Background Within the framework of the Austrian healthcare reform, a publicly funded project with the aim of resolving medication related problems (MRPs) by means of inhospital clinical pharmacy services (CPS) was conducted.
Purpose The aim of the study was to detect and resolve MRPs and to analyse the clinical pharmacists’ interventions.
Material and methods CPS were implemented on one oral surgery ward (40 beds) in a large academic teaching hospital (2000 beds). On weekdays, three pharmacists alternately provided continuous CPS, comprising medication reviews (MRs) of newly admitted patients and patient counselling at discharge. Ward round participation took place twice weekly. All MRPs, proposed interventions and the physicians’ acceptance rate were assessed and recorded during the study period (October 2014 to September 2015; patient counselling starting in April 2015) according to an adapted classification system1. Further project relevant data (eg, demographics, involved medications, time spent on CPS, etc) were also recorded.
Results MRs were performed in 2171 patients, with 1477 MRPs detected in 1361 patients (62.7%; 46% female; average age 56 years; average medicines/day: 8.3). Patients with MRPs were older and took more medicines. Common MRPs were medicines prescribed without an indication (10.9%), overdosing (9.8%) and choosing a suboptimal administration route (8.2%). The most common clinical pharmacists’ interventions were the provision of information (20.6%) and the recommendations to discontinue medicines (16.6%) or alter dosages (9.8%). The most frequently involved medicines were proton pump inhibitors, NSAIDs and antibiotics. The overall physicians’ acceptance rate was 93.7%. 37% of interventions were assessed as directly reducing medicines’ expenses on the ward, while only 11.5% led to an increase. A total of 459 patients were counselled, and 187 MRPs (12.7%) were resolved at discharge. The average (±SD) time/day spent on CPS was 125 (±62) min.
Conclusion Continuous CPS have considerably contributed to the resolution of MRPs in oral surgery patients, as illustrated by the high number of interventions performed and the high acceptance rate. Counselling at discharge helped to further resolve MRPs. Based on the project results, the political decision to extend funding has been taken.
References and/or Acknowledgements
Allenet B, et al. Pharm World Sci 2006;28:1818.
References and/or AcknowledgementsConflict of interest.
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