Medication Reviews by a Clinical Pharmacist at an Irish University Teaching Hospital.

Alan Kearney,Derina Byrne,Ciaran Halleran,Laura Sahm,Elaine Walsh,Jennifer Haugh

doi:10.3390/pharmacy5040060

Alan Kearney, Derina Byrne + Show 4 more

Open Access

https://doi.org/10.3390/pharmacy5040060

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Abstract

Purpose: Pharmacist-led medication reviews in hospitals have shown improvement in patient outcomes. The aim of this study is to describe the prevalence and nature of pharmacist interventions (PIs) following a medication review in an Irish teaching hospital. Methods: PIs were recorded over a six-month period in 2015. PIs were assessed by a panel of healthcare professionals (n = 5) to estimate the potential of adverse drug events (ADEs). Descriptive statistics were used for the variables and the chi square test for independence was used to analyse for any association between the variables. Results: Of the 1216 patients (55.8% female; median age 68 years (interquartile range 24 years)) who received a medication review, 313 interventions were identified in 213 patients. 412 medicines were associated with PIs, of which drugs for obstructive airway disease (n = 82), analgesics (n = 56), and antibacterial products for systemic use (n = 50) were the most prevalent. A statistically significant association was found between PI and patient’s age ≥65 years (p = 0.000), as well as female gender (p = 0.037). A total of 60.7% of the PIs had a medium or high likelihood of causing an ADE. Conclusion: Pharmacist-led medication review in a hospital setting prevented ADEs. Patients ≥65 years of age and female patients benefited the most from the interventions.

Highlights

Whilst medication is used to prevent, treat, and manage disease and illness, medication management is the most common intervention in order to prevent adverse drug events (ADEs) [1].The use of medication has inherent risks, and medication errors compound these risks and can lead to increased morbidity and mortality [1]
A total of 1216 patients received a medication review; pharmacist interventions (PIs) were identified in 213 patients
A significant result for the Kolmogorov-Smirnov statistic (p < 0.05) for the continuous variables reported, patient age, length of hospital stay, number of co-morbidities, and number of regular and PRN medicines prescribed indicates that the data does not follow a normal distribution

Summary

Introduction

Whilst medication is used to prevent, treat, and manage disease and illness, medication management is the most common intervention in order to prevent adverse drug events (ADEs) [1].The use of medication has inherent risks, and medication errors compound these risks and can lead to increased morbidity and mortality [1]. The traditional role of a pharmacist as a compounder and a dispenser of medicines resulted in the pharmacist being quite detached from other healthcare professionals (HCPs) [2]. The joint guidelines from the International Pharmaceutical Federation and the World Health Organisation (WHO) on good pharmacy practice have identified that multidisciplinary collaboration among HCPs is paramount to improving patient safety and outcomes [3]. In addition to sourcing, compounding, and dispensing medicines, pharmacists provide tailored advice to both HCPs and patients on the optimal and safe use of medicines [2]. A pharmacist-led medication review and the communication of subsequent interventions to HCPs is an example of non-traditional pharmacy services provided by pharmacists [2]

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