Clinical Pharmacy and Medication Safety

Abstract

W hile medication safety and preventive adverse drug event strategies have been more prominently reported in the medical literature over the last decade, the pharmacist's role in improving the safety of medication use has been a part of the pharmacy literature since the 1960s. The inaugural issue of The Annals of Pharmacotherapy was published in January 1967 as Drug Intelligence, and over the years the journal has undergone a few more name changes. The Annals of Pharmacotherapy was started by a dedicated group of pharmacists as an independent journal of hospital pharmacy to highlight best practices for US and foreign pharmacists. 1 According to Don Francke's editorial, one of the objectives of Drug Intelligence was to encourage hospital pharmacists to "relate more directly to the patient, the physician, and the nurse and to take his place on the health-care team as a practitioner of clinical phar-macy…." Many of the early issues of Drug Intelligence were focused on what the practice of "clinical pharmacy" should be and were a forum for discussion of the development of clinical pharmacy practice at many hospitals. 2-8 The education of pharmacists and pharmacy students to prepare them for "clinical pharmacist" roles was also discussed; these clinical pharmacy roles continue to evolve and have expanded from hospital practice to ambulatory and other settings.In another editorial, Don Francke described the multidisciplinary nature of medication errors. 9 He was very timely in identifying solutions for medication errors and improving medication safety. He emphasized that improved communication and automation of decision-making of the medication use process by physicians, pharmacists, and nurses, as well as cooperative interdisciplinary action, were key to providing better patient care and reducing medication errors, 9 or what we now term adverse drug events. Gloria Francke authored an early article on the definition of clinical pharmacy and listed the multidisciplinary process of medication error prevention as 1 of 5 factors influencing the development of clinical pharmacy practice. 3 Gloria Francke called for pharmacists to work more closely with nurses and physicians to improve provision and control of medications from the time of procurement to the time of administration to improve medication safety.Several articles and editorials in The Annals discussed the direction and roles that pharmacists should take in providing better patient care as practitioners of clinical pharmacy. Medication distribution in US hospitals in the 1960s now seems almost primitive, with pharmacists overseeing the distribution of drugs from the pharmacy to the patientcare units and nurses being responsible for stocking and preparation of medications, often with duplication of effort by pharmacists, physicians, and nurses, 7,8 compared with current distribution systems that use robotics, computers, and other technology to control the medication use process within the institution. Improved medication technology and control of the distribution p...

Medication Review: What’s in a Name and What Is It about?

“…By the mid-1960s, pharmacists transitioned towards a more patient-centered approach, introducing the concept of clinical pharmacy [1,2,4], the beginning of an evolution detailed further in Figure 1. Pharmacists actively participated in optimizing patient medication therapies within hospital settings [13]. While pharmacists have been examining medicine charts and offering recommendations to prescribers since the 1980s, this practice was not yet widely adopted in primary care settings during that period [4,14].…”

Understanding Pharmacist Communication and Medication Errors: A Systematic Literature Review

“…[2,6] Pharmacists play various roles in the healthcare system and Understanding Pharmacist Communication and Medication Errors: A Systematic Literature Review pharmaceutical care requires the pharmacist's involvement to prevent and solve drug related problems. [7] Additionally, pharmacists help with improving safety of medication use, [8] quality assurance and care services, which can reduce or eliminate the risk of errors. [9] Medication errors can be due to prescribing, dispensing and drug administration errors and related factors to the drug distribution chain.…”

Medication safety activities of hospital pharmacists in Ghana; challenges and perceived impact on patient care

“…Significant among these interventions is the role of pharmacists in maximizing the safe, effective, and efficient use of medicines [16][17][18][19][20]. Bond and Raehl [21] showed that pharmacy practice has the propensity to improve patient outcomes, reduce rates of adverse events and mortality, and maintain value over time.…”