/library/oar/handle/123456789/123153 2026-06-12T17:36:31Z /library/oar/handle/123456789/135065 Title: Proposing an educational framework for the specialisation as a responsible person in pharmaceutical processes Abstract: This work and its abstract are both under embargo until the restriction is lifted. Description: Ph.D.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/132989 Title: Clinical pharmacy services within an interdisciplinary model of care in adult oncology Abstract: Identifying effective clinical pharmacist contributions within the provision of pharmaceutical services, enhances outcomes of therapy and supports interdisciplinary oncology patients’ management. The aim of this project was to develop, implement and evaluate a pharmaceutical care model within oncology, reflecting the relevant contribution of pharmacists through optimisation of patient care. The objectives were to undertake a gap analysis assessing current pharmaceutical service with established practice guidelines, to develop a standard operating procedure (SOP) for the service provision, and to implement a pharmaceutical care model and consolidate it. The research was divided into three phases. The first two phases included the evaluation of the existing policy framework, gap-finding and identification of weaknesses and opportunities. An SOP was completed and consequently, a pharmaceutical care model was constructed through adoption and adaptation of guidelines obtained from various international bodies and validated by an expert panel (n=4). Phase three of the research involved the implementation of the developed model, whereby the application of the developed SOP was undertaken across the compounding unit and oncology wards over a period of two months. This involved a thorough review of each individual patient medication record and identification of any pharmaceutical care issues. These issues were then classified using the PCNE (Pharmaceutical Care Network Europe) classification. Findings from the gap analysis (Phase 1) were that 29 of the 75 sub-sections of the gap-finding instrument, which pertain to the duties of a clinical pharmacist working in the ward, were not carried out fully, neither in the oncology ward nor at the compounding unit by any health care professional. The developed SOP (Phase 2), which consists of three dimensions, namely patient parameters, pharmacotherapeutic choice including dosing, and drug delivery systems, comprised three main components: the validation of the drug dosage and regimen in accordance with the indication, the validation of the prescribed drug delivery method, and the verification of the demographic information submitted by the doctor on the prescription. For each patient, in order to track cumulative doses and to note any changes from prior cycles, data from each prescription was entered into a synoptic patient medication record. For the implementation aspect (Phase 3), out of the 307 cases investigated, 72 drug related problems (DRPs) were identified. These DRPs were categorised into three sections: the occurrence of side effects (n=38, 53%), namely hypersensitivity reactions, incorrect dosage of pre-medication, and incorrect administration rate; issues with dose selection (n=28), the most common of which was the administration of a high dose; as well as issues with drug selection (n=6). These identified drug related problems were shared with the doctors, and the change or rationale for their decision was then reflected on the prescription. Expanding the pharmacist contribution to oversee a holistic patient approach within oncology pharmacotherapy management strengthens the interprofessional care model that streamlines patient needs within a personalised patient approach. This phased study design was intended to spearhead the transformation from a product-centric to a patient-centric approach within hospital oncology service in a controlled and solid manner, respecting principles of change management dynamics. Description: Pharm.D.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/132981 Title: Establishing a pharmacist-led helpline service for paediatric oncology patients Abstract: The pharmacist has a key role in detecting, preventing, and resolving drug-related problems (DRP’s), and the pharmacy profession shoulders a crucial role in the safe and effective provision of patient-centred pharmacotherapy. It is noted that differences exist between patients who are receiving treatment at hospital and those who are discharged on treatment at home. The aim of this research was to establish a pharmacist-led helpline framework for paediatric oncology patients. The objectives were to evaluate the expectations of physicians, nurses, and parents/legal guardians of the proposed service; to compile and validate the tools required to run the helpline service; to develop a quality management system required to run the service and to identify the training needs for pharmacists that are required to support the helpline. This study wasset at the Paediatric-Adolescent Oncology ward within Sir Anthony Mamo Oncology Centre (SAMOC) at Mater Dei Hospital (MDH). The methodology was divided into three phases. Phase one involved a literature review exercise identifying the information required for the development of the tools to be used for the pharmacist-led helpline. Phase two focused on the development and validation of the tools such as pre-service gap analysis questionnaires and a post-service questionnaire. During Phase two, the training needs for pharmacists providing the service of the pharmacist-led helpline were also identified through a focus group. Phase three of the research focused on the development of a quality management system (QMS) including required standard operating procedure (SOP) to support the implementation of the pharmacist-led helpline for paediatric oncology patients. Study outcomes include the documentation required to run the pharmacist-led helpline namely the helpline documentation sheet, the referral form, the post service evaluation questionnaire and the SOP. From the pre service questionnaire results, it was recorded that a pharmacist-led helpline service is an essential support service for parents/caregivers of paediatric oncology patients from both the healthcare professionals’ perspective as well as the parents’/caregivers’ perspective. All participants who answered the questionnaires agreed unanimously. Lack of knowledge in the parents/caregivers cohort, about the pharmacist’s expertise about medicines was noted. This research provided a link between paediatric oncology patients within the community and the hospital team by enabling response to the patients’ needs in a more timely and efficient manner. The developed framework can be adapted for use in other clinical settings. Description: Pharm.D.(Melit.) 2024-01-01T00:00:00Z /library/oar/handle/123456789/132980 Title: Accessibility of unavailable medication Abstract: Accessibility and availability to adequate treatment always impacted public health, especially in the aftermath of geopolitical and pandemic exigencies. This research aims to establish an evidence-based framework that provides a rational and prompt medicine accessibility strategy based on availability while meeting the needs of the patients. The research design involved two phases, a retrospective quantitative analysis of medicinal sales over the previous decade from within the Mater Dei Hospital (MDH). A trend and statistical analysis were carried out for each medication. Graphs and statistical results generated allowed the identification of positive and negative correlations across the data collected. It was subsequently distinguished that the ten most requested statistically significant medications exhibited the highest positive correlation coefficients across the duration of data collected. These preparations are potassium bicarbonate and chloride effervescent tablets, phenobarbital sodium 30mg tablets, propranolol 10mg, cyclizine 50mg, labetalol 200mg, acetazolamide 250mg tablets, propranolol 10mg, nifedipine 10mg modified release tablets, pentoxifylline 400mg tablets, iron preparation syrup and metoprolol 100mg tablets. Additionally, data collected also provided the opportunity to identify medications with a negative correlation. Notably, clozapine 100mg tablets and methylphenidate 10mg tablets exhibited the strongest negative correlations. The second phase related to the thematic analysis of data gathered across focus groups from healthcare professionals representing different specialities or fields. Each focus group represented the surgical, medical, intensive care, operating theatre and pharmacy settings within the MDH. Data collected identified six main challenges encountered across the listed clinical areas affecting the accessibility and availability aspects of medications. Primarily acknowledging the need for communication and collaboration across all stakeholders. Additionally, the data collected aided in developing a local evidence-based framework to safeguard treatment accessibility while maintaining an updated healthcare aspect. The framework captures operational and therapeutic assessments to aid in the prior identification of drug shortages and mitigation strategies. Framework also integrates an impact analysis, capturing the importance of the identification and logistical processes associated with ensuring the availability and accessibility of appropriate medication. The importance of constant communication among all stakeholders for the implementation and prevention of drug shortages is highlighted. In conclusion, this study identified frequent medications requested from the MDH pharmacy from within the community. The findings provide an opportunity to increase the accessibility and availability of medicines to the local community by private community pharmacy suppliers. Description: Pharm.D.(Melit.) 2024-01-01T00:00:00Z