(946) An International, Multicenter Post Hoc Analysis of Medication Management in ICU Recovery Clinics

Introduction: Over five million intensive care unit admissions occur annually in the United States. Post Intensive Care Syndrome (PICS) is a significant consequence of critical illness affecting long-term patient outcomes. Interprofessional intensive care unit-recovery centers (ICU-RCs) promote patient and family recovery where critical care pharmacists are proven key members of the team. Amidst the COVID-19 pandemic, ICU-RCs frequently transitioned from in-person to telehealth visits to facilitate safe, patient-centered, comprehensive care. There is a paucity of research evaluating the effects of pharmacist medication-related interventions performed in a telehealth setting.

Methods: Post-hoc analysis of interventions implemented by pharmacists among adult patients referred to 12 ICU-RCs between September 2019 and July 2021, as reported in a recently published study – An International, Multicenter Evaluation of Comprehensive Medication Management by Pharmacists in ICU Recovery Centers. Patients who received a comprehensive medication review by an ICU pharmacist were included. Medication-related interventions performed by a pharmacist during in-person visits was compared to those performed during telehealth visits.

Results: There were 507 patients referred to an ICU-RC of which 474 patients attended a clinic visit. Of those, 472 received a comprehensive medication review with 313 patients attending in-person and 159 patients attending via telehealth. The incidence of medication-related interventions implemented was higher in the in-person group compared to the virtual group (86.5% vs. 79.2%, p=0.04). There was no difference in median number of pharmacist interventions between in-person and telehealth groups (2 vs. 2, p=0.13). ICU admission diagnosis was an independent predictor of medication-related interventions among all patients.

Conclusions: The incidence of pharmacist interventions at ICU-RC was higher when visits were in-person versus telehealth. Pharmacists aid in meeting the complex pharmacologic challenges of PICS in both settings.