Background and importance The emergency department (ED) has been described as a dynamic and complex environment vulnerable to medical errors.
The clinical pharmacist (CP) has proven to be a key part of the multidisciplinary team for improving the quality and safety of patient care.
Services provided by pharmacists in the ED include traditional clinical pharmacy services, responding to medical emergencies, providing consultations on medication issues and identifying drug-related problems.
Aim and objectives To analyse and evaluate the CP’s interventions in the ED.
Material and methods A descriptive prospective study of the CP’s interventions performed in a 2-month-work rotation period in the ED was performed. The study was conducted in a 400-bed hospital that serves a population of 250 000 inhabitants.
The following variables were collected: type of pharmaceutical intervention, pathology associated with IP, proactive intervention (yes/no) and acceptance of the intervention (yes/no).
A database was designed to record the interventions that were carried out during the study period and data were processed with Microsoft Excel.
Results A total of 308 interventions were recorded in the period of study classified as:
– Prescription suggestion (n=2).
– Adequacy of treatment (n=46): dose or pharmaceutical presentation adjustments (n=20), antibiotic therapy (n=26).
– Prevention of adverse reactions (n=11): contraindication (n=1), inappropriate doses (n=2), duplications (n=3), interactions (n=2), analytical monitoring recommendation (n=3).
– Support tasks (n=244): medication reconciliation (n=242), drug information to the physician (n=2).
– Others (n =5).
90.5% were proactive interventions and 99% of them were accepted by the physician.
The main pathologies involved were: psychiatric (18.8%), cardiovascular (16.5%: hypertension (9.8%) and atrial fibrillation/heart failure (6.7%)), endocrine (11.2%: diabetes (5.8%), dyslipidaemia (3.6%), hypothyroidism (1.8%)), respiratory (10.3%), gastrointestinal (5.4%), non-classified pain (5.4%), glaucoma (4%), onco-haematological (2.7%), neurological (2.2%) and dermatological (1.8%).
Conclusion and relevance The number of CP’s interventions carried out during the study period is optimal, when compared with data from other studies carried out. The major part of the CP interventions were based on medication reconciliation. In a very high percentage of cases, the pharmacist works proactively and his interventions are almost always accepted.
This study demonstrates the role and importance of the pharmacist incorporated into the ED multidisciplinary team.
Conflict of interest No conflict of interest
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