English abstract
Objectives: To characterise the pharmaceutical care provided by
a clinical pharmacists working in a tertiary health care institute,
where the extent to which the pharmacist contributes to changes
in prescribing patterns use of medications, and patient knowledge
was described.
Methods: A retrospective single cohort study design was
used. Qualitative and quantitative evaluation of a documented
pharmaceutical care plan was undertaken. Electronic
pharmaceutical care descriptor (Microsoft Access® database) was
used for analysis. 167 patients [mean age of 53 yrs, 70% male]
from a Medical Health Centre in a tertiary hospital where a
clinical pharmacist had provided a medication review. The study
patients were those who had either been admitted to cardiology or
infectious disease wards.
Results: There were 291 pharmaceutical care issues [PCIs; mean
per patient (2)] comprising of 67% (n=194) relating to treatment
monitoring and 33% (n=97) relating to treatment changes,
representing a total of 291 drug therapy problems [DTPs; mean
per patient (2)]. The resolution rate of DTPs was 70%, where 61%
of recommended changes and 75% of recommended monitoring
were implemented.
Conclusion: The clinical pharmacist successfully addressed
most PCIs while attending ward rounds, reviewing in-patient
prescriptions and counselling discharged patients. The electronic
pharmaceutical care plan was very effective in recording the
pharmacist's ward activities and the pharmaceutical care provided.
However, further studies are required in order to explore longterm clinical pharmacists in-put using a well established electronic
care plan; part of Al-Shifa computer system in Omani health
centres.
