Abstract

EXPLORING DRUG-RELATED PROBLEMS AMONG THE PATIENTS ADMITTED IN ICU: A COMPREHENSIVE ANALYSIS

Niranjan Ishwar Kubasad*, Shah Mohammed Qutub-E-Alam, Tumu Saathvika, Nisar Ahmed and Mahendra Kumar Bettur Jayappa

ABSTRACT

Background: ICU patients face heightened risks of adverse drug events due to complex medications. Clinical pharmacists play a vital role in optimizing therapy, reducing errors, and improving patient outcomes. This study provides essential insights for pharmacist-led interventions in ICU settings, enhancing drug safety and patient care. Aim: To conduct a comprehensive analysis of drug-related problems among patients admitted to the ICU, including identifying common types of DRPs, their causes, and the effectiveness of pharmacist interventions in addressing these issues. Methodology: A Prospective Observational and Interventional study was conducted for a period of six months in CSI Holdsworth Memorial (Mission) Hospital, Mysore. All the patients who were admitted to Intensive Care Unit during the study period were reviewed intensively. All the required data were collected from various sources including medical records of the patient. Results: The study included 112 patients, with a mean age of 51.01 ± 18.8 years, comprising a predominantly male population (71.4%) compared to females (28.57%). A significant proportion of patients were alcoholics (26.7%) and smokers (20.5%), indicating a higher prevalence of these conditions among males. The primary reasons for ICU admission were acute poisoning, CNS disorders, and infective etiologies. Hypertension and diabetes mellitus were the most common comorbidities observed. On average, patients stayed in the ICU for 3.75 ± 2.11 days, with durations ranging from 1-3 days (61.6%) to 12-15 days (0.89%). Upon assessing drug-related problems (DRPs) in ICU patients, we found that out of 112 patients, DRPs were observed in 100 patients (89.28%). Among these, the most frequent DRP was drug interactions, observed in 76 patients (67.85%), followed by adverse effects in 9 patients (8.03%), drug duplication in 5 patients (4.46%), drug use without indication in 4 patients (3.57%), untreated indications in 3 patients (2.67%), contraindications in 1 patient (0.89%), high dose in 1 patient (0.89%), and sub therapeutic dose in 1 patient (0.89%). Additionally, 12 patients (10.71%) did not exhibit any DRPs during the assessment. Polypharmacy (20%) has been accounted as one of the major risk factors for DRPs followed by co-morbidities (11%). Among the 100 patients with drug-related problems (DRPs), 86 patients (86%) did not experience any negative impact. However, among the remaining 14 patients (14%), the following negative impacts were observed: increased treatment cost in 5% of patients, treatment failure in 3% of patients, complications in 3% of patients, high mortality in 2% of patients, and prolonged ICU stay in 1% of patients. Around 82.28% of patients were discharged with improvement, indicating good prognosis and healthcare. Conclusion: The study highlights prevalent drug-related problems (DRPs) among ICU patients, with drug interactions being the most common issue. Polypharmacy and comorbidities were significant risk factors. Most patients didn’t experience negative impacts and were discharged with improvement, indicating good prognosis and healthcare. However, a small percentage faced adverse outcomes, emphasizing the need for ongoing monitoring and interventions to address DRPs and enhance patient outcomes.

Keywords: Drug-related problems (DRPs), Polypharmacy, ICU patients, Pharmacist interventions.