Pharmacist-managed patient assessment and medication refill clinic.

The effectiveness of a pharmacist in determining the appropriateness of prescription renewal for patients appearing at a hospital-based refill clinic was investigated. In part 1, data were collected on the clinic as it traditionally functioned with staff physicians evaluating the patients. In parts 2 and 3, data were collected with the pharmacist assuming the assessment function. In part 2, a physician reviewed the pharmacist's decisions before the patient left. In part 3, the pharmacist functioned without supervision and the physician reviewed patient records retrospectively. Physician agreement with the pharmacist's decisions was the primary criterion for determining effectiveness, and was found to be 99% in part 2, for a total of 105 patients. In part 3, physician agreement remained at the 99% level for a total of 106 patients. Patient waiting time was about the same in each part of the study because of clinic procedures beyond the pharmacist's control. A pharmacist can be cost-effective in this role if the task is combined with regular pharmaceutical functions.

Evaluation of clinical pharmacy services on a polydrug detoxification unit.

A five month study was undertaken to evaluate the role played by a clinically trained pharmacist on a polydrug detoxification unit. A total of 69 patients were included in the study. Four parameters were investigated in the evaluation. These sought to document the pharmacist's ability to: (1) evaluate degree of dependence; (2) develop, monitor and adjust detoxification protocols; (3) monitor and treat general medical needs; and (4) educate patients in the area of drug abuse. Based on the results of this investigation, it is concluded that a clinically trained pharmacist can be a beneficial addition to such a detoxification unit.