Q&A: How Pharmacists Are Being Formalized as Essential Clinical Partners

Amid recent events within the emergency care space, a collection of health care leaders convened to confirm the role of pharmacists on intensive care unit (ICU) teams. Now formalized as essential members of emergency care teams, pharmacists across the country—not just those working in critical care—have garnered further support from several reputable organizations regarding their crucial roles on interprofessional health care teams.

“I would say that the concept that pharmacists are considered essential members of the ICU team, I don't think that's new,” Andrea Sikora, PharmD, MSCR, FCCM, FCCP, BCCCP, associate professor of biomedical informatics at the University of Colorado School of Medicine, told Drug Topics. “What the problem has been is that it's lip service, to some extent. We say this really great thing about, ‘Oh, we need pharmacists,’ but then when you actually go into the unit, you'll find that if someone is on vacation or PTO, you're asked to take on 2 teams that day.”

Sikora recently led a group of experts to provide recommendations for integrating critical care pharmacists within ICU teams. Published in the Journal of the American College of Clinical Pharmacy in August, the paper details what many experts agree is how pharmacists in critical care need to be part of the greater ICU team, working with other professionals and providing their medication expertise.

Sikora led a 21-member panel on critical care pharmacists and their role as essential members within ICU teams. | image credit: Mumtaaz D/peopleimages.com / stock.adobe.com

Drug Topics recently caught up with Sikora to break down what went into leading this committee and how these guidelines are expected to impact the greater pharmacy community going forward. While there are certainly details and next steps to iron out following these guidelines being released, Sikora believes her and her team’s work can truly uplift the profession as a whole going forward.

READ MORE: Q&A: New ICU Guidelines Highlight, Confirm Role of Critical Care Pharmacists

Drug Topics: The guideline updates formalize pharmacists as “essential clinical partners.” Can you elaborate on the difference between this formal recognition and the role pharmacists held previously?

Andrea Sikora: I would say that the concept that pharmacists are considered essential members of the ICU team, I don't think that's new. I think that, generally, that is something that has been endorsed by the Society of Critical Care Medicine and is generally accepted as being very important. Interestingly, the burn ICU accreditation requires a pharmacist to be part of the burn ICU process. What the problem has been is that it's lip service, to some extent. We say this really great thing about, ‘Oh, we need pharmacists.’ But then, when you actually go into the unit, you'll find that if someone is on vacation or PTO, you're asked to take on 2 teams that day. Well, you can only round on one team at a time, so you know that you're not going to be present and giving the best quality of care for a team you're not even with. Again, holidays, weekends, evenings, these are real gaps in the quality of care that we can provide, and we see it in terms of medication errors and adverse drug events.

To me, what this document is saying, as opposed to just saying they're essential clinical partners, it's saying you have to make sure that there is a pharmacist for every ICU patient. These are members of the team that need to be there 24/7, 365. Think of how crazy it would be to go into an ICU and not have a nurse or a physician. I think that this document is trying to say that is similarly not best practice to lack a pharmacist.

Drug Topics: What do these developments mean for the pharmacy profession as a whole in regard to how pharmacists will choose their career paths and professional duties in the future? In other words, do you think these recommendations will result in greater calls to pharmacists entering the emergency care space?

Andrea Sikora: That is a big conversation that this panel had was, if we start saying that you need to have weekends, overnights, holidays, evening shift, that there is going to be a potential increase in demand for highly trained critical care pharmacists. But I see that as being a good thing. My hope is that, as we start seeing more positions open up, you're going to see that people are going to have an interest in being in those positions. I think that these guidelines, to me, also provide validation for how important the role is on the team.

I had a pharmacist colleague who basically was in charge of the rollout of all of the continuous renal replacement therapy services in the hospital. You might think, ‘Oh, that should be the nephrologist,’ but it was actually the medical ICU pharmacist, and it was a beautifully done process. I have other pharmacist colleagues who identified gaps in the medication safety process and put together protocols, order sets, and guidelines. I think this is really trying to kind of say, ‘I see you, and I see the work that you're doing and how important that is.’

I also think that at times, just in clinical pharmacy in general, we have struggled with asking a lot of the individuals in those roles. You're a teacher, you're an educator, you're doing QI, you're doing direct patient care, all these different things, but not always being recognized for all of those different hats that you're wearing that are improving outcomes. I do feel that this document does a good job of saying we know that all of those things provide value to the health care system and to patient care.

Not only do we want to celebrate that, but we want to actively put infrastructure in to support it. I hope people want to go into it. My years as a critical care pharmacist are some of the best of my life. I still look back very fondly and think of that as a special thing. Even though, at this point in my career, I’ve transitioned into more of a research space, I still think of it as a wonderful career and profession to be in for that matter.

READ MORE: Q&A: Equity in Pharmacy Means Meeting Patients Where They Are

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Reference

Sikora A, Murray B, Henry K, et al. Consensus recommendations for the integration of critical care pharmacists on intensive care unit teams: endorsed by the American Association of Critical‐Care Nurses, American College of Clinical Pharmacy, American Society of Health‐System Pharmacists, Institute for Safe Medication Practices, and Society of Critical Care Medicine. JACCP. August 4, 2025. https://doi.org/10.1002/jac5.70084