Clinical Pharmacist Interventions in Intensive Care Units during Hajj

Abstract

Background: Hajj pilgrimage is the largest mass gathering worldwide. The Saudi Ministry of Health (MOH) provides free medical services for all pilgrimages. In 2022, MOH incorporated clinical pharmacy services in intensive care units (ICUs) of the sacred rituals hospitals. In addition to their role in ICUs settings, they were involved in other activities related to emergency department admissions as well as conducting several educational services at the hospital level. This study aimed to describe the impact of clinical pharmacy services implementation during the Hajj season and to explore the clinical interventions delivered to ICU patients. Materials and Methods: A multicenter-retrospective, chart-review study including adult critically ill patients (>14 years old) admitted to ICUs of seven sacred rituals hospitals between June 30 and July 14, 2022. Patients were excluded if they were not admitted to the ICU or admitted to an area with no assigned clinical pharmacist. Clinical interventions were categorized based on a modified version of the American Society of Health-System Pharmacists (ASHP) categorization. The study was approved by MOH Central Institutional Review Board (IRB) on September 18, 2022 (Ref. 22-41 E). Results: Clinical pharmacists performed 269 interventions for 82 patients admitted to the ICUs of participating hospitals. Each patient had a median of three interventions (interquartile range 2–5). The most common intervention was the untreated indication (n = 93; 34.5%), followed by dose adjustment (n = 60; 22.3%) and improper drug selection (n = 42; 15.6%). The ICU teams ultimately accepted all interventions. Conclusion: Incorporating clinical pharmacy services into ICU settings during Hajj season optimized patient care. The variety of provided clinical interventions shows the impact of clinical pharmacists’ presence among multidisciplinary teams. Further studies are needed to explore the economic implication of clinical pharmacist services during Hajj.