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Clinical and Financial Impact of Pharmacy Services in the Intensive Care Unit: Pharmacist and Prescriber Perceptions

Authors

  • Robert MacLaren,

    Corresponding author
    • Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
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  • R. Brett McQueen,

    1. Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
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  • Jon Campbell

    1. Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado
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  • A 300-word abstract was submitted to the American College of Clinical Pharmacy and a poster presentation of content occurred at the annual meeting, October 20–24, 2012.

For questions or comments, contact Robert MacLaren, Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Mail Stop C238, V20-1227, 12850 East Montview Boulevard, Aurora, CO 80045; e-mail: rob.maclaren@ucdenver.edu.

Abstract

Study Objective

To compare pharmacist and prescriber perceptions of the clinical and financial outcomes of pharmacy services in the intensive care unit (ICU).

Design

ICU pharmacists were invited to participate in the survey and were asked to invite two ICU prescriber colleagues to complete questionnaires.

Setting

ICUs with clinical pharmacy services.

Methods

The questionnaires were designed to solicit frequency, efficiency, and perceptions about the clinical and financial impact (on a 10-point scale) of pharmacy services including patient care (eight functions), education (three functions), administration (three functions), and scholarship (four functions). Basic services were defined as fundamental, and higher-level services were categorized as desirable or optimal. Respondents were asked to suggest possible sources of funding and reimbursement for ICU pharmacy services.

Results

Eighty packets containing one 26-item pharmacy questionnaire and two 16-item prescriber questionnaires were distributed to ICU pharmacists. Forty-one pharmacists (51%) and 46 prescribers (29%) returned questionnaires. Pharmacists had worked in the ICU for 8.3 ± 6.4 years and devoted 50.3 ± 18.7% of their efforts to clinical practice. Prescribers generally rated the impact of pharmacy services more favorably than pharmacists. Fundamental services were provided more frequently and were rated more positively than desirable or optimal services across both groups. The percent efficiencies of providing services without the pharmacist ranged between 40% and 65%. Both groups indicated that salary support for the pharmacist should come from hospital departments of pharmacy or critical care or colleges of pharmacy. Prescribers were more likely to consider other sources of funding for pharmacist salaries. Both groups supported reimbursement of clinical pharmacy services.

Conclusion

Critical care pharmacy activities were associated with perceptions of beneficial clinical and financial outcomes. Prescribers valued most services more than pharmacists. Fundamental services were viewed more favorably than desirable or optimal services, possibly because they occurred more frequently or were required for safe patient care. Substantial inefficiencies may occur if pharmacy services disappeared. Considerable support existed for funding and reimbursement of critical care pharmacy services.

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