Role of the Clinical Pharmacist in the Oncologic Intensive Care Unit

  • Brian M. DeeEmail author
Reference work entry


A clinical pharmacist is an essential and valuable member of the multidisciplinary ICU team. The impact of ICU clinical pharmacy services is well documented in the primary literature, with positive outcomes in areas such as adverse drug events, drug-drug interactions, antimicrobial therapy, anticoagulant therapy, sedation/analgesia therapy, and provision of advanced cardiac life support. Recent research has shown that the presence of clinical pharmacists in ICUs that care for critically ill oncology patients is associated with decreased mortality. Critical care clinical pharmacists who practice in oncology ICUs often face a unique set of circumstances, including high level of patient acuity, complex pharmacotherapeutic regimens, and high volume of medication use. These practitioners should be familiar with the management of oncology-specific disease states and the complications associated with the treatment of malignancy. The integration of clinical pharmacists and clinical pharmacy services in oncology ICUs is imperative.


Intensive care unit Critical care Pharmacy Clinical pharmacist Clinical pharmacy services Oncology 


  1. 1.
    Bond CA, Raehl CL. Clinical pharmacy services, pharmacy staffing, and hospital mortality rates. Pharmacotherapy. 2007;27:481–93.CrossRefGoogle Scholar
  2. 2.
    Brilli RJ, et al. Critical care delivery in the intensive care unit: defining clinical roles and the best practice model. Crit Care Med. 2001;29:2007–19.CrossRefGoogle Scholar
  3. 3.
    Chant C, Dewhurst NF, Friedrich JO. Do we need a pharmacist in the ICU? Intensive Care Med. 2015;41:1314–20.CrossRefGoogle Scholar
  4. 4.
    Cullen DJ, Sweitzer BJ, Bates DW, Burdick E, Edmondson A, Leape LL. Preventable adverse drug events in hospitalized patients: a comparative study of intensive care and general care units. Crit Care Med. 1997;25:1289–97.CrossRefGoogle Scholar
  5. 5.
    Draper HM, Eppert JA. Association of pharmacist presence on compliance with advanced cardiac life support guidelines during in-hospital cardiac arrest. Ann Pharmacother. 2008;42:469–74.CrossRefGoogle Scholar
  6. 6.
    Erstad BL, Haas CE, O’Keeffe T, Hokula CA, Parrinello K, Theodorou AA. Interdisciplinary patient care in the intensive care unit: focus on the pharmacist. Pharmacotherapy. 2011;31:128–37.CrossRefGoogle Scholar
  7. 7.
    Koch A, Checkley W. Do hospitals need oncological critical care units? J Thorac Dis. 2017;9:E304–9.CrossRefGoogle Scholar
  8. 8.
    Leape LL, Cullen DJ, Clapp MD, Burdick E, Demonaco HJ, Erickson JI, Bates DW. Pharmacist participation on physician rounds and adverse drug events in the intensive care unit. JAMA. 1999;282:267–70.CrossRefGoogle Scholar
  9. 9.
    MacLaren R, Bond CA. Effects of pharmacist participation in intensive care units on clinical and economic outcomes of critically ill patients with thromboembolic or infarction-related events. Pharmacotherapy. 2009;29:761–8.CrossRefGoogle Scholar
  10. 10.
    MacLaren R, Devlin JW, Martin SJ, Dasta JF, Rudis MI, Bond CA. Critical care pharmacy services in United States hospitals. Ann Pharmacother. 2006;40:612–8.CrossRefGoogle Scholar
  11. 11.
    MacLaren R, Bond CA, Martin SJ, Fike D. Clinical and economic outcomes of involving pharmacists in the direct care of critically ill patients with infections. Crit Care Med. 2008;36:3184–9.CrossRefGoogle Scholar
  12. 12.
    Marshall J, Finn CA, Theodore AC. Impact of a clinical pharmacist-enforced intensive care unit sedation protocol on duration of mechanical ventilation and hospital stay. Crit Care Med. 2008;36:427–33.CrossRefGoogle Scholar
  13. 13.
    Ng TM, et al. Pharmacist monitoring of QTc interval-prolonging medications in critically ill medical patients: a pilot study. Ann Pharmacother. 2008;42: 475–82.CrossRefGoogle Scholar
  14. 14.
    Preslaski CR, Lat I, MacLaren R, Poston J. Pharmacist contributions as members of the multidisciplinary ICU team. Chest. 2013;144:1687–95.CrossRefGoogle Scholar
  15. 15.
    Rudis MI, Brandl KM. Position paper on critical care pharmacy services. Society of Critical Care Medicine and American College of Clinical Pharmacy Task Force on Critical Care Pharmacy Services. Crit Care Med. 2000;28:3746–50.CrossRefGoogle Scholar
  16. 16.
    Soares M, et al. Effects of organizational characteristics on outcomes and resource use in patients with cancer admitted to intensive care units. J Clin Oncol. 2016;34:3315–24.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.The University of Texas MD Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Todd W. Canada
    • 1
  • Jeffrey J. Bruno
    • 2
  1. 1.Clinical Pharmacy Svcs, Pharmacy Clinical ProgramsThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Clinical Pharmacy Specialist – Critical Care / Nutrition SupportThe University of Texas MD Anderson Cancer CenterHoustonUSA

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