Heike Hilgarth1,2,3, Christian Waydhas3,4,5, Frank Dörje2,6, Julia Sommer6, Stefan Kluge7,8, Karl Peter Ittner9,10,11. 1. Klinikapotheke und Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland. 2. Ausschuss für Intensivmedizin und klinische Ernährung, ADKA - Bundesverband Deutscher Krankenhausapotheker e. V., Berlin, Deutschland. 3. Sektionsgruppe Qualitätsverbesserung und Informationstechnologie, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland. 4. Klinik und Poliklinik für Chirurgie, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Bochum, Deutschland. 5. Medizinische Fakultät, Universität Duisburg-Essen, Essen, Deutschland. 6. Apotheke des Universitätsklinikums Erlangen, Universitätsklinikum Erlangen, Erlangen, Deutschland. 7. Klinik für Intensivmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland. 8. Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland. 9. Sektionsgruppe Qualitätsverbesserung und Informationstechnologie, Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI), Berlin, Deutschland. karl-peter.ittner@ukr.de. 10. Lehr- und Forschungseinheit Pharmakologie, Fakultät für Medizin, Universität Regensburg, Regensburg, Deutschland. karl-peter.ittner@ukr.de. 11. Klinik für Anästhesiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland. karl-peter.ittner@ukr.de.
Abstract
BACKGROUND: Critically ill patients are particularly susceptible to adverse drug events. International studies show that pharmaceutical care has a positive impact on patient and drug therapy safety. Nationally, the integration of pharmacists into the multidisciplinary team and participation in ward rounds is required. The aim of this work is to assess the scope and extent of pharmaceutical care in intensive care units (ICU) in Germany. METHOD: In a literature and database search, 13 relevant pharmaceutical activities were identified. Based on this, an online survey with 27 questions on the implementation of pharmaceutical care in ICU was prepared by a panel of experts. The survey was sent to heads of German ICUs. RESULTS: Of the participants, 35.3% (59/167) have established regular pharmaceutical care. Drug information (89.7% [52/58]), pharmaceutical interventions with change of therapy (e.g., ward rounds; 67,2% [39/58]), regular evaluation of prescriptions (medication analysis; 65.5% [38/58]) as well as the monitoring of medication (e.g., side effects, effectiveness, costs; 63.8% [37/58]) were most frequently mentioned. The participants with pharmaceutical care (58/168) graded 7 of 13 but those without (104/168) only two activities as 'essential/indispensable'. CONCLUSION: Only a few ICU in Germany have already integrated ward pharmacists into the multidisciplinary team. Once a pharmaceutical service has been established, a greater role/importance is assigned to several pharmaceutical activities.
BACKGROUND: Critically ill patients are particularly susceptible to adverse drug events. International studies show that pharmaceutical care has a positive impact on patient and drug therapy safety. Nationally, the integration of pharmacists into the multidisciplinary team and participation in ward rounds is required. The aim of this work is to assess the scope and extent of pharmaceutical care in intensive care units (ICU) in Germany. METHOD: In a literature and database search, 13 relevant pharmaceutical activities were identified. Based on this, an online survey with 27 questions on the implementation of pharmaceutical care in ICU was prepared by a panel of experts. The survey was sent to heads of German ICUs. RESULTS: Of the participants, 35.3% (59/167) have established regular pharmaceutical care. Drug information (89.7% [52/58]), pharmaceutical interventions with change of therapy (e.g., ward rounds; 67,2% [39/58]), regular evaluation of prescriptions (medication analysis; 65.5% [38/58]) as well as the monitoring of medication (e.g., side effects, effectiveness, costs; 63.8% [37/58]) were most frequently mentioned. The participants with pharmaceutical care (58/168) graded 7 of 13 but those without (104/168) only two activities as 'essential/indispensable'. CONCLUSION: Only a few ICU in Germany have already integrated ward pharmacists into the multidisciplinary team. Once a pharmaceutical service has been established, a greater role/importance is assigned to several pharmaceutical activities.