Investigating the impact of clinical pharmacist interventions on paediatric hospital patients

Aim: To determine how the professional activities of clinical pharmacists benefit paediatric hospital patients. Methods: A systematic search for original-research, English-language articles published between January 2000 and October 2017, within the PubMed, CINAHL, EMBASE, AustHealth, and Google Scholar databases was conducted. MeSH terms included: 'clinical pharmacist', 'paediatric/pediatric', 'hospital', and 'intervention'. Articles discussing pharmacist-initiated interventions on paediatric patients were eligible for inclusion. Results: Twelve articles matched the eligibility criteria, encompassing over 35 000 paediatric patients in nine countries, who received 11 209 pharmacist interventions relating to prescriptions and medication orders. The average acceptance rates of these interventions was nearly 90%, and led to reductions in medication errors, improvements in medical condition management, cost-savings, and reduced length of hospital stay. Prevented medication errors included over- and under-dosing, missed doses, gaps in medication history, allergies, and near-misses. Cost savings were substantial due to reduced wastage in total drug costs, and the prevention of adverse events and their associated costs. Clinical pharmacists also improved patient understanding, satisfaction, and adherence to their medications. Interventions provided by clinical pharmacists were most beneficial during ward rounds and the medication-ordering phase of treatment, where real-time advice to prescribers could be provided, which in turn led to a high acceptance of pharmacist recommendations. Conclusion: Clinical pharmacists play an essential role in multidisciplinary care, and can deliver substantial benefits for paediatric hospital patients, by reducing medication error frequency and severity, and reduced costs related to adverse effects, drug utilisation, and length of hospital stay.