Drug-related problems (DRPs) are a common problem in clinics that can have a negative impact on patients' treatment outcomes, cost of care and morbidity/mortality rates. The involvement of clinical pharmacist on patient care provides benefits to prevent and/or to manage those DRPs. This study aimed to determine the DRPs in the third-step intensive care unit (ICU) and to show the contributions of the clinical pharmacist to the management of these problems.

Patients and methods

This study was carried out prospectively between May 1st, 2021 and July 31st, 2022 in anesthesiology and reanimation ICUs of a university hospital. ICU patients were monitored daily by a clinical pharmacist and during the wards, consultancy services and interventions were provided to the ICU team on drug selection, drug doses, drug administration routes, drug-indication appropriateness, drug side effects, drug-drug interactions, drug-food/nutritional solution interactions, techniques of administration of drugs through the enteral feeding tube, and drug incompatibility. The final decision on whether to make a change in the treatment was made by the attending physician.

Results

A total of 75 patients were included in the study. The median age of the patients (minimum-maximum) was 74 (21–98) years, and 49 (65.33%) of these patients were male. The number of drugs per patient (mean ± standard deviation) was 10.27 ± 5.12. Total of 379 DRPs were observed and 74 of those DRPs did not require any recommendations. Clinical pharmacist's recommendations on 287 (94.1%) DRPS were accepted out of 305 recommendations by the physicians and applied into practice. Among the recommendations, 121 (39.7%) were related to drug dose adjustment (Table 1) and antibiotics constitute the drug group with the highest dose adjustment recommendation (n = 103, 85.1%) (Table)

Conclusion

Clinical pharmacist plays an active role in detection and management of DRPs, therefore involvement of clinical pharmacist in multidisciplinary healthcare teams especially in ICUs is important to improve optimum patient treatment.