ArticleExploratory research in clinical and social pharmacy2026
Breaking the safety barrier: Risk factors for unjustified non-acceptance of pharmaceutical interventions in the PICU and their association with mortality.
Article in Exploratory research in clinical and social pharmacy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: While pharmaceutical interventions (PIs) serve as safety barriers in Pediatric Intensive Care Units (PICU), their effectiveness relies on acceptance by the multidisciplinary team. Objective: Therefore, this study sought to identify factors associated with the acceptance and refusal of PIs in a PICU, with focus on identifying risk factors for non-acceptance PIs and their association with mortality. Methods: A retrospective analytical study was conducted in a PICU. Zero-Inflated Negative Binomial (ZINB) and standard Negative Binomial (NB) regression models were applied to determine independent predictors of total PIs, accepted PIs (PIa), and Non-Accepted PIs ('PIna)-stratified into Justified (PInaJ) and Unjustified (PInaUJ) refusals. Results: Of 864 admissions, 565 patients with identified PIs were included with 3091 PIs. The acceptance rate was 72.2%. PInaUJ accounted for 6.8% ( Conclusion: Pharmacotherapeutic risk reflects process complexity and surgical status, not severity. The PInaUJ-mortality link signals team dysfunction during deterioration, supporting risk-based screening and mandatory refusal justification in prescribing systems.
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