심장외과 중환자실에서 임상약사의 약처방 중재 활동 분석 (Analysis of Clinical Pharmacist Interventions in the Cardio-Surgical Intensive Care Unit)

서지정보

· 발행기관 : 한국병원약사회
· 수록지 정보 : 병원약사회지 / 38권 / 2호 / 185 ~ 194페이지
· 저자명 : 손유민, 고민지, 박효정, 이재현, 이용석, 이후경, 김정미, 조양현, 민명숙

초록

Background : It has been reported that clinical pharmacists’ participation in the multidisciplinary intensive care unit (ICU) team reduces the number of medication errors and improves the clinical outcome. However, studies assessing the role of pharmacists in a cardio-surgical ICU (CSICU) are limited. The aim of this study was to analyze pharmacologic interventions and identify pharmacologic problems that require pharmacist intervention in a CSICU.
Methods : The research was conducted by retrospectively reviewing the electronic medical records of patients aged 18 years or older who were admitted to the CSICU of Samsung Medical Center from April 1 2019 to June 30 2019.
Results : During the study, the clinical pharmacist monitored 12,021 drug prescriptions for 205 patients and conducted 379 pharmacologic interventions. The most common pharmacologic intervention recommended by the pharmacist was nutritional support (19.0%), followed by therapeutic drug monitoring (TDM) (18.5%) and provision of drug information (14.8%). The most frequently mediated group of drugs was antibiotics (31.1%), and the causes for pharmacologic intervention of antibiotics were mostly TDM (51.7%) and inappropriate dosage (20.3%). The intervention rate of ‘pain, sedation and delirium-related drugs’ was 17.2%, while the intervention rate of ‘antiarrhythmics, anticoagulant, and antiplatelet agents’ was 13.2%. The most common reason for intervention in both groups was missed prescriptions, followed by adverse drug events and inappropriate dosages. The acceptance rate of intervention was 92.2%.
Conclusion : Clinical pharmacists’ participation in the ICU has enabled active drug prescription monitoring, proper nutrition support, and TDM. The acceptance rate of intervention is high. The CSICU requires pharmacologic intervention of pain, sedation and delirium-related drugs specific to critically ill patients, as well as drugs indicated for cardio-surgery.

영어초록

Background : It has been reported that clinical pharmacists’ participation in the multidisciplinary intensive care unit (ICU) team reduces the number of medication errors and improves the clinical outcome. However, studies assessing the role of pharmacists in a cardio-surgical ICU (CSICU) are limited. The aim of this study was to analyze pharmacologic interventions and identify pharmacologic problems that require pharmacist intervention in a CSICU.
Methods : The research was conducted by retrospectively reviewing the electronic medical records of patients aged 18 years or older who were admitted to the CSICU of Samsung Medical Center from April 1 2019 to June 30 2019.
Results : During the study, the clinical pharmacist monitored 12,021 drug prescriptions for 205 patients and conducted 379 pharmacologic interventions. The most common pharmacologic intervention recommended by the pharmacist was nutritional support (19.0%), followed by therapeutic drug monitoring (TDM) (18.5%) and provision of drug information (14.8%). The most frequently mediated group of drugs was antibiotics (31.1%), and the causes for pharmacologic intervention of antibiotics were mostly TDM (51.7%) and inappropriate dosage (20.3%). The intervention rate of ‘pain, sedation and delirium-related drugs’ was 17.2%, while the intervention rate of ‘antiarrhythmics, anticoagulant, and antiplatelet agents’ was 13.2%. The most common reason for intervention in both groups was missed prescriptions, followed by adverse drug events and inappropriate dosages. The acceptance rate of intervention was 92.2%.
Conclusion : Clinical pharmacists’ participation in the ICU has enabled active drug prescription monitoring, proper nutrition support, and TDM. The acceptance rate of intervention is high. The CSICU requires pharmacologic intervention of pain, sedation and delirium-related drugs specific to critically ill patients, as well as drugs indicated for cardio-surgery.

참고자료

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