Pharmacist role in providing care for patients with septicemia in Lampang hospital
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Abstract
Septicemia is commonly present among hospitalized patients and it increases the mortality. Pharmacists should provide pharmaceutical care and ensure that patients with septicemia receive the correct and appropriate antibiotics. Objective: The present study examined the effect of pharmacist providing pharmaceutical care for patients hospitalized with septicemia. Factors associated with the pharmacist’s interventions on antibiotic prescribing and with the drug and dosage adjustment following the interventions were determined. Methods: Prospective analytical study design was used. Data collection was conducted between October 2019 and April 2021. Study patients were divided into three groups 1) the group that pharmacist interventions were accepted by attending physicians leading to antibiotic adjustment 2) the group that did not receive pharmacist interventions and 3) the group that pharmacist interventions were not accepted by physicians. Multivariate logistic regression analysis was used to determine factors associated with pharmacist interventions and physician acceptance of pharmacist interventions. Results: Out of 322 patients with septicemia prescribed antibiotics, 127 (39.4%) were given the interventions and 109 (85.8%) had the antibiotic adjustment. Patients who had immunosuppressants prior to the antibiotic prescribing and those who got first prescribed commonly used antibiotics had a lower chance of the interventions (odds ratio (OR), 0.31; 95% CI, 0.11-0.87 and 0.44; 0.25-0.79, respectively). On the contrary, patients with chronic kidney diseases were more likely to receive the interventions (OR, 2.39; 95% CI, 1.31, 4.33). Patients with HIV/AIDS had a lower chance of the physician acceptance of pharmacist interventions (OR, 0.11; 95%CI, 0.02-0.64), whereas those having sepsis acquired from communities and those receiving sympathomimetic agents if necessary had a higher chance of the intervention acceptance (OR, 3.38; 95%CI, 1.02-11.22 and 4.24; 1.29-13.88, respectively). Conclusion: This study revealed the importance of involving pharmacist in healthcare team for patients with septicemia, especially for antibiotic prescribing and effects on physician acceptance.
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