내과계 중환자실 팀활동을 통한 약사의 처방중재 활동 평가
Effect of Clinical Pharmacist’s Interventions in The Medical Intensive Care Unit
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Background : Patients admitted to an intensive care unit (ICU) present with diseases and conditions of high severity and are at high risk of adverse drug events (ADEs). In previous studies, pharmacist’s intervention has been shown to reduce the length of ICU day and enhance clinical effects. Since May 2015, a pharmacist has attended rounds in the medical ICU (MICU) at a severance hospital. Methods : From January 2014 to December 2014 and from January 2016 to December 2016, the intervention data were analyzed and clinical effects were estimated by reviewing the electronic medical records of patients admitted to the MICU. Results : During 2016, the number of interventions for MICU was 1202, which is significantly more than that for 2014, when 850 (70.7%) interventions were performed through individual review; also, the rate of acceptance in 1202 was higher than that in 2014. The most common intervention type was dose adjustment (589, 49%), followed by drug recommendation (250, 20.8%) and unnecessary prescription (124, 10.3%). The result of evaluating the clinical effects showed that the length of stay in the MICU tended to be shorter (9 days vs. 5 days, p 0.001) and the ICU mortality rate decreased (29.0% vs 22.1%, p=0.002). Conclusions : The applications of interventions through individual review have been more readily accepted by physicians than those through data processing. Participation of the pharmacist in the ICU team was associated with appropriate drug use and clinical efficacy of patients.
Abstract
Background : Patients admitted to an intensive care unit (ICU) present with diseases and conditions of high severity and are at high risk of adverse drug events (ADEs). In previous studies, pharmacist’s intervention has been shown to reduce the length of ICU day and enhance clinical effects. Since May 2015, a pharmacist has attended rounds in the medical ICU (MICU) at a severance hospital. Methods : From January 2014 to December 2014 and from January 2016 to December 2016, the intervention data were analyzed and clinical effects were estimated by reviewing the electronic medical records of patients admitted to the MICU. Results : During 2016, the number of interventions for MICU was 1202, which is significantly more than that for 2014, when 850 (70.7%) interventions were performed through individual review; also, the rate of acceptance in 1202 was higher than that in 2014. The most common intervention type was dose adjustment (589, 49%), followed by drug recommendation (250, 20.8%) and unnecessary prescription (124, 10.3%). The result of evaluating the clinical effects showed that the length of stay in the MICU tended to be shorter (9 days vs. 5 days, p 0.001) and the ICU mortality rate decreased (29.0% vs 22.1%, p=0.002). Conclusions : The applications of interventions through individual review have been more readily accepted by physicians than those through data processing. Participation of the pharmacist in the ICU team was associated with appropriate drug use and clinical efficacy of patients.
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