Descriptive Analysis of Acceptance by Prescribers and Economic Benefit of Pharmacist Recommended Interventions in a Critical Care Unit

Lee, Yoon-Jung; Gettman, Lana

doi:10.24926/iip.v9i2.958

Cited by 4 publications

(3 citation statements)

References 38 publications

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“…12,14 Apart from; the acceptance rate was reported in the range of 47% to 93%, with a higher acceptance rate in developing countries. 12,14,20,42,[51][52][53][54] The current study depicted that the most common type of interventions provided were: discontinue drug(s) followed by add drug(s), change dose, and change route which was roughly similar with other studies. For instance, the most common interventions provided by Clinical Pharmacists were: add a drug, rectification of incomplete prescriptions, change of drug or dosage, and discontinue drug by the first study; 52 while add drug followed by reduce dose by the second study; 53 and reduce dose by the third study .…”

Section: Discussionsupporting

confidence: 82%

“…39 Another study added that the most common type of DTPs was unnecessary drug therapy followed by needs additional drug therapy. 14 The role of clinical pharmacists in the identification and resolution of DTPs was accessed and documented with a different result in general medical wards 12,20,42,[47][48][49][50] and the Surgery ward 8,21 with more intention of antimicrobial userelated problems, throughout the world. But, there was no data in Ethiopian Surgical wards and few data in medical wards that accessed the role of clinical pharmacists in identification and resolution of DTPs.…”

Section: Discussionmentioning

confidence: 99%

“…12 Also, clinical pharmacists are well-trained professionals in preventing and reducing the consequence of DTPs. 20,21 Thus, they are found to be cost-effective. Therefore, clinical practice should constitute the mainstream practice of clinical pharmacy in every ward rather than an "optional" specialty.…”

Section: Introductionmentioning

confidence: 99%

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<p>Drug Therapy Problems and the Role of Clinical Pharmacist in Surgery Ward: Prospective Observational and Interventional Study</p>

Tefera¹,

Zewudie²,

Jima³

et al. 2020

DHPS

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Background: Drug therapy problems (DTPs) are of major concern in health care because of the associated increased cost of treatment, morbidity, and mortality. Thus, clinical practice should constitute the mainstream practice of clinical pharmacy in every ward. However, nothing is known about DTPs and the role of clinical pharmacist in the surgical ward of Ethiopia (the neglected ward). Objective: To assess the prevalence of DTP among patients hospitalized at the surgical ward and the role of clinical pharmacists in their identification and resolution. Methods: Hospital-based prospective observational and interventional study design was used with daily patients' chart review using a semi-structured questionnaire among hospitalized adult patients at the surgical ward. After identification of DTP, verbal communication was used as a means of intervention with the treating physician. Acceptance of clinical pharmacist's intervention was considered only if a change was made to the patients' medication order. To identify determinants of DTPs, multiple stepwise forward logistic regression analysis was done by SPSS version 20.0. Statistical significance was considered at p-value < 0.05. Written informed consent was sought and the data were secured. Results: The response rate was 97.1% (300) for the final analysis. The mean (±SD = standard deviation) age of the participants was 42.62 ±18.29 with male (67%) predominance. DTP was identified in 76% of study participants. A total of 449 DTPs were identified, which equates with an average of 1.97 per patient. Dose too low 124/449 (27.6%) and dose too high 81/449 (18.0%) were found to be the most common types of DTPs. The intervention rate was 86.0% (196/228 per patients) and 86.2% (387/449 DTPs), with the acceptance rate of 85.2% (167/196 per patients) and 78% (302/387 per DTP) which mean (67.3%) 302/449 of the problems were fully resolved by the clinical pharmacist. Poly-pharmacy [AOR, 7.23; 95% CI, 2.29-22.13: P-value < 0.001] and hospital stay > 20 days [AOR, 5.42; 95% CI, 2.74-10.70; p < 0.001] were the only independent predictors for DTPs. Conclusion and Recommendation: This study identified a high prevalence of DTP which was independently predicted by the presence of poly-pharmacy and >20 days of hospital stay. The rate of intervention provided and acceptance from the physician was high, which is one indicator that the role of clinical pharmacists in the identification and resolution of DTP was paramount in the surgery ward and should be implemented as a must not as optional.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

<p>Drug Therapy Problems and the Role of Clinical Pharmacist in Surgery Ward: Prospective Observational and Interventional Study</p>

Tefera¹,

Zewudie²,

Jima³

et al. 2020

DHPS

View full text Add to dashboard Cite

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Independent pharmacist prescriber in critical care: One step closer with artificial intelligence

Saadah

Khan

Sulaiman

et al. 2022

Informatics in Medicine Unlocked

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A cost avoidance study of critical care pharmacists’ interventions in a tertiary institution in Singapore

Jeremy

Lin

2022

American Journal of Health-System Pharmacy

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Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose The economic impact of critical care pharmacists in the intensive care unit (ICU) setting has not been evaluated in Singapore despite ICUs being high-cost areas. This study was conducted to determine the costs avoided as a result of pharmacists’ interventions within multidisciplinary ICU teams in a tertiary hospital in Singapore. Methods A single-center, retrospective observational study of accepted pharmacists’ interventions was conducted over 6 months in 2020. We adopted a previously published systematic approach to estimate the costs avoided by the healthcare system through pharmacists’ interventions. Interventions were independently reviewed by a critical care pharmacist, an intensivist, and an investigator. Cost avoidance was calculated in terms of the additional ICU length of stay that would have resulted had a pharmacist not intervened as well as the direct cost savings achieved. Results There were 632 medication-related problems (MRPs) associated with the 527 accepted interventions, as some interventions involved multiple MRPs. The most common interventions included correcting inappropriate drug regimens (n = 363; 57%), recommending drug monitoring (n = 65; 10%) and addressing omission of drugs (n = 50; 8%). Over 6 months, gross cost avoidance and net cost avoidance achieved were $186,852 and $140,004, respectively, resulting in a ratio of potential monetary cost avoidance to pharmacist salary of 3.99:1. The top 3 interventions that resulted in the greatest cost avoidance were those that corrected inappropriate drug regimens ($146,870; 79%), avoided adverse drug events (ADEs) ($10,048; 5%), and led to discontinuation of medications without any indication ($7,239; 4%). Conclusion Pharmacists can reduce healthcare expenditure substantially through cost avoidance by performing various interventions in ICUs, particularly in the areas of correcting inappropriate drug regimens, avoiding ADEs, and discontinuing unnecessary medications.

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Descriptive Analysis of Acceptance by Prescribers and Economic Benefit of Pharmacist Recommended Interventions in a Critical Care Unit

Abstract: Background: Pharmacist clinical intervention is defined as the action that identifies and prevents medication-related problems

Cited by 4 publications

References 38 publications

<p>Drug Therapy Problems and the Role of Clinical Pharmacist in Surgery Ward: Prospective Observational and Interventional Study</p>

<p>Drug Therapy Problems and the Role of Clinical Pharmacist in Surgery Ward: Prospective Observational and Interventional Study</p>

Independent pharmacist prescriber in critical care: One step closer with artificial intelligence

A cost avoidance study of critical care pharmacists’ interventions in a tertiary institution in Singapore

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