Nd. Barber et al., PREDICTING THE RATE OF PHYSICIAN-ACCEPTED INTERVENTIONS BY HOSPITAL PHARMACISTS IN THE UNITED-KINGDOM, American journal of health-system pharmacy, 54(4), 1997, pp. 397-405
Pharmacists' clinical interventions in a group of British hospitals we
re counted, and a model to determine factors that affected the interve
ntion rate was developed. All pharmacists who visited patient wards in
27 acute care hospitals recorded their daily ward visits and their cl
inical interventions during five consecutive days (Monday through Frid
ay) in June 1993. An intervention was defined as any recommendation ma
de with the intent of changing drug treatment. Mixed-model Poisson reg
ression was used to try to explain variations in the intervention rate
, defined as the number of physician-accepted interventions divided by
the number of occupied-bed days. Possible predictors of intervention
rate considered were characteristics of the hospitals, the wards, and
the pharmacists. During the study period, 248 pharmacists visited 10,4
78 beds and proposed 3,501 interventions. Of these interventions, 3371
were accepted, 56 were rejected, and 74 were unresolved. The most fre
quent reasons for the interventions involved the dose (29%), the need
for therapy (21%), the choice of drug (14%), and the route (12%). Ward
type, pharmacist grade, and the total time the pharmacist spent on th
e wards were significant predictors of the intervention rate. To valid
ate the model, data were collected during the same period in 1994; the
model predicted the number of interventions within 1 of the actual nu
mber in 82% of cases. In a model explaining the factors that affected
the rate of physician-accepted pharmacist interventions in acute care
hospitals in the United Kingdom, ward type, pharmacist grade, and tota
l time spent on the ward by the pharmacist were significant predictors
of the intervention rate.