Background and Importance Clinical pharmacy services have been recently introduced in a local intensive care unit (ICU) and consequently, service evaluation is anticipated. There is the need for a tool to capture pharmaceutical interventions in ICU and assess their impact on specific patient outcomes.

Aim and Objectives To develop and validate a tool to describe and classify drug-related problems (DRPs) and pharmaceutical interventions (PIs) in ICU and evaluate the clinical relevance of the PI in preventing a potential Adverse Drug Event (pADE).

Material and Methods A classification system based on Pharmaceutical Care Network Europe (PCNE) V9.1 was identified to capture and resolve DRPs identified in ICU. The PCNE V9.1 classification provides extensive categories of DRPs. Evaluation of impact of PIs in preventing a pADE is conducted using an established score¹. The pADE score reflects the likelihood of an ADE occurring in the absence of a PI. The developed data collection tool was validated by an expert panel made up of three clinical pharmacists practising in ICU and a consultant intensivist. The expert panel assessed the tool for face and content validity and practicality in ICU setting. Subsequently, the tool was piloted in ICU for 10 days.

Results The data collection tool consists of seven sections namely patient demographics with details about pertinent laboratory results, description of DRP and PI, classification of DRP and PI, outcome of PI, and categorisation of medications involved. The final section of the tool relates to evaluation of PI in relation to prevention of a pADE and contains five categories, zero to high, which correspond to the probability of a pADE occurring if the pharmacist had not intervened. Examples from literature are presented for each pADE category to assist with the evaluation of PIs. Following validation and pilot testing, four sections were amended to better adapt the tool to ICU setting.

Conclusion and Relevance The development of such a data collection tool is important to standardise the classification of DRPs and interventions recommended by pharmacists in ICU. The tool contributes to data demonstrating value of pharmacist interventions on patient outcomes.

References and/or Acknowledgements 1. Nesbit TW, et al. Implementation and pharmacoeconomic analysis of a clinical staff pharmacist practice model. AJHP. 2001;58(9):784–790. DOI:10.1093/ajhp/58.9.784

Conflict of Interest No conflict of interest.