Prevalence And Comparative Analysis Of Clinical Pharmacist’s Treatment Related Interventions Across Four Icus At A Teaching Hospital
DOI:
https://doi.org/10.52783/jns.v14.2640Keywords:
clinical pharmacist interventions, treatment related problems, critical care, ICUAbstract
Background: Treatment-related problems (TRPs) are a significant concern in intensive care units (ICUs), where critically ill patients often require complex treatment regimens. Despite their high prevalence, TRPs can be reduced through effective clinical pharmacist interventions. This study aimed to identify and analyze TRPs across different ICU types at a tertiary hospital in Jordan and provide targeted recommendations to optimize pharmaceutical care.
Methods: A retrospective descriptive analysis was conducted using data collected from ICU patients admitted between January and December 2024. The study focused on TRPs identified by clinical pharmacists in neonatal (NICU), medical (MICU), surgical (SICU), and pediatric (PICU) ICUs. Data on TRPs and pharmacist interventions were extracted from electronic medical records, categorized, and analyzed using descriptive statistics.
Results: A total of 10,445 TRPs were identified across the four ICUs. The most frequent TRPs in the NICU were therapeutic drug monitoring (TDM) (34.98%) and dosage regimen issues (32.05%). In the SICU, TDM (37.21%) and medication reconciliation issues (25.58%) were predominant. The MICU exhibited the highest prevalence of dosage regimen problems (30.30%) and a notable need for additional diagnostic tests (12.52%). In the PICU, dosage regimen issues accounted for 38.86% of TRPs, followed by TDM (16.67%). Across all ICUs, the resolution of TRPs improved progressively throughout the study period, with 50% resolved by the fourth quarter.
Conclusions: This study highlights the critical role of clinical pharmacists in managing TRPs and improving patient outcomes in ICUs. The findings emphasize the need for ICU-specific strategies, including enhanced TDM protocols, standardized dosing guidelines, and interdisciplinary collaboration, to address the unique challenges of each ICU type. These results provide a foundation for future quality improvement initiatives aimed at optimizing pharmaceutical care in critical care settings.
Downloads
Metrics
References
Abdelaziz, K., & Abdelrahim, M. E. (2015). Identification and categorisation of drug-related problems on admission to an adult intensive care unit. European Journal of Hospital Pharmacy, 22(3), 138–141.
Abu-Oliem, A., Al-Sharayri, M., & Hakuz, N. (2013). A clinical trial to investigate the role of clinical pharmacist in resolving/preventing drug related problems in ICU patients who receive anti-infective therapy. Jordan Journal of Pharmaceutical Sciences, 6(3), 239–246.
Acharya, U., Shankar, P. R., Palaian, S., Dangol, R., Jha, N., & Thakur, A. (2023). Pattern of drug therapy related problems encountered by clinical pharmacists in a critical care setting in Nepal. Pharmacy Practice (Granada), 21(2), 13.
Alam, K., Sharan, Y., Ghosh, N., Sarraf, D. P., & Sah, A. K. (2020). Pattern of medication related problems in patients admitted to intensive care units at a Teaching Hospital in Western Nepal: a Pharmacovigilance Study. Journal of Pharmaceutical Sciences and Research, 12(10), 1282-1287.
Albayrak, A., Başgut, B., Bıkmaz, G. A., & Karahalil, B. (2022). Clinical pharmacist assessment of drug-related problems among intensive care unit patients in a Turkish university hospital. BMC Health Services Research, 22(1), 79.
Ayhan, Y. E., Karakurt, S., & Sancar, M. (2022). The effect of the clinical pharmacist in minimizing drug‐related problems and related costs in the intensive care unit in Turkey: A non‐randomized controlled study. Journal of Clinical Pharmacy and Therapeutics, 47(11), 1867–1874.
Bansal, N., Momin, S., Bansal, R., Venkata, S. K. R. G., Ruser, L., & Yusuf, K. (2024). Pharmacokinetics of drugs: newborn perspective. Pediatric Medicine, 7.
Bekele, F., Bereda, G., Tamirat, L., Geleta, B. A., & Jabessa, D. (2021). “Childrens are not just “little adults”. The rate of medication related problems and its predictors among patients admitted to pediatric ward of southwestern Ethiopian hospital: A prospective observational study. Annals of Medicine and Surgery, 70, 102827.
Bilbao-Meseguer, I., Barrasa, H., Rodríguez-Gascón, A., Asín-Prieto, E., Maynar, J., Sánchez-Izquierdo, J. Á., ... & Isla, A. (2022). Optimization of levetiracetam dosing regimen in critically ill patients with augmented renal clearance: a Monte Carlo simulation study. Journal of Intensive Care, 10(1), 21.
Blaser, A., Starkopf, J., Moonen, P. J., Malbrain, M., & Oudemans-van Straaten, H. (2018). Perioperative gastrointestinal problems in the ICU. Anaesthesiology Intensive Therapy, 50(1).
Bowdle, T. A., Jelacic, S., & Nair, B. (2016). Evaluation of perioperative medication errors. Anesthesiology, 125(2), 429-431.
Çakir, A., Memiş, H., Gün, Z. Ü., & Biçakcioglu, M. (2024). Evaluation of drug-related problems of intensive care unit patients by clinical pharmacists: A retrospective study. Turkish Journal of Pharmaceutical Sciences, 21(4), 274–280.
Cierniak, K. H., Gaunt, M. J., & Grissinger, M. (2018). Perioperative medication errors: uncovering risk from behind the drapes. Penn Patient Saf Advis, 15(4), 22-38.
Cipolle, R. J., Strand, L. M., & Morley, P. C. (2012). Pharmaceutical care practice: the patient-centered approach to medication management (pp. 435-644). New York: McGraw-Hill Medical.
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.
Escriva Gracia, J., Aparisi Sanz, A., Brage Serrano, R., & Fernandez Garrido, J. (2021). Medication errors and risk areas in a critical care unit. Journal of Advanced Nursing, 77(1), 286-295.
Henry Basil, J., Premakumar, C. M., Mhd Ali, A., Mohd Tahir, N. A., & Mohamed Shah, N. (2022). Prevalence, causes and severity of medication administration errors in the neonatal intensive care unit: a systematic review and meta-analysis. Drug Safety, 45(12), 1457-1476.
Hisham, M., Sivakumar, M. N., & Veerasekar, G. (2016). Impact of clinical pharmacist in an Indian Intensive Care Unit. Indian Journal of Critical Care Medicine: Peer-Reviewed, Official Publication of Indian Society of Critical Care Medicine, 20(2), 78–83.
Jordan University Hospital., 2024, retrieved from:
Kane-Gill, S. L., Jacobi, J., & Rothschild, J. M. (2010). Adverse drug events in intensive care units: risk factors, impact, and the role of team care. Critical care medicine, 38, S83-S89.
Li, X. X., Zheng, S. Q., Gu, J. H., Huang, T., Liu, F., Ge, Q. G., ... & Shi, L. W. (2020). Drug-related problems identified during pharmacy intervention and consultation: implementation of an intensive care unit pharmaceutical care model. Frontiers in Pharmacology, 11, 571906.
MacTavish, P., Quasim, T., Purdie, C., Ball, M., Barker, L., Connelly, S., & McPeake, J. (2020). Medication-related problems in intensive care unit survivors: Learning from a multicenter program. Annals of the American Thoracic Society, 17(10), 1326–1329.
Martins, R. R., Silva, L. T., & Lopes, F. M. (2019). Impact of medication therapy management on pharmacotherapy safety in an intensive care unit. International Journal of Clinical Pharmacy, 41(1), 179–188.
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.
Noella, N. Y. I. R. A. M. B. A. R. U. S. H. I. M. A. N. A. (2022). Identifying medication errors in the neonatal intensive care unit in two hospitals in Rwanda: a cross-sectional study (Doctoral dissertation, University of Rwanda).
Özgan, B., Ayhan, Y. E., Apikoglu, S., & Karakurt, S. (2024). Clinical pharmacist interventions in nutrition-and drug-related problems in critically ill patients with renal dysfunction: a non-randomized controlled study. Frontiers in Medicine, 11, 1473719.
Póvoa, P., Moniz, P., Pereira, J. G., & Coelho, L. (2021). Optimizing antimicrobial drug dosing in critically ill patients. Microorganisms, 9(7), 1401.
Shirzad-Yazdi, N., Taheri, S., Vazin, A., Shorafa, E., Abootalebi, S. N., Hojabri, K., & Shafiekhani, M. (2024). Drug-related problems among pediatric intensive care units: Prevalence, risk factors, and clinical pharmacists’ interventions. BMC Pediatrics, 24(1), 714.
Tasaka, Y., Tanaka, A., Yasunaga, D., Asakawa, T., Araki, H., & Tanaka, M. (2018). Potential drug-related problems detected by routine pharmaceutical interventions: safety and economic contributions made by hospital pharmacists in Japan. Journal of pharmaceutical health care and sciences, 4, 1-11.
Tharanon, V., Putthipokin, K., & Sakthong, P. (2022). Drug-related problems identified during pharmaceutical care interventions in an intensive care unit at a tertiary university hospital. SAGE Open Medicine, 10, 20503121221090881.
Toukhy, A., Fayed, S., Sabry, N., & Shawki, M. (2021). The impact of an established pharmaceutical care pathway on drug related problems in an intensive care unit. The American journal of the medical sciences, 362(2), 143-153.
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.
