Hamadalneel Yousif B, Ahmed Hifa O
Clinical Pharmacy & Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan.
Integr Pharm Res Pract. 2024 May 9;13:43-49. doi: 10.2147/IPRP.S459170. eCollection 2024.
Critical care pharmacists are uniquely qualified to provide a key role within the critical care multi-disciplinary team in managing the aspect of therapy, given their contributions to improved patient outcomes, medication safety, and reduced cost of the drug. Therefore, the purpose of this study was to assess the frequency, type, and impact of clinical pharmacist interventions in the Intensive Care Unit and their physicians' acceptance.
This was a cross-sectional, prospective study. Data were gathered over six months (15th June 2023 to 15th December 2023) on a daily basis, with a minimum sample size of 384 interventions. All patients admitted to the ICU at Wad Medani Teaching Hospital, Gezira State, Sudan during the study period were included.
In general, a total of 510 interventions were made for 123 patients throughout the six months course of study. Among them, 493 (96.7%) clinical pharmacist interventions were agreed by physicians. Among categories of interventions, most of the recommendations were concerned about safety 34.11% (174/510), in which drug discontinuation due to long duration was the highest one 48.27% (48/174) followed by the renal dose adjustment 30.46% (53/174). Another clinical intervention involving indication accounted for 23.33% (119/510) in second place. Regarding the cost-saving interventions the study showed that, of the total number of interventions, 124 had a costrelated component, accounting for (24.31%) of the total interventions. Among all the interventions, the addition of drug, with a frequency of 103 (20.2%) was the most recurring intervention, followed by dosing at 100 (19.6%), and renal dose adjustment at 53 (10.4%).
This study demonstrated how clinical pharmacists might enhance critical care patients' quality management while reducing the costs associated with medication and care. In addition, it contributes valuable insights into the integration of clinical pharmacists in ICU settings, especially in resource-limited environments.
鉴于重症监护药剂师对改善患者预后、用药安全及降低药物成本所做的贡献,他们在重症监护多学科团队中具备独特资质,能在治疗管理方面发挥关键作用。因此,本研究旨在评估临床药剂师在重症监护病房进行干预的频率、类型及影响,以及医生对这些干预的接受程度。
这是一项横断面前瞻性研究。在六个月(2023年6月15日至2023年12月15日)期间每天收集数据,最小样本量为384次干预。研究期间入住苏丹杰济拉州瓦德迈达尼教学医院重症监护病房的所有患者均被纳入。
总体而言,在为期六个月的研究过程中,共对123名患者进行了510次干预。其中,493次(96.7%)临床药剂师的干预得到了医生的认可。在各类干预中,大多数建议涉及安全性,占34.11%(174/510),其中因用药时间过长而停药的比例最高,为48.27%(48/174),其次是肾脏剂量调整,占30.46%(53/174)。另一个涉及适应证的临床干预占第二位,为23.33%(119/510)。关于节省成本的干预措施,研究表明,在所有干预措施中,有124项与成本相关,占总干预措施的(24.31%)。在所有干预措施中,添加药物的频率最高,为103次(20.2%),其次是给药调整,为100次(19.6%),肾脏剂量调整为53次(10.4%)。
本研究表明临床药剂师如何在降低药物和护理相关成本的同时,提高重症监护患者的质量管理水平。此外,它为临床药剂师融入重症监护病房环境,尤其是在资源有限的环境中,提供了有价值的见解。