Using the Danish National Evaluation as a tool to measure patient-perceived drug information.

INTRODUCTION: In 2017, as part of the Danish National Evaluation (LUP), some patients at Lillebaelt Hospital reported receiving insufficient information about their drug treatment. The aim of this study was to evaluate the effect of a multifaceted clinical pharmacist intervention on patient-reported levels of drug information received and patients' perceptions of safety and comfortability with their drug treatment. METHODS: In this feasibility study, the intervention consisted of a multifaceted service including two patient interviews using a motivational interviewing approach. The interviews were held during admission and after discharge as a follow-up phone call. Patients were asked questions similar to those used in the LUP about the level of information they had received, and they self-evaluated their safety and comfortability with their drug treatment. RESULTS: A total of 157 patients received the intervention; 135 patients were eligible for follow-up. Approximately 60% of the patients responded that the intervention had positively affected their feelings of safety and comfortability with their drug treatment. There was no significant difference in the patients' responses to the LUP questions regarding the level of information they had received before and after the intervention. CONCLUSIONS: The intervention improved the majority of the patients' perceptions of safety and comfortability with their drug treatment. Although all patients received information about their drug treatment and their questions were answered, this was not reflected in their responses to the LUP questions. FUNDING: The Development Council of Lillebaelt Hospital. TRIAL REGISTRATION: The study was approved by the Danish Data Protection Agency.

[Development of patient-specific issues in relation to medicines is a challenge to all health-care professionals].

As a consequence of implementing clinical pharmacy at hospitals in Denmark, the need of defining some of the services delivered appeared: medication anamnesis, medication reconciliation, medication review and prescription review. Consensus was reached on the definitions with qualification by 20 colleagues from hospital pharmacies throughout the country as well as from external stakeholders. As an additional benefit, the definitions could cover the pharmacy services performed in primary care as well, which may help improve communication in the interface management of medication treatment.

Medication reconciliation and prescribing reviews by pharmacy technicians in a geriatric ward.

OBJECTIVE: Incomplete medication histories obtained on hospital admission are responsible for more than 25% of prescribing errors. This study aimed to evaluate whether pharmacy technicians can assist hospital physicians' in obtaining medication histories by performing medication reconciliation and prescribing reviews. A secondary aim was to evaluate whether the interventions made by pharmacy technicians could reduce the time spent by the nurses on administration of medications to the patients. METHODS: This observational study was conducted over a 7 week period in the geriatric ward at Odense University Hospital, Denmark. Two pharmacy technicians conducted medication reconciliation and prescribing reviews at the time of patients' admission to the ward. The reviews were conducted according to standard operating procedures developed by a clinical pharmacist and approved by the Head of the Geriatric Department. FINDINGS: In total, 629 discrepancies were detected during the conducted medication reconciliations, in average 3 for each patient. About 45% of the prescribing discrepancies were accepted and corrected by the physicians. "Medication omission" was the most frequently detected discrepancy (46% of total). During the prescribing reviews, a total of 860 prescription errors were detected, approximately one per medication review. Almost all of the detected prescription errors were later accepted and/or corrected by the physicians. "Dosage and time interval errors" were the most frequently detected error (48% of total). The time used by nurses for administration of medicines was reduced in the study period. CONCLUSION: This study suggests that pharmacy technicians can contribute to a substantial reduction in medication discrepancies in acutely admitted patients by performing medication reconciliation and focused medication reviews. Further randomized, controlled studies including a larger number of patients are required to elucidate whether these observations are of significance and of importance for securing patient safety.

[Successful implementation of pharmaceutical intervention at an acute medical admission unit]. / Vellykket implementering af farmaceutisk intervention på Akut Modtage Afdeling.

We document the process of implementing a clinical pharmacist service at the acute medical admission unit at Odense University Hospital. During the period December 2009 through April 2010 we reviewed 915 medication lists, which resulted in 628 interventions with generic substitution as the most frequent. The overall acceptance rate was 80%, albeit varying from 99% for generic substitution to 25% for change of administration route.