European hospital pharmacists congress in Vienna: working with doctors and patients to optimise provision of medication

While most people are familiar with their local pharmacy – and value the services it provides – they are perhaps less aware of the role played by hospital pharmacies in the healthcare system. “As hospital pharmacists, we are highly qualified experts in medicines and their use. Because we are involved in patient therapy at a very early stage as part of a multidisciplinary treatment team, we play a significant role in eliminating medication errors, while helping to improve patient safety,” explained Fiona Nagele, MSc, clinical pharmacologist at the Vienna General Hospital pharmacy and keynote speaker representing Austria at the EAHP Congress. Besides logistics, procurement, production, analysis and quality management, the list of her responsibilities also includes provision of pharmaceutical-related information and clinical pharmacology. One of her core roles as a clinical pharmacologist is to participate in ward rounds, support medical personnel and caregivers, and consult patients directly. “Our work is very much valued by the doctors and caregivers working at Vienna General Hospital – in fact, anonymous surveys show that 62% of respondents believe that our consultation on patient treatment led to an improvement in care,” Nagele noted.

Medical advances: around 500 publications each week

Evidence-based medicine (EBM) is one of the cornerstones of modern treatment. It integrates clinical experience and patient values with the best available research information. But with new research findings coming to light all the time, EBM is now extremely complex. “To-day, a doctor would need to wade through somewhere in the region of 500 publications every week to ensure that they are up to speed on all the latest medical findings. As hospital pharmacists, we have a targeted approach to combing through systemic reviews of pharmaceuticals, conduct our own research into the literature and compile practical guides for doctors and caregivers. We are also involved in drawing up treatment comparisons and internal guidelines. Throughout the process, we provide objective and high-quality information on all pharmaceu-tical therapy options, helping to massively alleviate the pressures that doctors find themselves under in this area,” she confirmed in a summary of her day-to-day work. Based on this and taking into account specific guidelines as well as information from patients, clinical pharma-cists provide pharmacotherapy suggestions that are tailored to the needs of individual patients.

From atrial fibrillation to long-term stroke prevention

A case in point: among the patients on the cardiology ward where Nagele works are people diagnosed with atrial fibrillation. Due to their heightened risk of suffering a stroke, they are also prescribed blood-thinning medication. Various medicines are available. “We analyse kidney function, BMI and patient age as well as possible interactions with other medications. The preselected medications are then discussed with the individual patient, taking into account considerations such as how often they have to be taken, and their lifestyle. Working alongside the treating physician, this enables us to identify the right medication for each individual,” Nagele said.

Identifying medication errors and deprescribing

Studies have shown that up to 7% of hospital admissions each year are attributable to side effects or adverse interactions between medications. “The emergency surgery department could admit a patient with a femoral neck fracture, to pick one example. In many cases, breaks of this kind are found in patients who are also taking sleeping or anxiety medication. So what we do is look at these incidences very closely, analyse the medication from the perspective of possible interactions and suggest adjustments to the treatment approach as required,” the clinical pharmacologist explained. This level of consultancy helps to prevent further accidents, discontinue use of certain medicines, or find more suitable alternatives.

Clinical pharmaceutical care – already standard procedure in other countries

Vienna General Hospital has already recognised the benefits of clinical pharmacology as a vital element of the hospital pharmacy’s work. Since 2016, the number of wards where clinical pharmacologists work has increased from 3 to 50. For more than six years, though, just 17% of Austrian hospitals have had their own dispensing pharmacies. Blanket clinico-pharmacological services of the kind found in Anglo-American healthcare systems would be a desirable development here in Austria. At the EAHP Congress around 3,000 participants from all over Europe will discuss how hospital pharmacies can help to improve patient care in various sessions inspired by this year’s theme of “changing roles in a changing world”.

About IAKW-AG

Internationales Amtssitz- und Konferenzzentrum Wien, Aktiengesellschaft (IAKW-AG) is responsible for maintaining the Vienna International Centre (VIC) and operating the Austria Center Vienna. The Austria Center Vienna is Austria’s largest conference centre, with 19 halls, 180 meeting rooms, and some 26,000 m² of exhibition space, and is one of the top players on the international conference circuit.