06 fevereiro, 2014

ASSESSMENT OF WARD-BASED CLINICAL PHARMACY SERVICES IN JIMMA UNIVERSITY SPECIALIST HOSPITAL, ETHIOPIA: THE CASE OF INTERNAL MEDICINE


A Berhane, E Ali, O Peggy, S Suleman.
University of Gondar, Clinical Pharmacy,Gondar, Ethiopia; Jimma University, Health Services Planning and Management,Jimma, Ethiopia; Washington, School of Pharmacy, Seatle, USA; Jimma University,School of Pharmacy, Jimma, Ethiopia.

Eur J Hosp Pharm 2013;20(Suppl 1):A1–A238

Background Patient-centred clinical pharmacy practise has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding, dispensing and supplying drugs, though it is poorly developed in Africa. Implementation of patient-centred practise is an important goal for maximizing the utility of the profession. But, studies on the work done by pharmacists in inpatient wards in resource-constrained settings are scarce.

Purpose To assess ward-based clinical pharmacy services in an internal medicine ward of Jimma University Specialist Hospital.

Materials and Methods The study was carried out on the internal medicine ward from March to April, 2011 at Jimma University Specialist Hospital. It was a prospective observational study. Clinical pharmacy interns providing pharmaceutical care to inpatients twice per week over a 2-month period were documented. Interventions optimising rational drug use and their acceptance were recorded. The clinical signifi cance of interventions was evaluated by an independent team (1 internist, 1 pharmacologist). Results of the study were reported in the form of fi ndings and percentages.

Results A total of 149 drug-related interventions for 48 patients was documented. Of these, 133 (89.3%) were clinical pharmacy intern-initiated interventions and 16 (10.7%) were interventions initiated by another health care professional. The most frequent drug-related problems (DRPs) underlying interventions were unnecessary drug treatment 36 (24.2%), additional drug treatment needed 34 (22.8%) and noncompliance 29 (19.5%). The most frequent type of intervention was change of dose/instruction for use, 23 (15.4%). 68.4% of interventions were fully accepted and 29.3% were partially accepted. Interventions with major and moderate clinical significance numbered 46 (49.5%) and 25 (26.9%) respectively.

Conclusions A clinical pharmacist contributes to improved inpatient treatment, even with a modest contribution such as participation in the pre-round meeting and the ward round twice per week.

Category of drug-related problem* Interventions, n (% of total)

Unnecessary drug treatment 36 (24.2%)
Additional drug treatment 34 (22.8%)
Ineffective drug 4 (2.7%)
Dose too low 18 (12.1%)
Adverse drug reaction 16 (10.7%)
Dose too high 12 (8%)
Noncompliance 29 (19.5%)
Total 149 (100%)

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