Adding value through pharmacy validation: a safety and cost perspective
Rationale, aims and objectives Prescribing errors (PE) are frequent, cause significant harm to patients and prove costly. Few studies demonstrate the impact of pharmacist interventions. The objectives of this study were to characterize the severity and cost of the potential outcome of PE that pharma...
Saved in:
Published in | Journal of evaluation in clinical practice Vol. 22; no. 2; pp. 253 - 260 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
Blackwell Publishing Ltd
01.04.2016
|
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Rationale, aims and objectives
Prescribing errors (PE) are frequent, cause significant harm to patients and prove costly. Few studies demonstrate the impact of pharmacist interventions. The objectives of this study were to characterize the severity and cost of the potential outcome of PE that pharmacists can prevent and to develop an economic analysis.
Method
We performed a non‐randomized, prospective, observational study of all prescriptions made to adult patients admitted to a 1300‐bed tertiary teaching hospital in Madrid (Spain) by means of a computerized physician order entry tool combined with a clinical decision support system. We analysed PE intercepted through the pharmacist validation process between January and June 2013. An independent team determined the severity of the potential adverse drug event (ADE) and the probability of causing an ADE (PAE). We estimated the cost avoidance and performed an economic analysis. A kappa statistic was used to verify inter‐observer agreement.
Results
484 PE were intercepted: 36.2% of PE were classified as being of minor severity, 59.1% as moderate and 4.7% as serious. The most common type of moderate‐serious PE found was excessive dose (30%, 94/309), followed by insufficient dose (20%, 62/309), and omission (19%, 58/309). The most frequent families of drugs involved in moderate‐serious PE were antineoplastic agents (22.3%, 69/309) and antimicrobials (17.2%, 53/309). The PAE was higher than 40% in 49% of PE. We estimated a cost avoidance of €291,422 and a return on investment of €1.7 for each €1 spent on a pharmacist's salary. The overall inter‐rater agreement for the participants was moderate for severity (κ = 0.57; P <0.005) and strong for the PAE (κ = 0.77; P <0.005).
Conclusions
Pharmacists add important value in preventing PE, and their interventions are financially beneficial for the institution. |
---|---|
Bibliography: | iPharma (Pharmacy Innovation Center of the Hospital General Universitario Gregorio Marañón) - No. PI12/02883 ArticleID:JEP12466 istex:BACD91DA0C708F7D0BFCFF4E53A10C2E5E9152A2 ark:/67375/WNG-JPB15VFM-B ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Undefined-1 ObjectType-Feature-3 content type line 23 |
ISSN: | 1356-1294 1365-2753 |
DOI: | 10.1111/jep.12466 |