Optimising medical treatment - how pharmacist-acquired medication histories have a positive impact on patient care

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The Pharmaceutical Journal
Vol 277 No 7431 p737-739
16 December 2006

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Original papers

Optimising medical treatment — how pharmacist-acquired medication histories have a positive impact on patient care

By Ann Slee, Keith Farrar, Don Hughes and Simon Constable

Ann Slee, MSc, MRPharmS, is clinical lecturer at the School of Pharmacy and Chemistry, Liverpool John Moore’s University, and clinical lead, ePrescribing Programme, NHS Connecting for Health. At the time of the study she was director of pharmacy at Conwy and Denbighshire Trust.

Keith Farrar, MPharm, MRPharmS, is clinical lecturer at the School of Pharmacy and Chemistry, Liverpool John Moore’s University. At the time of the study he was director of pharmacy at Wirral Hospitals NHS Trust.

Don Hughes, MSc, MRPharmS, is director of pharmacy at Conwy and Denbigh NHS Trust. At the time of the study he was director of pharmacy at the Countess of Chester Trust.

Simon Constable, MB BS, MRCP(UK), is lecturer in clinical pharmacology in the department of pharmacology and therapeutics, University of Liverpool.

Correspondence to:
Ann Slee
e-mail ann.slee@nhs.uk

Abstract

Aim
To identify whether a proactive clinical pharmacy review of a patient's treatment at the point of admission could potentially avoid adverse events.

Design
A multicentre prospective study.

Subjects and setting
All acute medical patients admitted over a five-day period to seven acute NHS trusts in England and Wales.

Outcome measures
Type, severity and outcome of pharmacist interventions.

Results
Pharmacists reviewed 791 of 1,170 medical patients. 464 pharmacist contributions were made in 298 patients, 391 (84%) of which were accepted by the relevant medical staff. One was rejected and 72 (16%) were unresolved at the time of reporting. 82 (17.7%) were considered to have prevented potentially serious events. The most common intervention (41.4%) was to add a drug that had inadvertently been omitted from the prescription.

Conclusion
There is a role for a proactive pharmacist review of medical patients on admission to identify the medication needs of individual patients and to correct prescriptions where these are not in line with those needs.

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