PDA-Based Documentation of Medication Interventions in an Ambulatory Care Setting

Abstract

Background:

Although personal digital assistant (PDA)-based documentation systems are available for documentation of clinical pharmacy services, none is specific to documentation of drug-related problems (DRPs) in the ambulatory care setting.

Objective:

To describe types of medication interventions performed by pharmacists in an urban ambulatory care clinic within a teaching hospital, determine predictors of preselected DRPs, and describe physician acceptance rates.

Methods:

Following development of a PDA-based documentation system, this 6 month prospective study documented interventions performed by a clinical pharmacy team. Descriptive statistics were employed to describe the type and frequency of interventions and physician acceptance rates. Multivariate logistic regression analysis was used to determine significant predictors for preselected DRPs.

Results:

Over a 6 month period, 965 interventions were documented. The patients' mean ± SD age was 61.8 ± 15.51 years, 72.3% of patients were female, and the mean number of medications was 7.1 ± 3.95 per intervention. The most common interventions were laboratory monitoring (56.2%), patient education (14.5%), and changes in drug therapy (12.4%). The use of antihypertensive agents was a predictor for the DRPs “dose too high” and “dose too low” (p = 0.001 and p = 0.003, respectively). Of the applicable interventions, 89.8% (246/274) were accepted by the physician.

Conclusions:

Pharmacists in this urban ambulatory care clinic offered a variety of recommendations that were well received by physicians.