The Clinical Pharmacist-Led Medication Review Service at the Surgical Department: A Feasibility Study.
Maria Christiansen, Niels Joensen, Ramune Jacobsen
PMID 40317547WHAT IT FOUND
Pharmacist-led medication reviews found medication problems in 39 of 42 older surgical patients.
Physicians accepted 61 of 123 proposed changes. Staff reported notes were easy to miss and communication roles were unclear.
Key findings
01Thirty-nine of the 42 included patients had at least one medication-related problem.
02Physicians accepted 61 of 123 proposed medication changes, and printed delivery was accepted more often than notes alone.
03Staff feedback reported that the pharmacist was not visible to all shift workers and that pharmacist notes were sometimes overlooked in the medical record.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
This was a single-centre feasibility study, so it did not test whether the service improved patient outcomes compared with usual care. Only 42 patients were included, all from one surgical ward, and patients had to be able to consent and contribute to medication history. Data collection and medication review were done by one pharmacist. The study could offer the service to only an average of 1.6 hospitalised patients per day because consent and data protection requirements limited the sample. Acceptance rates were calculated for 35 patients, not all 42, because one patient was discharged before review finalisation and one died with records deleted. Qualitative feedback from physicians and nurses was not anonymous, which may have limited how openly they spoke. The PCNE classification describes medication problems and causes but does not analyse deeper clinical issues. Acceptance of proposed changes is not the same as measuring patient benefit.
The easy way to misread this
Do not read the 49.6% acceptance rate as proof that pharmacist-led medication review improves patient outcomes. This was a feasibility study, and the authors state that an intervention study is still needed to prove effectiveness.