Activities on admission and during hospital stay: summary of potential process benefits studied
| Potential benefit | Results and references |
|---|---|
| The clinical pharmacist identifies DRPs systematically | A mean 1.9 DRPs (mainly errors in medication lists) were identified using the LIMM MIF part 1. They also identified a mean 7.6 DRPs using the LIMM MRF.8 MIF parts 1–3 can be used clinically and for research purposes.9 The clinical pharmacist identified a mean 6.5 DRPs using the MIF and MRF10 |
| Identifies errors that would not be identified by standard care | Using MIF part 1, a mean of 1 error in medications lists was identified which normally would not be identified by standard care.6 Using MRF and LIMM symptom assessment form, 8 DRPs were identified which would not be identified by standard care.11 |
| Recommendations from the pharmacist to the physician to solve and prevent DRPs is performed systematically | 81% and 62% of real DRPs identified using MIF part 1 and MRF, respectively, were presented and recommended.8 56% of all DRPs identified using MIF part 1 and MRF were presented and recommended10 |
| The physician completes the pharmacist's recommendations systematically | 90%8 and 64%10 of the recommendations were completed by the physician |
| The pharmacist's recommendations are clinically significant | Among real DRPs, 83% and 49% of recommendations were ranked as ‘somewhat significant’ or higher and ‘significant’ or higher, respectively8 |
| Patient treatment becomes more appropriate | MAI was improved and the number of inappropriate drugs was reduced during hospital stay13 and also 2 weeks after discharge12 |
| Physicians and nurses are satisfied with the pharmacist in the team and the benefit for the patient | The stated benefit for the patients and for the healthcare team, and also the pharmacist performance were valued as high, with a median and range within 5–6 on a 6 level scale (1=no, 6=large benefit)10 11 |
| Hospital readmission decreases | Hospital readmission within 3 months due to DRPs decreased by 55%, from 12 to 5.6.13 Total readmission was not affected14 |
DRP, drug-related problem; LIMM, Lund Integrated Medicines Management; MAI, Medication Appropriateness Index; MIF, medication interview form; MRF, medication review form.