The effects of introducing a clinical pharmacist on orthopaedic wards in Denmark.
OBJECTIVE
To assess the effects and cost effects of introducing clinical pharmacists on hospital wards.


METHODS
Comparative prospective study on four orthopaedic surgical wards in two hospitals. The primary effect variables were 10 target areas widely considered to be indicators of good prescription practice. Prescriptions not following good practice in these intervention areas were defined as "sub-optimal prescriptions," and then discussed between a physician and a clinical pharmacist. The primary parameter was the difference in the number of days with a sub-optimal prescription (Mann-Whitney test).


RESULTS
On an average 20% of all the patients had a sub-optimal prescription. Of these, 70% were changed by the physician after intervention by the clinical pharmacist. There was a statistically significant difference in the duration of days in treatment with a sub-optimal prescription. Where sub-optimal prescriptions were changed, 43% resulted in cost reductions. The reductions achieved could cover 47% of the costs of clinical pharmacy service.


CONCLUSIONS
Clinical pharmacy services offered to four orthopaedic surgical wards resulted in reduction of sub-optimal prescriptions. Every time the pharmacist screened seven patients one sub-optimal prescription was found and adjusted. The reduction in medicine costs due to adjusted sub-optimal prescriptions could not cover the whole cost of clinical pharmacy service.
Buck
Thomas Croft
TC
Health Department, Vejle County, Damhaven 12, DK-7100 Vejle, Denmark. tcb@vejleamt.dk
Brandstrup
Lene
L
Brandslund
Ivan
I
Kampmann
Jens Peter
JP
D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D003718:Denmark; D004358:Drug Therapy / Q000592:standards; D005260:Female; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D008297:Male; D008875:Middle Aged; D009985:Orthopedics / Q000458:organization & administration*; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D010818:Practice Patterns, Physicians' / Q000191:economics / Q000592:standards*; D024382:Professional Role; D011446:Prospective Studies; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D000078329:Workforce