The HPAI Annual Clinical Conference featured a range of fascinating presentations by expert pharmacists on their chosen topics of interest. These included ‘e-Medication Reconciliation at Cork University Hospital (CUH)’ by Ms Emily Byrne, CUH; ‘A Qualitative Study of Paediatric Delirium Diagnosis and the Lived Experience of Parents’ by Mr Diarmaid Semple of Children’s Health Ireland, Crumlin; ‘Unplanned Hospitalisation Due To Adverse Drug Events in Frail Older Adults with Cancer’ by Mr Darren Walshof University Hospital Waterford; and ‘A Scoping Review of Advanced or Specialist Pharmacist Roles in Hospital Outpatient Settings’ by Ms Emer McManus or St Vincent’s University Hospital.
Mr Semple, who is also chair of the HPAI Education Committee and Annual Conference organiser, provided an overview of the challenges in paediatric delirium. He also outlined some research conducted with colleagues to examine the lived experience of paediatric delirium (PD) for patients and their families and told the attendees: “An estimated 20 per cent of admissions to
our Critical Care Unit develop paediatric delirium, and we have more than 1,000 admissions per year.” Mr Semple and colleagues interviewed parents to gauge their experiences of having a child with PD to assess the parental impact, and designed a model to deal with such cases.
The CALM model (Collaborative Approach to Limit and Manage Paediatric Delirium) is designed to provide tailored measures that help each individual child, create a dialogue between healthcare professionals and parents, and provide reliable sources of information.
In her talk, Ms Byrne explained the benefits of e-medication reconciliation (e-MR) at CUH, and told the attendees that since April 2025, she and her colleagues have done more than 9,000 e-MRs, with real-time output averages of 65 per cent MR complete of the adult population, and 75 per cent of these performed within 24 hours of admission. It is now standard practice for all pharmacists and medication management technicians at CUH. “The biggest outcome of this project is that we are reaching patients earlier now in their admission,” she said. “Our rate of MR completed within 24 hours has gone up 18 points to 75 per cent, which is probably the most rewarding aspect.”
She also provided a background to the FIT (Frailty Intervention Team) service, which is designed to ensure frail older patients have early access to interdisciplinary expertise, and to decrease the patient experience time spent in the emergency department. The FIT service also manages the complete episode of care, from triage and/or admission, to a definitive place of care.
Mr Walsh reinforced the need for high- quality research in hospital pharmacy, and there is a need for more research on adverse drug events (ADEs) in frail older patients with cancer, he said. He explained that he conducted a study at University Hospital Waterford with colleagues into this area and found that pharmacist-led MRs have resulted in a 65 per cent statistically significant reduction in unplanned hospitalisations due to ADEs.
“We are proactively influencing therapeutic decision-making,” Mr Walsh told the conference in reference to his study findings. “The prevalence of medication- related problems is really profound. Just under 60 per cent of patients had at least one clinically-significant drug interaction that the MDT agreed required intervention. Fifty-five per cent of patients were on at least one potentially inappropriate medication at baseline, and 46 per cent had a potentially omitted medication with
‘We found that pharmacists are taking on diverse and advanced roles across many clinical specialties’
an indication or symptom that was not being pharmacologically treated, but should have been.”
Ms McManus spoke about how to enhance the role of Advanced Specialist Pharmacists in the hospital outpatient setting. She and her colleagues conducted a scoping review of 126 studies that provided a worldwide picture of advanced pharmacy practice roles in healthcare, and she told the conference: “We know that advanced practice is growing and ambulatory care is growing, but at the moment there is no literature review that brings all of that evidence together.”
With regard to specialist areas where pharmacists are working worldwide, oncology/haematology is the most common area, with 23.5 per cent, and
this is followed by cardiology at 19.8 per cent, she explained. Within haematology, subspecialisation in anticoagulation is the most common, and in cardiology, over half of the pharmacists’ roles were in heart failure, and in endocrinology, over 75 per cent specialised in diabetes, she explained, however education and training resources were poorly reported across the board.
In terms of governance, only 25 per cent of studies described credentialling that a pharmacist needed to undertake within the organisation, and quality assurance processes were not well described within the literature.
“We found that pharmacists are taking on diverse and advanced roles across many clinical specialties,” Ms McManus concluded. “However standards are lacking, both between organisations and also between countries. Education and training hasn’t been clearly reported and taking both of those into account, it makes it difficult to understand whether a role that was successfully implemented in one setting could be transferred to somewhere else,” she told the conference. “There is
a need for better reporting and better standardisation of education and training pathways, and we have the opportunity to strengthen the reporting of quality assurance and regulatory oversight.”
