|
Lea Knez, Magister Farmacije, is research pharmacist,
academic department of pharmacy, Barts and The London NHS Trust.
Raisa Laaksonen, PhD, MRPharmS, is lecturer in pharmacy practice,
department of pharmacy and pharmacology, University of Bath. At
the time of the study she was research fellow, academic department
of pharmacy, Barts and The London NHS Trust.
Catherine Duggan, PhD, MRPharmS, is associate director of clinical
pharmacy for evaluation and development, East and South East England
Specialist Services, and senior clinical lecturer, School of Pharmacy,
University of London. At the time of the study she was director,
academic department of pharmacy, Barts and The London NHS Trust.
Rajinder Nijjar, ClinDipPharm, MRPharmS, is senior directorate
pharmacist — cancer services, Barts and The London NHS Trust.
Correspondence
to: Raisa Laaksonen, Department of Pharmacy and Pharmacology,
University of Bath, Bath BA2 7AY
e-mail r.laaksonen@bath.ac.uk |
Abstract
Aim
To evaluate clinical interventions in cancer services made by pharmacists on the wards and in the dispensing of chemotherapy doses to assess pharmacists’ contribution to patient care.
Design
A prospective cross-sectional survey.
Subjects and setting
Nine clinical pharmacists providing services on six cancer wards and at
the chemotherapy production unit (CPU) at Barts and The London NHS Trust,
London.
Outcome measures
The type and frequency of clinical interventions made by pharmacists and
their significance to patient care, as rated by an expert panel of pharmacy
staff.
Results
115 pharmacist interventions on 340 cases (prescriptions, chemotherapy
doses or patients) were observed. In 94% of cases, the pharmacist’s
advice was accepted by medical practitioners. The panel rated 64% of interventions
to have a significant, very significant or potentially life-saving effect
on patient care.
The panel and a consultant medical oncologist reached
agreement on the significance rating of only 17% of a sample of interventions;
however, both rated 77% of the interventions to be significant, very
significant or potentially life-saving. At the CPU, most interventions
involved cancer
therapy and were considered more significant than those made on the wards
which mainly involved support therapy.
Pharmacists of higher grades contributed
more to care of patients on complex drug therapy, whose therapy required
more significant interventions.
Conclusions
Interventions made by pharmacists are related to the level of practice,
with more complex interventions made by more senior or experienced
staff. Pharmacist interventions can improve the standard of patient
care, reduce
risk and prevent major toxicity. The contribution of pharmacists is
required for high quality services. |
The
Pharmaceutical Journal