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The Spectrum of Clinical Pharmacy Services in a Non-University Hospital-A Comprehensive Characterization Including a
Olaf Zube1, Wiebke Schlüter1,2,3, Johanna Dicken1
1Bundeswehr Hospital Pharmacy, 22049 Hamburg, Germany.
Pharmacy (Basel, Switzerland)
|November 24, 2025
Summary
Clinical pharmacy services (CPS) identify numerous drug-related problems (DRP) with serious consequences. While many recommendations are made, only half are implemented, highlighting a gap in optimizing patient care.
Area of Science:
- Pharmacy Practice
- Clinical Pharmacy
- Patient Safety
Background:
- Clinical pharmacy services (CPS) offer patient care benefits.
- Resource allocation and recommendation outcomes for CPS require clarification.
- Understanding drug-related problems (DRP) and adverse drug reactions (ADR) from CPS is crucial.
Purpose of the Study:
- To characterize CPS resource allocation in routine care.
- To identify DRP and recommendations made by CPS.
- To determine the occurrence of ADR resulting from identified DRP.
Main Methods:
- Retrospective analysis of patient charts and pharmacy documentation.
- Standardized data collection using checklists and pharmacist interviews.
- Risk assessment of DRP using the NCC-MERP score.
Main Results:
- 1000 CPS documented in 504 patients; 66.87% initiated during ward rounds.
- Indications and respiratory agents were frequent topics/classes; 48.61% of CPS took 16-30 min.
- 358 DRPs identified, with 5.03% "very severe" and 42.74% "severe"; 15.36% resulted in ADRs. 53.97% of 932 recommendations were implemented.
Conclusions:
- CPS identify a significant number of DRP with serious clinical implications.
- Implementation rates for CPS recommendations indicate potential for improved patient outcomes.
- Further research is needed to optimize CPS effectiveness and recommendation uptake.
Keywords:
adverse drug reactionsclinical pharmacy servicesdecision managementdrug-related problemshospital pharmacypharmacy managementMore Related Videos
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