Effectiveness of pharmaceutical care in an intensive care unit from China. a pre- and post-intervention study

ABSTRACT

To describe the development and implementation of pharmaceutical care services in an in-patient setting, and to examine the effectiveness of pharmacist interventions. A single-center, 2-phase [pre-/post-intervention phase] design was performed in an intensive care unit [ICU] of a university-affiliated hospital. Patients in the post-intervention phase [March 2011 to June 2011] received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase [December 2010 to March 2011] received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions. During the 3-month study period, the clinical pharmacist made 232 interventions for 416 admitted patients; of these, 202 [87.1%] were accepted by physicians or nurses, and dosage adjustment [n=83, [35.8%]] was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 [p 0.001]; medication errors, of incorrect dose or dosing interval, were markedly improved [decreased from 0.87 to 0.14; p<0.001], the drug cost per patientday decreased from $347.43 to $307.36 [p=0.095], and the length of ICU stay did not change significantly [6.14 days versus 5.93 days; p=0.14]. The presence of the pharmacist in the ICU resulted in significant reduction of medication errors and had potential drug-cost-saving effects, but did not have an influence on decreasing the length of ICU stay