Role of pharmacist during COVID-19 pandemic: A retrospective study focused on critically ill COVID-19 patients

Abstract

Background and aim During the Coronavirus 2019 (COVID-19) crisis, there has been a huge demand for medications and unprecedented utilization of intensive care unit (ICU) services that subsequently and profoundly impacted the quality of medical care provided to COVID-19 patients. This study aimed to shed light on the role of pharmacists on the health care provided to critically ill COVID-19 patients. Methods A retrospective study, was conducted in Diriyah hospital in Riyadh, Saudi Arabia on all COVID-19 patients admitted to the ICU between June 27 th and August 15 th , 2020 until patients were transferred to the medical ward, discharged, or deceased. All medication related interventions performed by pharmacists have been documented electronically, collected and subsequently categorized and analyzed. Results The mean age of patients was 58.8 years (± 12.98 SD), with age of > 64 years in approximately 37 %. Four hundred and seventy interventions (470) were made by pharmacists of which 32 %, 11.7 %, 4 %, 2.6 %, 2.1 % were due to error in dosing regimens, drug duplication, missing drug information, drugs requiring prior authorization, and missing critical information, respectively; while 40.6 % were due to medication shortage of which 40.3% were substituted with alternative medications. Based on the analysis of drugs involved in interventions, medication groups that were mainly associated with interventions included antibiotics (16.8 %), electrolytes/minerals (11.7 %) and vitamins (9.4 %). Conclusion During health crises such as COVID-19 pandemic, the role of pharmacists in the ICU services becomes extremely crucial for providing better patients’ outcomes. Further studies should be conducted to follow up these findings in the context of COVID-19 pandemic.

Analysis of Hospital Pharmacists’ Interventions in a Covid -19 Isolation Centre of a Tertiary Hospital in Ghana

“…This is in line with published literature suggesting that hypertension is a risk factor for Covid-19 morbidity and mortality [34][35][36][37]. Again, in a pharmacists' intervention study in Saudi Arabia [26], hypertension and diabetes were the most prevalent comorbidities which were diagnosed in 59.5% and 58% of the patients respectively, quite higher compared to 35% and 18.7% obtained in our study. Other pharmacists' intervention studies also showed hypertension, diabetes, and renal impairment as most prevalent in a Covid-19 ward [38].…”

“…The mean age of our study is in line with other published literature related to pharmacists' intervention in a Covid-19 scenario. [26]. Other pharmacists' intervention studies in Covid-19 settings had more males than females [27], but other studies were quite similar to this study in terms of their mean age and percentage of females to males [28].…”

“…Drug shortage /drug refill accounted for 9% percent of medication errors detected in our study. This is quite low compared to a similar study that had a drug shortage of 40% [26]. Additionally, a study assessing the role of clinical pharmacy services showed that 26.6%, 21.5%, and 10.3% of pharmacist's interventions were related to drug discontinuation, drug dosing adjustments, and therapeutic drug monitoring, respectively [42].…”

“…Many studies have been conducted investigating the essential services delivered by pharmacists during the Covid-19 pandemic and concluded that pharmacists were likely to show a superior role during this pandemic in multiple aspects, such as providing drug information for healthcare providers, patient counseling, and provision of drug information to patients, ensuring the availability of all needed medications. [26].…”

Challenges and opportunities of clinical pharmacists during COVID-19: A review of the literature

“…They also helped with dose adjustment depending on patients' responses, laboratory results, body weight, renal or hepatic impairment, as well as the need for renal replacement therapy, such as hemodialysis or continuous renal replacement therapy (Gurnani et al, 2021;Surapat et al, 2021;Traynor, 2020). One retrospective study identified 470 interventions done by pharmacists to critically ill patients within less than 3 months during the pandemic (Alwhaibi et al, 2021). Most of these interventions pertained to suggesting alternatives to drugs on shortage.…”