Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool

ABSTRACT: Background: It has been well recognized that pharmaceutical interventions (PIs) can prevent patient harm related to prescribing errors. Various tools have been developed to facilitate the detection and the reduction of inappropriate prescriptions and some have shown benefit on clinical ou...

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Autores principales: Akram Farhat, PhD, Rime Abou-Karroum, MSc, Alice Panchaud, PhD, Chantal Csajka, PhD, Amal Al-Hajje, PhD
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Lenguaje:EN
Publicado: Elsevier 2021
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spelling oai:doaj.org-article:60c8db6a522243238f5e120f6f0946ea2021-11-18T04:43:12ZImpact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool0011-393X10.1016/j.curtheres.2021.100650https://doaj.org/article/60c8db6a522243238f5e120f6f0946ea2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S0011393X2100028Xhttps://doaj.org/toc/0011-393XABSTRACT: Background: It has been well recognized that pharmaceutical interventions (PIs) can prevent patient harm related to prescribing errors. Various tools have been developed to facilitate the detection and the reduction of inappropriate prescriptions and some have shown benefit on clinical outcomes. Objective: The objective of this study was to evaluate the clinical, economical, and organizational impact of interventions generated by clinical pharmacists in hospitalized patients, and to evaluate the performance of an explicit tool, the Potentially Inappropriate Medication Checklist for Patients in Internal Medicine (PIM-Check), in detecting each pharmacist's intervention. Methods: A cohort retrospective study was conducted on hospitalized patients. The impact of PIs based on pharmacists’ standard examination was evaluated using the Clinical, Economic, and Organizational (CLEO) tool. The performance of PIM-Check in detecting each intervention was assessed by conducting a retrospective medication review based on available information collected from patients’ records. A qualitative analysis was also conducted to identify the types of PIs that PIM-Check failed to detect. Results: The study was performed on 162 patients with a median age of 68 years (interquartile range = 46–77 years) and a median hospital stay of 5 days (interquartile range = 4–7 days). The pharmacists generated 1.9 PIs per patient (n = 304) of which 31% were detected by PIM-Check. The acceptance rate of the interventions by physicians was 84% (n = 255). Among the accepted interventions, 53% (n = 136) had a clinical impact graded CL ≥ 2C (moderate or major), whereas the majority of them were not detected by PIM-Check (63%; 86 out of 136). In addition, 46% of accepted interventions (n = 117) were associated with a cost decrease, among which 62% were not detected by PIM-Check (73 out of 117). The qualitative analysis shows that PIM-Check mostly failed to detect PIs related to dose adjustment, overprescribing, and therapy monitoring. Conclusions: According to the CLEO tool evaluation of PIs, our results show that clinical pharmacists’ interventions are associated with improved clinical outcomes. In comparison with pharmacists’ interventions, PIM-Check failed in detecting the majority of interventions associated with a moderate or major impact.Akram Farhat, PhDRime Abou-Karroum, MScAlice Panchaud, PhDChantal Csajka, PhDAmal Al-Hajje, PhDElsevierarticleCLEOpharmaceutical interventionsPIM-Checkpotentially inappropriate medication listprescribing errorsTherapeutics. PharmacologyRM1-950ENCurrent Therapeutic Research, Vol 95, Iss , Pp 100650- (2021)
institution DOAJ
collection DOAJ
language EN
topic CLEO
pharmaceutical interventions
PIM-Check
potentially inappropriate medication list
prescribing errors
Therapeutics. Pharmacology
RM1-950
spellingShingle CLEO
pharmaceutical interventions
PIM-Check
potentially inappropriate medication list
prescribing errors
Therapeutics. Pharmacology
RM1-950
Akram Farhat, PhD
Rime Abou-Karroum, MSc
Alice Panchaud, PhD
Chantal Csajka, PhD
Amal Al-Hajje, PhD
Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
description ABSTRACT: Background: It has been well recognized that pharmaceutical interventions (PIs) can prevent patient harm related to prescribing errors. Various tools have been developed to facilitate the detection and the reduction of inappropriate prescriptions and some have shown benefit on clinical outcomes. Objective: The objective of this study was to evaluate the clinical, economical, and organizational impact of interventions generated by clinical pharmacists in hospitalized patients, and to evaluate the performance of an explicit tool, the Potentially Inappropriate Medication Checklist for Patients in Internal Medicine (PIM-Check), in detecting each pharmacist's intervention. Methods: A cohort retrospective study was conducted on hospitalized patients. The impact of PIs based on pharmacists’ standard examination was evaluated using the Clinical, Economic, and Organizational (CLEO) tool. The performance of PIM-Check in detecting each intervention was assessed by conducting a retrospective medication review based on available information collected from patients’ records. A qualitative analysis was also conducted to identify the types of PIs that PIM-Check failed to detect. Results: The study was performed on 162 patients with a median age of 68 years (interquartile range = 46–77 years) and a median hospital stay of 5 days (interquartile range = 4–7 days). The pharmacists generated 1.9 PIs per patient (n = 304) of which 31% were detected by PIM-Check. The acceptance rate of the interventions by physicians was 84% (n = 255). Among the accepted interventions, 53% (n = 136) had a clinical impact graded CL ≥ 2C (moderate or major), whereas the majority of them were not detected by PIM-Check (63%; 86 out of 136). In addition, 46% of accepted interventions (n = 117) were associated with a cost decrease, among which 62% were not detected by PIM-Check (73 out of 117). The qualitative analysis shows that PIM-Check mostly failed to detect PIs related to dose adjustment, overprescribing, and therapy monitoring. Conclusions: According to the CLEO tool evaluation of PIs, our results show that clinical pharmacists’ interventions are associated with improved clinical outcomes. In comparison with pharmacists’ interventions, PIM-Check failed in detecting the majority of interventions associated with a moderate or major impact.
format article
author Akram Farhat, PhD
Rime Abou-Karroum, MSc
Alice Panchaud, PhD
Chantal Csajka, PhD
Amal Al-Hajje, PhD
author_facet Akram Farhat, PhD
Rime Abou-Karroum, MSc
Alice Panchaud, PhD
Chantal Csajka, PhD
Amal Al-Hajje, PhD
author_sort Akram Farhat, PhD
title Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
title_short Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
title_full Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
title_fullStr Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
title_full_unstemmed Impact of Pharmaceutical Interventions in Hospitalized Patients: A Comparative Study Between Clinical Pharmacists and an Explicit Criteria-Based Tool
title_sort impact of pharmaceutical interventions in hospitalized patients: a comparative study between clinical pharmacists and an explicit criteria-based tool
publisher Elsevier
publishDate 2021
url https://doaj.org/article/60c8db6a522243238f5e120f6f0946ea
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