Perspectives from the frontline: A pharmacy department's response to the COVID-19 pandemic

Am J Health Syst Pharm. 2020 Aug 20;77(17):1409-1416. doi: 10.1093/ajhp/zxaa176.

Abstract

Purpose: The global coronavirus disease 2019 (COVID-19) pandemic has created unprecedented strains on healthcare systems around the world. Challenges surrounding an overwhelming influx of patients with COVID-19 and changes in care dynamics prompt the need for care models and processes that optimize care in this medically complex patient population. The purpose of this report is to describe our institution's strategy to deploy pharmacy resources and standardize pharmacy processes to optimize the management of patients with COVID-19.

Methods: This retrospective, descriptive report characterizes documented pharmacy interventions in the acute care of patients admitted for COVID-19 during the period April 1 to April 15, 2020. Patient monitoring, interprofessional communication, and intervention documentation by pharmacy staff was facilitated through the development of a COVID-19-specific care bundle integrated into the electronic medical record.

Results: A total of 1,572 pharmacist interventions were documented in 197 patients who received a total of 15,818 medication days of therapy during the study period. The average number of interventions per patient was 8. The most common interventions were regimen simplification (15.9%), timing and dosing adjustments (15.4%), and antimicrobial therapy and COVID-19 treatment adjustments (15.2%). Patients who were admitted to an intensive care unit care at any point during their hospital stay accounted for 66.7% of all interventions documented.

Conclusion: A pharmacy department's response to the COVID-19 pandemic was optimized through standardized processes. Pharmacists intervened to address a wide scope of medication-related issues, likely contributing to improved management of COVID-19 patients. Results of our analysis demonstrate the vital role pharmacists play as members of multidisciplinary teams during times of crisis.

Keywords: COVID-19; antimicrobial stewardship; care bundles; organization & administration; pandemics; pharmacists; pharmacy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / adverse effects
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects
  • COVID-19 / epidemiology
  • COVID-19 Drug Treatment*
  • Critical Care / organization & administration
  • Drug Therapy, Combination / adverse effects
  • Drug Therapy, Combination / methods
  • Electrolytes / administration & dosage
  • Electrolytes / adverse effects
  • Female
  • Hospital Mortality
  • Humans
  • Intensive Care Units / organization & administration
  • Interdisciplinary Communication
  • Male
  • Medical Records Systems, Computerized / organization & administration
  • Medication Therapy Management / organization & administration*
  • Middle Aged
  • Pandemics / prevention & control
  • Pharmacists / organization & administration*
  • Pharmacy Service, Hospital / organization & administration*
  • Professional Role
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anticoagulants
  • Antiviral Agents
  • Electrolytes