Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Okumura, Lucas Miyake; Silva, Daniella Matsubara da; Comarella, Larissa

doi:10.1016/j.rppede.2016.04.001

Cited by 13 publications

(24 citation statements)

References 13 publications

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“…This result was higher than what has been found in international and Brazilian studies conducted in general pediatrics, in which DRP ranged from 20 to 70%. [16][17][18][19][20][21] The result, however, is lower than what was observed in the study by Sabry et al, 11 in which all 60 cardiopathic children evaluated were exposed to DRP while in an Egyptian hospital. However, it is worth noting that local specificities, population characteristics, methods of identification and classification of DRPs and the follow-up time of the study make these comparisons difficult.…”

Section: Characteristics Valuecontrasting

confidence: 63%

“…22,23 Similar to pediatric studies, antimicrobials were the group of drugs most involved in GRP. [16][17][18][19][20]24,25 Some authors state that the risk of adverse events related to each drug is directly associated with the frequency of prescription. 24,25 However, similar to the findings of Blix et al, 26 in our study the most involved medications were not necessarily the most prescribed, showing that the risk of damage is related to the chemical and pharmacological characteristics of the medications, as well as patient characteristics.…”

Section: Characteristics Valuementioning

confidence: 99%

“…27,28 Pharmacists intervened in 17 out of every 20 DRPs identified, and virtually all of the proposed interventions were accepted by doctors and nurses, a finding also seen in other studies. 18,19,21 Thus, the broad support provided by the NICU professional team demonstrates the need to strengthen clinical pharmacy services as one of the main strategies for prevention and reduction of DRP.…”

Section: Characteristics Valuementioning

confidence: 99%

See 2 more Smart Citations

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Nascimento

Leopoldino

Santos

et al. 2020

Rev. paul. pediatr.

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Objective: To determine the frequency and nature of the Drug Related Problems (DRP) in neonates with cardiac diseases admitted to an Intensive Care Unit. Methods: This prospective cross-sectional study was developed at the Neonatal Intensive Care Unit (NICU) of a teaching maternity hospital in Brazil from January 2014 to December 2016. All neonates diagnosed with any heart disease (congenital heart disease, cardiomyopathy, arrhythmias, etc.) and who were admitted to the NICU for more than 24 hours with at least one prescribed drug were included in the study. Demographic and clinical data were collected from the records of the institution’s clinical pharmacy service. DRP and their respective interventions were independently reviewed and classified by two pharmacists. DRP classification was performed through the Pharmaceutical Care Network Europe v6.2 system. Results: 122 neonates were included in the study. The frequency of neonates exposed to DRP was 76.4% (confidence interval of 95% [95%CI] 65.9–82.0), with a mean of 3.2±3.8 cases/patient. In total, 390 DRP were identified, of which 49.0% were related to “treatment effectiveness”, 46.7% to “adverse reactions” and 1.0% to “treatment costs”. The medicines most involved in DRP were Vancomycin (10.2%; n=46), Meropenem (8.0%; n=36) and Furosemide (7.1%; n=32). Pharmacists performed 331 interventions, of which 92.1% were accepted by physicians and nurses. Conclusions: The study showed that DRP are very frequent in patients with cardiac diseases hospitalized in the NICU, predominating problems related to the effectiveness and safety of the drug treatment.

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Section: Characteristics Valuecontrasting

confidence: 63%

Section: Characteristics Valuementioning

confidence: 99%

Section: Characteristics Valuementioning

confidence: 99%

See 1 more Smart Citation

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Nascimento

Leopoldino

Santos

et al. 2020

Rev. paul. pediatr.

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“…In this journal, Okumura et al reported on their experience following introduction of a CPS into a single, 12 bed pediatric ICU 6. Already in a small sample of patients (n=53), the impact of the CPS on the detection of preventable ADE (n=141 events in 53 cases) was relevant.…”

Section: Can We Reduce the Burden Of Adverse Drug Events?mentioning

confidence: 99%

Adverse drug events in pediatric intensive care are common, but improvement strategies exist and are effective

Allegaert

2016

Revista Paulista de Pediatria (English Edition)

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“…The presence of clinical pharmacists in ICUs in countries with advanced clinical pharmacy services has reduced the number of adverse events, improved cost savings and medications, decreased mortality rates during ICU stay, and shortened the duration of ICU admission. Critical care pharmacists in those countries contributed greatly to patient safety and appropriate medication use 5,6,[10][11][12][13][14][15] . However, less information is known about MEs and role of clinical pharmacists in Middle Eastern and African countries [16][17][18] .…”

Section: Introductionmentioning

confidence: 99%

Untitled

2018

IJPSR

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Background: The limited evidence of the critical role of clinical pharmacists in Egyptian teaching hospitals led to the fact that critical care pharmacists' responsibilities are still focused on dispensing and drug distribution. Objective: Assess the important role of clinical pharmacy service activities in an Egyptian intensive care unit (ICU) by describing the impact of medication errors on clinical outcome of critically ill-patients with renal insufficiency. Methods: An observational retrospective cohort study was carried out over a five months period on patients admitted to ICU with estimated creatinine clearance (CrCl) less than 50 ml/min on admission and known to have chronic kidney disease (CKD). Patient records, physician orders, pharmacy and nursing notes of 69 patients were collected and reviewed by a clinical pharmacist. Medication errors were assessed. Main outcome measure was Length of ICU stay and mortality. Results: One hundred and seventeen MEs were identified; prescribing errors (58.9%), wrong administration technique (17.9%), drug-preparation errors (11.9%) and monitoring errors (11.1%). Errors in renal dose adjustment were the most frequent prescribing errors (66.7%). The length of ICU stay was positively correlated with number of medication errors per prescription (r=0.392, p=0.001) and mortality was associated with significantly higher number of medication errors (p=0.01). Only 29% of errors observed were documented in pharmacy records and 93% of documented pharmacy interventions were accepted by the physicians. Conclusion: Decreasing morbidity and mortality in critically ill Egyptian patients with renal insufficiency may be achieved through optimizing clinical pharmacy services with prescription intervention activities.

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Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Cited by 13 publications

References 13 publications

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Drug-Related Problems in Cardiac Neonates Under Intensive Care

Adverse drug events in pediatric intensive care are common, but improvement strategies exist and are effective

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