Original Crit Care Shock (2018) 21:7-14 Comparative analysis of clinical pharmacy interventions in a pediat- ric intensive care unit Joseph M. LaRochelle, Kayrah Jack, Brent A. Kitto, Aryn Karpinski, Amy M. Creel Abstract Objective: The objectives of this study were 1) to describe and characterize interventions per- formed by a clinical pharmacist and 2) provide a comparative analysis of length of stay, mortal- ity, and drug charges in control and interven- tion groups. Design: This was a retrospective analysis of clinical pharmacy interventions performed in a Pediatric Intensive Care Unit (PICU) over two years. The clinical pharmacy faculty member was a dual-residency trained specialist in pedi- atric critical care, and was on-site in the PICU for approximately 0.5 full time equivalents. Setting and patients: The interventions occurred in an 18-bed medical-surgical PICU in a ter- tiary care children's hospital. All patients ad- mitted to the PICU during the study period were included. Interventions: The intervention group was com- prised of patients admitted to the PICU during the study period for which the clinical pharma- cist suggested changes in medication therapy. All other PICU patients were included in the control group. Interventions suggested were varied, including drug dosing adjustments, an- tibiotic recommendations, sedation recommen- dations, and discontinuation of drug therapy. Measurements and main results: On average, there were 4.4 interventions per patient (0.35 interventions per patient-day). Dosing recom- mendations, pharmacokinetic recommenda- tions, and discontinuation of medications were the most common types of interventions per- formed. Antibiotics and sedation/analgesia were the most common drug classes for intervention. There were statistically significant differences in the length of stay and mortality of groups, with both higher in the intervention group. No- tably, the intervention group also had higher Pediatric Risk of Mortality (PRISM) scores and drug charges, signifying increased severity of illness compared to the control group. Estimat- ed annual cost savings in the intervention group was $ 86,000. Conclusions: Antibiotics and sedation/analgesia dosing were the most common areas for phar- macy interventions. Patients with higher PRISM scores had increased interventions. Cost savings were considerable even with a part time pharmacist. Key words: Pharmacy practice, pediatrics, pharmacy interventions, pharmacists, pharmacy service. Crit Care Shock 2018 Vol. 21 No. 1 7 Address for correspondence: Joseph M. LaRochelle, PharmD, BCPPS, FCCP Xavier University of Louisiana, College of Pharmacy 1 Drexel Drive, New Orleans, LA 70125, USA Tel: 504-520-5328 Fax: 504-520-7971 Email: jlaroche@xula.edu From Xavier University of Louisiana College of Pharmacy and Louisiana State University Health Sciences Center School of Medicine, New Orleans, LA, USA (Joseph M. LaRochelle), CVS Health, Katy, Texas, USA (Kayrah Jack), Ochsner Health System, New Orleans, LA, USA (Brent A. Kitto), Col- lege of Education, Health, and Human Services, School of Foundations, Leadership, and Administration, Kent State Uni- versity, Kent, Ohio, USA (Aryn Karpinski), and Pediatric Critical Care Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA (Amy M. Creel). Introduction In both adult and pediatric populations, studies have shown a positive impact by pharmacists on . patient care. (1-3) The American Academy of Pe- diatrics and the Society of Critical Care Medicine have also described the importance of having pharmacists involved in the care of patients. (4,5) In previous work, our group conducted a descrip- tive study, which detailed the types and numbers of clinical interventions suggested by our pharmacist. (6) This work included detailed descriptions of the interventions suggested and changes made by the medical team, as well as baseline characteristics of the patient population. In our current study, we expanded the time frame of the original study and included a control group for an in-depth compari- son of outcomes. The objectives of this study were twofold: 1. To describe and characterize the interventions per- formed by the clinical pharmacist; 2. Provide a comparative analysis of the length of stay, mortali- ty, and drug charges for patients in the control and intervention groups. Estimated cost savings for pa- .