CPC-057 Evolution of Clinical Trial Prescribing Incidents

Abstract

Background 'Pharmacists in the Emergency Department' is a twoyear implementation project carried out in collaboration between the pharmacy of Capital Region and the Emergency Department (ED) at Hillerød hospital. The task of the pharmacist is to draw up a current and valid medicines history and to make a medicines review before the physician sees the patient at the ED. During the first year of the project the interventions developed gradually while the professional skills and clinical experience of the pharmacists built up. Purpose To describe the evolution of the interventions recommended when Drug Related Problems (DRPs) are identified, as described in the pharmacist's notes. Materials and Methods 5 samples of pharmacist's notes were recorded. The samples represent the interventions made in the 2 first weeks of each quarter of 2011 and the first quarter of 2012. This showed the development in interventions made by pharmacists. The interventions were coded based on 8 categories of DRP introduced by Hepler and Strand. In total 383 pharmacist's notes were analysed. Results In all 549 DRPs were identified. 70-80% of the pharmacist's notes contained one or more DRP. On average 1.4 DRPs were identified per note. During the first 15 months of the project the DRPs recorded evolved as follows: The number of comments tended to increase in the categories "inappropriate choice of drug", "overdose", "adverse drug events" and "medicine without reasonable indication". The number of comments identified in the category "interactions" decreased. The categories "untreated indication", "subtherapeutic dosing" and "inappropriate use by the patient" were stable throughout the study period. Conclusions When introducing a new pharmaceutical service one must expect a gradual evolution of the interventions as the pharmacist gradually develops hands-on-competencies and clinical experience on the particular ward. After 12 months, the findings in the pharmacist notes were stable. This must be taken into account when introducing new pharmaceutical services in the clinic.No conflict of interest. Evolution of clinical trial PrEscribing inciDEnts