International Journal of Clinical Pharmacy

, Volume 34, Issue 1, pp 127–135 | Cite as

Perceived value of ward-based pharmacists from the perspective of physicians and nurses

  • Ulrika GillespieEmail author
  • Claes Mörlin
  • Margareta Hammarlund-Udenaes
  • Mariann Hedström
Research Article


Background Clinical pharmacy in a hospital setting is relatively new in Sweden. Its recent introduction at the University Hospital in Uppsala has provided an opportunity for evaluation by other relevant professionals of the integration of clinical pharmacists into the health-care team. Objectives The objectives of this descriptive study were to evaluate the perceived value of wardbased clinical pharmacists from the perspective of hospital based physicians and nurses and to identify potential advantages and disadvantages related to the new inter professional collaboration. Another objective was to evaluate the experiences of general practitioners on receiving medication reports from ward-based clinical pharmacists. Setting Two acute internal medicine wards at the University Hospital in Uppsala, where a previously reported randomized controlled trial investigating the effects of ward based clinical pharmacists on re-visits to hospital was undertaken. Methods Data were collected by questionnaires containing closed- and open-ended questions. The questionnaires were distributed during the nine-month study period of the randomized controlled trial by an independent researcher to 29 hospital-based physicians and 44 nurses on the study wards and to 21 general practitioners who had received two or more medication reports. Answers were analysed descriptively for the closed-ended questions and by content analysis for the open-ended questions. Main outcome measure The main outcome measure was the physicians’ and nurses’ level of satisfaction with the new collaboration with clinical pharmacists, from a hospital and primary care perspective. Results Seventy-six percent of the hospital-based physicians and 81% of the nurses completed the questionnaire. Ninety-five percent of the physicians and 93% of the nurses were very satisfied with the collaboration. Out of the 17 general practitioners (81%) that completed the questionnaire 71% wanted to continue to receive medication reports in a similar way in the future. Increased patient safety and improvements in patients’ drug therapy were the main advantages stated by all three groups of respondents. Eighteen percent of the hospital-based physicians and 21% of the nurses thought that the collaboration had been time-consuming to certain or to a high extent. Conclusions The majority of the respondents, both GPs and hospital based physicians and nurses, were satisfied with the new collaboration with the ward based pharmacists and perceived that the quality of the patients’ drug therapy and drug-related patient safety had increased.


Clinical pharmacy Collaboration Inter-professional relationships Multidisciplinary team Nurses Physicians Sweden 




Conflicts of interest



  1. 1.
    Hammond RW, Schwartz AH, Campbell MJ, Remington TL, Chuck S, Blair MM, et al. Collaborative drug therapy management by pharmacists–2003. Pharmacotherapy. 2003;23(9):1210–25.PubMedCrossRefGoogle Scholar
  2. 2.
    Farrell B, Pottie K, Woodend K, Yao V, Dolovich L, Kennie N, et al. Shifts in expectations: evaluating physicians’ perceptions as pharmacists become integrated into family practice. J Interprof Care. 2010;24(1):80–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Gillespie U, Alassaad A, Henrohn D, Garmo H, Hammarlund-Udenaes M, Toss H, et al. A comprehensive pharmacist intervention to reduce morbidity in patients 80 years or older: a randomized controlled trial. Arch Intern Med. 2009;169(9):894–900.PubMedCrossRefGoogle Scholar
  4. 4.
    Scullin C, Scott MG, Hogg A, McElnay JC. An innovative approach to integrated medicines management. J Eval Clin Pract. 2007;13(5):781–8.PubMedCrossRefGoogle Scholar
  5. 5.
    Murray MD, Ritchey ME, Wu J, Tu W. Effect of a pharmacist on adverse drug events and medication errors in outpatients with cardiovascular disease. Arch Intern Med. 2009;169(8):757–63.PubMedCrossRefGoogle Scholar
  6. 6.
    Makowsky MJ, Koshman SL, Midodzi WK, Tsuyuki RT. Capturing outcomes of clinical activities performed by a rounding pharmacist practicing in a team environment: the COLLABORATE study [NCT00351676]. Med Care. 2009;47(6):642–50.PubMedCrossRefGoogle Scholar
  7. 7.
    Schmader KE, Hanlon JT, Pieper CF, Sloane R, Ruby CM, Twersky J, et al. Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly. Am J Med. 2004;116(6):394–401.PubMedCrossRefGoogle Scholar
  8. 8.
    Holland R, Battersby J, Harvey I, Lenaghan E, Smith J, Hay L. Systematic review of multidisciplinary interventions in heart failure. Heart. 2005;91(7):899–906.PubMedCrossRefGoogle Scholar
  9. 9.
    Spinewine A, Swine C, Dhillon S, Lambert P, Nachega JB, Wilmotte L, et al. Effect of a collaborative approach on the quality of prescribing for geriatric inpatients: a randomized, controlled trial. J Am Geriatr Soc. 2007;55(5):658–65.PubMedCrossRefGoogle Scholar
  10. 10.
    Kaboli PJ, Hoth AB, McClimon BJ, Schnipper JL. Clinical pharmacists and inpatient medical care: a systematic review. Arch Intern Med. 2006;166(9):955–64.PubMedCrossRefGoogle Scholar
  11. 11.
    Bond CA, Raehl CL, Franke T. Clinical pharmacy services, hospital pharmacy staffing, and medication errors in United States hospitals. Pharmacotherapy. 2002;22(2):134–47.PubMedCrossRefGoogle Scholar
  12. 12.
    Schumock GT, Butler MG, Meek PD, Vermeulen LC, Arondekar BV, Bauman JL. Evidence of the economic benefit of clinical pharmacy services: 1996–2000. Pharmacotherapy. 2003;23(1):113–32.PubMedCrossRefGoogle Scholar
  13. 13.
    Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, et al. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282(3):267–70.PubMedCrossRefGoogle Scholar
  14. 14.
    Bergkvist A, Midlov P, Hoglund P, Larsson L, Eriksson T. A multi-intervention approach on drug therapy can lead to a more appropriate drug use in the elderly. LIMM-Landskrona Integrated Medicines Management. J Eval Clin Pract. 2009;5(4):660–7.CrossRefGoogle Scholar
  15. 15.
    Bond CA, Raehl CL, Franke T. Interrelationships among mortality rates, drug costs, total cost of care, and length of stay in United States hospitals: summary and recommendations for clinical pharmacy services and staffing. Pharmacotherapy. 2001;21(2):129–41.PubMedCrossRefGoogle Scholar
  16. 16.
    Hellstrom LM, Bondesson A, Hoglund P, Midlov P, Holmdahl L, Rickhag E, et al. Impact of the Lund Integrated Medicines Management (LIMM) model on medication appropriateness and drug-related hospital revisits. Eur J Clin Pharmacol. 2011;67(7):741–52.PubMedCrossRefGoogle Scholar
  17. 17.
    Zwarenstein M. Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes (Review). The Cochrane Library. 2009(3).Google Scholar
  18. 18.
    Ray MD. Shared borders: achieving the goals of interdisciplinary patient care. Am J Health Syst Pharm. 1998;55(13):1369–74.PubMedGoogle Scholar
  19. 19.
    Pottie K, Farrell B, Haydt S, Dolovich L, Sellors C, Kennie N, et al. Integrating pharmacists into family practice teams: physicians’ perspectives on collaborative care. Can Fam Physician. 2008;54(12):1714–1717 e5.PubMedGoogle Scholar
  20. 20.
    McPherson K. Working and learning together: good quality care depends on it, but how can we achieve it? Qual Health Care. 2001;10(Suppl 2):46–53.Google Scholar
  21. 21.
    Dey RM, de Vries MJ, Bosnic-Anticevich S. Collaboration in chronic care: unpacking the relationship of pharmacists and general medical practitioners in primary care. Int J Pharm Pract. 2011;19(1):21–9.PubMedCrossRefGoogle Scholar
  22. 22.
    Doucette WR, Nevins J, McDonough RP. Factors affecting collaborative care between pharmacists and physicians. Res Social Adm Pharm. 2005;1(4):565–78.PubMedCrossRefGoogle Scholar
  23. 23.
    McDonough RP, Doucette WR. A practical guide to pharmaceutical care. 2nd ed. Washington: American Pharmaceutical Association; 2003. p. 139–52.Google Scholar
  24. 24.
    Holland R, Smith R, Harvey I. Where now for pharmacist led medication review? J Epidemiol Community Health. 2006;60(2):92–3.PubMedCrossRefGoogle Scholar
  25. 25.
    Adamcik BA, Ransford HE, Oppenheimer PR, Brown JF, Eagan PA, Weissman FG. New clinical roles for pharmacists: a study of role expansion. Soc Sci Med. 1986;23(11):1187–200.PubMedCrossRefGoogle Scholar
  26. 26.
    Weber R. Basic content analysis. London: Sage Publications; 1990. 1090.Google Scholar
  27. 27.
    Lisby M, Thomsen A, Nielsen LP, Lyhne NM, Breum-Leer C, Fredberg U, et al. The effect of systematic medication review in elderly patients admitted to an acute ward of internal medicine. Basic Clin Pharmacol Toxicol. 2010;106(5):422–7.PubMedGoogle Scholar
  28. 28.
    Stemer G, Lemmens-Gruber R. The clinical pharmacist’s contributions within the multidisciplinary patient care team of an intern nephrology ward. Int J Clin Pharm. 2011;33(5):759–62.PubMedCrossRefGoogle Scholar
  29. 29.
    Kazdin A. Research design in clinical psychology. 4th ed. Allyn & Bacon: Boston; 2003. pp. 90–1Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2011

Authors and Affiliations

  • Ulrika Gillespie
    • 1
    • 2
    Email author
  • Claes Mörlin
    • 2
  • Margareta Hammarlund-Udenaes
    • 1
  • Mariann Hedström
    • 3
  1. 1.Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical BiosciencesUppsala UniversityUppsalaSweden
  2. 2.Department of MedicineUppsala UniversityUppsalaSweden
  3. 3.Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden

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