Characteristics of hospital pharmacist interventions and their clinical, economic and organizational impacts: a five-year observational study on the French National Observatory

Background: Since 2006, French hospital pharmacists have been able to document their interventions in the National Observatory Act-IP© and, since 2016, to assess the potential clinical, economic and organizational impacts of pharmacist interventions (PIs) via the CLEO© tool.

Aim: To describe pharmacist interventions in French hospitals from 2017 to 2021 and to evaluate their potential impacts using the CLEO© tool.

Method: The study was conducted to examine PIs documented in the Act-IP© Observatory. For each intervention, the pharmacist used the CLEO© tool to evaluate the clinical impact, using a six-point scale ranging from negative to avoiding a fatality; the economic impact, i.e., whether there was a decrease or an increase in direct costs; and whether there was a positive or negative organizational impact from the health care providers' perspective.

Results: 121,792 PIs were assessed using the CLEO© tool for at least one outcome. Interventions with a potentially significant clinical impact accounted for 84.3% interventions and were classified as follows: minor, 28.3%; moderate, 40.3%; major, 15.0%; and avoiding a fatality, 0.7%, impacts. These interventions mainly involved antineoplastics, antithrombotic agents and some antibacterial agents. Most of the pharmacist interventions led to decreases in direct costs (50.4%) and positive organizational impacts (61.0%), especially for proton pomp inhibitors.

Conclusion: Many PIs have positive clinical, economic and organizational impacts, which highlights the added value of pharmacists in patient safety and positive impacts on health care teams. The pertinence of PIs can now be assessed by the CLEO© tool with a broader focus than prescribers' acceptance.