Background and importance Patients in an intensive care unit (ICU) are in a critical condition and often receive complex pharmacotherapy that needs to be adjusted frequently. It has been shown that a multidisciplinary approach, including pharmacists in the ICU team, improves the pharmacologic treatment of patients and helps to provide more individualised therapy.1
Aim and objectives The aim of this study was to identify the most common pharmaceutical care issues (PCI) in the ICU, to assess the acceptance rate of interventions by physicians and nurses made by the clinical pharmacist (CP), and to evaluate the time spent on chart reviews.
Material and methods This was a prospective observational study conducted in a 10 bed ICU in an acute care hospital during 2019. The clinical pharmacist visited the ICU 1–2 times a week and performed chart reviews. Recommendations were verbally communicated to the nurses and physicians, and interventions documented using the Pharmaceutical Care Network Europe classification of PCI.
Results During the study period, the CP visited the ICU 65 times and identified 232 PCI. On average, during each visit, 5 (n=315) patients’ charts were reviewed and 1.6 (n=147) interventions per patient were made. 80% (n=52) of the CPs’ visits lasted less than 60 min and of them, 27% (n=14) less than 15 min. The most common PCI were ‘wrong dosage form’ (12%, n=27), ‘subtherapeutic dose’ (11%, n=26), ‘need for additional drug’ (11%, n=25) and ‘inappropriate drug’ (10%, n=24). 136 (59%, n=232) PCI were accepted by physicians without adjustments, 8 (3%) were accepted with adjustments, 8 (3%) were not accepted and information was missing/not possible to assess for 75 (32%) PCI.
Conclusion and relevance This study shows that there is a need for a CP in the ICU. More regular visits and better collaboration with other healthcare professionals could improve patient outcomes.
References and/or acknowledgements
Cvikl M and Sinkovič A. Interventions of a clinical pharmacist in a medical intensive care unit—A retrospective analysis. Bosn J Basic Med Sci 2020;20:495–501.
Conflict of interest No conflict of interest
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