EAHP survey 2010 on hospital pharmacy in Europe: parts 4 and 5. Clinical services and patient safety

Abstract

Decentralised clinical services, with a pharmacist working in the ward at least 50% of the time or with pharmacists visiting the ward daily, are not very common in Europe. For-profit hospitals offer the service remarkably less than other hospitals, and 39.8% of hospital pharmacies offer clinical services occasionally. There is a variety of patient oriented clinical activities delivered by European hospital pharmacies, including the provision of drug information, pharmacokinetic consultations, therapeutic drug monitoring, management prevention of adverse drug reactions and medication errors. Hospital pharmacy involvement in managing the interface between primary and hospital care is less common. In general, clinical activities are not well documented. For inpatients, on average, only 14.7% and 21.9% of the hospital pharmacies that took part in the survey said they write down their interventions in the medical records and in pharmacy records, respectively. IT systems are broadly used in the provision of drug information but also in profiling patient medication and for dosage calculations. Patient safety is a major interest of hospital pharmacists and, on average, 55.0% of hospital pharmacies recorded that they have implemented a system to ensure patient safety.

Clinical pharmacy services that influence prescribing in the Western Pacific Region based on the FIP Basel Statements

“…These independent variables were selected for inclusion in the models based on previous literature, suggesting they may be associated with the implementation of clinical pharmacy services [18,20,30,36,37].…”

“…The Canadian Society of Hospital Pharmacists and the European Association of Hospital Pharmacists have also monitored hospital pharmacy practices regularly in their respective regions through surveys to hospital pharmacy directors and managers [17,18]. In Canada (2011/2012), the vast majority of directors (88 %) stated that they had pharmacists assigned to an inpatient program, with 85 and 44 % of hospital pharmacy directors having pharmacists conduct medication reconciliation on admission and discharge respectively [17].…”

“…Europe is still developing its clinical pharmacy services, with only the United Kingdom claiming to offer daily clinical pharmacy services to the wards in more than half of their hospitals. In comparison, an average of 6 % of hospital pharmacy directors in Europe reported to have pharmacists' spending half of their time on a ward [18]. Whilst public hospitals in Europe were three times as likely to have a pharmacist visit their wards daily compared to private hospitals, only 20 % of these hospitals had pharmacists visit the patient on admission and/or provide counselling on discharge [18].…”

Support for paediatric prescribers: what is discussed at hospital board level?

“…Providing clinical pharmacy services may be more challenging in other European countries where the number of pharmacists spending time on the wards is lower 26. However, clinical pharmacy services are well established in the USA where the American Society of Health-System Pharmacists has policies regarding medication therapy and the role of the pharmacist 27.…”

Finnish pharmacists’ perceptions of their work on the wards in hospitals and health centres

“…Overall, pharmacists’ job descriptions have taken shape mainly on the basis of the expectations of other professionals. In several countries it is not uncommon for pharmacists to work with patients, physicians and other members of the care team, providing patient oriented clinical services, for example patient counselling, pharmacokinetic consultations and therapeutic drug monitoring 3 5…”