4CPS-209 Benefit of medication reviews by a renal pharmacist in the setting of a computerised physician order entry system

Abstract

methods From June until December 2020, a clinical pharmacist (CP) provided CPS, which included medication reviews and subsequent ward round participations (A: haemato-oncology, 11 beds; B: HSCT unit, 10 beds). The CP and an independent expert panel consisting of two clinical pharmacists and two paediatric haemato-oncologists assessed the PI for clinical significance. 1 Economic benefit was estimated retrospectively by drug therapy cost reductions and avoided follow-up costs based on prevention and management of adverse drug reactions (ADR). 2 Results During 32 ward rounds, 230 DRP were addressed in 36 children (median age 7 (0.4-17) years). The acceptance rate for PI was 73.5%. The most common DRP concerned need for drug monitoring, need for information/therapy discussion and drug-drug interactions; the most common PI were drug-monitoring, drug-information and dose adjustments. The CP assessed 66% of PI as very significant or significant and correlation with the expert rating was significant (p£0.0001). Costs of CPS were C¼ 7200. PI led to estimated drug therapy cost reductions of C ¼ 5500. Prevention of 11 and identification of 24 ADR led to estimated avoided follow-up costs of C ¼ 14 300-C ¼ 27 500 and C ¼ 31 200, respectively. Conclusion and relevanceThis evaluation showed that CPS for a tertiary care centre specialising in paediatric haemato-oncology is capable of identifying and preventing DRP by clinically significant PI. The estimated economic benefit of CPS was at least six-fold higher than its costs. Based on the results, CPS were expanded in our hospital.