1992 National Clinical Pharmacy Services Study.

STUDY OBJECTIVE

To determine the extent of hospital-based clinical pharmacy services in 1992.

DESIGN

National survey with trend comparison to 1989.

SETTING

All 1597 United States acute care, general medical-surgical and pediatric hospitals with 50 or more licensed beds and one or more full-time pharmacists (43% of all U.S. hospitals).

MEASUREMENTS AND MAIN RESULTS

Fourteen clinical pharmacy services, carefully defined to indicate pharmacist proactive or concurrent patient care provision, were assessed to determine pharmacists' specific patient care responsibilities. The percentage of hospitals offering each of the services increased from 1989 to 1992, with greatest growth in management of adverse drug reactions (22% increase), pharmacokinetic consultations (14%), and drug therapy protocols (12%). The mean percentage of patients actually receiving clinical pharmacy services ranged from 0.2% for pharmacist participation on the cardiac arrest team to 36.1% for daily monitoring of drug therapy. Pharmacists conducted clinical research in 13% of all hospitals, averaging 3.9 +/- 4.3 protocols per year with a total budget of $79,765 +/- $128,641.

CONCLUSIONS

Clinical pharmacy services continue to expand; however, even the most common direct patient care service is provided to a small number of inpatients.