Clinical and economic impact of clinical pharmacist intervention in a hematology unit

Abstract

Background Medication errors can lead to preventable adverse drug events and associated hospitalization and healthcare cost to patients. Pharmacotherapy in patients with hematologic malignancies is more complex than that in general medicine patients. This study evaluated the clinical and economic impact of clinical pharmacist intervention in a hematology unit. Methods This retrospective study compared the number of pharmacist interventions and the economic impact for one year before and after a clinical pharmacist was deployed in a hematology unit. The clinical pharmacist joined the ward rounds and gave patient counseling and recommendations on medication use. For pharmacist intervention analysis, we compared the number and type of interventions. For cost analysis, we calculated the cost savings, estimated the cost avoidance, and compared the benefit–cost ratio between the two periods. Results The average length of hospitalization reduced from 19.27 days to 16.69 days after clinical pharmacist deployment. The rate of pharmacist interventions in medication orders increased from 143 out of 42,501 prescriptions (0.34%) to 826 out of 44,175 prescriptions (1.87%) (P < 0.00001). The calculated cost savings (NT$37,080 and NT$252,280), cost avoidance (NT$582,100 and NT$2,304,600), and benefit–cost ratio (0.77 and 3.19) increased after clinical pharmacist deployment. Conclusion This study demonstrated that the number of interventions significantly increased after clinical pharmacist deployment. This service could reduce medication errors, preventable adverse drug events, and costs of both medications and potential adverse drug events.