Acceptance and importance of clinical pharmacists' LIMM-based recommendations

Int J Clin Pharm. 2012 Apr;34(2):272-6. doi: 10.1007/s11096-012-9609-3. Epub 2012 Jan 18.


Objective: The objective of this study was to evaluate the quality of the clinical pharmacy service in a Swedish hospital according to the Lund Integrated Medicine Management (LIMM) model, in terms of the acceptance and clinical significance of the recommendations made by clinical pharmacists.

Method: The clinical significance of the recommendations made by clinical pharmacists was assessed for a random sample of inpatients receiving the clinical pharmacy service in 2007. Two independent physicians retrospectively ranked the recommendations emerging from errors in the patients' current medication list and actual drug-related problems according to Hatoum, with rankings ranging between 1 (adverse significance) and 6 (extremely significant).

Results: The random sample comprised 132 patients (out of 800 receiving the service). The clinical significance of 197 recommendations was assessed. The physicians accepted and implemented 178 (90%) of the clinical pharmacists' recommendations. Most of these recommendations, 170 (83%), were ranked 3 (somewhat significant) or higher.

Conclusion: This study provides further evidence of the quality of the LIMM model and confirms that the inclusion of clinical pharmacists in a multi-professional team can improve drug therapy for inpatients. The very high level of acceptance by the physicians of the pharmacists' recommendations further demonstrates the effectiveness of the process.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel*
  • Drug-Related Side Effects and Adverse Reactions
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Interdisciplinary Communication
  • Male
  • Medication Errors / prevention & control*
  • Medication Reconciliation / organization & administration
  • Medication Therapy Management / organization & administration*
  • Medication Therapy Management / standards
  • Middle Aged
  • Models, Organizational*
  • Patient Care Team / organization & administration
  • Pharmacists / organization & administration*
  • Pharmacists / psychology
  • Pharmacy Service, Hospital / organization & administration*
  • Pharmacy Service, Hospital / standards
  • Physicians* / psychology
  • Quality of Health Care / organization & administration*
  • Quality of Health Care / standards
  • Retrospective Studies
  • Risk Assessment
  • Sweden