Evaluation of a controlled, national collaboration study on a clinical pharmacy service of screening for risk medications

Background Risk medications are frequently associated with adverse events and hospitalisations. Objective To evaluate a risk medication screening service for in-patients at Danish hospitals. Setting Danish hospitals. Methods The study was designed as a controlled, prospective intervention study. Inpatients were screened for the use of five risk medications; anticoagulants, digoxin, methotrexate, NSAIDs and opioids, and during the intervention period recommendations were made by clinical pharmacists according to a standardized intervention scheme. The recommendations were discussed with the physician face-to-face. Main outcome measure Readmissions within 6 months after discharge. Results In total, 1,007 control and 775 intervention patients were included in the study. The study found that half of the patients (50 % during the control and 48 % during the intervention period) admitted to Danish hospitals were treated with at least one of the five selected risk medications, significantly more drug related problems (DRPs) were identified during the control period (1.7/patient during the control and 1.4/patient during the intervention period (p < 0.001)), and the acceptance rate of recommendations (62 %) was similar to medication management service studies in the literature (39–100 %). However, no impact on outcome measures was found. The majority (69 %) of the clinical pharmacists reported that they had increased their professional competences by participating in the study, and that a national clinical pharmacy study may be used in promoting and implementing a unique clinical pharmacy service throughout the country (67 %). Conclusion The study showed that a national screening service for risk medications could help identify and address DRPs. Despite no impact on the selected outcome measures, it is likely that the screening service could be included in a medication management review with further focus on the individual patient to ensure positive outcomes, or that the screening service should be delivered to selected patients groups, who might have maximum benefit of the service.