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. 2016 Feb;20(2):78-83.
doi: 10.4103/0972-5229.175931.

Impact of clinical pharmacist in an Indian Intensive Care Unit

Mohamed Hisham  1 , Mudalipalayam N Sivakumar  1 , Ganesh Veerasekar  2
Affiliations

Impact of clinical pharmacist in an Indian Intensive Care Unit

Mohamed Hisham et al. Indian J Crit Care Med. 2016 Feb.

Abstract

Background and objectives: A critically ill patient is treated and reviewed by physicians from different specialties; hence, polypharmacy is a very common. This study was conducted to assess the impact and effectiveness of having a clinical pharmacist in an Indian Intensive Care Unit (ICU). It also evaluates the clinical pharmacist interventions with a focus on optimizing the quality of pharmacotherapy and patient safety.

Materials and methods: The prospective, observational study was carried out in medical and surgical/trauma ICU over a period of 1 year. All detected drug-related problems and interventions were categorized based on the Pharmaceutical Care Network Europe system.

Results: During the study period, average monthly census of 1032 patients got treated in the ICUs. A total of 986 pharmaceutical interventions due to drug-related problems were documented, whereof medication errors accounted for 42.6% (n = 420), drug of choice problem 15.4% (n = 152), drug-drug interactions were 15.1% (n = 149), Y-site drug incompatibility was 13.7% (n = 135), drug dosing problems were 4.8% (n = 47), drug duplications reported were 4.6% (n = 45), and adverse drug reactions documented were 3.8% (n = 38). Drug dosing adjustment done by the clinical pharmacist included 140 (11.9%) renal dose, 62 (5.2%) hepatic dose, 17 (1.4%) pediatric dose, and 104 (8.8%) insulin dosing modifications. A total of 577 drug and poison information queries were answered by the clinical pharmacist.

Conclusion: Clinical pharmacist as a part of multidisciplinary team in our study was associated with a substantially lower rate of adverse drug event caused by medication errors, drug interactions, and drug incompatibilities.

Keywords: Adverse drug reaction; critical care pharmacist; drug interaction; medication error.

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Figures

Figure 1
Figure 1
Visible Y-site drug incompatibility reported in our Intensive Care Unit between cefepime and vancomycin
Figure 2
Figure 2
Y-site drug compatibility chart prepared for most commonly used intravenous drugs in Intensive Care Unit
See this image and copyright information in PMC

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