TY - JOUR
T1 - An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers
AU - Stollings, Joanna L.
AU - Poyant, Janelle O.
AU - Groth, Christine M.
AU - Rappaport, Stephen H.
AU - Kruer, Rachel M.
AU - Miller, Emily
AU - Whitten, Jessica A.
AU - Mcintire, Allyson M.
AU - McDaniel, Cara M.
AU - Betthauser, Kevin D.
AU - Mohammad, Rima A.
AU - Kenes, Michael T.
AU - Korona, Rebecca Bookstavar
AU - Barber, Alexandra E.
AU - MacTavish, Pamela
AU - Dixit, Deepali
AU - Yeung, Siu Yan A.
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2023/10
Y1 - 2023/10
N2 - Background: Post-intensive care syndrome (PICS) is defined as a new or worsening impairment in physical, cognitive, or mental health following critical illness. Intensive care unit recovery centers (ICU-RC) are one means to treat patients who have PICS. The purpose of this study is to describe the role of pharmacists in ICU-RCs. Research Question: What is the number and type of medication interventions made by a pharmacist at an ICU-RC at 12 different centers? Study Design and Methods: This prospective, observational study was conducted in 12 intensive care units (ICUs)/ICU-RCs between September 2019 and July 2021. A full medication review was conducted by a pharmacist on patients seen at the ICU-RC. Results: 507 patients were referred to the ICU-RC. Of these patients, 474 attended the ICU-RC and 472 had a full medication review performed by a pharmacist. Baseline demographic and hospital course data were obtained from the electronic health record and at the ICU-RC appointment. Pharmacy interventions were made in 397 (84%) patients. The median number of pharmacy interventions per patient was 2 (interquartile range [IQR] = 1,3). Medications were stopped and started in 124 (26%) and 91 (19%) patients, respectively. The number of patients that had a dose decreased and a dose increased was 51 (11%) and 43 (9%), respectively. There was no difference in the median total number of medications that the patient was prescribed at the start and end of the patient visit (10, IQR = 5, 15). Adverse drug event (ADE) preventive measures were implemented in 115 (24%) patients. ADE events were identified in 69 (15%) patients. Medication interactions were identified in 30 (6%) patients. Interpretation: A pharmacist plays an integral role in an ICU-RC resulting in the identification, prevention, and treatment of medication-related problems. This paper should serve as a call to action on the importance of the inclusion of a pharmacist in ICU-RC clinics.
AB - Background: Post-intensive care syndrome (PICS) is defined as a new or worsening impairment in physical, cognitive, or mental health following critical illness. Intensive care unit recovery centers (ICU-RC) are one means to treat patients who have PICS. The purpose of this study is to describe the role of pharmacists in ICU-RCs. Research Question: What is the number and type of medication interventions made by a pharmacist at an ICU-RC at 12 different centers? Study Design and Methods: This prospective, observational study was conducted in 12 intensive care units (ICUs)/ICU-RCs between September 2019 and July 2021. A full medication review was conducted by a pharmacist on patients seen at the ICU-RC. Results: 507 patients were referred to the ICU-RC. Of these patients, 474 attended the ICU-RC and 472 had a full medication review performed by a pharmacist. Baseline demographic and hospital course data were obtained from the electronic health record and at the ICU-RC appointment. Pharmacy interventions were made in 397 (84%) patients. The median number of pharmacy interventions per patient was 2 (interquartile range [IQR] = 1,3). Medications were stopped and started in 124 (26%) and 91 (19%) patients, respectively. The number of patients that had a dose decreased and a dose increased was 51 (11%) and 43 (9%), respectively. There was no difference in the median total number of medications that the patient was prescribed at the start and end of the patient visit (10, IQR = 5, 15). Adverse drug event (ADE) preventive measures were implemented in 115 (24%) patients. ADE events were identified in 69 (15%) patients. Medication interactions were identified in 30 (6%) patients. Interpretation: A pharmacist plays an integral role in an ICU-RC resulting in the identification, prevention, and treatment of medication-related problems. This paper should serve as a call to action on the importance of the inclusion of a pharmacist in ICU-RC clinics.
KW - adverse drug event
KW - medication reconciliation
KW - pharmacist
KW - post-intensive care syndrome
KW - post-intensive care syndrome clinic
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U2 - 10.1177/08850666231176194
DO - 10.1177/08850666231176194
M3 - Article
C2 - 37198935
AN - SCOPUS:85163008576
SN - 0885-0666
VL - 38
SP - 957
EP - 965
JO - Journal of Intensive Care Medicine
JF - Journal of Intensive Care Medicine
IS - 10
ER -