Today Online, Sep 4, 2007 

IT is considered standard practice for pneumonic patients to be prescribed antibiotics — but things could get a tad complicated if the intensive care patient also has impaired kidney function.

Patients who simultaneously suffer from both conditions require a lower dose of antibiotics, as even a slight overdose could further damage their kidneys.

To prevent such Adverse Drug Events (ADE), the National University Hospital (NUH) piloted a Health Ministry-funded project that saw pharmacists making the rounds with the healthcare team, and being stationed in the Intensive Care Unit for consultation.

This initiative has proven its worth — with a whopping 84 per cent drop in potential negative drug reactions at the hospital.

"The specialised knowledge of the pharmacist is fully utilised when it would be most useful — at the time of ordering," an NUH spokesperson told Today.

This success rate was revealed yesterday by Minister of State for Health Heng Chee How at the National Healthcare Group's conference on enterprise risk management in healthcare.

He also spoke of how the medication reconciliation project at Alexandra Hospital had averted 48 per cent of potential medication errors and 5.2 per cent of potential ADEs, resulting also in indirect cost savings.

Adopted from the United States, medical reconciliation compares the complete list of a patient's current home medications — including supplements and traditional Chinese medicines — with his new requirements after discharge from hospital.

For instance, when a woman in her 40s was admitted to Alexandra Hospital for pneumonia, doctors found that she had a high amount of liver enzymes in her, which could cause serious liver injuries. Upon recalling her medications, doctors discovered that she was taking medicines for high blood pressure and cholesterol — and it was the drugs for the latter that were causing the elevated liver enzymes.

"A handful of patients are not able to communicate effectively their medication background," said Alexandra Hospital's chief pharmacist M K Fatimah.

"By doing medication reconciliation, it significantly prevented the aggravation of her condition, which may have resulted in her being hospitalised again for liver-related issues."

by

Daphne Chuah
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