(213) A Clinical Pharmacist-Led Integrated Approach for The Evaluation of Drug-Related Problems Among Critically Ill Patients

Sunday, August 28, 2022

8:00 AM – 1:45 PM CEST

Location: Hall C

Publication Number: 1258

Presenting Author(s)

Chalasani Sri Harsha, MPharm
– JSS College of Pharmacy, Dept of Pharmacy Practice, JSS College of Pharmacy, Mysuru, Karnataka, India

Co-Author(s)

Priya Aradhya
– JSS College of Pharmacy, Karnataka, India
Ramesh Madhan, PhD
– Professor, JSS College of Pharmacy, Mysore, India
Subhash Chandra BJ
– JSS Medical College & Hospital, Karnataka, India

Background: Intensive Care Units have been highlighted as a prime setting for drug-related problem due to the complex nature of the patients making them vulnerable and hence require constant monitoring.

Objectives: To determine rate and pattern of drug related problems amongst patients admitted at critical care units (CCU) of tertiary hospital.

Methods: An interventional study was carried out for a period of six months in CCU. Patients were followed till their discharge. All the necessary data were collected and analysed. Hepler and Strand's classification was used to categorize the DRPs. The data was assessed categorically, and the predictors associated with DRPs are being determined using odds ratio with CI 95%, and p< 0.05.

Results: A total of 136 subjects enrolled who met the study criteria, of which 75 (55.14%) were males and 61 (44.86%) were females. Majority of the study population [78 (57%)] presented with more than two co-morbidities. Young-old group of the study participants {[61-70 years [38 (37.25%)]} had the majority co-morbid conditions with a hospital stay of 6-10 days. A total of 117 drug-related problems were identified, the majority of DRPs were Drug-Drug Interactions [38 (59%; n = 64)] were pharmacokinetic and rest were pharmacodynamic], followed by drug usage without indication (10.26%), overdoses (8.55%), untreated indication (6.84%), and adverse drug reactions (6.84%). 62 (57.26%) of the cases the level of significance of intervention made belonged to ‘major’ followed by [41(35.05%)] ‘moderate’ and only 9 [(7.69%)] attributed to ‘mild’ category. Of the 117 reported drug related problems, 107 [(91.46%)] DRPs were accepted in critical care units. Polypharmacy, and length of stay in CCUs are found to be predictors of the DRPs reported.

Conclusions: Drug interactions accounted to the major drug-related problem of CCUs, but not many were serious or significant. Clinical pharmacists' involvement in the healthcare team would reduce these occurrences, increase patient safety, and improve quality of life.