Acceptance and importance of clinical pharmacists’ LIMM-based recommendations
Objective The objective of this study was to evaluate the quality of the clinical pharmacy service in a Swedish hospital according to the Lund Integrated Medicine Management (LIMM) model, in terms of the acceptance and clinical significance of the recommendations made by clinical pharmacists. Method The clinical significance of the recommendations made by clinical pharmacists was assessed for a random sample of inpatients receiving the clinical pharmacy service in 2007. Two independent physicians retrospectively ranked the recommendations emerging from errors in the patients’ current medication list and actual drug-related problems according to Hatoum, with rankings ranging between 1 (adverse significance) and 6 (extremely significant). Results The random sample comprised 132 patients (out of 800 receiving the service). The clinical significance of 197 recommendations was assessed. The physicians accepted and implemented 178 (90%) of the clinical pharmacists’ recommendations. Most of these recommendations, 170 (83%), were ranked 3 (somewhat significant) or higher. Conclusion This study provides further evidence of the quality of the LIMM model and confirms that the inclusion of clinical pharmacists in a multi-professional team can improve drug therapy for inpatients. The very high level of acceptance by the physicians of the pharmacists’ recommendations further demonstrates the effectiveness of the process.
KeywordsClinical pharmacist Clinical significance Drug-related problems Hospital Medication reconciliation Medication review Sweden
The assistance of Kristin Holmqvist and Nedal Ahmad, pharmacy students, who classified a large number of the drug-related problems and medication discrepancies, is acknowledged. Also, this study would not have been possible without the dedication and commitment of the ward staff.
Conflicts of interest
The authors declare no conflicts of interest.
- 1.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. doi: 10.1007/s00228-010-0982-3.PubMedCrossRefGoogle Scholar
- 8.Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. New York: The McGraw-Hill Companies Inc; 1998.Google Scholar