Abstract
Background Studies have revealed that the inclusion of a clinical pharmacist as a member in multidisciplinary medical team has been associated with improved medication use, reduced adverse drug reaction, reduced cost of treatment, and improved health outcomes. Objective The objectives of this study were to evaluate the implementation of clinical pharmacy recommendations and services, the acceptance rate by the physicians, and the anticipated outcomes of the recommendations at a hospital in Yemen. Methods Different units of the University of Science and Technology Hospital, Sana’a were included in this study. All the recommendations and services provided by the clinical pharmacist during daily activities were documented between June 2013 and November 2015. The provided recommendations were classified based on the type, acceptance rate, and the anticipated outcomes. Main outcome measure Type and quality of clinical pharmacists’ recommendations, anticipated impact of the recommendations on health outcomes, and their acceptance rate. Results Throughout the study period, a total of 957 patients in different hospital units were visited and provided with a total of 3307 interventions and services. The most frequent types of clinical pharmacist’s interventions were drug discontinuation (23.6%, n = 782), inappropriate dose interval or time (n = 735, 22.2%), and add medication (18.9%, n = 626). Overall, 61.8% (n = 2044) of the provided recommendations were accepted by the physicians. The most anticipated outcomes were improved the effectiveness of therapy (45.1%, n = 1909), avoid adverse drug reactions (29%, n = 1228), and decrease the cost of medications (18.8%, n = 797). Conclusion Clinical pharmacist’s recommendations resulted in improving drug therapy and decreasing adverse effects for inpatients at the University of Science and Technology Hospital. This suggests that the implementation of clinical pharmacy services is essential and has a positive outcome on patient care.
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References
Burke JM, Miller WA, Spencer AP, Crank CW, Adkins L, Bertch KE, et al. Clinical pharmacist competencies: American college of clinical pharmacy. Pharmacother J Hum Pharmacol Drug Ther. 2008;28(6):806–15.
Alefan Q, Halboup A. Chapter 11—pharmacy practice in jordan. In: Fathelrahman AI, Ibrahim MIM, Wertheimer AI, editors. Pharmacy practice in developing countries. Boston: Academic Press; 2016. p. 211–32.
Quinones ME, Pio MY, Chow DH, Moss E, Hulstein JL, Boatright SM, et al. Impact of clinical pharmacy services on outcomes and costs for indigent patients with diabetes. Am J Manag Care. 2016;22(4):e147–52.
Bond C, Raehl CL. Clinical pharmacy services, pharmacy staffing, and adverse drug reactions in United States hospitals. Pharmacother J Hum Pharmacol Drug Ther. 2006;26(6):735–47.
Bond CA, Raehl CL. Clinical pharmacy services, pharmacy staffing, and hospital mortality rates. Pharmacotherapy. 2007;27(4):481–93. https://doi.org/10.1592/phco.27.4.481.
Al-azzam SI, Shara M, Alzoubi KH, Almahasneh FA, Iflaifel MH. Implementation of clinical pharmacy services at a University Hospital in J ordan. Int J Pharm Pract. 2013;21(5):337–40.
Somers A, Robays H, De Paepe P, Van Maele G, Perehudoff K, Petrovic M. Evaluation of clinical pharmacist recommendations in the geriatric ward of a Belgian University Hospital. Clin Interv Aging. 2013;8:703.
Kheir N, Zaidan M, Younes H, El Hajj M, Wilbur K, Jewesson PJ. Pharmacy education and practice in 13 middle eastern countries. Am J Pharm Educ. 2008;72(6):133. https://doi.org/10.5688/aj7206133.
Hisham M, Sivakumar MN, Veerasekar G. Impact of clinical pharmacist in an Indian Intensive care unit. Indian J Crit Care Med Peer-Rev Off Publ Indian Soc Crit Care Med. 2016;20(2):78.
Malfará M, Pernassi M, Aragon D, Carlotti A. Impact of the clinical pharmacist interventions on prevention of pharmacotherapy related problems in the paediatric intensive care unit. Int J Clin Pharm. 2018;40(3):513–9.
Gunterus A, Lopchuk S, Dunn C, Floyd R, Normandin B. Quantitative and economic analysis of clinical pharmacist interventions during rounds in an acute care psychiatric hospital. Mental Health Clin. 2016;6(5):242–7.
Mekonnen AB, Yesuf EA, Odegard PS, Wega SS. Implementing ward based clinical pharmacy services in an Ethiopian University Hospital. Pharm Pract. 2013;11(1):51.
Galindo C, Olivé M, Lacasa C, Martínez J, Roure C, Lladó M, et al. Pharmaceutical care: pharmacy involvement in prescribing in an acute-care hospital. Pharm World Sci. 2003;25(2):56–64.
Kucukarslan SN, Peters M, Mlynarek M, Nafziger DA. Pharmacists on rounding teams reduce preventable adverse drug events in hospital general medicine units. Arch Intern Med. 2003;163(17):2014–8.
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.
Breuker C, Abraham O, Di Trapanie L, Mura T, Macioce V, Boegner C, et al. Patients with diabetes are at high risk of serious medication errors at hospital: interest of clinical pharmacist intervention to improve healthcare. Eur J Int Med. 2017;38:38–45.
Patel H, Gurumurthy P. Implementation of clinical pharmacy services in an academic oncology practice in India. J Oncol Pharm Pract. 2019;25(2):369–81.
Chen C-C, Hsiao F-Y, Shen L-J, Wu C-C. The cost-saving effect and prevention of medication errors by clinical pharmacist intervention in a nephrology unit. Medicine. 2017;96(34):e7883.
Hanlon JT, Lindblad CI, Gray SL. Can clinical pharmacy services have a positive impact on drug-related problems and health outcomes in community-based older adults? Am J Geriatr Pharmacother. 2004;2(1):3–13.
Bond C, Raehl CL. national clinical pharmacy services survey: clinical pharmacy services, collaborative drug management, medication errors, and pharmacy technology. Pharmacother J Hum Pharmacol Drug Ther. 2008;28(1):1–13.
Krähenbühl-Melcher A, Schlienger R, Lampert M, Haschke M, Drewe J, Krähenbühl S. Drug-related problems in hospitals. Drug Saf. 2007;30(5):379–407.
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The authors would like to express their special thanks for Prof Dr. Ross Tsuyuki for his guidance and review of our manuscript. We would also like to acknowledge UST pharmacy students 2016/2017 for their help with data collection.
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Kubas, M.A., Halboup, A.M. Implementation of clinical pharmacist recommendations and services at a University Hospital in Yemen. Int J Clin Pharm 42, 51–56 (2020). https://doi.org/10.1007/s11096-019-00936-x
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DOI: https://doi.org/10.1007/s11096-019-00936-x