Perceived barriers to pharmacist engagement in adverse drug event prevention activities in Ghana using semi-structured interview.
BACKGROUND
Pharmacist involvement in the prevention of medication errors is well documented. One such method, the process by which hospital pharmacists undertake these clinical interventions needs to be described and documented. The perceived barriers to pharmacists succeeding in getting their recommendations accepted could inform future safety strategy development. This study was therefore to trace the typical process involved and explore the perceived barriers to pharmacists' medication safety efforts.


METHODS
This study involved a retrospective evaluation of routine clinical interventions collected at a tertiary hospital in Ghana over 23 months. A sample of pharmacists who had submitted these reports were then interviewed.


RESULTS
The interventions made related to drug therapy changes (76.0%), monitoring (13.0%), communication (5.4%), counselling (5.0%) and adverse drug events (0.6%). More than 90% of interventions were accepted. The results also showed that undertaking clinical interventions by pharmacists followed a sequential order with two interlinked subprocesses: Problem Identification and Problem Handling. In identifying the problem, as much information needed to be gathered, clinical issues identified and then the problems prioritised. During the problem handling stage, detailed assessment was made which led to the development of a pharmaceutical plan. The plan was then implemented and monitored to ensure appropriateness of desired outcomes. The main barrier mentioned by pharmacist related to the discrepant attitudes of doctors/nurses. The other barriers encountered during these tasks related to workload, and inadequate clinical knowledge. The attitudes were characterised by conflicts and egos resulting from differences in status/authority, responsibilities, and training.


CONCLUSIONS
Though the majority of recommendations from pharmacists were accepted, the main barrier to hospital pharmacist engagement in medication error prevention activities related to discrepant attitudes of doctors and nurses. Proper initiation and maintenance of collaborative working relationship in hospitals is desired between the healthcare team members to benefit from the medication safety services of hospital pharmacists.
Pharmacy Department, Korle Bu Teaching Hospital, Accra, Ghana. franklinach@hotmail.co.uk.
Franklin
F
Acheampong
Department of Clinical & Social Pharmacy, Faculty of Pharmacy & Pharmaceutical sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana. berkopanyin@hotmail.com.
Berko Panyin
BP
Anto
D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control*; D005260:Female; D005869:Ghana; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000523:psychology*; D061214:Patient Safety / Q000592:standards*; D010595:Pharmacists / Q000523:psychology*; D055553:Prescription Drugs / Q000592:standards*; D012189:Retrospective Studies
D055553:Prescription Drugs