Impact of Pharmacist Interventions and Interprofessional Agreement in Critical Care: Analysis Using the Clinical, Economic, and Organizational Tool.

Background: Pharmaceutical interventions (PIs) are essential for ensuring medication safety in high-risk settings like intensive care units (ICUs). Assessment of the potential relevance of PIs generally considers their clinical, economic, and organizational impacts. Objective: To analyze PIs in an ICU and to evaluate the level of agreement on their impact across clinical, economic, and organizational dimensions. Methods: A retrospective study was conducted in a 10-bed ICU. All documented PIs performed by clinical pharmacists for patients admitted to the ICU and meeting the inclusion criteria were included. The clinical, economic, and organizational (CLEO) tool was used to assess the impacts of each intervention. Agreement among 3 health care professionals regarding the impact of these interventions was evaluated using the Fleiss kappa (κ) statistic. Results: A total of 178 PIs were documented, of which 145 (involving 158 patients) were included in the analysis, after exclusion of PIs with incomplete data. The mean age of the 158 patients was 48 (standard deviation 20) years, and 117 (74%) were male. According to the clinical pharmacist evaluator, clinical impact was rated as "major" for 30 (21%) of the 145 PIs. In addition, 62 (43%) of the PIs were considered to have a "favourable" organizational impact, and 46 (32%) had a positive economic impact (i.e., decreased cost). The Fleiss κ coefficient revealed a low level of agreement among health care professionals regarding their evaluation of PIs across all 3 dimensions. Conclusions: In the ICU setting, PIs play a vital role in improving patient outcomes; however, standardization of evaluation methods is essential to ensure consistency, reduce subjectivity, and enhance the overall impact of such interventions.