Documentation of clinical activities in community pharmacy using the ClinPhADoc tool: preliminary results
- At: PPR 2022 (2022)
- Type: Poster
- By: AMADOR-FERNáNDEZ, Noelia (Center For Primary Care And Public Health (unisanté), University Of Lausanne)
- Co-author(s): Noelia Amador-Fernández, Postdoc Researcher, Center For Primary Care And Public Health (unisanté), University Of Lausanne, Switzerland
Tiffany Baechler, Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne , Switzerland
Patricia Quintana Bárcenas
Drug related problems (DRP) have a significant clinical and economic burden. The management of DRPs involves diverse clinical activities and partners. Pharmacists’ clinical activities have demonstrated benefits but they are scarcely reported, especially in community pharmacies (CPs). ClinPhADoc is a tool developed to document clinical activities that was shown to be reliable and acceptable for documenting pharmacists’ clinical activities in Swiss CPs.
To describe prevalence of DRPs and time required for their management using ClinPhADoc in a Swiss CP integrated in an academic outpatient hospital.
An observational study was carried out for five years, since 2017, in a CP (Unisanté) in Lausanne. The documentation was done using an electronic version of ClinPhADoc on the same 21 pre-selected days each year (depending on seasons, holidays and rotations in medical internship) to collect a sample representative of all prescriptions received. Two out of the 14 pharmacists (depending on shifts in the days selected) documented: prescription medication, DRP type (clinical: when affect efficacy/toxicity; technical: related to medication use; procedural: related to renewals of outdated prescriptions); clinical consequence (increased toxicity, efficacy loss); pharmacist’s intervention (prescription modified or not); implied partner (patient/caregiver, prescriber and/or none) and time needed for DRP management. The preliminary data presented covers from January 2017 to March 2020.
A total number of 111,601 prescriptions were received, of which 7,097 (6.4%) were documented with 877 DRPs detected. The most frequent DRP was procedural (n=284, 32.4%), followed by clinical: dosage/posology (n=141, 16.1%) and drug interaction (n=98, 11.2%). DRPs detected throughout the years were consistent.
The longest mean time for management was for clinical DRPs: no indication (18.3min, CI95%=[11.2-25.5]); side effect (15.6min, CI95%=[5.6-36.8]) and drug interaction (8.6min, CI95%=[4.8-10.2]). Most DRPs (n=231, 26.3%) were managed by the pharmacist alone. DRPs took less working time when managed by the pharmacist alone than when the management involves the patient and/or the prescriber.
DRP prevalence was high with procedural DRPs being the most frequently observed. Clinical DRPs took longer time to be managed. ClinPhADoc and its related documentation process have been proven an effective tool for documenting CP activities. DRPs documented can be used to develop interprofessional interventions to prevent them.
Community pharmacy services; Medication review; Documentation.