A Methodological Assessment of Pharmacist Therapeutic Intervention Documentation (TID) in a Single Tertiary Care Hospital in Jeddah, Kingdom of Saudi Arabia

Documentation and classification of hospital pharmacist interventions: A scoping review

The practice of documenting pharmacist interventions (PIs) has been endorsed by many hospital pharmacists' societies and organizations worldwide. Current systems for recording PIs have been developed to generate data on better patient and healthcare outcomes, but harmonization and transferability are apparently minimal. The present work aims to provide a descriptive and comprehensive overview of the currently utilized PI documentation and classification tools contributing to increased evidence systematization. A systematic literature search was conducted in PubMed, Scopus, Web of Science and the Cumulative Index to Nursing and Allied Health Literature. Studies from 2008, after the release of the Basel Statements, were included if interventions were made by hospital or clinical pharmacists in a global hospital setting. Publications quality assessment was accomplished using the Mixed Methods Appraisal Tool. A total of 26 studies were included. Three studies did not refer to the documentation/classification method, 10 used an in-house developed documentation/classification method, seven used externally developed documentation/classification tools and six described method validation or translation. Evidence confirmed that most documentation/classification systems are designed in-house, but external development and validation of PI systems to be used in hospital practice is gradually increasing. Reports on validated PI documentation/classification tools that are being used in hospital clinical practice are limited, including in countries with advanced hospital pharmacy practice. Needs and gaps in practice were identified. Further research should be conducted to understand why using validated documentation/classification methods is not a disseminated practice, knowing patients' and organizational advantages.

Pharmacists' Interventions on Electronic Prescriptions from Various Specialty Wards in a Malaysian Public Hospital: A Cross-Sectional Study

Background: The emergence of new technologies in the area of health information and communication helps pharmacists to check the safety of medications used via electronic prescribing. Objectives: The study aimed to identify the rate and types of problems with electronic prescriptions (e-prescriptions) that required pharmacist intervention at an inpatient pharmacy, and to evaluate prescribers' acceptance of these interventions. Methods: A retrospective cross-sectional study on the interventions of e-prescriptions documented by pharmacists was conducted in a public hospital inpatient pharmacy. Data were collected for descriptive analysis using a collection form, including the e-prescription interventions, types of wards, drugs involved, and acceptance of intervention by prescribers. A chi-square test was used to evaluate the association between ward pharmacist availability and the rate of interventions. Results: A total number of 11,922 (3.3%) pharmacist interventions were proposed for 357,760 e-prescriptions ordered in the 12 month study period. Of the total number of proposed interventions, 11,381 (95.5%) were accepted by prescribers. The interventions on e-prescriptions were from surgical wards (11.7%) followed by intensive care (5.6%), paediatric (3.5%) and medical specialty wards (2.9%). Anti-infective agents (33.8%) and cardiovascular medicines (27.0%) were among the drugs with the highest rate of interventions. The most common type of intervention was revising the drug regimen (58.4%), especially with anti-infective agents (33.8%). Prescribers in surgical wards showed the highest level of acceptance of pharmacist interventions, which was 97.37%. The presence of ward pharmacists showed a higher number of interventions (6.2 vs. 1.0%, p < 0.001) than wards without pharmacists, as well as a higher percentage of acceptance (96.4 vs. 91.1%, p < 0.001) towards e-prescription intervention. Conclusion: In e-prescribing, errors can be prevented by pharmacists' interventions on e-prescriptions. This helps to prevent medication errors and thus optimise rational pharmacotherapy in patients. The role of ward pharmacists in pharmaceutical care is highly accepted by prescribers.