title: Impact of clinical pharmacist in an Indian Intensive Care Unit.
abstract: OBJECTIVE
  A critically ill patient is treated and reviewed by physicians from different specialties; hence, polypharmacy is a very common. This study was conducted to assess the impact and effectiveness of having a clinical pharmacist in an Indian Intensive Care Unit (ICU). It also evaluates the clinical pharmacist interventions with a focus on optimizing the quality of pharmacotherapy and patient safety.
  
  
  METHODS
  The prospective, observational study was carried out in medical and surgical/trauma ICU over a period of 1 year. All detected drug-related problems and interventions were categorized based on the Pharmaceutical Care Network Europe system.
  
  
  RESULTS
  During the study period, average monthly census of 1032 patients got treated in the ICUs. A total of 986 pharmaceutical interventions due to drug-related problems were documented, whereof medication errors accounted for 42.6% (n = 420), drug of choice problem 15.4% (n = 152), drug-drug interactions were 15.1% (n = 149), Y-site drug incompatibility was 13.7% (n = 135), drug dosing problems were 4.8% (n = 47), drug duplications reported were 4.6% (n = 45), and adverse drug reactions documented were 3.8% (n = 38). Drug dosing adjustment done by the clinical pharmacist included 140 (11.9%) renal dose, 62 (5.2%) hepatic dose, 17 (1.4%) pediatric dose, and 104 (8.8%) insulin dosing modifications. A total of 577 drug and poison information queries were answered by the clinical pharmacist.
  
  
  CONCLUSIONS
  Clinical pharmacist as a part of multidisciplinary team in our study was associated with a substantially lower rate of adverse drug event caused by medication errors, drug interactions, and drug incompatibilities.
authors.affiliation: Department of Critical Care Medicine, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hisham
authors.affiliation: Department of Critical Care Medicine, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Mudalipalayam N
authors.initials: MN
authors.lastname: Sivakumar
authors.affiliation: Department of Epidemiology, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India.
authors.forename: Ganesh
authors.initials: G
authors.lastname: Veerasekar
keywords: Adverse drug reaction; critical care pharmacist; drug interaction; medication error