Objectives:

The goal of this study is to identify drug-related problems (DRPs) and risk factors associated with the emergence of DRPs in intensive care unit (ICU) patients. In addition, it was aimed to enlighten pharmacists who are considering specializing in the critical care pharmacy field in the future.

Methods:

This retrospective longitudinal study was performed in the anaesthesiology and reanimation ICU of a universityaffiliated tertiary care hospital. Identified DRPs by clinical pharmacists were classified by the Pharmaceutical Care Network Europe Classification for DRPs, v9.1. The DRPs, the relationship between various patient-related factors and risk factors associated with the emergence of DRPs are examined through statistical analysis.

Results:

In total, 222 patients were included in the study 128 (57.7%) of which were male. DRP count was 388 in 135 of patients (1.75 ± 2.47 DRPs per patient). In group in which at least 1 DRP identified, the duration of hospitalization was longer than the group in which no DRP identified (p<0.001). In groups in which there was the presence of mechanical ventilation support at admission or mortality, the mean DRP count was significantly higher than the other group (p<0.05). Age, duration of hospitalization, and the Acute Physiology and Chronic Health Evaluation II score at admission had positive relationships with the drug-related problem count, but the Glasgow Coma Scale shows a negative relationship (p<0.05). According to the binary logistic regression analysis, in which the age of the patient, the Glasgow Coma Scale score, the Acute Physiology and Chronic Health Evaluation II score at admission, the duration of hospitalization, and the presence of mechanical ventilation support at admission were included, only the Acute Physiology and Chronic Health Evaluation II score at admission and the duration of hospitalization have significantly affected the emergence of DRPs. The major problem was related to the treatment effectiveness (47.9%) and it was followed by treatment safety problems (29.9%). These problems’ major causes were dose selection (44.0%) and drug selection (36.8). The interventions made at drug level (97.2%) and prescriber level (2.3%). The acceptance rate of interventions and the resolution rate of the DRPs was found as 93.6% and 85.1%, respectively. The top three medications that caused DRPs the most were as follows: meropenem, colistin, and piperacillin-tazobactam.

Conclusion:

Clinical pharmacists detect and treat DRPs quickly. Our analysis shows that clinical pharmacy services are needed in high-drug-related problem wards like ICU.

Keywords: clinical pharmacist, critical illness, intensive care units, medication errors