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Identification and categorisation of drug-related problems on admission to an adult intensive care unit

Objective To identify and categorise drug-related problems (DRPs) presented to an adult intensive care unit (ICU). Methods A prospective, observational study: 86 patients out of 2389 admitted to the ICU were reported to experience DRPs. Variables studied were: reason for ICU admission; length of ICU stay; need for cardiovascular support; need for mechanical ventilation or dialysis; Glasgow Coma Scale score on presentation to hospital; Acute Physiology and Chronic Health Evaluation (APACHE) II score; predicted mortality. Results The number of patients admitted due to a drug overdose was 45 (52%; 16 female), which was more than the rest of the patients put together (41 (48%; 11 female). The former were older and suffered more deterioration of renal function. The need for inotropic drugs and mechanical ventilation, the APACHE II score and median LOS were significantly higher in drug overdose patients. Only four (4.6%) admissions were due to a suicide attempt, and three (3.4%) trauma patients were admitted for DRPs; all were related to drug overdose. Hypoglycaemic medication was the cause of the DRPs in 19% of the patients. The total mortality rate was 4.6%; all of the deaths were unpreventable. Conclusions DRPs represented a small proportion of admissions to the ICU. Drug overdose represented a large proportion of the DRPs. Hypoglycaemia was the most common cause of admission for DRPs.