International Journal of Clinical Pharmacy

, Volume 40, Issue 3, pp 513–519 | Cite as

Impact of the clinical pharmacist interventions on prevention of pharmacotherapy related problems in the paediatric intensive care unit

  • Márcia Malfará
  • Maria Pernassi
  • Davi Aragon
  • Ana CarlottiEmail author
Research Article


Background Problems related to pharmacotherapy are common in patients admitted to the paediatric intensive care unit (PICU) and are associated with increased healthcare costs. Data on the impact of clinical pharmacist interventions to prevent pharmacotherapy-related problems and to minimize costs in the PICU are limited. Objectives To evaluate the number and type of clinical pharmacist interventions in the PICU and to determine cost savings associated with them. Setting a ten bed PICU of a tertiary-care university hospital in Brazil. Method This was a prospective, observational study conducted over 1-year. The Failure Mode and Effects Analysis (FMEA) tool was applied at the beginning of the study to assess drug-related risks in the PICU and to guide clinical pharmacist interventions. Main outcome measure Number and type of clinical pharmacist interventions and healthcare-related costs. Results One hundred sixty-two children were followed-up by the clinical pharmacist and 1586 prescriptions were evaluated; pharmacotherapy-related problems were identified in 12.4% of them. Sixteen of 75 failure modes identified by FMEA were potentially reduced by the clinical pharmacist interventions. There were 197 interventions with a cost saving of R$ 15,118.73 (US$ 4828.00). Clinical pharmacist interventions were related to drug interaction and therapeutic monitoring (34.5%), drug selection (22.3%), dosing and frequency (16.8%), prescription (13.2%) and administration (13.2%). Ninety-seven per cent of the clinical pharmacist interventions were accepted by the medical team. The interventions with larger cost savings were related to administration (39%). Conclusion The clinical pharmacist interventions minimized the risks of pharmacotherapy-related problems and contributed to the reduction of costs associated with medical prescription.


Brazil Clinical pharmacy DRPs Healthcare costs Paediatric intensive care unit Pharmacotherapy-related problems 



We thank all the members of the FMEA team for their participation in this study.


This study did not receive any specific funding support.

Conflicts of interest

The authors have no conflicts of interest to disclose.


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Faculdade de Medicina de Ribeirão PretoUniversidade de São PauloRibeirão PretoBrazil

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