Journal of Neurocritical Care (대한신경집중치료학회지)

The Korean Neurocritical Care Society (대한신경집중치료학회)
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Effects of Medication Reconciliation and Cost Avoidance Analysis by Clinical Pharmacists in a Neurocritical Care Unit

뇌신경계 중환자실 전담 약사의 활동에 따른 약물 조정 효과 및 회피비용 분석

  • Cho, Ui Sang (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Song, Young Joo (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Jung, Young Mi (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Choi, Kyung Suk (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Eunsook (Department of Pharmacy, Seoul National University Bundang Hospital) ;
  • Lee, Euni (College of Pharmacy, Seoul National University) ;
  • Han, Moon-Ku (Department of Neurology, Seoul National University Bundang Hospital)
  • 조의상 (분당서울대학교병원 약제부) ;
  • 송영주 (분당서울대학교병원 약제부) ;
  • 정영미 (분당서울대학교병원 약제부) ;
  • 최경숙 (분당서울대학교병원 약제부) ;
  • 이은숙 (분당서울대학교병원 약제부) ;
  • 김은경 (서울대학교 약학대학) ;
  • 한문구 (분당서울대학교병원 신경과)
  • Received : 2018.10.30
  • Accepted : 2018.12.06
  • Published : 2018.12.30
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Abstract

Background: The role of clinical pharmacists in medication therapy to improve clinical and economic outcomes has been reported in the literature. This study was conducted to analyze the changes in details of medication interventions before and after the introduction of clinical pharmacists into the care of neurocritical care unit (NCU) patients, and to evaluate the economic effects of clinical pharmacists by calculating the avoidance cost. Methods: A retrospective study was conducted reviewing the electronic medical records from June 2013 to May 2014 (before), and from June 2016 to May 2017 (after). We calculated the number and rates of intervention, the acceptance rates of it, and also reviewed the list of interventions. We calculated avoidance cost if there was no intervention. Results: The monthly mean number of interventions increased from 8.0 (${\pm}5.7$) to 31.7 (${\pm}12.8$) (P<0.001) and the frequency of intervention also increased from 0.8% to 1.6% (P=0.003). The most frequently provided pharmacist intervention was nutritional support before introduction of clinical pharmacists and discussions on the medication plan after. The number of classified interventions was 14 before introduction of clinical pharmacist services and 33 after. The calculated cost avoidance associated with a clinical pharmacists' integration was 77,990,615 won per year. Conclusion: Introduction of clinicals pharmacist into the NCU was associated with increased intervention rates and expanded types of clinical interventions. The cost avoidance achieved by the pharmacists' interventions can be further explored to evaluate if similar expansions of pharmacists' services achieve similar results in other settings.

Keywords

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