Background Over recent decades, the pharmacist’s role has evolved with the development of pharmaceutical care, defined as the active participation of the pharmacist in patient care, in collaboration with the doctor and other healthcare professionals in order to improve the patient’s quality of life. Based on this, we have established a pharmaceutical care programme in an emergency department (ED).
To describe more frequent pharmaceutical interventions (PIs) in an ED
To analyse the rate of acceptance of the PIs and which were accepted.
Materials and Methods Descriptive-prospective study, for six months, in a University Hospital. All medical prescriptions from the ED were evaluated. If any drug-related problems (DRPs) were detected, the prescriber was notified of a recommendation. The following variables were collected: sex, age, reason for the intervention: DRPs especially adaptation to the pharmaceutical guide used in the hospital (AP), medical service (emergency, medical unit, surgical unit), type of PI, type of DRP, acceptance rate (accepted, not accepted, not assessable). Data were analysed with SPSS vs. 5.
Results The pharmacist reviewed the medical orders of 987 patients. A total of 669 interventions for 320 patients (77 years ±15, 50.3% female) were recorded. The pharmacist carried out an average of 0.7 interventions/patient throughout the study period. PIs/unit: 59% emergency, 28% medical unit, 13% surgical unit. The reasons for interventions were: DRP (60%) or AP (40%) detected. Types of DRP: indication 32.6%, efficacy 26.6% and safety 40.8%. More frequent PIs: AP 40%, posology change 26%, start treatment 13%, change in form of administration 10%, stop treatment 8%. The overall rate of acceptance of the pharmacist’s recommendations was 76.8% (8.6% rejected and 14.6% not assessable).Rate of acceptance/unit: emergency 85%, medical unit 75%, surgical unit 76%.
Conclusions The most frequent PIs were adaptation to the pharmaceutical guide and dosage change.
Emergencies physicians accepted more PIs than other doctors or surgeons and medical units rejected more PIs than other units (25%).
Interventions by a clinical pharmacist had a major impact on reducing prescribing errors in the study period, thus improving the quality and safety of care provided.
No conflict of interest.
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