Abstract
Background
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.
Method
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.
Results
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.
Conclusion
This work highlights the positive clinical relevance of pharmacists' interventions
in rheumatology and the importance of medico-pharmaceutical collaboration to prevent
medication errors.
Keywords
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Article info
Publication history
Published online: October 25, 2018
Accepted:
August 29,
2018
Received in revised form:
August 27,
2018
Received:
June 17,
2018
Identification
Copyright
© 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
