Assessment of a clinical pharmacy activity in an intensive care unit in côte d’ivoire

• Autores: Pascal Abrogoua Danho, Elisée Doffou, Major Akroman, Lacina Soro, Antoine Amonkou
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 18, Nº. 1, 2016, pág. 7
• Idioma: inglés
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• Resumen

  • Background: clinical pharmacy activities in an intensive care unit contribute to improve patient’s care from a clinical and economic standpoint.

    Objective: This study aimed to assess the relevance of Pharmacist Interventions (PI) issued during a pilot clinical pharmacy study in an intensive care unit in Abidjan (Côte d’Ivoire).

    Method: We conducted a cross-sectional and descriptive study from September 2013 to February 2014. The PI classification tool of the French Society of Clinical Pharmacy was used. A standard dashboard was used proactively (during routine medical rounds and staffs) or retrospectively (analysis of patient records) with the following components: patient information, identification of drug-related problems (DRP), PI supported by a pharmaceutical opinion, the rating of the clinical impact of PI and their level of acceptance by physicians. The rating used was derived from that of Bayliff and Einarson and evolved from PI₀ to PI₃. The score assigned to each PI varied; as the importance of the potential clinical impact of the DRP was correlated to the severity of clinical consequences avoided by the PI.

    The relevance of PI was assessed by their acceptance rate by physicians and by the analysis of their clinical impact. The software SPSS Version 20.0 (IBM, USA) was used for statistical analysis.

    Results: The study involved 103 patients who had a mean age of 36.29 ±19.49 years and a sex ratio M/F of 1.1. A total of 150 PI were completed in which 14% were performed during medical visits and 86% on analysis of patient records. The main detected DRP focused on non-compliance with the recommendations (46%) and drug-drug interactions (24%). The most important PI made were proposals for drug choice (44%), proposals for monitoring safety and efficacy parameters (18.7%) and dose adjustments (16%). The PI acceptance rate by the medical staff was very high (94.6%). The majority of PI (84.5%) were rated PI₀ that is to say without direct clinical impact but with informative purpose. PI with significant clinical impact (PI₁) and highly significant clinical impact (PI₂) represented 9.9% and 4.9% of PI respectively. Only one PI with vital clinical impact was recorded (0.7%).

    Conclusion: PI performed as part of the implementation of clinical pharmacy activities were relevant and contributed to the therapeutic optimization and prevention of iatrogenic events in an intensive care unit in Côte d’Ivoire