Clinical pharmacy interventions in intensive care unit patients

Area of Science:

• Clinical Pharmacy
• Critical Care Medicine
• Pharmacoeconomics

Background:

• Critically ill patients often have complex medication regimens requiring specialized management.
• Clinical pharmacists (CPs) play a vital role in evaluating and managing drug therapy in intensive care units (ICUs).
• Understanding drug-related problems (DRPs) is crucial for enhancing medication safety and quality.

Purpose of the Study:

• To analyze pharmaceutical care provided by CPs in a Taiwanese medical center's ICUs.
• To explore DRPs in ICU patients to improve drug therapy quality and safety.
• To identify key areas for pharmaceutical intervention in critical care settings.

Main Methods:

• Retrospective study from February 2019 to January 2020.
• CPs with at least 2 years of experience participated in ICU teams.
• Individualized drug treatment evaluation and intervention documented in Clinical Pharmacy Service Records, adhering to Taiwan's NHI Scheme for Improving Hospital Drug Safety and Quality.

Main Results:

• 12 CPs evaluated 4374 pharmacy care records.
• Medication reconciliation was the primary care category (67.2%).
• Interventions frequently addressed dosing errors (55.8%) and involved antimicrobial agents (81.3%).
• Patients with renal dysfunction needed more interventions (OR=1.63).
• 99.2% of interventions were accepted, with 90.8% implemented within 24 hours.

Conclusions:

• Pharmaceutical interventions were significantly higher for patients with renal dysfunction.
• Inappropriate dosing or frequency of antimicrobial agents were common issues requiring intervention.
• CPs' interventions are highly accepted and rapidly implemented, improving ICU drug safety.