When patients can’t eat normally, hospitals give them nutrition through IV tubes. This nutrition needs the right balance of minerals like potassium and sodium, or patients can get sick. Researchers looked at what happened when pharmacists (medicine experts) took charge of managing these minerals instead of doctors or dietitians doing it alone. They found that patients had fewer mineral imbalances when pharmacists were in charge. However, this didn’t change how long patients stayed in the hospital or whether they had heart problems. The study suggests pharmacists are really good at catching and fixing mineral problems early.

The Quick Take

  • What they studied: Does having a pharmacist manage minerals in IV nutrition work better than having doctors or dietitians do it?
  • Who participated: 128 hospital patients total (64 in each group) who received nutrition through IV because they couldn’t eat normally. One group had pharmacists managing their minerals starting in 2022, and the other group was treated before that when doctors and dietitians managed minerals.
  • Key finding: When pharmacists managed minerals, only 13.3% of patients had abnormal mineral levels compared to 24.2% in the other group. This is a big difference that shows pharmacists caught and fixed problems much better.
  • What it means for you: If you or a loved one needs IV nutrition in the hospital, having a pharmacist involved in managing minerals may help prevent dangerous imbalances. However, this study doesn’t prove it changes how long you stay in the hospital or prevents heart problems, so more research is needed.

The Research Details

This was a ’look-back’ study where researchers examined medical records from two groups of hospital patients. The first group (64 patients) received IV nutrition starting January 2022 or later, when pharmacists were managing the mineral additives. The second group (64 patients) received IV nutrition before November 2021, when doctors and dietitians were managing minerals. Researchers compared how many patients in each group had abnormal mineral levels in their blood tests.

The researchers looked at five important minerals: sodium, potassium, chloride, magnesium, and phosphorus. They counted how many times patients had abnormal levels of these minerals during their hospital stay. They also checked whether patients needed extra minerals added to their IV nutrition, how long they stayed in the hospital, and whether they had heart rhythm problems or died.

This type of study is useful because it uses real patient information from actual hospital care, not a controlled experiment. However, because researchers weren’t controlling everything that happened, there could be other differences between the groups that affected the results.

Mineral imbalances in IV nutrition are a real problem that doctors have struggled with for years. When minerals get too high or too low, patients can develop serious heart problems or other complications. This study is important because it’s one of the first to show that having a pharmacist specifically focus on managing these minerals might be a solution. Pharmacists have special training in how medicines and nutrients work in the body, so they might be better at catching problems early.

This study has some strengths: it used real patient data from an actual hospital, had equal numbers of patients in both groups, and looked at specific, measurable outcomes. However, there are limitations: it only included patients from one hospital, so results might be different elsewhere; patients in the two groups might have been different in ways not measured; and the study couldn’t prove that pharmacist involvement directly caused the improvement because other things might have changed between 2021 and 2022.

What the Results Show

The main finding was clear: patients had significantly fewer abnormal mineral levels when pharmacists managed their IV nutrition minerals. In the pharmacist group, only 13.3% of patients had abnormal mineral readings, compared to 24.2% in the doctor/dietitian group. This means pharmacists reduced mineral problems by almost half.

Pharmacists also added extra minerals more often when needed (16.4% of the time versus 11.2%), which suggests they were catching problems and fixing them faster. Additionally, no patients in the pharmacist group had critically dangerous mineral levels, while 0.3% of the other group did.

These results suggest that pharmacists are very skilled at managing minerals in IV nutrition and preventing problems before they become serious. The improvements were statistically significant, meaning they’re unlikely to have happened by chance.

The study also looked at whether these improvements in mineral management led to bigger health benefits. Surprisingly, there were no differences between groups in: how long patients stayed in the hospital, how long they received IV nutrition, whether they had heart rhythm problems (arrhythmias), or whether they died. This suggests that while pharmacists are excellent at managing minerals, preventing mineral imbalances alone may not be enough to change these larger health outcomes.

This is one of the first studies specifically looking at how pharmacists affect mineral management in IV nutrition. Most previous research focused on whether IV nutrition itself helps patients, not on who manages it best. This study fills an important gap by showing that the person managing minerals matters. The findings support the idea that specialized expertise (pharmacists) can improve specific medical management, even if it doesn’t change overall hospital outcomes.

This study has several important limitations. First, it only looked at one hospital, so results might be different at other hospitals with different systems or patient populations. Second, the two groups were treated at different times (2021 vs. 2022), so other changes in hospital practices or technology might have affected results. Third, researchers couldn’t randomly assign patients to groups, so there might be unknown differences between the groups that affected outcomes. Fourth, the study was relatively small with only 128 patients total. Finally, the study couldn’t prove that better mineral management directly caused any health improvements because it didn’t measure enough health outcomes.

The Bottom Line

Based on this research, hospitals should consider having pharmacists manage mineral additives in IV nutrition. This appears to significantly reduce mineral imbalances (high confidence in this specific finding). However, patients shouldn’t expect this change alone to shorten hospital stays or prevent all complications (lower confidence in broader health impacts). If you’re receiving IV nutrition, ask your hospital whether a pharmacist is involved in managing your minerals.

This research matters most for: hospital administrators deciding how to organize their pharmacy services; patients receiving IV nutrition who want the best mineral management; doctors and pharmacists working with IV nutrition patients; and hospital dietitians who work alongside pharmacists. This doesn’t apply to people eating food normally or taking oral supplements.

Improvements in mineral levels should be visible within days to weeks of starting pharmacist-led management, since blood tests can show changes quickly. However, don’t expect to feel dramatically different immediately—the benefit is preventing serious complications rather than causing noticeable symptom improvement.

Want to Apply This Research?

  • If you’re receiving IV nutrition, ask your healthcare team for your electrolyte lab values weekly and track them in the app. Record: sodium, potassium, chloride, magnesium, and phosphorus levels. Note whether they’re normal, high, or low. This helps you see if your mineral management is working well.
  • Ask your hospital care team: ‘Is a pharmacist managing my IV nutrition minerals?’ If yes, note this in your app. If no, ask why not and whether it’s possible. This empowers you to advocate for the best care. Also, if you’re discharged, ask for your final mineral levels to share with your outpatient doctor.
  • Create a weekly check-in reminder to review your electrolyte lab results if you’re on long-term IV nutrition. Track trends over time rather than individual values. If you notice your minerals are frequently abnormal, ask your care team if pharmacist involvement could help. Keep a record of which minerals are problematic so you can discuss patterns with your doctor.

This research shows that pharmacist-led mineral management in IV nutrition reduces abnormal mineral levels in hospital patients. However, this study was conducted at one hospital and doesn’t prove that better mineral management prevents serious health complications or changes hospital outcomes. If you or a loved one is receiving IV nutrition, discuss these findings with your healthcare team. This information is educational and should not replace medical advice from your doctor or pharmacist. Always consult with your healthcare provider before making changes to your medical care or nutrition plan.