Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review

Vo, Thi Ha; Charpiat, B.; Catoire, Claire; Juste, M.; Roubille, R.; Rose, François-Xavier; Chanoine, Sébastien; Bosson, Jean‐Luc; Conort, O.; Allenet, Benoît; Bedouch, Pierrick

doi:10.1007/s40264-015-0370-0

Cited by 32 publications

(27 citation statements)

References 139 publications

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“…Hence, using clinical significance categorization systems as assessment methods does not seem robust and is most likely highly dependent on the choice of individual raters. This is supported by a review by Vo et al, who found limited results for the validity and reliability of tools for assessing the potential significance of pharmacist interventions [ 82 ]. Consequently, using a clinical significance rating as a method to prioritise DRP categories does seem suboptimal.…”

Section: Discussionmentioning

confidence: 70%

Investigating the Relative Significance of Drug-Related Problem Categories

Kjeldsen¹,

Nielsen

Olesen

2017

Pharmacy

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The aim of the review was to investigate whether an assessment of clinical significance can be related to specific drug-related problems (DRPs) and hence may assist in prioritizing individual categories of DRP categorization systems. The literature search using Google Scholar was performed for the period 1990 to 2013 and comprised primary research studies of clinical pharmacy interventions including DRP and clinical significance assessments. Two reviewers assessed the titles, abstracts, and full-text papers individually, and inclusion was determined by consensus. A total of 27 unique publications were included in the review. They had been conducted in 14 different countries and reported a large range of DRPs (71–5948). Five existing DRP categorisation systems were frequently used, and two methods employed to assess clinical significance were frequently reported. The present review could not establish a consistent relation between the DRP categories and the level of clinical significance. However, the categories “ADR” and possibly “Drug interaction” were often associated with an assessed high clinical significance, albeit they were infrequently identified in the studies. Hence, clinical significance assessments do not seem to be useful in prioritizing individual DRPs in the DRP categorization systems. Consequently, it may be necessary to reconsider our current approach for evaluating DRPs.

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Section: Discussionmentioning

confidence: 70%

Investigating the Relative Significance of Drug-Related Problem Categories

Kjeldsen¹,

Nielsen

Olesen

2017

Pharmacy

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“…This has led to the reliance on key performance indicators to track interventions in many institutions. [8][9][10] It is currently unknown which pharmacist interventions are likely to be most impactful in the current pandemic; however, published recommendations have promoted interventions ranging from medication stewardship to coordination of laboratory timing to telehealth visits, when feasible. 11,12 Operational pharmacy services will also be impacted, and pharmacists and technicians will have to be adaptable to the shifts in medication needs that will accompany the influx of critically ill patients.…”

mentioning

confidence: 99%

Surviving the surge: Evaluation of early impact of COVID-19 on inpatient pharmacy services at a community teaching hospital

McConachie

Martirosov

Wang

et al. 2020

American Journal of Health-System Pharmacy

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Purpose The coronavirus disease 2019 (COVID-19) pandemic has presented novel challenges to healthcare systems; however, an analysis of the impact of the pandemic on inpatient pharmacy services has not yet been conducted. Methods Results of an observational assessment of operational and clinical pharmacy services at a community teaching hospital during the first weeks of the COVID-19 pandemic are presented. Service outcomes of the inpatient pharmacy were evaluated from February 1 to April 8, 2020. Outcomes during the weeks preceding the first COVID-19 admission (February 1 to March 11, 2020) and during the pandemic period (March 12 to April 8, 2020) were compared. Evaluated outcomes included daily order verifications, clinical interventions, and usage of relevant medications. An exploratory statistical analysis was conducted using Student’s t test. Results During the pandemic period, the number of new order verifications decreased from approximately 5,000 orders per day to 3,300 orders per day (P < 0.01), a reduction of 30% during the first 4 weeks of the pandemic compared to the weeks prior. Average daily pharmacokinetic dosing consults were reduced in the pandemic period (from 82 to 67; P < 0.01) compared to the prepandemic period; however, total daily pharmacist interventions did not differ significantly (473 vs 456; P = 0.68). Dispensing of hydroxychloroquine, azithromycin, enoxaparin, and sedative medications increased substantially during the pandemic period (P < 0.01 for all comparisons). Conclusion The operational and clinical requirements of an inpatient pharmacy department shifted considerably during the first weeks of the COVID-19 pandemic. Pharmacy departments must be adaptable in order to continue to provide effective pharmaceutical care during the pandemic.

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“…We used a new validated tool to assess the clinical impact of PIs. 19 The CLEO tool has been recently created according to different scales available in the literature 24 and provided suitable inter-rater and intrarater reliabilities. This CLEO tool was used to assess clinical impact of PIs on injectable antineoplastic prescriptions in a French Hospital Chemotherapy Preparation Unit 33 and was translated and validated in a German version.…”

Section: Discussionmentioning

confidence: 99%

Clinical evaluation of pharmacists’ interventions on multidisciplinary lung transplant outpatients’ management: results of a 7-year observational study

et al. 2020

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ObjectivesLung transplant (LT) recipients require multidisciplinary care because of the complexity of therapeutic management. Pharmacists are able to detect drug-related problems and provide recommendations to physicians through pharmacists’ interventions (PIs). We aimed at assessing the clinical impact of PIs on therapeutic management in LT outpatients.DesignData were collected prospectively from an LT recipients cohort during 7 years. A multidisciplinary committee assessed retrospectively the clinical impact of accepted PIs.SettingFrench University Hospital.ParticipantsLT outpatients followed from 2009 to 2015.Primary outcome measuresClinical impact of PIs performed by pharmacists using the CLEO tool and the Pareto chart.Results1449 PIs led to a change in patient therapeutic management and were mainly related to wrong dosage (39.6%) and untreated indication (19.6%). The clinical impact of PIs was ‘avoids fatality’, ‘major’ and ‘moderate’, in 0.1%, 7.0% and 57.9%, respectively. Immunosuppressants, antimycotics for systemic use and antithrombotic agents had the greatest clinical impact according to the Pareto chart. PIs related to drug–drug interactions (10%) mainly had a moderate and major clinical impact (82.3%, p<0.0001).ConclusionClinical pharmacists play a key role for detecting drug-related problems mostly leading to a change in therapeutic management among LT outpatients. Our study provides a new insight to analyse the clinical impact of PIs in order to target PIs which have most value and contribute to patient care through interdisciplinary approach.

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Tools for Assessing Potential Significance of Pharmacist Interventions: A Systematic Review

Cited by 32 publications

References 139 publications

Investigating the Relative Significance of Drug-Related Problem Categories

Investigating the Relative Significance of Drug-Related Problem Categories

Surviving the surge: Evaluation of early impact of COVID-19 on inpatient pharmacy services at a community teaching hospital

Clinical evaluation of pharmacists’ interventions on multidisciplinary lung transplant outpatients’ management: results of a 7-year observational study

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