Assessment of Clinical Pharmacy Services Implemented in Drug Information Center in an Egyptian Hospital

Abstract

Drug information centers are specialized settings that aim at enhancing knowledge of medicines use, promoting rational prescribing among HCPs, and reducing ME to maximize therapeutic outcomes. These centers provide many activities among which RDU, ADRs reporting and providing authentic individualized and accurate DI to the HCPs regarding medication related inquiries through DIS. Clinical pharmacists provide a communication system for providing other HCPs with information necessary for optimal drug therapy for patients. Many studies have revealed the positive role of clinical pharmacy services in improving patients' clinical and economic outcomes. The present study focused on assessing the role of clinical pharmacist in providing clinical services through a local DIC at New Cairo Hospital. These services were summarized in rationalizing human albumin use, and assessing knowledge attitude and practice of HCPs at the hospital and evaluating the DIS provided represented in DIRs assessment. Therefore, to achieve this aim, a multifaceted project was carried out. The first study was done to evaluate human albumin dispensing pattern and aimed at minimizing its misuse through clinical pharmacist implemented strategies in the ICU. The study was retrospective prospective 3-phase interventional study that was conducted over a period of 2 years. It included three phases; a preparation phase to determine the criteria for rationalizing albumin prescription and to prepare a suitable dispensing form to control for albumin dispensing. This phase was followed by a retrospective pre-implementation phase in which the clinical pharmacists reviewed all medical records of ICU patients who received albumin and classified them into appropriate and inappropriate indications according to the developed protocol. Finally, a prospective implementation phase, where the prepared protocol and the restriction dispensing form were used. The pattern of albumin dispensing and its cost were documented and compared between the retrospective and prospective phases. The first study has shown that: clinical pharmacists’ interventions led to a significant reduction of albumin misuse. In addition, cost reduction was consequently obtained following albumin use optimization. The second study aimed at evaluating the knowledge, attitude and practices of HCPs about PV before and after clinical pharmacists’ intervention at New Cairo Hospital and aimed at encouraging ADRs reporting and raising awareness about the National program of PV. This study was a prospective 3-phase interventional study that was conducted on HCPs at New Cairo Hospital over a period of 9 months. The first phase was a pre-education phase where a questionnaire investigating knowledge, attitude and practice of HCPs of PV and ADRs reporting was administered by HCPs to obtain the baseline data. It was followed by an intervention phase, where the clinical pharmacists, aided by the EPVC, educated the HCPs about PV and the proper method of reporting. Finally, a post-education phase, where the questionnaire was re-administered by the participants after 9 months from receiving education. The second study has shown that the educational program had a substantial impact on improving knowledge, attitude, and practice of HCPs towards PV and on enhancing the process of ADRs reporting, and that continuous education for HCPs is recommended to maintain high levels of knowledge, attitude, and practice. The third study aimed at evaluating the performance of the DIC providing DIS, offered by the clinical pharmacists and at increasing the awareness of HCPs about these services. This was a retrospective-prospective 4-phase interventional study that was conducted in a DIC in clinical pharmacy department at New Cairo Hospital, for a period of 3 years. At baseline, assessment of the HCP’s awareness about the DI services provided was carried out through circulating an awareness questionnaire. After then, a retrospective phase was done: where all the DIRs that were received and answered by the DIC were collected a year retrospectively, and were assessed to evaluate the DI services provided, and to discover the interventions required to improve these services. Then intervention phase was done, where suggestions that were given by HCPs in the baseline awareness q