The role of the resident pharmacist in patient safety based on PRE-AVOID

Abstract

In a system referred to as PRE-AVOID, pharmacists are requested to send reports to the Japanese Society of Hospital Pharmacists (JSHP) about all the cases in which side effects due to pharmacotherapy, drug interactions, and lack of therapeutic effect have been prevented or alleviated while practicing pharmaceutical care in consideration of patients' clinical conditions. Since 2008, Ageo Central General Hospital (our hospital) has had resident pharmacists in all the wards, and our hospital has constructed the PRE-AVOID system. In this study, we examined trends in the number of PRE-AVOID reports in our hospital between fiscal year 2004 and 2011；the number of PRE-AVOID reports according to the task conducted at the time of the reported event；and the comparison between PRE-AVOID reports of our hospital and those of all over Japan. The average number of PRE-AVOID reports was 19.5 per year until fiscal year 2008, the average after the fiscal year 2009 was 469.3 per year. In most reports, the task conducted at the time of the event consisted of hospital ward duties and guidance regarding medication management. Of the reported 18,208 reviews from all medical institutions in Japan, 566 reports were of our hospital (3.11%). The marked increase in the number of PRE-AVOID reports is likely attributed to the fact that the placement of resident pharmacists in hospital wards has allowed for detailed observation and examination of the status of medication usage, and that the acquisition of information from nurses has allowed for the detection of a larger number of cases eligible for PRE-AVOID reports. Another possible reason is the facilitation of prescription-related suggestions provided by drug-dispensing pharmacists owing to resident pharmacists in hospital wards. Our study showed that resident pharmacists in hospital wards play an important role in safety of medical treatment.