IMPACT OF A NEW CLINICAL PHARMACY CONSULTATION SYSTEM: A RETROSPECTIVE STUDY AT A TRAINING AND RESEARCH HOSPITAL IN TÜRKİYE

Abstract

Objective: The clinical pharmacy specialization program (CPSEP), initiated in 2018, aims to train expert pharmacists for clinical pharmacy services in hospitals. No study has yet evaluated medication therapy recommendations within the first "clinical pharmacy consultation system (CPCS)" integrated into Türkiye’s hospital framework. This study aims to assess the clinical pharmacy services delivered through the CPCS. Material and Method: This study was conducted on a tertiary-level hospital in Istanbul between February 2024-January 2025. The first 11 months of CPCS integration were evaluated. Result and Discussion: Sixty-nine patients were consulted, mostly adults (59.4%), primarily in hospital wards (65.2%) and intensive care units (26.1%). Common diagnoses included acute kidney injury (34.8%), infections (29.0%), and hematological malignancies (18.8%). Patients had a median of 9 medications (IQR, 8–15) and 2 comorbidities (IQR, 1–3). Common consultation reasons were adverse drug reactions (39.1%), potential drug interactions (27.5%), medication errors (14.5%), and inappropriate drug selection (5.8%). Eighty recommendations were provided, mostly regarding drug/laboratory monitoring (44.9%), dose adjustments (15.9%), and drug initiation/substitution (15.9%). Most consultations (84.1%) involved a single recommendation. These findings indicate that CPCS is actively used in drug therapy management within the national healthcare system. Although around five similar systems have been integrated in Turkish hospitals since 2023, this study presents the first published results of CPCS.

Keywords

• Clinical pharmacy
• clinical pharmacy consultation system
• drug-related problems
• specialization in pharmacy

YENİ KLİNİK ECZACILIK KONSÜLTASYON SİSTEMİNİN ETKİSİ: TÜRKİYE'DEKİ BİR EĞİTİM VE ARAŞTIRMA HASTANESİNDE YAPILAN RETROSPEKTİF ÖN ÇALIŞMA

Abstract

Amaç: 2018 yılında başlatılan klinik eczacılık uzmanlık programı (KEUP), hastanelerde klinik eczacılık hizmetleri için uzman eczacı yetiştirmeyi amaçlamaktadır. Türkiye'nin hastane çerçevesine entegre edilen ilk "klinik eczacılık konsültasyon sistemi (KEKS)" kapsamında ilaç tedavisi önerilerini değerlendiren henüz bir çalışma yoktur. Bu çalışma, KEKS aracılığıyla klinik eczacılık hizmetlerini değerlendirmeyi amaçlamaktadır. Gereç ve Yöntem: Bu çalışma, Şubat 2024-Ocak 2025 tarihleri arasında İstanbul'da üçüncü basamak bir hastanede yürütülmüştür. KEKS entegrasyonunun ilk 11 ayına ait süreç değerlendirilmiştir. Sonuç ve Tartışma: KEKS üzerinden 69 hasta danışıldı, hastaların büyük çoğunluğu yetişkindi (%59.4). KEKS’e en sık konsültasyon gönderen bölümler yatan hasta servisleri (%65.2) ve yoğun bakım üniteleri (%26.1) oldu. Hastalarda yaygın görülen tanılar akut böbrek hasarı (%34.8), enfeksiyonlar (%29.0) ve hematolojik maligniteler (%18.8) idi. Hastaların ortanca ilaç sayısı 9 (5-28) ve ortanca komorbidite sayısı 2 (1-7) idi. En sık konsültasyon nedenleri advers ilaç olayları (%39.1), olası ilaç etkileşimleri (%27.5), ilaç kullanım hataları (%14.5) ve uygunsuz ilaç seçimi (%5.8) idi. Konsültasyonlarda ilaç/laboratuvar takibi (%44.9), doz ayarlamaları (%15.9) ve yeni ilaç başlanması/ilaç modifikasyonu (%15.9) üzerine odaklanılmış, toplam 80 öneri yapılmıştır. Konsültasyonların çoğunluğu (%84.1) tek bir öneriyle sonuçlanmıştır. Bulgular KEKS'in ulusal sağlık sistemi içerisinde, özellikle ilaç danışmanlığı için aktif olarak kullanıldığını göstermektedir. Türkiye'de 2023'ten itibaren yaklaşık beş benzer sistem hastanelerde faaliyette olmasına rağmen, bu çalışma KEKS’den elde edilen ilk sonuçları temsil etmektedir.

Keywords

• Eczacılıkta uzmanlık
• ilaçla ilgili problemler
• klinik eczacılık
• klinik eczacılık konsültasyon sistemi

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