Article Text

PDF
Promoting clinical pharmacy services through advanced medication review in the emergency department
  1. Ana de Lorenzo-Pinto1,
  2. Raquel García-Sánchez1,
  3. Ana Herranz1,
  4. Iria Miguens2,
  5. María Sanjurjo-Sáez1
  1. 1Pharmacy Department, Hospital General Universitario Gergorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
  2. 2Emergency Department, Hospital General Universitario Gergorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
  1. Correspondence to Dr Ana de Lorenzo-Pinto, Pharmacy Department, Hospital General Universitario Gregorio Marañón, Madrid 28007, Spain; ana.lorenzo{at}salud.madrid.org

Abstract

Objectives To determine if an advanced medication review carried out in the emergency department (ED) increases the number of pharmacotherapy recommendations (PR) and the severity of the detected prescribing errors.

Methods We designed an analytic observational prospective cohort study with preintervention assessment (PRE) and postintervention assessment (POST). In PRE, prescription review was done by pharmacists located in the pharmacy department; they took into account only the information provided by the computerised physician order entry system. In POST, pharmacists were physically present in the ED and performed an advanced medication review. The main variables were number of PR and the severity of detected prescribing errors according to the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) severity index. Clinical variables were number of calls to physicians on duty during the first 48 hours of admission, readmissions at 30 days, visits to the ED at 30 days, inhospital mortality and length of stay.

Results The study population comprised 102 patients (51 in PRE and 51 in POST). In PRE, the number of PR per patient was 1.1; in POST, this value increased by 53% (1.7 PR per patient; P=0.014), especially in the case of PR related to home medications. The severity of prescribing errors was higher in POST (P=0.004). There was a trend towards better results for all clinical outcomes in POST although statistical significance was not reached.

Conclusions An advanced medication review in the ED increases the number of PR and the severity of the detected prescribing errors.

  • emergency service
  • medication errors
  • pharmacists
  • pharmacotherapy recommendations
  • quality of health care

Statistics from Altmetric.com

Request Permissions

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.