Initial observations on the implementation of a CPS in a rural hospital in Austria

AIM To determine which types of clinical pharmacy interventions are needed at a small rural 360-bed hospital in Austria, and to assess the physicians’ acceptance rate of the pharmacists’ suggestions.
METHODS Data on interventions made by one clinical pharmacist were collected over a six-month period and rated on a six-point clinical significance scale. A subset of 30 interventions was rated for clinical significance by four independent consultants to determine inter-rater reliability.
RESULTS During the six-month period, 255 clinical pharmacy interventions were made. In a subset of 159 patients, 95 met the criteria for medication review which
resulted in 140 interventions being made. Clinical pharmacy input was needed by 59.8% (98/159) of patients, requiring on average 1.5 interventions per patient. Acceptance rate was 59.5% (153/255), a change was considered by the physician involved, but not immediately followed through with in 40.0% (102/255). Average score for clinical significance intervention rating was 2.18. Inter-rater reliability
(IRR) agreement was ‘good’ between the four consultants, and the four consultants with the pharmacist, respectively.
CONCLUSION Clinical pharmacy services (CPS) are needed and well accepted in Austrian hospitals. The clinical pharmacist is a missing member of the multidisciplinary ward team, a key player in reducing adverse drug reactions and improving patient safety, enabling treatment to become more holistic and patient-centred.