Key result
Among 59 patients admitted to intensive care, 57% of prior long-term medications were stopped and often not reintroduced, while new medications were frequently continued without clear indication.
Observational (n=59)
ICU admission is associated with significant, potentially inadvertent changes to patients' long-term medication regimens, highlighting the need for better prescription reconciliation.
ICU medication changes may persist without indication; this Level 3 cohort study leaves open effects on long-term outcomes.
Many patients admitted to intensive care units consume long-term medication. New drugs may be commenced during intensive care intended for the short term or longer. Patients are often cared for by several teams during hospital admission and long-term medication may inadvertently be permanently discontinued. Following admission, new therapies relevant only in the short term could be continued beyond intensive care and hospital discharge. We conducted a retrospective analysis of drug prescription by examining patients' notes and charts before, during and after intensive care admission. Of 197 drugs prescribed up to intensive care admission to 59 patients, 112 (57%) were stopped. Ninety-nine of these were not reintroduced by intensive care discharge and 34 were not reintroduced by hospital discharge. Of 154 drugs commenced during intensive care, 96 (62%) had no listed reason for their introduction. Twenty-eight were continued beyond hospital discharge, some without apparent ongoing indication. Reliable mechanisms to prevent prescription errors are required.
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Campbell et al. (2006) conducted an observational in Intensive care unit admission (n=59). Intensive care unit admission was evaluated on Changes to long-term medication (discontinuation of prior drugs and continuation of new drugs). Among 59 patients admitted to intensive care, 57% of prior long-term medications were stopped and often not reintroduced, while new medications were frequently continued without clear indication.
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