THE CHALLENGES OF IMPLEMENTATION AND THE IMPACT OF CLINICAL PHARMACY IN THE HOSPITAL ENVIRONMENT

Abstract

Clinical pharmacy represents an evolution in pharmaceutical practice, shifting the focus from medication to direct patient care, aiming to optimize pharmacotherapy, and promote the rational and safe use of medicines. In the hospital environment, the clinical pharmacist's role is essential for patient safety and quality of care. This article analyzes, through a narrative literature review, the main challenges for the implementation of clinical pharmacy in the hospital setting and the clinical and economic impact of its activities, based on 23 scientific articles published mostly between the years 2010 and 2024. The literature demonstrates that the primary challenges for implementing these services include administrative overload, human resource shortages, a lack of patient prioritization tools, and cultural integration barriers. Conversely, the impact of the practice is notably positive, evidenced by a high volume of interventions with acceptance rates exceeding 95%, a significant reduction in medication errors, improved outcomes in high-risk populations, and a substantial economic return. This return occurs mainly through avoided costs from preventing adverse events, which can be more than three times greater than direct savings. It is concluded that, despite the obstacles, the implementation of clinical pharmacy is a fundamental strategy for improving quality of care and the sustainability of the health system, requiring investment in professional training and the full integration of the pharmacist into the multidisciplinary team.