Differential impact of on-site or telepharmacy in the intensive care unit: a controlled before-after study

Int J Qual Health Care. 2021 Feb 5;33(1):mzab011. doi: 10.1093/intqhc/mzab011.

Abstract

Background: Clinical pharmacists have an important role in the intensive care unit (ICU) team but are scarce resources. Our aim was to evaluate the impact of on-site pharmacists on medical prescriptions in the ICU.

Methods: This is a retrospective, quasi-experimental, controlled before-after study in two ICUs. Interventions by pharmacists were evaluated in phase 1 (February to November 2016) and phase 2 (February to May 2017) in ICU A (intervention) and ICU B (control). In phase 1, both ICUs had a telepharmacy service in which medical prescriptions were evaluated and interventions were made remotely. In phase 2, an on-site pharmacist was implemented in ICU A, but not in ICU B. We compared the number of interventions that were accepted in phase 1 versus phase 2.

Results: During the study period, 8797/9603 (91.6%) prescriptions were evaluated, and 935 (10.6%) needed intervention. In phase 2, there was an increase in the proportion of interventions that were accepted by the physician in comparison to phase 1 (93.9% versus 76.8%, P < 0.001) in ICU A, but there was no change in ICU B (75.2% versus 73.9%, P = 0.845).

Conclusion: An on-site pharmacist in the ICU was associated with an increase in the proportion of interventions that were accepted by physicians.

Keywords: critical Care; intensive care unit; interdisciplinary team; pharmacist; pharmacy service; quasi-experiment.

MeSH terms

  • Controlled Before-After Studies
  • Humans
  • Intensive Care Units
  • Pharmacists
  • Pharmacy Service, Hospital*
  • Physicians*
  • Retrospective Studies