https://www.um.edu.mt/library/oar/handle/123456789/477 Tue, 04 Aug 2026 16:37:45 GMT 2026-08-04T16:37:45Z https://www.um.edu.mt/library/oar/handle/123456789/148380 Title: Validation instruments for community pharmacy : pharmaceutical care for the third millennium Authors: Azzopardi, Lilian M. Abstract: This book presents a comprehensive framework for evaluating and improving the quality of professional services provided by community pharmacists. The book develops practical and scientifically grounded validation instruments designed to measure pharmacy performance, document pharmacist interventions, and demonstrate the contribution of pharmaceutical care to patient outcomes. Drawing on principles of quality assurance, outcome assessment, and community pharmacy practice, it outlines methods for assessing pharmacy settings, equipment, dispensing processes, patient counselling, response to minor ailments, and other key components of pharmaceutical service delivery. The volume also discusses the development and application of quantitative measurement systems that enable the systematic monitoring of professional standards and continuous quality improvement. Supported by case studies, survey instruments, and practical implementation strategies, the book provides pharmacists, educators, healthcare administrators, and policymakers with tools for establishing evidence-based validation programmes in community pharmacy settings. Sat, 01 Jan 2000 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148380 2000-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148254 Title: Quality care standards analysis Abstract: Quality in health care presents a range of interpretations including accreditation and certification, compliance with rules and regulations, meeting established levels, use of modern equipment, efficiency, and performing inspections. When taking into account a patient-oriented approach, quality of pharmacy services represents optimum patient care to meet patient’s needs. So, structures and processes are necessary to measure the patient care provided and, therefore, measure quality. [excerpt] Sat, 01 Jan 2005 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148254 2005-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148192 Title: Pharmacist-led ambulatory blood pressure monitoring in community pharmacy : an operational feasibility case series Authors: Vella, Michaela; Wirth, Francesca; Camilleri, Liberato; Azzopardi, Lilian M. Abstract: Objectives: To evaluate the operational feasibility of pharmacist-led ambulatory blood pressure monitoring (ABPM) in community pharmacy practice.; Materials and Methods: This operational feasibility case series recruited eligible participants from four community pharmacies located in three geographical districts in Malta over a three-month recruitment period. Process feasibility included recruitment uptake and participant acceptability. Management feasibility included the completion of a valid 24-hour ABPM recording and successful tracking of post-referral outcomes. Pragmatic post-hoc benchmarks were applied: uptake of at least 60%, completion of valid recordings of at least 80%, and post- referral outcome tracking of at least 80%. Exact 95% confidence intervals (CIs) were calculated using the Clopper-Pearson method.; Results: Ten of 20 invited participants consented, corresponding to an uptake rate of 50% (95% CI, 27.2–72.8%). Valid 24-hour ABPM recordings meeting the pre-defined recording quality criteria were obtained for 9 of the 10 participants, corresponding to a completion rate of 90% (95% CI 55.5–99.7). 4 participants were referred for physician review, and post-referral outcomes were obtained for all 4 participants, corresponding to a tracking rate of 100% (95% CI 39.8–100.0). Three of the 4 referred participants reported an intensification of their antihypertensive treatment.; Conclusion: Pharmacist-led ABPM in community pharmacies demonstrated operational feasibility regarding completion of valid recordings and post-referral tracking, although uptake requires improvement. Participant-reported treatment changes should be interpreted as exploratory signals, and larger implementation studies are warranted. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148192 2026-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/148136 Title: Pharmacists’ recommendations for fluid minimisation in critically ill patients Authors: Agius, Ruth; Vella Szijj, Janis; Azzopardi, Lilian M. Abstract: Background: Effective fluid management is essential to reduce the risk of fluid overload, which is associated with worse outcomes in critically ill patients. Intravenous fluids, including hidden fluids, are necessary and frequently used in the intensive care unit (ICU).1 Aim: To assess pharmacists’ interventions related to minimising hidden fluids for patients admitted to the ICU and evaluate the significance of these interventions in their ability to prevent potential adverse drug events (ADEs). Method: The research was conducted during three months in a mixed ICU of an acute general hospital, where clinical pharmacists participate in ward rounds as members of the multidisciplinary team. Recommendations made by pharmacists related to fluid minimisation were compiled. In collaboration with ICU physicians and nurses, the pharmacists suggested fluid minimisation interventions depending on clinical indication and the amount of hidden fluids being administered. The data was classified into the type of intervention, and was evaluated for potential prevention of an adverse drug event (ADE) by an expert panel of healthcare professionals. Results: Pharmacists intervened in minimising hidden fluids for 17 patients (10%) out of 164 patients admitted to the ICU over the three months. Fluid minimisation was required in patients with heart failure and pulmonary oedema, patients with severe renal impairment, patients with brain injury necessitating a neutral fluid balance, and patients with respiratory distress syndrome requiring a conservative fluid strategy to improve lung function, amongst others. Several interventions were recommended by pharmacists for each patient to reduce the total fluid intake, involving multiple medications. These included concentrating infusions when administering via a central venous catheter for all patients (n = 17), opting for a more fluid-restricted enteral feed (n = 5), and converting medications from intravenous to enteral route (n = 3). The recommendations successfully reduced fluid intake by 700 mL over 24 h for a patient with heart failure, and 820 mL over 24 h for a patient with a brain injury. The expert panel found these interventions had a medium probability (77%) or low probability (23%) of preventing a potential ADE. Conclusion: This study highlights the importance of pharmaceutical recommendations in targeted fluid minimisation strategies. The pharmacists' interventions to reduce hidden fluid in specific critically ill patients helped mitigate fluid overload and prevent potential ADEs in this patient group. Thu, 01 Jan 2026 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/148136 2026-01-01T00:00:00Z