Characterization of drug-related problems identified by clinical pharmacy staff at Danish hospitals

Kjeldsen, Lene Juel; Birkholm, Trine; Fischer, Hanne; Graabæk, Trine; Kibsdal, Karina Porsborg; Ravn-Nielsen, Lene Vestergaard; Truelshøj, T

doi:10.1007/s11096-014-9939-4

Cited by 25 publications

(18 citation statements)

References 12 publications

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“…Similar results have been observed previously [5, 20, 30]. In addition, previous research shows that cardiovascular and psychotropic drugs contribute to hospitalisations due to adverse events in older people [6].…”

Section: Discussionsupporting

confidence: 90%

“…These drugs, except hydroxyzine, also caused DRPs in previous research. Although hydroxyzine was not included as a specific substance in previous research, the association between DRPs and the drug class of anxiolytics has been observed [5, 20, 30]. The drugs that contributed most frequently to DRPs in this study can be attributed to different explanations.…”

Section: Discussionmentioning

confidence: 82%

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Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden

Peterson

Gustafsson

2017

Drugs - Real World Outcomes

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BackgroundPolypharmacy and increased sensitivity to side effects cause adverse drug events, drug–drug interactions and medication errors in the elderly.ObjectiveThe objective of this study was to investigate the prevalence and type of drug-related problems and associated factors among patients admitted to a clinical pharmacist service-naïve medical ward in an inland hospital in northern Sweden.MethodsDuring September–November 2015 and February–April 2016, clinical pharmacists working as part of a ward team on the medical ward conducted 103 medication reviews. Drug-related problems were identified and classified. Associated factors, drug classes and specific drugs involved were also investigated.ResultsThe clinical pharmacists identified 133 drug-related problems in 66% [68/103] of the study population. The most common drug-related problems in this study were inappropriate drug use and interactions. Cardiovascular drugs and psychotropic drugs were most commonly involved. Drug-related problems were more frequently observed at higher age, increasing number of drugs prescribed and in patients with reduced renal function. In the multivariate analysis, only the number of prescribed drugs was still significant.ConclusionDrug-related problems were commonly observed among patients admitted to the medical ward. Medication reviews conducted by clinical pharmacists as part of a ward team resulted in several interventions to improve the patients’ drug treatment.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 82%

Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden

Peterson

Gustafsson

2017

Drugs - Real World Outcomes

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“…Problems related to suboptimal pharmacotherapy such as untreated indications or inappropriate dosing regimens were also repeatedly identified. These findings correspond well with a characterisation from 2014 of medicine-related problems entered in a Danish national database 19. All clinical service in our study was provided by a single experienced clinical pharmacist (WBH) to give a consistent delivery of service, but this setup can, however, lower the generalisability of the results, which is a limitation in the study design.…”

Section: Discussionsupporting

confidence: 85%

“…The number of prescribed medicines at discharge as well as all written clinical recommendations were entered in a Danish national database of medicine-related problems 19. Acceptance of the clinical recommendations, defined as documented alteration in the medication regimens done by the physicians, was assessed by post look-ups in the medical records.…”

Section: Methodsmentioning

confidence: 99%

Pharmacist-led interventions improve quality of medicine-related healthcare service at hospital discharge

Duedahl

Hansen

Kjeldsen³

et al. 2017

Eur J Hosp Pharm

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ObjectivesThis study aims to investigate the effects on quality of the medicine-related healthcare service provided at hospital discharge after implementing a pharmacist-led patient-centred discharge service.MethodsMedical in-patients ready for discharge and prescribed at least six medicines were eligible for inclusion in this descriptive intervention study. A ward-based clinical pharmacist provided a patient-centred discharge service which comprised medication review (including reconciliation if appropriate), medication counselling and verification of the medication discharge summary plans. Satisfaction with the pharmacist-led interventions was collected by questionnaires and follow-up telephone interviews. A quality audit on the medical information stated in the discharge summary plans was conducted.ResultsA total of 313 medical records were prospectively reviewed by the clinical pharmacist, and 745 medicine-related problems each leading to a clinical recommendation were identified. The total rate of acceptance by the physicians was found to be 84%. The quality audit revealed a significantly higher quality of the medication discharge summary plans sent to primary care regarding content of updated lists of medication after the pharmacist’s intervention. The involved physicians stated that contributions from the pharmacist had eased their workload and helped them to obtain a more rational prescribing practice. The interviewed patients felt secure and well-informed about their medicines.ConclusionsContributions from clinical pharmacists can improve both the quality of and satisfaction with the medicine-related healthcare service provided at hospital discharge and secure continuity of medical care at transitions.

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“…Clinical pharmacy services aim to provide comprehensive medication management that optimizes patient outcome . Many studies have emphasized the positive impact of clinical pharmacy services on the detection of drug‐related problems (DRPs) and patient outcome in various clinical settings . DRPs include all the issues that may interfere with the success of pharmacotherapy, and are closely linked to reduced clinical benefits of treatment and poor patient outcome .…”

mentioning

confidence: 99%

Clinical Pharmacist‐Provided Services In Iron‐Overloaded Beta‐Thalassaemia Major Children: A New Insight Into Patient Care

Bahnasawy

Wakeel

Beblawy

et al. 2017

Basic Clin Pharma Tox

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Iron-overloaded β-thalassaemia major (BTM) children have high risk of delayed sexual/physical maturation, liver/heart diseases and reduced life expectancy. The lifelong need to use iron chelators, their unpleasant administration, side effects and lack of awareness regarding iron overload risks all hamper BTM patient compliance to iron chelators. This study evaluated the impact of clinical pharmacist-provided services on the outcome of iron-overloaded BTM children. Forty-eight BTM children were randomly assigned to either control group, who received standard medical care, or intervention group, who received standard medical care plus clinical pharmacist-provided services. Services included detection of drug-related problems (DRPs) and their management, patient education regarding disease nature and iron chelators, as well as providing patient-tailored medication charts. After six months of study implementation, there was a highly significant difference between the control and intervention groups in serum ferritin (SF) (mean: 3871 versus 2362, μg/l, p = 0.0042), patient healthcare satisfaction (median: 24.47 versus 90.29, p < 0.0001) and quality of life (QoL) (median: 49.84 versus 63.51, p = 0.0049). The intervention group showed a decline from baseline to the end of study in DRPs (64-4), the number of non-compliant patients (24-3) and mean SF levels (3949-2362 μg/l, p < 0.0001). Clinical pharmacist-provided services can positively impact the outcome of BTM children.

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Characterization of drug-related problems identified by clinical pharmacy staff at Danish hospitals

Cited by 25 publications

References 12 publications

Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden

Characterisation of Drug-Related Problems and Associated Factors at a Clinical Pharmacist Service-Naïve Hospital in Northern Sweden

Pharmacist-led interventions improve quality of medicine-related healthcare service at hospital discharge

Clinical Pharmacist‐Provided Services In Iron‐Overloaded Beta‐Thalassaemia Major Children: A New Insight Into Patient Care

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