary care hospital. Aust J Hosp Pharm. 2001; 31(1): 26–30.

George B, Rao PGM. Assessment and evaluation of drug information services provided in a south Indian teaching hospital. Indian J Pharmacol. 2005; 37(5): 315–318.

Kirschenbaum HL, Rosenberg JM. Educational programs offered by colleges of pharmacy and drug information centres with in the United States. Am J Pharm Educ. 1984; 48(2): 155–7.

The Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Drug Information. SHPA Standards of Practice for Drug Information Services.The Australian Journal of Hospital Pharmacy 1999: 29(3):171-176.

Parthasarathi G.s A Textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 19. Universities press (India) Private Limited; 2012; 332–37.

Kaleemudin Mohammed, Sankham Rajendran D, Bojaraj Suresh. The role of clinical pharmacist in poison related admission in a secondary care hospital. Aust J Hosp Pharm. 2001; 31(1): 26–30.

Parthasarathi G. A Textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 20 by Ramesh M, Shobha Churi. Universities press (India) Private Limited; 2012; 343.

Parthasarathi G. A Textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 19 by Ramesh M, Shobha Churi. Universities press (India) Private Limited; 2012; 354–55.

Parthasarathi G. A Textbook of Clinical Pharmacy Practice (Essential concepts and skills). 2nd Edn. Chapter 20 by Ramesh M, Shobha Churi. Universities press (India) Private Limited; 2012; 350–54.

CDC (Centres of Disease Control and Prevention). National Centre for Chronic Disease Prevention and Health Promotion (NCCDPHP). Available Online at: https://www.cdc.gov/about/organization/cio-orgcharts/nccdphp.html

William Kelly H, Sorkness Christine A. Asthma: Pharmacotherapy handbook. 9th Edn.

Williams Dennis M, Bourdet Sharya V. Access Pharmacy. Chapter 44: Chronic Obstructive Pulmonary Disease. Available online at: https://accesspharmacy.mhmedical.com/content.aspx?

bookid=2577&sectionid=233592805

Saseen Joseph J, MacLaughlin Eric J. Pharmacotherapy Handbook. Chapter 13: Hypertension. 7th Edn. India: McGraw-Hill Education/Medical; 2011.

Adam Felman. Everything you need to know about hypertension. Medically reviewed by Spriggs Brenda B. (M.D, MPH, FACP). Medical News Today. 2019 Jul 22.

Saseen Joseph J, MacLaughlin Eric J. Pharmacotherapy Handbook. Chapter 13: Hypertension. 10th Edn. India: McGraw-Hill Education/Medical; 2017.

MedlinePlus. Kia wang et al. Medicines Also called: Drugs. Medications medicine (Baltimore). 2020 May.

Jamshid Alaeddini. Angina Pectoris. Drugs & Diseases. Updated: Jul 19, 2018. Available Online at: https://emedicine.medscape.com/article/150215-overview

Americana bêtes Association. Diabetes facts and figures. Available at: http://diabetes.org/

diabetes-statistics.jp. Accessed Jan 27, 2004.

Atkinson MA, Eisenbarth GS. Type 1 diabetes: New perspectives on disease pathogenesis and treatment. Lancet. 2001; 358(9277): 221–229.

Raffel LJ, Scheuner MT, Rotter JI. Genetics of diabetes. In: Porte D Jr, Sherwin RS, editors. Ellenberg & Rifkin’s Diabetes Mellitus. 5th Edn. Stamford, CT: Appleton & Lange; 1997; 401–454.

Bennett P, Rewers M, Knowler W. Epidemiology of diabetes mellitus. In: Porte D Jr, Sherwin RS, editors. Ellenberg & Rifkin’s Diabetes Mellitus. 5th Edn. Stamford, CT: Appleton & Lange; 1997; 373–400.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2004; 27(Suppl 1): S5–S10.

Gale EA. The rise of childhood type 1 diabetes in the 20th century. Diabetes. 2002; 51(12): 3353–3361.

Froguel P, Zouali H, Vionnet N, et al. Familial hyperglycaemia due to mutations in glucokinase. Definition of a subtype of diabetes mellitus. N Engl J Med. 1993; 328(10): 697–702.

American Diabetes Association. Standards for medical care: Screening for diabetes. Diabetes Care. 2004; 27(Suppl 1): S15–S17.

American Diabetes Association. Type 2 diabetes in children and adolescents. Diabetes Care. 2000; 23: 381–389.

Kahn SE, Porte D Jr. The pathophysiology of type II (non-insulin dependent) diabetes mellitus: Implications for treatment. In: Porte D Jr, Sherwin RS, editors. Eilenberg & Rifkin’s Diabetes Mellitus. 5th Edn. Stamford, CT: Appleton & Lange; 1997; 487–512.

American Diabetes Association. Standards of medical care for patients with diabetes mellitus. Diabetes Care 2004; 27(Suppl 1): S15–S35.

Bakris GL, Williams M, Dworkin L, et al. Preserving renal function in adults with hypertension and diabetes: A consensus approach. National Kidney Foundation Hypertension and Diabetes Executive Committees Working Group. Am J Kidney Dis. 2000; 36(3): 646–661.

Deedwania PC. Hypertension and diabetes: new therapeutic options. Arch Intern Med. 2000; 160(11): 1585–1594.

American Diabetes Association. Nutrition principles and recommendations in diabetes. Diabetes Care. 2004; 27(Suppl1): S36–S46.

American Diabetes Association. Diabetes mellitus and exercise. Diabetes Care. 2004; 27(Suppl 1): S58–S62.

Wells Barbara G, Dipiro Joseph T, Cecily V. Pharmacotherapy handbook. 7th Edn. Chapter 19. McGraw-Hill Companies; 2009; 212–25.

Sherman Steven I, Talbert Robert L. Pharmacotherapy handbook. Thyroid disorder. 7th Edn. McGraw-Hill Education; 2008.

Schraga Erik D. Hypothyroidism and Myxedema Coma. Emergency Medicine, Medscape. Updated: May 12, 2021. [Available at]: https://emedicine.medscape.com/article/768053-overview

Vikram Patel, Somnath Chatterji, Dan Chisholm, Shah Ebrahim, Gururaj Gopalakrishna, Colin Mathers, Viswanathan Mohan, Dorairaj Prabhakaran, Ravindran Ravilla D, Srinath Reddy K. A review article on Chronic diseases and injuries in India reviewed by The Lancet. Lancet. 2011; 377(9736): 413–28.

Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save. Lancet. 2005; 366(9496): 1578–82.

Ezzati M, Vander-Hoorn S, Lawes CMM, et al. Re-thinking the ‘diseases of affluence’ paradigm: global patterns of nutritional risks in relation to economic development. Public Library Sci Med. 2005; 2(5): e133.

McKeown T. The Origins of Human Disease. Oxford: Blackwell; 1988; 233.

Popkin BM. The Bellagio conference on the nutrition transition and its implications for health in the developing world; Italy; 2001 August 20-24. Public Health Nutr. 2002: 5(1A): 93–280.

World Health Assembly. Diet, physical activity and health. In: 55th World Health Assembly. Geneva. 13–18 May, 2002. Resolutions and Decisions, Annexes. Geneva: WHO.

World Health Organization. Preventing Chronic Disease: A Vital Investment. Geneva: WHO; 2005.

Yach D, Beaglehole R. Globalization of risks for chronic diseases demands global solutions. Perspectives Global Dev Techno. 2004; 3(1–2): 213–33.

World Health Organization. The World Health Report 2003: Shaping the Future. Geneva: WHO; 2003.

Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for 2000 and projections for 2030. Diabetes Care. 2004; 27(5): 1047–53.

Meetoo D, McGovern P, Safadi R. An epidemiological overview of diabetes across the world. Br J Nurs. 2007; 16(16): 1002–7.

Stewart BW, Kleihaus S, editors. World Cancer Report. Lyon, France: IARC Press; 2003.

Popkin, BM, Haines, PS, Patterson, R. Dietary changes among older Americans 1977–87. Am. J. Clin. Nutr. 1992; 55: 823–30.

World Health Organization. The World Health Report 2002. Geneva: WHO; 2002a. World Health Organization. WHO Strategy for Prevention and Control of Chronic Respiratory Diseases? Geneva: WHO; 2002b.

Bumgarner R. China: non-communicable disease issues and options re-visited. Soc Prev Med. 2004; 38: 202–10.

Mascie-Taylor CGN, Karim E. The burden of chronic disease. Science. 2003; 302(5652): 1921–2.

Frenk J, Bobadilla JL, Sepulveda J, Cervantes LM. Health transition in middle-income countries: new challenges for health care. Health Policy Plan. 1989; 4(1): 29–39.

Basnayar B, Rajapasha LC. Cardiovascular and infectious diseases in South Asia: the double whammy. Br Med J. 2004; 328: 781–781.

Steyn K, Bradshaw D, Norman R, Laubscher R. Determinants and treatment of hypertension in South Africans: the first Demographic and Health Survey. S Afr Med J. 2008; 98(5): 376–80.

Hawkes C. Marketing activities of global soft drinks and fast-food companies in emerging markets: a review. In: WHO Globalization, Diets and Non-communicable Diseases. Geneva: WHO; 2002.

McNeal J. Children as Consumers of Commercial and Social Products. Washington DC: Pan American Health Organization; 2002.

Walsh D. Slipping Under the Radar: Advertising and the Mind. Paper presented at the WHO Symposium: Marketing to Young People; Apr 2002; Treviso, Italy. 2002.

Horgen KB, Brownell KD. Confronting the toxic environment: environmental, public actions in a world of crisis. In: Wadden TA, Stunkard AJ, editors. Handbook of Obesity Treatment. New York: Guildford Press; 2002; 95–106.

Bettcher DW, Yach D. Guindon Global trade and health: Key linkages and future challenges. Bull World Health Organ. 2000; 78(4): 521–34.

Strong K, Mathers C, Leeder S, Beaglehole R. Preventing chronic diseases: how many lives can we save. Lancet. 2005; 366(9496): 1578–82.

de Beyer J, Brigden LW. Tobacco Control Policy: Strategies, Successes and Setbacks. World Bank/Research for International Tobacco Control, Washington DC. 2003; 189.

Nishtar S. Public-private ‘partnerships’ in health: a global call to action. Health Res Policy Syst. 2004; 2(1): 5.

Nishtar S, Bile KM, Ahmed A, et al. Process, rationale, and interventions of Pakistan’s National Action Plan on Chronic Diseases. Prev Chronic Dis. 2006; 3(1): A14.

O’Halloran J, Miller GC, Britt H. Defining chronic conditions for primary care with ICPC-2. Family Pract. 2004; 21(4): 381–6.

Isfahan Healthy Heart Programme. (1999). Projects. Available at: http://tinyurl.com/62r4zz (accessed 20 Nov 2008).

World Health Organization. Tobacco-free Initiative. Religion and Tobacco. Geneva: WHO; 2008.

International Diabetes Federation. Diabetes Atlas. 6th Edn. Available at: http://www.idf.org/sites/default/files/attachments/SEA%20factsheet.pdf; 2014. Accessed Jan 1, 2016.

Leng, O, Razvi S. Hypothyroidism in the older population. Thyroid Res. 2019 Dec; 12(1): 1-0.

Taylor PN, Lazarus JH, Dayan CM. Global epidemiology of hyperthyroidism and hypothyroidism. Nat Rev Endocrinol. 2018 May; 14(5): 301–316.

Holman H, Lorig K. Patients as partners in managing chronic disease. Partnership is a prerequisite for effective and efficient health care. Br Med J (Clinical Research Editorial). 2000; 320(7234): 526–7.

Lorig KR, Sobel DS, Stewart AL, et al. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care 1999; 37(1): 5–14.

Kim MJ. Nursing in a global village. Chart. 2001; 98(4): 4–7. Davidson PM, Meleis AI, Daly J, Douglas M. Globalisation as we enter the 21st century: reflections and directions for nursing education, science, research and clinical practice. Contemp Nurse. 2003; 15(3): 162–74.

Healy P. Poor performance. Nurs Stand. 2001; 15(33): 13. Falk-Rafael A. Speaking truth to power: nursing’s legacy and moral imperative. ANS Adv Nurs Sci. 2005b; 28(3): 212–23.

Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. a systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med. 2012; 10(2): 142–151.

Garin N, Koyanagi A, Chatterji S. Global multimorbidity patterns: a cross-sectional, population-based, multi-country study. J Gerontol A Biol Sci Med Sci. 2015; 71(2): 205–214.

Violan C, Foguet-Boreu Q, Flores-Mateo G. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One. 2014; 9(7): e102149.

Hajat C, Kishore SP. The case for a global focus on multiple chronic conditions. BMJ Global Health. 2018; 3(3): e000874.

Fairall LR, Zwarenstein M, Bateman ED. Effect of educational outreach to nurses on tuberculosis case detection and primary care of respiratory illness: pragmatic cluster randomised controlled trial. BMJ. 2005; 331(7519): 750–754.

Berg JS, Dischler J, Wagner DJ, Raia JJ, Palmer-Shevlin N. Medication compliance: a healthcare problem. Ann Pharmacother. 1992; 27(9 Suppl): S1–S24.

Eccles N. Telemedicine in developing countries: challenges and successes. Harvard Coll Glob Health Rev. 2012. Available at: https://www.hcs.harvard.edu/hghr/print/spring-2011/telemedicine-developing

Mukherjee S. Prepare for the digital health revolution. Fortune. 2017; 175(6): 37–45. Available at: http://fortune.com/2017/04/20/digital-health-revolution

Boyd CM, McNabney MK, Brandt N. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatric Soc. 2012; 60(10): E1–25.

Wagner EH, Austin BT, Von Korf M. Improving outcomes in chronic illness. Manag Care Q. 1996; 4(2): 12–25. Wagner EH, Austin BT, Von Korf M. Organizing care for patients with chronic illness. Milbank Q. 1996; 74(4): 511–44.

Indredavik B, Slørdahl SA, Bakke F, Rokseth R, Helheim LL. Stroke unit treatment. Long-term effects. Stroke. 1997; 28(10): 1861–66.

Ronning OM, Guldvog B. Stroke units versus general medical wards, I: twelve- and eighteen-month survival: a randomized, controlled trial. Stroke. 1998; 29(1): 58–62.

Retchin SM, Brown RS, Yeh SC, Chu D, Moreno L. Outcomes of stroke patients in Medicare fee for service and managed care. JAMA. 1997; 278(2): 119–24.

Starfield B. Primary care: concept, evaluation, and policy. New York: Oxford University Press; 1992.

Pritchard P, Hughes J. Shared care: the future imperative? London: Royal Society of Medicine Press; 1995.

Cochrane Collaboration LA, Mays NB, Barjesteh K, Bond C. Expanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes. Cochrane Database Syst Rev. 2000;(3):CD000336.

Hanlon JT, Weinberger M, Samsa GP, Schmader KE, Utech KM, Lewis IK, et al. A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy. Am J Med. 1996; 100(4): 428–437.

Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999; 21: 267–270.

Bogden PE, Abbott RD, Williamson P, Onopa JK, Koontz LM. Comparing standard care with a physician and pharmacist team approach for Uncontrolled Hypertension. J Gen Intern Med. 1981; 13(11): 740–745.

Starfield B. Primary care: concept, evaluation, and policy. New York: Oxford University Press; 1992.

Becker MH, Drachmann RH, Kirsch JP. Continuity of paediatrician: new support for an old shibboleth. J Paediatrics Med Care. 1974; 84(4): 599–605.

Hjortdahl P, Laerum E. Continuity of care in general practice: effect on patient satisfaction. BMJ. 1992; 304(6837): 1287–1290.

Wasson JH, Sauvigne AE, Mogielnicki RP, Frey WG, Sox CH, Gaudete C, et al. Continuity of outpatient medical care in elderly men. A randomized trial. JAMA. 1984; 252(17): 2413–2417.

Rich MW, Beckham V, Wittenberg C, Leven CL, Freedlan KE, Carney RM. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995; 333(18): 1190–95.

Stuck AE, Aronow HU, Steiner A, et al. A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. N Engl J Med. 1995; 333(18): 1184–89.

Pearson P, Jones K. The primary health care non-team? BMJ. 1994; 309(6966): 1387–1388.

Jishnu V, Gilhotra RM, Mishra DN. Pharmacy education in India: Strategies for a better future. J Young Pharm. 2011; 3(4): 334–42.

Dandiya PC. Pharmaceutical education in India: An introspection for better future. Pharma Times. 2011; 43: 19. en.wikipedia.org/wiki/Clinical_Pharmacy_and_Public_Health_Education.

George PP, Molina JA, Cheah J, Chan SC, Lim BP. The evolving role of the community pharmacist in chronic disease management a literature review. Ann Acad Med Singap. 2010; 39(11): 861–867.

Talasaz AH. The Potential Role of Clinical Pharmacy Services in Patients with Cardiovascular Diseases. J Teh Univ Heart Ctr. 2012; 7(2): 41–46.

Dave JB. Does bright future await pharmacy students? Pharma Times. 2011; 43(3): 13.

Shantanu K. Pharmacy Education: Current problems and suggested solutions. Indian J Pharm Educ. 2004; 38: 154.

Dasgupta A. Introduction to therapeutic drug monitoring: Handbook of Drug Monitoring Methods. Humana Press; 2008; 1–39.




DOI: https://doi.org/10.37591/rrjohp.v11i2.2688

Refbacks

  • There are currently no refbacks.


Copyright (c) 2021 Research & Reviews: A Journal of Health Professions