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Pharmacists can take overall responsibility for A&E patients, study reveals

By Costanza Pearce

20 Mar 2019

Pharmacists with additional clinical training can take overall responsibility for patients in emergency departments, a new study has revealed.

The University of Manchester study, published in the International Journal of Clinical Pharmacy last week (16 March), surveyed 20 emergency department pharmacist practitioners (EDPPs) from 15 UK hospitals and the care they provided for 682 patients.

More than half of the EDPPs (55%) took on the role of designated care provider for some of the patients they cared for, the research found.

The study said that the EDPPs’s roles included ‘hands-on care or making key care decisions and taking associated responsibility’ and that the pharmacists supported patients with problems ‘of any severity and at any stage of their visit’.

Of the 682 patients the EDPPs in the study provided care for, 39% received clinical examinations and 40% received reviews of test or procedure results. The EDPPs prescribed a total of 603 medicines to 266 patients and performed ‘procedures’ on 63, the study said.


A ‘versatile solution’


The EDPPs surveyed had completed additional clinical skills training such as independent prescribing (16%) or phlebotomy (5%) courses, or a more comprehensive postgraduate certificate like Manchester Pharmacy School’s ‘Advanced Specialist Training in Emergency Medicine’ (ASTEM) programme (5%).

Pharmacists with such training were welcomed as a ‘versatile solution’ to shortages of doctors and nurses and a perceived lack of pharmaceutical care such as checking prescriptions in A&E departments.

The EDPPs were found to most often care for patients classed as having a specific medical condition (37%), in particular cardiac-related complaints, or infections (23.5%) which were most commonly respiratory conditions.

The pharmacists also performed or reviewed clinical examinations for 50% of patients, diagnosed 35%, performed procedures for 9% and prescribed medicines for 39%, of which 46% were new medicines.

The study concluded that ‘pharmacists have the confidence to independently initiate new medicines’ so legislation and guidance should ‘ensure the correct balance between permitting and limiting autonomy to ensure patient safety’.

Study author Daniel Greenwood said: ‘There is no doubt that pharmacists with additional clinical skills training have a role to play in A&E departments.’

The study was funded by Pharmacy Research UK, the UK Clinical Pharmacy Association, the Centre for Pharmacy Postgraduate Education and Health Education North West.

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