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Clinical pharmacy and clinical trials (including case series)
Evaluation of pharmacist clinical interventions profile in a university hospital
  1. E. Echarri Arrieta,
  2. M. Suárez-Berea,
  3. T. Rodriguez-Jato,
  4. L. Campano,
  5. B. Rodriguez,
  6. M. Touris,
  7. J. Gonzalez,
  8. A. Mosquera,
  9. A. Suárez-Rodriguez,
  10. F. Martínez-Bahamonde
  1. 1Complejo Hospitalario Universitario de Santiago de Compostela, Servicio de Farmacia, Santiago de Compostela, Spain

Abstract

Background The pharmacist is incorporated step by step to daily clinical activities at hospital. However, there is still a lack of uniformity both among the tasks assumed and also the way of performing these tasks.

Purpose The aim of this paper is to evaluate the profile for clinical pharmacy interventions at University Hospital environment.

Materials and methods The authors performed a prospective, open and descriptive study for twelve months (January-December 2010) of the interventions made by pharmacists in a centralised model, after establishing a classification of tasks, and their codification, that the pharmacist could assume in relation to the clinical patient management. This relation was made after reviewing the methodology proposed by Dader Group (Granada's pharmaceutical group), and introducing some important modifications. As a previous result The authors proposed an encoding system of pharmacist's clinical tasks grouped into seven categories: proposing to withdraw a drug, propose to incorporate a drug, exchange, dosage recommendation, confirmation personal treatment, information and monitoring.

Results The authors have evaluated a total of 35.642 inpatients, distributed into 12 surgical units (17.437 inpatients), 16 medical units (14.545 inpatients), and 14 units without individualised dose distribution system (3.660 patients). There have been a total of 7.219 pharmacist interventions: 3.836 (medical), 3.200 (surgical) and 183 (no unit dose). The rate interventions / patient is equal in medical and surgical units (0.22) and both four times higher than in units without unit dose (0.05). Profile evaluated interventions shows that the main intervention in any area is the therapeutic exchange (73%), followed by dosage recommendation (14.2%), withdrawal proposal (4.7%), monitoring (2.7%), information (2.2%), proposed incorporation (1.8%) and confirmation of treatment (1.2%). There is no difference between the profile of interventions in medical, surgical or wards without unit doses. There is an important difference between the medical profile and haematology profile for pharmaceutical interventions, because this is a unit that has a pharmacist assigned in a decentralised model.

Conclusions The pharmaceutical intervention profile does not change between surgical and medical units in our centralised model. The intervention rate for wards with unit dose is five times higher. The average intervention rate is 0.22. The higher average intervention rate for medical units is 0.46, and for surgical units is 0.65.

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