IJPP 2004, 12: 1-6
© 2004 Int J Pharm Pract
Received August 18, 2003
Accepted January 4, 2004
ISSN 0961-7671

Chelsea & Westminster Healthcare NHS Trust, London

Deirdre Brady, medical admissions pharmacist

Hammersmith Hospitals NHS Trust and the School of Pharmacy, University of London

Bryony Dean Franklin, director, academic pharmacy unit

Correspondence: Ms Brady, Pharmacy Department, Chelsea & Westminster Healthcare NHS Trust, 369 Fulham Road, London SW10 9NH

E-mail: deirdre.brady@chelwest.nhs.uk

Acknowledgments: The authors would like to thank the judges who participated in this study (Ms Helen Morgan, Mr Barry Jubraj, Dr Yohan Samarasinghe, Dr Akill Jackson, Mr Rupert Thorne and Ms Deborah Bovey) and the nursing staff on William Gilbert ward for their patience and co-operation during the undertaking of this project. This paper was submitted in part fulfilment of the requirements for the Masters of Science Degree in Pharmacy Practice, University of London.

Original Papers

An evaluation of the contribution of the medical admissions pharmacist at a London teaching hospital

Deirdre Brady and Bryony Dean Franklin

Abstract
Objective To evaluate the contribution of the medical admissions pharmacist (MAP) at a London teaching hospital.

Method A descriptive study using quantitative methods to compare the activities of former non-designated pharmacists with that of the currently employed MAP in relation to interventions made regarding the drug therapy of patients in one medical admissions ward in a London hospital. The outcome measures were numbers of pharmacist interventions made and their clinical significance. A multi-disciplinary panel assessed clinical significance using an adapted form of a previously validated method.

Key findings Overall, significantly more interventions were made per day after appointment of the MAP (P = 0.003). In particular, interventions relating to drug administration/route, choice, dose, medication history and need for drug therapy significantly increased. Interventions made by the MAP were found to be of greater clinical significance when compared with those made by the non-designated pharmacists (P = 0.005). In a separate assessment of medication history accuracy, 12% of the patients’ regular medicines were unintentionally omitted and 6% of prescriptions unintentionally changed. All unintentional omissions and discrepancies identified resulted in an intervention by the MAP. The majority of these interventions were found to be of moderate clinical significance.

Conclusions The MAP made more interventions than the previous non-designated ward pharmacists and, overall, the interventions were of greater clinical significance. The research demonstrates the potential contribution of an MAP on post-admission ward rounds to ensure the safe and appropriate prescribing of medicines on the medical admissions ward. Confirming medication histories was shown to be important in ensuring appropriate prescribing of patients’ regular medicines on admission to hospital.