A Pilot Project for Clinical Pharmacy Services in a Clinic for Children With Medical Complexity

The primary objective of the project was to assess the impact of clinical pharmacy services in a clinic for children with medical complexity. Secondary objectives were to identify and characterize the drug-related needs of these patients and to describe and develop the role of a pharmacist in the clinic.

This was a prospective descriptive study in which a clinical pharmacist staffed the clinic for children with medical complexity for 11 weeks, from January to March 2011. This allowed for the collection of baseline data, such as patient characteristics and measurements of pharmacist workload and assessment (eg, types of drug therapy problems, medication reconciliation, medication teaching).

A pharmacist participated in 46 clinic visits with 43 patients, identifying a total of 42 drug therapy problems. Of the 42 problems, 35 actual and 7 potential drug problems were identified, resulting in approximately 1 problem per patient. The most common actual problems included "dose too small" (37.1%) and "patient requires a medication for untreated condition" (20%). Common potential problems included "drug interactions" (43%) and "adverse effects" (57%).

The pilot study demonstrates that children with medical complexity are at high risk for drug therapy problems and the presence of a clinic pharmacist is beneficial in the identification, prevention, and resolution of drug therapy problems, while helping ensure continuity of care in this population.