Evaluation of drug therapy problems among renal patients receiving care in some tertiary hospitals in Nigeria

Abstract

Purpose: To determine the prevalence of drug therapy problems (DTPs)

Clinical pharmacy practice in the care of Chronic Kidney Disease patients: a systematic review

“…[ 37 , 43 ] Development of protocols and compiling and updating guidelines were also described in two studies [ 22 , 34 ]. Performing medication reconciliation [ 46 ]; providing patient medication counselling, education on disease status or medication, conducting motivational interviews to improve adherence were also reported [ 15 , 25 , 27 , 29 , 30 , 34 , 36 , 37 , 42 , 43 , 47 – 50 , 55 , 57 , 58 , 60 ]. A number of studies reported pharmacists’ participation in ward rounds [ 17 , 22 , 35 , 37 , 38 , 40 ], providing educational sessions to healthcare professionals [ 22 , 34 ] and performing activities such as medication use evaluations [ 34 ].…”

“…Across all studies, the pharmacists identified 5302 drug-related problems in 2933 patients. Pharmacists made 3160 recommendations to healthcare professionals with an acceptance rate varying from 33.3% in a community setting; [ 16 ] 46.43% in a dialysis unit; [ 59 ] to around 95% in hospital settings [ 17 , 24 , 42 , 51 , 52 , 57 ]. Only three studies reported the clinical significance of recommendations.…”

“…A pharmacist-based quality improvement programme consisting of pharmacists’ interactions with the patients and electronic collaboration with the physicians was associated with a significant improvement in the measurement of PTH during the study period [ 15 ]. Pharmacists’ interventions led to medication therapy modifications [ 16 – 21 , 24 – 29 , 31 , 33 , 37 , 42 , 46 ] and resolving medication record discrepancies [ 46 , 57 ]. Patients’ compliance with ongoing blood pressure (BP) monitoring post kidney transplantation was significantly improved with pharmacists’ input [ 41 ].…”

“…Printed information leaflets and written information on dialysis note in regional language were provided to the patients. Adherence pattern before and after patient educational intervention was assessedNot reportedPatricia and Foote (2016)USA [46]Prospective uncontrolled study (17 months)Regional dialysis unitsTo identify the extent and type of medication discrepancies and MRPs experienced by dialysis patients during pharmacist-initiated medication reviews and determine if the resulting recommendations made by the pharmacy team to the patient’s provider were accepted90 HDNRPatients requested to bring their medication to dialysis unit and medication reconciliation conducted by the pharmacy teamNot reportedRamadaniati et al (2016)Indonesia [31]Prospective uncontrolled study (3 months)Medical wards and an ICCU in a major teaching hospitalTo identify and evaluate drug-related problems (DRPs) in patients with CKD105 CKDNRIdentification of DRPs through the direct patient interview, discussion with nurses and assessment of patients’ medication charts and medical recordsNot reportedAdibe et al (2017)Nigeria [42]Prospective uncontrolled study (5 months)Nephrology units of three tertiary hospitalsTo determine the prevalence of DTPs, identify the types of DTPs, and assess the outcomes of DTP interventions among renal patients receiving care in three Nigerian tertiary hospitals287 patients with renal illnesses72.34 (7.56)Identify and report DRPs. Patient education and counsellingNot reportedAlshamrani et al (2018)Saudi Arabia [59]Retrospective uncontrolled study (3 months)Outpatient haemodialysis unit of a tertiary hospitalTo determine the prevalence of polypharmacy and the Medication Related Problems in haemodialysis patients83 HD patientsMedian age 63, IQR (49–1)The pharmacy resident reviewed electronic medical records and analysed each medication regimen for eligible patients to identify MRPsNot reportedChandrasekhar et al (2018)India [60]Prospective interventional study (12 months)Outpatient nephrology departmentTo evaluate medication adherence behaviour of patients using questionnaire and enhance adherence by various cost effective interventions which have greater effect on the health of patients with CKD163 CKD patien...…”

Determinants of Willingness to Pay for Pharmacists Provided Medication-Related Services Among Outpatients in South-Eastern Nigeria Teaching Hospitals

“…This situation had been attributed to lack of motivation via rewards or reimbursement for the services as it is currently free-of-charge 18 . Pharmacists' lack of motivation might likely explain the growing trend of medication-related problems, particularly among outpatients with chronic diseases [19][20][21][22] . To date, no prior study has assessed the economic value of pharmacist-provided services in the hospital.…”