A Prospective Descriptive Study Evaluating the Impact of Clinical Pharmacists on Inpatient Addiction Services Qualitatively Assessed Through Patient-Reported Outcomes
Bibliographic record
Abstract
ABSTRACT Background: Located at the Peter Lougheed Centre in Calgary, Alberta, the Addiction Recovery Community Health (ARCH) team is a unique multidisciplinary inpatient consult service that is supported by a clinical pharmacist. By quantifying and describing the interventions provided by ARCH pharmacists, this study provides an extensive analysis of the clinical services that pharmacists can offer patients experiencing substance use disorder (SUD). Objective: (1) To describe and quantify the types of interventions provided by ARCH pharmacists related to pharmacotherapy for alcohol use disorder (AUD) and opioid use disorder (OUD). (2) To assess patient perspectives on the involvement and contributions of the ARCH pharmacist on the care they receive while in the hospital. Methods: This was a prospective descriptive study conducted between June 2021 and December 2022. Demographic and intervention data was collected from ARCH pharmacist progress notes and classified accordingly. Upon discharge, an optional survey was provided to capture patient perspectives on the care they received from ARCH pharmacists. Results: A total of 50 patients (54% male) were included in the study. The mean±SD age of patients was 43.96 ± 12.9 y. Most patients presented with OUD compared with AUD (66% vs. 26%). Overall, 293 interventions were identified, with follow-up and monitoring (36%) being the most common and Naloxone kit and training (1%) being the least common. Medication prescribed or recommended (17%) included the initiation of therapies such as acamprosate, naltrexone, and extended-release buprenorphine injection. Survey results demonstrated that patients had overwhelmingly positive experiences with ARCH pharmacists involved in their care. Conclusions: Beyond simply treatment initiation, pharmacists have the opportunity to become involved in many aspects of care in patients with SUD. Contexte: Située au Peter Lougheed Centre de Calgary, en Alberta, l'équipe Addiction Recovery Community Health (ARCH) est un service de consultation multidisciplinaire unique pour les patients hospitalisés, qui bénéficie du soutien d’un pharmacien clinicien. En quantifiant et en décrivant les interventions des pharmaciens de l'équipe ARCH, cette étude fournit une analyse approfondie des services cliniques que les pharmaciens peuvent offrir aux patients souffrant de troubles liés à l’utilisation de substances (TUS). Objectifs: (1). Décrire et quantifier les types d’interventions fournies par les pharmaciens de l’ARCH concernant la pharmacothérapie des troubles liés à la consommation d’alcool (TCA) et des troubles liés à la consommation d’opiacés (TCO). (2). Évaluer le point de vue des patients sur l’implication et la contribution du pharmacien de l’ARCH dans les soins qu’ils reçoivent à l’hôpital. Méthodes: Il s’agit d’une étude descriptive prospective menée entre juin 2021 et décembre 2022. Les données démographiques et d’intervention ont été recueillies à partir des notes d'évolution du pharmacien de l’ARCH et classées en conséquence (tableau 1). À la sortie de l’hôpital, une enquête facultative a été fournie pour recueillir le point de vue des patients sur les soins qu’ils ont reçus des pharmaciens de l’ARCH. Résultats: Au total, 50 patients (54% d’hommes) ont été inclus dans l'étude. L'âge moyen ± SD des patients était de 43,96 ± 12,9 ans. La plupart des patients présentaient des TCO par rapport aux TCA (66% vs 26%). Dans l’ensemble, 293 interventions ont été identifiées, le suivi et la surveillance (36%) étant les plus courants et le kit de Naloxone et la formation (1%) étant les moins courants. Les médicaments prescrits ou recommandés (17%) comprenaient l’initiation de thérapies telles que l’Acamprosate, la Naltrexone et la Buprénorphine injectable à libération prolongée. Les résultats de l’enquête ont montré que les patients ont eu des expériences extrêmement positives avec les pharmaciens de l’ARCH impliqués dans leurs soins. Conclusions: Au-delà de la simple initiation du traitement, les pharmaciens ont la possibilité de s’impliquer dans de nombreux aspects des soins prodigués aux patients souffrant d’un TUS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".