Translation and validation of a tool to assess the impact of clinical pharmacists’ interventions

Stämpfli, Dominik; Baumgartner, Pascal C.; Boeni, Fabienne; Bedouch, Pierrick; Lampert, Markus L.; Hersberger, Kurt E.

doi:10.1007/s11096-018-0755-0

Cited by 18 publications

(22 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We retrospectively estimated the relevance of each PI using CLEO de , a validated tool to evaluate the potential impact of a PI in three dimensions (CLinical, Economic, and Organisational). For the present study, we only considered the clinical and economic dimension, which both reached good interrater and excellent test‐retest reliability …”

Section: Methodsmentioning

confidence: 99%

Evaluation of drug‐related problems and subsequent clinical pharmacists’ interventions at a Swiss university hospital

et al. 2019

Self Cite

View full text Add to dashboard Cite

What is known and objective: The evaluation of clinical pharmacy services is essential for their further development and establishment. We analysed drug-related problems (DRPs) and subsequent clinical pharmacists' interventions (PIs) at a Swiss university hospital. Method:We conducted a retrospective analysis of DRPs and subsequent PIs that were identified and implemented during interdisciplinary ward rounds in internal medicine at the University Hospital Basel, Switzerland, between 2015 and 2017. We estimated the potential clinical and economic impact of PIs using a validated evaluation tool (CLEO de ). Results and discussion:Based on medication reviews of 5441 patients, clinical pharmacists identified 5024 DRPs, of which 2892 DRPs (57.6%) were followed by a PI that was directly accepted and implemented by the physician in charge and included in the present analysis. The leading cause and type of PIs were inappropriate dose and dose adjustment, respectively. Overall, 97.8% of DRPs were followed by PIs with an expected clinical benefit for the patients (major: 11.1%; moderate: 27.6%; minor: 59.1%). The drugs most often involved in PIs of major clinical impact were antithrombotics, acid blockers and cardiovascular drugs. With regard to the economic impact, 40.7% of DRPs implied PIs resulting in an increase of immediate therapy costs, whereas 39.3% implied PIs resulting in a decrease of immediate therapy costs. The remaining PIs were cost-neutral. What is new and conclusion:This study emphasizes that clinical pharmacists may help improve the effectiveness and safety of pharmacotherapy on acute care medical wards. K E Y W O R D S clinical pharmacy, drug-related problems, hospital, internal medicine, medication review, pharmacist intervention 1 | WHAT IS K NOWN AND OBJEC TIVE Drug-related problems (DRPs) are defined as events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes. Underlying causes can be related to the selection of a drug, drug form or dose, treatment duration, the logistics of the prescribing and dispensing process, drug administration, patient behaviour or outcome monitoring. 1 DRPs are common in Swiss hospitals. For instance, on two internal medicine wards at the University Hospital Geneva, a clinical | 925 REINAU Et Al.

show abstract

Section: Methodsmentioning

confidence: 99%

Evaluation of drug‐related problems and subsequent clinical pharmacists’ interventions at a Swiss university hospital

et al. 2019

Self Cite

View full text Add to dashboard Cite

show abstract

“…The organizational dimension evaluates the impact on the process of care, focusing on the view of the health care professionals: reduced time expenditures, decreased work load, improved work place safety, and simplified collaborations. This tool was also translated and validated a the German version [19].…”

Section: Introductionmentioning

confidence: 99%

Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study

Zecchini

Chanoine

et al. 2020

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background: Pharmacists play a key role in ensuring the safe use of injectable antineoplastics, which are considered as high-alert medications. Pharmaceutical analysis of injectable antineoplastic prescriptions aims to detect and prevent drug related problems by proposing pharmacist interventions (PI). The impact of this activity for patients, healthcare facilities and other health professionals is not completely known. This study aimed at describing the clinical, economic, and organizational impacts of PIs performed by pharmacists in a chemotherapy preparation unit.Methods: A prospective 10-week study was conducted on PIs involving injectable antineoplastic prescriptions. Each PI was assessed by one of the four multidisciplinary expert committees using a multidimensional tool with three independent dimensions: clinical, economic and organizational. An ancillary quantitative evaluation of drug cost savings was conducted. Results: Overall, 185 patients were included (mean age: 63.5 ± 13.7 years; 54.1% were male) and 237 PIs concerning 10.1% prescriptions were recorded. Twenty one PIs (8.9%) had major clinical impact (ie: prevented hospitalization or permanent disability), 49 PIs (20.7%) had moderate clinical impact (ie: prevented harm that would have required further monitoring/treatment), 62 PIs (26.2%) had minor clinical impact, 95 PIs (40.0%) had no clinical impact, and 9 PIs (3.8%) had a negative clinical impact. For one PI (0.4%) the clinical impact was not determined due to insufficient information. Regarding organizational impact, 67.5% PIs had a positive impact on patient management from the healthcare providers' perspective. A positive economic impact was observed for 105 PIs (44.3%), leading to a saving in direct drug costs of 15,096 €; 38 PIs (16.0%) had a negative economic impact, increasing the direct drug cost by 11,878 €. Overall cost saving was 3218€. Conclusions: PIs are associated with positive clinical, economic and organizational impacts. This study confirms the benefit of pharmacist analysis of injectable antineoplastic prescriptions for patient safety with an overall benefit to the healthcare system.

show abstract

“…The potential economic impact of the medication discrepancy was assessed using the economic dimension of the tool CLEOde (CLinical, Economic, and Organizational), a validated tool for the assessment of the potential relevance of pharmacists' interventions [22]. In this study, the economic dimension of CLEOde was defined as immediate impact of medication discrepancies on the medication costs (levels: increase, null, decrease) from a healthcare system's perspective by comparing the medication of the BPML and the latest medication prescription.…”

Section: Potential Clinical Severity and Economic Impact Of The Identmentioning

confidence: 99%

“…a Classification adapted from Cornish et al [21]. b Classification adapted from Stämpfli et al [22]. Class 1 = unlikely to have an effect, Class 2 = potential moderate effect, Class 3 = potential severe effect.…”

Section: Potential Clinical Severity Of the Medication Discrepancies mentioning

confidence: 99%

See 1 more Smart Citation

Medication Discrepancies in Community Pharmacies in Switzerland: Identification, Classification, and Their Potential Clinical and Economic Impact

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: Transitions of care are high-risk situations for the manifestation of medication discrepancies and, therefore, present threats for potential patient harm. Medication discrepancies can occur at any transition within the healthcare system. Methods: Fifth-year pharmacy students assessed a best possible medication list (BPML) during a medication review (based on medication history and patient interview) in community pharmacies. They documented all discrepancies between the BPML and the latest medication prescription. Discrepancies were classified using the medication discrepancy taxonomy (MedTax) classification system and were assessed for their potential clinical and economic impact. Results: Overall, 116 patients with a mean age and medication prescription of 74 (± 10.3) years and 10.2 (± 4.2), respectively, were analyzed. Of the 317 discrepancies identified, the most frequent type was related to strength and/or frequency and/or number of units of dosage form and/or the total daily dose. Although, the majority of discrepancies were rated as inconsequential (55.2%) on health conditions, the remainder posed a potential moderate (43.2%) or severe impact (1.6%). In 49.5% of the discrepancies, the current patients’ medication cost less than the prescribed. Conclusion: Community pharmacies are at a favorable place to identify discrepancies and to counsel patients. To improve patient care, they should systematically perform medication reconciliation whenever prescriptions are renewed or added.

show abstract

Translation and validation of a tool to assess the impact of clinical pharmacists’ interventions

Cited by 18 publications

References 17 publications

Evaluation of drug‐related problems and subsequent clinical pharmacists’ interventions at a Swiss university hospital

Evaluation of drug‐related problems and subsequent clinical pharmacists’ interventions at a Swiss university hospital

Clinical, economic and organizational impact of pharmacist interventions on injectable antineoplastic prescriptions: a prospective observational study

Medication Discrepancies in Community Pharmacies in Switzerland: Identification, Classification, and Their Potential Clinical and Economic Impact

Contact Info

Product

Resources

About