외과계 중환자실 약사의 처방중재효과 평가
Effects of Pharmacist Interventions in a Surgical Intensive Care Unit
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Patients admitted to an intensive care unit (ICU) are at high risk for prescribingerrors. The presence of a pharmacist in the ICU has been shown to reduce the incidence of prescribingerrors, the length of stay and to prevent adverse drug events (ADEs). Since 25 March2013, pharmacists have started to participate in monitoring of medication and in rounding in thesurgical ICU (SICU) at the Samsung Medical Center. The purpose of this study was to evaluatethe effects of a pharmacist’s role in the SICU. A historical case control study was conducted by a retrospective electronic medical record chartreview. Therefore, patients were assigned to either the control group (patients who were admittedto the SICU from 25 March to 30 June 2012) or the intervention group (patients who wereadmitted to the SICU from 25 March to 30 June 2013). Demographic features, frequency andtypes of inappropriate prescribing, ADEs and length of stay in SICU were reviewed in both groups. A total of 8,523 medications for 151 patients in the intervention group and a total of 9,642 medicationprofiles for 160 patients in the control group were reviewed in each group. There were57(83%) drug-related interventions in the intervention group and 12(17%) information serviceswith pharmacist intervention. Thirty eight (67%) of drug-related interventions were found for anadjustment of the dosage regimen according to organ dysfunctions. The incidence of inappropriateprescribing per 1,000 monitored patient-days in was much lower in the intervention groupthan in the control group: 1.48 vs. 104.22 p<0.001. In the control group, the majority of inappropriateprescribing counted for an overdose of antibiotics. One preventable ADE occurred in thecontrol group. However, there were none in the intervention group. The length of stay in the ICUtended to be shorter and the number of hospital days to be smaller in the intervention group thanin the control group (3 days vs. 4 days. p=0.089, 16 days vs. 17 days, p=0.059). The intervention of a pharmacist in the SICU was associated with significant reductions ininappropriate prescribing and the number of ADEs.
Abstract
Patients admitted to an intensive care unit (ICU) are at high risk for prescribingerrors. The presence of a pharmacist in the ICU has been shown to reduce the incidence of prescribingerrors, the length of stay and to prevent adverse drug events (ADEs). Since 25 March2013, pharmacists have started to participate in monitoring of medication and in rounding in thesurgical ICU (SICU) at the Samsung Medical Center. The purpose of this study was to evaluatethe effects of a pharmacist’s role in the SICU. A historical case control study was conducted by a retrospective electronic medical record chartreview. Therefore, patients were assigned to either the control group (patients who were admittedto the SICU from 25 March to 30 June 2012) or the intervention group (patients who wereadmitted to the SICU from 25 March to 30 June 2013). Demographic features, frequency andtypes of inappropriate prescribing, ADEs and length of stay in SICU were reviewed in both groups. A total of 8,523 medications for 151 patients in the intervention group and a total of 9,642 medicationprofiles for 160 patients in the control group were reviewed in each group. There were57(83%) drug-related interventions in the intervention group and 12(17%) information serviceswith pharmacist intervention. Thirty eight (67%) of drug-related interventions were found for anadjustment of the dosage regimen according to organ dysfunctions. The incidence of inappropriateprescribing per 1,000 monitored patient-days in was much lower in the intervention groupthan in the control group: 1.48 vs. 104.22 p<0.001. In the control group, the majority of inappropriateprescribing counted for an overdose of antibiotics. One preventable ADE occurred in thecontrol group. However, there were none in the intervention group. The length of stay in the ICUtended to be shorter and the number of hospital days to be smaller in the intervention group thanin the control group (3 days vs. 4 days. p=0.089, 16 days vs. 17 days, p=0.059). The intervention of a pharmacist in the SICU was associated with significant reductions ininappropriate prescribing and the number of ADEs.
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