Tehran University of Medical Sciences

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Clinical and Economic Impact of Comprehensive Medication Management Implementation by Clinical Pharmacists in an Intensive Care Unit: A Cost-Benefit Analysis Publisher



Rezazadeh A1, 2 ; Hajimiri SH3, 4 ; Kebriaeezadeh A3, 4 ; Gholami K1, 2 ; Hashemian F5 ; Khoshnevisan A6 ; Mohebbi N1, 2
Authors
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Authors Affiliations
  1. 1. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Pharmacoeconomics and Pharmaceutical Administration, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
  6. 6. Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Pharmaceutical Health Services Research Published:2021


Abstract

Objectives: Critically ill patients are at risk of drug-related problems (DRPs) and healthcare-related cost. Clinical pharmacists are specifically trained in pharmacotherapy evaluation; they can identify and prevent DRPs. We aim to evaluate clinical and economic impact of clinical pharmacist by cost-benefit analysis in intensive care unit. Methods: This was a prospective, interventional study from healthcare provider perspective which conducted over 6 months in a neurosurgery intensive care unit (ICU) of a university hospital on 162 patients. A clinical pharmacist was dedicated to implement comprehensive medication management. All pharmacotherapy problems were categorized and economic impact of clinical pharmacist's interventions including cost-benefit ratio and net benefit in the ICU was assessed. Key findings: A total of 1524 interventions were done. The top five pharmacotherapy-related problems were defined as, drug selection (33.3%), dose adjustment (17.32%), fluid and electrolyte management (12.99%), drug discontinuation (12.07%) and therapeutic drug monitoring (6.75%). The minimum and maximum benefit-cost ratio was 8.4:1 to 12.7:1 and net benefit was $169,205 to $266,633, respectively over the 6-month period. Conclusions: The participation of a clinical pharmacist in a multidisciplinary ICU team by implementation of comprehensive medication management may reduce healthcare expenditures and improve drug safety. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.