Background Pharmacist review of drug prescriptions in the intensive care unit (ICU) has been shown to prevent errors and improve patient outcomes. However, it is necessary to evaluate the efficacy of interventions performed by pharmacists.

Purpose To classify and measure the type of interventions performed by pharmacists on ICU prescriptions and to measure the physician’s acceptance of the recommendations.

Material and methods Retrospective observational study of pharmaceutical intervention on ICU prescribing, from 1st September 2013 to 31st August 2014.

All the information about interventions was obtained from the computerised physician order entry system.

Drug related problems (DRPs) detected were classified as follows:

Indication:

DRP1: the patient was not using the medicines that he needed.

DRP2: the patient was using medicines that he did not need.

Effectiveness:

DRP3: the patient was using an erroneous medicine.

DRP4: the patient was using a lower dose and/or a different dose schedule than required and/or did not continue treatment for the full course indicated.

Safety:

DRP5: the patient was using a higher dose or a different dose schedule than required and/or exceeding the full course of treatment indicated.

DRP6: the patient was using a medicine that causes an adverse drug reaction.

Overall percentage of interventions accepted and the percentage of interventions accepted in each subgroup were calculated.

Results During the study, 105 interventions were recorded, of which 62 (59.1%) were accepted.

Types of DRP were: DRP1 8 (7.6%); DRP2 17 (16.2%); DRP3 3 (2.9%); DRP4 19 (18.1%); DRP5 32 (30.5%); DRP6 26 (24.8%).

Acceptance rates in each subgroup were: DRP1 5 (62.5%); DRP2 13 (76.5%); DRP3 1 (33.3%); DRP4 10 (52.6%); DRP5 20 (62.5%); DRP6 13 (50.0%).

Conclusion

1. The most common types of pharmacist interventions over ICU prescriptions were in connexion with DRP5 and DRP6.

2. However, the best rates of acceptance by physicians were achieved by interventions regarding with DRP1, DRP2 and DRP5.

Reference

1. Hasan SS, et al. Impact of pharmacists’ intervention on identification and management of drug-drug interactions in an intensive care setting. Singapore Med J 2012;53(8):526–31

ReferenceNo conflict of interest.