Linked to EAHP Statements

Section 4 – Clinical Pharmacy Services: Statements 4.1, 4.3, 4.8
Section 5 – Patient Safety and Quality Assurance: Statement 5.2
Section 6 – Education and Research: Statements 6.2, 6.3

ACPE UAN: 0475-0000-18-028-L04-P. An application based activity.

Abstract

In order to optimise drug therapy in inpatients, it is important to develop a systematic and integrated approach to the management of medications from the time of admission, during the hospital stay and at discharge. Pharmacists, performing medication reviews in a multi-professional team, must be able to prioritise which drug related problems (DRPs) to focus on to ensure that patient harm is avoided and treatment goals reached.

The clinical relevance of the interventions initiated by pharmacists has been investigated previously using different tools for assessment. For example, Hatoum et al. used a ranking system that focused on the value of the service by assessing the potential impact of pharmacists' recommendations.

In this workshop, several real patient cases will be presented; each together with one isolated DRP and recommendation for solution. The recommendations have all been assessed previously by experts using a validated tool for the classification of importance. The participants will assess the importance individually (using a voting system) and the results will be compared to the experts' opinion and discussed in plenum.

Learning objectives

• Describe approaches to assess the clinical significance of pharmacists' recommendations (arising from drug related problems)
• Reflect on the clinical significance of recommendations in their own setting, using patient cases in group discussions with colleagues for educational purposes
  

Educational need addressed

Pharmacists are still relatively new members of multidisciplinary teams. When performing medication reviews and identifying drug related problems (DRPs), they will need to be able to prioritise and focus on resolving those issues that are most relevant to the patient at that time.

Keywords: assessing clinical significance, pharmacists' recommendations, drug related problems

Handouts: Ulrika Gillespie and Henrik Toss