(1009) Effect of Inpatient Pharmacist Medication Reconciliation on Interventions in ICU Recovery Centers

Introduction: As members of the interdisciplinary team in intensive care unit recovery centers (ICU-RCs), critical care pharmacists complete comprehensive medication reviews to optimize medication therapies after hospital discharge. Inpatient pharmacists may also complete medication reconciliations during hospitalization, which may impact pharmacist-led interventions at ICU-RCs. The association between these two pharmacist-led interventions remains poorly described in available literature.

Methods: This study was a post-hoc analysis of an international, multicenter cohort study of adult patients from 12 ICU-RCs who had a comprehensive medication review conducted by a pharmacist between September 2019 and July 2021. Patients were divided into two groups: those who had a medication reconciliation completed by a pharmacist during hospitalization and those who did not. The primary endpoint was the number of medication interventions made at the patient’s first ICU-RC visit. A multivariable logistic regression was performed to identify factors associated with a medication intervention at the ICU-RC visit.

Results: There were 323 patients included in the final analysis with 83 patients in the medication reconciliation group and 240 patients in the no medication reconciliation group. There was no difference observed in the number of medication interventions between groups (2 vs 2, p = 0.06). There was a higher incidence of any intervention (86.3% vs 78.3%, p = 0.09) and dose adjustment (20.4% vs 9.6%, p = 0.03) in the no medication reconciliation group. Of the eight included covariates in the multivariable logistic regression, only ICU SOFA score was observed to be associated with an increased odds of a medication intervention at the first ICU-RC visit (aOR 1.15, 95% CI 1.05-1.23, p < 0.01).

Conclusions: Pharmacist-led, inpatient medication reconciliations were not associated with fewer medication interventions at the first ICU-RC visit, however patients who did not have an inpatient medication reconciliation had a higher incidence of dose adjustments at the clinic. Further investigation into the role of medication reconciliation in various transitions of care is warranted.