Getting hospital-based pharmacists out from "behind the counter" to work directly with inpatients and health care teams reduces medication errors and problems, according to a University of Iowa and Department of Veterans Affairs review of previously published studies.
The change in pharmacists' roles also has helped patients understand and follow their drug regimes. Previously, pharmacists did not often see hospitalized patients firsthand. However, in the last 20 years, pharmacists have become more involved in collaborative care for patients.
"Pharmacists play an incredibly important role in caring for hospitalized patients in terms of medication safety and helping determine that patients are on the most appropriate medications," said Peter Kaboli, who led the review study and is an investigator with the Center for Research in the Implementation of Innovative Strategies at the Veterans Affairs Iowa City Health Care System and assistant professor of internal medicine in the UI Roy J. and Lucille A. Carver College of Medicine.
"Hospitals and health systems are seeing the value of putting pharmacists in direct contact with patients and having the pharmacists interact with other health care providers on a daily basis," added Kaboli, who also is a hospitalist.
The team analyzed 36 studies that were published between 1985 and 2005 in English-language, peer-reviewed journals. The review appears in the Archives of Internal Medicine.
Kaboli said earlier studies of pharmacy care in hospitals usually focused on specific drugs, such as blood thinners, or specific diseases. "That's important," Kaboli said, "but it's also important to look at the bigger picture." The later studies analyzed by the team point to a systems-approach and how pharmacists care for inpatients by meeting with them at admittance, visiting during "rounds" and meeting again at discharge.
At both UI Hospitals and Clinics and within the VA Health Care Systems, pharmacists play a critical role in managing disease for inpatients, and it is not only about delivering drugs but also information.
Over the past several decades, the number of medications and the complexity of drug therapy has grown enormously, said Paul Abramowitz, director of Pharmaceutical Care at UI Hospitals and Clinics, where approximately 90 pharmacists provide clinical care.
"Pharmacists focus on all aspects of the patient's drug therapy. They work with the patient, physician, and nurse to help maximize the benefits and outcomes of medications and to minimize adverse effects," Abramowitz said.
"This also includes a significant amount of attention to medication safety in every step in the medication use process" added Abramowitz, who also is a professor and an assistant dean at the UI College of Pharmacy.