Background and importance Several associations of scientists and clinical pharmacists have developed the specialty of critical care pharmacists, among them the American College of Clinical Pharmacy, the American Society of Health System Pharmacist and the Operating Room Satellite Pharmacy Association. Patient safety and clinical outcomes are enhanced when clinical pharmacists participate proactively as a member of the multidisciplinary intensive care unit (ICU) team.

Aim and objectives To describe the pharmaceutical interventions (PIs) carried out by a resident pharmacist and its acceptance in a tertiary referral hospital.

Material and methods A prospective and descriptive study was carried out in an ICU of 30 beds in a tertiary referral hospital for 2 months, from July to August 2019. Pharmacist interventions, both proactive recommendations and resolution of question by the rest of the care team, were considered. Variables included were number of ICU admissions, number of PIs, drugs involved according to the anatomical therapeutic chemical (ATC) classification, type of PI and acceptance rate. PIs were classified into seven groups: dosage adjustment, pharmacokinetic monitoring, stopping treatment, switching to equivalent therapeutic drug or pharmaceutical form, information about drug administration, duplicity and other (eg, date and time of administration).

Results A total of 430 patients were admitted to the ICU during the study period. We performed 115 PIs in 66 patients (1 intervention/3 patients admitted): 13.9% were related to dosage adjustment, 24.4% to pharmacokinetic monitoring, 12.2% to stopping treatment, 2.6% to switching to an equivalent therapeutic drug or pharmaceutical form, 16.5% to drug administration information, 18.3% to drug duplicity and 12.2% other. Regarding ATC classification, 42.6% of PIs were related to group J, 13.9% to group B, 12.2% to group H, 6.1% to groups N and C, 4.4% to groups A and R, and 10.5% to group V. The acceptance rate was 94.5%.

Conclusion and relevance The clinical pharmacist integration into the ICU enhanced pharmacotherapy optimisation of critical patients, especially through pharmacokinetic monitoring and interventions related to anti-infective drugs. The acceptance rate was >90%, which indicated a considerable concern by the ICU team.

References and/or acknowledgements 1. Preslaski CR, Lat I, MacLaren R, Poston J. Pharmacist contributions as members of the multidisciplinary ICU team. Chest 2013;144:1687–1695.

No conflict of interest.