Development of clinical pharmacy programs integrated into patient care pathways using adverse event risks.

Area of Science:

• Clinical Pharmacy
• Healthcare Management
• Patient Safety

Background:

• Economic pressures necessitate prioritizing clinical pharmacy activities.
• The
• 5P project
• aims to personalize clinical pharmacy programs within care pathways.

Purpose of the Study:

• To present an adverse event (AE) risk management approach for developing clinical pharmacy programs.
• Utilizing two distinct methods: the Delphi method and inductive approach analysis of semi-directed interviews.

Main Methods:

• The Delphi method was applied to orthogeriatric (OG) care pathways.
• Semi-directed interviews were conducted for pediatric kidney transplantation (PKT) care pathways.
• Healthcare providers identified AE risks, required clinical pharmacy activities, patient prioritization criteria, and optimal care pathway integration points.

Main Results:

• For OG pathways: Patients ≥90 years old, with cardiovascular diseases, on potentially inappropriate medications, or with obesity/diabetes were prioritized post-operatively and during rehabilitation. Activities included prescription reviews and medication reconciliation.
• For PKT pathways: Activities were for all patients, with priority on pre-transplantation, immediate post-operative, and post-transplantation phases. Prescription reviews and educative interviews were key.

Conclusions:

• The study demonstrates two effective methods for prioritizing and targeting clinical pharmacy activities within care pathways.
• These developed programs have been successfully implemented in a teaching hospital setting.