ROLE OF A PHARMACIST IN IMPROVING THE QUALITY OF TREATMENT IN INPATIENTS

1
ROLE OF A PHARMACIST IN IMPROVING THE QUALITY OF
TREATMENT IN INPATIENTS

• Sabina Farooq Dr Shobarani R H , Dr Venugopal
  Reddy, Geetha pradeep, Soumya k.L .
• Pharmacy practice
• Al-ameen college of pharmacy.bangalore.

2
INTRODUCTION

• Clinical pharmacy is defined as an umbrella of
  services aimed at maximizing the
  pharmacotherapeutic effect and minimizing the
  risk of developing adverse drug effects for the
  health care system.
• The fundamental responsibility of a pharmacist is
  to ensure that every patient receives the most
  appropriate treatment in the most convenient and
  cost effective form.
• Drug use is a complex process and there are many
  drug related challenges at various levels
  involving prescriber, pharmacist and patients.
  (1)
• (1) Schwartzberg E , Livny S, Sterenberg
  A, Troista A, Oren M, Shani S. Evaluation of the
  impact of a clinical pharmacist on the quality
  and cost of pharmacotherapy in a general surgical
  department, the Hillel- Yaffe Medical Center.
  Harefuah 2003 142(1)5-9

3
Contd..

• Addition of a clinical pharmacist to the health
  care team attending ward rounds in hospital
  settings helps
• Assisting physician in pharmacotherapy decision
  making and providing pharmacokinetic
  consultation.
• Monitoring patient for drug efficacy and safety
• Detecting medication error and drug-drug /
  drug-food interaction.
• Improved patient care.
• Reduced length of hospital stay and health care
  cost.

4
Contd..

• The basic aim of this project was to test whether
  inclusion of the clinical pharmacist improved
  pharmaceutical care of patients and how the
  pharmacist could truly contribute to patient care.

5
OBJECTIVES

• To identify the medication errors.
• Detection of Adverse Drug Reaction.
• To detect Drug-Drug interaction.
• Correlation between treatment and indication.
• Irregularities in laboratory investigations.

6
METHODOLOGY

• Data was obtained from prospective series of
  patients who were admitted to the medicine ward
  in St Marthas hospital and Victoria hospital in
  Bangalore from 15th September 2006 to 28th
  October 2006.
• Inclusion criteria
• Patients taking five or more medications
• Patients suffering from acute or severe illness.
• Patients with symptoms suggestive of an adverse
  drug reaction

7

• Exclusion criteria
• The following categories of patient were excluded
  from the study.
• Short stay or acute medical admissions.
• Those admitted for overnight observation.
• Patients with whom communication was not
  possible.
• Based on inclusion and exclusion criteria 76
  patients were enrolled in the study, of which 30
  were from Victoria hospital and 46 were from St
  Marthas hospital

8
Contd..

• From the pts case file the following information
  was collected.
• Presenting complaints
• Complete history of the patient
• Laboratory reports
• Diagnosis
• Treatment
• Discharge summary

9
(No Transcript)
10
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
11
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
12
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
13
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
14
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
15
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
16
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
17
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
18
RESULTS
In 76 cases the problems that were identified
were
A total of 76 patients were enrolled in the study
of which 30 patients were from Victoria hospital
and 45 patients were from St Marthas hospital. A
thorough review of each case was done, with aim
to know the relevance of the medications with the
diagnosis.
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
CONCLUSION

• From the above study I observed that medical
  decision making is particularly prone to errors
  due to the urgency, complexity and uncertainty in
  clinical situations.
• Thus medication review by a pharmacist can reduce
  the number of inappropriate drugs prescribed and
  thus pharmacist can play an important role in
  improving the quality of treatment of inpatients.

27
References
A study was conducted by the Department of Health
Policy and Management, Harvard School of Public
Health, USA ( 1993-94) to measure the effect of
pharmacist participation on medical rounds and
the rate of preventable adverse drug events
(ADEs). Preventable ADEs were identified by
review of medical records of the randomly
selected patients during both preintervention and
postintervention phases. The pharmacist made 366
recommendations related to drug ordering, of
which 362 (99) were accepted by physicians.
28
Contd..

• Thomson Micromedex
• Medclik
• AFHS
• CIMS
• Internal Medicine by Harrison
• Current Consult Medicine
• Internet

29
(No Transcript)
30
THANK YOU