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Hospital pharmacist interventions in a central hospital
  1. Fátima Falcão1,
  2. Erica Viegas2,
  3. Carla Lopes2,
  4. Rita Branco2,
  5. Ana Parrinha2,
  6. Marina Lobo Alves2,
  7. Filipa Leal2,
  8. Vanessa Pina2,
  9. Brenda Madureira2,
  10. Patrícia Cavaco2,
  11. Sofia Santos2,
  12. Sandra Carreira2
  1. 1Department of Pharmacy, Centro Hospitalar de Lisboa Ocidental, Faculty of Pharmacy, iMed.ULisboa Research Institute for Medicines, Universidade de Lisboa, Lisboa, Portugal
  2. 2Department of Pharmacy, Centro Hospitalar de Lisboa Ocidental, Hospital de S. Francisco Xavier, Lisbon, Portugal
  1. Correspondence to Fátima Falcão, Serviços Farmacêuticos, Centro Hospitalar de Lisboa Ocidental, Estrada do Forte do Alto do Duque 1495-005 Lisboa, Portugal; mffalcao{at}chlo.min-saude.pt

Abstract

Objective The aim of this study is to describe and categorise pharmacist interventions (PIs) in a central hospital and report acceptance rates by physicians.

Methods A retrospective study was carried out in a 350-bed central hospital between January and June 2013. Eleven pharmacists screened the pharmacotherapy charts for drug-related problems leading to PIs. The recommendations resulting from this analysis were entered in the electronic prescribing system. All the PIs registered on the electronic medical record system during the study period were eligible for inclusion. Interventions were quantified and characterised. Computer records were consulted to assess acceptance rate by physicians.

Results A total of 1249 PIs were made by 11 pharmacists, and covered 147 drugs, with the most common being antibacterial (25%) and for the central nervous system (24%) and cardiovascular system (18%). Of the 1249 PIs, 18% concerned acetaminophen, 13% enoxaparin and 10% amoxicillin/clavulanic acid. The PIs were classified into three main categories: drug, dosage and administration related. When we analysed the most relevant PI type (n>20), the highest acceptance rate was for dosage adjustment according to therapeutic indication (58.1%) and renal function (57.4%). The global rate of acceptance was 53%.

Conclusions Pharmacists’ recommendations entered in the electronic prescribing system with a short explanation, as well as the pharmacotherapy recommendation, are immediately available to the doctor; however, the relatively low acceptance rate suggests that a further study also evaluating verbal interventions is needed, since the most urgent recommendations are made verbally, and this would likely increase the acceptance rate.

  • CLINICAL PHARMACY
  • EPIDEMIOLOGY
  • MEDICAL ERRORS
  • PHARMACOTHERAPY
  • INSTITUTIONAL MEDICATION SURVEILLANCE

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