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Pharmaceutical care necessitates significant efforts from patients, informal caregivers, the interprofessional team of health care professionals and health care system administrators. Collaboration, mutual respect and agreement amongst all stakeholders regarding responsibilities throughout the complex process of pharmaceutical care is needed before patients can take full advantage of modern medicine. Based on the literature and policy documents, in this position paper, we reflect on opportunities for integrated evidence-based pharmaceutical care to improve care quality and patient outcomes from a nursing perspective.
2. Advices to Strengthen Integrated, Evidence-Based Pharmaceutical Care
Offer a framework for nurses’ contributions to integrated pharmaceutical care.Nurses need to communicate clearly on how they can and do contribute to integrated pharmaceutical care.
Expand research on nursing interventions in pharmaceutical care.
Expand research on interprofessional collaboration in pharmaceutical care.As interprofessional collaboration in pharmaceutical is so fundamental to the quality of integrated, people-centred care and patient outcomes, research should continue to focus on facilitators of high-quality interprofessional pharmaceutical care  and the barriers to bringing this into practice. This research should also consider how gender, gender-based assumptions, stereotypes and preconceptions still influence participants .
Ensure that available evidence is implemented in practice.Substantial parts of evidence resulting from research are not translated into practice and therefore fail to generate expected outcomes. Therefore, extra efforts from all professionals involved (clinicians, managers, regulators and policy makers) are needed to ensure research results are implemented in clinical practice .
Create and maintain an international network of nurses with expertise in pharmaceutical care.Such a network serves not only to enhance collaboration, exchange initiatives and disseminate information but also to provide a point of contact for other professional groups to identify nurse representatives to be engaged in research and policy making on pharmaceutical care. Engaging in debates at this level will develop interprofessional frameworks for the implementation of pharmaceutical care and strengthen nurses’ contribution to research, policy, education and clinical practice.
Collaborate with representatives of other disciplines to develop a framework for interprofessional pharmaceutical care.The framework should be developed and co-designed as a collaboration between all disciplines involved in pharmaceutical care. The goals are optimum care quality and patient outcomes, allowing for contextual factors, such as expertise, treatment availability and costs. Knowledge gained from implementation science models, such as the CICI framework, can be harnessed to improve the usability of such frameworks  and uncover and address any challenges in implementing the framework.
Ensuring best use of medicines
Eliminating inequityThe inequity in the outcomes and processes of care is often based on socio-economic or territorial inequalities, resulting in restricted access to quality health care services. Nurses have potential to contribute to pharmaceutical care and to deliver safe and optimal pharmaceutical care . There is little evidence that nurse substitutions  or nurse practitioners’ care  or costs  differ from those of doctors, particularly when prescribing practices are compared. The evidence suggests that non-medical prescribing is safe and can provide beneficial outcomes , even though nurses tend to prescribe less than doctors  and have reservations regarding working unsupported .Furthermore, nurses, together with pharmacists and physicians, need to explicitly take into account the impact of social diversity when researching and developing interventions or guidelines or policies or providing education in pharmaceutical care. Interprofessional collaboration with shared goals on the elimination of inequality in pharmaceutical care can help us move forward.
Promoting patient safetyPatient safety related to pharmaceutical care is suboptimal . The adoption of standardised international pharmacotherapy curricula and assessments for pre- and post-registration nurse education would provide the foundation for nurses to meet practice requirements and realise their full potential, whilst maintaining comparable standards of care, not only at national levels, but also at European and international levels . Avoiding unsafe medication practices, minimising avoidable harm caused by medicines and meeting the WHO third patient safety challenge  requires a focus on patient outcomes.
The entry is from 10.3390/ijerph18115973
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