Drug-related Problems Classification Research Articles

The evaluation and classification of drug-related problems by a clinical pharmacist in an internal diseases intensive care unit: A prospective cohort 7-month study

The evaluation and classification of drug-related problems by a clinical pharmacist in an internal diseases intensive care unit: A prospective cohort 7-month study

Drug-related problems in hospitalized patients with chronic kidney diseases and clinical pharmacist interventions

BackgroundPatients with chronic kidney disease (CKD) are at high risk of drug-related problems (DRPs) because of extensive comorbidities and pharmacokinetic changes. This study aimed to identify DRPs and possible contributing factors in hospitalized patients with CKD, and evaluate the efficacy of the clinical pharmacist services in detection and intervention of DRPs in a large general hospital in Zhejiang Province, eastern China.MethodsWith the approval of the Ethics Committee, patients with CKD admitted to the nephrology ward from January to December 2020 were enrolled in this prospective study. The clinical pharmacist identified and intervened the DRPs during hospitalization. The DRPs were classified using the Pharmaceutical Care Network Europe (PCNE) DRP classification system, and all data were statistically analyzed using Statistical Package for Social Science (SPSS) version 26.0.ResultsA total of 914 patients with CKD were included, with 463 DRPs observed among 420 (45.95%) participants; the average DRP per patient was 0.51 (standard deviation [SD], 0.60) before pharmacist intervention. Treatment safety accounted for the highest proportion of problems (43.84%), followed by treatment efficacy, accounting for 43.20%. Drug selection was the most common cause of DRPs (60.26%), and antibiotics and cardiovascular agents were the most common drugs associated with DRPs (32.84% and 28.66%, respectively). A total of 85.53% of pharmaceutical intervention recommendations were followed, and 84.23% of DRPs were completely resolved after intervention by the clinical pharmacist. The proportion of patients who experienced DRPs decreased to 7.77%, with an average of 0.08 (SD 0.28) DRPs during hospitalization after pharmacist’s intervention. Significant contributing factors for DRPs were CKD stage 4, number of comorbid diseases, number of prescribed medications, and hospitalization days in both the univariate and multivariate logistic regression models.ConclusionDRPs are common among hospitalized patients with CKD in China. CKD stage 4, the number of comorbidities, use of multiple prescription drugs, and extended length of hospital stay are contributing factors for DRPs. Even only one clinical nephrology pharmacist in the nephrology ward, clinical pharmacist can play an important role in facilitating the identification of DRPs in patients with CKD and assisting physicians resolve DRPs in this single center study in China.

The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver cirrhosis patients

Patients with decompensated cirrhosis have typically prescribed a combination of therapeutic and prophylactic medications. Polypharmacy increases the probability of medication errors and drug related problems. Clinical pharmacists are highly effective at identifying, resolving, and preventing clinically important drug-related problems in their patients' care. The objectives of the study were the identification and classification of drug-related problems, as well as the discussion of these problems with health care providers (physicians, pharmacists, and nurses) and patients. Reduce their incidence as effectively as possible and educate all research participants on the significance of following their prescribed drug regimen. Prospective, interventional, clinical study for 80 hospitalized decompensated liver cirrhosis patients was designed in two phases, an observational phase to identify drug related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and an interventional phase to increase the awareness of patients and the health care providers about those problems and to propose a proper solution for each one. The majority of drug-related problems were attributable to the Effect of drug treatment not optimal in 41.5%, Adverse drug events (possibly) occurring in 41.5 %, and Untreated symptoms or indications in 17%. Causes were Drug dose too high in 30.2%, Patient unintentionally using the drug in the wrong way in 22.6%, and Prescribed drug not available in 13.2%. Omeprazole and lactulose were the most common medications causing problems. Acceptance and full implementation were high and observed in 71.7% of pharmacist interventions while 15.1% of the intervention have no agreement. Significant numbers of Iraqi patients with decompensated liver cirrhosis have drug-related problems, and the use of proton pump inhibitors in too high dose was accountable for a large number of problems. Physicians and clinical pharmacists collaborated exceptionally well

Applicability of drug-related problem (DRP) classification system for classifying severe medication errors

BackgroundSeveral classification systems for medication errors (MEs) have been established over time, but none of them apply optimally for classifying severe MEs. In severe MEs, recognizing the causes of the error is essential for error prevention and risk management. Therefore, this study focuses on exploring the applicability of a cause-based DRP classification system for classifying severe MEs and their causes.MethodsThis was a retrospective document analysis study on medication-related complaints and authoritative statements investigated by the Finnish National Supervisory Authority for Welfare and Health (Valvira) in 2013–2017. The data was classified by applying a previously developed aggregated DRP classification system by Basger et al. Error setting and harm to the patient were identified using qualitative content analysis to describe the characteristics of the MEs in the data. The systems approach to human error, error prevention, and risk management was used as a theoretical framework.ResultsFifty-eight of the complaints and authoritative statements concerned MEs, which had occurred in a wide range of social and healthcare settings. More than half of the ME cases (52%, n = 30) had caused the patient’s death or severe harm. In total, 100 MEs were identified from the ME case reports. In 53% (n = 31) of the cases, more than one ME was identified, and the mean number of MEs identified was 1.7 per case. It was possible to classify all MEs according to aggregated DRP system, and only a small proportion (8%, n = 8) were classified in the category “Other,” indicating that the cause of the ME could not be classified to specific cause-based category. MEs in the “Other” category included dispensing errors, documenting errors, prescribing error, and a near miss.ConclusionsOur study provides promising preliminary results for using DRP classification system for classifying and analyzing especially severe MEs. With Basger et al.’s aggregated DRP classification system, we were able to categorize both the ME and its cause. More research is encouraged with other ME incident data from different reporting systems to confirm our results.

Investigation of drug-related problems in patients hospitalized in chest disease wards: A randomized controlled trial.

Objective: According to the World Health Organization (WHO), chest diseases are among the 10 diseases that cause the highest mortality worldwide. Drug-related problems (DRPs), readmission, and antimicrobial resistance are critical problems in chest disease wards. Active involvement of clinical pharmacists (CPs) who are focused on reducing the risks of potential problems is needed. The aim of this study is to investigate the effects of pharmaceutical care (PC) services on the pulmonology service. Method: A randomized controlled trial at a university hospital in Istanbul was conducted between June 2020 and December 2021. The participants were randomized into the control group (CG) and intervention group (IG). In the CG, CPs identified and classified the DRPs according to Pharmaceutical Care Network Europe v9.0 (PCNE) and provided solutions to DRPs for the IG. The effect of PC services was evaluated by the number and classification of DRPs, and readmissions within 30days were compared between the two groups. Results: Out of 168 patients, 82 were assigned to the IG. The average number of medicines administered per patient in the CG and IG was 14.45 ± 7.59 and 15.5 ± 6.18, respectively. In the CG and IG, the numbers of patients with DRPs were 62 and 46, respectively. The total number of DRPs was 160 for CG and 76 for IG. A statistically significant difference was found in favor of the IG, in terms of the number of patients with DRPs, the total number of DRPs, and readmission within 30 days (p < 0.05). Conclusion: In this study, CP recommendations were highly accepted by the healthcare team. Pharmaceutical care services provided by CPs would decrease possible DRPs and led to positive therapeutic outcomes. Cognitive clinical pharmacy services have beneficial effects on health care, and these services should be expanded in all settings where patients and pharmacists are present.

IDENTIFIKASI DRUG RELATED PROBLEMS (DRPs) PENGGUNAAN ANTIHIPERTENSI PASIEN HIPERTENSI DI RSU AZZAHRA KALIREJO LAMPUNG TENGAH

A person is diagnosed with hypertension if there is an increase in systolic blood 140 mmHg and diastolic blood pressure 90 mmHg. Treatment of hypertension aims to reduce morbidity and mortality. Hypertensive patients receiving polypharmacy pharmacological therapy are at risk of developing DRPs. The purpose of this study was to identify the incidence of Drug Related Problems (DRPs) in the use of antihypertensives in hypertensive patients at Azzahra Kalirejo General Hospital, Central Lampung in 2021. This study was non-experimental with a retrospective descriptive design, then identified using the classification of DRPs according to Robert J. Cipolle EL. Pharmaceutical Care Practice and Medscape and Drug Interaction Chacker applications to identify drug interactions, and use the Medication Possession Ratio (MPR) formula to identify patient non-compliance. Based on the results of research at Azzahra Kalirejo General Hospital, Central Lampung, of the 135 samples that met the inclusion criteria, 80% of the samples experienced DRPs. Based on gender characteristics, there were 50.37% male and 49.62% female with 0% of patients aged &lt;25 years, age 26-45 years 30.3%, age 46-65 years 57.8% and age &gt; 65 years 11.8%. The most widely prescribed antihypertensive drug was furosemide as much as 42.2%, the most antihypertensive combination was a combination of two drugs as much as 57%. The most use of non antihypertensive drugs is PPI and analgesics as much as 12.8%. Cases of DRPs requiring additional therapy were 1.9%, drug therapy was not necessary 7.4% cases, inappropriate drugs 4.6% cases, doses too low and high in 0% cases, drug interactions were 77.8% with major severity 11.7%, minor 34.5% cases and moderate as many as 53.7%, patient non-compliance with DRPs occurred in 51.9% cases. Keywords: Antihipertensive, DRPs, Furosemide, Hypertension

Standard for the use of the Chinese classification system for drug-related problems

The discovery, resolution, intervention and evaluation of drug-related problems (DRPs) are core processes for pharmacists to perform pharmaceutical care. Based on the literature and data of foreign DRPs classification system and current pharmaceutical practice experience, the Chinese DRPs classification system was initially established after selection and integration, and then gradually improved through multiple rounds of public verification method. Finally, a standard for the use of the "Chinese Drug-related Problems Classification System" that conforms to the Chinese population and medical model was formed. The Chinese DRPs classification system includes six parts, i.e., problem, DRP evaluation, cause, intervention plan, acceptance of intervention plan, and DRP status. It aims to provide a basis for Chinese pharmacists to carry out standard and standardized pharmaceutical care and improve the quality of clinical drug treatment management.

Comparison of the prevalence and nature of potentially inappropriate medication use in geriatric outpatients between tertiary and community healthcare settings: a multicenter cross-sectional study.

Background Geriatric outpatients with polypharmacy have a high risk of potentially inappropriate medication (PIM) use. Aim To identify differences in both prevalence and patterns of PIMs and drug-related problems (DRPs) in older outpatients who visited the tertiary hospitals (THs) and community health centers (CHCs) and analyze associated factors. Method A prospective cross-sectional study was conducted in five THs and five CHCs from September 2018 to November 2019 in Beijing, China. Data were collected from outpatients aged ≥ 65years with chronic diseases and polypharmacy. PIMs were evaluated using the 2015 and 2019 Beers Criteria and the Screening Tool of Older Persons' Prescriptions (STOPP) criteria. DRPs were classified using the Helper-Strand DRP Classification. The prevalence and types of PIMs and DRPs were compared, and relevant factors were analyzed. Results The prevalence of PIMs based on the 2015 Beers Criteria was higher in patients from the THs, while PIMs based on the 2019 Beers Criteria did not show a significant difference. PIM prevalence based on STOPP Criteria and DRPs was higher in patients from CHCs. Visiting CHCs was an independent factor of PIMs based on the 2015 Beers Criteria (OR 0.774, 95% CI 0.604-0.992) and the STOPP Criteria (OR 2.427, 95% CI 1.883-3.128), and DRPs (OR 3.612, 95% CI 2.682-4.865). Conclusion Differences in PIM and DRP might be due to the patients and settings. Specific measures to improve the appropriateness of medications in both settings should be used.

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

The goal of epilepsy treatment is to control seizures without drug related problems (DRPs). The evaluation of anti-seizure drugs (ASD) strategies and identification of DRPs are rarely studied. This study aimed primarily to evaluate the choice of ASD according to international guidelines and secondarily to identify and describe anti-seizure drug-related problems. A cross-sectional study was conducted during 1 year among Lebanese adults with epilepsy attending neurology clinics. The choice of ASD was compared to National Institute for Health and Care Excellence guidelines. Drug-drug interactions were evaluated by the Lexicomp database, and the DRP classification was performed using the Pharmaceutical Care Network Europe classification. A total of 404 patients with epilepsy were included. The prescription for an ASD was in accordance with the indication set in guidelines in 75.0% of population, and 1078 DRPs were identified. The main DRPs detected were adverse drug reactions (51.0%), inappropriate combinations of drugs (50.0%), and suboptimal drug regimens (46.3%). Single and divorced patients, who living in Mount Lebanon, and who took the old with the new generation had a less risk to have an inadequate prescription to guidelines. However, female gender, controlled epilepsy, multiple ASDs, and living in a rural region increased DRPs. This study showed that quarter of the population used ASDs contraindicated according to international guidelines. Since DRPs were related to the number and type of ASD prescribed, it is important to assess the case of each patient by a clinical pharmacist to prevent drug-drug interactions and iatrogenic issues.

Clinical pharmacist assessment of drug-related problems among intensive care unit patients in a Turkish university hospital

BackgroundCritically ill patients treated in the intensive care units (ICUs) often suffer from side effects and drug-related problems (DRPs) that can be life-threatening. A way to prevent DRPs and improve drug safety and efficacy is to include clinical pharmacists in the clinical team. This study aims to evaluate the classification of drug-related problems and the implementation of clinical pharmacy services by a clinical pharmacist in the ICU of a university hospital in Turkey.MethodsThis study was carried out prospectively between December 2020 and July 2021 in Gazi University Medical Faculty Hospital Internal Diseases ICU. All patients hospitalized in the intensive care unit for more than 24 h were included in the study. During the study, the clinical pharmacist's interventions and other clinical services for patients were recorded. DRPs were classed according to the Pharmaceutical Care Network Europe V.8.02.ResultsA total of 151 patients were included during the study period corresponding to 2264 patient-days. Patients with DRPs had a longer hospital stay and a higher mortality rate (p < 0.05). 108 patients had at least one DRP and the total number of DRPs was 206. There was an average of 1.36 DRPs per patient, 71.5% of patients experienced DRP and 89.22 DRPs per 1000 patient-days. A total of 35 ADEs were observed in 32 patients. ADE incidence was per 1000 patient-days 15.45. ADEs were caused by nephrotoxicity (48.57%), electrolyte disorders (17.14%), drug-induced thrombocytopenia (17.14%), liver enzyme increase (8.57%) and other causes (8.57%). Drug selection (40.29%) and dose selection (54.36%) constituted most of the causes of DRPs. Dose change was the highest percentage of planned interventions with a rate of 56.79%. Intervention was accepted at a rate of 90.8% and it was fully implemented.ConclusionIn this study, the importance of the clinical pharmacist in the determination and analysis of DRPs was emphasized. Clinical pharmacy services like the one described should be implemented widely to increase patient safety.

Frequency and risk factors for the development of drug related problems among rheumatoid arthritis patients

BackgroundRheumatoid arthritis (RA) patients are at high risk for development of drug related problems (DRPs) due to multiple drug use. This study aimed to estimate the frequency and risk factors for the development of drug related problems among RA patients in Indian setting. MethodsA prospective cohort study was carried out for twenty-two months in a tertiary care teaching hospital. Patients who met study eligibility criteria were randomised either into intervention or usual care group. All the patients’ data were screened for the presence of DRPs. Identified DRPs were categorized into problems and their causes using Pharmaceutical Care Network Europe (PCNE V8.02) DRP Classification system. Clinical pharmacists proposed interventions to resolve DRPs in intervention group. ResultsA total of 320 RA patients [Intervention group, n = 160 and usual care group, n = 160] were enrolled in this study. Overall, 463 DRPs were identified among 88.4% of patients, and frequency of DRPs was 1.6 per patient. Treatment safety (41.2%) and patient related factors (28.2%) was the most common category and cause of DRPs respectively. Advanced age and polypharmacy were the common risk factors identified for the development of DRPs. ConclusionThis study revealed DRPs are common among RA patients and those are related to the treatment safety and efficacy. Clinical pharmacists’ provided interventions had significant impact on DRPs resolution among RA patients.

Drug-related problems and determinants among elective surgical patients: A prospective observational study.

Objectives:The aim of this study was to assess drug-related problems and determinants among elective surgical patients admitted to Jimma University Medical Center.Methods:A hospital-based prospective observational study was conducted at Jimma University Medical Center, from April 10 to July 10, 2018. Data were collected through patients’ interview and physicians’ medication orders and charts review using pre-tested questionnaire and data abstraction formats. Drug-related problems were assessed for each patient using drug-related problem classification tool. Data were analyzed using Statistical Package for Social Science for windows; version 21.0. The predictors of drug-related problems were determined by multivariable logistic regression analysis. A p-value of less than or equal to 0.05 was considered to be statistically significant.Results:Of the total 141 participants, 98 (69.5%) of them had at least one drug-related problem during their hospital stay. A total of 152 drug-related problems were identified among 141 elective surgical patients. The most common identified drug-related problems were indication-related problems (39%) followed by effectiveness-related problems (21%) and safety-related problems (21%). The presence of complication (adjusted odds ratio = 2.90, 95% confidence interval (1.302, 3.460)), American Society of Anesthesiologists Physical Status ⩾ 2 (adjusted odds ratio = 6.01, 95% confidence interval (1.0011, 9.500)), and postoperative antibiotics (adjusted odds ratio = 6.027, 95% confidence interval (1.594, 22.792)) were independent predictors of drug-related problems.Conclusion:The prevalence of drug-related problems is high among elective surgical patients. The indication-related problems were the most common category of drug-related problem identified among elective surgical patients. The presence of complication, American Society of Anesthesiologists Physical Status ⩾ 2, and postoperative antibiotics were the independent predictors of drug-related problems.

Drug-Related Problems Among Ambulatory Heart Failure Patients on Follow-Up at Debre Berhan Comprehensive Specialized Hospital, Ethiopia.

PurposeThe purpose of this study was to assess drug-related problems (DRPs) among ambulatory heart failure (HF) patients attending at medical referral clinic of Debre Berhan Comprehensive Specialized Hospital, Ethiopia.Materials and MethodsA hospital-based cross-sectional study was conducted among 344 HF patients. Drug-related problems were classified using modified Cipolle’s DRP classification schemes and drug–drug interactions were assessed using Micromedex, up-to-date, and drug.com drug–drug interaction checkers. The data was entered into Epidata version 4.2.0 and analyzed using SPSS version 25.0 statistical software. Descriptive statistics were used to summarize patients’ characteristics. Univariable and multivariable binary logistic regression analysis was performed to identify associated factors with dependent variables. P < 0.05 was considered statistically significant.ResultsThe mean age of the study participants was 53.38 ± 18.84 years and nearly half (45%) were in the age group of 31–60 years. Drug-related problems were found in 80.8% of HF patients. A total of 416 DRPs were identified. Adverse drug reaction (35.58%) was the top DRPs identified followed by the need for additional drug therapy (30.53%) and ineffective drug therapy (26.9%), respectively. Diuretics (45%), beta-blockers (BBs) (12.42%), and angiotensin-converting enzyme inhibitors (ACEIs) (10%) were the commonly used drug classes by study participants. The presence of comorbidity (p ˂ 0.001) and level of education of study participants (p = 0.03) had a significant association with the occurrence of DRPs.ConclusionThe prevalence of DRPs among ambulatory HF patients was high. The presence of comorbidity and the educational level of study participants had a significant association with the occurrence of DRPs. Checking potential drug–drug interactions before starting a new therapy, monitoring adverse drug reactions, ensuring sustainable availability of medications, and regular education programs are recommended to minimize DRPs.

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

BackgroundThe 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.MethodsA 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.ResultsA 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).ConclusionsDRPs 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.

The Impact of an Established Pharmaceutical Care Pathway on Drug Related Problems in an Intensive Care Unit

BackgroundThe incidence of drug related problems (DRPs) in intensive care units (ICU) is higher compared to any other wards in the hospital, requiring a structured pathway to ensure optimum detection of DRPs. The study aimed to evaluate the impact of implementing a pharmaceutical care pathway on the detection and management of DRPs in an ICU. MethodsThe study was conducted in a general ICU and included three phases: tool preparation phase included the development of a core measures reference pathway and daily working scenario flow-charts, a control phase where the patient files and pharmacists' case assessment notes were retrospectively reviewed to detect the rate of DRPs before pathway implementation and a prospective phase similar to the control phase but with the implementation of the new pathway. The number and classification of DRPs and required core measures in the control and implementation phases were documented. ResultsUsing the new pathway, the detection of unmet core measures increased from 7.3% in the control phase to 99% in the implementation phase (p-value <0.001). The prevalence of unidentified DRPs/1000 patients' service days decreased from 98.1 in the control phase to 27.08 in the implementation phase (p-value <0.001). However, there was no significant difference between the phases regarding mortality rate and length of ICU stay. ConclusionsThe implementation of a unified pharmaceutical care pathway improved the detection of DRPs in ICU patients.

ANALISIS DRUG RELATED PROBLEMS (DRPs) PADA PASIEN RAWAT JALAN DIABETES MELITUS TIPE 2 DI UPT PUSKESMAS RAWAT INAP GEDONG AIR BANDAR LAMPUNG

Abtract Diabetes mellitus (DM) is a serious chronic disease that occurs because the pancreas does not produce enough insulin or when insulin is not use effectively in the body. This study aims to analyze the incidence of Drug Related Problems (DRPs) and find out the category of DRPs in outpatients with a diagnosis of type 2 diabetes mellitus at UPT Puskesmas Gedong Air Inpatient for the Bandar Lampung. This research is a nonexperimental research with a descriptive design taken retrospectively. The sampling technique used in this study is total sampling based on the patient's medical record data. Data were analyzed using the classification of DRPs according to Cipolle 2004, then using Medscape Tools as a tool to check potential drug interactions. The results of this study were 61 patients including 29 patients (46%) with DRPs and 33 patients (54%) without DRPs. The number of male patients is 25 patients and the number of female patients is 36 patients with age range 25-45 and 46-65. A total 52 patien Type 2 Diabetes Mellitus have cormobid and 9 patients without comorbid. DRP categories that occur include drugs without indication as much (8%), indications without drugs as much as (15%), and potential drug interactions (48%). The conclusion in this study is that Drug Related Problems (DRPs) have occurred in outpatients diagnosed with type 2 diabetes mellitus in UPT Puskesmas Gedong Air Inpatient with the highest DRPs category is the potential for drug interactions (48%). Key words: Diabetes Mellitus Type 2, Drug Related Problems

Drug-related problems in Ethiopian public healthcare settings: Systematic review and meta-analysis.

Identification and prevention of drug-related problems have become the central role of patient-centered pharmacy practitioners. After the initiation of patient-oriented pharmacy service, many studies evaluating magnitude of drug-related problems at facility level in Ethiopia have been conducted, though the extent of the problem at a national level remains unknown. Hence, this systematic review and meta-analysis is undertaken with the aim of quantifying the prevalence of drug-related problems in Ethiopian public healthcare settings using Cipolle/Strand classification system. Electronic databases were searched including PubMed, EMBASE, Web of Science, MEDLINE and HINARI, Google Scholar and ResearchGate for both published and unpublished works. Data on study characteristics and outcomes were extracted using the format developed on Microsoft Excel. The primary measure was the pooled prevalence of drug-related problems. The meta-analysis was conducted using OpenMeta[Analyst].A total of 17 studies were included in this systematic review and meta-analysis. The pooled prevalence of drug-related problems of patients who experienced at least one drug-related problem during their therapy was found to be 69.4% (95% confidence interval: 61.5–77.4). The most frequently reported types of drug-related problems were “need for additional drug and “noncompliance,” together accounting for more than half of the drug-related problems. The most frequently reported factors associated with drug-related problems were patients’ age, polypharmacy, comorbidities and the number days of hospital stay.The prevalence of drug-related problems in Ethiopian public healthcare settings was found to be high. Inconsistent reporting of drug-related problems was observed across the studies. It is imperative to design and implement interventions aimed at reducing drug-related problems. Responsible stakeholders should adopt uniform drug-related problem classification approach to ensure uniform reporting of drug-related problems in Ethiopian healthcare settings

The Role of Clinical Pharmacist in Reducing Drug Related Problems in Hemodialysis Patients

Abstract&#x0D; Prescribing drugs to patients to treat ailments or reducing their morbidity may not be enough, even if the drugs were all indicated and in the right dose. Clinical pharmacists play a pivotal role in conducting information and instruction to patients and conveying feedback to treating physician when appropriate, and the final goal is in the interest of the patient. Identification and classification of drug related problems and discussing them with the health care providers. Prospective, interventional, clinical study for 180 hemodialysis patients, and was designed as two phases, an observational phase to identify drug related problems and classifying them according to the latest Pharmaceutical Care Network Europe classification, an interventional phase to increase the awareness of patients and the nephrologists about those problems and proposing a proper solution for each one. The main drug related problems was related to the effect of drug treatment being not optimal in 58.7%, followed by no effect in 17.8%, and least for unrelated symptoms or indications in 4.8%; causes were inappropriate combination and patients taking less drug than prescribed (both 17.4%), followed by no/or incomplete drug treatment in spite of existing indication in 12.2%, drug without indication in 10.4%. Erythropoietin and calcium were the most frequently drugs with problems. Acceptance and full implementation were observed in 34.3%, while half of the drug related problems had unknown implementation (51.3%). There were significant numbers of drug related problems among Iraqi patients on hemodialysis, the use of erythropoietin, calcium carbonate and sevelamer was responsible for most of inappropriate combinations. Physicians and clinical pharmacist cooperation was excellent.&#x0D; Keywords: Drug related problems, Hemodialysis, Clinical pharmacist.

Hastanede Yatan Pediatrik Hastalarda İlaç Tedavisinin İncelenmesi: Klinik Eczacı Önerileri

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

Hastanede Yatan Pediatrik Hastalarda İlaç Tedavisinin İncelenmesi: Klinik Eczacı Önerileri

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.