Pharmacist Adscription To Intensive Care: Generating Synergies

Abstract

Objective: To evaluate incorporation of the hospital pharmacist to the routine activity of an Intensive Care Unit (ICU).

Design: A prospective observational study was carried out to evaluate the impact of pharmacist interventions, made by a pharmacist temporarily assigned to the ICU, upon medical prescriptions.

Setting: A medical and surgical ICU with 21 beds.

Patients: Patients with at least one ICU stay were included, while patients with admission and discharge in periods when the pharmacist was not present were excluded.

Interventions: The interventions were made after daily review of the prescriptions, and were communicated verbally or in writing to the supervising physician.

Main variables: Number of interventions, therapeutic group of the drugs involved, type of intervention and degree of acceptance.

Results: A total of 194 interventions were made in 62 patients. The majority were related to safety aspects (33%) and the optimization of therapy (32%). The most frequent interventions were the administration of drugs via the nasogastric tube (19%) and pharmacokinetic monitoring (14.4%). The most frequently involved groups of drugs were anti-infectious agents (33%) and digestive system medications (27%). A total of 56.2% of the interventions were made verbally, and 80% were accepted.

Conclusions: Pharmacist adscription to an ICU and the implementation of interventions on prescriptions have allowed improvement of safety and the optimization of pharmacotherapy in more than 50% of the patients. The high rate of acceptance of these interventions would support the implementation of such programs in critical care units.

Keywords: Critical care team; Drug therapy; Equipo de cuidados intensivos; Farmacoterapia; Farmacéutico de hospital; Hospital pharmacy; Intensive Care Unit; Intervenciones farmacéuticas; Pharmacist interventions; Safety; Seguridad; Unidad de Cuidados Intensivos.