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KMID : 0941820150250030138
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Korean Journal of Clinical Pharmacy
2015 Volume.25 No. 3 p.138 ~ p.144
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Initiation of Pharmaceutical Care Service in Medical Intensive Care Unit with Drug Interaction Monitoring Program
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Choi Jae-Hee
Choi Kyung-Suk
Lee Gwang-Sup
Rhie Sandy Jeong
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Abstract
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Objective: It is to evaluate the drug interaction monitoring program as a pilot project to develop a pharmaceutical care model in a medical intensive care unit and to analyze the influencing factors of drug interactions.
Method: Electronic medical records were retrospectively investigated for 116 patients who had been hospitalized in a medical intensive care unit from October to December in 2014. The prevalence of adverse reaction with risk rating higher than ‘D’ was investigated by Lexi-Comp® Online database. The factors related with potential drug interaction and with treatment outcomes were analyzed.
Results: The number of patients with a potential interaction of drug combination was 92 (79.3%). Average ages, the length of stay in the intensive care unit and the numbers of prescription drugs showed significant differences between drug interaction group and non-drug interaction group. Opioids (14.4%), antibiotics (7.2%), and diuretics (7.2%) were most responsible drug classes for drug interactions and the individual medications included furosemide (6.4%), tramadol (4.9%), and remifentanil (4.5%). There were 950 cases with a risk rating of ‘C’ (84.6%), 142 cases with a risk rating of ‘D’ (12.6%), and 31 cases with a risk rating of ‘X’ (avoid combination) (2.8%). The factors affecting drug interactions were the number of drugs prescribed (p < 0.0001) and the length of stay at intensive care unit (p < 0.01). The patients in intensive care unit showed a high incidence of adverse reactions related to potential drug interaction.Therefore, drug interaction monitoring program as a one of pharmaceutical care services was successfully piloted and it showed to prevent adverse reaction and to improve therapeutic outcomes.
Conclusion: Active participation of a pharmacist in the drug management at the intensive care unit should be considered.
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KEYWORD
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drug interaction, intensive care unit, pharmacist, pharmaceutical care
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