A clinical pharmacist operating within an intensive care unit (ICU) has both economic and clinical benefits for health systems and patients, a systematic review has revealed.
Published in the European Journal of Hospital Pharmacy, the researchers noted that it is in ICUs where seriously ill patients are often administered expensive medications and may be at risk of serious adverse events, particularly due to medication errors.
In addition, clinical pharmacy is a fast-growing discipline in Europe in which pharmacists work directly with other healthcare professionals to ensure patients receive the safest and most effective therapeutic management.
The study therefore sought to determine the pharmacoeconomic and clinical impact of pharmaceutical care and service within ICUs.
Using Meta-Analyses (PRISMA) 2020 methodology, researchers from Nimes University Hospital and the University of Montpellier in France identified pharmacoeconomic studies published from 2017 to 2021 in Pubmed, Web of Science and Science Direct.
They carried out a qualitative methodological assessment of 525 articles using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) grid, commonly used to make economic evaluations in healthcare. In total, 11 papers were selected for analysis.
Clinical benefits were measured by a reduction in the risk of adverse events related to care, the reduced duration of time spent on mechanical ventilation and a decrease in the time patients spent in the ICU and hospital.
All studies reported economic savings with cost-benefit ratios ranging from €2.48 to €24.20 per €1 invested. The avoided costs per patient ranged from €29.73 to €194.24 per day of hospitalisation.
The analysis showed that pharmaceutical care in the ICU had no impact on the mortality rate of patients.
The mean CHEERS compliance score was moderate (63%) with a standard deviation of 17%, the latter demonstrating that the quality of the studies was heterogeneous.
The findings highlight both the economic and clinical benefits of a clinical pharmacist operating in the ICU, but that more extensive randomised studies are needed to confirm their role.
Reference
Simonetti, L et al. Pharmacoeconomic and clinical impact of pharmaceutical service in the intensive care unit: a systematic review. European Journal of Hospital Pharmacy 2024; Sept 13: DOI: 10.1136/ejhpharm-2024-004208.
