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5PSQ-005 Utility of the therapeutic complexity index adapted to critically ill patients as a method of stratification for pharmaceutical care
  1. L Doménech1,
  2. GZ Maria Blanca1,
  3. GD Maria Rosa1,
  4. GS Josep Maria2,
  5. L Pilar1,
  6. M Queralt Gorgas1
  1. 1Vall D´Hebron University Hospital, Pharmacy Department, Barcelona, Spain
  2. 2Consortium of Health And Social Care of Catalonia, Pharmacy Department, Barcelona, Spain


Background and Importance Intensive Care Unit workload pharmacist providing ICU clinical services has not been optimised.

Aim and Objectives To measure the complexity of medication regimens in adult ICU and analyse the utility of this indicator as a method for patient stratification in pharmaceutical care for critically ill patients.

Material and Methods Observational, descriptive, prospective study conducted at a third-level hospital. A cross-sectional approach was employed to review treatment regimens and measure the MRC-ICU (Medication Regimen Complexity Intensive Care Unit Index) for all ICU adult patients admitted.

Demographic variables and 23 items related to each patient’s treatment and clinical conditions were collected, then these items were scored as defined in table 2 of Gwynn et al. The MRC-ICU was calculated by summing the total score of the 23 items.

Results Seventy-one patients were included in the study (70% bed occupancy; 65% male), with a mean age of 58 ± 16.6 years.

Among these, six patients (8%) were classified as neurocritical, 12 with respiratory failure, 11 with traumatic injuries, 11 with coronary conditions, four postoperative cardiac patients, 17 post-lung transplants, five with septic shock and five with digestive semi-critical conditions. The average number of prescribed medications per patient was 18 ± 7.

At the time of the study, the mean length of stay was 22 ± 24 days, and the mean MRC-ICU was 13 ± 8. Respiratory failure exhibited the highest MRC-ICU (median 19; IQR 10–23), followed by post-lung transplant patients (median 17; IQR 14–23), septic shock (median 12; IQR 10–16), post-operative cardiac cases (median 10.5; IQR 9–12), and neurocritical conditions (median 9; IQR 5–14). The drugs contributing most to complexity were antibiotics, continuous perfusion sedoanalgesia, and immunosuppressants.

Conclusion and Relevance In our study, patients admitted to the ICU due to Acute Respiratory Failure or following Lung Transplantation exhibited MRC-ICU.

These patients may be considered as candidates for prioritised pharmaceutical care.

To optimise resources It would be necessary to correlate the score with the interventions performed by the pharmacist upon admission to the unit and those accumulated until discharge.

References and/or Acknowledgements 1. Gwynn ME et al. Development and validation of a medication regimen complexity scoring tool for critically ill patients. Am J Health Syst Pharm. 2019;76(Supplement_2):S34-S40.

Conflict of Interest No conflict of interest.

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