Characteristics and acceptance factors of pharmacists’ interventions from the national Act-IP© observatory: a six-year longitudinal study

Abstract

Abstract Background In France, hospital pharmacists perform medication order reviews during patients’ hospitalization process. This activity can be centralized in the pharmacy or carried out directly in the ward, in contact with the healthcare team. During this review, pharmacists can perform pharmacists’ interventions to optimize therapeutics. Since 2006, they can document their interventions, via the national Act-IP© observatory. Aim To assess the characteristics of pharmacists’ interventions and their acceptance by physicians in French hospitals between 2014 and 2019. Method Between 2009 and 2014, we performed a 6-year observational study of pharmacists’ interventions documented on the Act-IP© French observatory. Results A total 194,684 pharmacists’ interventions were documented on the observatory and concerned mainly a “dosage adjustment” (25.6%). These interventions were mainly related to drugs from the central nervous system (23.7%). Seventy percent of pharmacists’ interventions were accepted by physicians. Acceptance rate was higher when conducted by a pharmacist regularly practicing in the ward (ORa = 1.60, CI 95 [1.57–1.64]). Physicians’ acceptance was significantly associated with 1) ward specialty: emergency (ORa = 1.24, CI 95 [1.14–1.35]); 2) type of intervention: “drug discontinuation”, “drug switch” (ORa = 1.15, CI 95 [1.12–1.19]) and “addition of a new drug” (ORa = 1.15, CI 95 [1.12–1.19]); 3) drug group: antineoplastic and immunomodulators (ORa = 3.67, CI 95 [3.44–3.92]), as well as blood and blood-forming organs (ORa = 1.10, CI 95 [1.05–1.20]). Conclusion This 6-year longitudinal study highlights the role of clinical pharmacists, and particularly those integrated into wards to improve both intervention acceptance and collaboration with physicians in patient care and drug safety.