Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Sah, Sujit Kumar; Subramanian, Ramaswamy; Ramesh, Madhan

doi:10.1016/j.cegh.2022.100969

Cited by 4 publications

(1 citation statement)

References 25 publications

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“…Although interview two resulted in a different top three of most common types of unique DRPs when compared to interviews one, three and four, the top three subtypes per interview remained constant. This study quantified relatively high numbers of DRPs (median of 5 (IQR 3–9) unique DRPs per patient) when compared to previous studies, which reported 1–2 DRPs per patient in rheumatic diseases populations [ 8 , 9 , 21 ]. Main DRPs in patients with rheumatic diseases identified in other (pro- and retrospective) studies include treatment safety, treatment effectiveness, adverse reactions and drug-drug interactions.…”

Section: Discussionmentioning

confidence: 93%

Drug-related problems reported by patients with rheumatic diseases: an observational study

et al. 2023

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Background Drug-related problems can negatively influence treatment outcome and well-being for patients with rheumatic diseases. Thus, it is important to support patients in preventing or resolving drug-related problems as quickly as possible. To effectively develop interventions for this purpose, knowledge on the frequency and character of drug-related problems is needed. Therefore, this study aims to quantify and characterize drug-related problems reported by patients with inflammatory rheumatic diseases along their treatment process. Methods A prospective observational study was conducted in a Dutch outpatient pharmacy. Adult patients with rheumatic diseases that were prescribed medication by a rheumatologist were questioned about experienced DRPs by telephone 4 times in 8 weeks using a structured interview-guide. Patient-reported DRPs were scored on uniqueness (i.e., if a specific DRP was reported in multiple interviews by one individual, this was counted as one unique DRP) and were categorized using a classification for patient-reported DRPs and analysed descriptively. Results In total, 52 participants (median age 68 years (interquartile range (IQR) 62–74), 52% male) completed 192 interviews with 45 (87%) participants completing all 4 interviews. The majority of patients (65%) were diagnosed with rheumatoid arthritis. Patients reported a median number of 3 (IQR 2–5) unique DRPs during interview 1. In subsequent interviews, patients reported median numbers of 1 (IQR 0–2), 1 (IQR 0–2) and 0 (IQR 0–1) unique DRPs for interviews 2–4 respectively. Participants reported a median number of 5 (IQR 3–9) unique DRPs over all completed interviews. Unique patient-reported DRPs were most frequently categorized into (suspected) side effects (28%), medication management (e.g., medication administering or adherence) (26%), medication concerns (e.g., concerns regarding long-term side-effects or effectiveness) (19%) and medication effectiveness (17%). Conclusions Patients with rheumatic diseases report various unique DRPs with intervals as short as two weeks. These patients might therefore benefit from more continuous support in-between contact moments with their healthcare provider.

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Section: Discussionmentioning

confidence: 93%

Drug-related problems reported by patients with rheumatic diseases: an observational study

et al. 2023

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Addressing Glucocorticoid-Related Problems with the Clinical Pharmacist Collaboration in Rheumatology Practice: A Prospective Follow-Up Study

Bahap-Kara,

Sariyildiz,

Yardimci

et al. 2024

Rheumatol Ther

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Introduction Glucocorticoids (GCs) play a crucial role in the treatment of many rheumatic diseases regarding their anti-inflammatory and immunosuppressive effects. Inappropriate use of GCs can exacerbate GC-related problems besides complex treatment regimens and miscellaneous well-established adverse events. Although several guidelines exist for managing these problems, there is lack of real-life studies evaluating the problems at the patient level. This study aims to identify GC-related problems among patients with rheumatic diseases and address how they have been solved. Methods This prospective follow-up study was conducted between January 2021 and June 2022 at a university rheumatology outpatient clinic and included patients using GCs. A clinical pharmacist assessed patients for possible GC-related problems at baseline, 3 months, and 6 months. Identified problems, their causes, interventions to address these problems, and their outcomes were categorized using the Pharmaceutical Care Network Europe (PCNE v9.1) classification system. The resolution of the problems was evaluated at the patient’s next follow-up visit. Results A total of 156 patients were included, and 236 GC-related problems were identified in 66% of the patients. Adverse drug events (possible) accounted for the highest proportion of GC-related problems (94.1%), and the most common causes were lack of laboratory monitoring of GC-related adverse events (41.5%) and lack of drug treatment despite existing indications (39.8%). The median cumulative prednisolone dose was higher in patients with GC-related problems (3115 vs. 5455 mg, p = 0.007). The clinical pharmacist suggested 381 interventions: 47.7% ( n = 182) at the ‘prescriber level’, 31.8% ( n = 121) at the ‘patient level’, and 20.5% ( n = 78) at the ‘drug level’. Of those interventions, 98% were accepted, and 80.1% of the problems were solved. Conclusions This study showed that the prevalence of GC-related problems is high in patients with rheumatic diseases. Integrating clinical pharmacists into the multidisciplinary rheumatology team provides an advantage in effectively identifying and managing GC-related problems at an early stage.

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Identification of Drug Related Problems (DRPs) in Rheumatoid Arthritis Patients at Palembang City Hospital

Hairun Niza,

Sarah Hanifah Az-Zahra Anwar,

Sintya Merinda

2024

JFIKI

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Background: Rheumatoid arthritis is a chronic systemic inflammatory arthritis disease that affects mainly synovial joints. The incident of RA can lead to the emergence of complications or comorbidities, which then allows patients to receive a variety of therapies that can trigger the incidence of DRPs during the treatment. The prevalence of RA in Indonesia itself in 2018 has reached 7.30%, with the highest percentage occurring in the elderly age group and more prevalent in women. Objective: This study aimed to determine the incidence of DRPs in RA patients in Palembang city hospitals based on the category of DRPs identified as related to drug selection and dose selection problems, as the relationship between demographic factors and the incidence of DRPs. Methods: This research is non-experimental study conducted with a retrospective cross-sectional survey. Data collection was carried out by looking at patient medical record data at X and Y Hospital in Palembang from January 2021 to March 2023. Results: The results showed that the most frequent drps in the drug selection category were drug interactions (72.03%), while in the dose selection category were insufficient dosage regimens (60.74%). The results of bivariate analysis between the incidence of DRPs and gender (p=0.809), age (p=0.879), the number of drugs used (p=0.001), and comorbidities (p=0.089). Conclusion: There is no relationship between demographic factors and comorbidities with the incidence of DRPs, and there is a relationship between the number of drugs and the incidence of DRPs.

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Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

Cited by 4 publications

References 25 publications

Drug-related problems reported by patients with rheumatic diseases: an observational study

Drug-related problems reported by patients with rheumatic diseases: an observational study

Addressing Glucocorticoid-Related Problems with the Clinical Pharmacist Collaboration in Rheumatology Practice: A Prospective Follow-Up Study

Identification of Drug Related Problems (DRPs) in Rheumatoid Arthritis Patients at Palembang City Hospital

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