Description of a clinical pharmacy service in a coronary care unit

Abstract

To  describe  the  a  clinical  pharmacy/pharmaceutical  care  service  based  in  the  Pharmacotherapy   Workup  method  (PW)  and  implemented  in  a  coronary  care  unit  (CCU)  of  a  philanthropic  general   hospital  and  describe  its  results.  This  is  a  descriptive  study  conducted  in  a  large  hospital  with  14  beds   of  CCU.  The  study  sample  consisted  of  all  patients  included  in  the  clinical  pharmacy  service  for  a   period  of  eight  months  (n=860  –  99%  confidence  interval,  sampling  error  of  2.06%).  The  profile  of   Drug  Therapy  Problems  (DTPs)  were  analyzed  (DTPs  were  assessed  and  classified  according  to   the  Pharmacotherapy  Workup  method  -  PW).  Pharmaceutical  interventions  were  classified  as  either   “accepted” or “not accepted”. The patients had a mean age of 65 years and the majority were male (52.8%). 2,042 prescription orders were evaluated and 350 DTPs were identified: 40.3% (n=141) related to the indication of the medication (DTP1 - 12.3%; DTP2 - 28%); 26.8% (n = 94) to effectiveness (DTP4 -  26.8%); 24.9% (n = 89) to safety (DTP5 - 2.6%, DTP6 - 22.3%); and 8% (n = 28) to adherence. Each identified DTP generated an intervention with the medical staff of which 81.7% (n = 286) were accepted.  A  high  number  of  DTPs  was  detected  and  resolved.  This  shows  the  need  of  the  implementation  and   expansion of pharmaceutical clinical services as the one described in this study, especially when one has  in mind the vulnerability of the population accompanied by CCUs.