Development of a Proactive Screening Model for Pharmaceutical Care in Inpatients

Abstract

Background: Drug-related problems (DRPs) and adverse drug reactions (ADRs) are significant factors affecting patient safety and clinical outcomes. Inpatient pharmaceutical care in the wards of Sawanpracharak Hospital is primarily based on incident reporting combined with direct observation, which does not comprehensively cover all patients. In addition, there is a lack of a systematic, proactive screening process to identify patients at risk of drug-related problems.

Objective: (1) To develop and evaluate a patient screening model for proactive inpatient pharmaceutical care and (2) to assess the identification, prevention, and resolution of drug-related problems (DRPs) in hospitalized patients.

Methods: This action research was conducted in three phases: (1) problem analysis and development of a patient screening model for proactive inpatient pharmaceutical care using trigger tools, direct observation, chart review by healthcare professionals, and voluntary patient reporting, with patient screening performed based on predefined trigger criteria; (2) implementation of the developed model (October 5, 2023, to May 31, 2025); and (3) data collection and outcome analysis after implementation, compared with the pre-implementation period. Data were analyzed using descriptive and inferential statistics, including the chi-square test and Mann–Whitney U test. Statistical significance was set at p-value < 0.05.

Results: Following the development of the model, the number of patients receiving pharmaceutical care increased significantly by 7.61-fold compared with the pre-development period (p-value < 0.001). Significant increases in the number of patients receiving pharmaceutical care were observed among patients receiving warfarin therapy, patients experiencing adverse drug reactions, and patients receiving medications requiring education on special administration techniques (p-value < 0.001). The rate of DRPs was 12.53 per 1,000 patient-days. The majority of identified problems (49.17%) were ADR-related, and ward pharmacists successfully prevented 48.55% of these events from reaching patients.

Conclusion: The developed patient screening model for proactive inpatient pharmaceutical care has the potential to enhance the identification of patients requiring pharmaceutical care and improve the detection, prevention, and resolution of drug-related problems effectively.