AUTHOR=Atey Tesfay Mehari , Peterson Gregory M. , Salahudeen Mohammed S. , Simpson Tom , Boland Camille M. , Anderson Ed , Wimmer Barbara C. 

TITLE=Clinical and economic impact of partnered pharmacist medication charting in the emergency department

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2023.1273657

DOI=10.3389/fphar.2023.1273657

ISSN=1663-9812

ABSTRACT=Introduction
Partnered pharmacist medication charting (PPMC), a process redesign hypothesised to improve medication safety and interdisciplinary collaboration, was trialed in a tertiary hospital’s emergency department (ED). 
Objective
To evaluate the health-related impact and economic benefit of PPMC.
Methods
A pragmatic, controlled study compared PPMC to usual care in the ED. PPMC included pharmacist-documented best-possible medication history (BPMH), followed by a clinical conversation between a pharmacist and a medical officer to jointly develop a treatment plan and chart medications. Usual care included a medical officer-led traditional medication charting in the ED, without a pharmacist-obtained BPMH or clinical conversation. Outcome measures, assessed after propensity score matching, were length of hospital or ED stay, relative stay index (RSI), in-hospital mortality, 30-day hospital readmissions or ED revisits, and cost.
Results
A total of 309 matched pairs were analysed. The median RSI was reduced by 15.4% with PPMC (p = 0.029). There were no significant differences between the groups in the median length of ED stay (8 vs. 10 hours, p = 0.52), in-hospital mortality (1.3% vs 1.3%, p > 0.99), 30-day readmission rates (21% vs 17%; p = 0.35) and 30-day ED revisit rates (21% vs 19%; p = 0.68). The hospital spent approximately $282.4 for the cost of PPMC care per patient to avert at least one medication error bearing high/extreme risk. PPMC saved approximately $1233 on the average cost of each admission.
Conclusion
Implementing the ED-based PPMC model was associated with a significantly reduced RSI and admission costs, but did not affect clinical outcomes.