Issue 175 Item 5 Pharmacists As Part of the Team Reduce Cost by $923 Per Patient

Having a pharmacist on the rounding team of a general medical unit reduced adverse drug events (ADEs) by 78%.
"Fatal ADEs were the sixth leading cause of death in the US in 1994, with 10.9% of all hospital patients experiencing some adverse drug reaction and 2.1% of admissions resulting in serious events," write Suzan N. Kucukarslan, PhD, from the Henry Ford Hospital in Detroit, Michigan, and colleagues. "Having a pharmacist available when patients are evaluated during the rounding process may reduce the likelihood of preventable ADEs."

In this single-blind, standard-care controlled study, including a pharmacist with the rounding team on general medical units reduced the rate of preventable ADEs by 78%, from 26.5 per 1,000 hospital days to 5.7 per 1,000 hospital days. Of 150 documented interventions recommended by the pharmacist, 147 were accepted by the team. Interventions recommended most frequently were dosing-related changes and suggestions to add a drug to ongoing therapy.

Reducing preventable ADEs led to significant cost-savings, because mean length of stay in patients with preventable ADEs was 1.4 days longer than in patients who did not have an unexpected event. For patients in a semiprivate room incurring only internal medicine service charges, this would result in a cost-savings of $923 per admission.

"In most practice settings, the pharmacist is placed distant from the medication selection step of the patient care process," the authors write. "Pharmacist participation with the medical rounding team on a general medicine unit contributes to a significant reduction in preventable ADEs." Arch Intern Med. 2003;163:2014-2018