Prevalence of medication-related problems among patients with renal compromise in an Indian hospital

Castelino, Ronald L.; Sathvik, BS; Parthasarathi, G; Gurudev, KC; Shetty, Manjunath S; Narahari, M G

doi:10.1111/j.1365-2710.2011.01266.x

Cited by 26 publications

(24 citation statements)

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“…Cardiovascular agents and anti-infective agents were the most common therapeutic class of medications implicated with drug related problems. This result is consistent with the studies carried out by Sathvik et al, Krska J et al, Zaher Al Salmi and Al-hajje et al 17,18,19,20 where cardiovascular agents were the highest rate associated with drug related problems but differ from the studies carried out by Struck P et al 21 in which antibiotics are the most frequently involved in drug related problems. The reason for the difference in the therapeutic classes involved may be because of the differences in the underlying diseases.…”

Section: Discussionsupporting

confidence: 90%

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2015

IJPSR

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Introduction: Drug related problems occur commonly in patients who often receive polypharmacy with multiple co-morbid conditions. This constitutes a major health problem because of their negative consequences with increased morbidity and mortality. Aims and Objectives: The aim of the study was to assess the impact of clinical pharmacist interventions in drug therapy in hospitalized diabetes mellitus patients with hypertension. Methodology: A Prospective interventional study was carried out in the medicine wards of a tertiary care teaching hospital over a period of 10 months from September 2013 to June 2014. The drug therapy details of the patients were collected from inpatient case records. Clinical pharmacist reviewed the drug therapy, identified the drug related problems during ward rounds and discussed with the physicians and suitable suggestions was provided which had been documented. Results: A total of 147 drug therapy problems were identified from 111 patient case records. The number of drug related problems was predominant in males than females. Drug related problems were commonly seen in patients aged between 61-80 years of age. The most common drug related problems was found to be improper drug selection (22.44%) followed by drug use without indication (19.04%). The most frequent suggestions by the clinical pharmacist were on cessation of drug (25.17%). The acceptance rate of suggestions and the changes in drug therapy was found to be high (52.38%). The level of significance of drug related problems was found to be moderate significance in grade. Conclusion: Involvement of clinical pharmacist as a member of healthcare team during the ward rounds in hospitalized patients with diabetes mellitus helps in identification and prevention of drug related problems which will help to rationalise the drug therapy, achieve better therapeutic outcomes and improved quality of patient care. INTRODUCTION: Diabetes mellitus is a chronic progressive metabolic disturbance characterized by hyperglycemia due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone or both.

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Section: Discussionsupporting

confidence: 90%

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2015

IJPSR

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“…The most common type of DRPs was overdosage (38%), as shown in Table 2. This finding was linier with the finding from a study conducted by Prasanna et al [7] and Castelino et al [8], which confirmed the high dose of prescribing as the major DRPs. Yet, this finding was different with the finding from a study conducted by Samoy et al [9] which confirmed that adverse drug reactions was the most frequent of DRPs.…”

Section: Resultscontrasting

confidence: 45%

A Study of Drug Related Problem in Urologic Patients: a Cohort Prospective Study

Faizah

Diniya

2017

Asian J Pharm Clin Res

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Objective: Drug Related problems (DRPs) are the clinical domain of the pharmaceutical care practitioner. The purpose of identifying drug therapy problems is to help patients on achieving their goals of therapy and realizing the best possible outcomes from drug therapy. The purpose of this study was to determine the number of DRPs and to classify DRPs that occurred in post-operative patients from urology surgery ward. Methods:A 3-month prospective study was conducted by considering 62 hospitalized post-operative patients from urology surgery ward at the Teaching Hospital in Surabaya, East Java, Indonesia. Clinical pharmacists were involved in medical rounds to identify DRPs.Results: From 37 patients, 81 DRPs were identified in this study. About 20 patients were considered to have more than one DRP. The most common identified DRPs were overdosage (38%), drug use without indication (20%), improper drug (11%), drug interaction (10%), untreated indication (9%), adverse drug reaction (7%), failure to receive drug (4%), and subtherapeutic drugs (1%). The clinical pharmacists were involved in doing dose adjustment, monitoring, evaluating drug discontinuation, doing drug substitution and additional therapy, counseling to patients, increasing dose, and referring to prescriber. Conclusion:The most identified DRPs were overdosage, drug use without indication, and improper drug. Clinical pharmacist's intervention was required to identify, prevent, resolve DRPs, and assist patient on achieving their goals of therapy and improving their quality of life.

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“…The types of medications associated with MRPs in our study portrayed the common prescribing pattern in the paediatric population [ 3 , 21 , 22 ]. However, medicines of the “blood and blood forming agents” are unique to MRPs in renal patients [ 12 , 13 , 23 , 24 ]. The medications that were more often associated with MRPs were also those more often prescribed.…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of medication-related problems in children with kidney disease

et al. 2014

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BackgroundMedication-related problems (MRPs) are the undesirable effects of pharmacotherapy that can potentially lead to harm. The epidemiology of MRPs in paediatric renal patients is unknown. We aimed to characterise MRPs in this population at two tertiary care hospitals in the UK.MethodsPrescription charts for children (≤18 years) were reviewed to identify MRPs, and characterised using a specific proforma with a standard operational definition. MRP predictors were evaluated by logistic regression and severity was assessed using a validated scale.ResultsTwo hundred and sixty-seven MRPs were identified from 266 prescription chart reviews. The incidence was 51.2 % (203 MRPs, 166 charts; 95 % CI 43.2–60.6 %) of hospitalised patients and 32 % (64 MRPs, 100 charts; 95 % CI 22.9–41.1 %) in outpatients. The number of prescribed medications was the only independent predictor during inpatient treatment (OR 1.06, 95 % CI 1.02–1.10, p = 0.002) with no significant predictors identified at outpatient clinics. The severity level of the MRPs was minor: 53.9 %, (144 out of 267); or moderate: 46.1 %, (123 out of 267). Sub-optimal drug effect was the predominant MRP (inpatient: 68 %; outpatient: 39 %). Prescribing error and patients' medicine-taking behaviour were the main contributory factors. The majority of the MRPs in the inpatient setting were resolved.ConclusionMany factors are associated with MRPs in children; the associations are cumulative and interdependent. Investment in preventive strategies and extending the support from the acute health care setting into the community are invaluable for optimising pharmacotherapy.

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Prevalence of medication-related problems among patients with renal compromise in an Indian hospital

Abstract: Medication-related problems are frequent in renally compromised patients in our patient population. The high level of acceptance of clinical pharmacist's recommendations by the nephrologists demonstrates that clinical pharmacists may help improve overall patient care in this setting.

Cited by 26 publications

References 24 publications

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A Study of Drug Related Problem in Urologic Patients: a Cohort Prospective Study

Epidemiology of medication-related problems in children with kidney disease

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