Impact of medication therapy management on pharmacotherapy safety in an intensive care unit

Martins, Renato Rocha; Silva, Lunara Teles; Lopes, Flávio Marques

doi:10.1007/s11096-018-0763-0

Cited by 24 publications

(36 citation statements)

References 42 publications

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“…Most of the damages were considered temporary and required intervention. It is in accordance with the results of other studies (16,25) . The positive predictive value showed that the "Abrupt medication stop", "INR > 6" and "Serum glucose <50 mg/dl" had a greater ability to detect an adverse drug event when they were identified in medical records of patients.…”

Section: Discussionsupporting

confidence: 94%

Performance of the trigger tool methodology in the identification of adverse drug events in intensive care / Desempenho da metodologia trigger tool na identificação de eventos adversos a medicamentos em unidade intensiva

Agrizzi¹,

Castilho²

2021

Braz. J. Hea. Rev.

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Adverse drug events (ADE) may increase the length of hospital stay, cause complications in the patient's clinical condition, contribute to death and increase hospital costs. The aim of this study was to apply the trigger tool methodology based on the method proposed by the Institute for Healthcare Improvement for the detection of adverse drug events in an intensive care unit, assessing the incidence of event and the feasibility of incorporating this practice into the unit. After the development of a trigger list, a retrospective review was carried out on a random sample of 10 patient records / month, among patients over 18 years of age, of both sexes, who were hospitalized in the intensive care unit of the study hospital. The incidence of patients with adverse drug events was 15%, and the rate of ADE was 15.8 ADE / 100 medical records, with most (85%) of the events categorized as temporary damage requiring intervention. The main therapeutic classes involved in adverse events were antibiotics, anticoagulants, sedatives and hypoglycemic agents. The main advantage of the methodology was the ability to detect more adverse drug events than the voluntary notification, methodology present at the institution at that time.

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Section: Discussionsupporting

confidence: 94%

Performance of the trigger tool methodology in the identification of adverse drug events in intensive care / Desempenho da metodologia trigger tool na identificação de eventos adversos a medicamentos em unidade intensiva

Agrizzi¹,

Castilho²

2021

Braz. J. Hea. Rev.

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“…Due to severity of illness and major changes in organ function, critically ill patients have complex and changing pharmacokinetics and pharmacodynamics, requiring careful evaluation and drug therapy management. Considerable evidence supports the value of having clinical pharmacists (CPs) in ICUs during multidisciplinary critical care 2‐9 . In addition, numerous pharmaceutical economics studies have shown that pharmaceutical intervention can lead to cost savings 10‐18 …”

Section: What Is Known and Objectivementioning

confidence: 99%

Clinical pharmacy interventions in intensive care unit patients

2020

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“…Once pharmacists identify any DRPs, they report them to physicians and discuss with them the necessary corrective measures. There is ample evidence in the literature supporting the positive impact of pharmacists on the detection and resolution of DRPs, thereby improving patient safety and clinical outcomes 6,24,25 . The results also revealed individual efforts made by a growing number of pharmacists to implement clinical pharmacy services in the hospitals.…”

Section: Discussionmentioning

confidence: 95%

“…This requires pharmacists’ collaboration with other healthcare professionals and the patient in designing, implementing, and monitoring a therapeutic plan with the aim to identify, resolve, and prevent drug‐related problems (DRPs) 3,4 . In developed countries, collaborative practice models, such as medication therapy management have been adopted as frameworks in which pharmacists collaborate with patients, physicians, and other healthcare professionals to provide team‐based care to patients resulting in improved health outcomes 5‐7 …”

Section: Introductionmentioning

confidence: 99%

Enablers and challenges to pharmacy practice change in Kuwait hospitals: a qualitative exploration of pharmacists’ perceptions

Katoue

2020

Evaluation Clinical Practice

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Rationale, aims, and objectives The practice of hospital pharmacists in many developing countries has been changing to include the delivery of direct patient care services, but practice change can be a challenging process. This article explores the perceptions of hospital pharmacists in Kuwait about the enablers and challenges to expanding their scope of practice to include direct patient care. Methods A phenomenological qualitative approach was employed to conduct focus group interviews to explore pharmacists’ perceptions about their professional practice at different hospitals across Kuwait. Data were collected from 110 pharmacists using 11 focus group interviews. The interviews were audio‐recorded, transcribed verbatim, and analysed using framework analysis. Results The practice of most hospital pharmacists includes limited direct patient care role. However, a growing number of pharmacists have been introducing clinical pharmacy services at hospitals. Three themes about enablers to practice change emerged from data: (a) increasing physicians’ acceptance to pharmacists’ role in patient care, (b) patients’ trust in pharmacists’ knowledge about medications, and (c) pharmacists’ perceived benefits of providing direct patient care. These benefits includes enhancing patients’ safety and adherence to therapy and improving the professional identity of pharmacists. Participants’ perceived challenges to practice change include professional, individual, and organizational challenges. Most participants welcomed assuming direct patient care role. They agreed that pharmacists need to receive adequate education and training and to be equipped with a clinical degree to responsibly provide direct patient care services at hospitals. Conclusions Pharmacists have been increasingly attempting to provide clinical pharmacy services in Kuwait hospitals. This qualitative data revealed breadth of challenges hindering pharmacists’ attempts to expand their professional practice to include direct patient care role. It also outlines facets of improvement and enablers to practice change. The collaboration between different stakeholders in the profession is essential to support pharmacists’ efforts in achieving the change in the scope of pharmacy practice to improve patient care services.

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Impact of medication therapy management on pharmacotherapy safety in an intensive care unit

Cited by 24 publications

References 42 publications

Performance of the trigger tool methodology in the identification of adverse drug events in intensive care / Desempenho da metodologia trigger tool na identificação de eventos adversos a medicamentos em unidade intensiva

Performance of the trigger tool methodology in the identification of adverse drug events in intensive care / Desempenho da metodologia trigger tool na identificação de eventos adversos a medicamentos em unidade intensiva

Clinical pharmacy interventions in intensive care unit patients

Enablers and challenges to pharmacy practice change in Kuwait hospitals: a qualitative exploration of pharmacists’ perceptions

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