Evaluating the Effectiveness of Risk Categories for Prioritising Patients for Best Possible Medication History...

The Pharmacist Workload Prioritisation Work Instruction (PWPWI) was developed to optimise clinical pharmacy services, such as best possible medication history (BPMH) completion. Inpatients are assigned a risk category and associated BPMH completion timeframe.

To determine the proportion of inpatients who met criteria for urgent, high, moderate, and low risk, and the proportion in each category who were reviewed within 24 hours of admission, to inform PWPWI updates.

Clinical, pathologic, medication data, and whether or not the BPMH was completed within 24-hours, was retrospectively collected for inpatients from a single institution and the PWPWI was used to assign risk category.

Data was collected for 280 patients. Prioritisation risk categories were assigned as 3% urgent and requiring immediate review, 61% high risk requiring review within 24-hours, 2% moderate risk requiring review within 48-hours, and 34% low risk. Overall, BPMHs were completed within 24-hours for 54% patients; 50% of the urgent risk individuals, 57% of the high risk, 100% of the moderate risk, and 46% of the low risk.

This study found that nearly two-thirds of patients were urgent or high risk, affecting the completion timeframes. The study's findings, including four key recommendations, will update the PWPWI. Regular evaluations of such tools are suggested to adapt to changes in clinical care and local context. Following the update, the pharmacy department will receive training to optimise BPMH prioritisation.