The Evaluation and Impact of a Patient Prioritisation Tool for Clinical Pharmacy Services: Hospital Setting

The Aim of this thesis: To evaluate the impact of a validated Assessment Risk Tool had on clinical pharmacists at Midland Regional Hospital, Tullamore, Ireland. Objectives of this research: (1) To evaluate the impact of the ART by performing a comparative analysis between the before- after study since implementation. (2) To assess the communication between prescriber and pharmacist. (3) To conduct a survey that evaluates the pharmacist’s preference on the implementation of the ART. Methodology: The before – after study was carried out focusing on specific measures from July 2017 to March 2018. A quantitative review was conducted with a selected number of drug charts to evaluate the full impact of the Assessment Risk Tool. For the before study 149 drug charts was assessed and for the after study 140. Prescribers actions were followed in response to pharmacists interventions. A total of 15 pharmacists, after implementation of the ART, were surveyed to evaluate the impact the tool had on daily work as clinical pharmacists. Data were analysed using Excel and SPSS software program. Descriptive statistics were generated in the form of numbers and percentage. To evaluate statistical significance of relation between variables chi-square (χ2) test was applied. Results: Comparative analysis between before- and after - study showed an increase in endorsement of drug charts for P1 (19 % vs 36.8%) and P2 (39.5% vs 54.0%) and a decrease in P3 drug charts (40.7% vs 9.2%). Evidence from the study shows a low response rate from prescribers to pharmacist’s interventions: 43% no response rate of drug charts with a recommendation from a pharmacist – 29% was P1 and 34.1% P2 patient drug charts. Surveyed pharmacists were overall satisfied (87.6%) with the ART and a positive preference when working with the ART. 66.7% have followed by agreeing to the ART has assisted in identifying patients who are more medically complicated and the tool has made them notice certain aspects of patient care management pre-implementation. Conclusion: Pharmacists response to survey mirrors the positive impact the tool has done overall. Assessment Risk Tool put in place was found to be useful in prioritising patients for pharmacists interventions such as medication reviews