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Publications (2)2.33 Total impact

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    ABSTRACT: Background: Correct dosing of antimicrobial drugs in septic patients receiving continuous renal replacement therapy (CRRT) is complex. This study aimed to evaluate the effects of dosing adjustments performed by pharmacists on the length of intensive care unit (ICU) stay, ICU cost, and antimicrobial adverse drug events (ADEs). Methods: A single-center, 2-phase (pre-/post-intervention) study was performed in an ICU of a university-affiliated hospital. Septic patients receiving CRRT in the post-intervention phase received a specialized antimicrobial dosing service from critical care pharmacists, whereas patients in the pre-intervention phase received routine medical care without involving pharmacists. The 2 phases were compared to evaluate the outcomes of pharmacist interventions. Results: Pharmacists made 183 antimicrobial dosing adjustment recommendations for septic patients receiving CRRT. Changes in CRRT-related variables (116, 63.4%) were the most common risk factors for dosing errors, and β-lactams (101, 55.2%) were the antimicrobials most commonly associated with dosing errors. Dosing adjustments were related to a reduced length of ICU stay from 10.7 ± 11.1 days to 7.7 ± 8.3 days (p = 0.037) in the intervention group, and to cost savings of $3525 (13,463 ± 12,045 vs. 9938 ± 8811, p = 0.038) per septic patient receiving CRRT in the ICU. Suspected antimicrobial adverse drug events in the intervention group were significantly fewer than in the pre-intervention group (19 events vs. 8 events, p = 0.048). Conclusions: The involvement of pharmacists in antimicrobial dosing adjustments in septic patients receiving CRRT is associated with a reduced length of ICU stay, lower ICU costs, and fewer ADEs. Hospitals may consider employing clinical pharmacists in ICUs.
    Scandinavian Journal of Infectious Diseases 09/2013; · 1.71 Impact Factor
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    ABSTRACT: To describe the development and implementation of pharmaceutical care services in an in-patient setting, and to examine the effectiveness of pharmacist interventions. A single-center, 2-phase (pre-/post-intervention phase) design was performed in an intensive care unit (ICU) of a university-affiliated hospital. Patients in the post-intervention phase (March 2011 to June 2011) received pharmaceutical care from a clinical pharmacist, while patients in the pre-intervention phase (December 2010 to March 2011) received routine medical care. The pre- and post-intervention phases were then compared to evaluate the outcomes of pharmacist interventions. During the 3-month study period, the clinical pharmacist made 232 interventions for 416 admitted patients; of these, 202 (87.1%) were accepted by physicians or nurses, and dosage adjustment (n=83, [35.8%]) was the type of intervention implemented most often. In the group that received the participation of pharmacists, medication errors per patient decreased from 1.68 to 0.46 (p<0.001); medication errors, of incorrect dose or dosing interval, were markedly improved (decreased from 0.87 to 0.14; p<0.001), the drug cost per patient-day decreased from $347.43 to $307.36 (p=0.095), and the length of ICU stay did not change significantly (6.14 days versus 5.93 days; p=0.14). The presence of the pharmacist in the ICU resulted in significant reduction of medication errors and had potential drug-cost-saving effects, but did not have an influence on decreasing the length of ICU stay.
    Saudi medical journal 07/2012; 33(7):756-62. · 0.62 Impact Factor