Medical Inspection – Health Blog

Of the charts for 52 patients randomly selected from the Medical Records Department list, 22 (42%) patients were seen by a clinical pharmacist during their admis­sion, and medication-history information for 6 (27%) of these 22 patients was obtained from PharmaNet.

From the charts for 66 patients in total (52 from the hospital’s Medical Records Department and 14 from the Pharmacy Department’s list), charts for 11 were excluded because there was no evidence of any prescription medications taken before admission. This left a total of 55 charts for analysis: 19 for patients who were not seen by a clinical pharmacist, 18 for patients who were seen by a clinical pharmacist and for whom no PharmaNet review was carried out, and 18 for patients who were seen by a clinical pharmacist and for whom a PharmaNet review had been conducted. The mean age of these 55 patients was 75 ±8 years, and the mean duration of their hospital stay was 13.2 ± 12.5 days. The majority (69%, 38/55 patients) of patients were male. Of those for whom a PharmaNet review was conducted, the mean time after admission until PharmaNet was accessed was 3.8 ±4.5 days.

Table 1. Completeness of Before-Admission Prescription Medication Lists Documented by Various Health Care Professionals

Table 2. Drug-Related Problems Documented in the Medical Record, According to Pharmacist Activity

Evaluation of the data by profession revealed that pharmacists recorded the highest proportion of medications taken before admission and the fewest number of missed medications, regardless of whether PharmaNet was reviewed (Table 1). However, the variation within these results was large, and the differences between them were not statistically significant. When medication histories documented by pharmacists were compared with the composite of all other professions, the differences were still not statistically significant, neither when evaluated as a proportion of medications taken before admission (76% ± 25% versus 70% ± 29%, p = 0.25), nor when evaluated as the number of missed medications (1.5 ± 1.5 versus 1.9 ± 2.3, p = 0.34). The use of PharmaNet did not seem to enhance the completeness of medication-history information pharmacists obtained, whether evaluated by the proportion of documented medications taken before admission (76% ± 21% versus 77% ± 30%, p = 0.94) or evaluated by the number of medications taken before admission that were missed (1.6 ± 1.4 versus 1.4 ± 1.6, p = 0.74). More drug-related problems relating to medications taken before admission per patient were documented when PharmaNet was used to obtain a medication history (1.5 ± 1.3 versus 0.6 ± 0.9, p = 0.02) (Table 2). However, patients for whom PharmaNet was reviewed tended to take more prescription medications before admission than those for whom PharmaNet was not reviewed (7.0 ± 2.8 versus 5.4 ± 2.8, p = 0.10). Without the use of PharmaNet, pharmacists documented more drug-related problems than other health care professionals when taking medication histories; however, the highest number of drug-related problems was identified when a pharmacist used PharmaNet. The mean severity index of drug-related problems was similar, regardless of whether PharmaNet was used. Most drug-related problems identified with PharmaNet were related to medical conditions for which patients did not receive therapy in hospital (i.e., “untreated indication”) (Table 3), and more of these problems involved cardiovascular medications than any other medication (Table 4).  silagra tablets

Table 3. Types of Drug-Related Problems Documented in Medical Records of Patients for Whom PharmaNet Was Reviewed

Table 4. Drug Categories of Drug-Related Problems Documented in Medical Records of Patients for Whom PharmaNet Was Reviewed

Related Posts:

• Comparison of the Completeness of Prescription Medication Histories: DISCUSSION part 2
• Comparison of the Completeness of Prescription Medication Histories: DISCUSSION
• Comparison of the Completeness of Prescription Medication Histories: METHODS
• Comparison of the Completeness of Prescription Medication Histories