关键词: Clinical impact Drug-related problem Medication review Pharmacists' interventions Rheumatology

Mesh : Adolescent Adult Aged Aged, 80 and over Child Drug Prescriptions / statistics & numerical data Female France Hospital Units Hospitals, Teaching Humans Male Medication Errors / prevention & control statistics & numerical data Middle Aged Pharmacists / statistics & numerical data Pharmacy Service, Hospital / statistics & numerical data Physicians / statistics & numerical data Professional Role Retrospective Studies Rheumatology Young Adult

来  源:   DOI:10.1016/j.ejim.2018.08.017   PDF(Sci-hub)

Abstract:
Pharmacists contribute to reduce the number of medication errors during medication review. Nevertheless, few French studies report the potential clinical impact of pharmacists\' interventions performed after detecting drug-related problems. The objective was to evaluate the clinical relevance of pharmacists\' interventions in a rheumatology ward from medical and pharmaceutical perspectives.
The analysis was conducted on pharmacists\' interventions performed between January 1 and December 31, 2015 in a French teaching hospital. Similar pharmacists\' interventions were grouped in one item and they were analysed according to 11 drug categories. The clinical significance of pharmacists\' interventions was considered independently by a pharmacist and a rheumatologist using a validated French scale that categorises drug-related problems from minor to catastrophic. The agreement between the two professionals was analysed using the weighted kappa coefficient.
Of 1313 prescriptions reviewed, 461 pharmacists\' interventions (171 items) were formulated for drug-related problems with an acceptance rate of 67.2%. Of the 418 interventions selected for clinical significance analysis, 235 interventions (56.2%) for the physician and 400 interventions (95.7%) for the pharmacist were at least significant. The two professionals evaluated equally the clinical relevance of 90 items (50.6%). The categories with the most similarities were the analgesics/anti-inflammatory drugs (78.1%), the antidiabetics (75.0%) and the anticoagulants (71.4%). The agreement was estimated by a weighted kappa coefficient of 0.29.
This work highlights the positive clinical relevance of pharmacists\' interventions in rheumatology and the importance of medico-pharmaceutical collaboration to prevent medication errors.
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