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4CPS-336 Impact of check of medication appropriateness (CMA) in optimising analgesic prescribing

Publication Date Mar 1, 2021

Abstract

Background and importance Pain therapy in inpatients is regularly suboptimal and might be improved by clinical pharmacy services with the aim of optimising pain control and reducing iatrogenic harm related to adverse drug events and overuse. In our hospital, we have implemented a software supported check of medication appropriateness (CMA), which is a centralised pharmacist led service consisting of a clinical rule based screening for potentially inappropriate prescriptions (PIPs) and a subsequent medication review by pharmacists. Aim and objectives We aimed to investigate the impact of the CMA on pain related prescribing. Material and methods A quasi-experimental study was performed in a 1995 bed tertiary hospital, using an interrupted time series design. Pre-implementation, patients were exposed to standard of care. Afterwards, a pain focused CMA comprising 12 clinical rules pertaining to analgesic prescribing were implemented in the post-implementation period. A regression model was used to assess the impact of the intervention on the number of pain related residual PIPs. For the pre-implementation period, data collection was performed retrospectively (January 2016 to December 2018). Post-implementation (January 2019 to July 2020), an initial PIP was identified prospectively in the CMA. The total number of recommendations and acceptance rate were recorded for the post-implementation period. Results At baseline, the median proportion of residual PIPs was 69.0% (range 50.0–83.3%) with a median number of 13.1 (range 9.5–15.8...

Concepts

Potentially Inappropriate Prescriptions Total Number Of Recommendations Post-implementation Period Use Of Clinical Rules Clinical Rules Interrupted Time Series Clinical Pharmacy Services Analgesic Prescribing Therapy In Inpatients Pharmacist Involvement

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