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Clinical pharmacy and clinical trials (including case series)
The impact of pharmacist participation in a multidisciplinary team on an oncology ward compared with a ward clinical pharmacy service
  1. N.M. Marques da Silva
  1. 1St. Vincent's Private Hospital, Dublin, Rep. of Ireland

Abstract

Background Integration of pharmacists into multidisciplinary teams has been shown to have a positive effect in several clinical, pharmaceutical and financial indicators. Literature on the oncology setting and in non-teaching facilities is sparse and no literature is available on fully private healthcare facilities or on Irish hospitals. Differences in methods, outcome measures and working frameworks make the available evidence difficult to generalise.

Purpose To compare 2 models of pharmaceutical care delivery, with and without pharmacist participation in multidisciplinary teams, and identify the more effective.

Materials and methods This was a prospective study over two periods of 26 consecutive working days. The pharmacist provided a clinical pharmacy service to the oncology ward in both groups. In the intervention group (IG) the pharmacist participated in daily multidisciplinary meetings. Number and nature of Drug Related Problems (DRPs), time needed to provided clinical service and physician acceptance rates were the outcome measures. Numerical variables were analysed with the Student t-test and χ2 test for categorical variables.

Results 124 patients in the control group (CG) and 130 in the IG were included in this study. 86 DRPs in 37 patients were identified in the CG and 129 in 57 patients in the IG (p=0.024; RR=1.47 95% CI 1.05 to 2.05). The time needed to provide the clinical service increased from 177 min. (CG) to 231 min. (IG) (p<0.01). The acceptance rate of the pharmacist's interventions was 88.6%. The type, causes and outcomes of the DRPs did not differ between groups. Central nervous system drugs (23.3%) were the class most involved in DRPs. Over 83% of patients with DRPs were prescribed 6 or more regular drugs.

Conclusion When integrated into a multidisciplinary team, the pharmacist's work resulted in higher number of DRPs prevented and resolved with a higher percentage of patients having DRPs detected. This contributes to drug rationalisation and safety with potential clinical benefits for patients, potential cost savings for the hospital and pharmacy department.

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