Table 1

Key features of the Pharmaceutical Care in Tallaght Hospital (PACT) intervention and standard care

	Standard care	PACT intervention
Service arrangement	Aligned to a ward	Aligned to a medical team
Clinical pharmacists involved	Service delivered by routine clinical pharmacists	Service delivered by one of two PACT clinical pharmacists
Service at admission	Contributed to admission medication history taking	Led admission medication history taking and reconciliation
Service during admission	Made minor changes and endorsements to the drug prescription and administration chart (drug chart), for example, clarify an intended formulation or notate to facilitate appropriate administration, for example, ‘before food’	Made minor and major changes to the drug chart, as required, and these were co-signed by a medical practitioner
	Delivered routine clinical pharmacy tasks (drug chart review; therapeutic drug monitoring; medication review; contribution of suggestions to optimise medication use and medication information queries)	Delivered routine clinical pharmacy tasks (drug chart review; therapeutic drug monitoring; medication review; contribution of suggestions to optimise medication use and medication information queries)
Service at discharge	No service	Discharge medication reconciliation
		Made minor and major changes to the discharge medication list, as required, and these were co-signed by a medical practitioner