The utilization of a clinical pharmacist--a way of decreasing medications in a community hospital

This article summarizes the results of a study designed to evaluate clinical pharmacy services as a means of reducing drug usage in a 170-bed community hospital. A total of 591 medication orders for 93 hospitalized patients were evaluated. A pharmacy resident made recommendations regarding the appropriateness of the medication order to the attending physicians. A team of reviewing physicians later evaluated these recommendations. The resident's suggestions were also monitored by a university-affiliated and experienced clinical pharmacist. The number of medications ordered which the pharmacy resident would have prescribed during consultation with physicians was 312 (53 percent), while the overseeing clinical pharmacist would have prescribed 352 (60 percent). Two hundred and fifteen therapeutic recommendations were provided by the pharmacy resident, of which 38 (17.6 percent) were carried out by the attending physician. The reviewing physicians did not agree with 37 of these recommendations. Twenty-two drug interactions were detected, of which eleven were thought to be of definite clinical significance by the pharmacy resident. The study demonstrated that a 40 percent reduction in medication utilization could result in a community hospital, while the same level of therapeutic effectiveness was maintained, by using the services of a properly trained clinical pharmacist. The patient care appraisal committee which was appointed to evaluate the study reviewed the results and agreed that, based on the cost factor and improvement of patient care, clinical pharmacy services would be beneficial.