Identification and solution of drug-related problems in the neurology unit of a tertiary hospital in China

Abstract

Background The prevalence and characteristics of drug-related problems (DRPs) and factors associated with the occurrence of DRPs in the neurology unit in China remain unknown. This study aimed to determine the prevalence, characteristics and severity ratings of DRPs and identify factors associated with the occurrence of DRPs in the neurology unit of a tertiary care and academic teaching hospital in China. Methods A retrospective study of DRPs and pharmacists’ interventions for neurology patients was performed during a non-consecutive 24-month study period. Patient demographics and clinical characteristics, and pharmacist’s intervention records were collected. The characteristics and severity ratings of DRPs were categorized using the Pharmaceutical Care Network Europe (PCNE) DRP classification tool V9.00 and the National Coordinating Council for Medication Error Reporting and Prevention (NCC-MERP) classification respectively. Results A total of 242 DRPs were detected for 974 admitted patients, an average of 0.25 DRPs per patient. Treatment safety was the major type of DRPs (106;43.8%) followed by treatment effectiveness (78;32.2%). The primary causes of DRPs were drug selection (124;44.1%) and dose selection (92;32.7%). Clinical pharmacists provided 525 interventions, and most interventions occurred at the prescriber level (241;45.9%). A total of 91.4% of these interventions were accepted, contributing to solving 93.0% of the identified problems. The majority of DRPs (210;86.8%) were rated at severity categories B to D (causing no patient harm). Multiple logistic regression showed that creatinine clearance, number of medications used, nasogastric feeding, diabetes, and infectious diseases were associated with more frequent DRPs (p < 0.05). Conclusions DRPs are relatively common in the neurology unit in China, with primary causes of drug and dose selection, and clinical pharmacists can effectively reduce and prevent DRPs to optimize medication therapy.

Identification of drugs-related problems and pharmacists’ interventions in a hospital in Southern Brazil

“…Um estudo realizado em Portugal, com 31 pacientes idosos institucionalizados, identificou o possível risco de reação adversa (49,5%) como principal PRM e efeito do tratamento fora do esperado com 14,8% 19. Já em um estudo realizado na China, incluindo 198 pacientes internados em unidade de cuidados neurológicos, mostrou que 43,8% dos PRMs estavam relacionados ao domínio de segurança, seguido de 32,2% relacionados ao domínio de efetividade 20 .…”

“…Com relação as causas dos PRMs, o domínio mais frequentemente encontrado no estudo foi o de seleção de dose com 46,7% e o de seleção do medicamento com 32,5%. Esses dados sáo similares dos encontrados em estudos internacionais, nos quais a principal causa dos PRMs está ligada a seleção do medicamento em primeiro lugar e em segundo lugar ao domínio de seleção de dose 14,20,21,22,23,24 .…”

Management of epilepsy in Lebanon: Medication reviews and drug‐related problems

“…The frequency of DRPs was high with an average of 2.7 DRPs per patient, in a population considered young with a mean age of 38.4 years. In China, 242 DRPs were detected for 974 patients with an average 0.25 DRPs per patient 34 . In Ethiopia, a total of 352 DRPs were identified from 291 participants with an average number of DRPs per patient was 1.2 17 .…”

“…In China, 242 DRPs were detected for 974 patients with an average 0.25 DRPs per patient. 34 In Ethiopia, a total of 352 DRPs were identified from 291 participants with an average number of DRPs per patient was 1.2. 17 The main DRPs detected in this study were the inappropriate association of drugs, the occurrence of ADRs, the lack of drug effect, and taking a dose less than prescribed.…”

Drug-related problems among community-dwelling elderly with ischemic stroke in China

“…When the death rates were evaluated in terms of gender, the rate was higher in men than in women. 18 More specifically, in studies related to DRPs, problems in ambulatory patients, 19 neurological problems, 20 respiratory problems, and cardiac problems have been reported. 21,22 A drug-related problem (DRP) is defined as an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes.…”