Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy

Autor: Enrico Pasut, Nicola Lombardi, Li Wei, Paolo Giorgi Rossi, Silvia Leschiutta, Maisoon Ghaleb, Maria Grazia Troncon
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Drug-Related Side Effects and Adverse Reactions
Attitude of Health Personnel
Health Services for the Aged
education
Psychological intervention
Drug-related problems
Pharmacists
030226 pharmacology & pharmacy
Health administration
Antiparkinson Agents
03 medical and health sciences
Patient safety
0302 clinical medicine
Elderly
Pharmaceutical care
Internal medicine
Physicians
Health care
medicine
Internal Medicine
Humans
Medication Errors
030212 general & internal medicine
Aged
business.industry
Health Policy
Nursing research
lcsh:Public aspects of medicine
Communication
Health services research
lcsh:RA1-1270
Middle Aged
Anti-Bacterial Agents
Clinical pharmacy
Clinical pharmacist
Italy
Clinical Pharmacy Information Systems
Female
Health Services Research
business
Pharmacy Service
Hospital
Research Article
Zdroj: BMC Health Services Research
BMC Health Services Research, Vol 18, Iss 1, Pp 1-9 (2018)
ISSN: 1472-6963
Popis: Background Successful implementation of clinical pharmacy services is associated with improvement of appropriateness of prescribing. Both high clinical significance of pharmacist interventions and their high acceptance rate mean that potential harm to patients could be avoided. Evidence shows that low acceptance rate of pharmacist interventions can be associated with lack of communication between pharmacists and the rest of the healthcare team. The objective of this study was to evaluate the effect of a structured communication strategy on acceptance rate of interventions made by a clinical pharmacist implementing a ward-based clinical pharmacy service targeting elderly patients at high risk of drug-related problems. Characteristics of interventions made to improve appropriateness of prescribing, their clinical significance and intervention acceptance rate by doctors were recorded. Methods A clinical pharmacy intervention study was conducted between September 2013 and December 2013 in an internal medicine ward of a teaching hospital. A trained clinical pharmacist provided pharmaceutical care to 94 patients aged over 70 years. The clinical pharmacist used the following communication and marketing tools to implement the service described: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis; Specific, Measurable, Achievable, Realistic and Timely (SMART) goals; Awareness, Interest, Desire, Action (AIDA) model. Results A total of 740 interventions were made by the clinical pharmacist. The most common drug classes involved in interventions were: antibacterials for systemic use (11.1%) and anti-parkinson drugs (10.8%). The main drug-related problem categories triggering interventions were: no specific problem (15.9%) and prescription writing error (12.0%). A total of 93.2% of interventions were fully accepted by physicians. After assessment by an external panel 63.2% of interventions (96 interventions/ per month) were considered of moderate clinical significance and 23.4% (36 interventions/ per month) of major clinical significance. The most frequent interventions were to educate a healthcare professional (20.4%) and change dose (16.1%). Conclusions To our knowledge this is the first study evaluating the effect of a structured communication strategy on acceptance rate of pharmacist interventions. Pharmaceutical care delivered by the clinical pharmacist is likely to have had beneficial outcomes. Clinical pharmacy services like the one described should be implemented widely to increase patient safety.
Databáze: OpenAIRE
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