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Vol. 42. Num. 9.December 2018
Pages e23-e28Pages 517-572
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Vol. 42. Num. 9.December 2018
Pages e23-e28Pages 517-572
Original article
DOI: 10.1016/j.medine.2018.02.005
Pharmacist adscription to intensive care: Generating synergies
Adscripción del farmacéutico a cuidados intensivos: generando sinergias
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M.T. Franco Serenoa,
Corresponding author
mtfranco@sescam.jccm.es

Corresponding author.
, R. Pérez Serranoa, R. Ortiz Díaz-Miguelb, M.C. Espinosa Gonzálezb, H. Abdel-Hadi Álvarezb, A. Ambrós Checab, M. Rodríguez Martíneza
a Servicio de Farmacia, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
b Servicio de Medicina Intensiva, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
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Tables (5)
Table 1. Types of pharmaceutical interventions.
Table 2. Study variables.
Table 3. Types of interventions carried out.
Table 4. Interventions according to pharmacotherapeutic group.
Table 5. Intervention outcomes according to category.
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Abstract
Objective

To evaluate incorporation of the hospital pharmacist to the routine activity of an intensive care unit (ICU).

Design

A prospective observational study was carried out to evaluate the impact of pharmacist interventions, made by a pharmacist temporarily assigned to the ICU, upon medical prescriptions.

Setting

A medical and surgical ICU with 21 beds.

Patients

Patients with at least one ICU stay were included, while patients with admission and discharge in periods when the pharmacist was not present were excluded.

Interventions

The interventions were made after daily review of the prescriptions, and were communicated verbally or in writing to the supervising physician.

Main variables

Number of interventions, therapeutic group of the drugs involved, type of intervention and degree of acceptance.

Results

A total of 194 interventions were made in 62 patients. The majority were related to safety aspects (33%) and the optimization of therapy (32%). The most frequent interventions were the administration of drugs via the nasogastric tube (19%) and pharmacokinetic monitoring (14.4%). The most frequently involved groups of drugs were anti-infectious agents (33%) and digestive system medications (27%). A total of 56.2% of the interventions were made verbally, and 80% were accepted.

Conclusions

Pharmacist adscription to an ICU and the implementation of interventions on prescriptions have allowed improvement of safety and the optimization of pharmacotherapy in more than 50% of the patients. The high rate of acceptance of these interventions would support the implementation of such programs in critical care units.

Keywords:
Hospital pharmacy
Pharmacist interventions
Intensive care unit
Critical care team
Drug therapy
Safety
Resumen
Objetivo

Evaluar la incorporación de un farmacéutico de hospital a la actividad habitual de una unidad de cuidados intensivos (UCI).

Diseño

Estudio observacional prospectivo para evaluar las intervenciones farmacéuticas, realizadas por un farmacéutico adscrito temporalmente a una UCI, sobre las prescripciones médicas.

Ámbito

UCI médico-quirúrgica con 21 camas.

Pacientes

Se incluyeron los pacientes con al menos una estancia en UCI y se excluyeron los pacientes con ingreso y alta en periodos en los que no se contó con la presencia física del farmacéutico.

Intervenciones

Se realizaban tras la revisión diaria de las prescripciones y se comunicaban de forma verbal o escrita al médico responsable.

Variables principales

Intervenciones realizadas, grupo terapéutico de los medicamentos implicados, forma de realización de la intervención y el grado de aceptación.

Resultados

Se realizaron 194 intervenciones en 62 pacientes. La mayoría estaban relacionadas con aspectos de seguridad (33%) y optimización de la terapia (32%). Las más frecuentes se dirigieron a la administración de medicamentos por sonda nasogástrica (19%) y a la monitorización farmacocinética (14,4%). Los grupos de medicamentos más implicados fueron los antiinfecciosos en un 33% de los casos y los del aparato digestivo en un 27%. El 56,2% de las intervenciones se realizaron verbalmente y el 80% fueron aceptadas.

Conclusiones

La adscripción de un farmacéutico a una UCI y la realización de intervenciones sobre las prescripciones han permitido mejorar la seguridad y optimizar la farmacoterapia en más de la mitad de los pacientes. La alta tasa de aceptación de las mismas apoyaría la implementación de este tipo de programas en las unidades de críticos.

Palabras clave:
Farmacéutico de hospital
Intervenciones farmacéuticas
Unidad de cuidados intensivos
Equipo de cuidados intensivos
Farmacoterapia
Seguridad

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