title: Nationwide evaluation of day-to-day clinical pharmacists' interventions in German hospitals.
abstract: OBJECTIVE
  To describe and evaluate the extent and diversity of nationwide data from clinical pharmacists' interventions (PIs) in German hospitals.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  The ADKA-DokuPIK German database, a national anonymous self-reported Internet-based documentation system for routine PIs as well as for medication errors reported by German hospital pharmacists.
  
  
  RESULTS
  Data sets from ADKA-DokuPIK entered between January 2009 and December 2012 were analyzed descriptively. A total of 27,610 PIs were entered, mainly by ward-based clinical pharmacists (82.5%). Most of the PIs were performed on surgical wards (37.8%), followed by anesthesiology/intensive care unit/intermediate care unit and internal medicine. The most prevalent therapeutic subgroup that was the trigger for the PIs was antibacterials for systemic use (13.9%), followed by antithrombotic agents, analgesics, drugs for acid-related disorders, and agents acting on the renin-angiotensin system. About a quarter of interventions (23.4%) were performed due to inappropriate use of drugs, followed by use of a wrong dose or administration interval (22.1%), resulting in the most frequently taken actions of change of dose, change of drug, and drug stopped/paused (withheld). Altogether, the implementation rate of the PIs was 85.5%. Underlying medication errors were predominantly classified as "error, no harm" according to the National Coordinating Council for Medication Error Reporting and Prevention.
  
  
  CONCLUSIONS
  For the first time in a European country, our findings show the scope of clinical pharmacist involvement in patient care in daily clinical practice and demonstrate the usefulness and importance of their proactive interventions in the prevention of hazards and risks for hospital inpatients.
authors.affiliation: Pharmacy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Stem Cell Transplantation, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: Claudia
authors.initials: C
authors.lastname: Langebrake
authors.forename: Angela
authors.initials: A
authors.lastname: Ihbe-Heffinger
authors.forename: Katja
authors.initials: K
authors.lastname: Leichenberg
authors.forename: Sandra
authors.initials: S
authors.lastname: Kaden
authors.forename: Mareike
authors.initials: M
authors.lastname: Kunkel
authors.forename: Michael
authors.initials: M
authors.lastname: Lueb
authors.forename: Heike
authors.initials: H
authors.lastname: Hilgarth
authors.forename: Carina
authors.initials: C
authors.lastname: Hohmann
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data; D016208:Databases, Factual; D005858:Germany; D006801:Humans; D008508:Medication Errors / Q000706:statistics & numerical data; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data*; D056737:Safety-Based Drug Withdrawals / Q000706:statistics & numerical data
keywords: clinical pharmacy services; drug-related problems; medication safety; pharmacist interventions