(070) Evaluation of critical care clinical pharmacist services and Predictors in identifying the medication related problems in critically ill patients in South India- A hospital based interventional study

Publication Number: 733

Background: Intensive cardiac care patients have multiple of serious underlying diseases and complication like septic shock, sepsis. Medication -Related Problems are precipitate to despite the existence of standard guidelines, that compromises the therapy outcomes and burdens to the patient. Globally, 17.3 million people die from cardiovascular diseases each year, and by 2030, that number is projected to rise to 23.6 million.

Objectives: The aim of the study was to assess the critical care clinical pharmacist services, cost outcomes and initiate optimization of pharmacotherapy in patients with cardiac diseases.

Methods: A single center prospective interventional study with two phases was conducted in intensive cardiac care unit of a secondary care referral teaching hospital in South India. Study was carried out for a period of twelve months. Patient’s relevant data with DRPS were analyzed by using Pharmaceutical care Network European (PCNE V9.1). During pre-phase patient’s receives routine medical care whereas in post-phase receives critical care clinical pharmacist services and optimize the pharmacotherapy for identified drug related problem.

Results: The critical care clinical pharmacist in intensive Cardiac care unit made 464 interventions for 332 admitted patients. A total of 180 DRPs were identified from 211 patients. The rate of 169 DRPs in Pre-Phase and 42 DRPs in Post phase. The most frequent DRPs were ineffective drug therapy (35.29%) in pre-phase and in post phase (48.27%) effect of drug treatment not optimal. Most frequent causes were drug use process (22.97%). The average drug cost was 3969.92 in pre-phase and reduced to 2484.07 in post-phase. The rate of occurrence of DRPs were 0.7 per patient among the study subjects; DRP’s occurred at a rate of 0.9 among subjects in the pre-phase and 0.5 in the post-phase.

Conclusions: The presence of critical care pharmacist in intensive cardio care unit result in significant reduction of drug related problems and increased medication safety and thereby decreased economic burden to critically ill cardiac patients.