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On-ward participation of clinical pharmacists in a Chinese intensive care unit for patients with COVID-19: A retrospective, observational study.
Wang, Rongrong; Kong, Limin; Xu, Qiang; Yang, Ping; Wang, Xiaojuan; Chen, Na; Li, Lu; Jiang, Saiping; Lu, Xiaoyang.
  • Wang R; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Kong L; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Xu Q; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Yang P; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Wang X; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Chen N; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Li L; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
  • Jiang S; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address: j5145@zju.edu.cn.
  • Lu X; Department of Pharmacy, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Electronic address: luxiaoyang@zju.edu.cn.
Res Social Adm Pharm ; 17(1): 1853-1858, 2021 01.
Article in English | MEDLINE | ID: covidwho-548161
ABSTRACT

BACKGROUND:

The practical experiences of active pharmacists involved in managing critically ill patients with coronavirus disease 2019 (COVID-19) have been rarely reported.

OBJECTIVE:

This work aimed to share professional experiences on medication optimization and provide a feasible reference for the pharmaceutical care of critically ill patients with COVID-19.

METHODS:

This study was conducted in a COVID-19-designated hospital in China. A group of dedicated clinical pharmacists participated in multidisciplinary rounds to optimize the treatments for critically ill patients with COVID-19. Consensus on medication recommendations was reached by a multidisciplinary team through bi-daily discussion. Related drug, classification, cause, and adjustment content for recommendations were recorded and reviewed.

RESULTS:

A total of 111 medication recommendations were supplied for 22 out of 33 (56.7%) critically ill patients from 1 February 2020 to 18 March 2020, and 106 (95.5%) of these were accepted. Among these recommendations, 64 (67.7%), 32 (28.8%), and 15 (13.5%) were related to antibiotics and antifungals, antiviral agents, and other drugs, respectively. Recommendation types significantly differed for different anti-infectives (p < 0.05). For antibiotics and antifungals, treatment effectiveness accounted for 60.9% of recommendation types, with 15 (38.5%) cases related to untreated infections. For antiviral agents, adverse drug events were the most common recommendation types (84.4%), with 20 (74.1%) cases related to liver function dysfunction. Discontinuation of suspected antiviral agents (66.7%) was usually recommended after the occurrence of adverse events that may progress and bring poor outcomes.

CONCLUSION:

Forceful and extensive on-ward participation is recommended for clinical pharmacists in managing critically ill patients. Our experiences highlight the need for special attention toward untreated infections and adverse events related to antiviral agents.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmacists / Pharmacy Service, Hospital / COVID-19 / Intensive Care Units Type of study: Observational study / Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Res Social Adm Pharm Journal subject: Pharmacy Year: 2021 Document Type: Article Affiliation country: J.sapharm.2020.06.005

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmacists / Pharmacy Service, Hospital / COVID-19 / Intensive Care Units Type of study: Observational study / Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: Res Social Adm Pharm Journal subject: Pharmacy Year: 2021 Document Type: Article Affiliation country: J.sapharm.2020.06.005