A Standardized, Structured Approach to Identifying Drug-Related Problems in the Intensive Care Unit: FASTHUG-MAIDENS

Mabasa, Vincent H; Malyuk, Douglas L; Weatherby, Elisa-Marie; Chan, Alice

doi:10.4212/cjhp.v64i5.1073

Cited by 19 publications

(32 citation statements)

References 14 publications

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“…The DTP related to the indication were the second most detected group (37.5%). The discontinuation of the use of unnecessary medications has an impact on reducing the risk of adverse events, drug interactions, medication errors, and costs associated with hospitalization 23 . The introduction of an additional medication, in turn, is associated with the professional's ability to detect untreated conditions or prophylactic measures that require the use of medications.…”

Section: Rbfhss Revista Brasileira De Farmácia Hospitalar E Serviços mentioning

confidence: 99%

Description of a Comprehensive Medication Management service in an adult intensive care unit

Souza¹,

Nascimento²,

Oliveira³

et al. 2020

Rev Bras Farm Hosp Serv Saude

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Objective: To describe the results of a Comprehensive Medication Management (CMM) service offered to patients of an adult intensive care unit. Methods: A descriptive cross-sectional study of the results of the CMM service (April 2017 to November 2018). All the patients followed up in the CMM service were included in the sample of this study. The service was integrally based on the Pharmaceutical Care Practice and, therefore, used the Pharmacotherapy Workup (PW) method. the drug therapy Problems (DTP) were quantified and classified according to the PW method. The main medications involved in the DTP were also described, as well as the acceptance of the interventions by the multidisciplinary care team members and patients. Results: 146 patients were followed up during the study period, and 512 DTP were identified. Of these DTP, most were related to medication safety (37.7%) and to indication (37.5%). The main causes were high dose (23.0%, with emphasis on dose adjustments in cases of kidney injury), need for additional medication (18.9%, inclusion of medication for electrolytic, glycemic, and prophylactic control), and unnecessary medication (18.6%, emphasis on de-prescription of antibiotics that were not indicated). Most of the problems (23.6%) were related to the therapeutic class of systemic anti-infective agent. Of the total DTP detected, 81.6% were resolved. A total of 451 interventions were implemented, of which 92.9% (n=419) were with physicians. The majority of the interventions with physicians were accepted (n=344, 82.1%). Conclusion: A high number of drug therapy problems have been detected and resolved by the CMM pharmacist, with emphasis on safety problems. The high acceptability of the interventions reinforces the need for the service applied to the critical patient.

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Section: Rbfhss Revista Brasileira De Farmácia Hospitalar E Serviços mentioning

confidence: 99%

Description of a Comprehensive Medication Management service in an adult intensive care unit

Souza¹,

Nascimento²,

Oliveira³

et al. 2020

Rev Bras Farm Hosp Serv Saude

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“…FAST HUG MAIDENS is a mnemonic used to identify drug-related problems in the ICU. [ 3 ] Papadimos et al . used FAST HUG mnemonic to reduce the incidence of ventilator-associated pneumonia in a surgical ICU.…”

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confidence: 99%

FAST HUGS BID: Modified mnemonic for surgical patient

Nair¹,

Naik²,

Rayani³

2017

Indian Journal of Critical Care Medicine

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confidence: 99%

“…In this issue of the CJHP, we have 3 papers that once again remind us of the impact of adverse drug events and drug-related problems in hospital patients. [8][9][10] For over 20 years, pharmaceutical care has been the framework for our inpatient practice models. 11 Prolonged and continuous access to the patient, to the patient's information, and to other health care providers places hospital pharmacists in a unique practice setting ideal for the identification, resolution, and prevention of drug-related problems.…”

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confidence: 99%

Adverse Drug Events and Hospital Pharmacy Practice: Thinking Outside Our Box

Zed

2011

CJHP

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A dverse drug events are unfavourable occurrences related to the use and misuse of medications.1 It has been estimated that adverse drug events account for more than 17 million emergency department visits and almost 9 million hospital admissions annually in the United States.2,3 A cost-of-illness model published in 2001 estimated that annual costs associated with morbidity and mortality secondary to adverse drug events exceeded US$177 billion.3 Until recently, the effects of adverse drug events in Canada had not been characterized, but it is now evident that significant morbidity, mortality, and economic impact can be related to adverse drug events. More specifically, it has been estimated that as many as 25% of general medicine admissions and 12% of visits by adults to the emergency department in this country are directly related to adverse drug events, of which 70% are deemed preventable. 4,5 In the Canadian Adverse Events Study, 7.5% of all inpatients experienced an adverse event during their hospital stay and nearly 24% of the events were related to drug or fluid administration. 6 Finally, in another study, 23% of patients experienced an adverse event within 30 days after hospital discharge, 72% of the events were associated with drugs, and 50% of the events were preventable. 7These staggering data suggest that we have underestimated the magnitude of this problem but also that we are presented with a tremendous opportunity to explore and implement strategies for both inpatients and outpatients to reduce these events. In this issue of the CJHP, we have 3 papers that once again remind us of the impact of adverse drug events and drug-related problems in hospital patients. [8][9][10] For over 20 years, pharmaceutical care has been the framework for our inpatient practice models.11 Prolonged and continuous access to the patient, to the patient's information, and to other health care providers places hospital pharmacists in a unique practice setting ideal for the identification, resolution, and prevention of drug-related problems. However, despite attempts to improve the communication of patient information at the time of discharge to the community setting, it is well established that this transition is not seamless. Shortcomings in communication, follow-up, and monitoring place patients at risk in the immediate postdischarge period. 11,12 In the longer term, the system of dispersed health care providers in the community setting creates ongoing access and communication challenges. The community pharmacist's access to the patient's information and to other health care providers is also limited. Together, the complexities of these issues contribute to the high rates of adverse drug events that are seen both shortly after hospital discharge 8 and in the longer-term, ambulatory care setting. 13Examples exist of programs and practice models that attempt to address these problems. However, there remains an opportunity for hospital pharmacists, working with other health care providers, to further enhance the care provi...

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A Standardized, Structured Approach to Identifying Drug-Related Problems in the Intensive Care Unit: FASTHUG-MAIDENS

Cited by 19 publications

References 14 publications

Description of a Comprehensive Medication Management service in an adult intensive care unit

Description of a Comprehensive Medication Management service in an adult intensive care unit

FAST HUGS BID: Modified mnemonic for surgical patient

Adverse Drug Events and Hospital Pharmacy Practice: Thinking Outside Our Box

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