Authors (including presenting author) :
Fung PC(1)
Affiliation :
(1)Pharmacy, Tuen Mun Hospital
Introduction :
Critically-ill patients are at higher risk of drug-related problems (DRPs). DRPs may result in undesirable clinical outcomes such as suboptimal treatment response and adverse drug events. Unlike the United States and other western countries, where clinical pharmacists are shown to improve patient outcomes in ICU, critical care pharmacist is not available in most public hospitals in Hong Kong.
Objectives :
This study aims to report DRPs identified and develop a pilot clinical pharmacy service in ICU wards in a local tertiary hospital.
Methodology :
A prospective, service-based study was conducted over one month in 2 ICU wards in Tuen Mun Hospital. Clinical pharmacy service was provided every weekday morning. A pharmacist reviewed medication orders of admitted cases and performed interventions to optimize therapeutic treatment. DRPs identified and interventions made were recorded and analyzed. Number of drug information equerries was also reported.
Result & Outcome :
During the one-month period, 25 DRPs were identified for 73 included patients. The most common types of DRP were related to “treatment effectiveness” (56%) and “treatment safety” (36%). Most DRPs (80%) were caused by inappropriate dose selections. Antibiotics (52%) followed by antiviral drugs (20%) was the most common drug associated with DRPs. Nine interventions were made to prescriber and 7 (78%) were accepted by ICU physicians. Two drug information were answered during service period. Pharmacist participation in the critical care can identify drug related problems and provide recommendations. Seventy-eight percent of pharmacist interventions were accepted and implemented by physicians. Clinical pharmacy service is welcomed by ward colleagues. Medication review can be prioritized to patients with more severe disease if there is limited recourse available. If a full-time clinical pharmacist is available, more clinical activities including medication reconciliation, therapeutic drug monitoring and drug education can be performed.
Co-location with:
