Background Pharmacist interventions are important to improve patient safety, avoid physicians prescriptions errors and reduce unnecessary expenses. Electronic assisted prescription is a differential factor to document pharmaceutical interventions, and to analyse their distribution and acceptability quickly and easily.
Purpose To assess clinical pharmacist interventions made using a computerised physician order entry system (CPOE) for hospital patients and physicians’ acceptance after electronic assisted prescription implementation.
Material and methods A retrospective study of pharmaceutical interventions was conducted over 9 months (January 2016 to September 2016) after implementation of electronic assisted prescriptions. Differences between original prescriptions and pharmaceutical recommendations were reported to the physicians using the Farmatools application from CPOE. Types of recommendations, medical departments, pharmacotherapeutic group of drug involved, degree of acceptance and type of accepted pharmaceutical interventions were recorded.
Results There were 863 pharmaceutical interventions. Withdrawal treatments proposals were 430 (49.8%): 378 (43.8%) for excessive treatment duration, 23 (2.7%) for therapeutic duplications, 22 (2.5%) according to an antibiogram, 5 (0.6%) for allergies and 2 (0.2%) for other reasons. There were 152 (17.6%) suggestions for therapy change: 83 (9.6%) according to an antibiogram, 41 (4.8%) for interactions, 21 (2.4%) according to therapeutic protocol change and 7 (0.8%) for others causes. Dose adjustment interventions were 133 (15.4%), due to 82 (9.5%) overdosing, 29 (3.4%) renal insufficiency and 22 (2.5%) under dosing. Proposals for modifying administration frequency were 117 (13.5%). Pharmaceutical interventions were detected in internal medicine (37.4%), surgery (10.3%) and pneumology (9.7%) departments, among others. Antimicrobials were the most frequent therapeutic group involved in recommendations (52.3%), followed by haematopoietic drugs (12%) and cardiovascular drugs (11.8%). There were 401 (46.5%) interventions accepted by physicians, 449 (52%) not accepted proposals and the rest were not evaluable. The most accepted suggestions were 158 (41.7%) treatment withdrawals for excessive duration, followed by 47 (57.3%) overdosage adjustment and 33 (39.7%) therapy change according to an antibiogram.
Conclusion Almost half of the pharmaceutical interventions were withdrawal treatment proposals. Excessive duration was the main reason for suggesting withdrawal of treatment. The most frequent recommendations were recorded for the internal medicine and surgery departments. More than half of the interventions involved antimicrobials drugs. About half of the proposals were accepted. The most frequently accepted interventions were withdrawal of treatments due to excessive duration.
No conflict of interest
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.