What are the main factors affecting physician implementation of hospital pharmacist recommendations to optimise medication appropriateness?

Physician implementation of hospital pharmacies recommendations. Written by Mr Robert Callaghan and Dr Kieran Dalton. Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.

Therefore, for more information on this study, please review the open access paper at: https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1111/bcp.14987

Hospital Pharmacists play a key role in identifying and resolving instances of potentially inappropriate prescribing. This is particularly in multimorbid older patients with polypharmacy.

Evidence from many randomised controlled trials has backed this up. They show that pharmacists reduce the incidence of adverse drug reactions, emergency department visits, in addition to medication related readmissions.

Importantly, pharmacist interventions with a high proportion of medication recommendations implemented by physicians are more likely to achieve significant improvements in patient outcomes.  This is compared to those with lower implementation rates. These generally result in non-significant patient outcomes.

The main factors affecting physicians’ implementation of hospital pharmacist recommendations have very little research conducted to explore it.

Therefore, researchers from University College Cork decided to investigate this. They did this by conducting one on-one semi-structured interviews with hospital pharmacists and physicians from two Irish teaching hospitals.

14 interviews were performed in total. This included six pharmacists (sampled based on experience) and two physicians. They’re from each of the following grades: intern, senior house officer, registrar, and consultant. At the time of the interviews, pharmacists did not have prescribing authority within either hospital. They primarily worked according to a ward based clinical pharmacy model.

The article above was Written by Mr Robert Callaghan (he is a 4th year pharmacy student) and Dr Kieran Dalton. It is based on a peer-reviewed research paper conducted by Dr Kieran Dalton, Dr Aoife Fleming, Professor Stephen Byrne. (School of Pharmacy, University College Cork) In addition to Professor Denis O’Mahony (Cork University Hospital).

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