Evaluation of Drug-Related Problems in a Pediatric Bone Marrow Transplantation Unit Identified by a Clinical Pharmacist in-training in a 7-Month Period

Nesligül Özdemi̇r,Ayce Celi̇ker,Bulent Barıs Kuskonmaz,Fatma Visal Okur,Duygu Uckan Ceti̇nkaya

doi:10.33808/clinexphealthsci.590213

Abstract

Objective: This cross sectional study was performed to demonstrate the importance of clinical pharmacists’ participation in pediatric hematopoietic stem cell transplantation patient management with regards to the detection, prevention, and management of drug-related problems.Methods: The study was carried out from 1st October 2015 to 1st May 2016 in a pediatric bone marrow transplantation unit of a tertiary care hospital. The inpatients and outpatients between 0 to 18 years of age were included and the patients were monitored and evaluated for drug-related problems (interactions, side effects, preparation, and administration). A clinical pharmacist-in-training made recommendations to the physicians and the nurses on the problems that were identified.Results: Twenty inpatients and twenty-two outpatients were monitored during the study. In total, 245 problems were identified in the inpatients, 37.14 % of which were drug-related; 33 % of the drug-related problems were the side effects of cyclosporine. Eleven recommendations on drug-related problems were made to the physicians and six of them were for the problems identified in the inpatient services with regards to drug dosing and administration. Five recommendations regarding total parenteral nutrition, drug incompatibility, drug administration from the feeding tube, and drug side effects were made to the nurses. Twenty-nine information on the dosing, side effects, incompatibilities, administration, and preparation of the drugs, were given by the pharmacist to the physicians and the nurses.Conclusion: Clinical pharmacists’ participation will improve the detection and the management of drug-related problems in pediatric hematopoietic stem cell transplantation units in Turkey.

Highlights

Hematopoietic Stem Cell Transplantation (HSCT) is currently a common medical practice in the world; it is performed on > 40,000 patients annually as reported in European Blood and Marrow Transplantation Registry [1]
The presence of a clinical pharmacist in the HSCT team is an approach aimed at improving the quality of care, through their contribution to detection, prevention and management of drug-related problems (DRPs) [8,9]
The involvement of a clinical pharmacist in a HSCT team has become a requirement in the recent editions of the Joint Accreditation Committee of International Society for Cellular Therapy-European Group for Blood and Marrow Transplantation/The Foundation for the Accreditation of Cellular Therapy standards, and this is expected to play a role in generalizing this practice for all HSCT Units [11]

Summary

Introduction

Hematopoietic Stem Cell Transplantation (HSCT) is currently a common medical practice in the world; it is performed on > 40,000 patients annually as reported in European Blood and Marrow Transplantation Registry [1]. Many transplantation units in developed countries have pharmacy staff in their multidisciplinary teams who routinely attend clinical rounds and are actively involved in the management of DRPs and in decision making. This has not become a standard practice in most of the units in the developing countries including Turkey. The involvement of a clinical pharmacist in a HSCT team has become a requirement in the recent editions of the Joint Accreditation Committee of International Society for Cellular Therapy-European Group for Blood and Marrow Transplantation/The Foundation for the Accreditation of Cellular Therapy standards, and this is expected to play a role in generalizing this practice for all HSCT Units [11]

Methods

Results

Discussion

Conclusion