Effects of multidisciplinary teams and an integrated follow-up electronic system on clinical pharmacist interventions in a cancer hospital
- 132 Downloads
Background The aim of drug therapy is to attain distinct therapeutic effects that not only improve patient’s quality of life but also reduce the inherent risks associated with the therapeutic use of drugs. Pharmacists play a key role in reducing these risks by developing appropriate interventions. Whether to accept or reject the intervention made by the pharmacist is a relevant consultant’s decision. Objective To evaluate the impact of electronic prompts and follow-up of rejected pharmacy interventions by clinical pharmacists in an in-patient setting. Setting Shaukat Khanum Cancer Hospital & Research Center, Lahore, Pakistan. Method The study was conducted in two phases. Data for 3 months were collected for each phase of the study. Systematic and quantifiable consensus validity was developed for rejected interventions in phase 1, based on patient outcome analyses. Severity rating was assigned to assess the significance of interventions. Electronic prompts for follow-on interventions in phase 2 were then developed and implemented, including daily review via a multidisciplinary team (MDT) approach. Main outcome measure Validity of rejected interventions, acceptance of follow-on interventions before and after re-engineering the pharmacy processes, rejection rate and severity rating of follow-on interventions. Result Of a total of 2649 and 3064 interventions that were implemented during phase 1 and phase 2, 238 (9%) and 307 (10%) were rejected, respectively. Additionally, 133 (56%) were inappropriate rejections during phase 1. The estimated reliability between pharmacists regarding rejected interventions was 0.74 (95% CI of 0.69, 0.79, p 0.000). Prospective data were analysed after implementing electronic alerts and an MDT approach. The acceptance rate of follow-on interventions in phase 2 was 60% (184). Conclusion Electronic prompts for follow-on interventions together with an MDT approach enhance the optimization of pharmacotherapy, increase drug rationality and improve patient care.
KeywordsElectronic alert Multidisciplinary team Pakistan Pharmacy interventions Rejected interventions
The author thanks all the clinical pharmacists for their help with obtaining background information on pharmacy interventions.
There was no specific funding source for this study.
Conflicts of interest
The authors declare no conflicts of interest.
- 13.Patient Statistics. Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan. 2016. https://www.shaukatkhanum.org.pk/about-us/statistics-gg/patient-statistics.html. Accessed 10 May 2016.
- 19.Al SZ. Clinical audit of pharmaceutical care provided by a clinical pharmacist in cardiology and infectious disease inpatients at the Royal Hospital, Muscat/Oman. Oman Med J. 2009;24:89–94.Google Scholar
- 28.Munk CL, Bendixen HK, Kjeldsen LJ. Medication review with a focus on fracture prophylaxis among patients suffering collum femoris fractures. EJHP Pract. 2011;17:26–30.Google Scholar
- 29.Boso-Ribelles V, Montero-Hernandez M, Font-Noguera I, Hernandez- Martin J, Martin-Ciges ES, Poveda-Andres JL. Evaluation of a plan for cardiology medication reconciliation on admission, and patient information at discharge, in a teaching hospital. EJHP Pract. 2011;17:2011–30.Google Scholar
- 30.Kjeldsen LJ, Olesen C, Truelshøj T, Nielsen LB. Quality assurance of medical treatment—an approach by Danish clinical pharmacists. EJHP Pract. 2011;17:31–4.Google Scholar
- 38.Chan DS, Kotzin DA. Adult vs pediatric clinical intervention trends: a four year, retrospective report. J Pediatr Pharm Pract. 1998;3:144–9.Google Scholar
- 40.Bates D. Patient safety research introductory course Session 1. What is patient safety? Geneva: World Health Organization. 2010. http://www.who.int/patientsafety/research/ps_online_course_session1_intro_2in1_english_2010_en.pdf. Accessed 26 Mar 2016.