Physicians’ Acceptance of Pharmacy Residents’ Recommendations on Drug Therapy
Keywords:
Clinicalpharmacy, Resident, Trainingprogram, Impact, EvaluationAbstract
The objective of this study was to evaluate the impact of a training program delivered to pharmacy residents. During their clinical pharmacy training program, the residents have to learn more about how to deal with drug related problems, develop clinically relevant recommendations, and develop communication skills to make therapeutic recommendations acceptable for the prescriber. Six pharmacy residents, working in different clinical wards, collected data during six consecutive weeks every time they gave a recommendation to a prescribing physician. The main issue was the prescribers’ level of acceptance of pharmacy residents’ recommendations. The items taken into account were the type of recommendation, the physician’s status and the mode of interaction between pharmacy residents and prescribers. Two hundred and twenty one interventions were collected. The major recommendations were changing drug regimen (39%) and enhancing monitoring (31%). The rate of prescribers’ acceptance of recommendations made by pharmacy residents was 47% (higher for senior prescribers (59%) than junior prescribers (41%)). Oral recommendations of around 80% were accepted.References
ASHP and ACCP “Supplemental standard and learning objectives for residency training in pharmacotherapy practice”, Pharmaco- therapy, 19(11) (1999), 1336–1348.
ASHP (1997) “Definition of pharmacy residencies and fellow- ships”, ASHP Residency Accreditation Regulations and Standards, pp 274–275.
Guignon, A.M., Grain, F., Allenet, B., Brudieu, E., Barjhoux, C., Bosson, J.L. and Calop, J. (2001) “Evaluation de l’impact clinique des opinions pharmaceutiques dans un service de me ́decine spe ́cialise ́e”, J. Pharm. Clin. 2(20), 118–123.
Hawkey, C.J., Hodgson, S., Norman, A., Daneshmend, T.K. and Garner, S.T. (1990) “Effect of reactive pharmacy intervention on quality of hospital prescribing”, Br. Med. J. 300, 986–990.
Haxby, D.G., Weat, C.W. and Goodman, B.W. (1988) “Family practice physicians perception of the usefulness of drug therapy recommendations from clinical pharmacists”, Am. J. Hosp. Pharm. 45, 824–827.
Leape, L.L., Cullen, D.J., Clapp, M.D., Burdick, E., Demonaco, H.J., Erickson, J.I. and Bates, D.W. (1999) “Pharmacist participation on physician rounds and adverse drug events in the intensive care unit”, J. Am. Med. Assoc. 282, 267 – 270.
Lee, A.J., Boro, M.S., Knapp, K.K., Meier, J.L. and Korman, N.E. (2002) “Clinical and economic outcomes of pharmacist recommendations in a Veterans Affairs Medical Center”, Am. J. Health Syst. Pharm. 59, 2070–2077.
Leemans, L. and Laekeman, G. (2000) “Collaboration between physicians and pharmacist: short report of one year of clinical internship in Belgium”, Pharm. Edu. 1, 1–4.
McDonough, R.P. and Doucette, W.R. (2001) “Dynamics of pharmaceutical care: developing collaborative working relationship between pharmacists and physicians”, J. Am. Pharm. Assoc. 41(5), 682–692.
McMahan, E.M., Hoffman, K. and McGee, G.W. (1994) “Physi- cian–nurse relationships in clinical settings: a review and critique of the literature 1966 – 1992”, Med. Care Rev. 51, 83–112.
Mohr, J. and Nevin, J.R. (1990) “Communication strategies in marketing channels: a theoretical perspective”, J. Market. 54, 36–51.
Mutnitz, A.H., Sterba, K.J., Peroutka, J.A., Sloan, N.E., Beltz, E.A. and Sorenson, M.K. (1997) “Cost savings and avoidance from clinical interventions”, Am. J. Hosp. Pharm. 54, 392–396.
Ranelli, P.L. and Biss, J. (2000) “Physicians perceptions of communication with and responsabilities of pharmacists”, J. Am. Pharm. Assoc. 40(5), 625–630.
Schmitt, D., Allenet, B., Brudieu, E., Leger, S., Romieu, P., Bosson, J.L., Franco, A. and Calop, J. (2001) “Acceptability of a computerized prescription writing in the hospital. Survey on 44 prescribers”, Presse Med. 30, 1478–1481.
Sorensen, T.D. and Biebighauser, S.M. (2003) “Pharmaceutical care leadership: an innovative pharmacy practice residency model”, J. Am. Pharm. Assoc. 43(4), 527–532.
White, C.M. and Chow, M.S. (1998) “Cost impact and clinical benefits of focused rounding in the cardiovascular intensive care unit”, Hosp. Pharm. 33, 419–423.
