Impact of clinical pharmacist interventions on the cost of drug therapy in intensive care units of a tertiary care teaching hospital

Lucca, Jisha M; Ramesh, Madhan; Narahari, Gopalakrishna M; Minaz, Nathani

doi:10.4103/0976-500x.99422

Cited by 31 publications

(34 citation statements)

References 8 publications

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“…It was found that systemic use of anti-infective agents was a leading reason for PEs with almost half the errors belonged to this class. This finding is consistent with a recent data supporting that PEs were mostly associated with the orders for antibiotics (34), while other drugs such as antiepileptics, had less frequent errors. Another study conducted in 20 hospitals in UK that included 26,019 prescriptions show that the most of prescribing errors were in parenteral administration of drugs, however, they reported that cardiovascular and endocrine medications were the most common classes associated with PEs (35).…”

Section: Discussionsupporting

confidence: 93%

Description of Pharmacists’ Reported Interventions to Prevent Prescribing Errors among in Hospital Inpatients: A Cross Sectional Retrospective Study

Alzahrani

Alwhaibi

Asiri

et al. 2020

Preprint

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Background: Prescribing errors (PEs) are a common cause of morbidity and mortality, both in community practice and in hospitals. Pharmacists have an essential role in minimizing and preventing PEs, thus, there is a need to document the nature of pharmacists’ interventions in preventing PEs. The purpose of this study was to describe reported interventions conducted by pharmacists that to prevent or minimize PEs in a tertiary care hospital. Methods: A retrospective analysis of the electronic medical records data was conducted to identify pharmacists’ interventions related to reported PEs. The PE-related data was extracted for a period of six-month (April to September 2017) and comprised of patient demographics, medication-related information, and the different interventions by the pharmacists. The study was conducted in a tertiary care hospital in Riyadh region. The study was ethically reviewed and approved by the hospital IRB committee. Descriptive analyses were appropriately conducted using the IBM SPSS Statistics. Results: A total of 2,564 pharmacists’ interventions related to PEs were recorded. These interventions were reported in 1,565 patients. Wrong dose (54.3%) and unauthorized prescription (21.9%) were the most commonly encountered PEs. Anti-infectives for systemic use (49.2%) and alimentary tract and metabolism (18.2%) were the two most common medications, which involved PEs. Most commonly reported pharmacists’ interventions included dose adjustments (44.0%), restricted medication approvals (21.9%), and therapeutic duplications (11%). Conclusions: PEs occur commonly in hospitals and pharmacists’ interventions are critical is preventing possible harm to patients. Care coordination and prioritizing patient safety through quality improvement initiatives at all levels of the health care system can play a key role in this quality improvement drive. Future studies should evaluate the impact of pharmacists’ interventions on patient outcomes.

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Section: Discussionsupporting

confidence: 93%

Description of Pharmacists’ Reported Interventions to Prevent Prescribing Errors among in Hospital Inpatients: A Cross Sectional Retrospective Study

Alzahrani

Alwhaibi

Asiri

et al. 2020

Preprint

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“…A study from Thailand reported that interventions made by pharmacist resulted in the direct cost saving of 1,971.43 US $ over 5 week study period [24]. Another study concludes that clinical pharmacist had a significant impact on the cost of drug therapy as the total net cost savings made over a 7 month study period were US $ 1796.7 [19]. We encourage further research to validate our findings.…”

Section: Discussionsupporting

confidence: 54%

Impact of pharmacist intervention in patient counseling at point of hospital discharge in a specialized cardiac center in Saudi Arabia

Assiri¹,

Khurshid²,

Almutairi³

et al. 2017

Trop. J. Pharm Res

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%). The most common reason for adding the drug during patient counseling was the omission of medications (35 %). Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARBs), antidiabetics and antihyperlipidemics were the classes of drugs often associated with counseling pharmacist interventions. The cost-saving interventions identified were 200 (39.4 %). Out of these, drug discontinuation (n = 143) was the most frequent suggestion provided by the intervening pharmacist, followed by a dose reduction resulting in cost savings of 66.5 % (US $ 6,590.10) and 8.9 % (US $ 882.32), respectively. Conclusion:The results indicate that discharge medication discrepancies decrease as a result of pharmacist-facilitated patient counseling at the point of hospital discharge.

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“…In low- and middle-income countries clinical pharmacy services are limited 9 , 10 and implementation of such services could faces various challenges, such as: (i) lack of clinically qualified pharmacists; 11 (ii) poor pharmaceutical literacy among patients; 12 (iii) under-utilization of research evidence due to underdeveloped health-care systems; 13 (iv) restrictions in medicines regulatory capacity; 13 (v) poor availability of essential medicines; and (vi) limitations in accessing high quality medicines 11 . Hence, findings from implementation of clinical pharmacy services in high-income countries cannot be generalizable to low- and middle-income countries.…”

Section: Introductionmentioning

confidence: 99%

Ward-based clinical pharmacists and hospital readmission: a non-randomized controlled trial in Sri Lanka

Shanika

Jayamanne

Wijekoon

et al. 2017

Bull. World Health Organ.

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ObjectiveTo assess if a ward-based clinical pharmacy service resolving drug-related problems improved medication appropriateness at discharge and prevented drug-related hospital readmissions.MethodBetween March and September 2013, we recruited patients with noncommunicable diseases in a Sri Lankan tertiary-care hospital, for a non-randomized controlled clinical trial. The intervention group received usual care and clinical pharmacy service. The intervention pharmacist made prospective medication reviews, identified drug-related problems and discussed recommendations with the health-care team and patients. At discharge, the patients received oral and written medication information. The control group received usual care. We used the medication appropriateness index to assess appropriateness of prescribing at discharge. During a six-month follow-up period, a pharmacist interviewed patients to identify drug-related hospital readmissions.ResultsData from 361 patients in the intervention group and 354 patients in the control group were available for analysis. Resolutions of drug-related problems were higher in the intervention group than in the control group (57.6%; 592/1027, versus 13.2%; 161/1217; P < 0.001) and the medication was more appropriate in the intervention group. Mean score of medication appropriateness index per patient was 1.25 versus 4.3 in the control group (P < 0.001). Patients in the intervention group were less likely to be readmitted due to drug-related problems (44 patients of 311 versus 93 of 311 in the control group; P < 0.001).ConclusionA ward-based clinical pharmacy service improved appropriate prescribing, reduced drug-related problems and readmissions for patients with noncommunicable diseases. Implementation of such a service could improve health care in Sri Lanka and similar settings.

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Impact of clinical pharmacist interventions on the cost of drug therapy in intensive care units of a tertiary care teaching hospital

Cited by 31 publications

References 8 publications

Description of Pharmacists’ Reported Interventions to Prevent Prescribing Errors among in Hospital Inpatients: A Cross Sectional Retrospective Study

Description of Pharmacists’ Reported Interventions to Prevent Prescribing Errors among in Hospital Inpatients: A Cross Sectional Retrospective Study

Impact of pharmacist intervention in patient counseling at point of hospital discharge in a specialized cardiac center in Saudi Arabia

Ward-based clinical pharmacists and hospital readmission: a non-randomized controlled trial in Sri Lanka

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