Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation

Background Critically ill patients often experience several transitions of care following critical illness. Research has explored the challenges which patients have with medication management across these transitions. It is unclear whether patients admitted to critical care due to COVID-19 will have...

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Main Authors: Martin Shaw, Tara Quasim, Pamela MacTavish, Rakesh Kishore, Joanne McPeake, Ruth Forrest, Antoin Breslin, Fiona MacGregor, Alison Oprey
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/8/1/e001037.full
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author Martin Shaw
Tara Quasim
Pamela MacTavish
Rakesh Kishore
Joanne McPeake
Ruth Forrest
Antoin Breslin
Fiona MacGregor
Alison Oprey
author_facet Martin Shaw
Tara Quasim
Pamela MacTavish
Rakesh Kishore
Joanne McPeake
Ruth Forrest
Antoin Breslin
Fiona MacGregor
Alison Oprey
author_sort Martin Shaw
collection DOAJ
description Background Critically ill patients often experience several transitions of care following critical illness. Research has explored the challenges which patients have with medication management across these transitions. It is unclear whether patients admitted to critical care due to COVID-19 will have similar challenges. The aim of this study was to explore medication management in critical care survivors following severe COVID-19.Methods Between 3 and 7 months post hospital discharge, patients who had been admitted to critical care due to severe COVID-19 were invited to an established recovery service. During the clinic consultation a medication review was performed by a pharmacist. This included medicines reconciliation, assessing the appropriateness of each of the prescribed medications and identification of medication changes. We also assessed changes to pain management in the discharge period.Results In total, 78 patients had a full medication review available. Over 70% of patients were taking an increased dose of medicine or a new medicine at clinic. There was a significant overall increase in new medication during the clinic consultation, across different British National Formulary classifications (OR: 1.73 (95% CI: 1.28 to 2.34), p<0.001). Compared with pre critical care admission, there was a significant increase in the number of patients taking regular analgesia following severe COVID-19 infection (23 (29.5%) vs 39 (50%), p<0.001).Conclusion Following severe COVID-19, patients may require new or increasing doses of medicines. Ongoing review of these patients is crucial to ensure optimal outcomes.
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spelling doaj-art-552090319c654d359cc91af506c0b60e2025-08-20T02:22:32ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2021-001037Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluationMartin Shaw0Tara Quasim1Pamela MacTavish2Rakesh Kishore3Joanne McPeake4Ruth Forrest5Antoin Breslin6Fiona MacGregor7Alison Oprey8School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, G31 2ER, UKAnaesthesia & Critical Care, Glasgow Royal Infirmary, Glasgow, UK1 NHS Greater Glasgow and Clyde, Glasgow, UKIntensive Care Unit, NHS Greater Glasgow and Clyde, Glasgow, UKNHS Greater Glasgow and Clyde, Glasgow, UKIntensive Care Unit, Queen Elizabeth University Hospital, Glasgow, UKSchool of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UKRoyal Alexandra Hospital, NHS Greater Glasgow and Clyde, Glasgow, UKQueen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UKBackground Critically ill patients often experience several transitions of care following critical illness. Research has explored the challenges which patients have with medication management across these transitions. It is unclear whether patients admitted to critical care due to COVID-19 will have similar challenges. The aim of this study was to explore medication management in critical care survivors following severe COVID-19.Methods Between 3 and 7 months post hospital discharge, patients who had been admitted to critical care due to severe COVID-19 were invited to an established recovery service. During the clinic consultation a medication review was performed by a pharmacist. This included medicines reconciliation, assessing the appropriateness of each of the prescribed medications and identification of medication changes. We also assessed changes to pain management in the discharge period.Results In total, 78 patients had a full medication review available. Over 70% of patients were taking an increased dose of medicine or a new medicine at clinic. There was a significant overall increase in new medication during the clinic consultation, across different British National Formulary classifications (OR: 1.73 (95% CI: 1.28 to 2.34), p<0.001). Compared with pre critical care admission, there was a significant increase in the number of patients taking regular analgesia following severe COVID-19 infection (23 (29.5%) vs 39 (50%), p<0.001).Conclusion Following severe COVID-19, patients may require new or increasing doses of medicines. Ongoing review of these patients is crucial to ensure optimal outcomes.https://bmjopenrespres.bmj.com/content/8/1/e001037.full
spellingShingle Martin Shaw
Tara Quasim
Pamela MacTavish
Rakesh Kishore
Joanne McPeake
Ruth Forrest
Antoin Breslin
Fiona MacGregor
Alison Oprey
Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
BMJ Open Respiratory Research
title Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
title_full Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
title_fullStr Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
title_full_unstemmed Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
title_short Evaluation of medication changes following severe COVID-19 infection: a multicentre evaluation
title_sort evaluation of medication changes following severe covid 19 infection a multicentre evaluation
url https://bmjopenrespres.bmj.com/content/8/1/e001037.full
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