Background and importance Clinical pharmacy is considered an integral discipline in the health care system to improve patients’ health outcomes by optimising therapy and reducing drug-related problems (DRP), which are highly detected in oncological patients with complex therapies.
Aim and objectives Evaluate the clinical, economic and organisational impact of pharmaceutical interventions (PI).
Material and methods An observational, prospective and interventionist study was conducted in an oncology unit from October 2020 to March 2021. Clinical pharmacists identified, during medication review, relevant DRPs, which were subsequently classified according to the Overhage & Lukes severity scale, which led to a PI. All PIs were analysed to evaluate clinical, economic and organisational impact through the multidimensional tool CLEO.
Data were collected in an Excel database through the systematic review of inpatients via an electronic medical record program (HPHCISv.3.8). Variables collected were demographic, DRP detected, severity, PI recommended and its acceptance and later implementation.
The relationship between clinical, economic and organisational IPs relevance and DRP severity was assessed throughout with Spearman’s correlation coefficient.
Results During the study period, 153 patients were included (50% female) with a mean age of 66 years. In one-third of the patients, 114 DRP and IP were recorded. The most common DRP identified were ‘supratherapeutic dosage’ (25.4%), ‘untreated indication’ (21.1%) and ‘subtherapeutic dosage’ (13.2%). Medication errors were considered significant in 68.4% of cases. PIs were mainly related to dose adjustment (35.1%) and untreated indication (22%). They were accepted in 78.1% of cases.
Clinical impact of PIs was ‘major’, ‘moderate’ and ‘minor’, in 4.4%, 16.4% and 79.2%, respectively. Regarding the economic and organisational dimension, 33.3% of PI would decrease the costs of care and 80.7% would be favourable on the quality of medical care.
The severity of the medication error and the clinical, economic and organisational significance of the PI were correlated with a medium statistical reliability level (Spearman’s ρ=0.343; ρ=0.439 and ρ=0.487, respectively).
Conclusion and relevance The present study proves clinical pharmacists play a key role for detecting DRPs during medication review, whose severity relates to significant clinical, economic and organisational relevance. PIs allow an improvement of the quality standards of medical care while having a positive impact on cost saving in the clinical process. Including a clinical pharmacist as an essential member of the multidisciplinary group would lead to an improvement in the care process.
Conflict of interest No conflict of interest
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