Analysis of Pharmacist Interventions in Adult COVID-19 Patients Admitted to a Tertiary Care Hospital

Abstract

Background: Pharmacists are integral members of the multidisciplinary healthcare team who, with their skills, knowledge, and training, are well positioned to prevent, identify, and manage medication-related issues. Many published articles related to COVID-19 management have highlighted the important role of the pharmacists in assuring the safe, effective, and cost-effective use of medications. During such challenging times of COVID-19 pandemic that resulted in a high demand on medical resources and healthcare providers, pharmacists are well positioned to contribute and add more efforts to the healthcare system to achieve best use of the available resources including medications and providing high quality pharmaceutical care to help the patients and support the healthcare providers. Methods: This is a retrospective chart review included all admitted adult patients with confirmed COVID-19 diagnosis from 1 March 2020 till 30 June 2020. The documented clinical pharmacist interventions were extracted from the EMR and reviewed by multiple clinical pharmacists to identify type, number, frequency, outcome, and physician’s acceptance rate of documented interventions. Results: A total of 484 pharmacist interventions included in the final analysis. Antimicrobial stewardship interventions were the most reported (149, 30.8%) and antibiotics were the most reported class of medication, constituting 31.1% of the total interventions. “Optimized therapy” was the most commonly reported outcome (58.8%). Overall, 50.8% (246) of the interventions were rated as having “moderate” clinical significance using the clinical significance scoring tool. The physicians’ acceptance rate was 94.7%. Conclusion: Pharmacist interventions are associated with improved communication and medication use in admitted adult patients with COVID-19. Clinical pharmacists can play a crucial role in optimizing medication use in patients with COVID-19 through prevention, identification, and resolving existing or potential drug-related problems.

Interventions and Impact of Pharmacist-Delivered Services for People Infected with COVID-19: A Systematic Review

“…All studies were published in English and reported from February 2020 to January 2022. Three studies were prospective cohort studies [ 35 , 36 , 37 ], while the other four were retrospective observational studies [ 38 , 39 , 40 , 41 ]. Six studies were done in the inpatient setting [ 35 , 36 , 38 , 39 , 40 , 41 ], while one was done at a community pharmacy [ 37 ].…”

“…Three studies were prospective cohort studies [ 35 , 36 , 37 ], while the other four were retrospective observational studies [ 38 , 39 , 40 , 41 ]. Six studies were done in the inpatient setting [ 35 , 36 , 38 , 39 , 40 , 41 ], while one was done at a community pharmacy [ 37 ]. The studies’ sample sizes ranged from 22 [ 38 ] to 438 participants [ 35 ].…”

“…Besides Surapat et al [ 36 ], all included studies mentioned the follow-up duration but none mentioned the duration of interaction with either patient or physician. Two studies did not provide any information about the age of the patients [ 36 , 37 ], whereas five studies did provide the mean age of patients, i.e., 46.3–68 years [ 35 , 38 , 39 , 40 , 41 ]. The participants included in the studies were pharmacists, health care providers (HCP), such as physicians, and COVID-19 positive and negative patients (part of the control group).…”

“…Table 1 shows the overall quality scores (range 3–8 points) assigned to studies based on the research question by the authors. All studies failed to demonstrate that outcomes of interest were not present at the beginning of the study [ 35 , 36 , 37 , 38 , 39 , 40 , 41 ]. Biases in the non-exposed cohort selection [ 36 , 38 , 39 , 40 , 41 ], variations in the comparability of cohorts on a study design basis [ 36 , 38 , 39 , 40 , 41 ], and insufficient follow-up for outcomes of interest [ 36 , 38 ] were other reasons for the lower score.…”

“…A total of 2825 interventions were made by pharmacists in inpatients. Six studies identified dosage errors among the five most common reasons for intervention, including overdosing and underdosing [ 35 , 37 , 38 , 39 , 40 , 41 ]. TDM was second of the five most common interventions, which resulted in pharmacist-initiated alterations in prescribed medication regimes [ 35 , 37 , 38 , 40 , 41 ].…”