4CPS-095 Medication management in acute admissions: a temporary hold of non-essential medication using a pharmacist-developed pocket card

<h3>Background and Importance</h3> Acute admission wards play a crucial role in providing rapid assessment, investigation, and treatment for patients with acute medical conditions. Clinical pharmacists perform medication management and may reduce medication use and strain on nurse resources by implementing a procedure to temporarily hold potentially unnecessary medications, for example topical treatments or osteoporosis medications. <h3>Aim and Objectives</h3> This study evaluated the number of medications that may be paused during acute admissions and assessed the usability of a pharmacist-developed pocket card designed to assist pharmacists and physicians in pausing medications in an emergency department. <h3>Material and Methods</h3> First, pharmacists developed a pocket card based on an audit of physicians’ previous medication management and a pharmacist assessment of non-essential medications during acute admissions. The card listed medications that may be temporarily held regardless of clinical context during the stay in the acute ward. Second, clinical pharmacists tested the card during seven working days to pause medications after physicians’ admission orders were entered. Third, physicians were introduced to the card for use during admission orders, and its effectiveness in supporting medication management was evaluated during another seven days. <h3>Results</h3> In the first week, 30 patients were included with a total of 327 medication orders. Of these, 60 (18.3%) were on the pocket card. Physicians paused 23 medications (38.3% of the pocket card medications, 7.0% of total orders) and pharmacists paused an additional 30 medications (50.0% of the pocket card medications, 9.2% of total orders). Overall, interventions covered 16.2% of all orders. In the second week, 35 patients were included with 468 medication orders in total. Of these, 122 (26.1%) were on the pocket card. After introduction to the card, physicians paused 81 (66.4% of the pocket card medications, 17.3% of total orders) and pharmacists paused an additional 30 (24.6% of the pocket card medications, 6.4% of total orders). Overall, interventions covered 23.7% of all orders. <h3>Conclusion and Relevance</h3> This study showed that the pharmacist-developed pocket card effectively supports medication management. Introducing physicians to the card helps them reduce the use of non-essential medications during acute admissions. This may reduce overall medication use and strain on nursing resources during short hospital stays. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest