Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Louvain, Belgium.
Pharmacy Department, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium.
BMC Med Inform Decis Mak. 2022 Jul 5;22(1):177. doi: 10.1186/s12911-022-01921-7.
To support appropriate prescribing hospital-wide, the 'Check of Medication Appropriateness' (CMA) service was implemented at the University Hospitals Leuven. The CMA concerns a clinical rule based and pharmacist-led medication review service. The aim of this study was to explore both physicians' and pharmacists' feedback on the optimised CMA service to further improve the service.
An anonymous e-questionnaire was sent to all physicians active in the University Hospitals Leuven (n = 1631) and to all clinical pharmacists performing the CMA service (n = 16). Feedback was collected using multiple choice questions. During a 5-month period, physicians were also contacted in case of non-acceptance of recommendations to investigate barriers affecting implementation. Thematic analysis was performed and additional acceptance after telephone contact within 24 h was registered.
A total of 119 physicians (7.3%) and 16 pharmacists (100%) completed the e-questionnaire. The overall service was assessed as clinically relevant to highly relevant by 77.7% of physicians. The main reasons for non-acceptance of recommendations were related to workload, work environment and time constraints. About two thirds (66.3%) of initially not-accepted recommendations were accepted after phone contact. A nearly full consensus was reached among pharmacists (15/16) on the centralised CMA being complementary to current clinical pharmacy activities. Two major barriers were reported by pharmacists: (1) too limited time allocation and (2) a large number of irrelevant alerts.
The CMA was perceived as clinically relevant by the majority of end-users. Acceptance rate of pharmaceutical recommendations was further increased by calling the physician. Increasing the specificity of clinical rules in the future is imperative.
为了在全院范围内支持合理处方，鲁汶大学医院实施了“药物适宜性检查”（CMA）服务。CMA 是一项基于临床规则并由药剂师主导的药物审查服务。本研究旨在探讨医生和药剂师对优化后的 CMA 服务的反馈意见，以进一步改进该服务。
向所有在鲁汶大学医院工作的医生（n=1631）和执行 CMA 服务的所有临床药师（n=16）发送了匿名电子问卷。使用多项选择题收集反馈意见。在 5 个月的时间里，还联系了医生，如果他们不接受建议，以调查影响实施的障碍。进行了主题分析，并记录了在 24 小时内通过电话联系后的额外接受情况。
共有 119 名医生（7.3%）和 16 名药剂师（100%）完成了电子问卷。77.7%的医生认为该服务在临床上是相关的，高度相关。不接受建议的主要原因与工作量、工作环境和时间限制有关。大约三分之二（66.3%）的最初未被接受的建议在电话联系后被接受。药剂师达成了几乎完全的共识（15/16），认为集中式 CMA 是对当前临床药学活动的补充。药剂师报告了两个主要障碍：（1）时间分配过于有限，（2）大量不相关的警报。
大多数最终用户认为 CMA 在临床上是相关的。通过打电话给医生，接受药物建议的比例进一步提高。未来增加临床规则的特异性至关重要。
