Clinical Pharmacokinetics: Perceptions of Hospital Pharmacists in Palestine about how it is Taught and Applied

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Aqel, Rafeef
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جامعة النجاح الوطنية
Background: The American society of health-system pharmacists (ASHP) defined clinical pharmacokinetic (CPK) as "the application of pharmacokinetic (PK) principles to the safe and effective therapeutic management of drugs in an individual patient". Where the main aims of CPK are optimizing efficacy and reducing toxicity. CPK is one of the main courses in pharmacy curriculum, as graduating pharmacists will be responsible of initiating and adjusting drug doses and making decisions about drugs that need therapeutic drug monitoring (TDM) when they go to their work places. Application of TDM in many studies showed improvement in patient outcomes including achieving drug levels within a fewer number of days, shortening length of hospitalization, reducing mortality and morbidity, shortening febrile period and increasing medication safety. In this study we looked at pharmacist's perceptions and training background in PK courses contents they received during their undergraduate pharmacy programs. We also aimed to determine the barriers experienced by the pharmacists when applying PK principles in their current practice and explore the influence of the respondents’ characteristics on their perception about clinical PK. Method: This is a descriptive cross sectional self-administered questionnaire that targeted licensed hospital pharmacists in most hospitals under the umbrella of the Ministry of Health (MOH) in Palestine, in addition to pharmacists working in most private hospitals in the West Bank (WB) and Jerusalem. The questionnaire was prepared to obtain the relevant answers that contribute to the final results. The data was collected between August and November of 2018. Results: In this study a total of 145 questionnaires were distributed among hospital pharmacists in Palestine. Most of the participants were female (78.6%) and the vast majority of participants (71.7%) had taken their first pharmacy degree from Palestine. PK courses were taught in 74.5% of the undergraduate programs with most of the courses (57.9%) covering basic PK principles. In addition 88.3% of participants hadn't received any PK related courses after graduation. While rating the degree to which various barriers hindered the application of PK principles in current practice, we found that the lack of PK related continuing education topics was the highest in importance category (55.2%). Furthermore, we had an agreement between more than half of pharmacists about adequacy, importance and relevance of PK courses in their undergraduate programs to current practice. Pharmacists who took their pharmacy degree from foreign countries other than Palestine were more agreed about adequacy, efficacy and way of teaching of CPK courses with significant association as (p < 0.05). Conclusions: Improving the depth and methods by which PK courses are taught, in addition to providing continuous education learning (CEL) for hospital pharmacists in PK will improve pharmacist's perception about PK courses and their application in clinical practice as only 11.7% of pharmacists had taken any related former courses after graduation, also having a CEL for other health care professionals will improve application of clinical pharmsicts role as poor understanding of PK by the health care professionals where one of the barriers that faced pharmacists in application PK.
pharmacokinetic, clinical pharmacists, barriers, curriculum.