Crocker et al.Crocker C. A multidisciplinary follow-up clinic after patients’ discharge from ITU. Br J Nurs. 2003;12(15):910-4.
|
2003 |
Descriptive study |
101 post-ICU patients seen in the clinic |
To describe the experience of a multidisciplinary clinic |
No |
Yes |
Visit to ICU and referral to specialist. Interventions included drug reconciliation, physical therapy, and occupational therapy assistance |
This service has been extremely valuable to patients and their care and has helped staff understand the needs of patients once they have left intensive care. |
30 minutes are spent with the doctor to review medications |
Cuthbertson et al.Cuthbertson BH, Rattray J, Campbell MK, Gager M, Roughton S, Smith A, et al. The PRaCTICaL study of nurse led, intensive care follow-up programmes for improving long term outcomes from critical illness: a pragmatic randomised controlled trial. Br Med J. 2009;339:b3723.
|
2009 |
A pragmatic, nonblinded, multi-center, randomized controlled trial |
286 patients ages ≥18 years recruited after discharge from intensive care |
Nurse led intensive care follow-up programs (involve medications review) versus standard care follow-up programs |
No (nurse) |
Yes |
To test the hypothesis that nurse-led follow-up programs are effective and cost effective in improving quality of life after discharge from intensive care |
A nurse led intensive care follow-up programs showed no evidence of being effective or cost effective in improving patients’ quality of life in the year after discharge from intensive care. |
Review of current drug therapy within 9 months (97%) Changes to current medications within 9 months (2%) |
Bell et al.Bell CM, Brener SS, Gunraj N, Huo C, Bierman AS, Scales DC, et al. Association of ICU or hospital admission with unintentional discontinuation of medications for chronic diseases. JAMA. 2011;306(8):840-7.
|
2011 |
A population-based cohort study |
3963 patients aged 66 years or older using at least 1 of 5 long-term medications |
To evaluate rates of potentially unintentional discontinuation of medications following hospital or ICU admission |
No |
Yes |
Rates of medication discontinuation were compared across three groups: patients admitted to the ICU, patients hospitalized without ICU admission, and non-hospitalized patients (controls) |
Patients with chronic diseases were at risk for potentially unintentional discontinuation after hospital admission. Admission to the ICU was generally associated with an even higher risk of medication discontinuation. |
The highest rate of medication discontinuation occurred in the antiplatelet or anticoagulant agent group (19.4%) |
Morandi et al.Morandi A, Vasilevskis E, Pandharipande PP, Girard TD, Solberg LM, Neal EB, et al. Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc. 2013;61(7):1128-34.
|
2013 |
Prospective cohort study |
120 patients ≥60 years old who survived an ICU hospitalization |
To determine types of PIMs and AIMs, which PIMs are most likely to be considered AIMs, and risk factors for PIMs and AIMs in elderly ICU survivors at hospital discharge. * potentially (PIMs) and inappropriate medications (AIMs). |
Yes |
Yes |
PIMs were defined according to published criteria; AIMs were adjudicated by a multidisciplinary panel. Medication lists were abstracted at the time of preadmission, ward admission, Intensive Care Unit (ICU) admission, ICU discharge, and hospital discharge |
Certain types of PIMs, which are commonly initiated in the ICU, are more frequently considered inappropriate upon clinical review. Efforts to reduce AIMs in elderly ICU survivors should target these specific classes of medications. |
The number of pre-admission PIMs (P<.001), at hospital discharge |
Khan et al.Khan BA, Lasiter S, Boustani MA. CE: critical care recovery center: an innovative collaborative care model for ICU survivors. Am J Nurs. 2015;115(3):24-31.
|
2015 |
Descriptive study |
53 patients ≥18 years of age, admitted to ICU, and either spent ≥48 hours on mechanical ventilation or had delirium for ≥48 hours |
Evaluation by the interdisciplinary team (intensive care physician, nurse, and social worker) and the creation of a personalized care plan, including cognitive exercises, self-management training manuals, pharmacological and nonpharmacological prescriptions, and proactive referrals to community resources, neuropsychologists, and physical rehabilitation services |
No |
Yes |
To share experience of implementing the collaborative critical care model and its patient characteristics |
Patients who participated in 3 visits showed better physical performance in the 6-minute Walk Test and better leg strength over time. There were improvements in scores on anxiety, depression, and PTS scores. |
Stollings et al.Stollings JL, Bloom SL, Wang L, Ely EW, Jackson JC, Sevin CM. Critical Care Pharmacists and Medication Management in an ICU Recovery Center. Ann Pharmacother. 2018;52(8):713-723.
|
2018 |
A prospective, observational cohort study conducted in ICU recovery center |
All adults referred to the ICU-RC at an academic tertiary care center (Vanderbilt University Medical Center) |
To describe the role of an ICU-RC critical care pharmacist in identifying and treating medication-related problems among ICU survivors |
Yes |
Yes |
The pharmacist completed a full medication review, including medication reconciliation, patient interview, medication counseling, and resultant interventions, during the ICU-RC appointment. |
Use of a critical care pharmacist resulted in the identification and treatment of multiple medication-related problems in an ICU-RC as well as implementation of preventive measures. |
39% patients had medication(s) stopped at the clinic appointment, and (32%) patients had new medication(s) started. The pharmacist identified (16%) patients who had an adverse drug event (ADE) |
Kram et al.. |
2018 |
This single-center, pre-post quality improvement study |
358 patients, who were at least 18 years of age, and admitted to an adult ICU (medical, surgical, cardiothoracic surgery, neurosciences, and cardiac) with an AAP ordered while in the ICU |
To evaluate whether a pharmacist-initiated electronic handoff tool can reduce the overall, and potentially inappropriate hospital discharge prescribing rate of atypical antipsychotics (AAP) initiated in AAP-naïve critically ill adults. |
Yes |
Yes (AAP only) |
The intervention included the following: Upon order verification or recognition of an AAP initiated in the ICU in an AAP-naïve patient, the ICU clinical pharmacist generated an electronic handoff that flagged this medication for daily follow-up |
A pharmacy-initiated electronic handoff tool may reduce the proportion of AAP-naïve ICU survivors with an AAP continued at the time of ICU transfer |
The proportion of ICU survivors with an AAP continued at the time of ICU transfer to the floor was reduced post intervention. (78.7% vs 66.7%, P=.012). |
Sevin et al.Sevin CM, Bloom SL, Jackson JC, Wang L, Ely EW, et al. Comprehensive care of ICU survivors: Development and implementation of an ICU recovery center. J Crit Care. 2018;46:141-148.
|
2018 |
A prospective, observational feasibility study |
Eligible patients were critically ill adults ≥18 years old with one or more risk factors for the development of PIC |
Referred patients were followed by an ICU-RC coordinator (this role was performed at various times by a nurse practitioner, case manager, or clinical pharmacist) throughout their hospital stay and then offered an appointment. |
Yes |
Yes |
To describe the design and initial implementation of an Intensive Care Unit Recovery Center (ICU-RC) in the United States |
An ICU-RC identified a high prevalence of cognitive impairment, anxiety, depression, physical debility, lifestyle changes, and medication-related problems warranting intervention. Whether an ICU-RC can improve ICU recovery in the US should be investigated in a systematic way. |
The median number of pharmacy interventions, was 4 per patient |
Coe et al.Coe AB, Bookstaver RE, Fritschle AC, Kenes MT, MacTavish P, Mohammad RA, et al. Pharmacists’ perceptions on their role, activities, facilitators, and barriers to practicing in a post-intensive care recovery clinic. Hosp Pharm. 2020;55(2):119-125.
|
2020 |
Cross-sectional study |
9 ICU recovery center pharmacists |
To describe ICU recovery clinic pharmacists’ activities, roles, and perceived barriers and facilitators to practicing in ICU recovery clinics across different institutions |
Yes |
Yes |
15 survey questions |
The ICU recovery clinic pharmacists address ICU survivors’ medication-related needs by providing direct patient care in collaboration within the interdisciplinary ICU recovery. clinic setting. Strategies to mitigate a pharmacist’s barriers to practicing in ICU recovery clinics, such as lack of dedicated time and inability to adequately bill for pharmacist services |
Seven (78%) pharmacists always performed medication reconciliation and a comprehensive medication review in each patient visit. |
Haines et al.Haines KJ, Sevin CM, Hibbert E, Boehm LM, Aparanji K, Bakhru RN, et al. Key mechanisms by which post-ICU activities can improve in-ICU care: results of the international THRIVE collaboratives. Intensive Care Med. 2019;45(7):939-947.
|
2019 |
Qualitative inquiry via SCCM focus group |
Participants were recruited from the in-person meetings of the THRIVE collaborative sites for follow-up clinics |
To identify the key mechanisms that clinicians perceive improve care in ICU |
Yes |
No |
A semi-structured interview guide was used with prompting questions. |
The follow‑up of patients and families in post‑ICU care settings was perceived to improve care within the ICU via five key mechanisms. |