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



Rezazadeh A^{1, 2} ; Hajimiri SH^{3, 4} ; Kebriaeezadeh A^{3, 4} ; Gholami K^{1, 2} ; Hashemian F⁵ ; Khoshnevisan A⁶ ; Mohebbi N^{1, 2}
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.