Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program.
- Author:
Jae Hee CHOI
1
;
Kyung Sook CHOI
;
Kwang Seup LEE
;
Sandy Jeong RHIE
Author Information
1. Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, South Korea. sandy.rhie@ewha.ac.kr
- Publication Type:Original Article
- Keywords:
drug interaction;
intensive care unit;
pharmacist;
pharmaceutical care
- MeSH:
Analgesics, Opioid;
Anti-Bacterial Agents;
Diuretics;
Drug Interactions*;
Electronic Health Records;
Furosemide;
Humans;
Incidence;
Intensive Care Units*;
Critical Care*;
Length of Stay;
Pharmaceutical Services*;
Pharmacists;
Pilot Projects;
Prescription Drugs;
Prevalence;
Retrospective Studies;
Tramadol
- From:Korean Journal of Clinical Pharmacy
2015;25(3):138-144
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. METHOD: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-Comp(R) Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed. RESULTS: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes. CONCLUSION: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.
