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.