Pertinence et efficience d’une nouvelle méthodologie d’analyse pharmaceutique des prescriptions au CHU de Dijon

Gougeard, Antoine; Fouquier, Bastian; Malbranche, C.; Prudent, Christelle

doi:10.1016/j.phclin.2020.09.005

Cited by 1 publication

(1 citation statement)

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“…Prioritizing medication review according to the type of patients and drugs makes it possible to optimize available human resources and increase the rate of PIs issued, as has already been demonstrated ( Allenet et al, 2009 ; Philippe et al, 2017 ; Gougeard et al, 2021 ). Mobile clinical pharmacy activity using MDSS tools could be a good compromise between proximity and prioritization of targeting.…”

Section: Discussionmentioning

confidence: 98%

Acceptance Factors for In-Hospital Pharmacist Interventions in Daily Practice: A Retrospective Study

et al. 2022

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Introduction: Performing pharmacist interventions (PIs) during the medication review helps to improve the quality of care. The acceptance by the physician of these PIs is a good indicator of the quality of this clinical pharmacy activity. The objective of this study was to determine, in the Amiens-Picardie teaching hospital (France), factors of acceptance in a variable environment of activity (central pharmacy, in the care units, computer assisted).Methods: All PIs transcribed by pharmacists on the Act-IP© site between November 2018 and April 2019 were analyzed using a complementary search in patient records. The environment, type, and clinical impact on patient health of each PI was collected. Linear mixed-effects models with a random pharmacist intercept were used to investigate the relationship between PI modalities and their chance of being accepted.Results: A total of 3,100 PIs were traced, of which 2,930 had been followed over time. Of these, 2,930 PIs, 1,504 (51.3%) were performed by a postgraduate pharmacist and 1,426 (48.7%) by a pharmacy resident, 1,623 (55.4%) were performed by verbal exchange, 455 (15.5%) by telephone, 846 (28.9%) by computer software, and 6 (0.2%) by paper. The clinical impact on patient health was major for 976 PIs (33.3%) and vital for 26 PIs (0.9%). According to the Anatomical Therapeutic Chemical Classification (ATC), they were mainly related to anti-infectives (30.3%), the nervous system (18.7%), and blood and blood-forming organs (17.3%). In total, 2,415 PIs (82.4%) were accepted. According to the multivariate model, a PI was more often accepted when it was transmitted orally rather than by software (+27.7%, 95% CI: +23.2 to +32.1%) and when it was transmitted to a medical resident rather than a postgraduate physician (+4.4%, 95% CI: 1.2–7.6%). In these cases, there was a major rather than a moderate clinical impact on patient health (+4.3%, 95% CI: +1.1–+7.6%).Conclusion: This study highlights the importance of the quality of the exchange with the prescriber and the prioritization of high-risk interventions as key points of medication review to improve rate of pharmacist interventions accepted by physician.

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Section: Discussionmentioning

confidence: 98%