Dr. Singari. Jaya Jyothi*1, Dr. Kotha. Sravya Reddy2, Dr. P. Pallavi Priya3, Dr. M. Madanmohan Rao4
1,2Pharm .D [Post Baccalaureate], Department of Pharmacy Practice, PRRMCP, Kadapa, Andhra Pradesh, India.
3Assistant Professor, Pharm .D Post Baccalaureate, Department of Pharmacy Practice, PRRMCP, Kadapa, Andhra Pradesh, India.
4Assistant Professor, MBBS, M.D, Department of General Medicine, RIMS, Kadapa, YSR district, Andhra Pradesh, South India.
Intensive Care Unit (ICU) is the emergency ward specialty that cares for critically ill patients, at the most vulnerable moments of their life. It faces the challenge of evaluating the early phases of the biological behavior in diseases. The problems, challenges and practices of emergency are globally similar. Hence, this prospective and concurrent observational study was carried out over a period of 6 months in the ICU department of RIMS Kadapa. After obtaining the approval by Institutional Review Board. Based on Inclusion and Exclusion criteria patients are included in the study. All the necessary and relevant baseline information was collected by using “Chart Review Method”. The research work started with the main objectives of drug use pattern/prescribing pattern of drugs and other parameters are clearly discussed in results. Clinical Pharmacist plays a key role in this process because of their expertise in the area of pharmaceutical care. In our study based on demographic details like age, sex, literature, socio-economic status, marital status and habitual history the following results were presented. Based on patients length of stay in ICU; <5 days are about 150 (60%), Based on routes of administration; Maximum value of dosage forms used in ICU was Intravenous 1025 (67.57%) and Minimum value is Capsules 05 (0.32%).Based upon the disease exposure in ICU; 167(66.80%) are new exposure and 83(33.20%) past exposure were identified in our study and stated in results. Among 250 cases; 81(32.40%) were Poison Cases. Among 1518 drugs prescribed; 1198 (78.91%) were Generic Drugs and 320 (21.08%) were Branded Drugs. Among 250 prescriptions; 1518 drugs were prescribed and Maximum 220 (14.49%) are Anti-Ulcers. Minimum 02 (0.13%) were Anti-Fungal, Anti-Malarial and followed by other drug classifications. Out of 250 prescriptions; Average number of drugs per each prescription was between 7-14 drugs. Medication errors were identified in ICU Patients are 103; 67.96% are having untreated indications, 2.91% were Drug without indication and 29.12% are prescribing error are observed during the course of our work. The patient was in need of TDM for Narrow therapeutic drug due to 2.91% of having drug without indication was given. Medication Adherence in ICU Patients; 34% are Regular and Irregular 66% are at past and 60% are Regular and 40% are Irregular in our prospective and concurrent observational study. The study concludes that a wide spectrum of drugs is utilized from various drug classes and there was a scope for improving rational use of drugs. The prescription of generic drugs needs to be promoted. Role of clinical pharmacist proves significant in ICU for Drug Therapy management of critically ill patients to decrease drug related problems in complex therapy as well to improve the therapeutic outcome of the treatment. Our study may be helpful in identifying and introducing the new concept of drug therapy management of patients in different disease conditions in critical care units in A.P state and it is an urgent need for appointing clinical pharmacist in every hospital to increase rational use of drugs and to improve patients QOL.