Objective To describe the development and implementation of pharmaceutical care services in a diabetes ward, and to examine the effectiveness of pharmacist interventions. Setting Tongde hospital of Zhejiang province, a 1,200-bed South China teaching hospital, serving the local community. Method A single-center, 2-phase (pre-/post-intervention phase) designs was performed in the diabetes ward of a general hospital. Patients in post-intervention phase (October 2012 to December 2012) received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase (January 2012 to March 2012) received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions. Main outcome measure type and number of interventions, and medication errors assessed at the baseline and at the end of pharmaceutical care were the main outcome measures. Results During the 3-month study period, the clinical pharmacist made 240 interventions for 473 admitted patients; of these, 207 (86.3 %) were accepted by physicians or nurses, and dosage adjustment [n = 83, (34.6 %)] was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 (p < 0.001); medication errors, of incorrect dose or dosing interval, were markedly improved (decreased from 0.87 to 0.14; p < 0.001), the drug cost per patient day decreased from $347.15 to $309.74 (p = 0.095), and the length of diabetes ward stay did not change significantly (16.14 vs. 15.93 days; p = 0.15). Conclusion The presence of the pharmacist in the diabetes ward resulted in significant reduction in medication errors and had potential drug-cost-saving effects.
China Diabetes mellitus Hospital pharmacist Intervention study Medication error Pharmacist intervention Pharmaceutical care
This is a preview of subscription content, log in to check access.
We would like to acknowledge Dr Yun—long Tian, Dr Hai—bin Dai and Ms Xiu—li Yang for their involvement.
This study was supported by the Health Bureau of Zhejiang province (2012zyy011).
Conflicts of interest
Weant KA, Humphries RL, Hite K, Armitstead JA. Effect of emergency medicine pharmacists on medication-error reporting in an emergency department. Am J Health Syst Pharm. 2010;67:1851–4.CrossRefPubMedGoogle Scholar
Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166:955–64.CrossRefPubMedGoogle Scholar
Pepper MJ, Mallory N, Coker TN, Chaki A, Sando KR. Pharmacists’ impact on improving outcomes in patients with type 2 diabetes mellitus. Diabetes Educ. 2012;38(3):409–16.CrossRefPubMedGoogle Scholar
Devlin JW, Bhat S, Roberts RJ, Skrobik Y. Current perceptions and practices surrounding the recognition and treatment of delirium in the intensive care unit: a survey of 250 critical care pharmacists from eight states. Ann Pharmacother. 2011;45:1217–29.CrossRefPubMedGoogle Scholar
Ernst AA, Weiss SJ, Sullivan A, Sarangarm D, Rankin S, Fees M, et al. On-site pharmacists in the ED improve medical errors. Am J Emerg Med. 2012;30:717–25.CrossRefPubMedGoogle Scholar
Zhang C, Zhang LL, Huang L, Luo R, Wen J. Clinical pharmacists on medical care of pediatric inpatients: a single-center randomized controlled trial. PLoS One. 2012;7:e30856.CrossRefPubMedPubMedCentralGoogle Scholar
Klopotowska JE, Kuiper R, Van Kan HJ, De Pont AC, Dijkgraaf MG, Lie-A-Huen L, et al. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study. Crit Care. 2010;14:R174.CrossRefPubMedPubMedCentralGoogle Scholar
Moffett BS, Mott AR, Nelson DP, Gurwitch KD. Medication dosing and renal insufficiency in a pediatric cardiac intensive care unit: impact of pharmacist consultation. Pediatr Cardiol. 2008;29:744–8.CrossRefPubMedGoogle Scholar
MacLaren R, Bond CA, Martin SJ, Fike D. Clinical and economic outcomes of involving pharmacists in the direct care of critically ill patients with infections. Crit Care Med. 2008;36:3269–70.CrossRefGoogle Scholar
Zhu M, Guo DH, Liu GY, Pei F, Wang B, Wang DX, et al. Exploration of clinical pharmacist management system and working model in China. Pharm World Sci. 2010;32:411–5.CrossRefPubMedGoogle Scholar
Best practices for hospital and health-system pharmacy. Position and guidance documents of ASHP. American Society of Health-System pharmacists, 2005–2006.Google Scholar
Chen XQ, editor. New materia medica. Beijing (China): New Materia Medica; 2010. ISBN 978-7-117-13788-1.Google Scholar
Kaushal R, Bates DW, Abramson EL, Soukup JR, Goldmann DA. Unit-based clinical pharmacists’ prevention of serious medication errors in pediatric inpatients. Am J Health Syst Pharm. 2008;65:1254–60.CrossRefPubMedGoogle Scholar
Borges AP, Guidoni CM, Ferreira LD, de Freitas O, Pereira LR. The Pharmaceutical care of patients with type 2 diabetes mellitus. Pharm World Sci. 2010;32:730–6.CrossRefPubMedGoogle Scholar
Galt KA. Cost avoidance, acceptance, and outcomes associated with a pharmacotherapy consult clinic in a Veterans Affairs medical center. Pharmacotherapy. 1998;18:1103–11.PubMedGoogle Scholar
Wang HY, Chan AL, Chen MT, Liao CH, Tian YF. Effects of pharmaceutical care intervention by clinical pharmacists in renal transplant clinics. Transplant Proc. 2008;40:2319–23.CrossRefPubMedGoogle Scholar
Krahenbuhl MA, Schlienger R, Lampert M, Haschke M, Drewe J, Krahenbuhl S. Drug-related problems in hospitals: a review of the recent literature. Drug Saf. 2007;30:379–407.CrossRefPubMedGoogle Scholar
Shen J, Sun Q, Zhou X, Wei Y, Qi Y, Zhu J, Yan T. Pharmacist interventions on antibiotic use in inpatients with respiratory tract infections in a Chinese hospital. Int J Clin Pharm. 2011;33:929–33.CrossRefPubMedGoogle Scholar
Thomas DR, Ludo WE, Steven S. Economic effects of clinical pharmacy interventions: a literature review. Am J Health Syst Pharm. 2008;65:1161.CrossRefGoogle Scholar
Kopp BJ, Mrsan M, Erstad BL, Duby JJ. Cost implications of and potential adverse events prevented by interventions of a critical care pharmacist. Am J Health Syst Pharm. 2007;64:2483–7.CrossRefPubMedGoogle Scholar