Korean J Clin Pharm.
2015 Sep;25(3):138-144. 10.0000/kjcp.2015.25.3.138.
Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program
- Affiliations
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- 1Graduate School of Clinical Health Sciences, Ewha Womans University, Seoul 120-750, South Korea. sandy.rhie@ewha.ac.kr
- 2Department of Pharmacy, Konkuk University Medical Center, Seoul 143-729, South Korea.
- 3Department of Pharmacy, Seoul National University Bundang Hospital, Kyunggi-do 463-707, South Korea.
- 4College of Pharmacy, Ewha Womans University, Seoul 120-750, South Korea.
- KMID: 2226404
- DOI: http://doi.org/10.0000/kjcp.2015.25.3.138
Abstract
OBJECTIVE
It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions. METHOD: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than 'D' was investigated by Lexi-Comp(R) Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed.
RESULTS
The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of 'C' (84.6%), 142 cases with a risk rating of 'D' (12.6%), and 31 cases with a risk rating of 'X' (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction. Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes.
CONCLUSION
Active participation of a pharmacist in the drug management at the intensive care unit should be considered.
MeSH Terms
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Analgesics, Opioid
Anti-Bacterial Agents
Diuretics
Drug Interactions*
Electronic Health Records
Furosemide
Humans
Incidence
Intensive Care Units*
Critical Care*
Length of Stay
Pharmaceutical Services*
Pharmacists
Pilot Projects
Prescription Drugs
Prevalence
Retrospective Studies
Tramadol
Analgesics, Opioid
Anti-Bacterial Agents
Diuretics
Furosemide
Prescription Drugs
Tramadol
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