Authors : Lucas Miyake Okumura, Daniella Matsubara da Silva, Larissa Comarella
Abstract
Objective
The implementation of Clinical Pharmacy Services (CPS) in healthcare has gained recognition as the standard of care. Endorsed by prestigious organizations such as the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy, CPS plays a vital role in enhancing patient care. In Brazil, although there have been isolated instances of CPS initiatives, their significance in pediatric care for children and adolescents remains largely unacknowledged. Consequently, the impact of implementing bedside CPS in a Pediatric Intensive Care Unit (PICU) in Brazil warrants discussion. This brief report seeks to explore the effects of introducing a bedside CPS in a Brazilian PICU and shed light on its outcomes.
Methods
This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with <18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.
Results
Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.
Conclusions
Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.
Citation: Lucas Miyake Okumura, Daniella Matsubara da Silva, Larissa Comarella Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units doi:10.1016/j.rppede.2016.04.001
Received: 15 January 2016 Accepted: 17 March 2016 Available online: 16 April 2016
Copyright: © 2016 Sociedade de Pediatria de Sao Paulo. Published by Elsevier Editora Ltda. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Funding
LMO receives a monthly scholarship from the Brazilian Ministry of Education. By the time of CPS implementation, he was a sixth year pharmacy student.
Conflicts of interest
The authors declare no conflicts of interest.
Acknowledgements
We would like to thank Dr. Leonardo Cavadas Soares (Former Clinical Director), who provided an outstanding preceptorship, scientific and clinical support among Clinical Pharmacy Services implementation. The service reported in this manuscript was supported by all health care professionals from Waldemar Monastier Children's Hospital, especially those dedicated to critically ill children.
