Ten reasons for the presence of pharmacy professionals in the intensive care unit

McKenzie, Cathrine; Spriet, Isabel; Hunfeld, Nicole

doi:10.1007/s00134-023-07285-4

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…Given the specific needs of ICU patients, ensuring their medication safety is a critical concern. The European Society of Critical Care Medicine highlighted the need for pharmacy professionals in the ICU through an article published in Intensive Care Medicine, citing ten reasons, including the promotion of rational drug use and the benefits of pharmacovigilance ( McKenzie et al, 2024 ). Although the economic value of ICU pharmaceutical care is widely acknowledged, comprehensive economic evaluations remain scarce, with most studies focusing solely on cost-benefit analyses and lacking cost-effectiveness assessments ( Bosma et al, 2018 ; Crosby et al, 2023 ).…”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of pharmaceutical care in adult critically ill patients: based on a prospective cohort study

Wei,

Hu,

Chen

et al. 2024

Front. Pharmacol.

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BackgroundThe medication regimen for critically ill patients is complex and dynamic, leading to a high incidence of drug-related problems. This study aimed to assess the effectiveness and economic efficiency of pharmaceutical care for these patients.MethodsIn this prospective cohort study conducted in a tertiary hospital, adult patients were assigned either to a clinical pharmaceutical care group or a control group based on existing clinical grouping rules. Health outcomes and economic indicators were collected, followed by a cost-effectiveness analysis.ResultsThe acceptance rate for clinical pharmacist interventions was 89.31%. The pharmaceutical care group exhibited significant reductions in the rate of medication errors (40.65% vs. 61.69%, P < 0.001) and adverse drug events (44.52% vs. 56.45%, P = 0.020). The usage rates for special-grade antibiotics (85.16% vs. 91.13%, P = 0.009) and proton pump inhibitors (77.42% vs. 88.71%, P = 0.002) were also lower in the pharmaceutical care group. Secondary outcomes did not show significant differences in total hospital stay (21 days vs. 22 days, P = 0.092). However, ICU stay was significantly shorter (9 days vs. 11 days, P = 0.003) in the pharmaceutical care group. Cost-effectiveness analysis demonstrated that each 1% reduction in adverse drug events associated with ICU pharmaceutical care saved $226.75 in ICU hospitalization costs and $203.42 in total ICU drug costs. A 1% reduction in the medication error rate saved $128.57 in ICU hospitalization costs and $115.34 in total ICU drug costs.ConclusionsPharmaceutical care significantly reduces adverse drug events and medication errors, promotes rational use of medications, decreases the length of ICU stay, and lowers treatment costs in critically ill patients, establishing a definitive advantage in terms of cost-effectiveness.

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Section: Discussionmentioning

confidence: 99%

Cost-effectiveness analysis of pharmaceutical care in adult critically ill patients: based on a prospective cohort study

Wei,

Hu,

Chen

et al. 2024

Front. Pharmacol.

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“…A similar discussion was recently raised regarding the administration of methylene blue in septic shock [ 8 ]. This underscores the relevance of efficient interdisciplinary teams caring for critically ill patients, in which pharmacists have a pivotal role in optimizing safe and effective drug administration [ 9 ].…”

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confidence: 99%

Norepinephrine dose and concentration reporting: the devil is in the details

Kattan,

Ibarra-Estrada,

Jung

2024

Intensive Care Med

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A Case-Study of Metoclopramide Prescription Error : A Grim Reminder

Wallet,

Doudet,

Theissen

et al. 2024

J Med Syst

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The integration of Computerized Provider Order Entry (CPOE) systems in hospitals has been instrumental in reducing medication errors and enhancing patient safety. This study examines the implications of a software oversight in a CPOE system : Metoclopramide had a concentrated formulation (100 mg) delisted (and then not manufactured) in 2014 due to safety concerns. Despite this, the CPOE system continued to accept prescriptions for this formulation because it was not removed from the medication library by the pharmacist. The objective of our study was to describe this specific prescription error related to an outdated the medication library of the CPOE. We analyzed all metoclopramide prescriptions from 2014, to 2023. Our findings showed that errors involving 100 mg or more dosages were relatively rare, at 2.98 per 1000 prescriptions (34 errors in 11,372 prescriptions). Notably, 47.1% of these errors occurred during on-call shifts, and 68% of these errors led to actual administration. These errors correlated with periods of higher nurse workload. The findings advocate for the integration of dedicated pharmacists into ICU teams to minimize medication errors and enhance patient outcomes, and a proactive medication management in healthcare.

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Ten reasons for the presence of pharmacy professionals in the intensive care unit

Cited by 6 publications

References 13 publications

Cost-effectiveness analysis of pharmaceutical care in adult critically ill patients: based on a prospective cohort study

Cost-effectiveness analysis of pharmaceutical care in adult critically ill patients: based on a prospective cohort study

Norepinephrine dose and concentration reporting: the devil is in the details

A Case-Study of Metoclopramide Prescription Error : A Grim Reminder

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