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Int J Clin Pharm. 2021 Aug 17; doi: 10.1007/s11096-021-01313-3. Epub 2021 Aug 17.

Clinical pharmacists' interventions across German hospitals: results from a repetitive cross-sectional study.

International journal of clinical pharmacy

Claudia Langebrake, Carina Hohmann, Susanne Lezius, Michael Lueb, Gesine Picksak, Wencke Walter, Sandra Kaden, Heike Hilgarth, Angela Ihbe-Heffinger, Katja Leichenberg

Affiliations

  1. Hospital Pharmacy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany. [email protected].
  2. Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. [email protected].
  3. Department of Pharmacy, Klinikum Fulda gAG, Fulda, Germany.
  4. Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  5. Department of Pharmacy, Klinikum Bielefeld Gem. GmbH, Bielefeld, Germany.
  6. Pharmacy, Hannover Medical School, Hannover, Germany.
  7. Department of Pharmacy, University Hospital Dresden, Dresden, Germany.
  8. Hospital Pharmacy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
  9. Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  10. Hospital Pharmacy, Klinikum Starnberg GmbH, Academic Teaching Hospital of the Ludwig-Maximilians University, Starnberg, Germany.
  11. Department of Pharmacy, University Hospital Jena, Jena, Germany.

PMID: 34402022 DOI: 10.1007/s11096-021-01313-3

Abstract

Background Pharmacists' interventions (PI) are suitable to improve medication safety and optimise patient outcome. However, in Germany, clinical pharmacy services are not yet available nationwide. Aim To gain prospective data on the extent and the composition of routine PI with special focus on intervention rates among German hospital pharmacists during two intervention weeks. Methods Within a repetitive cross-sectional study, clinical pharmacists documented all PIs on five days during a one-month period (intervention week) in 2017 and 2019 using the validated online-database ADKA-DokuPIK. Additionally, data regarding the supply structure/level of medical care, the extent of clinical pharmacy services and their professional experience were collected. All data were anonymised before analysis. Results In total, 2,282 PI from 62 pharmacists (2017) and 2578 PI from 52 pharmacists (2019) were entered. Intervention rate increased from 27.5 PI/100 patient days in 2017 to 38.5 PI/100 patient days in 2019 (p = 0.0097). Frequency of clinical pharmacy services on a daily basis significantly increased from 60% (2017) to 83% (2019). Reasons for PIs from the categories "drugs" (e.g. indication, choice, documentation/transcription) and "dose" were most common in both intervention weeks. The vast majority of underlying medication errors in both intervention weeks were categorised as "error, no harm" (80.3 vs. 78.6%), while the proportion of errors which did not reach the patient, doubled to 39.8% in IW-2019. Conclusion Regular and daily clinical pharmacy services become more established in Germany and clinical pharmacists are increasingly involved in solving drug related problems proactively and early during the medication management process.

© 2021. The Author(s).

Keywords: Drug related problem; Medication errors; Medication therapy management; Pharmacists’ interventions; Pharmacy service, hospital

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