Prospective cohort study of adverse events monitored by hospital pharmacists

Purpose To examine the feasibility of pharmacist-led intensive hospital mon itoring of adverse events (AEs) associated with newly marketed drugs. Subjects/setting 303 patients admitted to Southampton Hospitals who were pr escribed selected newly marketed drugs during their inpatient stay in 1998. Methods Prospective observational study. Patients were identified from comp uterized pharmacy records, clinical pharmacist ward rounds, dispensary reco rds or via nursing staff. The pharmacist reviewed medical notes and recorde d AEs, suspected adverse drug reactions (ADRs) and reasons for stopping dru gs. Outcomes Incidence of AEs, ADRs; proportionate agreement between the physic ian's and pharmacist's event recording. Results 303 patients were monitored. Of the patients taking newly marketed drugs 92% were identifiable using pharmacy computer systems and pharmacist ward visits. There were 21 (7%) suspected ADRs detected during this pilot s tudy. The types of adverse events detected were broadly similar to those id entified by general practice-based prescription event monitoring. However, biochemical changes featured more frequently than in general practice. Diff erences between adverse events recorded by pharmacist and physician were sy stematic and attributed to differences in event coding. Conclusion Pharmacist-led monitoring in a typical NHS hospital setting was effective at detecting ADRs in newly marketed drugs. However, this effort m ight have been substantially less time-consuming and more effective were el ectronic patient records (EPRs) available. Pharmacy computer systems are no t designed to be patient focused and are therefore unable to identify patie nts taking newly marketed drugs. It is argued that future EPR and computeri sed patient-specific prescribing systems should be designed to capture this data in the same way as some US systems are currently able to do. Copyrigh t (C) 2001 John Wiley & Sons, Ltd.