Role of Clinical Pharmacy Services in Vitamin Supplementation in Critically Ill Cancer Patients: A 3-Year Retrospective Study at a Comprehensive Cancer Centre

Authors

  • Nadine N. Abdelhadi Faculty of Pharmacy, Aqaba University of Technology, Aqaba, Jordan
  • Alaa Dabbous Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
  • Saad M. Jaddoua Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan

DOI:

https://doi.org/10.35516/jjps.v18i2.2557

Keywords:

Clinical pharmacy services, nutrition support pharmacy, vitamins, critical care

Abstract

Background: Clinical pharmacists provide nutrition support pharmacy services, including evaluating micronutrient status and managing vitamin use. However, only a limited number of studies have explored the role of clinical pharmacists in managing vitamin supplementation.

Objective:  To explore clinical pharmacists’ interventions in managing vitamin supplementation in critically ill cancer patients admitted to intensive care units.

Methods: This retrospective analysis reviewed 9,949 electronically reported clinical pharmacist interventions for patients admitted to the ICU from January 2020 to December 2022. All patient records with clinical pharmacists’ interventions related to vitamin supplementation in ICU cancer patients were extracted and analyzed.

Results: The total number of interventions related to vitamin management was 129 (1.30%). Vitamin D was the most commonly used vitamin supplement (n = 39, 30.2%). Initiation of vitamin supplementation (n = 55, 42.6%) was the most frequent intervention by clinical pharmacists. The acceptance rate by physicians was 100%.

Conclusion: Clinical pharmacists play a key role in managing nutrition support therapy and vitamin supplementation in critically ill cancer patients. This study represents the first experience in Jordan and serves as a role model. Further research is needed to investigate barriers to implementing nutrition support pharmacy services and vitamin supplementation in Jordan, as well as to explore the impact of these services on patient outcomes. 

References

ACCP. Definition of Clinical Pharmacy. ACCP Compass [Internet]. 2024 [cited 2024 Mar 1]. Available from: https://www.accp.com/stunet/compass/definition.aspx

Dreischulte T., van den Bemt B., Steurbaut S.; European Society of Clinical Pharmacy. European Society of Clinical Pharmacy definition of the term clinical pharmacy and its relationship to pharmaceutical care: a position paper. Int. J. Clin. Pharm. 2022; 44(4):837–842. DOI: https://doi.org/10.1007/s11096-022-01422-7

Board of Pharmacy Specialties. BPS specialties. Board of Pharmacy Specialties [Internet]. 2024 [cited 2024 Mar 1]. Available from: https://bpsweb.org/bps-specialties/

Hilgarth H., Wichmann D., Baehr M., Kluge S., Langebrake C. Clinical pharmacy services in critical care: results of an observational study comparing ward-based with remote pharmacy services. Int. J. Clin. Pharm. 2023; 45(4):847–856. DOI: https://doi.org/10.1007/s11096-023-01559-z

Borthwick M. The role of the pharmacist in the intensive care unit. J. Intensive Care Soc. 2019; 20(2):161–164. DOI: https://doi.org/10.1177/1751143718769043

Arredondo E., Udeani G., Horseman M., Hintze T.D., Surani S. Role of Clinical Pharmacists in Intensive Care Units. Cureus 2021; 13(9):e17929. DOI: https://doi.org/10.7759/cureus.17929

Jurado L.V., Steelman J.D. The role of the pharmacist in the intensive care unit. Crit. Care Nurs. Q. 2013; 36(4):407–414. DOI: https://doi.org/10.1097/CNQ.0b013e3182a11057

Althomali A., Altowairqi A., Alghamdi A., et al. Impact of Clinical Pharmacist Intervention on Clinical Outcomes in the Critical Care Unit, Taif City, Saudi Arabia: A Retrospective Study. Pharmacy (Basel) 2022; 10(5):108. DOI: https://doi.org/10.3390/pharmacy10050108

Bosma B.E., van den Bemt P.M.L.A., Melief P.H.G.J., van Bommel J., Tan S.S., Hunfeld N.G.M. Pharmacist interventions during patient rounds in two intensive care units: Clinical and financial impact. Neth. J. Med. 2018; 76(3):115–124.

Fideles G.M., de Alcântara-Neto J.M., Peixoto Júnior A.A., et al. Pharmacist recommendations in an intensive care unit: three-year clinical activities. Rev. Bras. Ter. Intensiva 2015; 27(2):149–154. doi:10.5935/0103-507X.20150026 DOI: https://doi.org/10.5935/0103-507X.20150026

Muñoz-Pichuante D., Villa-Zapata L. Benefit of incorporating clinical pharmacists in an adult intensive care unit: A cost-saving study. J. Clin. Pharm. Ther. 2020; 45(5):1127–1133. doi:10.1111/jcpt.13195 DOI: https://doi.org/10.1111/jcpt.13195

Al Dali S., Al-Badriyeh D., Gulied A., et al. Characteristics of the clinical pharmacist interventions at the National Center for Cancer Care and Research Hospital in Qatar. J. Oncol. Pharm. Pract. 2023; 0(0). doi:10.1177/10781552231187305 DOI: https://doi.org/10.1177/10781552231187305

McClave S., DiBaise J., Mullin G., Martindale R. ACG clinical guideline: Nutrition therapy in the adult hospitalized patient. Am. J. Gastroenterol. 2016; 111(3):315–334. DOI: https://doi.org/10.1038/ajg.2016.28

National Cancer Institute. Definition of vitamins. NCI Dictionary of Cancer Terms [Internet]. 2024 [cited 2024 Apr 8]. Available from:

https://www.cancer.gov/publications/dictionaries/cancer-terms/def/vitamin

Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient. JPEN 2016; 40(2):159–211. DOI: https://doi.org/10.1177/0148607115621863

Yalcin S., Gumus M., Oksuzoglu B., Ozdemir F., Evrensel T., Sarioglu A., et al. Nutritional aspect of cancer care in medical oncology patients. Clin. Ther. 2019; 41(11):2382–2396. DOI: https://doi.org/10.1016/j.clinthera.2019.09.006

Sioson M., Martindale R., Abayadeera A., Abouchaleh N., Aditianingsih D., Bhurayanontachai R., et al. Nutrition therapy for critically ill patients across the Asia–Pacific and Middle East regions: A consensus statement. Clin. Nutr. ESPEN 2018; 24:156–164. DOI: https://doi.org/10.1016/j.clnesp.2017.11.008

American Society for Parenteral and Enteral Nutrition (ASPEN). What is nutrition support therapy? Nutritioncare.org [Internet]. 2024 [Accessed: Mar 01, 2024]. Available from:

https://www.nutritioncare.org/About_Clinical_Nutrition/What_is_Nutrition_Support_

ASPEN. What is a nutrition support professional? Nutritioncare.org [Internet]. 2024 [Accessed: Mar 01, 2024]. Available from:

https://www.nutritioncare.org/what-is-a-NSP/

Value of nutrition support therapy: Impact on clinical and economic outcomes in the United States. J. Parenter. Enteral Nutr. 2020; 44(3):395–406. DOI: https://doi.org/10.1002/jpen.1768

Berger M.M., Shenkin A., Schweinlin A., et al. ESPEN micronutrient guideline. Clin. Nutr. 2022; 41(6):1357–1424. doi:10.1016/j.clnu.2022.02.015 [published correction appears in Clin. Nutr. 2024; 43(4):1024].

Dresen E., Pimiento J.M., Patel J.J., Heyland D.K., Rice T.W., Stoppe C. Overview of oxidative stress and the role of micronutrients in critical illness. JPEN J. Parenter. Enteral Nutr. 2023; 47(Suppl 1):S38–S49. DOI: https://doi.org/10.1002/jpen.2421

Harnett J.E., Ung C.O.L., Hu H., Sultani M., Desselle S.P. Advancing the pharmacist’s role in promoting the appropriate and safe use of dietary supplements. Complement. Ther. Med. 2019; 44:174–181. doi:10.1016/j.ctim.2019.04.018 DOI: https://doi.org/10.1016/j.ctim.2019.04.018

Harnett J.E., Ung C.O.L. Towards defining and supporting pharmacists' professional role associated with traditional and complementary medicines – A systematic literature review. Res. Soc. Adm. Pharm. 2023; 19(3):356–413. doi:10.1016/j.sapharm.2022.11.001 DOI: https://doi.org/10.1016/j.sapharm.2022.11.001

The jamovi project. jamovi (Version 2.3) [Computer software]. 2022. Available at: https://www.jamovi.org

R Core Team. R: A language and environment for statistical computing (Version 4.1) [Computer software]. 2021. Available at: https://cran.r-project.org (R packages retrieved from MRAN snapshot 2022-01-01).

Zhou X., Qiu F., Wan D., et al. Nutrition support for critically ill patients in China: role of the pharmacist. Asia Pac J Clin Nutr. 2019; 28(2):246–251. doi:10.6133/apjcn.201906_28(2).0006

Giancarelli A., Davanos E. Evaluation of nutrition support pharmacist interventions. J. Parenter. Enteral Nutr. 2014; 39(4):476–481. DOI: https://doi.org/10.1177/0148607114551025

Salman G., Boullata J.I. The value of nutrition support pharmacist interventions. Crit. Care Explor. 2022; 10(2):e0650. doi:10.1097/CCE.0000000000000650 DOI: https://doi.org/10.1097/CCE.0000000000000650

Gallagher J., Byrne S., Woods N., Lynch D., McCarthy S. Cost-outcome description of clinical pharmacist interventions in a university teaching hospital. BMC Health Serv. Res. 2014; 14:177. doi:10.1186/1472-6963-14-177 DOI: https://doi.org/10.1186/1472-6963-14-177

Alqassieh R., Odeh M., Jirjees F. Intraoperative insulin infusion regimen versus insulin bolus regimen for glucose management during CABG surgery: A randomized clinical trial. Jordan J. Pharm. Sci. 2023; 16(3):487–498. doi:10.35516/jjps.v16i3.708 DOI: https://doi.org/10.35516/jjps.v16i3.708

Daghash R., Al-Saaideh M.A., Itani R. Evaluation of pharmacotherapy standards during pregnancy among Jordanian pharmacy colleges graduates. Jordan J. Pharm. Sci. 2023; 16(3):607–620. doi:10.35516/jjps.v16i3.972 DOI: https://doi.org/10.35516/jjps.v16i3.972

Jarab A.S., Al-Qerem W., Mukattash T.L., Alqudah S.G., Abu-Zaytoun L., Al-Azayzih A., Khdour M. Public perception of pharmacist’s role during COVID-19 outbreak in Jordan. Jordan J. Pharm. Sci. 2022; 15(3):365–377. DOI: https://doi.org/10.35516/jjps.v15i3.410

Downloads

Published

2025-06-25

How to Cite

Abdelhadi, N. N., Dabbous, A., & Jaddoua, S. M. (2025). Role of Clinical Pharmacy Services in Vitamin Supplementation in Critically Ill Cancer Patients: A 3-Year Retrospective Study at a Comprehensive Cancer Centre. Jordan Journal of Pharmaceutical Sciences, 18(2), 332–340. https://doi.org/10.35516/jjps.v18i2.2557

Issue

Section

Articles