Clinical pharmacy interventions for critically ill patients

• Published in: Journal of critical care Vol. 81; p. 154619
• Main Authors: Kara, Emre, Soysal, Hatice Yagmur, Yumrucu, Fatma Gul, Halacli, Burcin, Ersoy, Nazmiye Ebru Ortac, Demirkan, Kutay, Topeli, Arzu
• Format: Journal Article
• Language: English
• Published: Philadelphia Elsevier Inc 01-06-2024; Elsevier Limited
• Subjects: Clinical pharmacist; Critically ill; Drug stores; Drug-related problems; Intensive care; Pharmacists; Drug-related problems; Intensive care; Clinical pharmacist; Critically ill
• ISSN: 0883-9441; 1557-8615
• DOI: 10.1016/j.jcrc.2024.154619

Hospitalized patients in intensive care units (ICUs) frequently suffer from drug-related problems (DRPs). Clinical pharmacists may help to prevent, detect, and manage DRPs to improve drug safety and efficacy in multidisciplinary teams. This study aims to evaluate drug-related problems and clinical pharmacists' recommendations in the ICU of a university hospital in Turkey.
This study was carried out between January–February 2023 (2 months) in the ICU of a university hospital. All patients hospitalized in the ICUs were evaluated in the study, and patients with one or more clinical pharmacists were included. During the study period, the clinical pharmacists' interventions and responses to requests from physicians were recorded. DRPs were classified according to the Pharmaceutical Care Network Europe Drug Related Problem Classification V.9.1.
At least one recommendation was made for a total of 71 patients. The mean age of the patients was 59.8 ± 21.22 years, and 41% (n = 29) were women. One hundred twenty-nine different recommendations were proposed by clinical pharmacists. Of these, 16 (12.4%) were in response to the questions requests from physicians and 113 (87.6%) of them were related to the DRPs detected by the pharmacists during their daily ward rounds. 98.4% (n = 127) of the recommendations were accepted and 79.5% (n = 101) were implemented. Recommendations were most frequently made about meropenem (n = 28, 21.7%), enoxaparin (n = 10, 7.8%) and colistin (n = 9, 7.0%). 103 (91.1%) DRPs were probable and 10 (8.9%) DRPs were existing problems. The classification of drug-related problems and recommendations is given in Table 1.
The importance of the clinical pharmacists' interventions in the determination and management of DRPs was emphasized in this study. In our study, most DRPs were caused by drug doses, and most interventions were accepted.
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