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Open AccessArticle

The Role of the Clinical Pharmacist in an Irish University Teaching Hospital: A Mixed-Methods Study

1
Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork T12 YN60, Ireland
2
Pharmacy Department, South Infirmary Victoria University Hospital, Cork T12 X23H, Ireland
3
Department of General Practice, University College Cork T12 YN60, Ireland
4
Pharmacy Department, University Hospital Kerry, Rathass, Tralee V92 NX94, Ireland
5
Pharmacy Department, Mercy University Hospital, Grenville Place, Cork T12 WE28, Ireland
*
Author to whom correspondence should be addressed.
Pharmacy 2020, 8(1), 14; https://doi.org/10.3390/pharmacy8010014
Received: 17 December 2019 / Revised: 16 January 2020 / Accepted: 24 January 2020 / Published: 30 January 2020
(This article belongs to the Special Issue Clinical Pharmacists' Interventions in Chronic Care)
Medication review (MR) is a vital part of the pharmacist’s role in hospital. However, in the South Infirmary Victoria University Hospital (SIVUH), Cork, Ireland, this has not been fully implemented due to resource issues. In addition, the cost of providing this service has not been evaluated. Moreover, it is not clear how other members of the multidisciplinary team e.g., Nurses, value any interventions made as a result of the MR. This mixed methods study assessed the impact of MR in terms of (i) potential clinical harm, (ii) cost avoidance and (iii) the views of nursing staff on the role of the pharmacist. The setting is a 192-bed, voluntary, acute hospital, in the Munster region of Ireland. Study I: The pharmacist provided MR to patients conventionally once a week. Any interventions were then assessed for potential clinical harm and to calculate cost avoidance. Study II: Semi-structured interviews, guided by a topic guide were completed with 12 nurses (11 female). Thematic analysis was used to code the main themes. Main outcome measure: To estimate the cost, cost avoidance, and the net cost benefit ratio of MR provided by pharmacists. Study I: Of 128 patients who received the MR, 113 interventions were made. The estimated cost of providing the MR was €2559 (senior pharmacist). Using €1084 as the cost of an adverse drug event (ADE), the cost avoidance was calculated at €42,330. This led to a net cost benefit of €39,771 (senior pharmacist) which equated to a net cost benefit ratio of 16.5:1. Study II: The main themes were (i) perceptions of pharmacy services, (ii) the role of the pharmacist—past, present and future, and (iii) teamwork and communication. Nurses expressed a desire to have more pharmacists present on the wards. View Full-Text
Keywords: medication review; cost avoidance; adverse drug events; views of nurses; cost benefit ratio; semi-structured interviews medication review; cost avoidance; adverse drug events; views of nurses; cost benefit ratio; semi-structured interviews
MDPI and ACS Style

Ronan, S.; Shannon, N.; Cooke, K.; McKeon, T.; Walsh, E.K.; Kearney, A.; Sahm, L.J. The Role of the Clinical Pharmacist in an Irish University Teaching Hospital: A Mixed-Methods Study. Pharmacy 2020, 8, 14.

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