Background One of the activities of the pharmacist in a hospital is the screening of the electronic treatments for inpatients. During this process, some errors can be found in prescriptions. Pharmacist interventions are important to minimise the risk to the patient and increase the quality of care.
Purpose To analyse pharmacist interventions in electronic prescribing and degree of acceptance by doctors.
Materials and methods We analysed the pharmacist interventions during the period June 2011 – May 2013. After the first year a presentation about the results of the analysis was given to the pharmacy team, highlighting the most relevant and original interventions and proposals for better communication with the physician. Interventions are made through the computer during the validation (Lantools program).
Results The total number of interventions made was 2139 (788 first year and 1351 second year) with an average of 2.9 per day. The most common reasons were: dose adjustment for renal failure (26%), switching from intravenous to oral route (16%) and wrong dose (13%). The most frequent drugs were enoxaparin (18%), pantoprazole (12%) amoxicillin/clavulanic acid (6%) and paracetamol (5%). Of the recommendations that were reviewed (69%), 58% were accepted by the doctor.
Conclusions We observed that several interventions were not recorded. After the presentation the number of pharmaceutical interventions increased considerably; it seems to be a good motivational strategy for pharmacists. There are many reasons and drugs, but adjustment for renal failure (especially enoxaparin) and switching to oral route (especially pantoprazole) are the ones made more frequently. Communication with physicians must be improved in order to increase the degree of acceptance.
No conflict of interest.
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