Pharmacy support needed early on in hospital stay for medication-related problems

Patients in hospital need pharmacy input early on in their stay for medication-related problems (MRPs), a study in the International Journal of Pharmacy Practice (12 February 2020) has found^[1]
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Researchers collated data on admissions from adult medical wards at two UK hospitals between April and November 2016, and carried out descriptive analyses on clinically relevant — moderate or severe — preventable MRPs to find out what type of MRP they were experiencing and at which stage of the inpatient stay they were identified.

Among the 1,503 admissions, 2,614 validated MRPs were identified, of which 1,153 were moderate or severe, but preventable.

More than 70% of the clinically relevant MRPs were identified during or before the first ward-based pharmacy review of patients. In 46% of clinically relevant MRPs, ‘indication not treated/missing therapy’ was the reason for the MRP, while dose selection issues accounted for 24% of clinically relevant MRPs.

The researchers said their findings suggested that patients were at greatest need of pharmacist input, in terms of identification and resolution of clinically relevant MRPs, during the early stages of their stay, but that, as clinically relevant MRPs continue to occur, there was a need for ongoing pharmacy review.

“Our results also support the need for medicines reconciliation at admission and discharge, and suggest that, during the remainder of the inpatient stay, there is also need for ongoing clinical pharmacy review,” they said.