Impact of Clinical Pharmacist Interventions in Prescribing Errors in Hospitalized Diabetic Patients with Major Polypharmacy

Abstract

Background: While clinical pharmacists are expected to have a potential role in minimizing prescribing errors (PEs) in patients with diabetes, the effectiveness of their interventions on the incidence and clinical significance of PEs remains unclear. Objectives: To investigate the effectiveness of clinical pharmacist interventions in correcting PEs in diabetic patients with major polypharmacy. Methods: This was a prospective pre-post study conducted in a secondary care hospital in Jordan over 4 months. There were 2 phases: Control, in which PEs were identified and categorized and active, in which clinical pharmacists intercepted and corrected PEs. Clinical severity of prescribing incidents was evaluated by an expert panel, comprising a senior clinical pharmacist, an internist, and cardiologist. SPSS V26 was used for data analysis. Results: Of 928 patients, 432 were followed and reviewed during the control phase and 496 during the active phase. Clinical pharmacist interventions reduced PEs by 89.5%; from 27.6% (control) to 2.9% (active). PEs per patient and PEs per medication orders were reduced from 2.1 to 0.2 and from 0.3 to 0.03, respectively. Electronic selection errors, wrong dose frequency, duplicate drugs, and allergy errors disappeared in the active phase. Significant, serious, and lethal errors were significantly reduced from 35.4%, 11.6%, and 0.2% (control) to 13.5%, 3.1%, and 0.0% (active), respectively. drugs related to CVS (OR = 5.2; 95% CI, 3.1-8.6; P < .05) versus drugs related to endocrine system was more likely to be associated with the occurrence of PEs versus no PEs. However, drug belonging to infectious (OR = 0.6; 95% CI, 0.1-0.9; P < .05) versus drugs related to endocrine system was less likely to be associated with the occurrence PEs versus no PEs. Conclusion: Clinical pharmacist interventions significantly reduced PEs in patients with diabetes by 89.5% and most of these interventions were clinically significant.

Assessment of A new Strategy to Prevent Prescribing Errors Involving COVID-19 Patients in Community Pharmacies

“…Nevertheless, several authors have established a link between the prevention of PEs and improved pharmacological outcomes. 40,41 Second, the participants of the study self-reported the outcome measures, which might have incorporated some reporting bias, influencing the validity of the outcome assessment process. Nonetheless, direct observation was not a feasible technique to report the study outcomes given the COVID-19 situation.…”

Polypragmasy and the basics of personalized rational pharmacotherapy selection in older patients with obesity and type 2 diabetes mellitus

“…Привлечение клинического фармаколога в качестве эксперта по безопасности ЛС в команду по лечению ожирения с нарушениями углеводного обмена может способствовать раннему выявлению и предотвращению серьезных исходов, связанных с ошибками в назначениях ЛС. Мероприятия по содействию рациональной фармакотерапии должны быть нацелены, главным образом, на людей с сопутствующими заболеваниями и полипрагмазией, которые наиболее уязвимы к НПР [38,50]. Проспективное исследование, проведенное Abu-Naser D. и соавт.…”

“…Неправильная доза препарата была наиболее распространенной ошибкой (25,0%), за ней следовали назначение неправильного препарата (18,8%) и нежелательное лекарственное взаимодействие (11,5%). Таким образом, клинические фармакологи оптимизируют медикаментозную терапию и тем самым способствуют улучшению состояния здоровья [50]. Следовательно, чтобы избежать ошибок в терапии и неоправданного назначения огромного количества ЛС, врач должен хорошо понимать механизмы действия сахароснижающих ЛС.…”

Multicenter prospective observational study on hospital pharmacist interventions to reduce inappropriate medications

“…Prescription errors are clinically meaningful errors that occur when prescribing decisions or formulary processes, resulting in an unintentional and significant decrease in the probability of timely and effective treatment or an increased risk of harm compared to generally accepted practice ( Abdel-Qader et al, 2010 ) and can occur in daily clinical practice ( Bates et al, 1995 ; Noguchi et al, 2016 ). Therefore, preventing prescription errors is essential for hospitals, and hospital pharmacists play a vital role in comprehensively intervening in patient care to prevent adverse drug events (ADEs) ( Nester and Hale, 2002 ; Bond and Raehl, 2007 ; Abu-Naser, 2021 ).…”