Prescription monitoring

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Chapter: Hospital pharmacy : Clinical pharmacy

The core of pharmacists’ contribution to appropriate prescribing and medi-cation use is made whilst undertaking near-patient clinical pharmacy activities.


Prescription monitoring

 

The core of pharmacists’ contribution to appropriate prescribing and medi-cation use is made whilst undertaking near-patient clinical pharmacy activities. Checking and monitoring patients’ prescriptions on hospital wards is frequently the starting point for this process and on most hospital wards the prescription card and clinical observation charts (temperature, pulse rate, blood pressure, and so on) are typically kept at the end of the patient’s bed. This allows the clinical pharmacist to interact with the patient whilst reviewing the contents of the prescription.

 

The prescription is reviewed for medication dosing errors, appropriateness of administration route, drug interactions, prescription ambiguities, inappropriate prescribing and many other potential problems. Formal assessments of prescription charts in hospitals have shown that there are wide variations in the quality of prescribing and pharmacists are able to identify and resolve many clinical problems. Patients can be questioned on their medication histories, including allergies and intoler-ances, efficacy of prescribed treatment, side-effects and adverse drug reactions (ADRs). The routine presence of medical and nursing staff on the ward allows the pharmacist to communicate easily with other mem-bers of the healthcare team who value the prescription-monitoring service that clinical pharmacists provide.Patients’ notes are also accessible, to enable the pharmacist both to check important information that may affect their healthcare and to record details of any clinical pharmacy input made.

 

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