Clinical pharmacy in inpatient care

The aim of this paper is to describe how interventions by clinical pharmacists can provide quality pharmaceutical care to inpatients. Evidence-based pharmacotherapy is necessary for the practice of clinical pharmacy. The use of published data, patient-specific data, and data generated by conducted research are discussed with respect to unit dose computer systems, nutrition teams, and pharmacokinetic services, based on the experience of an European hospital pharmacy. Incorporating evidence into clinical pharmacy activities results in added value to these services. The implementation of evidence-based pharmacotherapy is not an easy task for three reasons: a lack of scientific evidence in many medical areas, a lack of authority of pharmacists in Europe to take an active part in decision-making for drug prescribing, and reluctance of some physicians to accept pharmacists within the health care team. Also, efforts are required to change education programs at the universities in Europe to better prepare clinical pharmacists in pharmacotherapy and pharmaceutical care.