Clinical pharmacist services within intensive care unit recovery clinics: An opinion of the critical care practice and research network of the American College of Clinical Pharmacy

Abstract

Intensive care unit recovery clinics (ICU‐RCs) have been proposed as a potential mechanism to address the multifaceted unmet needs of intensive care unit (ICU) survivors and caregivers. The needs of this population include, but are not limited to, medication optimization, addressing physical function and psychological needs, coordination of care, and other interventions that may help in improving patient recovery and reducing the rate of preventable readmissions. The objective of this opinion paper is to identify and describe clinical pharmacy services for the management of ICU survivors and their caregivers in an ICU‐RC. The goals are to guide the establishment and development of clinical pharmacist involvement in ICU‐RCs and to highlight ICU recovery research and educational opportunities. Recommendations provided in this paper are based on the following: a review of published data on clinical pharmacist involvement in the ICU‐RCs; a consensus of clinical pharmacists who provide direct patient care to ICU survivors and caregivers; and a review of published guidelines and literature focusing on the management of ICU survivors and caregivers. These recommendations define areas of clinical pharmacist involvement in ICU‐RCs. Consequently, clinical pharmacists can promote education on Post Intensive Care Syndrome and Post Intensive Care Syndrome‐Family; improve medication adherence; facilitate appropriate referrals to primary care providers and specialists; ensure comprehensive medication management and medication reconciliation; provide assessment of inappropriate and appropriate medications after hospitalization; address adverse drug events, medication errors, and drug interactions; promote preventive measures; and facilitate medication acquisition with the goal of improving patient outcomes and reducing health care system costs.

Addressing the post-acute sequelae of SARS-CoV-2 infection: a multidisciplinary model of care

“…A comprehensive medication review is the core service provided by a pharmacist in a PASC clinic. 92 , 93 This multifaceted review encompasses medication de-prescribing, initiation or restarting of drug regimens, and therapy optimisation. Whereas stress ulcer prophylaxis in the ICU is classically associated with inappropriate continuation, any medication initiated for an inpatient indication has the potential to be inappropriately continued in the outpatient setting.…”

“…Restrictions on in-person primary care in 2020 might have resulted in missed immunisations, and changes in employment status or medication insurance coverage might affect the continuation of previous drug therapy. 92 , 93 A critical care clinical pharmacist is well positioned to address these challenges as part of an interdisciplinary clinic team. 94 Pharmacists work with a medication access team to ensure affordability and appropriate access to medications.…”

Postintensive care unit follow-up general health survey: A cross-sectional study in a tertiary academic hospital

“…A recent opinion paper identi ed and described services for the management of ICU survivors and support of their caregivers in intensive care unit recovery clinics (ICU-RCs). The paper concluded that an interprofessional team in ICU-RCs can play a vital role to promote education on as post-intensive care syndrome (PICS), improve medication adherence, ensure comprehensive medication management and medication reconciliation, provide assessment of inappropriate and appropriate medications after hospitalization, and address adverse drug events (ADEs) 13 .…”

The impact of a clinical pharmacist in an interprofessional intensive care unit recovery clinic providing care to intensive care unit survivors

“…Recent retrospective data supports the presence of pharmacists to provide medication management 11,12 . Based on this evidence, the American College of Clinical Pharmacy (ACCP) Critical Care Practice Research Network (PRN) recommended that pharmacists should be involved in ICU‐RCs and provided guidance in developing pharmacist services in ICU‐RCs 9 . Overall, ICU‐RC pharmacists are positioned to promote medication safety, efficacy and adherence 3,9,11‐15 …”