Addressing the Intravenous Therapeutic Incompatibilities in ICU: Evaluating It’s Pharmacoeconomic Impact on Patient Care

Abstract

Introduction: Drug-drug interactions (DDIs) within the Intensive Care Unit (ICU) would have a major impact on patient outcomes, prolong hospital stays, and increase healthcare expenditures. This prospective observational study assesses the compatibility of intravenous (IV) drugs administered to ICU patients at Sudha Institute of Medical Science, Erode, focusing on the therapeutic incompatibilities along with their clinical and financial implications.

Methodology: This study was conducted from January to June 2023. It involved 75 ICU patients who were on more than two intravenous drugs and had more than 24 hours of ICU stay. Drug compatibility was assessed using references such as Lexicomp, Trissel's Handbook of Injectable Drugs, and manufacturer product information. The study analyzed drug interactions, their severity, and the impact on patient outcomes. IBM SPSS 29.0.1.0 was used for conducting statistical analyses that include descriptive statistics, ANOVA, and the Mann-Whitney U Test.

Results: The study found that therapeutic incompatibilities were present in several drug combinations, and the most common was Tramadol & Ondansetron at 16.67%. Patients with drug interactions had significantly longer stays in the ICU, and the average stay was between 4-7 days. The financial burden was substantial with the total cost of prolonged ICU stays amounting to ₹731,827, as compared to ₹69,163 for patients without drug interactions. Socioeconomic impact was most visible among patients from lower middle-class backgrounds (70.37%).

Conclusion: Therapeutic incompatibilities are a significant factor for extended ICU stays and increased health care costs, particularly among economically vulnerable patients. Appropriate medication management and adherence to strict protocols of drug administration are essential in reducing the incidence of drug interactions, improving clinical outcomes, and reducing financial burdens in critical care settings.