Clinical Pharmacy Interventions In The ICU At A Tertiary Hospital In Jordan
DOI:
https://doi.org/10.52783/jns.v14.2628Keywords:
Intensive Care Units (ICUs), Retrospective descriptive study, NICU (Neonatal Intensive Care Unit), PICU (Pediatric Intensive Care Unit) MICU (Medical Intensive Care Unit), SICU (Surgical Intensive Care Unit), Dosage regimen adjustments, Antibiotic stewardAbstract
Background: Clinical pharmacists play a crucial role in Intensive Care Units by optimizing medication therapy, preventing adverse drug events, and contributing to improved patient outcomes. Despite their significance, limited data exist on the specific impact of clinical pharmacy interventions in ICUs within Jordan.
Objective: This study aims to identify the types and frequency of clinical pharmacist interventions across four main ICUs namely neonatal, pediatric, medical, and surgical ICUs at a tertiary academic hospital in Jordan. Additionally, it seeks to determine the most frequent treatments associated with these interventions.
Methods: A retrospective descriptive study was conducted at Jordan University Hospital from January 2024 to June 2024. Clinical pharmacist intervention records were reviewed, and data were collected on patient demographics, types of medications, and categories of interventions. The interventions were classified according to a standardized system based on clinical pharmacy guidelines.
Results: Dosage regimen adjustments were the most common intervention across all ICUs, particularly in the NICU (86.7%) and PICU (58%). The MICU had a high rate of interventions related to unnecessary drug therapy (25.6%) and additional diagnostic tests (42.8%). In the SICU, enoxaparin (12.5%) was among the most frequently adjusted medications. Antibiotic stewardship was a key area of pharmacist intervention, with vancomycin being the most frequently adjusted antibiotic across all ICUs.
Conclusion: Clinical pharmacists contribute significantly to patient care in ICUs by ensuring appropriate medication use, preventing errors, and optimizing therapy. The findings support the need for continued integration of clinical pharmacists in ICU teams to enhance patient safety and improve clinical outcomes. Future research should focus on evaluating the long-term impact of these interventions on patient morbidity, mortality, and cost-effectiveness.
Downloads
Metrics
References
Agius, R. (2024). Quality evaluation of clinical pharmacy services in an intensive care unit. Journal of Clinical Pharmacy.
Alsayed, H. A. H., Sharif-Askari, F. S., Sharif-Askari, N. S., & Halwani, R. (2024). Clinical pharmacist interventions in an intensive care unit reduces ICU mortality at a tertiary hospital in Dubai, United Arab Emirates. Exploratory Research in Clinical and Social Pharmacy, 14, 100431.
Althomali, A., Altowairqi, A., Alghamdi, A., Alotaibi, M., Althubaiti, A., Alqurashi, A., ... & Elrggal, M. E. (2022). Impact of clinical pharmacist intervention on clinical outcomes in the critical care unit, Taif City, Saudi Arabia: A retrospective study. Pharmacy, 10(5), 108.
Arredondo, E., Udeani, G., Horseman, M., Hintze, T. D., & Surani, S. (2021). Role of clinical pharmacists in intensive care units. Cureus, 13(9).
Chiang, L. H., Huang, Y. L., & Tsai, T. C. (2021). Clinical pharmacy interventions in intensive care unit patients. Journal of Clinical Pharmacy and Therapeutics, 46(1), 128-133.
Colin, S. L., & Nutti, C. (2022). Pharmaceutical intervention: Description of the role of the clinical pharmacist in intensive care units. Rev Bras Farm Hosp Serv Saude, 13(2), 0766.
Cvikl, M., & Sinkovič, A. (2020). Interventions of a clinical pharmacist in a medical intensive care unit–A retrospective analysis. Bosnian Journal of Basic Medical Sciences, 20(4), 495.
Cvikl, M., & Sinkovič, A. (2020). Interventions of a clinical pharmacist in a medical intensive care unit–A retrospective analysis. Bosnian Journal of Basic Medical Sciences, 20(4), 495.
Gu, H., Sun, L., Sheng, B., Gu, X., Wang, S., Liu, L., ... & Chen, W. (2023). Benefits of pharmacist intervention in the critical care patients with infectious diseases: A propensity score matching retrospective cohort study. Australian Critical Care, 36(6), 933-939.
Halpern NA, Goldman DA, Tan KS, Pastores SM: Trends in critical care beds and use among population groups and Medicare and Medicaid beneficiaries in the United States: 2000-2010. Crit Care Med. 2016, 44:1490-9.
Heselmans, A., Van Krieken, J., Cootjans, S., Nagels, K., Filliers, D., Dillen, K., ... & Ramaekers, D. (2015). Medication review by a clinical pharmacist at the transfer point from ICU to ward: A randomized controlled trial. Journal of Clinical Pharmacy and Therapeutics, 40(5), 578-583.
Hisham, M., Sivakumar, M. N., & Veerasekar, G. (2016). Impact of clinical pharmacist in an Indian Intensive Care Unit. Indian Journal of Critical Care Medicine, 20(2), 78.
Ho, C. K., Mabasa, V. H., Leung, V. W., Malyuk, D. L., & Perrott, J. L. (2013). Assessment of clinical pharmacy interventions in the intensive care unit. The Canadian Journal of Hospital Pharmacy, 66(4), 212.
Hou, J., Li, J. F., Yan, X. J., Zhang, Y. L., Zhang, M. Y., & Zhang, Y. (2023). The effect of clinical pharmacist intervention on renal function impairment in patients with antimicrobial-induced acute kidney injury in ICU. Patient Preference and Adherence, 711-718.
Kim, J. M., Park, S. J., Sohn, Y. M., Lee, Y. M., Yang, C. S., Gwak, H. S., & Lee, B. K. (2014). Development of clinical pharmacy services for intensive care units in Korea. SpringerPlus, 3, 1-7.
Kim, Y., Rho, J., Suh, Y., Choi, K., Lee, E., Lee, E., & Choi, C. W. (2018). Pharmacist Interventions in Neonatal Intensive Care Unit and Associated Cost Avoidance and Cost Savings. Journal of Korean Society of Health-System Pharmacists, 35(3), 281-291.
Kollef, M. H. (2013). Optimizing antibiotic therapy in critical care settings. Critical Care Medicine, 41(12), 2829-2840.
Leache, L., Aquerreta, I., Aldaz, A., Monedero, P., Idoate, A., & Ortega, A. (2020). Clinical and economic impact of clinical pharmacist interventions regarding antimicrobials on critically ill patients. Research in Social and Administrative Pharmacy, 16(9), 1285-1289.
Lee, A., Kim, Y., & Chen, H. (2022). Optimizing antibiotic use in pediatric ICUs. Journal of Pediatric Pharmacology and Therapeutics, 27(8), 456-470.
MacTavish, P., Quasim, T., Shaw, M., Devine, H., Daniel, M., Kinsella, J., ... & McPeake, J. (2019). Impact of a pharmacist intervention at an intensive care rehabilitation clinic. BMJ Open Quality, 8(3), e000580.
Mahmoodpoor, A., Kalami, A., Shadvar, K., Entezari-Maleki, T., & Hamishehkar, H. (2018). Evaluation of clinical pharmacy services in the intensive care unit of a tertiary university hospital in the Northwest of Iran. Journal of research in pharmacy practice, 7(1), 30-35.
Mas-Morey, P., Ballesteros-Fernández, A., Sanmartin-Mestre, E., & Valle, M. (2018). Impact of clinical pharmacist intervention on antimicrobial use in a small 164-bed hospital. European Journal of Hospital Pharmacy, 25(e1), e46-e51.
Mohammad, R. A., Betthauser, K. D., Korona, R. B., Coe, A. B., Kolpek, J. H., Fritschle, A. C., ... & Stollings, J. L. (2020). Clinical pharmacist services within intensive care unit recovery clinics: An opinion of the critical care practice and research network of the American College of Clinical Pharmacy. Journal of the American College of Clinical Pharmacy, 3(7), 1369-1379.
Muñoz‐Pichuante, D., & Villa‐Zapata, L. (2020). Benefit of incorporating clinical pharmacists in an adult intensive care unit: A cost‐saving study. Journal of Clinical Pharmacy and Therapeutics, 45(5), 1127-1133.
Nicolau, D. P. (2009). Pharmacokinetics of antibiotics in critically ill patients. Clinical Microbiology & Infections, 14(Suppl. 3), 13-20.
Rybak, M. J., et al. (2020). Therapeutic monitoring of vancomycin: A revised consensus guideline. American Journal of Health-System Pharmacy, 77(11), 835-864.
Zhang, Q., Li, J., & Zhou, W. (2022). Thromboprophylaxis in surgical ICUs: A review. The Journal of Critical Care, 37(2), 145-152.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
