RESUMO
Objective: Electrolyte disorder (ED) is frequently encountered critically ill patients during admission or admission to the intensive care unit (ICU). This study aimed to determine the frequency of ED encountered in ICU patients to evaluate the relationship of ED with drugs. Methods: This prospective, multicenter study was conducted in the medical and anesthesiology ICUs of two training and research hospitals and included patients with at least one ED during admission or hospitalization in the ICUs. The relationship between ED and the drug was evaluated by calculating the logistic probabilistic method scale (LPMS) and the expert panel's evaluation. The correlation between EDs and LPMS was determined using Kendal tau. A binary logistic regression model was preferred in the analysis of factors related to ED. Statistical significance was set as p < 0.05. Results: A total of 117 patients were included in the study. A total of 165 EDs were detected, including at least one in 88 (75.2%) patients. According to the expert panel, 61 (21.7%) of EDs were drug-related, whereas according to the LPMS, 111 (39.6%) (p < 0.001). Mortality (50% vs. 13.7%) and mechanical ventilation rates (52.2% vs. 17.2%) were significantly higher in patients with ED (p < 0.001). Patients with ED had 8.352 times higher odds of exhibiting mortality (OR: 8.352, %95 CI: 1.598-43.648, p: 0.012) and need mechanical ventilation with higher odds of 3.229 (OR: 3.229 95% CI: 0.815-12.787 p: 0.045). Patient who required enteral or parenteral feeding were associated with an increased likelihood of exhibiting ED (respectively OR: 30.057, %95 CI: 2.265-398.892, p: 0.01, OR: 5.537, %95 CI: 1.406-21.800, p: 0.014). Conclusion: EDs are very common in the ICU. Dysnatremia was detected more commonly in other EDs. It has also been found that patients with ED are more often under mechanical ventilation, have more prolonged hospitalizations, and have higher mortality rates than patients without ED. The suitability of LPMS for assessing ED-drug relationships in the ICU context is questioned.
RESUMO
WHAT IS KNOWN AND OBJECTIVE: Drug-related problems (DRPs) are common in hospitalized patients in intensive care unit (ICU). The aim of the study is to reduce DRPs and associated costs with clinical pharmacist's (CP) recommendations. METHODS: The study is a prospective, non-randomized controlled study conducted in the ICU for a total of 6 months (1 January 2021-30 June 2021) in 2-month control, 2-month study, and 2-month control periods. Patients who were hospitalized for more than 24 h and used more than one medication were included in the study. The PCNE V9.1 Classification system was used in the classification of DRPs. During the intervention period, CP recommendations for DRPs were proposed to the healthcare team. RESULTS AND DISCUSSION: A total of 146 patients were included in the study. A total of 1061 DRPs from all periods were detected. The most common causes of DRPs were potential drug-drug interactions (31.76%), high dose (12.44%), and dose timing instruction errors (9.24%). For 347 DRPs identified during the study period, 259 interventions (74.63%) were recommended, and 238 (91.89%) were accepted by physicians. Interventions were mostly made as interrupting/discontinuing the drug (28.02%), changing the dose (25.27%), changing the instructions for use (20.32%), and starting a new drug (15.93%). Cost savings were achieved with CP recommendations applied. WHAT IS NEW AND CONCLUSION: The CP's recommendations were highly accepted by the healthcare team. With the CP's participation in routine patient rounds in the healthcare team of the ICU, drug-related costs would also decrease.