Abstract:
Clinical pharmacy practice has
developed internationally to expand the role of a
pharmacist well beyond the traditional roles of
compounding, dispensing and supplying drugs to
roles more directly in caring for patients. Studies on
the activities of the clinical pharmacist in an
inpatient ward in resource constrained settings are
scarce, however.
Objective: To assess ward based clinical pharmacy
services in an internal medicine ward of Jimma
University Specialized Hospital.
Methods: The study was carried out in the internal
medicine ward from March to April, 2011 at Jimma
University Specialized Hospital. The study design
was a prospective observational study where
pharmaceutical care services provided by clinical
pharmacists for inpatients were documented over a
period of two months. Interventions like optimization
of rational drug use and physician acceptance of
these recommendations were documented. Clinical
significance of interventions was evaluated by an
independent team (1 internist, 1 clinical
pharmacologist) using a standardized method for
categorizing drug related problems (DRPs).
Results: A total of 149 drug related interventions
conducted for 48 patients were documented; among
which 133(89.3%) were clinical pharmacists initiated
interventions and 16(10.7%) interventions were
initiated by other health care professionals. The
most frequent DRPs underlying interventions were
unnecessary drug therapy, 36(24.2%); needs
additional drug therapy, 34(22.8%) and
noncompliance, 29(19.5%). The most frequent
intervention type was change of dosage/instruction
for use, 23(15.4%). Acceptance rate by physicians
was 68.4%. Among the interventions that were
rated as clinically significant, 46(48.9%) and
25(26.6%) had major and moderate clinical
importance respectively.
Conclusion: Involving trained clinical pharmacists
in the healthcare team leads to clinically relevant
and well accepted optimization of medicine use in a
resource limited settings. This approach can likelybe generalized to other health care settings in the
country to improve medication outcomes.
