Impact of a ward based clinical pharmacist intervention on improving the quality use of medicines in patients with chronic non communicable diseases in a tertiary hospital
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Date
2014
Journal Title
Journal ISSN
Volume Title
Publisher
Sri Lanka Medical Association
Abstract
INTRODUCTION AND OBJECTIVES: To investigate the impact of a ward based clinical pharmacy service (CPS) on appropriate prescribing of discharge medications. METHODS: This is a non-randomised controlled trial conducted to assess CPS in a medical unit. Eligible patients admitted with non-communicable chronic diseases were considered. The female and the maie wards were the control and intervention during initial phase. Groups were swapped between two wards during next phase. The control patients received usual management. Intervention received CPS in addition to the existing management. Both clinical and demographic data were collected until discharge. Appropriateness of prescribing was assessed at discharge with the Medication Appropriateness Index (MAI). RESULTS: 354 (2140 medications) and 359 (2232 medications) patients' data were evaluated respectively in, control and intervention. Medications received per patient in both groups were similar. Appropriateness of discharged medications in intervention' group was significantly higher compared to control, 66% (235/359) and 34% (120/354) respectively (p< 0.0001). Furthermore, the mean MAI score per patient was significantly lower in intervention compared to th.e control (0.99 vs. 4.1, p< 0.001). Proportion of appropriate prescriptions in relation to all MAI criteria was significantly lower in intervention group compared to the control, all (p< 0.01). Among the drugs prescribed in the intervention [5% (112/2232)] and control groups, [20% (420/2140)] respectively had at least one inappropriate MAI criterion (p< 0.0001). CONCLUSIONS: This study demonstrates that a ward based CPS can reduce inappropriate prescribing of medications at discharge providing an opportunity to improve quality use of medicine.
Description
Oral Presentation Abstract (OP21), 127th Annual Scientific Sessions, Sri Lanka Medical Association, 2014 Colombo, Sri Lanka
Keywords
ward based clinical pharmacist intervention
Citation
The Ceylon Medical Journal. 2014; 59(Supplement 1):17-18