Authors (including presenting author) :
Wong VKC (1), Cheung TYH (1), Leung SYP (1), Cheng CMK (1), Yip CYW (1), Ngai VCY (1), Mak RWM (1), Wong HSY (1), Lo KY (2), Chui WCM (1), Tsang TC (2), Tsui SH (2)
Affiliation :
(1)Department of Pharmacy, Queen Mary Hospital (2)Accident and Emergency Department, Queen Mary Hospital
Introduction :
COVID-19 provided unprecedented global challenges to the delivery of health services. During the 5th wave of COVID-19 pandemic, tremendous number of elderly COVID-19 patients fluxed into the A&E department. These patients are often complex with multiple comorbidities, polypharmacy and at risk for drug related problems(DRPs). There is an urgent need of Clinical Pharmacy Service to relieve the workload of A&E.
Objectives :
To describe a successfully implemented Clinical Pharmacy Service model in the high-risk A&E department during the 5th wave of COVID-19 pandemic.
Methodology :
The Clinical Pharmacist screens for possible contraindications, performs a best possible medication history, drug interaction check, reviews pathology and advises on the appropriate dosing and suitability of the anti-viral at the A&E department including holding areas. The partnered medication review & charting were performed with A&E physicians whenever drug interactions were detected, which included recommendations on how patients could modify their regular therapies due to these interactions or cease any medications if they are unnecessary. Also, the Clinical Pharmacist discussed with the treating nurses regarding the medication plan for the patients and the medication supply logistics.
Result & Outcome :
A one-month service (from 28th February to 31st March 2022) was evaluated. During the study period 519 patients had pre-admission medications reviewed and charted by a Clinical Pharmacist in collaboration with the A&E doctor. Of these, 38 patients were dispensed Paxlovid or Molnupiravir. There were a total of 3,881 medication items reviewed with 1,898 medications charted by Clinical Pharmacist. Of these, 288 medications were ceased, due to being no clinical urgency, 8 medications had a dose change and 6 medications had a route change. Moreover, positive comments from the survey of A&E doctors (n=16) and nurses (n=36). 94% doctor and 97% nurse agreed that the service is helpful to relieve their workload; 94% doctor and 81% nurse agreed the service is more efficient process to discharge patient and 81% doctor and 92% nurse support to extend the service to regular basis. Clinical Pharmacists contribute significantly to the safe provision of partnered medication reviews, charting and drug information including prescribing COVID-19 therapies through the interdisciplinary teamwork. Investment to permanently embed the service should be sustained.
