Description of Pharmacist Interventions Based on Pharmaceutical Care and a Vulnerability Scoring Tool in a Tertiary...

Following a restructuring of its pharmacy practices and activities, the pharmacy department of the Institut universitaire de cardiologie et de pneumologie de Québec developed a patient prioritization tool to optimize its delivery of pharmaceutical care. This tool assigns a vulnerability score to patients according to their medications and certain vulnerability factors established in the literature. The tool identifies vulnerable patients who need pharmaceutical care on a mandatory basis (within 1 day) or a priority basis (between 1 and 3 days).

To describe pharmacist interventions carried out for patients admitted to the study institution, in terms of pharmaceutical care provided in relation to scoring with the prioritization tool.

This prospective study involved patients admitted to the study institution for at least 48 hours between May 10 and May 19, 2023. The prioritization tool was applied for all included patients, who were followed prospectively throughout their stay. The pharmacists recorded their interventions on a data collection form. Data were analyzed using frequency analysis, and relationships between variables were expressed using the Pearson correlation coefficients and percentages.

Of the 393 patients seen during the study period, 304 were included in the study. Of these, 186 had a priority designation and 64 had a mandatory designation, according to the prioritization tool. The pharmacists performed a total of 1023 interventions, with 194 of the 304 included patients receiving at least 1 pharmacist intervention. The number of interventions for each patient increased with the person's vulnerability score. The most frequent activities were chart review (n = 453, 44.3%), followed by the prescription (n = 115, 11.2%), dose adjustment (n = 64, 6.3%), and discontinuation (n = 64, 6.3%) of a medication. The mean response time was 1.25 days for patients deemed to need pharmaceutical care on a mandatory basis and 1.57 days for patients deemed to need care on a priority basis.

In this study, the number of interventions per patient increased with the person's vulnerability score. Although pharmacists responded faster than the recommended time for patients deemed to need care on a priority basis, the response time for patients needing care on a mandatory basis could be improved.