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Drug-related problems identified during pharmacy intervention and consultation: Implementation of an intensive care unit pharmaceutical care model
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  • Xiao-Xiao LI,
  • Si-qian Zheng,
  • Jia-hui Gu,
  • Tao Huang,
  • Fang Liu,
  • Qing-gang Ge,
  • Bin Liu,
  • Chao Li,
  • Min Yi,
  • You-fa Qin,
  • Rongsheng Zhao,
  • Luwen Shi
Xiao-Xiao LI
Peking University Third Hospital
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Si-qian Zheng
Peking University Third Hospital
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Jia-hui Gu
Peking University School of Pharmaceutical Sciences
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Tao Huang
Peking University School of Pharmaceutical Sciences
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Fang Liu
Peking University Third Hospital
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Qing-gang Ge
Peking University Third Hospital
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Bin Liu
Peking University Third Hospital
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Chao Li
Peking University Third Hospital
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Min Yi
Peking University Third Hospital
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You-fa Qin
Affiliated Dongguan Shilong People’s Hospital of Southern Medical University
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Rongsheng Zhao
Peking University Third Hospital
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Luwen Shi
Peking University School of Pharmaceutical Sciences
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Abstract

Aim To identify common drug-related problems (DRPs) during pharmaceutical intervention and consultation in an intensive care unit (ICU); to explore the gap between physicians and pharmacists on their understanding of each other’s capabilities and needs. Method A single-center prospective study was conducted in the ICU of a tertiary academic hospital for 21 months. A pharmaceutical care (PC) model was implemented by pharmacy care team, and data was collected during pharmaceutical intervention and consultation. Data analysis was performed on identified DRPs, causes and their relationships. DRPs’ frequency during intervention and consultation was compared. Problem-level descriptive analysis and network analysis were conducted using R 3.6.3. Result Implementation of PC model greatly improved the efficacy of pharmacists in both interventions proposed to solve DRPs (from 13.6 to 20.1 cases per month) and number of patients being closely monitored (from 7.7 to 16.9 per month). Pharmacists identified 427 DRPs during pharmaceutical intervention with primarily adverse drug events (ADEs, 34.7%) and effect of treatment not optimal (25.5%), and 245 DRPs during consultation (mainly ADEs, 58.4%). About three-fifths DRPs were caused by antibiotics. Comparing DRPs identified during pharmaceutical intervention and consultation, physicians consulted pharmacists more on questions related to medication safety, while pharmacists also paid attention to treatment effectiveness being consulted less commonly. Conclusion Implementation of PC model is beneficial in guiding pharmacy practice and improving efficacy especially under limited human resources. Physicians and pharmacists shall continue ensuring drug safety and be familiar with the scope of PC and clinical need for a better cooperation.

Peer review status:Published

11 Sep 2020Published in Frontiers in Pharmacology volume 11. 10.3389/fphar.2020.571906