Evaluating the Impact of a Pharmacist Independent Prescriber Service to the Older Person’s Acute Medical Unit

Introduction

The pharmacist’s role has been shown to be beneficial in the care of older people, and literature advocates for their inclusion within multidisciplinary teams due to particular features of this patient group (including prevalence of polypharmacy, and changing pharmacokinetics and pharmacodynamics of ageing.)

This work aims to evaluate the impact of a service change - namely the provision of a pharmacist independent prescriber (PIP) service (with a scope of practice and specialist interest in geriatrics), to the Older Person’s Acute Medical Unit (OPAMU).

Method

Data collection measured impact in two ways:

1. Interventions documented (over 5 clinical sessions) and analysed for type, clinical impact, and level of independence utilised by the PIP.
2. Views of medical OPAMU colleagues on the PIP role were gathered using an electronic questionnaire.

Ethics approval was not required for this service evaluation.

Results

27 interventions were made (22 clinical; 4 discharge planning; 1 regarding inpatient self-medicating).

16 clinical interventions were “significant” or “severe”. 14 interventions were made autonomously (within PIP scope of practice). The mode intervention type (n=12) related to medicines reconciliation.

100% of questionnaire respondents (n=5) felt there was a positive impact on patient safety, prescribing accuracy, prescribing timeliness, doctor workload, and discharge timeliness.

Respondents reported improved medication adherence, reduced length of stay and reduced patient harm.

Negative responses only related to times when the PIP was not present (due to working patterns or sickness).

Conclusions

This work highlights the benefits of a specialist PIP within the acute care of older people, particularly in improving patient safety and facilitating discharge. The service was viewed as beneficial by medic colleagues.

Future work is required to establish impact over a longer period, and direct comparison to similar units without a PIP would be beneficial in quantifying this impact.