Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Aug 14:14:1242779.
doi: 10.3389/fphar.2023.1242779. eCollection 2023.

Impact of clinical pharmacist-led intervention for drug-related problems in neonatal intensive care unit a randomized controlled trial

Nadir Yalçın  1 , Merve Kaşıkcı  2 , Hasan Tolga Çelik  3 , Karel Allegaert  4   5   6 , Kutay Demirkan  1 , Şule Yiğit  3
Affiliations

Impact of clinical pharmacist-led intervention for drug-related problems in neonatal intensive care unit a randomized controlled trial

Nadir Yalçın et al. Front Pharmacol. .

Abstract

Introduction: Drug-related problems (DRPs) incidence is higher in neonatal intensive care units (NICUs), compared to other pediatric wards due to aspects like off-label medications, pharmacokinetic/dynamic variability, or organ dysfunction/immaturity. This study aimed to determine whether and to what extent a clinical pharmacist intervention improves medication safety and prevents DRPs [medication errors (MEs), adverse drug reactions (ADRs), drug-drug interactions (DDIs)]. Methods: A prospective, randomized, double blind, controlled study in NICU-admitted neonates was conducted. NICU patients were randomly assigned to the intervention (clinical pharmacist-led) (IG) or control group (standard care such as clinical diagnosis, pharmacotherapy) (CG). The clinical pharmacist was involved in the IG to identify-prevent-intervene MEs, or identify and monitor ADRs and DDIs. The primary outcome was the number of neonates who developed at least one DRP compared with those seen across IG and CG. Secondary outcomes included length of hospital stay, total number of drugs or DRP type. Results: Neonates were randomly assigned to CG (n = 52) or IG (n = 48). In total, 45%, 42%, and 16% of patients had at least 1 MEs, ADRs, and clinically significant DDIs, respectively. The number of patients with at least 1 ME was 28 (53%) and 17 (35%) in the CG and IG (p>0.05). The median (range) number of ME was higher in CG [1 (0-7)] than in IG [0 (0-4)] (p = 0.003). Applying regression analysis, the CG had 2.849 times more MEs than the IG (p<0.001). Furthermore, the number of patients (CG to IG) with at least one detected ADR or clinical DDI was 19 (36%) to 23 (47%) (p>0.05) and 4 (7%) to 12 (25%), respectively (p = 0.028). Conclusion: Clinical pharmacist availability to systematically and standardized identify, prevent and resolve DRPs among NICU patients is effective. Daily detailed clinical pharmacist observations and interventions enables prevention and monitoring of DRPs. Clinical Trial Registration ClinicalTrials.gov, identifier NCT04899960.

Keywords: adverse drug reactions; clinical pharmacist (CP); drug-drug interactions (DDIs); drug-related problems (DRPs); medication errors; pharmaceutical care; pharmacotherapy optimization.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flow chart of the study procedure.
FIGURE 2
FIGURE 2
Scatter plots of total number of drugs, length of hospital stay and the number of medication errors.
FIGURE 3
FIGURE 3
Plots of Poisson Regression Model for the number of medication errors.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Abbassi A., Hasni N., Ben Hamida E. B. (2022). Impact of computerized physician order entry system on parenteral nutrition medication errors in a teaching neonatal intensive care unit. Ann. Pharm. Fr. 80 (6), 819–826. 10.1016/j.pharma.2022.05.002 - DOI - PubMed
    1. Alghamdi A. A., Keers R. N., Sutherland A., Ashcroft D. M. (2019). Prevalence and nature of medication errors and preventable adverse drug events in paediatric and neonatal intensive care settings A systematic review. Drug Saf. 42 (12), 1423–1436. 10.1007/s40264-019-00856-9 - DOI - PMC - PubMed
    1. Burckart G. J. (2012). Clinical pharmacology and clinical pharmacy A marriage of necessity Figure 1. Eur. J. Hosp. Pharm. Sci. Pract. 19 (1), 19–21. 10.1136/ejhpharm-2011-000002 - DOI
    1. Cady W. (1978). Clinical pharmacy vs. clinical pharmacology--is there a difference? J. Clin. Pharmacol. 18 (2-3), 157–159. 10.1002/j.1552-4604.1978.tb02439.x - DOI - PubMed
    1. Campino A., Lopez-Herrera M. C., Lopez-de-Heredia I., Valls I. S. A. (2008). Medication errors in a neonatal intensive care unit. Influence of observation on the error rate. Acta Paediatr. 97 (11), 1591–1594. 10.1111/j.1651-2227.2008.00982.x - DOI - PubMed

Associated data