Effectiveness of pharmaceutical care in an intensive care unit from China. A pre- and post-intervention study

OBJECTIVE: To describe the development and implementation of pharmaceutical care services in an in-patient setting, and to examine the effectiveness of pharmacist interventions.

METHODS: A single-center, 2-phase (pre-/post-intervention phase) design was performed in an intensive care unit (ICU) of a university-affiliated hospital. Patients in the post-intervention phase (March 2011 to June 2011) received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase (December 2010 to March 2011) received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions.

RESULTS: During the 3-month study period, the clinical pharmacist made 232 interventions for 416 admitted patients; of these, 202 (87.1%) were accepted by physicians or nurses, and dosage adjustment (n=83, [35.8%]) was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 (p<0.001); medication errors, of incorrect dose or dosing interval, were markedly improved (decreased from 0.87 to 0.14; p<0.001), the drug cost per patient-day decreased from $347.43 to $307.36 (p=0.095), and the length of ICU stay did not change significantly (6.14 days versus 5.93 days; p=0.14).

CONCLUSION: The presence of the pharmacist in the ICU resulted in significant reduction of medication errors and had potential drug-cost-saving effects, but did not have an influence on decreasing the length of ICU stay.