Dryden Lindsay, Dewhurst Norman F
St. Michael's Hospital, Toronto, ON, Canada.
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
Int J Pharm Pract. 2019 Apr;27(2):175-179. doi: 10.1111/ijpp.12481. Epub 2018 Aug 6.
To evaluate the clinical and cost implications generated by a newly integrated ED pharmacist in a Canadian urban, university-affiliated tertiary care hospital.
A pharmacist documented all interventions that took place over a 5-week period. Interventions were assessed by a review panel for clinical significance and probability of harm had the intervention not occurred. Direct medication cost and cost avoidance as a result of interventions were calculated.
The ED pharmacist made 421 interventions during the study period, 204 (48%) interventions were accepted at the time they were presented to the prescriber. After review, 53.9% of interventions were considered significant, and 52.9% were given a probability of patient harm of ≥50% had the intervention not occurred. Interventions resulted in an increase in direct medication costs of $1270, but generated a cost avoidance of $160 709. The projected direct medication cost estimate for one year was $13 208 with a cost avoidance of over $1.6 million.
The integration of a pharmacist into a Canadian ED resulted in patient care interventions that were assessed as clinically significant, with a substantial projected cost avoidance.
评估在加拿大一所城市大学附属三级护理医院新设立的急诊科药师所产生的临床影响和成本影响。
一名药师记录了为期5周内发生的所有干预措施。一个评审小组对干预措施进行评估，判断其临床意义以及若未实施该干预措施可能造成伤害的可能性。计算干预措施导致的直接用药成本和成本节约情况。
在研究期间，急诊科药师进行了421次干预，其中204次（48%）在向开处方者提出时被接受。经审查，53.9%的干预措施被认为具有重要意义，52.9%的干预措施若未实施，对患者造成伤害的可能性≥50%。干预措施使直接用药成本增加了1270美元，但节约了160709美元的成本。预计一年的直接用药成本估计为13208美元，成本节约超过160万美元。
在加拿大急诊科配备药师进行患者护理干预，经评估具有临床意义，预计可大幅节约成本。
