Clinical pharmaceutical care engagement at the Department of Infectious Diseases during the first COVID-19 pandemic wave - single centre experience
Abstract
Introduction: The aim of clinical pharmacist medication review and clinical pharmaceutical care as such is the provision of effective and safe pharmacotherapy, the minimization and elimination of risks associated with the use and administration of drugs to a patient. Based on a systematic evaluation of pharmacotherapy, adverse drug reactions, drug interactions, and dose adjustments of drugs in patients with renal or hepatic insufficiency are assessed.
Methods: This is a retrospective analysis of the provision of clinical pharmaceutical care for patients hospitalized at the Department of Infectious Diseases in University Hospital Hradec Králové during the first COVID-19 outbreak in Czech Republic within period 16. 3. 2020-31. 5. 2020. In the studied period, 93 patients were hospitalized at the Department of Infectious Diseases, of which 20 inpatients (21.5 %) were COVID positive.
Clinical pharmaceutical care was provided to these patients via distance approach and the outcomes were recorded. Furthermore, the acceptance of pharmacotherapeutic recommendations and physicians' feedback on the contribution of the clinical pharmacist were collected using a web-based questionnaire form.
Results: In the observed period, 45 out of 93 hospitalized patients were classified by a clinical pharmacist at medium risk of a drug related problem and 18 patients at high risk. In a total of 48.4 % of cases (45 patients), a pharmaceutical care plan was written (35 times at admission, 10 times during hospitalization), the effectiveness of which was subsequently verified 24 times.
All eight physicians caring for patients with COVID-19 provided feedback using web-based form. All considered collaboration with a clinical pharmacist beneficial, with two-thirds paying attention to pharmaceutical care plans on a regular basis.
However, before the multicisciplinary collaboration started, only three physicians were aware of clinical pharmaceutical care. Conclusion: With the hospitalization of the first COVID-19 positive patient at FN HK, the provision of clinical pharmaceutical care was extended to the Department of Infectious Diseases.
According to the number of recommended interventions and the opinions of physicians, this multidisciplinary involvement appears to be beneficial even in the context of distance cooperation. However, further studies are needed to assess the practical impact of the provision of clinical pharmaceutical care, to demonstrate their usefulness and to anchor clinical pharmacy more in standard healthcare.