2014 年 40 巻 8 号 p. 463-470
Clinical pharmacists are stationed in some wards in Asahikawa Medical University Hospital. In order to clarify the effectiveness of the pharmaceutical care provided by these ward pharmacists, we retrospectively reviewed the pharmaceutical interventions recorded from November 2010 through October 2012, irrespective of the physicians' acceptance or rejection.
There were 788 cases of interventions in total. Among these interventions, physicians accepted and subsequently changed the medical treatment provided in 709 cases (90.0%). The most frequent interventions (164 cases) were related to cancellation, resumption, non-execution of prescriptions, or change of dosing period. Above all, 31 cases were associated with a lack of cancellation or resumption before or after operations or medical treatments. In 5 of these cases, operations or medical treatments were postponed. Among all pharmaceutical interventions, there were 138 suggestions of prescriptions due to adverse drug reactions (ADR). In 37 cases (26.8%) of the suggestions, pharmacists successfully prevented ADR by proposing changes of prescriptions through a careful review of patients' drug history or information. In the other 101 cases (73.2%), further aggravation and prolongation of ADR were avoided after the onset of ADR. Fifty-five suggestions were based on renal function, which was the most common in all the 99 suggestions, indicating that ward pharmacists are paying special attention to the laboratory data of their patients.
In conclusion, these results provide further evidence that ward pharmacists help enhance the safety and efficacy of inpatients' drug therapy by performing pharmaceutical interventions through active listening to patients and careful examination of their medical records.