Leire Leache1, Irene Aquerreta2, Azucena Aldaz3, Pablo Monedero4, Antonio Idoate5, Ana Ortega6. 1. Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: lleache@unav.es. 2. Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: iaquerreta@unav.es. 3. Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: aaldaz@unav.es. 4. Department of Anaesthesia and Intensive Care, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: pmonedero@unav.es. 5. Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: aidoate@unav.es. 6. Pharmacy Service, Clínica Universidad de Navarra, Avenida Pío XII 36, Pamplona, 31008, Spain. Electronic address: aortega@unav.es.
Abstract
BACKGROUND: Incorporating in the Intensive Care Unit (ICU) a clinical pharmacist who performs interventions on antimicrobials may be cost-effective. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: A clinical pharmacist performing interventions on antimicrobials in the ICU has a positive impact on patient care and decreases costs.
BACKGROUND: Incorporating in the Intensive Care Unit (ICU) a clinical pharmacist who performs interventions on antimicrobials may be cost-effective. OBJECTIVES: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: A clinical pharmacist performing interventions on antimicrobials in the ICU has a positive impact on patient care and decreases costs.
Authors: Tim M J Ewoldt; Alan Abdulla; Nicole G M Hunfeld; Anouk E Muller; Diederik Gommers; Suzanne Polinder; Birgit C P Koch; Henrik Endeman Journal: Ther Drug Monit Date: 2022-02-01 Impact factor: 3.118