Clinical Pharmacist Impact on Intensive Care Unit Delirium: Intervention and Monitoring

Lightfoot, Myaa; Sanders, Adam; Burke, Christopher; Patton, J.L.

doi:10.1177/0018578718778226

Cited by 12 publications

(28 citation statements)

References 11 publications

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“…Considering other interventions, studies have evaluated pharmacist interventions involving sedative medications, as many patients in ICU facilities are prescribed sedatives to treat agitation in addition to analgesics to treat pain and/or antipsychotics to treat delirium 21,22 . Our study demonstrates that these interventions are numerous, accounting for more than 50% of total interventions.…”

Section: Resultsmentioning

confidence: 88%

Benefit of Incorporating Clinical Pharmacists in an Adult Intensive Care Unit: A Cost‐saving Study

Muñoz‐Pichuante

Villa‐Zapata

2020

J Clin Pharm Ther

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What is known and objective A framework to evaluate the impact of clinical pharmacists in intensive care units (ICUs) in Chile has not yet been established. This study evaluates the cost avoidance and cost‐benefit ratios of clinical pharmacist interventions in terms of treatment optimization in an adult ICU in southern Chile. Methods Clinical pharmacist interventions in a multidisciplinary adult ICU were assessed between January and December 2019. Only interventions suggested by pharmacists and accepted by the healthcare team were included in the analysis. Interventions were classified into six categories, and cost avoidance (in US dollars) was calculated for each category using a systematic validated approach. A cost‐benefit ratio for clinical pharmacy services in the adult ICU was also calculated. Results and discussion Over the 12‐month period, 505 interventions were performed in 169 patients, of whom 62% were male. Interventions were classified into the following six categories: adverse drug event prevention (18%), which led to $87 882 in savings; resource utilization (ie change in medication route) (10%), which led to $50 525 in savings; individualization of patient care (ie dose adjustment) (36%), which led to $57 089 in savings; prophylaxis (ie initiation of stress ulcer prophylaxis) (<1%), which led to $167 in savings; hands‐on care (ie bedside monitoring) (23%), which led to $57 846 in savings; and administrative and supportive tasks (ie patient own medication evaluation) (13%), which led to $9988 in savings. The total cost savings over the year‐long period were $263 500, resulting in a cost‐benefit ratio of 1:24.2. What is new and conclusion The participation of a clinical pharmacist in a multidisciplinary ICU team reduces healthcare expenditures through treatment optimization translated into cost avoidance. This study has corroborated prior evidence that clinical pharmacist involvement in ICUs provides economic value and quality assurance in healthcare settings.

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Section: Resultsmentioning

confidence: 88%

Benefit of Incorporating Clinical Pharmacists in an Adult Intensive Care Unit: A Cost‐saving Study

Muñoz‐Pichuante

Villa‐Zapata

2020

J Clin Pharm Ther

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“…Key features of the included studies are shown in ►Table 3. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]…”

Section: Resultsmentioning

confidence: 99%

“…Of the 15 included studies, 5 were randomized controlled trials, 27,30,31,33,34 6 were quasi-experimental, 22,25,28,29,32,35 2 were observational, 23,26 and 2 were cohort studies. 21,24 All of the studies had a control group and all 15 studies were deemed as good quality using the Newcastle-Ottawa Scale.…”

Section: Study Qualitymentioning

confidence: 99%

Untitled

2021

Appl Clin Inform

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Background and SignificancePharmacists' roles have expanded from traditional medication verification and dispensing to team-based patient care. 1,2 Since the early 1970s, pharmacists have been tangentially involved with inpatient care through pharmacokinetic consultations. More recently, pharmacists are assuming providers' roles with collaborative practice agreements, which in some cases allow them to manage chronic health care conditions, such as diabetes and cardiovascular conditions. 1 Clinical pharmacists' roles are becoming more specialized through pharmacy residency training programs and specialty certification, and they are recognized as crucial members of the multidisciplinary health Keywords ► clinical decision support ► pharmacy information systems ► inpatient care ► pharmacy ► clinical informatics ► pharmacist

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“…* Some of the studies are underpowered to detect a difference and do not show statistically significant outcomes. 31,33,56,69,70,72 Psychiatric pharmacists also show statistically significant benefits on patient-level outcomes in at least 5 peer-reviewed publications by providing services, including medication reviews, patient education, à patient and/or data evaluation for medication safety and efficacy, 26,31,35,37,40,41,47 and independent management of medication therapy upon referral. 50,[76][77][78][79]81 Twenty (31.3%) of the included studies have at least 1 BCPP author with formal advanced training in psychiatry/ neurology.…”

Section: Resultsmentioning

confidence: 99%

Impact of pharmacists on outcomes for patients with psychiatric or neurologic disorders

Werremeyer

Bostwick

Cobb³

et al. 2020

Mental Health Clinician

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Introduction Psychiatric and neurologic illnesses are highly prevalent and are often suboptimally treated. A 2015 review highlighted the value of psychiatric pharmacists in improving medication-related outcomes. There is a need to describe areas of expansion and strengthened evidence regarding pharmacist practice and patient care impact in psychiatric and neurologic settings since 2015. Methods A systematic search of literature published from January 2014 to June 2019 was conducted. Publications describing patient-level outcome results associated with pharmacist provision of care in a psychiatric/neurologic setting and/or in relation to central nervous system (CNS) medications were included. Results A total of 64 publications were included. There was significant heterogeneity of published study methods and data, prohibiting meta-analysis. Pharmacists practicing across a wide variety of health care settings with focus on CNS medication management significantly improved patient-level outcomes, such as medication adherence, disease control, and avoidance of hospitalization. The most common practice approach associated with significant improvement in patient-level outcomes was incorporation of psychiatric pharmacist input into the interprofessional health care team. Discussion Pharmacists who focus on psychiatric and neurologic disease improve outcomes for patients with these conditions. This is important in the current health care environment as most patients with psychiatric or neurologic conditions continue to have unmet needs. Additional studies designed to measure pharmacists' impact on patient-level outcomes are encouraged to strengthen these findings.

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Clinical Pharmacist Impact on Intensive Care Unit Delirium: Intervention and Monitoring

Cited by 12 publications

References 11 publications

Benefit of Incorporating Clinical Pharmacists in an Adult Intensive Care Unit: A Cost‐saving Study

Benefit of Incorporating Clinical Pharmacists in an Adult Intensive Care Unit: A Cost‐saving Study

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Impact of pharmacists on outcomes for patients with psychiatric or neurologic disorders

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