Clinical Pharmacist-Initiated Interventions for Medication-Related Problems in the Medical Intensive Care Unit of a Teaching University Hospital in South India: A Prospective Observational Study

Background

Medical Intensive Care Unit (MICU) admitted patients have complex drug regimens, serious underlying diseases which increase the risks of Medication-Related Problems (MRP). The study aims to identify, characterize and determine the effect of clinical pharmacist proposed interventions on improving patient safety and cost of care by evaluating MRPs in MICU.

Materials and Methods

The study was conducted for 8 months (April 2023 to November 2023) in the Department of MICU. Patients>24 hr of stay, consuming < 4 drugs and patients >18 years of age were enrolled in the study. A self-designed validated data collection form was prepared to collect patient details. The detected MRPs were mapped using the “Pharmaceutical Care Network European (PCNE) version 9.1”

Results

During the study period 705 patients were admitted to MICU out of them 382 were included. 489 MRPs were detected among 316 patients. MRP per patient was 1.54. The mean age was 62.78 years and disease per patient was 3.04. Most of the MRP were due to P1.1; No effect of drug treatment n=182 (37.22%). The major cause for the identified MRP was drug selection n=432 (34.28%). Majority of the interventions were planned at the drug level n=671 (50.93%), with an acceptance rate of 80.98%. Interventions accepted and fully implemented were 58.69%, Among these 74.64% of the problems had been resolved.

Conclusion

Integrating clinical pharmacist in the MICU team reduces the incidence of MRP, length of MICU and hospital stay and improves the patient’s health-related quality of life.