Background Although the role of the clinical hospital pharmacist as an important part of the multidisciplinary team has been studied, little is known from the literature about the impact of pharmacy intervention (PI) on optimising pharmacotherapy in abdominal surgery patients. In our small country, to date, no information is available.

Purpose The main goal was to improve patient safety and clinical pharmacy. Subgoals were using this evidence to implement throughout the whole hospital; and national improvement initiative to reduce medication errors.

Material and methods Clinical pharmacists were regularly doing medication reviews at the abdominal surgery department. Interactions were analysed by LexiComp Online. A PI form that was invented in the clinical hospital a year before was used and presented to the physician team at the next day morning rounds. Acceptance rate was noted as change in therapy. Descriptive statistical methods were used.

Results The survey was conducted from 1 October 2014 to 31 March 2015. All patients older than 18 years hospitalised at the examined ward were included in the study (539). 3773 therapy forms were analysed, of which there were 57 PI. Drug interactions stage D and X were the most common types of intervention (77%) of which almost half were accepted (48%). All interventions regarding dosing interval and duplication of therapy were accepted. Acceptance rate of PI (53%) can be attributed to a new role of hospital pharmacist in this hospital as part of a healthcare team, lack of physician time and differences in opinion between pharmacists and doctors.

Conclusion The study confirmed the importance and essential role of the clinical pharmacist as part of the multidisciplinary healthcare team, especially in abdominal surgery patients. The results are consistent with a small number of clinically significant medication errors that could be prevented, but they represent a remarkable cost to the healthcare system and can result in serious adverse effects in patients. With the knowledge based on clinical evidence, pharmacists´accepted interventions by physicians can optimise pharmacotherapy and patient safety.

References and/or Acknowledgements My gratitude to general hospital Dr Tomislav Bardek Koprivnica, Croatia, and the people who helped me to conduct the study

No conflict of interest.