Pharmacist Intervention Documentation in US Health Care Systems

Abstract

The methods, extent, and use of pharmacist intervention documentation (PID) were studied by surveying US health-systems pharmacy directors by mail. This survey focused on the qualities of a hospital's PID system, use of PID data, and demographics of responding hospital and pharmacy departments. The survey was sent to 1895 randomly selected hospital pharmacy directors from an American Society of Health-System Pharmacists (ASHP) mailing list. The response rate was 23% (433/1895). Commonly reported types of PID included changing or clarifying medication orders, eliminating therapeutic duplications, evaluating drug-drug interactions, avoiding adverse drug reactions, participating in formulary conversions, recommending medications, providing pharmacokinetic consults, making therapeutic substitutions, and reporting medication error and drug levels. The methods for documenting interventions varied widely and included paper, computer databases, medical records, personal digital assistants (PDAs), and combinations of the above. PID reports were frequently shared with hospital and pharmacy managers, Pharmacy and Therapeutics (P&T) committees, and process improvement groups. The majority of respondents reported dissatisfaction (lack of outcomes or cost savings data, labor intensive) with their current PID systems and hoped to implement comprehensive, user-friendly, labor-saving PID systems in the future.