Authors: Bracey, Gemma; Miller, Gavin; Franklin, Bryony Dean; Jacklin, Ann; Gaskin, Gill

Source: Clinical Medicine, Journal of the Royal College of Physicians, Volume 8, Number 1, February 2008 , pp. 53-57(5)

Publisher: Royal College of Physicians

Abstract:

The aim of this study was to determine the impact of two specialised admissions pharmacists on an acute medical admissions ward. For a one-week period, contributions made to the medical post-take ward round (PTWR), the number of drug histories taken and interventions made as a result, and the availability of medication needed on discharge were documented. An average of 1.1 contributions per patient were made on the PTWR; a large proportion of these concerned therapeutic choice. Pharmacists also intervened to stop medication due to adverse drug reactions in 12% (n=10) of contributions. Fifty-two drug histories were checked by a pharmacist, resulting in 61 interventions (1.1 interventions per patient). The majority of interventions resulted from the unintentional omission of a regular medication (65%, n=39). Only 24% (n=29) of items needed on discharge had to be dispensed in pharmacy and 33% (n=41) were available as patients' own drugs.

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Keywords: ADMISSIONS PHARMACISTS; ADVERSE DRUG REACTIONS; DRUG HISTORY; MEDICAL ADMISSIONS UNIT

Document Type: Research article

Publication date: 2008-02-01

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• Clinical Medicine is published six times a year and circulated to 20,000 Fellows and Members of the Royal College of Physicians. The journal is read by physicians both established and in training in hospitals across the world. It features a wide range of articles including original papers, professional issues, clinical guidance, medical humanities, ethics and clinical governance. The journal publishes the key features from the College lectures and conferences. Each issue has a CME section which reviews the latest advances in a chosen specialty.
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