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Santos A, Rodrigues C, Alcobia A. Pharmacy Department, Hospital Garcia de Orta, EPE, Almada, Portugal. farmaceuticos@hgo.min-saude.pt
Background: A systematic record is made by the pharmacist of interventions to medical prescriptions in a unit dose drug distribution system. This is a practical method that enables communication between health professionals and allows the detection and resolution of drug-related problems, so enhancing clinical activity. The main objective of this study was to quantify and characterise the pharmaceutical interventions made in some wards of the hospital.
Methods: Prospective observational study of the pharmaceutical interventions that were made during review of the drugs prescribed from January to June 2006 in the gastroenterology, infectious diseases, rheumatology, neurology and vascular surgery departments.
Results: During the study period, 510 interventions were made in the following categories: 259 (51%) nonhospital formulary drugs, 58 (11%) drug substitution, 55 (11%) therapeutic drug monitoring, 54 (11%) antibiotic justifications, 34 (7%) wrong dosage, 16 (3%) drug stability, 9 (2%) drug information, 8 (2%) duplicate therapeutics, 8 (2%) drug interactions, 7 (1%) change from intravenous to oral administration and 2 (<0.5%) wrong indication. Of the 76 drugs studied, those that generated most interventions were: bisoprolol, valsartan, piperacillin–tazobactam, meropenem and vancomycin. All interventions mentioned previously were accepted by the medical staff, as were the suggested courses of action related to interventions.
Conclusions: Adjustment of dosage, drug monitoring and drug stability are just some of the interventions that result in improvements to the care provided to patients, as well as a better management of the available resources. The prevention of these problems must be a priority for the pharmacy department, whose main goal is to ensure the safety and efficacy of the drugs administered in the hospital environment. The next step will be to create a computerized record to classify these interventions and determine the clinical and economic impact of drug-related problems.
Reference: 13th Congress of the European Association of Hospital Pharmacists. 2008
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