Impact of drug-related problems and clinical pharmacist interventions on therapeutic outcomes of the patients admitted to a tertiary care hospital

Biradar, S M.; Indu, Pathi; Manjunatha, G; Kalyane,; Ambali, Anand P.; Naikwadi, Akram; Pournamy, Pournamy; Nayakavadia, Neeraja; Prudvi, Prudvi

doi:10.5455/ijmsph.2017.1164412122016

Cited by 4 publications

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“…In the current study, as with other studies, 41‐43 the clinical pharmacist intervened on the majority of DRPs. The average intervention per DRPs was 1.04, which was lower than a previous report (1.46 interventions per DRPs) 35 .…”

Section: Discussionmentioning

confidence: 66%

Identification of drug‐related problems followed by clinical pharmacist interventions in an outpatient pharmacotherapy clinic

Shahrami

Forough

Najmeddin

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objective: Pharmacotherapy is an essential strategy for the treatment of many medical conditions especially chronic disease and often involves multiple medications being used simultaneously. Increasing the use of medications may pose some challenges to safe and effective drug therapy and if not identified and prevented by the pharmacists eventually can lead to drug-related problems (DRPs).The present study aimed to examine the incidence of DRPs in Iranian patients and to evaluate patients' adherence to the clinical pharmacist interventions as well as the physicians' acceptance of these recommendations. Methods:This study was conducted in a university-affiliated outpatient pharmacotherapy clinic over a 22-month period. Patients aged 18 years and older with at least one chronic disease receiving at least four medications were included in the study.The patients were interviewed by a clinical pharmacist for comprehensive medication review. DRPs were identified using the DOCUMENT classification system.Recommendations were provided by the clinical pharmacist including interventions involving patient and/or physician to resolve DRPs. The patients were followed up after 2 weeks to evaluate their compliance and physician acceptance of clinical pharmacist recommendations.Results and discussion: Two hundred patients were included in this study. Overall, 875 DRPs were identified with an average of 4.37 per patient. The most prevalent DRPs were related to patient education or information (22.8%), undertreated indications (17.4%) and patient compliance (17.2%). The most common drugs associated with DRPs were alimentary and metabolism (22.2% of DRPs) followed by the cardiovascular system (19.2%) and nervous system (9.6%) medications. The DRP incidence correlated with gender only and was higher in females (p = 0.019). The clinical pharmacist provided 912 interventions with an average of 4.56 and 1.04 interventions per patient and per DRPs respectively. Patient education (41.3%), medication initiation or discontinuation (24.5%), and non-pharmacological interventions (12.9%) were the most common clinical pharmacist interventions. Out of 912 interventions, 665 were | 965 SHAHRAMI et Al. How to cite this article: Shahrami B, Sefidani Forough A, Najmeddin F, et al. Identification of drug-related problems followed by clinical pharmacist interventions in an outpatient pharmacotherapy clinic.

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Section: Discussionmentioning

confidence: 66%

Identification of drug‐related problems followed by clinical pharmacist interventions in an outpatient pharmacotherapy clinic

Shahrami

Forough

Najmeddin

et al. 2022

Clinical Pharmacy Therapeu

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“…Our study showed more DRP's in people who stayed for 3-7 days. 9,12,17 This might be due to shifting of patients to better hospital setting (rural to urban setting) due to complex comorbidities. The other fact may be that the more patients have been discharged shareef et al, 10 and Rashmi Adhikari et al, 11 Drug interactions (40.6%) were highest followed by ADR's (18.73%), Drug Choice Problems (17.14%), Dosing Problems (9.84%).…”

Section: Discussionmentioning

confidence: 99%

“…Many studies in different settings were in accordance with these results. 9,12,17 Antimicrobials were the class of drugs which mostly contributed to the Drug Related Problems (27.54%). 11,12 This result might be due to inclusion of antibiotic in maximum number of medication chart and irrationality while prescribing them.…”

Section: Discussionmentioning

confidence: 99%

Role of Clinical Pharmacist in Drug Therapy Management in a Teritary Care Hospital

Pokkuluri¹,

Srujana²,

Harsha³

et al. 2023

Ind. J. Pharm. Pract.

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Objectives: Drug Therapy Management is a collaborative approach between a physician and a pharmacist. Implementation of DTM in hospitals have a higher chance of reducing DRP's and increase in patients' Quality of Life. The aim of this study is to evaluate types, frequency, and ways for minimizing Drug Related Problems and identify the role of clinical pharmacist in Drug Therapy Management. Methods: A Prospective Observational study was carried out in a tertiary care teaching hospital in Bhimavaram. All the in-patients who satisfied the inclusion criteria were enrolled. Patient demographics and necessary clinical data was collected. MS Excel and Graphpad Prism 9 Software were used to analyze the data. Chi-Square Test was implemented to obtain significance between number of diseases, age, number of drugs prescribed, length of hospital stays with DRP's. Results: Among 493 cases, total of 315 DRP's were detected (mean = 2.58 DRP's per patient). The highest occurring DRP was Drug Interactions (40.6%). Antibiotics (27.54%) were found to be highly contributing. The major cause for DRP's was inappropriate combination of drugs or drugs and food (39.75%). Drug discontinuation (26.35%) was the most appropriate type of recommendation. Conclusion: Findings in this study signify the need of adaptation of Drug Therapy Management thereby improving healthcare system. Most of the medication errors can be prevented with the interventions of clinical pharmacist as they have broad knowledge of clinical pharmacokinetics, drug use and safety.

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“…Out of 231 (60.15%) patients who experienced MRPs, 62% of MRPs were found in males, which is similar with the result of two studies done in India. 28 , 29 This might be due to increased medication use because of comorbid condition was higher in males and other various risk factors like smoking, alcoholism and chewing Khat compared to females. The prevalence of MRP was found to be 60.15% and average of MRPs per patient was 1.25± 1.18, which was lower than study conducted at JUMC (83.5%) and 2.6 ± 1.8, the difference could be due to setting difference where our study conducted chronic follow up patients in which senior physicians and clinical pharmacists are available more frequently.…”

Section: Discussionmentioning

confidence: 99%

Medication Related-Problems and Associated Factors Among Patients with Hypertension at a Tertiary Care Hospital in Ethiopia: A Prospective Interventional Study

Garedow,

Mamo,

Tesfaye

2023

IBPC

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Background Hypertension affects more than 1.4 billion people worldwide currently, with that number anticipated to climb to 1.6 billion by 2025 with high mortality and morbidity effects. Medication related problems in cardiovascular disease patients, especially among hypertension patients were found to be high and a critical problem which is associated with high mortality, complication, prolonged hospital stay, compromised quality of life and increase health care cost. Objective To determine medication related problems and its predictors among hypertension patients on chronic follow-up at Jimma Medical Center. Methods A prospective interventional study was conducted among hypertension patients from November 28, 2021 to June 30, 2022 at Jimma Medical Center. Medication related problems were classified and identified based on Pharmaceutical care network Europe drug classification tool version 9.0. Interventions were done through discussion with individual prescriber and patients. Consecutive sampling technique was used. Binary Logistic regression was used to identify independent predictors of medication related problems. Variables having P-values < 0.05 were considered statistically significant. Results Among 384 hypertension patients included in the study, 219 (57.1%) were male. The mean (SD) age was 49.06+17.79. Two thirds of study participants had at least one medication related problem. A total of 483 MRPs were identified among 231 (60.15%) patients. Treatment effectiveness related problem (55.48%) was the most common observed medication related problems. Alcoholism (AOR; 3.15, 95% CI [1.46–7.23]), stage II hypertension (AOR=2.77, 95% CI= [3.53–4.66]); comorbidity (AOR=2.88, 95% CI= [1.47–5.66]) and polypharmacy (AOR=3.07, 95% CI= [1.57–5.99]) were the independent predictors of medication related problems. Conclusion The prevalence of medication related problems was high among hypertensive patients. Alcoholism, stage II hypertension, comorbidity and poly-pharmacy were the predictors of medication related problems. Therefore, to overcome the problems, clinical pharmacists, physicians and other health care professionals have to work in collaboration.

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Impact of drug-related problems and clinical pharmacist interventions on therapeutic outcomes of the patients admitted to a tertiary care hospital

Cited by 4 publications

References 0 publications

Identification of drug‐related problems followed by clinical pharmacist interventions in an outpatient pharmacotherapy clinic

Identification of drug‐related problems followed by clinical pharmacist interventions in an outpatient pharmacotherapy clinic

Role of Clinical Pharmacist in Drug Therapy Management in a Teritary Care Hospital

Medication Related-Problems and Associated Factors Among Patients with Hypertension at a Tertiary Care Hospital in Ethiopia: A Prospective Interventional Study

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