Authors (including presenting author) :
Chiu LY(1), Law WL(1), Lai KS(1), Chan WYM(1), Mak CK(1), Mak LKK(1)
Affiliation :
(1)Department of Pharmacy, Tseung Kwan O Hospital
Introduction :
Outpatient Pharmacist Advanced Screening Service was implemented in Tseung Kwan O Hospital since 2018. Pharmacists perform therapeutic review and medication reconciliation of outpatient prescriptions that fulfilled pre-determined screening criteria. Four types of outpatient prescriptions were included: (1) medical prescriptions of patients enrolled in “E-fill” Drug Refill Service (DRS), i.e. patients aged 60 or above with polypharmacy (>/= 8 drugs) , had multi-specialty follow-ups and/or history of medical hospitalizations in past 12 months; (2) medical SOPD prescriptions of patients aged 60 or above with polypharmacy (>/=8 drugs) but not fulfilling other DRS criteria; (3) refill coupons; and (4) discharge prescriptions from medical wards. DRS prescription has been considered at high risk for drug related problems (DRPs), but how other types of prescription compare to it is unknown.
Objectives :
This study aimed at comparing the rates of DRPs identified between DRS prescriptions and non-DRS prescriptions specified as above in Outpatient Pharmacist Advanced Screening Service.
Methodology :
Pharmacists performed advanced screening by reviewing patients’ medication history, consultation notes and laboratory results from electronic patient record and cross checked with prescribed medications.
Prescription details from 28 December 2020 to 30 September 2021 were retrieved from Pharmacy Data Query Template. Intervention data were retrieved from the online intervention documentation system. Data were presented as counts and percentages. The rate of DRPs was calculated as the number of DRPs rectified per 100 prescriptions screened and were compared using Chi-square test, at a significance level of 0.05.
Result & Outcome :
15749 Prescriptions were screened during the study period. 5130 prescriptions (32.6%) were DRS prescriptions. Rates of DRPs (DRPs per 100 prescriptions screened) were: (1) DRS prescriptions: 5.7 (291/5130); (2) selected medical SOPD prescriptions: 6.7 (205/3042), (3) refill coupons 2.0 (72/3548) and (4) medical discharge prescriptions: 3.1 (125/4029). The rate of DRPs in DRS prescriptions was significantly higher than that of refill coupons and medical discharge prescriptions (p<0.01) but numerically lower than selected medical SOPD prescriptions (p=0.06).
Comparable rates of DRPs were observed in DRS prescriptions and selected medical SOPD prescriptions, suggesting that elderly patients with polypharmacy per se was a significant risk factor of DRPs regardless of having multi-specialty follow-ups and/or history of medical hospitalizations. This may shed light on the future direction of DRS enrollment criteria.
