Medication regimen complexity vs patient acuity for predicting critical care pharmacist interventions.

Purpose Quantifying and predicting critical care pharmacist (CCP) workload has significant ramifications for expanding CCP services that improve patient outcomes. Medication regimen complexity has been proposed as an objective, pharmacist-oriented metric that demonstrates relationships to patient ou...

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Publicado en:American Journal of Health-System Pharmacy Vol. 79; no. 8; pp. 651 - 656
Autores principales: Smith, Susan E, Shelley, Rachel, Sikora, Andrea
Formato: research tables/charts Journal Article
Publicado: Oxford University Press / USA 4/15/2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/15/2022
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      pub: Oxford University Press / USA
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        10.1093/ajhp/zxab460
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        atl: Medication regimen complexity vs patient acuity for predicting critical care pharmacist interventions.
      aug:
        au:
          Smith, Susan E
          Shelley, Rachel
          Sikora, Andrea
        affil: Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy , Athens, GA , USA
      sug:
        subj:
          Medication Management
          Patient Classification
          Critical Care
          Pharmacists
          Professional Role
          Human
          Post Hoc Analysis
          Prospective Studies
          Nonexperimental Studies
          Electronic Health Records
          Spearman's Rank Correlation Coefficient
          Multiple Linear Regression
          Age Factors
          Descriptive Statistics
          Drug Interactions
          APACHE (Acute Physiology and Chronic Health Evaluation)
          Scales
      ab: Purpose Quantifying and predicting critical care pharmacist (CCP) workload has significant ramifications for expanding CCP services that improve patient outcomes. Medication regimen complexity has been proposed as an objective, pharmacist-oriented metric that demonstrates relationships to patient outcomes and pharmacist interventions. The purpose of this evaluation was to compare the relationship of medication regimen complexity versus a traditional patient acuity metric for evaluating pharmacist interventions. Summary This was a post hoc analysis of a previously completed prospective, observational study. Pharmacist interventions were prospectively collected and tabulated at 24 hours, 48 hours, and intensive care unit (ICU) discharge, and the electronic medical record was reviewed to collect patient demographics, medication data, and outcomes. The primary outcome was the relationship between medication regimen complexity–intensive care unit (MRC-ICU) score, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and pharmacist interventions at 24 hours, 48 hours, and ICU discharge. These relationships were determined by Spearman rank-order correlation (r S) and confirmed by calculating the beta coefficient (β) via multiple linear regression adjusting for patient age, gender, and admission type. Data on 100 patients admitted to a mixed medical/surgical ICU were retrospectively evaluated. Both MRC-ICU and APACHE II scores were correlated with ICU interventions at all 3 time points (at 24 hours, r S = 0.370 [ P < 0.001] for MRC-ICU score and r S = 0.283 [ P = 0.004] for APACHE II score); however, this relationship was not sustained for APACHE II in the adjusted analysis (at 24 hours, β = 0.099 [ P = 0.001] for MRC-ICU and β = 0.031 [ P = 0.085] for APACHE II score). Conclusion A pharmacist-oriented score had a stronger relationship with pharmacist interventions as compared to patient acuity. As pharmacists have demonstrated value across the continuum of patient care, these findings support that pharmacist-oriented workload predictions require tailored metrics, beyond that of patient acuity.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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