The pharmacist's contribution to clinicians' ward rounds: analysis by the stages in the drug use process


Clinical Pharmacy Manager, Pharmacy Department, Ealing Hospital, Uxbridge Road, Southall, Middlesex England UB1 3HW


Hospital pharmacists are increasingly becoming an integral part of the clinical team, with many pharmacists now attending clinicians' ward rounds. This exploratory study observed five pharmacists attending ward rounds in hospitals in South East England, each on two or three occasions. The pharmacists volunteered to take part in the study and consent was obtained from the clinicians in charge. Each round was observed, tape recorded and transcribed. The verbal contributions of each member of the team to the discussions of drugs were analysed and categorised using the stages of the drug use process.

The rounds involved 109 patients and there were 269 separate conversations involving medication. Of these, 135 were patient-specific drug discussions where therapy was reviewed; the pharmacists made proposals to start, stop or alter therapy in nearly half of these discussions. There was no review of therapy in 38 per cent of patients in the study, ranging from 0 per cent on a medical round, to 75 per cent on a surgical round. The pharmacists were particularly involved in selecting the most appropriate dose, stopping drug therapy, and monitoring drugs. The clinicians were more involved in initiating drug therapy. All doctors questioned expressed their satisfaction with the pharmacists and their contribution to the ward rounds.