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Observational Study
. 2018 Aug;52(8):713-723.
doi: 10.1177/1060028018759343. Epub 2018 Feb 18.

Critical Care Pharmacists and Medication Management in an ICU Recovery Center

Joanna L Stollings  1 , Sarah L Bloom  1 , Li Wang  1 , E Wesley Ely  1   2 , James C Jackson  2   3 , Carla M Sevin  1
Affiliations
Observational Study

Critical Care Pharmacists and Medication Management in an ICU Recovery Center

Joanna L Stollings et al. Ann Pharmacother. 2018 Aug.

Abstract

Background: Many patients experience complications following critical illness; these are now widely referred to as post-intensive care syndrome (PICS). An interprofessional intensive care unit (ICU) recovery center (ICU-RC), also known as a PICS clinic, is one potential approach to promoting patient and family recovery following critical illness.

Objectives: To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors.

Methods: A prospective, observational cohort study was conducted of all outpatient appointments of a tertiary care hospital's ICU-RC between July 2012 and December 2015. The pharmacist completed a full medication review, including medication reconciliation, interview, counseling, and resultant interventions, during the ICU-RC appointment.

Results: Data from all completed ICU-RC visits were analyzed (n = 62). A full medication review was performed in 56 (90%) of these patients by the pharmacist. The median number of pharmacy interventions per patient was 4 (interquartile range = 2, 5). All 56 patients had at least 1 pharmacy intervention; 22 (39%) patients had medication(s) stopped at the clinic appointment, and 18 (32%) patients had new medication(s) started. The pharmacist identified 9 (16%) patients who had an adverse drug event (ADE); 18 (32%) patients had ADE preventive measures instituted. An influenza vaccination was administered to 13 (23%) patients despite an inpatient protocol to ensure influenza vaccination prior to discharge. A pneumococcal vaccination was administered to 2 (4%) patients.

Conclusions: Use of a critical care pharmacist resulted in the identification and treatment of multiple medication-related problems in an ICU-RC as well as implementation of preventive measures.

Keywords: adverse drug event; medication reconciliation; pharmacist; post–intensive care syndrome; post–intensive care syndrome clinic.

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Conflict of interest statement

Declaration of Conflicting Interests

The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: Joanna L. Stollings, Sarah L. Bloom, Li Wang, and James Jackson have no conflicts of interest to disclose; E. Wesley Ely has received honoraria for CME activities from Pfizer, Abbott, and Orion and grant support from Dr Franz Kohler Chemie GmbH; Carla M. Sevin has no conflicts of interest to disclose.

Figures

Figure 1
Figure 1. Flow diagram of patients seen by the pharmacist at the intensive care unit recovery center
Abbreviations: ICU-RC, intensive care unit recovery center; SNF, skilled nursing facility; mo, months.
Figure 2
Figure 2. Medications discontinued at the intensive care unit recovery center
Abbreviations: H2, histamine 2; ICU-RC, intensive care unit recovery center.
Figure 3
Figure 3. Medications started at the intensive care unit recovery center
Abbreviations: H1, histamine 1; H2, histamine 2; ICU-RC, intensive care unit recovery center; NSAID, nonsteroidal anti-inflammatory drug.
See this image and copyright information in PMC

Comment in

References

    1. Needham DM, Davidson J, Cohen H, et al. Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference. Crit Care Med. 2012;40:502–509. - PubMed
    1. Elliott D, Davidson JE, Harvey MA, et al. Exploring the scope of post-intensive care syndrome therapy and care: engagement of non-critical care providers and survivors in a second stakeholders meeting. Crit Care Med. 2014;42:2518–2526. doi: 10.1097/CCM.0000000000000525. - DOI - PubMed
    1. Unroe M, Kahn JM, Carson SS, et al. One-year trajectories of care and resource utilization for recipients of prolonged mechanical ventilation: a cohort study. Ann Intern Med. 2010;153:167–175. - PMC - PubMed
    1. Herridge MS, Cheung AM, Tansey CM, et al. One-year outcomes in survivors of the acute respiratory distress syndrome. N Engl J Med. 2003;348:683–693. doi: 10.1056/NEJMoa022450. - DOI - PubMed
    1. Jackson JC, Hart RP, Gordon SM, et al. Six-month neuropsychological outcome of medical intensive care unit patients. Crit Care Med. 2003;31:1226–1234. - PubMed

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