Key result
EICU pharmacist's intervention significantly reduced the median time from 4F-PCC prescription ordering to administration from 60 minutes to 21 minutes (p=0.02).
Why the study?
Few studies have evaluated whether emergency intensive care unit pharmacist intervention reduces time to 4F-PCC administration, with no such studies available in Japan.
Does EICU pharmacist intervention reduce time to four-factor prothrombin complex concentrate administration in patients requiring urgent anticoagulation reversal?
Cohort (n=10)
No
Does EICU pharmacist intervention reduce time to four-factor prothrombin complex concentrate administration in patients requiring urgent anticoagulation reversal?
Absolute Event Rate: 21% vs 60%
p-value: p=0.02
EICU pharmacist intervention significantly reduces the time from prescription ordering to administration of 4F-PCC for urgent warfarin reversal.
Background Four-factor prothrombin complex concentrate (4F-PCC) must be administered as soon as possible, and in our emergency intensive care unit (EICU), pharmacists are available on weekdays for consultation on expediting 4F-PCC administration. Although recent reports have described a reduction in time to 4F-PCC administration, few studies have addressed if this is because of EICU pharmacist’s intervention, and there are no such studies in Japan. Therefore, we aimed to examine whether EICU pharmacist’s intervention reduced time to 4F-PCC administration. Methods This single-center retrospective cohort study was conducted from December 2017 to May 2019. We enrolled patients who received 4F-PCC due to major bleeding or requirement of urgent surgical/invasive procedures (n = 10). Patients were divided into two groups, namely, the intervention group (n = 5), in which EICU pharmacists consulted on weekdays, and the nonintervention group (n = 5), in which an intervention was not possible because of the absence of the EICU pharmacist. Results The median time from patient presentation to the EICU to 4F-PCC administration (103 min vs. 111 min, p = 0.4) was similar between the two groups; however, the median time from 4F-PCC prescription ordering to administration was significantly shorter in the intervention group than in the nonintervention group (21 min vs. 60 min, p = 0.02). Conclusions EICU pharmacist’s intervention improves the process from 4F-PCC prescription to administration and can reduce time to 4F-PCC administration.
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Imanaka et al. (2020) conducted a cohort in Major bleeding or requirement of urgent surgical/invasive procedures requiring 4F-PCC (n=10). EICU pharmacist's intervention vs. No EICU pharmacist intervention was evaluated on Median time from 4F-PCC prescription ordering to administration (minutes) (p=0.02). EICU pharmacist's intervention significantly reduced the median time from 4F-PCC prescription ordering to administration from 60 minutes to 21 minutes (p=0.02).
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