Démarche pour la mise à niveau d'un secteur de soins pharmaceutiques: Le cas de l'hémato-oncologie pédiatrique

Abstract

Background: Although the concept of clinical pharmacy was originally developed some time ago, in the 1960s, there is a wide variety of programs in existence, as well as great disparity between programs where the presence of a pharmacist is provided in outpatient and inpatient settings. Objective: To test a method for upgrading pharmaceutical care areas in a hospital setting. Method: This descriptive study was conducted at the Sainte-Justine university health centre, a 500-bed mother-and-child hospital. The pharmaceutical care area that was used to exemplify the upgrading method was pediatric hematology-oncology. A 3-step method was used: review of the scientific literature, creation of a profile of the targeted area, and upgrading of the practice level according to the pre- and post-upgrading profile of the pharmaceutical activities in the area. Results: A total of 108 articles were identified in a search of the PubMed database, of which 22 were retained. After a complementary manual search, a total of 36 articles were evaluated. The articles retained included 3 guidelines, 11 development studies, 1 review of scientific literature, 6 pre- and post-intervention studies, and 15 quasi-experimental studies. Although patients in the pediatric hematology-oncology area account for only 5% of admissions to this hospital, the cases are highly complex, in terms of both the codification of the care phase and the potential for pharmaceutical intervention per admission. Conclusion: There are few data to illustrate a method for upgrading practice in a pharmaceutical care area. This study tested a method for upgrading pharmaceutical care in a pediatric hematology-oncology service, with a review of the scientific literature, a profile of the area, and the pharmacists' pre- and post-upgrading job description in this area.