PMU28 - Economic Impact of Pharmacy Resident's Interventions in Medical Intensive Care Unit of University Hospital in Thailand

Abstract

To quantify the impact of pharmacy resident on hospital cost while performing clinical services to the Medical Intensive Care Unit (MICU) from a hospital perspective. The documented clinical interventions of MICU residency pharmacist were reviewed retrospectively from October 2016 to January 2017. In the reviewing process, the Drug Related Problems (DRPs) which were screened, detected, and managed by the pharmacy resident were classified by senior pharmacy resident. These classified DRPs were also judged for the potential impacts to patients if there were no intervention made by the pharmacist and these potential impacts were calculated into cost avoidance. Cost of DRPs treatment including drug costs were collected from hospital database. There were 35 DRPs from 304 patients in MICU which were detected and managed by pharmacy resident. Most of DRPs were occurred in the prescribing process (94%). Over-therapeutic and sub-therapeutic level was the main reason of DRPs in MICU (37%). Vancomycin and Colistin had the highest frequency causing DRPs (11%). The acceptance rate of pharmacist’s intervention was 91%. The estimated cost avoidance from all interventions made by pharmacy resident in four months was 3,375.45 USD. The result of one-way sensitivity analysis demonstrated the potential impact in cost of medication and laboratory-test which ranged the hospital cost saving from 3,076.62 USD to 5,581.31 USD. Pharmacy resident had the potential impact in reducing hospital unnecessary healthcare cost due to medication errors or preventable DRPs. Moreover, including pharmacist as a member of MICU team could provide potential benefit to other healthcare members such as dosage recommendation and adjustments, medication recommendation or any pharmacy services which could facilitate team member for better treatment outcomes.