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DOES RECORDING OF MEDICATION HISTORY BY PHARMAECONOMIST IN THE EMERGENCY DEPARTMENT HAVE AN EFFECT AT OTHER HOSPITAL DEPARTMENTS? (submitted in 2019)

European Statement

Clinical Pharmacy Services

Author(s)

Maria Abrahamsen

Why was it done?

The aim of the initiative was, among others, to study whether MH by a pharmaconomist in the emergency department has positive effects in other departments. Since the majority of hospitalised patients are admitted through the emergency department it is expected that changes related to admission procedures affect other departments in the cases where patients are hospitalised. In theory recording of MH should be easy, due to the use of Shared Medication Record (FMK). FMK is an updated electronic medication list including all prescriptions filled at pharmacies within the last 2 years. In reality, often neither FMK nor the recorded MH is correct. MH recorded by pharmaconomist or pharmacist is implemented in other emergency departments, but the effect in other hospital departments has yet to be documented.

What was done?

At hospitalisation, part of the routine is to record the patient’s medicinal history. We implemented recording of medicinal history (MH) in the emergency department by a pharmaconomist instead of by a doctor.

How was it done?

The pharmaconomist was present at the emergency department weekdays during daytime to record the MH of newly admitted patients. When the pharmaconomists wasn’t present the doctor recorded the MH. To evaluate the effect in other departments, data registered by pharmaconomists at the department of geriatrics about medicinal changes, types of changes and number of patients with changes were used, combined with hospital data about the number of patients in the geriatric department at a given time. Data from 10 months before the initiative was compared with data from the 9 month test period.

What has been achieved?

At the department of geriatrics both the need for medicine changes due to inadequate MH and the number of patients with medicine changes related to inadequate MH was significantly reduced (p 0.05). The proportion of patients with changes was reduced from 43.7% to 36.9% and the number of changes per patient was reduced from 0.65 to 0.49. For both parameters the reduction is seen immediately after implementing MH by a pharmaconomist in the emergency department. The reduction has released time for nurses, doctors and pharmaconomists working outside the emergency department, though it isn’t possible to quantify the amount of released time.

What next?

Incorporation of a specialised professional such as a pharmaconomist early in a hospitalisation gives doctors, nurses and pharmaconomists working outside the emergency department extra time for other tasks. The effect of the initiative depends on the procedures for admissions since it requires that most patients are admitted through one department at the hospital.

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