Leache Leire, Aquerreta Irene, Aldaz Azucena, Monedero Pablo, Idoate Antonio, Ortega Ana
Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
Department of Anaesthesia and Intensive Care, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain.
Res Social Adm Pharm. 2020 Sep;16(9):1285-1289. doi: 10.1016/j.sapharm.2019.07.006. Epub 2019 Jul 8.
Incorporating in the Intensive Care Unit (ICU) a clinical pharmacist who performs interventions on antimicrobials may be cost-effective.
To evaluate the clinical and economic impact of clinical pharmacist interventions on antimicrobials in an ICU. To identify drug related problems and medication errors detected by the pharmacist.
A retrospective observational study was performed to analyze drug related problems, medication errors and clinical pharmacist interventions related to antimicrobials in adults admitted to an ICU in a 5-month period. The economic impact of pharmacist interventions was estimated considering difference in cost derived from antimicrobial treatment, adverse drug events and clinical pharmacist time.
A total of 212 drug related problems were detected in 114 patients, 18 being medication errors. Clinical pharmacist developed one intervention for each problem identified. 204 interventions (96.2%) were considered important with improved patient care and 7 (3.3%) very important. No negative impact of any intervention was identified. Physicians accepted 97.6% of the interventions. A potential saving of 10,905 € was estimated as a result of pharmacist interventions and 4.8 € were avoided per euro invested in a clinical pharmacist.
A clinical pharmacist performing interventions on antimicrobials in the ICU has a positive impact on patient care and decreases costs.
在重症监护病房（ICU）配备一名对抗菌药物进行干预的临床药师可能具有成本效益。
评估临床药师对抗菌药物的干预在ICU中的临床和经济影响。识别药师发现的药物相关问题和用药错误。
进行一项回顾性观察研究，以分析在5个月期间入住某ICU的成年患者中与抗菌药物相关的药物相关问题、用药错误和临床药师干预。考虑到抗菌药物治疗、药物不良事件和临床药师时间所产生的成本差异，估算药师干预的经济影响。
在114名患者中总共检测到212个药物相关问题，其中18个为用药错误。临床药师针对每个识别出的问题制定了一项干预措施。204项干预措施（96.2%）被认为对改善患者护理很重要，7项（3.3%）非常重要。未发现任何干预措施有负面影响。医生接受了97.6%的干预措施。药师干预估计可节省10905欧元，每投入1欧元用于临床药师可避免4.8欧元的花费。
在ICU中对抗菌药物进行干预的临床药师对患者护理有积极影响并可降低成本。
