Provision of on-call pharmacist services across public hospitals: a retrospective observational study

To quantify and describe the types of enquiries received by on-call hospital pharmacists across public metropolitan and regional hospitals.

A retrospective analysis of data entered by on-call pharmacists between January/2019 and December/2023 from across seven Local Health Networks in South Australia. Medicine-related enquiries were classified by type according to the Anatomical Therapeutic Chemical (ATC) classification system and 'APINCH' (Antimicrobials, Psychotropics, Potassium and electrolytes, Insulin, Narcotics and other sedatives, Chemotherapeutic agents, Heparin and anticoagulants) acronym.

There were 9069 phone enquiries received over the 5 years analysed. The largest number of calls related to medicine supply (62%) and medicine information (20%). Twelve percent of enquiries required a pharmacist to attend the hospital in person. The time period with the highest call numbers was 6 p.m.-8 p.m. (29%), followed by 8 p.m.-10 p.m. (23%) and 9 a.m.-5 p.m. (predominantly weekends; 15%). Nearly one-third of the medicine enquiries were for drugs that act on the nervous system classified using ATC system, with clozapine being involved with the highest frequency (n = 534; 6%). Over half of the medicine-related enquiries (n = 5046) were considered high-risk drugs using the 'APINCH' acronym. The most frequent subtype of 'APINCH' was antimicrobials (n = 2213/5046; 44%), followed by narcotics (24%) and psychotropics (16%).

The provision of on-call services involved a range of high-risk classification medicines that required timely supply and clinical advice from pharmacists. This study identifies the need for developing a state-wide approach to consolidate on-call data through technology to inform work processes and targeted education and resources for pharmacists and other professional staff.