외과계 중환자실 전담약사 유무에 따른 중재활동 변화 및 회피비용 분석
The Effects of Designated Pharmacist on Intervention and Cost Avoidance in the Surgical Intensive Care Unit
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Background : The prevention of adverse drug events had been documented by pharmacists in critically ill patients. The purpose of this study was to evaluate the effect of the designated pharmacists’interventions, acceptance rate and cost avoidance in the surgical intensive care unit (SICU) at a tertiary hospital in Korea. Methods : A retrospective observational study was conducted using electronic medical records. The frequencies of the interventions, acceptance rate, and type of interventions were observed. Cost avoidance was calculated from the potential benefit or harm of the pharmacists’recommendations and the expected extension of hospitalization without a pharmacist intervention. Results : The frequencies of the intervention increased from 0.16% to 0.56%(p 0.001) and the acceptance rate of the pharmacist intervention increased from 69% to 89%(p 0.05). Since the introduction of the designated pharmacist, pharmacists’interventions have expanded into the clinical field, such as total parenteral nutrition (TPN), drug recommendations and sharing treatment plans, possible adverse drug reactions, and therapeutic drug monitoring (TDM). The calculated avoidance cost per month associated with a designated pharmacists’intervention was 9,335,382 won/month. Conclusion : With the designated pharmacist, the frequencies of the pharmacists’intervention and the acceptance rate of interventions among the medical team increased. The cost avoidance from the pharmacists’interventions imply a potential economic advantage; therefore, it is necessary to evaluate the further economic effects of the pharmacists’intervention.
Abstract
Background : The prevention of adverse drug events had been documented by pharmacists in critically ill patients. The purpose of this study was to evaluate the effect of the designated pharmacists’interventions, acceptance rate and cost avoidance in the surgical intensive care unit (SICU) at a tertiary hospital in Korea. Methods : A retrospective observational study was conducted using electronic medical records. The frequencies of the interventions, acceptance rate, and type of interventions were observed. Cost avoidance was calculated from the potential benefit or harm of the pharmacists’recommendations and the expected extension of hospitalization without a pharmacist intervention. Results : The frequencies of the intervention increased from 0.16% to 0.56%(p 0.001) and the acceptance rate of the pharmacist intervention increased from 69% to 89%(p 0.05). Since the introduction of the designated pharmacist, pharmacists’interventions have expanded into the clinical field, such as total parenteral nutrition (TPN), drug recommendations and sharing treatment plans, possible adverse drug reactions, and therapeutic drug monitoring (TDM). The calculated avoidance cost per month associated with a designated pharmacists’intervention was 9,335,382 won/month. Conclusion : With the designated pharmacist, the frequencies of the pharmacists’intervention and the acceptance rate of interventions among the medical team increased. The cost avoidance from the pharmacists’interventions imply a potential economic advantage; therefore, it is necessary to evaluate the further economic effects of the pharmacists’intervention.
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