How Critical Care Pharmacists Help Improve Patient Outcomes

Patient outcomes, including mortality, ICU length of stay, and preventable/nonpreventable adverse drug events, were improved when critical care pharmacists were included in a multidisciplinary ICU team.  

In order to understand the effects of including critical care pharmacists in multidisciplinary ICU teams on patient outcomes, a team of researchers conducted a systematic review and meta-analysis. The research team used PubMed, EMBASE, and other references from prior systematic studies. According to the research team, they included “randomized controlled trials and nonrandomized studies that reported clinical outcomes such as mortality, ICU length of stay, and adverse drug events in groups with and without critical care pharmacist interventions.” 

Based on their criteria, the research team identified 4725 articles that were eligible for the analysis. However, only 14 were included in the final analysis.  

According to the findings, when critical care pharmacists were included in the ICU team, there was  a significant reduction in the likelihood of mortality (odds ratio, 0.78; 95% CI, 0.73–0.83; P < 0.00001) compared with no intervention at all. Further, for mixed ICUs, the mean difference in ICU length of stay was –1.33 days (95% CI, –1.75 to –0.90 d; P < 0.00001).  

The researchers also found that there was a significant reduction in the prevalence of adverse drug events when the multidisciplinary ICU team included a pharmacist (odds ratio for preventable and nonpreventable adverse drug events, 0.26; 95% CI, 0.15–0.44; P < 0.00001 and odds ratio, 0.47; 95% CI, 0.28–0.77; P = 0.003, respectively). 

“Including critical care pharmacists in the multidisciplinary ICU team improved patient outcomes including mortality, ICU length of stay in mixed ICUs, and preventable/nonpreventable adverse drug events,” the study authors concluded. 

—Julie Gould 

Reference:

Lee H, Ryu K, Sohn Y, et al. Impact on Patient Outcomes of Pharmacist Participation in Multidisciplinary Critical Care Teams: A Systematic Review and Meta-Analysis [published online May 2019]. Crit Care Med. DOI: 10.1097/CCM.0000000000003830