Evaluation of drug-related problems of intensive care unit patients by clinical pharmacists: a retrospective longitudinal study

INTRODUCTION: Drug-related problems (DRPs) are commonly encountered in intensive care unit (ICU) patients. The goal of this study is to identify DRPs and risk factors associated with the emergence of DRPs in ICU patients. In addition, it was aimed to enlighten pharmacists who are considering specializing in the critical care pharmacy field in the future.
METHODS: This cross-sectional study was performed in the anaesthesiology and reanimation ICU of a university-affiliated tertiary care hospital. Identified DRPs by clinical pharmacists were classified by the Pharmaceutical Care Network Europe Classification for DRPs, v9.1. The DRPs, the relationship between various patient-related factors and risk factors associated with the emergence of DRPs are examined through statistical analysis.
RESULTS: In total, 388 DRPs were identified in 135 of 222 patients. In groups in which there was the presence of mechanical ventilation support at admission or mortality, the mean DRP count was significantly higher than the other group (p<0.05). Age, duration of hospitalization, and the Acute Physiology and Chronic Health Evaluation (APACHE) II score at admission had positive relationships with the DRP count, but the Glasgow Coma Scale shows a negative relationship (p<0.05). According to the binary logistic regression analysis, only the APACHE II score at admission and duration of hospitalization have significantly affected the emergence of DRPs. The top three medications that caused DRPs the most were as follows: meropenem, colistin, and piperacillin-tazobactam.
DISCUSSION AND CONCLUSION: Clinical pharmacists detect and treat DRPs quickly. Our analysis shows that clinical pharmacy services are needed in high-DRP wards like ICUs.