Ronan Sarah, Shannon Nicola, Cooke Katie, McKeon Trish, Walsh Elaine K, Kearney Alan, Sahm Laura J
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork T12 YN60, Ireland.
Pharmacy Department, South Infirmary Victoria University Hospital, Cork T12 X23H, Ireland.
Pharmacy (Basel). 2020 Jan 30;8(1):14. doi: 10.3390/pharmacy8010014.
Medication review (MR) is a vital part of the pharmacist's role in hospital. However, in the South Infirmary Victoria University Hospital (SIVUH), Cork, Ireland, this has not been fully implemented due to resource issues. In addition, the cost of providing this service has not been evaluated. Moreover, it is not clear how other members of the multidisciplinary team e.g. Nurses, value any interventions made as a result of the MR. This mixed methods study assessed the impact of MR in terms of (i) potential clinical harm, (ii) cost avoidance and (iii) the views of nursing staff on the role of the pharmacist. The setting is a 192-bed, voluntary, acute hospital, in the Munster region of Ireland. The pharmacist provided MR to patients conventionally once a week. Any interventions were then assessed for potential clinical harm and to calculate cost avoidance. Semi-structured interviews, guided by a topic guide were completed with 12 nurses (11 female). Thematic analysis was used to code the main themes. Main outcome measure: To estimate the cost, cost avoidance, and the net cost benefit ratio of MR provided by pharmacists. : Of 128 patients who received the MR, 113 interventions were made. The estimated cost of providing the MR was €2,559 (senior pharmacist). Using €1084 as the cost of an adverse drug event (ADE), the cost avoidance was calculated at €42,330. This led to a net cost benefit of €39,771 (senior pharmacist) which equated to a net cost benefit ratio of 16.5:1. The main themes were (i) perceptions of pharmacy services, (ii) the role of the pharmacist-past, present and future, and (iii) teamwork and communication. Nurses expressed a desire to have more pharmacists present on the wards.
用药评估（MR）是药剂师在医院工作中的重要组成部分。然而，在爱尔兰科克的南医务室维多利亚大学医院（SIVUH），由于资源问题，这一工作尚未得到充分实施。此外，提供这项服务的成本尚未得到评估。而且，尚不清楚多学科团队的其他成员（如护士）如何看待因用药评估而进行的任何干预措施。这项混合方法研究从以下几个方面评估了用药评估的影响：（i）潜在临床危害；（ii）成本规避；（iii）护理人员对药剂师作用的看法。研究地点是爱尔兰芒斯特地区一家拥有192张床位的志愿急症医院。药剂师通常每周为患者进行一次用药评估。然后对所有干预措施进行潜在临床危害评估并计算成本规避情况。对12名护士（11名女性）进行了以主题指南为指导的半结构化访谈。采用主题分析法对主要主题进行编码。主要结果指标：估算药剂师提供用药评估的成本、成本规避情况以及净成本效益比。在接受用药评估的128名患者中，共进行了113项干预措施。提供用药评估的估计成本为2559欧元（高级药剂师）。将药物不良事件（ADE）的成本设定为1084欧元，计算得出成本规避为42330欧元。这导致净成本效益为39771欧元（高级药剂师），净成本效益比为16.5:1。主要主题包括：（i）对药学服务的看法；（ii）药剂师过去、现在和未来的作用；（iii）团队合作与沟通。护士们表示希望病房里能有更多药剂师。
