Abstract
A new administration fee was introduced for the clinical activities of hospital pharmacists responsible for inpatient pharmacotherapy monitoring in medical institutions in April 2012 in Japan. In September 2012, in Okayama University Hospital, we established prescription-support based on a protocol for physicians on the Neurosurgery Ward. The pharmacist assessed the “status of the patient” and “medication adherence,” and then subjectively decided on “continuing administration,” “medicine withdrawal,” “changing the method of dispensation (one-dose-package or powdered medicines),” and “changing the dosage form.” In this study, to verify the effect of the intervention for prescription-support based on the protocol, we investigated the number of revised prescriptions and the contents of revision in the periods of June-August 2012 and June-August 2013. The results of investigation revealed that the pharmacists significantly contributed to reducing prescriptions from 84 (changed medicine: 1, changed administration and/or dosage: 5, changed dosage form: 3, changed method of dispensation: 25, discontinued prescription: 50, respectively) to 10 (changed administration and dosage: 1, discontinued prescription: 9) (P < 0.001). The total amount of drug fees decreased from 63,732.68 to 2,148.65 yen. According to the questionnaire survey of neurosurgeons on the ward, the pharmacists were highly evaluated regarding the “efficiency of work,” “improvement of medical safety,” and “improvement of medication quality.” In conclusion, the pharmacists provided individual patients with optimized prescriptions, and markedly contributed to assuring the safety and efficacy of treatment with medication.
