A Review of Clinical Pharmacy Interventions Prior to Implementation of a Personal Digital Assistant Intervention Program in a Community Hospital

Abstract

Purpose

To evaluate pharmacist interventions and identify areas of improvement prior to decentralization and implementation of a personal digital assistant (PDA) program for documenting interventions.

Methods

Intervention data were collected from April 1999 to June 2001 using standardized intervention and activity forms. Following collection, data were analyzed to determine the most common medications requiring intervention, acceptance rates, total and estimated cost savings, interventions performed per care unit, and pharmacist time.

Results

A total of 3030 interventions were captured from April 1999 through June 2001. The most common interventions were dosage or frequency changes (80.6%). The total cost savings for the medication ingredients during the period reviewed was $43,733. The estimated cost savings/cost avoidance of interventions during the study period was $850,417. The most common care units involved in interventions were areas where clinical pharmacy faculty practiced: hematology/oncology, general medicine, and intensive care. From January 2001 to June 2001 a comparison of faculty to clinical pharmacists showed that faculty in three care areas (68 beds) documented 552 interventions, compared with 392 interventions by the clinical pharmacists responsible for the seven other care areas (200 beds) (P< 0.05).

Conclusions

This review reinforces the benefit of interventions on cost avoidance and patient care. Because a high percentage of interventions was lost due to follow up, implementation of a simplified, uniform approach to clinical intervention reporting through a PDA program and additional decentralization is expected to decrease lost interventions and increase estimated cost avoidance.