4CPS-167 Evaluation of pharmaceutical interventions: improvement plans

Background and importance Medication errors are frequent in the hospital setting, increasing the morbidity and mortality of patients. The pharmacist detects medication errors, preventing the appearance of medication related problems through pharmaceutical care and pharmacotherapeutic follow-up. Aim and objectives To evaluate pharmaceutical interventions and the degree of acceptance, and to evaluate the quality of interventions and optimise the process. Material and methods A descriptive retrospective study of 3 years’ duration of the interventions performed (October 2016–September 2019) was carried out. After reviewing and validating the electronic medical prescriptions and communicating to the responsible physician any possible medication errors detected by electronic messaging or by telephone, the pharmacist recorded the interventions performed daily in a database, classifying for further analysis. Results A total of 5137 interventions were recorded in 4032 patients. Of these, 3032 were accepted after communicating them to the prescribing physician. A total of 25.36% of the interventions were related to therapeutic duplications, 13% to drug interactions, 12.09% to documented drug allergies, 10.6% to dose error (66% excessive dosage and 34% insufficient dosage), 8.6% required clarification/request for information because of an incomplete medical order, 8.75% were inappropriate or unavailable pharmaceutical form, 8.5% were medications not included in the hospital guide and 5.5% were inappropriate dosage range. etc. The services with the highest number of interventions were internal medicine 1436; pneumology 359; neurology 356; cardiology 350; digestive 349; oncology 335; infectious diseases 290; traumatology 189; and psychiatry 183. The degree of acceptance of the interventions in the internal medicine service was 49%; digestive (79%); pneumology (76%); neurology (73%); and cardiology (75%). Conclusion and relevance Pharmaceutical interventions improve the quality of care and patient safety by reducing medication errors. The service with the highest number of interventions was internal medicine, although the degree of acceptance was not very high. These results highlight the importance of pharmaceutical interventions and suggest the need to implement an automatic registration system for the interventions performed, integrated into the electronic prescription programme, in order to facilitate interventions and promote their acceptance. References and/or acknowledgements No conflict of interest.