Table 2

Activities on admission and during hospital stay: summary of potential process benefits studied

Potential benefitResults and references
The clinical pharmacist identifies DRPs systematicallyA 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 careUsing 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 systematically81% 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 systematically90%8 and 64%10 of the recommendations were completed by the physician
The pharmacist's recommendations are clinically significantAmong real DRPs, 83% and 49% of recommendations were ranked as ‘somewhat significant’ or higher and ‘significant’ or higher, respectively8
Patient treatment becomes more appropriateMAI 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 patientThe 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 decreasesHospital 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.