The pharmacy profession has undergone tremendous changes over the past few decades. Pharmacists’ roles have expanded their boundaries to encompass more patient-centered services. However, the degree to which these roles are practised may vary. This scoping review is aimed at describing the extent and range of the professional pharmacy services offered in hospital pharmacies across different countries and the barriers underlying inappropriate or incomplete implementation of these services. Studies published in the English language between 2015 and 2019 were retrieved from the following databases: PubMed, CINAHL, Scopus, EBSCO Discovery Service, and Web of Science. A thematic analysis across the included studies produced two main themes. “Scope of practice” comprised three subthemes: pharmaceutical care practice, clinical pharmacy practice, and public health services and “Multiple levels of influence” comprised five subthemes: individual, interpersonal, institutional, community, and public policy-related factors. The hospital pharmacy services across countries ranged from traditional drug-centered pharmacy practice to a more progressive, clinically oriented practice. In some countries, there is an apparent inadequacy in the clinical pharmacy services provided compared to other clinical settings. Understanding the current pharmacy practice culture across different health care systems is an essential step towards improving the profession.

Background: Psychiatric pharmaceutical care is the provision of pharmaceutical care services to patients with psychiatric related illnesses or disorders. Several studies have demonstrated the positive influence psychiatric pharmaceutical care on patients’ clinical, humanistic and economic outcomes. This study aimed to examine the extent of psychiatric pharmaceutical care practice in a convenience sample of Malaysian government hospitals and the barriers to the provision of these services.Methods: An anonymous cross-sectional survey of registered pharmacists working at a convenience sample of government hospitals in Malaysia was undertaken from September 2019 to June 2020.Results: Pharmacists frequently ensured the appropriateness of the dose (55%), dosage form (47%) and dosing schedule (48%) of the dispensed medications. Most pharmacists infrequently worked with patients and healthcare professionals to develop a pharmacotherapeutic regimen and a corresponding monitoring plan (28%). There was no statistically significant difference in the provision of pharmaceutical care services with respect to gender, age, years of practice, and professional board certification. However, the services offered were influenced by the respondent’s education and pharmacy setting. The obstacles perceived by pharmacists included lack of time (89%), shortage of pharmacy staff (87%), the patients’ inability to comprehend medical information (85%), insufficient demand and acceptance by patients (82%), the lack of official policies and standardised practice protocols (78%), inaccessibility to the patients’ medical records (77%) and the lack of structured communication channels between pharmacists and physicians (75%), the pharmacists lack of knowledge/skills and confidence (78%) and insufficient recognition from physicians to the pharmacists’ skills (76%).Conclusions: This is the first study to explore the extent and barriers of psychiatric pharmaceutical care in Malaysian hospitals; it highlighted the need for mobilising pharmacists to expand these services.

Background: Clinical Practice Guidelines (CPGs) are systematically developed statements to assist practitioners and patients with appropriate health care for specific clinical circumstances. However, evidence suggests that the uptake of these recommendations in routine care is still limited, particularly in resource-constrained countries. Objectives: This article aimed to (1) identify current CPGs for the pharmacological management of MDD that address and are compatible with the needs of Malaysian psychiatrists (2) collate and summarise these CPG recommendations to produce a more culturally sensitive and end-user friendly guideline summary. Materials and Methods: A multidisciplinary steering group followed an adapted development approach that included; (1) searching for guidelines on the pharmacological management of adults with depression, (2) screening them for relevant recommendations, (3) critical appraising these guidelines, and (4) extracting the required information. A panel of experts then reviewed the developed guideline summary. Results: Six potentially relevant guidelines for the pharmacological management of depression in adults were identified. The developed summary included a decision algorithm to guide the selection of antidepressant therapy based on clinical factors, potential drug-drug interaction, tolerability, and cost of the medications. The review panel considered the summary recommendations easy to use and had the potential for uptake by busy psychiatrists. Conclusion: A CPG summary for the pharmacological management of depression was developed that focuses on evidence-based, contextually relevant recommendations that are feasible for implementation within the local healthcare settings in Malaysia. Practical Implications: The developed guideline summary has the potential to enhance the implementation of evidence-based practice in the management of Major Depressive Disorder within the Malaysian context.

Few studies have applied Benner's nursing theory in evaluating psychiatric nursing care for patients with schizophrenia and the complication of cancer. Further study and training are needed in the management of these diseases. (1) To elucidate and categorize psychiatric nursing expertise in schizophrenia and cancer according to the five stages of Benner's nursing theory. (2) To identify stage-specific learning needs for the psychiatric nursing care of schizophrenia and cancer, and to propose tailored educational programs. (3) To clarify the differences in the roles and training of psychiatric nurses in Malaysia and Japan. A qualitative descriptive design was adopted. Semi-structured interviews were conducted with a total of 20 psychiatric nurses in Malaysia and Japan. The data were thematically analyzed and categorized with Benner's theory. Benner's five stages of proficiency were: Novices followed pre-established routines; advanced beginners focused on psychiatric symptoms and behavior; competent nurses determined and prioritized methods of care; proficient nurses flexibly adjusted care to the patient's condition; and experts lent extensive experience to the team and patients. The following learning needs were identified: Novices struggled with identifying physical and psychiatric symptoms; advanced beginners had difficulties understanding ambiguous patient statements; competent nurses needed to improve emergency response skills; proficient nurses faced ethical challenges; and experts sought to pass on their knowledge. Stage-appropriate educational programs, such as a Visual Pain and Psychiatric Symptoms Evaluation Sheet, were proposed accordingly. Further investigations should assess the effectiveness of these educational programs, Japanese-Malaysian cultural differences, and psychiatric liaison nursing.