Effect of reactive pharmacy intervention on quality of hospital prescribing.

Hawkey, Christopher J.; Hodgson, Simon T.; Norman, Aaron D.; Daneshmend, T K; Garner, Solomon T.

doi:10.1136/bmj.300.6730.986

Cited by 109 publications

(77 citation statements)

References 17 publications

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“…The high percentage of interventions that were accepted by a physician showed that the vast majority were appropriate. The acceptance rate was similar to that reported in the USA, 17 and higher than a UK study, 18 where 83% of interventions made by a pharmacist were accepted, with the prescription altered in 75% of cases.…”

Section: Discussionsupporting

confidence: 68%

Including pharmacists on consultant-led ward rounds: a prospective non-randomised controlled trial

2011

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-This study aimed to compare interventions made by pharmacists attending consultant-led ward rounds in addition to providing a ward pharmacy service, with those made by pharmacists providing a ward pharmacy service alone. A prospective non-randomised controlled study on five inpatient medical wards was carried out at two teaching hospitals. A mean of 1.73 physician-accepted interventions were made per patient for the study group, compared to 0.89 for the control (Mann Whitney U, pϽ Ͻ0.001) with no difference between groups in the nature or clinical importance of the interventions. One physician-accepted intervention was made every eight minutes during the consultant-led ward rounds, compared to one every 63 minutes during a ward pharmacist visit. Pharmacists attending consultant-led ward rounds in addition to undertaking a ward pharmacist visit make significantly more interventions per patient than those made by pharmacists undertaking a ward pharmacist visit alone, rectifying prescribing errors and optimising treatment.

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Section: Discussionsupporting

confidence: 68%

Including pharmacists on consultant-led ward rounds: a prospective non-randomised controlled trial

2011

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“…Hence periodical auditing of drug utilization pattern is vital for promotion of rational use of drugs, for increasing the therapeutic efficacy and the cost effectiveness, for decreasing the adverse effects and to provide feedback to the prescribers 3 . It is important to realize that inappropriate use of drugs represent a potential hazard to the patients and an unnecessary expense 4 . Historically the pharmaceutical and medical profession has devoted considerable time and efforts to the development and rational utilization of safe and effective drugs for the treatment and prevention of illness.…”

Section: Introductionmentioning

confidence: 99%

Drug Utilization Pattern in Opthalmology Department at a Tertiary Care Hospital

Prajwal¹,

Rai²,

Kumar³

et al. 2013

Int. Res. J. Pharm.

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The objective of the study is to assess the average number of drugs per prescription, formulations being prescribed, various categories of drugs being prescribed and the category most often used in ophthalmology. This is a retrospective hospital based study carried out in the department of ophthalmology at A.J institute of medical sciences, Mangalore, India. The study period was from July 2012 to July 2013. Total number of prescriptions analyzed were 3543, in which total of 15,324 drugs were prescribed. Analysis of the prescriptions showed that average number of drugs per prescription was 4.325. The maximum number of drugs prescribed were in the form of eye drops (67.65 %), followed by ointments (11.66 %), tablet (7.8 %), capsules (7.23 %), syrup (3.54 %) and injection (2.12 %). The dosage form was indicated for 91 %, frequency of drug administration for 97 % drugs and duration of treatment for only 69 % of the drugs prescribed. Around 56.44 % of diagnosis accounted for senile immature cataract. Rest 15.33 % and 9.81 % acconting for pseudophakia and senile mature cataract respectively. The number of antibiotics prescribed was 8,955 (58.43 %), out of these 5,981 (66.79 %) antibiotics were prescribed in the form of drops, 2,782 (31.06 %) as ointment and 191 (2.13 %) orally. Number of encounters with anti-inflammatory and anti allergic drugs was 1,547 (10.1 %), mydriatics and cycloplegics 1,317 (8.6 %), miotics 474 (3.1 %), lubricant and miscellaneous eye drops 2,869 (18.72 %) and multivitamins 161 (1.05 %). Prescription writing errors were at its minimum thereby avoiding irrational prescriptions. Duration of treatment and prescribing by generic name were very low.

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“…Several e cient procedures for dealing with non-HDF requests have been postulated [32,33,34,35,36]. However, the availability of research evidence on HDF non-adherence is limited.…”

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confidence: 99%

Assessment of indicators for hospital drug formulary non-adherence

Fijn

Lenderink

Egberts

et al. 2001

Eur J Clin Pharmacol

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Background: Translation of rational drug therapy into practice remains an international problem. Although pharmacotherapeutic treatment guidelines (PTGs) as managerial tools are favoured over hospital drug formularies (HDFs), the latter are still applied in most hospitals. HDF enforcement often leads to timeconsuming consultation from the perspective of both pharmacy sta and prescriber. So far, research on HDFs has only been conducted outside Europe. Moreover, this research has only been descriptive. Straightforward indicators qualitatively characterising HDF non-adherence have never been assessed. Methods: A retrospective 1:1 case-control study was conducted across three general teaching hospitals. Non-HDF requests were compared with HDF requests. Data were multivariably analysed, considering patient, prescriber, drug, and HDF characteristics as possible indicators for non-adherence. Results: HDF adherence was almost universal across characteristics. Non-adherence was characterised by newly marketed drugs, drugs that were part of patients' pre-admission drug therapy, drugs with many fellow drugs within the drug group on the market, and drugs originating from a drug group for which the HDF was highly restrictive. Contrary to common perception, nonadherence was independent of medical specialty, therapeutic area, and patient characteristics. Conclusion: This research provides an epidemiological framework for hospitals (drug and therapeutics committees) for evaluating pharmacy data on HDF nonadherence. It can be used for educational tailor-made feedback to prescribers and for drug selection when the inclusion of newly marketed drugs is considered or HDF restrictiveness for certain drug groups is reconsidered. Moreover, it demonstrates the importance of a regional approach involving secondary and primary health care to establish continuity in seamless care of drug therapy.

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Effect of reactive pharmacy intervention on quality of hospital prescribing.

Abstract: Conclusions-Most reactive pharmacy interventions concerned prescribing errors with a limited potential for medical harm, but a small number of detected errors with a major potential for medical harm; cost savings were not appreciable.

Cited by 109 publications

References 17 publications

Including pharmacists on consultant-led ward rounds: a prospective non-randomised controlled trial

Including pharmacists on consultant-led ward rounds: a prospective non-randomised controlled trial

Drug Utilization Pattern in Opthalmology Department at a Tertiary Care Hospital

Assessment of indicators for hospital drug formulary non-adherence

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