Background Including a pharmacist within the multidisciplinary teams has been a basic objective in many hospitals in recent years.

Purpose To assess the efficiency of pharmaceutical care in the internal medicine service, based on an analysis of the pharmaceutical interventions (PIs) made and their impact on duration of hospital stay.

Material and methods Analysis of the interventions was derived from a prospective observational study between December 2014 and March 2015, involving a pharmacist integrated into the healthcare team with a working schedule from 09:00 to 14:00.

The level of risk associated with the PI was defined as a percentage risk of the patient’s hospital stay being prolonged had the intervention not been made (classification adapted from Overhage et al. and Bates et al.): fatal (60%), serious (40%), significant (10%) and non-significant (0%).

Results A total of 52 PIs were accepted and implemented in 60 patients: change of proposed dose 32%, change of proposed medicine 24.5%, proposed drug suspension 17%, complete/update medical order and medical report information 11.3%, proposed start of treatment 7.6% and monitoring recommendation 7.6%.

The therapeutic groups involved were mainly the following: group N (neurological) 32.2%, group C (cardiovascular) 26.4%, group J (anti-infectives for systemic use) 18.9% and group A (gastrointestinal and metabolic) 11.3%.

The risk of prolonging hospital stay according to PI was: serious 17%, significant 45.3% and non-significant 37.7%.

Conclusion According to severity, more than half of the PIs accepted implied a reduction in the duration of hospital stay (62.3%), resulting not only in increased patient safety but also in cost savings, thus demonstrating the efficiency of including a pharmacist in the internal medical service.

References and/or Acknowledgements

1. Overhage JM, Lukes A. Practical, reliable, comprehensive method for characterizing pharmacists clinical activities. Am J Health Systm Pharm 1999;56:2444-50

2. Bates DW, Cullen DJ, Laird N, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. JAMA 1995;274:29-34

References and/or AcknowledgementsNo conflict of interest.