Background The Ministry of Health in Norway has requested an expanded contribution from clinical pharmacy in healthcare delivery because of serious medication-related issues. Examples of this are participation in treatment teams in hospital wards and review of the patient’s total use of medicine in cooperation with a medical practitioner. The concept of integrated medicines management (IMM) has been approved as a model to enhance medication effectiveness and safety.

Purpose The objective of this study was to evaluate the clinical significance of recommendations made by pharmacists in drug-related problems (DRP).

Materials and Methods The study was conducted on a respiratory ward and a rheumatology ward at the University Hospital of St. Olav, Trondheim, Norway. Patients admitted to hospital in the period of June to October 2011 were included. All patients using one or more drugs at admission, having DRPs identified by the pharmacist according to the IMM (Integrated Medicine Management) model, were included. DRPs were identified through medicines reconciliation and medication reviews. All recommendations made by the pharmacists were independently assessed and scored by a physician with a special interest in pulmonary diseases, or respectively rheumatology, a clinical pharmacologist and a clinical pharmacist. A Hatoum six-point scoring system [1] for assessing the quality of pharmacists’ interventions was used, with rankings between 1. Adverse significance – (the recommendation supplied by the pharmacist may lead to adverse outcome and 6. Extremely significant – information qualified by life and death situation.).

Results A total of 112 recommendations in 46 patients (average age 66 years), were assessed. On average 4 DRPs per patient were found. 85% of the recommendations were assessed as somewhat significant or more (≥ rank 3). The physicians accepted 71% of the pharmacists’ recommendations.

Conclusions Recommendations made by pharmacists were assessed as clinically significant to a large extent. The fact that the physicians followed the pharmacists recommendations in most cases, demonstrates the effectiveness and value of the IMM model in improving patient drug treatment.

Reference

1. Hatoum HT et al, Evaluation of the contribution of clinical pharmacists: inpatient care and cost reduction. Drug Intelligence and Clinical Pharmacy, March 1988, Vol. 22, 252–258.

No conflict of interest.