Future enhanced clinical role of pharmacists in emergency departments in England:multi-site observational evaluation


Background There are concerns about maintaining appropriate clinical staffing levels in Emergency Departments. Pharmacists may be one possible solution. Objective To determine if Emergency Department attendees could be clinically managed by pharmacists with or without advanced clinical practice training. Setting Prospective 49 site cross-sectional observational study of patients attending Emergency Departments in England. Method Pharmacist data collectors identified patient attendance at their Emergency Department, recorded anonymized details of 400 cases and categorized each into one of four possible options: cases which could be managed by a community pharmacist; could be managed by a hospital pharmacist independent prescriber; could be managed by a hospital pharmacist independent prescriber with additional clinical training; or medical team only (unsuitable for pharmacists to manage). Impact indices sensitive to both workload and proportion of pharmacist manageable cases were calculated for each clinical group. Main outcome measure Proportion of cases which could be managed by a pharmacist. Results 18,613 cases were observed from 49 sites. 726 (3.9%) of cases were judged suitable for clinical management by community pharmacists, 719 (3.9%) by pharmacist prescribers, 5202 (27.9%) by pharmacist prescribers with further training, and 11,966 (64.3%) for medical team only. Impact Indices of the most frequent clinical groupings were general medicine (13.18) and orthopaedics (9.69). Conclusion The proportion of Emergency Department cases that could potentially be managed by a pharmacist was 36%. Greatest potential for pharmacist management was in general medicine and orthopaedics (usually minor trauma). Findings support the case for extending the clinical role of pharmacists.

Publication DOI: https://doi.org/10.1007/s11096-017-0497-4
Divisions: College of Health & Life Sciences
College of Health & Life Sciences > Aston Pharmacy School
Additional Information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Uncontrolled Keywords: clinical pharmacy,emergency department,pharmacist,pharmacist training,Pharmacy,Toxicology,Pharmacology,Pharmaceutical Science,Pharmacology (medical)
Publication ISSN: 2210-7711
Last Modified: 22 Jul 2024 07:13
Date Deposited: 27 Jun 2017 14:00
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Related URLs: http://www.scop ... tnerID=8YFLogxK (Scopus URL)
https://link.sp ... 1096-017-0497-4 (Publisher URL)
PURE Output Type: Article
Published Date: 2017-08-01
Published Online Date: 2017-06-26
Accepted Date: 2017-06-07
Submitted Date: 2016-07-18
Authors: Hughes, Elizabeth
Terry, David (ORCID Profile 0000-0001-7599-0916)
Huynh, Chi (ORCID Profile 0000-0001-6982-6642)
Petridis, Konstantinos
Aiello, Matthew
Mazard, Louis
Ubhi, Hirminder
Terry, Alex
Wilson, Keith
Sinclair, Anthony



Version: Published Version

License: Creative Commons Attribution

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