Clinical & Hospital Pharmacy

Introduction: The Department of Emergency Medicine (DEM) has a high-risk environment duo to its unique and complex workflow. Many high-risk medications are ordered and administered at bedside without being checked by pharmacist, which may lead to increase the incident of medication error and Adverse Drug Reactions (ADRs).

 

Objective: The objective of this study was to assess and evaluate the need of clinical pharmacy service in DEM at King Saud University Medical City, Saudi Arabia.

 

Method: A cross-sectional retrospective study (two-years) was conducted between January 2016 and December 2017 at Adult Emergency Department of King Saud University Medical City (KSUMC). The documentation of emergency medicine clinical pharmacist interventions was extracted from Esihi database.

 

Result: During the study period a total of 2255 interventions were documented by Emergency Medicine (EM) clinical pharmacist.The interventions were related to 862 patients. Interventions recommended By EM clinical pharmacist were: 645 (dose adjustments),108 (therapeutic substitution) and 354 (initiating drug therapy). ADRs were distinguished in 16 patients and interactionswere managed in 26 patients. The EM clinical pharmacist responded to 713 (information inquires) and 290 (pharmacokineticconsultations). Drugs discontinuation interventions were: 39 (avoid unjustified prescription), 37 (contraindication) and 19(duplicate therapy). The most interventions were related to antibiotic drugs (34%), followed by anticoagulant drugs (15%),followed by anticonvulsant drugs (10%). The acceptance rates for the EM clinical pharmacist recommendation from DEM physician were 93.9% in 2016 and 99% in 2017, respectively. The most outcomes of the interventions were optimized therapeutic effects (73%) and reconciliation was done for 796 patients.

 

Conclusion: This study shows the important role of clinical pharmacy service in the emergency department.