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Implementation of ward-based clinical pharmacy services in Belgium--description of the impact on a geriatric unit.

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Spinewine, Anne [UCL] Dhillon, Soraya [UCL] Mallet, Louise [UCL] Tulkens, Paul M. [UCL] Wilmotte, Léon [UCL] Swine, Christian [UCL]

BACKGROUND: Patient-centered clinical pharmacy services are still poorly developed in Europe, despite their demonstrated advantages in North America and the UK. Reporting European pilot experiences is, therefore, important to assess the usefulness of clinical pharmacy services in this specific context. OBJECTIVE: To report the results of the first implementation of Belgian clinical pharmacy services targeting patients at high risk of drug-related problems. METHODS: An intervention study was conducted by a trained clinical pharmacist providing pharmaceutical care to 101 patients (mean age 82.2 y; mean +/- SD number of prescribed drugs 7.8 +/- 3.5) admitted to an acute geriatric unit, over a 7 month period. All interventions to optimize prescribing, and their acceptance, were recorded. An external panel (2 geriatricians, 1 clinical pharmacist) assessed the interventions' clinical significance. Persistence of interventions after discharge was assessed through telephone calls. RESULTS: A total of 1066 interventions were made over the 7 month period. The most frequent drug-related problems underlying interventions were: underuse (15.9%), wrong dose (11.9%), inappropriate duration of therapy (9.7%), and inappropriate choice of medicine (9.6%). The most prevalent consequences were to discontinue a drug (24.5%), add a drug (18.6%), and change dosage (13.7%). Acceptance rate by physicians was 87.8%. Among interventions with clinical impact, 68.3% and 28.6% had moderate and major clinical significance, respectively. Persistence of chronic treatment changes 3 months after discharge was 84%. CONCLUSIONS: Involving a trained clinical pharmacist in a geriatric team led to clinically relevant and well-accepted optimization of medicine use. This initiative may be a springboard for further development of clinical pharmacy services.

Document type Article de périodique (Journal article) – Journal Article, Research Support, Non-U.S. Gov't
Publication date 2006
Journal information "The Annals of pharmacotherapy" - Vol. 40, no. 4, p. 720-8 (2006)
Peer reviewed yes
issn 1060-0280
Publication status Publié
Affiliations UCL - MD/FARM - Ecole de pharmacie
UCL - MD/ESP - Ecole de santé publique
UCL - (SLuc) Service de gériatrie
UCL - (MGD) Service de médecine gériatrique
MESH Subject Aged, 80 and over ; Belgium ; Drug Therapy - standards ; Health Services for the Aged - standards ; Hospital Departments - organization & administration - standards ; Humans ; Pharmacy Service, Hospital - organization & administration - standards
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Bibliographic reference Spinewine, Anne ; Dhillon, Soraya ; Mallet, Louise ; Tulkens, Paul M. ; Wilmotte, Léon ; et. al. Implementation of ward-based clinical pharmacy services in Belgium--description of the impact on a geriatric unit.. In: The Annals of pharmacotherapy, Vol. 40, no. 4, p. 720-8 (2006)
Permanent URL http://hdl.handle.net/2078.1/10534