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An evaluation of the contribution of the medical admissions pharmacist at a London teaching hospital

机译：对伦敦教学医院医疗收生药师的贡献的评估

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Objective To evaluate the contribution of the medical admissions pharmacist (MAP) at a London teaching hospital.Method A descriptive study using quantitative methods to compare the activities of former non-designated pharmacists with that of the currently employed MAP in relation to interventions made regarding the drug therapy of patients in one medical admissions ward in a London hospital. The outcome measures were numbers of pharmacist interventions made and their clinical significance. A multi-disciplinary panel assessed clinical significance using an adapted form of a previously validated method.Key findings Overall, significantly more interventions were made per day after appointment of the MAP (P=0.003). In particular, interventions relating to drug administration/route, choice, dose, medication history and need for drug therapy significantly increased. Interventions made by the MAP were found to be of greater clinical significance when compared with those made by the non-designated pharmacists (P= 0.005), In a separate assessment of medication history accuracy, 12% of the patients' regular medicines were unintentionally omitted and 6% of prescriptions unintentionally changed. All unintentional omissions and discrepancies identified resulted in an intervention by the MAP. The majority of these interventions were found to be of moderate clinical significance. Conclusions The MAP made more interventions than the previous non-designated ward pharmacists and, overall, the interventions were of greater clinical significance. The research demonstrates the potential contribution of an MAP on post-admission ward rounds to ensure the safe and appropriate prescribing of medicines on the medical admissions ward. Confirming medication histories was shown to be important in ensuring appropriate prescribing of patients' regular medicines on admission to hospital.
机译：目的评估伦敦教学医院的入院药剂师（MAP）的贡献。方法采用定量方法进行描述性研究，比较前非指定药剂师和当前雇用的MAP药剂师在有关干预措施方面的活动伦敦一家医院的一个住院病房对患者进行药物治疗。结果指标是药剂师干预的次数及其临床意义。一个多学科小组使用以前验证过的方法的改进形式评估了临床意义。关键发现总体而言，任命MAP后每天进行的干预明显更多（P = 0.003）。特别是，与药物给药/途径，选择，剂量，药物史和药物治疗需求有关的干预措施显着增加。与非指定药剂师进行的干预相比，使用MAP进行的干预具有更大的临床意义（P = 0.005）。在单独评估用药史的准确性中，无意中省略了12％的患者常规用药6％的处方无意间发生了变化。所发现的所有无意遗漏和差异导致MAP进行了干预。发现这些干预措施中的大多数具有中等临床意义。结论MAP比以前的非指定病房药剂师进行了更多的干预，总体而言，这些干预措施具有更大的临床意义。该研究表明，MAP对入院后病房巡回检查的潜在贡献，可确保在入院病房中安全，适当地开药。事实证明，确认用药史对确保患者入院时正确开处方常规药物很重要。

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