Positive evidence for clinical pharmacist interventions during interdisciplinary rounding at a psychiatric hospital

AbstractClinical pharmacists have not yet become an integral part of interdisciplinary ward rounds in most psychiatric hospitals across the European Union. This retrospective observational pre-post study examined the impact of clinical pharmacist recommendations in an interdisciplinary medical team during psychiatric hospital rounding. The study included all patients in a Slovenian psychiatric hospital who were hospitalized 2019–2020. The clinical pharmacist made 315 recommendations for a total of 224 participants (average age M = 59.4, median = 56). Psychiatrists accepted 295 (93.7%) of the recommendations. After the recommendations, the number of expressed and potential drug-related problems decreased in 166 (93.8%) and 129 (93.8%) interventions, respectively. Three months after discharge, 222 accepted recommendations were continued (70.5%). The most common recommendations were related to antipsychotics (19.4%, N = 61) followed by antidepressants (16.8%, N = 53). Including a clinical pharmacist in the interdisciplinary ward rounds at a psychiatric hospital reduced the number of expressed and potential drug-related problems with a very high recommendation acceptance rate. These results are the first in Central Europe to explore the benefits of including a clinical pharmacist in ward rounding.

Download Full-text

Clinical pharmacist interventions during clinical rounding in a psychiatric hospital: Positive evidence for pharmacists in interdisciplinary rounding at psychiatric hospital

10.21203/rs.3.rs-343442/v1 ◽

2021 ◽

Author(s):

Matej Stuhec ◽

Valentina Tement

Keyword(s):

European Union ◽

Psychiatric Hospital ◽

Clinical Pharmacist ◽

Psychiatric Hospitals ◽

Acceptance Rate ◽

Medical Team ◽

The European Union ◽

Ward Rounds ◽

The Impact ◽

Very High

Abstract Clinical pharmacists have not yet become an integral part of interdisciplinary ward rounds in most psychiatric hospitals across the European Union. This retrospective study examined the impact of the recommendations from a clinical pharmacist during hospital rounds as part of an interdisciplinary medical team in a psychiatric hospital. This retrospective observational pre-post study included all patients in a Slovenian psychiatric hospital who were hospitalized in 2019–2020. The clinical pharmacist made 315 recommendations for a total of 244 participants (average age M = 59.4, median = 56). Psychiatrists accepted 295 (93.7%) of the recommendations. After the recommendations, the number of expressed DRPs decreased in 166 interventions (93.8%) and the number of potential DRPs in 129 interventions (93.8%). Three months after discharge, 222 accepted recommendations were continued (70.5%). The most common recommendations were related to antipsychotics (19.4%, N = 61) followed by antidepressants (16.8%, N = 53). Including a clinical pharmacist in the interdisciplinary ward rounds in a psychiatric hospital reduced the number of expressed and potential DRPs with a very high recommendation acceptance rate. These results are the first in the European Union to show the benefits of including a clinical pharmacist in ward rounding.

Download Full-text

Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions

10.21203/rs.2.13459/v2 ◽

2019 ◽

Author(s):

Berhane Yohannes Hailu ◽

Derbew Fikadu Berhe ◽

Esayas Kebede Gudina ◽

Kidu Gidey ◽

Mestwat Getachew

Keyword(s):

Clinical Pharmacist ◽

Geriatric Patients ◽

Medical Center ◽

Optimization Methods ◽

Acceptance Rate ◽

Drug Related Problems ◽

Treatment Optimization ◽

Pharmacist Interventions ◽

Age Related ◽

The Impact

Abstract Background: Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization. Methods: A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems. Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037). Conclusions: Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.

Download Full-text

Drug related problems in admitted geriatric patients: The impact of clinical pharmacist interventions

10.21203/rs.2.13459/v1 ◽

2019 ◽

Author(s):

Berhane Yohannes Hailu ◽

Derbew Fikadu Berhe ◽

Esayas Kebede Gudina ◽

Kidu Gidey ◽

Mestwat Getachew

Keyword(s):

Clinical Pharmacist ◽

Geriatric Patients ◽

Medical Center ◽

Acceptance Rate ◽

Drug Related Problems ◽

Treatment Optimization ◽

Pharmacist Interventions ◽

Age Related ◽

The Impact ◽

Geriatric Inpatients

Abstract Background : Geriatric patients are at high risk of Drug Related Problems (DRPs) due to multi- morbidity associated polypharmacy, age related physiologic changes, pharmacokinetic and pharmacodynamics alterations. These patients are often excluded from premarketing trials that can further increase the occurrence of DRPs. This study was aimed to identify DRPs and determinants in geriatric patients admitted to medical and surgical wards, and to evaluate the impact of clinical pharmacist interventions for treatment optimization.Methods : A prospective observational study was conducted among geriatric patients admitted to medical and surgical wards of Jimma University Medical Center from April to July 2017. Clinical pharmacists reviewed patients drug therapy, identified drug related problems and provided interventions. Data were analyzed by using SPSS statistical software version 20.0. Descriptive statistics were performed to determine the proportion of drug related problems. Logistic regression analyses were performed to identify the determinants of drug related problems.Results: A total of 200 geriatric patients were included in the study. The mean age of the participants was 67.3 years (SD7.3). About 82% of the patients had at least one drug related problems. A total of 380 drug related problems were identified and 670 interventions were provided. For the clinical pharmacist interventions, the prescriber acceptance rate was 91.7%. Significant determinants for drug related problems were polypharmacy (adjusted odds ratio [AOR]=4.350, 95% C.I: 1.212-9.260, p = 0.020) and number of comorbidities (AOR=1.588, 95% C.I: 1.029-2.450, p = 0.037).Conclusions : Drug related problems were substantially high among geriatric inpatients. Geriatric patients with polypharmacy and comorbidities need special attention to prevent drug related problems. Involving clinical pharmacist in the clinical team resulted in the improved acceptance rate of treatment optimization.

Download Full-text

Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.202067 ◽

2020 ◽

Vol 54 (4) ◽

pp. 218-224

Author(s):

Merve Nur Işık ◽

Nazan Dalgıç ◽

Betül Okuyan ◽

Zeynep Yıldız Yıldırmak ◽

Mesut Sancar

Keyword(s):

Drug Use ◽

Clinical Pharmacist ◽

Medication Review ◽

Pediatric Patients ◽

Potential Drug ◽

Drug Related Problems ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

Download Full-text

Drug-related problems with targeted/immunotherapies at an oncology outpatient clinic

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155219861679 ◽

2019 ◽

Vol 26 (3) ◽

pp. 595-602

Author(s):

Esra Kucuk ◽

Aygin Bayraktar-Ekincioglu ◽

Mustafa Erman ◽

Saadettin Kilickap

Keyword(s):

Adverse Drug Event ◽

Clinical Pharmacist ◽

Adverse Drug Events ◽

Drug Event ◽

Targeted Chemotherapy ◽

Drug Related Problems ◽

Patients With Cancer ◽

Common Drug ◽

Oncology Care ◽

The Impact

Background Some studies in the literature describe drug-related problems in patients with cancer, although few studies focused on patients receiving targeted chemotherapy and/or immunotherapy. To identify the incidence of drug-related problems in patients receiving targeted chemotherapy and/or immunotherapy, and demonstrate the impact of a clinical pharmacist in an outpatient oncology care setting. Methods Prospective study was conducted in a hospital outpatient oncology clinic between October 2015 and March 2016. Patients greater than 18 years old receiving cetuximab, nivolumab, ipilimumab, or pembrolizumab were included in the study and monitored over a three-month period by a clinical pharmacist. Drug-related problems were analyzed using the Pharmaceutical Care Network Europe classification system. The main outcome measures were the frequency and causes of drug-related problems and the degree of resolution achieved through the involvement of a clinical pharmacist. Results A total of 54 patients (mean age: 57 ± 12 years) were included. There were 105 drug-related problems and 159 associated causes. Among the planned interventions (n = 149), 92 interventions were at the patient-level with 88 (96%) being accepted by the doctors. This resulted in 68 (65%) drug-related problems being completely resolved and 9 (8.6%) being partially resolved. The most common drug-related problem identified was “adverse drug event” (n = 38, 36%). Of the 105 drug-related problems, 63 (60%) related to targeted chemotherapy and/or immunotherapy with 34 (54%) classified as an “adverse drug event.” Conclusion Adverse drug events were the most common drug-related problems in patients with cancer. The involvement of a clinical pharmacist improved the identification of drug-related problems and helped optimize treatment outcomes in patients receiving targeted chemotherapy/immunotherapy.

Download Full-text

Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist

European Journal of Internal Medicine ◽

10.1016/j.ejim.2015.05.012 ◽

2015 ◽

Vol 26 (6) ◽

pp. 399-406 ◽

Cited By ~ 27

Author(s):

Bertrand Guignard ◽

Pascal Bonnabry ◽

Arnaud Perrier ◽

Pierre Dayer ◽

Jules Desmeules ◽

...

Keyword(s):

Internal Medicine ◽

General Internal Medicine ◽

Clinical Pharmacist ◽

Drug Related Problems ◽

General Internal ◽

The Impact

Download Full-text

Epidemiological Characteristics of Major Depression of Hospitalized Patients in Psychiatric Hospital “Demir Hisar” – Demir Hisar for a Five Year Period from 2013 to 2017

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2020.3555 ◽

2020 ◽

Vol 8 (A) ◽

pp. 378-384

Author(s):

Biljana Iliev ◽

Dimitar Bonevski ◽

Andromahi Naumovska

Keyword(s):

Major Depression ◽

Psychiatric Hospital ◽

Urban Areas ◽

Severe Depression ◽

Psychiatric Hospitals ◽

Hospitalized Patients ◽

Number Of Patients ◽

Wide Range ◽

Epidemiological Characteristics ◽

The Impact

BACKGROUND: Severe depression is a mental disorder with a wide range of changes in psychic functions, primarily of affectivity, and is manifested by dysphoric mood and reductive changes in cognitive, conative, and other psychic dynamics, with the presence of psychosomatic complaints and suicidal thoughts. There is always a triad of symptoms: Alteration of affectivity, anhedonia, and low energy with fatigue, but in her clinical picture, there are other symptoms, such as feeling guilty and helpless, obsessed with “black thoughts” with loss of confidence in themselves, with hopelessness, loss of appetite, and weight loss with present insomnia or hypersomnia, and more frequent thinking about death due to the feeling of worthlessness of life. This mental illness covers a vast area of the affective life of a human with a broad spectrum classified by ICD - 10- F 32, F 32.2, and F 32.3. AIM: The main goal is to determine the total number of patients with the major depression treated at “Demir Hisar” Psychiatric Hospital for a period of 5 years, retrospectively in 2013 until 2017 and to determine the impact of socio-demographic variables as risk factors and predictors. METHODS: The study is retrospective, and the necessary parameters for achieving the goals of the research are provided by analyzing the medical histories of all hospitalized patients treated in psychiatric hospitals Demir Hisar in the period from 2013 to 2017. Incidence rates and indexes of the dynamics of hospitalized patients with major depression were determined. RESULTS: About 61.8% of the patients are men and 38.2% women. Patients with no education and elementary school were 64.5% versus patients with high school and university 35.5% and are significantly underpowered. Regarding the employment status, 38.2% of patients are unemployed, and 61.8% of patients are employed. According to the cross-sectional study, 64.7% of men without education have severe depression and live in the city, and 53.3% of women with secondary education live in urban areas (city), meaning rural residence is associated with a reduced rate of severe depression. CONCLUSION: We can conclude that socio-demographic characteristics – age, gender, marital status, level of education, employment/unemployment status, and place of residence are related to the severity of depression.

Download Full-text

Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

Çocuk Enfeksiyon Dergisi/Journal of Pediatric Infection ◽

10.5578/ced.69774 ◽

2020 ◽

Vol 54 (4) ◽

pp. 237-243

Author(s):

Merve Nur Işık ◽

Nazan Dalgıç ◽

Betül Okuyan ◽

Zeynep Yıldız Yıldırmak ◽

Mesut Sancar

Keyword(s):

Drug Use ◽

Clinical Pharmacist ◽

Medication Review ◽

Pediatric Patients ◽

Potential Drug ◽

Drug Related Problems ◽

Cross Sectional ◽

Rational Drug Use ◽

Rational Drug

Download Full-text

Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions

BMC Geriatrics ◽

10.1186/s12877-020-1413-7 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 9

Author(s):

Berhane Yohannes Hailu ◽

Derebew Fikadu Berhe ◽

Esayas Kebede Gudina ◽

Kidu Gidey ◽

Mestawet Getachew

Keyword(s):

Clinical Pharmacist ◽

Geriatric Patients ◽

Drug Related Problems ◽

Pharmacist Interventions ◽

The Impact

Download Full-text

Assessment of drug related problems and clinical pharmacist interventions in paediatric department of a tertiary care teaching hospital

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20183926 ◽

2018 ◽

Vol 7 (10) ◽

pp. 1934 ◽

Cited By ~ 2

Author(s):

Deepishka Pemmasani ◽

Sai Deepak Gali ◽

Maanasa Arcot ◽

Durga Prasad T. S.

Keyword(s):

Clinical Pharmacist ◽

Tertiary Care ◽

Acceptance Rate ◽

Pediatric Care ◽

Drug Related Problems ◽

Interventional Study ◽

Pediatric Department ◽

Major Significance ◽

Pharmacist Interventions ◽

Paediatric Department

Background: Drug-related problems (DRPs) are frequent in hospitalization in pediatrics. The main aim of present investigation is to assess drug related problems and clinical pharmacist interventions in pediatric department of tertiary care hospital.Methods: It was a prospective, observational and interventional study carried over a period of 6 months.Results: A total of 66 patients were identified with drug related problems. Among them 31 (42%) were in between 1month–2 years followed by 25 (34%) were in between 2-11 years, 10(24%) were in between 11-18 years of age. 30(45.3%) patients were prescribed with 0-3 drugs followed by 21 (31.3%) were prescribed with 3-5 drugs, 15(23.3%) were prescribed with 6-10 drugs. Most of the DRP’s observed in the study were drug interactions 52(78.78%) [major-19 (36.53%), moderate-27 (5192%) and minor-6(11.53%)] followed by adverse drug reactions 12 (18.18%), and duplication errors were 2 (3.03%). Majority of the clinical pharmacist recommendations were duration change 52 (34.66%), drug change 10(6.66%), dose reduction 2 (1.35%) followed by drug termination 2 (1.33%). Major significance of DRPs were noted high 31(57.96%), whereas 25 (39.8%) were moderate and 8 (12.12%) were minor. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high in 57 (86.66%) cases while in 9 (13.33%) cases suggestions were accepted but therapy was not changed. There were no cases with neither suggestion were accepted nor therapy changed.Conclusions: Clinical pharmacist involvement in inpatient pediatric care can significantly help to identify, resolve and prevent the drug related problems. The study concluded that the clinical pharmacist has a significant role in patients care at hospital.

Download Full-text