A pilot study assessing the impact of the presence of a clinical pharmacist and a pharmacy resident at the infectious diseases department of a lebanese university hospital

Purpose: Clinical pharmacy services are still in their early implementation stages in Lebanon. The objective of this study was to evaluate the impact of clinical pharmacist presence at the infectious diseases department of a Lebanese university hospital even for a short period of time daily and to evaluate the acceptance of pharmacist’s interventions by prescribers.

Methods: A 21-month prospective analysis was conducted, including 240 hospitalized patients in the infectious diseases department and 475 interventions performed by the pharmacist. The pharmacy resident and the clinical pharmacist were present in the department for 1-2h/day. A pharmaceutical care plan was established and used to document patients’ problems and pharmacist’s interventions. Main criteria analyzed were: types and frequencies of problems detected, types of pharmaceutical interventions performed, their acceptance by the prescribers and factors affecting the interventions and their acceptance.

Results: Most patients (47%) were treated with 7 to 9 drugs concomitantly. The 3 most frequent problems detected were incorrect dosage, inappropriate administration modalities and no clear indication for the drug in the patient’s file or drug duplication and the 3 most frequent interventions performed by the pharmacist were stop/start/substitute a drug, change drug dosage/drug daily distribution, change drug administration time. The acceptance was the highest for I.TIM (change drug administration time) with 87%, followed by I.ROU (change route of administration) 75 % > I.HIS (complete/correct/perform medication history) 67 % and I.ADM (change administration method or drug form) 67 % and the lowest for I.FOL (request a lab test/exam/clinical follow-up) with only 40 %.

Conclusion: Even a short daily pharmacist presence is an added value in inpatient care at the infectious diseases department of Hôtel-Dieu de France university hospital. Areas of improvement are a better communication between the pharmacist and the prescribers and a longer presence of the clinical pharmacist in the clinical department. 300 words