Background Patients admitted to intensive care units (ICUs) are at higher risk than other patients of having problems, injuries and adverse drug reactions (ADRs) associated with their drug treatment.
Purpose To identify and categorise drug-related problems (DRPs) in an intensive care unit, using a standardised tool modified for use in critically ill patients.
Materials and Methods The Integrated Medicines Management model (IMM) was used as a standardised tool for both medicines reconciliation and medication reviews. All patients admitted to the Intensive Care Unit (ICU) at Levanger Hospital, Norway, during a 12-week period in 2011 were asked to participate in the study. DRPs identified by the pharmacist were discussed with the physicians in charge and changes in drug treatment were recorded.
Results A total of 23 patients were included in the study and 94 medication reviews were conducted (1–25 reviews per patient). One or more DRPs were identified for 16 of the patients. Overall 150 DRPs were identified by the pharmacist. Out of these 41% were related to discrepancies with the medicines list, 18% were non-optimal doses, 8% clinically relevant interactions and 8% non-optimal treatment. Input from the pharmacist was upheld by the physician and the medicine changed as suggested for 18% of the DRPs related to the medicines reconciliation and discrepancies with the medicines list and for 76% for DRPs identified in the medication review.
Conclusions DRPs were frequently identified in this cohort of ICU patients by the use of a standardised assessment tool. The majority of DRPs identified in the medication reviews were accepted by the physician. This indicates that the inclusion of a clinical pharmacist in the ICU multidisciplinary team may contribute to the quality of both acute and prophylactic drug treatment in critically ill patients.
No conflict of interest.
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