Contemporary patient care requires a multidisciplinary approach to monitoring, assessing, and managing diseases. Promoting multidisciplinary approaches encourages the purposeful participation of many healthcare professionals and harnessing their combined knowledge to provide tailored treatment plans. Pharmacists, skilled and knowledgeable professionals in medication management, drug-related problems, and disease prevention, can offer vital interventions that contribute to improved patient outcomes. Advances in healthcare and information technology have expanded pharmacists' professional roles and made them essential in healthcare. Pharmacist-managed clinics (PMCs), an innovative healthcare approach, could potentially improve patient safety, satisfaction, accessibility, and affordability to quality healthcare. Spread across the healthcare continuum, pharmacists have a well-defined role in providing comprehensive pharmaceutical care and interprofessional collaboration, further reinforcing the necessity of establishing PMCs. This narrative review aims to compile and summarize information on PMCs from PubMed, Scopus, Web of Science, and Google Scholar till December 2023. The PMC shortlist covers specialties such as cardiovascular, hematologic, endocrine, pain medicine, respiratory medicine, infectious diseases, gastrointestinal, nephrology, neurology, and oncology. Pharmacists in disease-specific PMCs have demonstrated improved treatment outcomes and access to specialty care. Additionally, based on peer-reviewed literature, the review also highlights how PMCs enhance the pharmacist's role in improving disease-specific outcomes, overall quality of care, and medication management. The inclusion criteria are randomized controlled trials, case-control studies, cohort studies, and pre-post studies involving patients from cardiology, hematology, endocrinology, pain medicine, respiratory medicine, infectious diseases, neurology, nephrology, gastroenterology, and oncology specialties, focusing on pharmacist-driven clinics, published in English, and covering any geographical location. The exclusion criteria include review articles, proposed models, commentaries, editorials, and those published in languages other than English. Our findings reveal that PMCs are underutilized globally. PMCs work better in developed countries, possibly on account of robust healthcare infrastructure, adequate healthcare budgets, availability of trained pharmacists, and supportive regulatory environments. The review found that pharmacist-led interventions, such as medication monitoring and patient education, significantly enhance therapeutic outcomes. Pharmacist Managed Clinics improve affordability and acceptability, expanding healthcare access in outpatient and inpatient settings. This review also highlights the critical need for implementing PMCs to improve healthcare delivery, particularly in providing comprehensive and accessible services in developing countries.

(1) Background: Piperacillin/tazobactam is a broad-spectrum antimicrobial encompassing most Gram-positive and Gram-negative aerobic and anaerobic bacteria. The inappropriate use of such broad-spectrum antibiotics is an important contributor to the rising rates of antimicrobial drug resistance worldwide. Drug utilization evaluation studies and pharmacists’ interventions are vital to assess, develop, and promote the rational use of antibiotics. This drug utilization study aimed to evaluate the current utilization practice of piperacillin/tazobactam in a hospital setting and assess the impact of pharmacist intervention in improving its appropriate use. (2) Methodology: In this study, we used a retrospective cohort and a prospective cohort, a cross-sectional, observational method. It included a retrospective (Cycle A/pre-intervention-CycA) phase followed by an educational interventional phase conducted by the pharmacists. During the 2 months of educational intervention, pharmacists used several methods, including workshops, lectures, oral presentations, and the development and reinforcement of clinical pathways to promote the judicious use of piperacillin/tazobactam. This was followed by a prospective (Cycle B/post-intervention-CycB) phase to improve piperacillin/tazobactam usage appropriateness. The appropriateness criteria for this drug utilization evaluation were established based on antimicrobial guidelines, the published literature, the institutional antibiogram, consultation from the antimicrobial stewardship committee, and the product monograph (Tazocin). The appropriateness of CycA and CycB patients was compared using the measurable elements, including indication and dose based on renal function, timely order for cultures, de-escalation, and use of extended infusion protocol. (3) Results: The study population comprised 100 patients in both CycA and CycB. The mean age of the patients was 66.28 ± 16.15 and 67.35 ± 17.98, and the ratios of men to women were found to be 49:51 and 61:39 in CycA and CycB, respectively. It was observed that inappropriate usage was high in CycA patients, and the appropriateness was improved in CycB patients. A total of 31% of inappropriate empirical broad-spectrum use was found in CycA, and it was reduced to 12% in CycB patients. The transition of appropriateness was observed in all measurable criteria, which includes the optimized dose according to the renal function (CycA = 49% to CycB = 94%), timely bacterial culture orders (CycA = 47% to CycB = 74%), prompt de-escalation (CycA = 31% to CycB = 53%), and adherence to extended infusion institutional guidelines (CycA = 34% to CycB = 86%). (4) Conclusions: The study highlighted important aspects of inappropriate piperacillin/tazobactam use. This can be considerably improved by proper education and timely interventions based on the pharmacists’ vigilant approach. The study results emphasized the need for surveillance of piperacillin/tazobactam usage by conducting similar drug utilization evaluations and practice to improve quality and safety in healthcare organizations globally.

Patient counseling is an important tool to help both healthcare providers and patients in achieving the desired health outcomes. It is one of the significant and well-established roles for pharmacists in the health care system, enabling them to develop a pharmacist-patient collaborative relationship to ensure medication compliance, improved adherence to the prescribed medication regimen and prevention of adverse drug events. Delivering effective and efficient patient counseling is often hindered by numerous personal and system-related challenges. Therefore, efforts to overcome these challenges necessitate developing and incorporating various tools and methods to establish an integrated patientcentered pharmacy design. This article demonstrates the development of one such integrated model in the Johns Hopkins Aramco Healthcare ambulatory care pharmacy setting. It includes components such as electronic health records, patient portal communication systems, telehealth models (both telephonic and virtual), physical redesign of the pharmacy layout, enhanced pharmacy website, and utilizing robotic dispensing systems to deliver more efficient and interactive patient counseling. The goal of implementing the innovative patient-centered pharmacy design and integration of the telehealth model was to mitigate many of the barriers faced by the pharmacist in the traditional system during patient counseling. This new integrated model provides an example for other healthcare organizations to improve patient counseling effectiveness and provide excellent patient-centered care.

The study aimed to evaluate the effectiveness of telepsychiatry combined with the expertise of psychiatric clinical pharmacists in identifying and addressing drug-related problems (DRPs) associated with psychotropic medications. Additionally, the research assessed physicians' acceptance of pharmacists' recommendations for managing these DRPs. A cohort retrospective study was conducted at a leading tertiary care hospital in Saudi Arabia spanning from January 2023 to January 2024 in a psychiatry setting. The study comprehensively examined all instances of interventions for DRPs facilitated through patient-initiated telepsychiatry encounters with psychiatric clinical pharmacists. Detailed and meticulously recorded notes from patient chart reviews, documented by the pharmacist in the Electronic Health Record (EHR), during each encounter, were reviewed. These notes provided significant information on psychiatric diagnosis, identified DRPs and the specific interventions and recommendations proposed by the clinical pharmacist to the attending physician. The Krska classification was utilised to classify and analyse the identified DRPs, ensuring a structured and systematic approach to the study's findings. A total of 259 pharmacist interventions were made, and the results revealed a remarkably high acceptance rate of 98.5% among physicians. The most common intervention (16.21%) involved targeted education to improve medication adherence. Additionally, substantial efforts were directed towards rectifying inappropriate dosage regimens, accounting for 13.51% of DRPs resolved by the pharmacist. Noteworthy interventions also encompassed the identification and management of potential or suspected adverse reactions, comprising 12.35% of the interventions, along with interventions addressing concerns regarding potentially ineffective therapy, which constituted 11.59%. The study underscores the critical role of pharmacists in psychiatric care, with high physician acceptance of their interventions. The diverse range of DRPs highlights the need to expand clinical pharmacy services and integrate pharmacists into psychiatric teams. Our findings clearly demonstrate that integrating pharmacists into psychiatric care settings is beneficial. This approach enhances DRP identification and management, ultimately enhancing patient care and treatment outcomes.