Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice

Article


Onatade, R., Appiah, S., Stephens, M. and Garelick, H. 2018. Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice. European Journal of Hospital Pharmacy. 25 (e1), pp. e21-e28. https://doi.org/10.1136/ejhpharm-2017-001303
TypeArticle
TitleEvidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice
AuthorsOnatade, R., Appiah, S., Stephens, M. and Garelick, H.
Abstract

Objectives: The role of clinical pharmacists in hospitals has evolved and continues to expand. In the UK, outside of a few national policy drivers, there are no agreed priorities, measures or defined outcomes for hospital clinical pharmacy (CP). This paper aims to (1) highlight the need to identify and prioritise specific CP roles, responsibilities and practices that will bring the greatest benefit to patients and health systems and (2) describe systematic weaknesses in current research methodologies for evaluating CP services and propose a different approach.
Method: Published reviews of CP services are discussed using the Economic, Clinical and Humanistic Outcomes framework. Recurring themes regarding study methodologies, measurements and outcomes are used to highlight current weaknesses in studies evaluating CP.
Results: Published studies aiming to demonstrate the economic, clinical or humanistic outcomes of CP often suffer from poor research design and inconsistencies in interventions, measurements and outcomes. This has caused difficulties in drawing meaningful conclusions regarding CP’s definitive contribution to patient outcomes.
Conclusion: There is a need for more research work in National Health Service (NHS) hospitals, employing a different paradigm to address some of the weaknesses of existing research on CP practice. We propose a mixed-methods approach, including qualitative research designs, and with emphasis on cost-consequence analyses for economic evaluations. This approach will provide more meaningful data to inform policy and demonstrate the contribution of hospital CP activities to patient care and the NHS.

Keywordsclinical pharmacy; economic outcomes; hospital; United Kingdom; clinical outcomes; humanistic outcomes; research methodologies
LanguageEnglish
PublisherBMJ
JournalEuropean Journal of Hospital Pharmacy
ISSN2047-9956
Electronic2047-9964
Publication dates
Online30 Oct 2017
Print28 Mar 2018
Publication process dates
Deposited20 Nov 2017
Submitted14 May 2017
Accepted15 Aug 2017
Output statusPublished
Accepted author manuscript
Copyright Statement

This is the author’s manuscript, the final version of record is published in European Journal of Hospital Pharmacy available from BMJ at: http://dx.doi.org/10.1136/ejhpharm-2017-001303
© European Association of Hospital Pharmacists (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Digital Object Identifier (DOI)https://doi.org/10.1136/ejhpharm-2017-001303
Web of Science identifierWOS:000430495200005
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Screening for Downs Syndrome pregnancy by mass spectral glycofingerprinting hCG-beta core in neat pregnancy urine.
Luttoo, J., Appiah, S., Butler, S. and Iles, R. 2009. Screening for Downs Syndrome pregnancy by mass spectral glycofingerprinting hCG-beta core in neat pregnancy urine. Middlesex University Postgraduate Summer Conference. London, UK
Impact of inulin on bile acids induced colon cancer: antioxidant and anti-proliferative effect of inulin on HCT 116 cell lines
Afolabi, B., Appiah, S., Pachenari, A. and Ghali, L. 2014. Impact of inulin on bile acids induced colon cancer: antioxidant and anti-proliferative effect of inulin on HCT 116 cell lines. Middlesex University Postgraduate Summer Conference. London, UK 19 Jun 2014
Impact of inulin on bile acids induced colon cancer
Afolabi, B., Appiah, S., Pachenari, A. and Ghali, L. 2013. Impact of inulin on bile acids induced colon cancer. Third AACR International Conference on Frontiers in Basic Cancer Research. National Harbor, MD, United States 18 - 22 Sep 2013
The mechanisms of arsenic bioremediation from water by the green microalgae Chlorella vulgaris
Pantoja Munoz, L., Purchase, D., Jones, H., Feldmann, J. and Garelick, H. 2014. The mechanisms of arsenic bioremediation from water by the green microalgae Chlorella vulgaris. THE BNASS / TraceSpec Tandem Conference. Aberdeen, Scotland, UK 31 Aug - 04 Sep 2014
The removal of arsenate from water using iron-modified diatomite (D-Fe): isotherm and column experiments
Pantoja Munoz, L., Jones, H., Garelick, H., Mohamedbakr, H. and Burkitbayev, M. 2014. The removal of arsenate from water using iron-modified diatomite (D-Fe): isotherm and column experiments. Environmental Science and Pollution Research. 21 (1), pp. 495-506. https://doi.org/10.1007/s11356-013-1891-7
Enhanced determination of As-phytochelatin complexes in Chlorella vulgaris using focused sonication for extraction of water-soluble species
Pantoja Munoz, L., Purchase, D., Jones, H., Feldmann, J. and Garelick, H. 2014. Enhanced determination of As-phytochelatin complexes in Chlorella vulgaris using focused sonication for extraction of water-soluble species. Analytical Methods. 6 (3), pp. 791-797. https://doi.org/10.1039/C3AY41629A
A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota
Cantas, L., Shah, S.Q.A., Cavaco, L., Manaia, C., Walsh, F., Popowska, M., Garelick, H., Bürgmann, H. and Sørum, H. 2013. A brief multi-disciplinary review on antimicrobial resistance in medicine and its linkage to the global environmental microbiota. Frontiers in Microbiology. 4. https://doi.org/10.3389/fmicb.2013.00096
Enzymatic formulation capable of degrading scrapie prion under mild digestion conditions
Okoroma, E., Purchase, D., Garelick, H., Morris, R., Neale, M., Windl, O. and Abiola, O. 2013. Enzymatic formulation capable of degrading scrapie prion under mild digestion conditions. PLoS ONE. 8 (7), pp. 1-7. https://doi.org/10.1371/journal.pone.0068099
Identification and characterisation of a Bacillus licheniformis strain with profound keratinase activity for degradation of melanised feather
Okoroma, E., Garelick, H., Abiola, O. and Purchase, D. 2012. Identification and characterisation of a Bacillus licheniformis strain with profound keratinase activity for degradation of melanised feather. International Biodeterioration and Biodegradation. 74, pp. 54-60. https://doi.org/10.1016/j.ibiod.2012.07.013
Power, participation and partnership: methodological reflection on researching professional doctorate candidates' experiences of researching in the workplace
Weller, G., Volante, M. and Garelick, H. 2011. Power, participation and partnership: methodological reflection on researching professional doctorate candidates' experiences of researching in the workplace. Work Based Learning e-Journal International. 2 (1), pp. 155-174.
Technical note: effects of arsenate (AS5+) on growth and production of glutathione (GSH) and phytochelatins (PCS) in Chlorella Vulgaris
Jiang, Y., Purchase, D., Jones, H. and Garelick, H. 2011. Technical note: effects of arsenate (AS5+) on growth and production of glutathione (GSH) and phytochelatins (PCS) in Chlorella Vulgaris. International Journal of Phytoremediation. 13 (8), pp. 834-844. https://doi.org/10.1080/15226514.2010.525560
Evaluation of herbs as potential alternatives for bear bile and rhino horn used in traditional Chinese medicines: chemical and biological analysis.
Appiah, S. 2006. Evaluation of herbs as potential alternatives for bear bile and rhino horn used in traditional Chinese medicines: chemical and biological analysis. PhD thesis Middlesex University School of Health and Social Sciences
Multi-criteria analysis for the assessment of options for the mitigation/remediation of arsenic in drinking water.
Ellis, J. and Garelick, H. 2009. Multi-criteria analysis for the assessment of options for the mitigation/remediation of arsenic in drinking water. in: Garelick, H. and Jones, H. (ed.) Reviews of environmental contamination and toxicology: an international perspective. New York Springer.
Evaluation study of the IHM project on the evaluation of the accreditation of health and social care managers: a pilot.
Weller, G. and Garelick, H. 2010. Evaluation study of the IHM project on the evaluation of the accreditation of health and social care managers: a pilot. London Middlesex University.
A novel enzymatic composition effective for prion degradation
Okoroma, E., Purchase, D., Garelick, H. and Abiola, O. 2011. A novel enzymatic composition effective for prion degradation. Society for General Microbiology Spring Conference. Harrogate, UK 11 - 14 Apr 2011
European MSc programs in nuclear sciences: to meet the need of stakeholders.
Skipperud, L., Salbu, B., Priest, N., Garelick, H., Tamponnet, T., Abbott, A. and Mitchell, P. 2011. European MSc programs in nuclear sciences: to meet the need of stakeholders. Nuclear Engineering and Design. 241 (4), pp. 1013-1017. https://doi.org/10.1016/j.nucengdes.2010.03.018
Keratin degradation by proteolytic microorganisms isolated from activated sludge and farmyard manure: possible application in decontamination of prion protein
Purchase, D., Garelick, H., Okoroma, E., Christen, H. and Abiola, O. 2007. Keratin degradation by proteolytic microorganisms isolated from activated sludge and farmyard manure: possible application in decontamination of prion protein. BAGECO 9: 9th Symposium on Bacterial Genetics and Ecology. Wernigerode, Germany
The development of work based learning for sustainable environmental education.
Garelick, H., Rounce, K. and Garnett, J. 2007. The development of work based learning for sustainable environmental education. World Environmental Education Congress 2007. Durban, South Africa 02 - 06 Jul 2007
Remediation technologies for the removal of arsenic from water and wastewater
Garelick, H., Bollinger, J., Bux, K., Caussy, D., Dybowska, A., Ellis, J., Feldmann, J., Jones, H., Priest, N., Shevah, Y., Sneddon, R., Valsami-Jones, E. and Visoottiviseth, P. 2005. Remediation technologies for the removal of arsenic from water and wastewater. 43rd IUPAC General Assembly. Beijing, China 13 - 21 Aug 2005
The development of a doctorate in Professional Studies in Health.
Rounce, K., Garelick, H., Vernon, L. and Portwood, D. 2005. The development of a doctorate in Professional Studies in Health. in: Rounce, K. and Workman, B. (ed.) Work based learning in health care: applications and innovations. Kingsham Press.
Investigation of the safety and efficacy of Chinese herbs traditionally used to treat inflammatory diseases
Appiah, S., Kokubun, T., Bremner, P., Heinrich, M., Bell, C. and Simmonds, M. 2003. Investigation of the safety and efficacy of Chinese herbs traditionally used to treat inflammatory diseases. 10th Annual Symposium on Complementary Health Care. London, UK 21 - 22 Nov 2003
Herbal alternatives to bear bile: effects of scutellaria baicalensis Georgi on IL-6 promoter and CYP3A4 activities.
Appiah, S., Bremner, P., Kokubun, T., Russell, M., Bell, C., Heinrich, M. and Simmonds, M. 2006. Herbal alternatives to bear bile: effects of scutellaria baicalensis Georgi on IL-6 promoter and CYP3A4 activities. 13th Annual Symposium on Complementary Health Care. Exeter, UK 12 - 14 Dec 2006
Plant substances as alternatives for animal products in traditional medicines.
Bell, C., Simmonds, M., Appiah, S. and Howes, M. 2006. Plant substances as alternatives for animal products in traditional medicines. London Department for the Environment, Food and Rural Affairs.
Sanitation and disease: health aspects of excreta and wastewater management.
Feachem, R., Bradley, D., Garelick, H. and Mara, D. 1983. Sanitation and disease: health aspects of excreta and wastewater management. Published for the World Bank by Wiley.
Water and health. [Chapter 6 of 'Sustainable water: chemical science priorities summary report']
Green, C., Donner, E., Faulkner, H., Garelick, H., Jones, H., Revitt, D. and Lundy, L. 2007. Water and health. [Chapter 6 of 'Sustainable water: chemical science priorities summary report']. Royal Society of Chemistry.
Safe water.
Garelick, H. 2002. Safe water. in: Dawood, R. (ed.) Travellers' health: how to stay healthy abroad. OUP.
Pollutant biodegradation potentials on airport surfaces.
Revitt, D., Garelick, H. and Worrall, P. 2002. Pollutant biodegradation potentials on airport surfaces. in: Strecker, E. and Huber, W. (ed.) Global solutions for urban drainage. American Society of Civil Engineers.
Existing competence and infrastructure in radiation protection training at postgraduate level within the EU and new entrant states.
Mitchell, P., Bowden, L., Vintro, L., García-Tenorio, R., Garelick, H., Holm, E., Kovacs, T., Kovats, N., Priest, N., Salbu, B., Skipperud, L. and Tamponnet, C. 2005. Existing competence and infrastructure in radiation protection training at postgraduate level within the EU and new entrant states. ETRAP2005 Conference (3rd International Conference on Education and Training in Radiological Protection). Brussels, Belgium 23 - 25 Nov 2005
Keratinase production by proteolytic micro-organisms in activated sludge and farmyard waste.
Okoroma, E., Purchase, D., Garelick, H. and Abiola, O. 2008. Keratinase production by proteolytic micro-organisms in activated sludge and farmyard waste. Society for General Microbiology, Autumn Meeting. Trinity College, Dublin, Ireland 08 - 11 Sep 2008
Bacterial keratinase: prospects for prion degradation.
Okoroma, E., Purchase, D., Garelick, H. and Abiola, O. 2009. Bacterial keratinase: prospects for prion degradation. Society for General Microbiology, Spring Meeting. Harrogate, UK 30 Mar - 02 Apr 2009
Mitigating arsenic pollution: bridging the gap between knowledge and practice
Garelick, H. and Jones, H. 2008. Mitigating arsenic pollution: bridging the gap between knowledge and practice. Chemistry International. 30 (4).
Organisational involvement in supporting the learned professional
Weller, G., Garelick, H., Naylor, D. and Sherry, R. 2010. Organisational involvement in supporting the learned professional. Work Based Learning e-Journal International. 1 (1), pp. 106-124.
A biokinetic model to describe the distribution and excretion of arsenic by man following acute and chronic intakes of arsenite/arsenate compounds by ingestion.
Adeyemi, A., Garelick, H. and Priest, N. 2010. A biokinetic model to describe the distribution and excretion of arsenic by man following acute and chronic intakes of arsenite/arsenate compounds by ingestion. Human and Experimental Toxicology. 29 (11), pp. 891-902. https://doi.org/10.1177/0960327110364912
Antimicrobial resistance of campylobacter species isolated from edible bivalve molluscs purchased from Bangkok markets, Thailand
Soonthornchaikul, N. and Garelick, H. 2009. Antimicrobial resistance of campylobacter species isolated from edible bivalve molluscs purchased from Bangkok markets, Thailand. Foodborne Pathogens and Disease. 6 (8), pp. 947-951. https://doi.org/10.1089/fpd.2008.0236
Degradation of scrapie infected brain homogenateby a novel bacterial keratinase
Okoroma, E., Purchase, D., Garelick, H., Jen, A., Morris, R. and Abiola, O. 2009. Degradation of scrapie infected brain homogenateby a novel bacterial keratinase. Prion 2009. Chalkidiki, Greece 23 - 25 Sep 2009
A multi-criteria approach for assessing options to remediate arsenic in drinking water
Ellis, J. and Garelick, H. 2009. A multi-criteria approach for assessing options to remediate arsenic in drinking water. in: Garelick, H. and Jones, H. (ed.) Reviews of environmental contamination: international perspectives on arsenic pollution and remediation New York Springer.
Constructed wetland control of BOD levels in airport runoff
Adeola, S., Revitt, D., Shutes, B., Garelick, H., Jones, H. and Jones, C. 2009. Constructed wetland control of BOD levels in airport runoff. International Journal of Phytoremediation. 11 (1), pp. 1-10. https://doi.org/10.1080/15226510802363220
Work based learning for the development of the chemistry professional.
Garelick, H., Page, A. and Weller, G. 2008. Work based learning for the development of the chemistry professional. 2nd International IUPAC Conference on Green Chemistry. 14 - 19 September 2008
Arsenic pollution sources
Garelick, H., Jones, H., Dybowska, A. and Valsami-Jones, E. 2008. Arsenic pollution sources. in: Garelick, H. and Jones, H. (ed.) Reviews of environmental contamination: international perspectives on arsenic pollution and remediation New York Springer.
Resistance to three antimicrobial agents of Campylobacter isolated from organically- and intensively-reared chickens purchased from retail outlets
Soonthornchaikul, N., Garelick, H., Jones, H., Jacobs, J., Ball, D. and Choudhury, M. 2006. Resistance to three antimicrobial agents of Campylobacter isolated from organically- and intensively-reared chickens purchased from retail outlets. International Journal of Antimicrobial Agents. 27 (2), pp. 125-130. https://doi.org/10.1016/j.ijantimicag.2005.09.020
Remediation technologies for arsenic contaminated drinking waters.
Garelick, H., Dybowska, A., Valsami-Jones, E. and Priest, N. 2005. Remediation technologies for arsenic contaminated drinking waters. Journal of Soils and Sediments. 5 (3), pp. 182-190. https://doi.org/10.1065/jss2005.06.140
An investigation into arsenic(V) removal from aqueous solutions by hydroxylapatite and bone-char.
Sneddon, I., Garelick, H. and Valsami-Jones, E. 2005. An investigation into arsenic(V) removal from aqueous solutions by hydroxylapatite and bone-char. Mineralogical Magazine. 69 (5), pp. 769-780. https://doi.org/10.1180/0026461056950287
Minimum requirements for reporting analytical data for environmental samples.(IUPAC Technical Report).
Egli, H., Dassenakis, M., Garelick, H., Grieken, R., Peijnenburg, W., Klasinc, L., Kördel, W., Priest, N. and Tavares, T. 2003. Minimum requirements for reporting analytical data for environmental samples.(IUPAC Technical Report). Pure and Applied Chemistry. 75 (8), pp. 1097-1106. https://doi.org/10.1351/pac200375081097
Hydrocarbon removal in an experimental gravel bed constructed wetland
Shutes, B., Katima, J., Omari, K., Revitt, D. and Garelick, H. 2003. Hydrocarbon removal in an experimental gravel bed constructed wetland. Water Science & Technology. 48 (5), pp. 275-282. https://doi.org/10.2166/wst.2003.0333
An assessment of the toxicity of some pesticides and their metabolites affecting a natural aquatic environment using the Microtox (TM) system
Amoros, I., Connon, R., Garelick, H., Alonso, J. and Carrasco, J. 2000. An assessment of the toxicity of some pesticides and their metabolites affecting a natural aquatic environment using the Microtox (TM) system. Water Science & Technology. 42 (1-2), pp. 19-24. https://doi.org/10.2166/wst.2000.0285
Comparison and recovery of escherichia coli and thermotolerant coliforms in water with a chromogenic medium incubated at 41 and 44.5°C
Alonso, J., Soriano, A., Carbajo, O., Amoros, I. and Garelick, H. 1999. Comparison and recovery of escherichia coli and thermotolerant coliforms in water with a chromogenic medium incubated at 41 and 44.5°C. Applied Environmental Microbiology. 65 (8), pp. 3746-3749.
The microbiology associated with glycol removal in constructed wetlands
Chong, S., Garelick, H., Revitt, D., Shutes, B., Worrall, P. and Brewer, D. 1999. The microbiology associated with glycol removal in constructed wetlands. Water Science & Technology. 40 (3), pp. 99-107. https://doi.org/10.2166/wst.1999.0145
Quantitative determination of escherichia coli in water using CHROMagar® E. coli
Alonso, J., Amoros, I., Chong, S. and Garelick, H. 1996. Quantitative determination of escherichia coli in water using CHROMagar® E. coli. Journal of Microbiological Methods. 25 (3), pp. 309-315. https://doi.org/10.1016/0167-7012(96)00002-4
Preparation and immunogenicity of an inactivated hepatitis A vaccine
Pellegrini, V., Fineschi, N., Matteucci, G., Marsili, I., Nencioni, L., Puddu, M., Garelick, H. and Zuckerman, A. 1993. Preparation and immunogenicity of an inactivated hepatitis A vaccine. Vaccine. 11 (3), pp. 383-387. https://doi.org/10.1016/0264-410X(93)90204-B
Characterization of a hepatitis A virus strain suitable for vaccine production
Fineschi, N., Cavalieri, F., Garelick, H., Prugnola, A., Pellegrini, V. and Zuckerman, A. 1991. Characterization of a hepatitis A virus strain suitable for vaccine production. Journal of Hepatology. 13, pp. S146-S151. https://doi.org/10.1016/0168-8278(91)90048-G
Persistence of hepatitis A virus in fulminant hepatitis and after liver transplantation.
Fagan, E., Yousef, G., Brahm, J., Garelick, H., Mann, G., Wolstenholme, A., Portmann, B., Harrison, T., Mowbray, J., Mowat, A., Zuckerman, A. and Williams, D. 1990. Persistence of hepatitis A virus in fulminant hepatitis and after liver transplantation. Journal of Medical Virology. 30 (2), pp. 131-136. https://doi.org/10.1002/jmv.1890300210
Cytotoxicity of fusobacterium ulcerans
Adriaans, B. and Garelick, H. 1989. Cytotoxicity of fusobacterium ulcerans. Journal of Medical Microbiology. 29 (3), pp. 177-180. https://doi.org/10.1099/00222615-29-3-177
Comparison of edmonston-zagreb and schwarz strains of measles vaccine given by aerosol or subcutaneous injection
Khanum, S., Garelick, H., Nasir, U., Mann, G. and Tomkins, A. 1987. Comparison of edmonston-zagreb and schwarz strains of measles vaccine given by aerosol or subcutaneous injection. The Lancet. 329 (8525), pp. 150-153. https://doi.org/10.1016/S0140-6736(87)91978-7
Concentration of virus from tap water at ambient salt and pH levels using positively charged filter media
Garelick, H. and Scutt, J. 1981. Concentration of virus from tap water at ambient salt and pH levels using positively charged filter media. Water Research. 15 (7), pp. 815-816. https://doi.org/10.1016/0043-1354(81)90134-2