Pharmacotherapeutic Follow-up in a Respiratory Intensive Care Unit: Description and Analysis of Results

Overview

Journal Einstein (Sao Paulo)

Specialty General Medicine

Date 2018 Jun 28

PMID 29947642

Authors

Ana Carolina de Souza E Silva

Domingos Savio de Carvalho Sousa

Eunice Bobo de Carvalho Perraud

Fatima Rosane de Almeida Oliveira

Bruna Cristina Cardoso Martins

Affiliations

Soon will be listed here.

Abstract

Objective: To describe and evaluate the pharmacotherapeutic follow-up by a clinical pharmacist in an intensive care unit.

Methods: A descriptive and cross-sectional study carried out from August to October 2016. The data were collected through a form, and pharmacotherapeutic follow-up conducted by a clinical pharmacist at the respiratory intensive care unit of a tertiary hospital. The problems recorded in the prescriptions were quantified, classified and evaluated according to severity; the recommendations made by the pharmacist were analyzed considering the impact on pharmacotherapy. The medications involved in the problems were classified according to the Anatomical Therapeutic Chemical Classification System.

Results: Forty-six patients were followed up and 192 pharmacotherapy-related problems were registered. The most prevalent problems were missing information on the prescription (33.16%), and those with minor severity (37.5%). Of the recommendations made to optimize pharmacotherapy, 92.7% were accepted, particularly those on inclusion of infusion time (16.67%), and dose appropriateness (13.02%), with greater impact on toxicity (53.6%). Antimicrobials, in general, for systemic use were drug class most often related to problems in pharmacotherapy (53%).

Conclusion: Pharmacotherapeutic follow-up conducted by a pharmacist in a respiratory intensive care unit was able to detect problems in drug therapy and to make clinically relevant recommendations.

References

Fernandez-Llamazares C, Calleja-Hernandez M, Manrique-Rodriguez S, Perez-Sanz C, Duran-Garcia E, Sanjurjo-Saez M . Prescribing errors intercepted by clinical pharmacists in paediatrics and obstetrics in a tertiary hospital in Spain. Eur J Clin Pharmacol. 2012; 68(9):1339-45. DOI: 10.1007/s00228-012-1257-y. View

Horn E, Jacobi J . The critical care clinical pharmacist: evolution of an essential team member. Crit Care Med. 2006; 34(3 Suppl):S46-51. DOI: 10.1097/01.CCM.0000199990.68341.33. View

. Suggested definitions and relationships among medication misadventures, medication errors, adverse drug events, and adverse drug reactions. Am J Health Syst Pharm. 1998; 55(2):165-6. DOI: 10.1093/ajhp/55.2.165. View

Camire E, Moyen E, Stelfox H . Medication errors in critical care: risk factors, prevention and disclosure. CMAJ. 2009; 180(9):936-43. PMC: 2670906. DOI: 10.1503/cmaj.080869. View

Reis W, Scopel C, Correr C, Andrzejevski V . Analysis of clinical pharmacist interventions in a tertiary teaching hospital in Brazil. Einstein (Sao Paulo). 2013; 11(2):190-6. PMC: 4872893. DOI: 10.1590/s1679-45082013000200010. View

Agalu A, Ayele Y, Bedada W, Woldie M . Medication prescribing errors in the intensive care unit of Jimma University Specialized Hospital, Southwest Ethiopia. J Multidiscip Healthc. 2011; 4:377-82. PMC: 3215350. DOI: 10.2147/JMDH.S24671. View

Morimoto T, Sakuma M, Matsui K, Kuramoto N, Toshiro J, Murakami J . Incidence of adverse drug events and medication errors in Japan: the JADE study. J Gen Intern Med. 2010; 26(2):148-53. PMC: 3019321. DOI: 10.1007/s11606-010-1518-3. View

Overhage J, Lukes A . Practical, reliable, comprehensive method for characterizing pharmacists' clinical activities. Am J Health Syst Pharm. 1999; 56(23):2444-50. DOI: 10.1093/ajhp/56.23.2444. View

Leape L, Cullen D, Clapp M, Burdick E, Demonaco H, Erickson J . Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999; 282(3):267-70. DOI: 10.1001/jama.282.3.267. View

10.

Bohomol E, Ramos L, DInnocenzo M . Medication errors in an intensive care unit. J Adv Nurs. 2009; 65(6):1259-67. DOI: 10.1111/j.1365-2648.2009.04979.x. View

11.

Fideles G, de Alcantara-Neto J, Peixoto Junior A, de Souza-Neto P, Tonete T, da Silva J . Pharmacist recommendations in an intensive care unit: three-year clinical activities. Rev Bras Ter Intensiva. 2015; 27(2):149-54. PMC: 4489783. DOI: 10.5935/0103-507X.20150026. View

12.

Gallotti R . [Adverse events -- or is it normal?]. Rev Assoc Med Bras (1992). 2004; 50(2):114. DOI: 10.1590/s0104-42302004000200008. View

13.

Klopotowska J, Kuiper R, van Kan H, de Pont A, Dijkgraaf M, Lie-A-Huen L . On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: an intervention study. Crit Care. 2010; 14(5):R174. PMC: 3219276. DOI: 10.1186/cc9278. View