Pharmacist advice is accepted more for medical than for surgical patients in an emergency department.

INTRODUCTION

Pharmacists' advice may reduce medication errors in the emergency department (ED). However, pharmacists' recommendations are of little value if not acknowledged by physicians. The aim of the present study was to analyze how often and which categories of pharmacist recommendations were taken into account by the physicians in a Danish ED. Special attention is paid to problems of significant or vital importance.

MATERIAL AND METHODS

Clinical pharmacists reviewed patient files within 24 hours of admission, described medication issues and made recommendations for solutions. It was subsequently noted whether the recommendations were taken into account by the physicians. Independent specialists in internal medicine and geriatrics reviewed the recommendations and assessed whether they were of minimal, moderate, significant or vital importance.

RESULTS

Among the 301 recommendations made, 59% were followed by the physicians. The physician followed the recommendation made for patients admitted with medical problems significantly more often than the recommendations made for surgical patients (69% versus 51%, p = 0.002). In 47%, the recommendations were of significant or vital importance. Even these recommendations were acknowledged more by the physicians caring for medical patients than by physicians caring for surgical patients (78% versus 57%, p = 0.009). The difference remained significant in the multivariate analysis.

CONCLUSION

Even though the pharmacists' recommendations were followed in many cases in an ED, there is still room for improvement, especially for the surgical patients.

FUNDING

The Amgros Research Foundation covered the costs for the independent specialists who reviewed the patient files.

TRIAL REGISTRATION

NCT01723462 (clinicaltrial.gov).