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Evaluation of the impact of the addition of a heart failure prescribing pharmacist to consultant-led heart failure ward round at a tertiary hospital
  1. Gayle Campbell1,2,
  2. Roula Razouk1,
  3. Vivian Auyeung3,
  4. Jessica Webb1,
  5. Tevfik F Ismail1,2
  1. 1Cardiology Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
  2. 2School of BMEIS, King’s College London, London, UK
  3. 3Institute of Pharmaceutical Science, London, UK
  1. Correspondence to Ms Gayle Campbell, Cardiology department, Guy's and St Thoma’s NHS Foundation Trust, London, SE1 7EH, UK; gayle.campbell{at}gstt.nhs.uk

Abstract

Objective Pharmacists attending general medical post-admission ward rounds is established good practice. However, there is a lack of evidence on the impact of specialist heart failure (HF) prescribing pharmacists on consultant HF ward rounds. The aim of this study was to evaluate the impact on prescribing when a specialist HF prescribing pharmacist attended inpatient HF ward rounds.

Methods A prospective service evaluation completed at a tertiary hospital between September and December 2020. The same HF prescribing pharmacist attended the HF consultant-led ward round once a week on 15 occasions. For each medicine change, the pharmacist documented: who suggested the intervention, the medicine, prescribing action, reason for review and the primary reason for change. Medicines were categorised into four groups (heart failure, cardiovascular, anticoagulation and other) for analysis.

Results A total of 158 patients were reviewed and 226 individual changes suggested; 48% of these were consultant led (n=108) and 52% (n=118) due to pharmacist recommendations. All medicines interventions were prescribed on the round by the pharmacist. For consultants, the primary reason for medicine change was to ensure efficacy of HF medicines, 80% (n=73), followed by safety (HF medicines), 20% (n=18). For the pharmacist, the primary reason was safety across all the medicine groups, 36% (n=42), followed by efficacy relating to missing drug history items, 24% (n=28).

Conclusions HF consultants focused on ensuring patients have the most effective combination of HF medications. The addition of a specialist HF prescribing pharmacist ensured a wider range of medicines were reviewed for safety and optimisation, helping to deliver a holistic review of all medications.

  • heart failure
  • medical errors
  • clinical medicine
  • evidence-based medicine
  • pharmacy service
  • hospital

Data availability statement

Data are available on reasonable request. Raw data on anonymised patient-level interventions would be available on reasonable request. Please contact GC ORCID ID: 0000-0001-6249-8797.

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Data availability statement

Data are available on reasonable request. Raw data on anonymised patient-level interventions would be available on reasonable request. Please contact GC ORCID ID: 0000-0001-6249-8797.

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