The impact of an in-department pharmacist on the prevention of drug iatrogenesis in a rheumatology department.

INTRODUCTION/OBJECTIVES: The primary objective was to evaluate the impact of an in-department pharmacist on the prevention of drug iatrogenesis in a rheumatology department. Secondary objectives were to determine (i) if medication history discrepancies were detected more frequently in the elderly or not, and (ii) if the mean number of treatments at admission had an impact on the number of medication history discrepancies. METHODS: Implementation of a clinical-pharmacy program based on medication reconciliation and medication review of prescription for all patients admitted to a rheumatology department between January and June 2017. The analytical approach was mainly descriptive and data were expressed as mean ± standard deviation (i.e., number of treatments at admission, number of medication reconciliations) and as proportions (i.e., acceptance rate, impact). Chi-squared tests and Student's test were performed to determine if there was a significant difference in outcomes. RESULTS: Three hundred twelve patients were included in the study, 517 medication history discrepancies in 243 (77.8%) patients and 196 pharmaceutical interventions in 133 (42.6%) patients. A significant difference was found in the number of medication history discrepancies and pharmaceutical interventions between the two age groups and in the mean number of treatments at admission between patients with or without medication history discrepancies. 15.4% of study patients had major medication history discrepancies and major pharmaceutical interventions. All patients and practitioners reported the usefulness of an in-department pharmacist. CONCLUSION: This program was found effective in terms of safety and improvement in the continuity of care. Key Points • This clinical-pharmacy program with an in-department pharmacist had a positive impact on the prevention of drug iatrogenesis in one rheumatology department. • 15.4% (n = 48) of study patients had major medication history discrepancies and major pharmaceutical interventions. • All practitioners and patients were satisfied with this clinical-pharmacy program.

[Optimising drug dispensation by pharmacy technicians: A quality approach]. / Optimisation des dispensations réalisées par les préparateurs en pharmacie : démarche qualité en rétrocession.

INTRODUCTION: In a context of continuity of quality improvement, we are committed to enhancing the care management and medication management of outpatients in the drug dispensation unit of our pharmacy. An audit was carried out to assess the training needs of pharmacy technicians (PTs). MATERIALS AND METHODS: All drug dispensations done over a 9-week period by the units PTs were audited. Data collected were: PTs' presentation to the patient, duration of drug dispensation, notion of introduction or renewal, the tools used during retrocession, and the explanations given to the patient about her/his treatment. PT perceptions and patient satisfaction were evaluated on a Likert scale from 1 to 5 and on a scale from 1 to 4, respectively. RESULTS: One hundred drug dispensation were audited: 21 introductions and 79 renewals. Tools were used in 52% of introductions and 11% of renewals. Administration modalities were explained for all introductions but for only 57% of renewals, 47% of adverse events and 9.5% of storage methods. Tolerance was discussed in 34% of drug dispensations and compliance in 19%. The scores of PT perception and patient satisfaction were 4.4/5 and between 3/4 and 3.9/4 depending on the items, respectively. CONCLUSION: Several areas for improvement are highlighted in this survey. PTs' complementary should include communication with outpatients. This approach is an integral part of the ISO 9001 certification obtained in 2019 in our drug dispensation unit.