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Ali M. Abbas Al-Ateya*


Objective: Analysis and evaluation of clinical pharmacist's suggestions according to the rate of their acceptance by the treating physicians (Prospective assessment) and subsequently benefit of clinical pharmacist involvement in integrated health care team during inpatients care. Background: All patients admitted to the hospital are subject to clinical pharmacy services. Where the clinical pharmacist as part of his/her daily routine works follow-up patients' treatments and documenting drug interactions and writing pharmaceutical suggestions about the treatments spent. These suggestions are presented to the doctor for acceptance or rejection as important in influencing the patient's condition. These pharmacological suggestions are of great importance in maximizing the treatment of patients and controlling the problems in treatment. Therefore, it is necessary to analyze these suggestions and the presentation of quality and importance and the rate of acceptance by doctors treating. This enhances the role of clinical pharmacist as a vital part of the patient's therapeutic care. Method: It was a prospective, observational and interventional study carried over a period of 2 months. This study included random sample of 100 patients (41 male and 59 female) admitted in three wards at Al-Fayha teaching hospital at the period from 1 January to 1 March 2018 with different disease conditions. All patients who have clinical pharmacist's suggestions in the clinical pharmacist's sheet. Also all the patients included having more than 5 drugs in their prescribed treatment. Total number of drugs for all patients' selected 650 drugs, including 270 drugs (41.5% of total drugs) presented to clinical pharmacist's suggestions. The quality of clinical pharmacist's suggestions was analyzed and evaluated according to the rate of acceptance (accepted, not accepted and neglected) by the treating physicians. The drugs were also analyzed and the clinical pharmacist's suggestions were analyzed. Results: From 100 patients(41 male and 59 female) who have 650 drugs in their treatment, 270 drugs with 270 clinical pharmacist suggestions identified. From these 270 clinical pharmacist suggestions 186(68%) accepted, 43(15%) not accepted and 41(15%) neglected by the treating physicians. The acceptance rate of clinical pharmacist suggestions was found to be high, the majority of these suggestions categorized with their acceptance rate as follow: 28(10%) management of dilutions(25(89%) accepted), 22(8%) dose adjustment(13(59%) accepted), 92(34%) management of drug-drug interactions(60(65%) accepted), 54(20%) treatment substitution(29(53%) accepted), 11(4%) treatment discontinuation(2(18%) accepted), 42(15%)monitoring(36(85%) accepted) and 23(8%) others(23(100%) accepted). As mentioned above 270 drugs affected by clinical pharmacist suggestions includes: 17 statins, 44 antibiotics,14 diuretics, 15 antiplatelet,11 anticoagulants, 21 fluids and electrolytes, 14 Proton pump inhibitors(PPI), 11 tramadol, 15 metoclopramide, 17 beta-blockers, 30 non-steroidal anti-inflammatory drugs(NSAID),12 angiotensin receptor blockers(ARB) and 49 others. Conclusions: The role of the clinical pharmacist in the hospitals has shifted from logistic and routine role in delivering treatment to the interactive role and clinical participation on the basis of scientific and proactive procedures in cooperation with the doctors to deliver the best therapeutic quality to the patient free from the problems of the medication led to wide acceptance of clinical pharmacist's suggestions and reliance. Physicians became believe that the results of the prescribed treatment are improved under the supervision of the clinical pharmacist. The pharmacist's widely accepted clinical suggestions from doctors have beneficial outcomes for patients and health institutions. Therefore, this study can reflect the effectiveness of the clinical pharmacist as one of the basic units of the medical staff that provides therapeutic services to patients. This type of studies can be used to assess the effectiveness of clinical pharmacists in health institutions.

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