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\begin{document}

\title{INFRINGEMENT OF CLINICAL PHARMACIST'S AUTHORITY}



\author[1]{Fitriana Mawardi}%
\author[2]{Ayuningtyas Lestari}%
\author[2]{Hari Kusnanto}%
\author[3]{Elsa Sasongko}%
\author[3]{Dany Hilmanto}%
\affil[1]{Ahmad Dahlan University}%
\affil[2]{Gadjah Mada University Faculty of Medicine Public Health and Nursing}%
\affil[3]{Padjadjaran University}%


\vspace{-1em}



  
  \date{May 27, 2024}


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\begin{abstract}
Clinical pharmacists are health care practitioners who have advanced
education and training in comprehensive medication management. Clinical
pharmacists participate in the management of specific medications or
individual disease states and collaborate with other health care team.
Despite the clinical pharmacist participate in healthcare team, there
are several cases of challenge in the interprofessional relationship
with other healthcare team especially related drug management. The role
of clinical pharmacists could be improved by increasing
interprofessional communication between doctors and clinical pharmacist
in the healthcare system. Previous studies reported that physicians were
comfortable with pharmacists detecting and preventing prescription
errors, but were uncomfortable with them recommending drug therapy to
patients. Acceptance of pharmacists' suggestions by prescribers is a
necessary component of the evaluation of clinical pharmacy services.%
\end{abstract}%



\sloppy


\textbf{INFRINGEMENT OF CLINICAL PHARMACIST'S AUTHORITY}

\textbf{Fitriana Mawardi\textsuperscript{1}, Ayuningtyas S
Lestari\textsuperscript{2}, Hari Kusnanto\textsuperscript{3}, Elsa P S
Sasongko\textsuperscript{4}, Dany Hilmanto\textsuperscript{5}}

\textsuperscript{~1}Public Health Department, Faculty of Medicine,
Universitas Ahmad Dahlan, Indonesia

\textsuperscript{2}Academic Hospital Universitas Gadjah Mada,
Yogyakarta, Yogyakarta Province, Indonesia

3Community and Family Medicine Department, Faculty of Medicine, Public
Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Yogyakarta
Province, Indonesia

\textsuperscript{4}Public Health Department, Faculty of Medicine,
Universitas Padjadjaran, West Java, Indonesia

\textsuperscript{5}Pediatric Department, Faculty of Medicine,
Universitas Padjadjaran, West Java, Indonesia

\textbf{Correspondence Information:}

Dr. Fitriana Mawardi, MD., M.Sc.FM., Sp.KKLP

Public Health Department Faculty of Medicine, Universitas Ahmad Dahlan,
Indonesia

Kampus 4, Kragilan, Tamanan, Kec. Banguntapan, Kabupaten Bantul, Daerah
Istimewa Yogyakarta, Indonesia

fitriana@med.uad.ac.id

\textbf{Abstract}

Clinical pharmacists are health care practitioners who have advanced
education and training in comprehensive medication management. Clinical
pharmacists participate in the management of specific medications or
individual disease states and collaborate with other health care team.
Despite the clinical pharmacist participate in healthcare team, there
are several cases of challenge in the interprofessional relationship
with other healthcare team especially related drug management.

The role of clinical pharmacists could be improved by increasing
interprofessional communication between doctors and clinical pharmacist
in the healthcare system. Previous studies reported that physicians were
comfortable with pharmacists detecting and preventing prescription
errors, but were uncomfortable with them recommending drug therapy to
patients. Acceptance of pharmacists' suggestions by prescribers is a
necessary component of the evaluation of clinical pharmacy services.

\textbf{Keyword:} Medication safety, patient safety, pharmacy

Clinical pharmacists are licensed professionals with advanced education
and training who work in all variety of patient care settings with a
focus on comprehensive medication management . Clinical pharmacists
focused on achieving optimal use of medications, emphasizing dosing,
monitoring, identification of adverse effects, and economic efficiency
to achieve the best possible patient outcomes. Globally, clinical
pharmacists are becoming more and more recognized as vital members of
the acute care and ambulatory patient care teams .

Clinical pharmacists participate in the management of specific
medications or individual disease states and collaborate with the other
health care team. As the example, patients benefit from team-based care
through improved control of blood pressure, and a higher proportion of
patients achieved controlled blood pressure when a pharmacist was part
of the team .

Healthcare teams can have different members, but the person best suited
for the job is usually given the most authority and responsibility for
that particular aspect of care. The culture of trust, shared objectives,
role and responsibility, good communication, and respect for one another
are essential to the effectiveness of a healthcare team. Team activities
should be guided by the patient's best interests .

Even though clinical pharmacists are members of healthcare teams, there
are still a number of obstacles in their interprofessional
relationships, particularly when it comes to medication management.
Increasing interprofessional communication between physicians and
clinical pharmacists within the healthcare system could enhance the role
of clinical pharmacists. Professional pharmacists are trained to analyse
and judge the accuracy of medication information. As a result, the
clinical pharmacist can be a very helpful source of information about
the safety and effectiveness of drugs. The physicians concurred strongly
that the clinical pharmacist was a trustworthy source of information
about medications. Clinical pharmacists were frequently asked by
physicians to provide information on medication alternatives,
interactions, availability, and side effects .

The majority of hospital doctors were familiar with the clinical
pharmacist, but they were unaware of the existence of clinical pharmacy
services in their hospital. Hospital doctors were satisfied that
clinical pharmacists were capable of providing clinical pharmacy
services to evaluate and assess a patient's drug therapy and monitor the
pharmacotherapeutic needs of the patient in order to ensure the
appropriate and safe use of drugs. However, they indicated that clinical
pharmacy is not practised in a uniform manner in many hospitals .

Most doctors were unwilling to accept a clinical pharmacist's decision
to change a prescription, but a small minority of doctors could accept
pharmacist recommendations and strongly agreed with the clinical
pharmacist's modification of a prescription. However, a different study
indicated that although most doctors support clinical pharmacists'
patient counselling, they are against pharmacists writing prescriptions.
According to earlier research, doctors felt at ease when pharmacists
identified and avoided prescription errors, but not so much when they
suggested medication therapy to patients. Prescribers' acceptance of
pharmacist recommendations is a crucial element in assessing clinical
pharmacy services .

Prescribers' reluctance to accept recommendations from clinical
pharmacists can be attributed to a number of factors, such as a lack of
knowledge about pharmacokinetic parameters on the part of the physician,
a negative attitude toward clinical pharmacy, and the quality of the
suggestions. As a result, clinical pharmacists and physicians must
collaborate to determine which medication is best for each patient's
needs. Unfortunately, there are many barriers that prevent clinical
pharmacists from making a positive impact on healthcare. These include
doctors' low acceptance of clinical pharmacists' clinical roles, a lack
of communication between doctors and pharmacists, patients' lack of
trust in clinical pharmacists' ability to provide patient care, concerns
about patient privacy and confidentiality, and a lack of support from
hospital administration for collaboration between doctors and clinical
pharmacists .

\textbf{CONCLUSION}

Clinical pharmacists are health care practitioners who have advanced
education and training in comprehensive medication management focused on
achieving optimal use of medications, emphasizing dosing, monitoring,
identification of adverse effects, and economic efficiency to achieve
optimal patient outcomes. Clinical pharmacists participate in the
management of specific medications or individual disease states and
collaborate with the other health care team. The clinical pharmacist
should conduct the drug management not drug prescription.

\textbf{BIBLIOGRAPHY}

\textbf{Funding statement:}We declare that we do not have any sponsor or
funding for this study\textbf{Conflict of interest disclosure:}We
declare there are no potential conflicts of interest of this article

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