Authors (including presenting author) :
Chiu LY(1), Law WL(1), Chan WYM(1), Mak CK(1), Mak LKK(1)
Affiliation :
(1)Department of Pharmacy, Tseung Kwan O Hospital
Introduction :
“E-FILL” Drug Refill Service (DRS) was piloted in Hospital Authority since 2018. Elderly patients with polypharmacy who have multi-specialty follow-ups and/or a history of medical hospitalizations are selected, and their medical prescriptions with a duration of 16 weeks or longer will be dispensed in batches. Pharmacists perform medication reviews before drug refills. When DRS was rolled out to Tseung Kwan O Hospital, a new model was piloted. Pharmacists additionally perform therapeutic review and medication reconciliation for DRS prescriptions upon first dispensing (i.e. Advanced Screening). Comprehensive medication history, consultation notes and laboratory results are utilized to reconcile patients’ best medications lists and validate appropriate use of ordered medications.
Objectives :
To evaluate the impact of Advanced Screening on patient care for patients enrolled in DRS.
Methodology :
This is a retrospective service review. Drug-related problem (DRP) interventions made during Advanced Screening from 28th December 2020 to 31st March 2021 were retrieved from the online intervention documentation system. Interventions were grouped according to their natures. Ten Pharmacists (five involved in the service while the other five did not) were invited to determine whether the interventions were highly probable to be captured by: (1) Advanced Screening only, (2) standard dispensing workflow, or (3) could not be determined. The interventions were assigned into each category if more than five pharmacists classified the interventions in the same category.
Result & Outcome :
813 DRS prescriptions were received and screened by pharmacists during the study period. Eighty-five interventions (i.e.,10.5 interventions per 100 prescriptions) were recorded.
Forty-five interventions (52.9%) were highly probable to be captured by Advanced Screening only, while thirty-two (37.6%) of them could be picked up by standard dispensing workflow. No conclusion could be made for the remaining eight (9.4%) as opinion diverse. Interventions captured only by Advanced Screening included: unnecessary drugs (20), inappropriate dose/frequency (12), drug omission (8), stock surplus (3), inappropriate drug choice (1) and treatment duration (1).
Advanced Screening is valuable for improving patient care in DRS by identifying DRPs upfront at an earlier stage. Many important interventions were made during Advanced Screening; if went unnoticed, these problems would be carried forward until drug refills 8 to 16 weeks later.
