Pharmaceutical services in primary health care. Quality of life challenges

Research Article

Pharmaceutical services in primary health care. Quality of life challenges

  • Laida Gallo Matos 1
  • Lázaro Rogelio Morell León 2
  • Dayma Margarita Clove Basulto 3
  • Adrian González Méndez 4

*Corresponding Author: Adrian González Méndez, Graduate in Health Technology Physical Therapy and Rehabilitation Profile. Assistant Professor. Associate Researcher at the University of Medical Sciences of Sancti Spiritus, Cuba.

Citation: Laida G. Matos, Lázaro R. Morell León, Dayma M C. Basulto, Adrian G. Méndez, (2024), Pharmaceutical services in primary health care. Quality of life challenges, J. General Medicine and Clinical Practice, 7(13); DOI:10.31579/2639-4162/204

Copyright: © 2024, Adrian González Méndez. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Received: 12 July 2024 | Accepted: 22 August 2024 | Published: 01 August 2024

Keywords: phc; pharmaceutical care; ops, pharmaceutical services.

Abstract

Introduction: During the last years of the 20th century, the functions and processes linked to medication logistics were perfected and strengthened, however, policies aimed at the rational use of medications and actions to implement all the measures were implemented much more slowly. processes aimed at patients, which are developed in pharmaceutical services. An objective always present in all these practices is to achieve the role of the pharmacist in health services, with emphasis on its importance in helping to satisfy the social need for effective and safe health care. 

Objective: Detail the action of the pharmacist and primary health care in pharmaceutical services in Cuba and the need for a paradigm shift. 

Methods: A descriptive study of bibliographic searches was carried out, for which primary and secondary sources of information in the medical newspaper library and various information centers were used, in indexed journals on the topic of pharmaceutical services. The sample was defined by scientific articles, degree theses and manuals in databases such as Google Scholar, Medline and Scielo related to Pharmaceutical Care topics; OPS, Pharmaceutical Services, in Spanish and English. 

Conclusions: pharmaceutical services must transform ways of working based on the guidance of the WHO/PAHO, improving themselves professionally to achieve the objectives set in relation to the integration of the pharmaceutical professional into the work of the health team in Primary Health Care (PHC). 

Introduction

During the last years of the 20th century, the functions and processes linked to medication logistics were refined and strengthened, however, policies aimed at the rational use of medications and actions to implement all the directed processes were implemented much more slowly. to patients, which are developed in pharmaceutical services.[1]. The American College of Clinical Pharmacy (ACCP) defined it as "a health sciences discipline in which pharmacists provide care to patients that optimizes drug therapy and promotes health, well-being, and the prevention of disease."[2]. After a few years of implementation, a critical reflection about clinical pharmacy led some pharmacists to conclude that there were no achievements with respect to the proposal of giving emphasis to the patient, given fundamentally because the majority of pharmaceutical practice was aimed at support the health team, focusing particularly on the medication and with hardly any interaction with the patient.[3].  In this context, Hepler and Strand proposed a novel philosophy of pharmaceutical practice, defined as Pharmaceutical Care (PA), which already implied a process where the pharmacist cooperates with the patient and other health professionals, assuming their responsibility, in achieving quality pharmacotherapy.[3]. 

All these practices at an international level did not encompass the full extension and development expected; when the main causes of their poor generalization are analyzed, many more external elements are found than the pharmacists' own technical-professional capacity, among which These include the insufficient availability of pharmaceutical professionals, isolation or lack of integration of pharmaceutical services (PS) into local health systems, inadequate structure of pharmacies, lack of pharmacist time due to the multiplicity of routine tasks they assume, many of which could be assumed by technicians, the need for systems, computer tools, sources of information and documentation, lack of support from governments and national authorities to implement FA policies, among others.[3]. 

An objective always present in all these practices is to achieve the role of the pharmacist in health services, with emphasis on its importance to contribute to satisfying the social need for effective, safe and economical health care, also highlighting the importance of the "teamwork method", something vital to obtain optimal performance of resources, both human and financial, to meet healthcare needs [4].

In 2006, an article titled "The Pharmacist and Public Health" 4 was published, in which an attempt was made to reflect on a group of factors that undermined the aspiration that the pharmacist could occupy his space as a true professional. in the Cuban health system. After 10 years, the reality that is observed is not far from what was seen back then, especially at the level of Primary Health Care (PHC), where their fundamental task should be to be part of the health team, directing their activity to guarantee proper use of medications by patients, participating in health education and prevention campaigns, aimed at promoting improved health and greater well-being of citizens, something still far away for today's pharmaceutical professional. In this article, it was pointed out that community pharmacists are in an optimal situation to carry out health prevention and promotion activities, since they have the possibility of communication and access to the public that is sometimes more difficult for other health professionals. Therefore, from the pharmacy users can be educated in order to reduce risk factors and modify their behaviors in a way that is favorable to health.[4].

None of these internationally developed models that were previously described have been implemented in Cuba in a generalized manner, with only a few isolated attempts with very good results; An example of this was the development of clinical pharmacy at the Amalia Simoni Hospital in Camagüey and in the provinces of Santiago de Cuba and Villa Clara [5,6]. led in these last two provinces by the Pharmacy Departments of the respective Universities.

It was also commented as a weakness in the work of the pharmacist in community pharmacies, that he was limited only to working with the medication, with little appreciation of his potential as a health promoter in the community. The development achieved by Pharmacoepidemiology and the creation of the Main Municipal Pharmacies, both very weakened in recent years, were given as positive examples; as well as the teaching figures of the Master's Degrees in Clinical Pharmacy and Pharmacoepidemiology as strengths for the development of pharmacists in Cuba, who continue to graduate professionals but are not capable "per se" of guaranteeing the training of all the professionals in charge of developing these models of pharmaceutical performance in Cuba.[4]. Finally, it is proposed that although a group of actions carried out were evident so that the primary care pharmacist had a place in improving the health of the population, it was still very far from providing the expected contribution of this professional [4]. something which currently remains with the same problems described at that time. Due to the above, the need arises to investigate the topic, so the objective is defined to detail the action of the pharmacist and primary health care in pharmaceutical services in Cuba and the need for a paradigm shift.

Method

A descriptive study of bibliographic searches was carried out, for which primary and secondary sources of information were used in the medical newspaper library and various information centers, in indexed journals on the topic of pharmaceutical services; as well as an exhaustive and continuous database search that included 73 articles from WHO/PAHO sites and drug regulatory agencies, among others. The universe was composed of articles in bibliographic databases such as Google Scholar, Medline and those provided by the Virtual Health Library by the Telematic Health Network in Cuba INFOMED; among them CUMED, LILACS, SCIELO, BIREME. The sample was defined by scientific articles in databases such as Pubmed, Medline, Scielo and others that were related to Pharmaceutical Care topics; OPS, Pharmaceutical Services. The articles had to be in Spanish and English. Of the 3 5 articles, 32 were eliminated from the final review due to non-compliance with the criteria established prior to the investigation. Finally, for this work the remaining 3 articles were analyzed.

Development

The pharmacist and Primary Health Care (PHC)

In 2007, when Dr. Margaret Chan assumed the General Directorate of the World Health Organization (WHO), she made the commitment to work on the development of PHC,7 by recognizing that the Member States, through their bodies, Regulators perceive the need to have more equitable, integrative and fair health systems, with a more comprehensive perspective on the effectiveness of the entire health system. Resolution WHA_62R_12.8 reinforces the commitment to continue working to strengthen health systems based on PHC and gives a specific mandate to WHO to support countries in this challenge. 7 Since that moment, PAHO/WHO has been working to reposition the renewed PHC strategy as an instrument for achieving Universal Health Coverage (UHC) where access to safe and effective medical products and technologies are part of one of the three fundamental dogmas. for CSU.[7]. Since the creation of the WHO, medicines have been considered priority inputs to achieve the right to the highest level of health.[7]. 

In 1977, the concept of "Essential Medicines" (EM) was launched and from the World Conference on Primary Health Care, they were considered one of the eight elements necessary to achieve the goal of health for all. Since then, the MEs have constituted one of the pillars of the formulation and implementation of national pharmaceutical policies, with a focus on public health and law.[7]. In 2008, the Pan American Health Organization (PAHO) began to promote an initiative to strengthen FS based on its development as an essential component within PHC, an activity promoted as part of the strengthening of health systems in the Americas.[7].

Despite the efforts and resources invested, access and rational use of medicines constitute a great challenge in most countries in the region. Among the main drawbacks we can mention the multiple problems that arise in management. of supplies, as well as inappropriate use of medications by both patients and users, as well as prescribers and dispensers.[7]. 

For these reasons, it is necessary to change the focus of drug policies and strategies, tending to develop "pharmaceutical policies" that until now only have the drug product strategy as their central axis. Therefore, the new vision of pharmaceutical services is to prioritize the individual, family and community (IFC), satisfying their health needs, seeking to guarantee comprehensive, integrated and continuous care of the population, having medicine as one of the elements essential, contributing to their equitable access and rational use.[7]. 

In 2009, a workshop sponsored by PAHO was held on the model of "Pharmaceutical Services based on Primary Health Care." The fundamental objective of which was to define the guidelines for the development of regional guidelines for the development of pharmaceutical services as an integral part of health services based on PHC. 19 professionals from different countries participated, including doctors, pharmacists and nurses, belonging to the Ministries of Health, Social Security, Academia, NGOs and PAHO. Professionals from the Dominican Republic, Nicaragua, Brazil, Colombia, Costa Rica, and experts from the WHO/PAHO with extensive experience in the pharmaceutical area were represented in this workshop.[7]. 

As a result of the workshop, the Vision of what we want to achieve in the region in relation to pharmaceutical services was defined, and it was written as follows: "pharmaceutical services, with social relevance, integrated into the health system based on PHC , that respond to the needs of the individual, the family and the community, with well-defined roles and functions that promote healthy lifestyles, access and rational use of medicines, contributing to their right to enjoy the highest possible level of health. health".[7].

As part of this initiative, the document "Guide for the development of pharmaceutical services based on PHC" was prepared, which was discussed at several expert meetings and submitted to public consultation. Likewise, the International Federation of Pharmacists (FIP) and the World Health Organization (WHO) updated Good Pharmacy Practices in 2011, which constitute quality standards for pharmaceutical services.[7].

These documents were the subject of discussion at meetings held in Costa Rica and Uruguay, organized jointly by PAHO, the Pharmaceutical Forum of the Americas (FFA) and the International Federation of Pharmacists (FIP), an experience that was later replicated in Argentina in 2012.[7]. 

As a result of all this, a PAHO/WHO position document was published in 2013 in relation to Pharmaceutical Services based on PHC, which defines pharmaceutical services as the "Set of actions in the health care system." health that seek to guarantee comprehensive, integrated and continuous care for the health needs and problems of the population, both individually and collectively, having medicine as one of the essential elements and contributing to its equitable access and rational use. These actions developed by the pharmacist, or under his coordination, incorporated into a health team and with community participation, have as their objective the obtaining of concrete health results with a view to improving the quality of life of the population". The categories, domains or groups of functions required for pharmaceutical practice are also defined, organized into four large groups:[8].

those linked to public policies, the organization, management of pharmaceutical systems and services.[8].

  • those linked to the medication.
  • those directly linked to the patient, family and community.
  • those linked to research and knowledge management.
  • those linked to professional performance. 

An interesting aspect discussed in this document is the reorganization of pharmaceutical services from a new perspective using process management.[8].

It is important to note that the "delivery of pharmaceutical services" is defined as a key process, because it is the one that implies the direct relationship with the user/patient. This process includes health promotion activities, dispensing, pharmacotherapeutic support, pharmacovigilance and support for responsible self-medication, processes that today in community pharmacies are not part of the priority tasks of professionals and technicians, fundamentally dedicated to trying to guarantee the presence of medications and their attention from a technical point of view.[8].

Subsequently, the strategic processes are defined that correspond to those that provide the organization's guidelines (policies and planning), as well as those that are not directly related to the patient, but contribute to their care. The activities of these processes are planning, implementation, management and evaluation of pharmaceutical services; the development and implementation of a quality management system for pharmaceutical services; participation in the selection of medications and in the evaluation of health technologies; providing information about medications; participation in the design, monitoring and evaluation of clinical trials; promoting permanent education of human resources and responding to situations of prevention and mitigation of disasters and health emergencies[8]. , practically none of these so-called strategic tasks do pharmacy professionals in Cuba currently actively participate in. It is very interesting to see how the activities that today are the center of the work of Cuban pharmacists, such as the management of the supply of medicines and other health technologies, the formulation and preparation of extemporaneous master preparations of medicines; the repackaging of medicine and other essential supplies, as well as the management of human and financial resources aspects; They are considered by the experts who prepare this document as support processes, which could perfectly be carried out by technical training personnel.[8].

Another aspect that is considered of great importance and designated as a critical success factor for the change of pharmaceutical services based on primary health care is the development of human resources competencies to be able to face the challenge of training part of the APS [8].  teams, something in which much remains to be done in the Cuban reality.

Another of the key work points to face the new realities, and which is considered of vital importance, is the updating of Pharmaceutical Regulation, for which it is essential that the essential regulatory functions can be carried out:[8].

  • legal/regulatory framework.
  • good practice standards.
  • surveillance mechanisms.
  • supervision and other mechanisms for compliance with the regulatory framework.[8].

Cuba has a strong and well-established regulatory system, which is governed by the work of the Center for State Control of Medicines, Equipment and Medical Devices (CECMED), as a Reference Regulatory Agency in the region, recognized both nationally and internationally, which has a very important weight in the Regulation of the areas of Industrial manufacturing, Distribution and Export and Import, but not for the activity of community and hospital pharmacy whose regulatory framework is fundamentally at the expense of the Directorate of Medicines and Health Technology of the Ministry of Public Health (MINSAP), does not present the same level of updating and development as that of CECMED.[8].

In this sense, in the month of March 2016, Resolution 88/2016 was approved by the MINSAP, which approves the General Regulation of Community Pharmacies [9]. which provides a legal framework for the functions that the pharmacist must perform, where each one is well classified. One of them, great emphasis is placed on dispensing, dispensary preparation, pharmaceutical care and pharmacovigilance; But this Regulation, in its article 7, assigns the pharmacist a group of economic-administrative activities that in practice result in technical tasks being displaced to the background. Another aspect that draws attention is that at no time is reference made to the PAHO/WHO call on the role of this professional in the actions of the PHC.[9]. 

Another point addressed in the PAHO/WHO document is ethics in pharmaceutical services, dividing it into three large groups: the medicalization of society, the inappropriate use of health technologies and the processes of capital accumulation in this sector [8].  In Cuba, work has been carried out in recent years on the development of a group of strategies aimed at minimizing the impact of the medicalization of society and achieving a more rational use of medicines, with the development since 1996 of Pharmacoepidemiology, However, there are still control aspects that must continue to be delved into to avoid the diversion of medicines and their illegal sale, phenomena that, despite the measures that have been taken at all levels, continue to weigh on the ethics of the professionals and technicians of the sector.[8].The WHO medicines strategy for the period 2008-2013 incorporates the orientation towards PHC, highlighting as a priority the use of scientific and operational evidence to support the renewal of PHC and increase national programs through identification and promotion of best practices. Selection for quality assurance and rational use of medicines for PHC, something in which Cuba had already shown results since the 1990s with the Pharmacoepidemiology strategy, a specialty that needs to rescue its achievements from previous decades, if it really is you want to obtain results in this aspect.[8]. 

Pharmaceutical services in Cuba

In a society like Cuba's, where there is no private pharmacy, there should be no pressure for the pharmaceutical professional regarding commercial profit, typical in any capitalist society, for which he would be in a position to dedicate all his efforts to the tasks of a true professional trained to improve the health of the population, a function that he has been performing without all his scientific potential being fully exploited.[4]. 

Every day the need to use this professional force, as an integral part of the multifactoriality of health, is becoming more evident, to contribute directly not only to the scientific and rational use of medicines in close collaboration with the rest of the health team, but also to to work as part of that team in achieving comprehensive health.[4]. 

It is the opinion of the authors of this article that among the factors that today constitute weaknesses that must be worked on to achieve the integration of the pharmaceutical professional into the PHC working group, are the following:[4]. 

  • Insufficient knowledge of the concept of a Pharmaceutical Service as part of the renewed PHC on the part of health professionals
  • The guidelines of health policies in the pharmaceutical area are mainly directed at the product
  • The insufficient preparation and demotivation of human resources in the SFs to be able to face the paradigm change
  • The predominant culture of patients who only believe doctors and hospitals and who in many cases see pharmacies as drug dispensing centers.
  • The lack of acceptance by the medical and nursing staff of the pharmacist as a member of the health team. 4

Need for a new paradigm

Society's growing expectations regarding health and health care translate into demands for services that are more focused on the group made up of the individual, family and community (IFC), a higher level of health care at the community level. and more effective participation in decisions [10]. Therefore, changes in Pharmacological Services cannot be less than such expectations.

The demographic transition brings with it an increase in life expectancy and non-communicable diseases [11]. along with the challenge of guaranteeing access to health care and the necessary therapeutic resources, including medicines. Therefore, it is necessary to adapt health systems and FS to recognize and different forms of communication, as well as action [12]. and new technologies that turn the act of prevention, diagnosis and treatment of diseases into a art. [13].

As part of the SF paradigm shift, the following is required: [8,13].

  • Full integration of the pharmacist into the PHC work group
  • Move from Pharmaceutical Care focused on the disease, towards Pharmaceutical Care focused on health, including promotion and prevention.
  • Transition from a Pharmaceutical Service focused on the medication, towards a Pharmaceutical Service focused on the individual, the family and the community
  • Achieve teamwork with the rest of the PHC professionals.
  • Update standards, guides and processes so that they are in line with the new paradigm.
  • Achieve adequate training of human resources and their sustainability.
  • Design professional training policies fundamentally service-oriented.

PAHO states that the mission of the pharmaceutical profession is "to contribute to the improvement of health and help patients with health problems to make the best use of medications. This mission has six components:[8].

  • always be available to patients.
  • identify, manage or detect health problems.
  • promote health.
  • ensure the effectiveness of medications.
  • prevent damage caused by medications.
  • make responsible use of limited healthcare resources.[8].

Mission that with the new paradigm, must fundamentally focus on improving the patient's health and that of the six components, the Cuban pharmacist will have to work hard on all of them and emphasize the necessary change of mentality that allows him to understand that his Their function is not to be behind a counter "selling" a health product, but beyond this, their reason for being is to be part of a team, whose fundamental objective is to fight so that health levels in Cuba are increasingly better.[8].

Conclusions

Pharmaceutical services must transform ways of working based on the guidance of the WHO/PAHO and adjusting to the standards established in the country, improving themselves professionally to achieve the objectives set in relation to the integration of the pharmaceutical professional into the work of the health team in the APS achieving a higher level of health care at the community level and more effective participation in decisions where changes in services cannot be less than such expectations so that Health levels in Cuba are increasingly better in response to the needs of society.

References

Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.

img

Virginia E. Koenig

Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.

img

Delcio G Silva Junior

Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.

img

Ziemlé Clément Méda

Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.

img

Mina Sherif Soliman Georgy

We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.

img

Layla Shojaie

The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.

img

Sing-yung Wu

Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.

img

Orlando Villarreal

Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.

img

Katarzyna Byczkowska

Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.

img

Anthony Kodzo-Grey Venyo

Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.

img

Pedro Marques Gomes

Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.

img

Bernard Terkimbi Utoo

This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.

img

Prof Sherif W Mansour

Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.

img

Hao Jiang

As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.

img

Dr Shiming Tang

Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.

img

Raed Mualem

International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.

img

Andreas Filippaios

Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.

img

Dr Suramya Dhamija

Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.

img

Bruno Chauffert

I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!

img

Baheci Selen

"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".

img

Jesus Simal-Gandara

I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.

img

Douglas Miyazaki

We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.

img

Dr Griffith

I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.

img

Dr Tong Ming Liu

I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.

img

Husain Taha Radhi

I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.

img

S Munshi

Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.

img

Tania Munoz

“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.

img

George Varvatsoulias

Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.

img

Rui Tao

Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.

img

Khurram Arshad

Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.

img

Gomez Barriga Maria Dolores

The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.

img

Lin Shaw Chin

Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.

img

Maria Dolores Gomez Barriga

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.

img

Dr Maria Dolores Gomez Barriga

Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.

img

Dr Maria Regina Penchyna Nieto

Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.

img

Dr Marcelo Flavio Gomes Jardim Filho

Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”

img

Zsuzsanna Bene

Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner

img

Dr Susan Weiner

My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.

img

Lin-Show Chin

My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.

img

Sonila Qirko

My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.

img

Luiz Sellmann