An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers

• Published in: Journal of intensive care medicine 2023-10, Vol.38 (10), p.957-965
• Main Authors: Stollings, Joanna L., Poyant, Janelle O., Groth, Christine M., Rappaport, Stephen H., Kruer, Rachel M., Miller, Emily, Whitten, Jessica A., Mcintire, Allyson M., McDaniel, Cara M., Betthauser, Kevin D., Mohammad, Rima A., Kenes, Michael T., Korona, Rebecca Bookstavar, Barber, Alexandra E., MacTavish, Pamela, Dixit, Deepali, Yeung, Siu Yan A.
• Format: Article
• Language: English
• ISSN: 0885-0666; 1525-1489
• DOI: 10.1177/08850666231176194

Background Post-intensive care syndrome (PICS) is defined as a new or worsening impairment in physical, cognitive, or mental health following critical illness. Intensive care unit recovery centers (ICU-RC) are one means to treat patients who have PICS. The purpose of this study is to describe the role of pharmacists in ICU-RCs. Research Question What is the number and type of medication interventions made by a pharmacist at an ICU-RC at 12 different centers? Study Design and Methods This prospective, observational study was conducted in 12 intensive care units (ICUs)/ICU-RCs between September 2019 and July 2021. A full medication review was conducted by a pharmacist on patients seen at the ICU-RC. Results 507 patients were referred to the ICU-RC. Of these patients, 474 attended the ICU-RC and 472 had a full medication review performed by a pharmacist. Baseline demographic and hospital course data were obtained from the electronic health record and at the ICU-RC appointment. Pharmacy interventions were made in 397 (84%) patients. The median number of pharmacy interventions per patient was 2 (interquartile range [IQR] = 1,3). Medications were stopped and started in 124 (26%) and 91 (19%) patients, respectively. The number of patients that had a dose decreased and a dose increased was 51 (11%) and 43 (9%), respectively. There was no difference in the median total number of medications that the patient was prescribed at the start and end of the patient visit (10, IQR = 5, 15). Adverse drug event (ADE) preventive measures were implemented in 115 (24%) patients. ADE events were identified in 69 (15%) patients. Medication interactions were identified in 30 (6%) patients. Interpretation A pharmacist plays an integral role in an ICU-RC resulting in the identification, prevention, and treatment of medication-related problems. This paper should serve as a call to action on the importance of the inclusion of a pharmacist in ICU-RC clinics.