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Dr Gaurav Singh Tomar
Senior Consultant and Head,
ISIC Multi-speciality Hospital
Vasant Kunj, New Delhi, Pin-110070
Abstract— Medication-related harm remains a leading and largely preventable cause of injury in healthcare, and pharmacy practice sits at every stage of the medication-use process where that harm arises. This study assessed the impact of a structured clinical pharmacy service — comprising ward-based medication review, pharmacist-led reconciliation at care transitions, and prescriber feedback — on patient-safety outcomes across three hospitals. Over a nine-month controlled evaluation of 4,860 admissions, the intervention reduced prescribing errors from 11.4 to 5.9 per 100 orders, cut unintentional medication discrepancies at admission by 52.6%, and lowered the preventable adverse drug event (ADE) rate from 6.8 to 3.5 per 1,000 patient-days. Thirty-day readmissions fell from 14.2% to 9.8%, and pharmacists intercepted 1,842 clinically significant issues, of which 71.4% were accepted by prescribers. Each pharmacist full-time equivalent was associated with net avoided costs exceeding the service cost. Structured clinical pharmacy practice materially improves medication safety.
Keywords— pharmacy practice; patient safety; medication errors; medication reconciliation; adverse drug events; clinical pharmacist
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