Drug-related Problems In Patients Research Articles

Determination of drug-related problems in the hematology service: a prospective interventional study

BackgroundPatients with hematological malignancies often require multidrug therapy using a variety of antineoplastic agents and supportive care medications. This increases the risk of drug-related problems (DRPs). Determining DRPs in patients hospitalized in hematology services is important for patients to achieve their drug treatment goals and prevent adverse effects. This study aims to identify DRPs by the clinical pharmacist in the multidisciplinary team in patients hospitalized in the hematology service of a university hospital in Turkey.MethodsThis study was conducted prospectively between December 2022 and May 2023 in the hematology service of Suleyman Demirel University Research and Application Hospital in Isparta, Turkey. DRPs were determined using the Pharmaceutical Care Network Europe (PCNE) 9.1 Turkish version.ResultsThis study included 140 patients. Older age, longer hospital stay, presence of acute lymphoblastic leukemia, presence of comorbidities, higher number of medications used, and polypharmacy rate were statistically significantly higher in the DRP group than in the non-DRP group (p < 0.05). According to multivariate logistic regression analysis, the probability of DRP in patients with polypharmacy was statistically significant 7.921 times (95% CI: 3.033–20.689) higher than in patients without polypharmacy (p < 0.001).Every 5-day increase in the length of hospital stay increased the likelihood of DRP at a statistically significant level (OR = 1.476, 95% CI: 1.125–1.938 p = 0.005). In this study, at least one DRP was detected in 69 (49.3%) patients and the total number of DRPs was 152. Possible or actual adverse drug events (96.7%) were the most common DRPs. The most important cause of DRPs was drug choice (94.7%), and the highest frequency within its subcategories was the combination of inappropriate drugs (93.4%).ConclusionsThis study shows the importance of including a clinical pharmacist in a multidisciplinary team in identifying and preventing DRPs in the hematology service.

The Prevalence and Impact of Clinical Pharmacists’ Intervention on Drug-Related Problems in Patients With Chronic Kidney Disease

The Prevalence and Impact of Clinical Pharmacists’ Intervention on Drug-Related Problems in Patients With Chronic Kidney Disease

Determination of drug-related problems according to PAIR criteria in dialysis patients: a cross-sectional study in tertiary care hospital

BackgroundDialysis patients are at high risk for drug-related problems (DRPs), which have significant consequences for their morbidity, mortality, and quality of life. Improved clinical outcomes can be achieved by preventing, identifying, and resolving these problems.MethodsThis is a retrospective observational study. In this study, the PAIR instrument (Pharmacotherapy Assessment in Chronic Renal Disease) was validated for use in Turkish. Validation consisted of three stages: translation back-translation with expert panel evaluation, reliability analysis using the test-retest method, and conceptual validity with both Pharmaceutical Care Network Europe (PCNE) and PAIR used to determine DRPs prevalence.ResultsIn total, 104 patients (mean ± SD age, 54.1 ± 15.8 years; 53.8% male) were included in the study. An expert panel evaluated the items in the criterion based on their intelligibility, service of purpose, differentiation, and cultural suitability during the translation stage. Content validity index (CVI) score was found to be 0.95. The reliability analysis was performed by applying the test-retest method and calculating correlation coefficient on 30 randomly selected patients one month later. Correlation coefficient (p) was found to be 0.8. To evaluate conceptual validity, 104 patients’ pharmacotherapy plans were assessed using both the PAIR and PCNE criteria. The prevalence of DRPs according to PAIR criteria (100.0%) and PCNE (73.1%) were statistically significantly different (p < 0.001).ConclusionsAs a result, PAIR criteria can identify clinically relevant DRPs in patients with CKD and is a new, validated tool to be used in Turkey, but may not be adequate for patients receiving dialysis. Therefore, it needs to be reviewed and updated for dialysis patients.

Pharmacist's Impact on Medication Adherence and Drug-Related Problems in Patients with Epilepsy.

Drug-related problems (DRPs) and non-adherence are important barriers to ensuring optimal antiseizure drug treatment. The aim of this study was to improve medication adherence, detect and manage DRPs, and decrease the number of seizures with pharmacist-led education in patients with epilepsy. A prospective and interventional study was conducted in collaboration with the Department of Neurology, the rational drug usage unit of a hospital pharmacy in a university hospital. The impact of pharmacist-led education on medication adherence and interventions in the management of DRPs was assessed in patients with epilepsy who were admitted to the outpatient clinic. A total of 39 patients with epilepsy were evaluated in terms of medication adherence, DRPs, and seizure control over a 2-month follow-up period and patient satisfaction with pharmacy services at the end of the study. A total of 59 DRPs were detected, and 71.2% of them were accepted and implemented both by physicians and/or patients. Pharmacist interventions solved 62.7% of DRPs. The number of patients with high-level medication adherence significantly increased from 17 to 28 after pharmacist-led education (p < 0.001). The number of seizures decreased in 19 patients (48.7%) during the 2-month period. Patient satisfaction was high in all patients. It is shown that the contribution of pharmacists in treating patients with epilepsy is beneficial in improving medication adherence, detection and management of DRPs, and decreasing the number of seizures.

A Research on Clinical Pharmacists' Assessment of Drug-Related Problems in Patients with Chronic Kidney Disease

The study focused on chronic kidney disease (CKD), emphasizing the need for early screening and treatment to prevent its progression. Conducted on 65 CKD patients, this prospective observational research aimed to analyze prescription patterns and identify drug-related issues (DRIs). Using the Pharmaceutical Care Network Europe categorization V 5.01, the study evaluated prescriptions and categorized DRPs. The participant group comprised 65 individuals, predominantly male (69.03%), with an average age of 44. The two primary comorbidities were diabetes mellitus (29.78%) and hypertension (34.97%). Notably, the average prescription count was 10, suggesting polypharmacy. Antibiotics emerged as the most commonly prescribed medication (13.98%). The study found medication interactions to be the most frequent DRP (48.54%), followed by drug choice problems (18.43%), dosage issues (8.36%), drug usage complications (10.46%), adverse reactions (1.24%), and other issues (11.28%). Lack of knowledge (42.16%) and the drug use process (30.81%) were identified as the leading causes of DRPs. The research underscores the critical role of continuous identification and management of DRPs by healthcare professionals to enhance patient health and quality of life, potentially leading to better clinical outcomes for CKD patients.

A Research on Clinical Pharmacists' Assessment of Drug-Related Problems in Patients with Chronic Kidney Disease

The aim of the study is to Spirulina protective effects against acute Fenitrothion-induced toxicity in rats. The objective of a present investigation has been to determine if Spirulina could protect male Wistar albino rats from the toxic effects of Fenitrothion by acting as an antioxidant and hepato-nephroprotector. The toxic effects of DLM are significantly influenced by oxidative stress. In numerous earlier interventions, antioxidants are useful in reducing DLM-induced toxicity. Spirulina is a strong antioxidant that has the potential to lessen the effects of numerous common chemotherapeutic drugs and insecticides. It is evident from the current study that DLM exposure caused variable changes in serum biochemical indicators, levels of lipid peroxidation, and the inhibition of antioxidant enzyme activity. In terms of biochemical changes in blood and tissues, antioxidant enzyme activity, and oxidative stress, AP pre-exposure offered almost full protection.

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.

A Clinical Pharmacist-led Approach on Reducing Drug Related Problems Among Patients with Neurological Disorders: An Interventional Study

BackgroundNeurological disorders are common in the general population and the majority of patients have other chronic diseases, necessitating the use of multiple medications, which increases the incidence of drug-related problems (DRPs). Studies from different countries discovered an average of 0.29–1.45 DRPs per patient admitted into the neurology unit. ObjectivesTo identify common DRPs and to evaluate the impact of clinical pharmacist's interventions in resolving the identified DRPs in patients with neurological disorders. MethodsA prospective interventional study was conducted in the Department of Neurology in a tertiary care teaching hospital in Southern India, for a period of six months. Patients aged ≥18 years and had been hospitalized for >24 h, were intensively monitored until discharge for the occurrence of any DRPs and pharmacist interventions were provided. The identified DRPs were classified according to Hepler and Strand's Classification. ResultsA total of 310 prescriptions were reviewed, of which 174 patients (mean age 45.93 ± 2.49 years) experienced at least one DRP during their hospital stay. The average DRP per patient was found to be 1.75, with drug-drug interactions [254 (83%)] being the predominant DRPs, followed by adverse drug reactions [13 (4%)], and drug duplications [9 (3%)]. Most of the drug-drug interactions were pharmacokinetic [144 (56.69%)]. Hyponatremia [2 (15%)]; and nausea and vomiting [2 (15%)] were most commonly reported ADRs. All 306 DRPs involved active clinical pharmacist intervention, of which [275 (89.87%)] of pharmacists' interventions were accepted, which led to modification of the therapy. ConclusionMonitoring the use of drugs allowed the clinical pharmacist to detect DRPs and to suggest interventions that promote rational drug prescribing, therapy optimization and enhanced patient safety.

Evaluation of burden of polypharmacy and potential drug related problems in patients with chronic kidney disease

Aim: The primary aim of the study is to analyze prevalence of polypharmacy, determine factors affecting polypharmacy and identify potential Drug Related Problems (DRPs) in patients with chronic kidney disease (CKD). Methods: A prospective observational study was conducted among 207 patients diagnosed with chronic kidney disease in a tertiary care hospital for a period of 6 months. Drug-Related Problems were identified, reported and categorized in accordance with the Helper and Strand, 1990 Classification. Binary logistic regression was used to identify the association between dependent variable and independent variables. Result: The mean age of the study population was 56.64 ±16.64 with male predominance (66%). The prevalence of polypharmacy was 76.8% and prescription pattern was analyzed in different stages of chronic kidney disease was found to be antiulcer drugs (84.5%) and antihypertensive (81.6%) were the most commonly prescribed class of drug. Age, gender, length of hospital stay, comorbidities such as diabetes mellitus and hypertension were determined as the main predictors for polypharmacy (p-value &lt; 0.05). Drug interaction (93.2%) was identified as main Drug-related problem associated with polypharmacy (p-value of 0.022). Conclusion: Polypharmacy has a positive correlation with advancement of chronic kidney disease which put them at higher risk for drug-related problems. Drug Related Problems may be prevented or reduced by early detection and modification of the above-mentioned predictors.

Drug-related problems among esophageal, gastric and colorectal cancer patients at the National and referral hospital in Kenya.

Cancer therapy has remarkable potential for drug-related problems due to the high cytotoxicity and narrow therapeutic index of most anti-neoplastic regimens. However, there is a lack of comprehensive studies on drug-related problems in patients with gastrointestinal cancer in Kenya. Therefore, the present study aimed to investigate the prevalence, types and predictors of drug-related problems among gastrointestinal cancer patients at Kenyatta National Hospital. A cross-sectional study was used to assess the prevalence of drug-related problems among a random sample of 160 esophageal, 103 gastric, and 96 colorectal cancer patients. Data were collected using a researcher-administered questionnaire and data abstraction tool after training the data collectors. Patient-specific details such as socio-demographic features, histological cancer types, cancer stage, comorbidity types, and treatment regimen were recorded after the review of medical records and patient interviews. The potential of drug-related problems was determined as per the standard guidelines. The data were entered and analysed using version 26.0 SPSS statistical software. Most esophageal (51.9%), gastric (59.2%), and colorectal (62.5%) cancer patients had a high prevalence of drug-related problems. The need for additional drug therapy and adverse drug reactions were the predominant categories of drug-related problems. Most adverse drug reactions identified had possible categories of causality score, mild severity levels, and definitely preventable types of adverse drug reactions among all gastrointestinal cancer patients. Comorbidity and advanced-stage disease were significant predictors of drug-related problems. Drug-related problems were prevalent among gastrointestinal cancer patients in our setting. Comorbidity and advanced stages of disease were significant predictors of drug-related problems.

Drug related problems in patients with pneumonia at Jasa Kartini Tasikmalaya city hospital

Background: Pneumonia is a severe infection that attacks lung tissue and is caused by bacteria, viruses or fungi. The incidence of Drug Related Problems (DRPs) in pneumonia can affect treatment outcomes leading to increased mortality and morbidity. Objective: To determine DRPs in pneumonia patients hospitalised at the Jasa Kartini Hospital (RSJK) Tasikmalaya City. Method: A descriptive observational study with retrospective data collection and consecutive sampling was conducted from January - December 2021. Demographic, quantitative, and DRPs data analysis with the number of patients who met the inclusion criteria (n = 69). Result: Based on demographics, pneumonia mostly affects elderly patients (&gt; 65 years) by 29.0%, female (52.2%), housewife work (34.8%) with Length Of Stay between five and six days (42.0%), diagnosis of pneumonia with comorbidities (73.9%), as well as payment status using private payment (43.5%). Based on quantitative analysis, the most widely used drugs were non-generic drugs (70.1%) and antibiotics (18.2%). Drug Related Problems (DRPs) as many as 50 cases with an category indication without drugs 11 cases (22.0%) which include indications of pulmonary tuberculosis, diarrhea, and hypertension; drugs without indication 0 cases; underdose in eight cases (16.0%) which included Analsik, Largactil, Alganax, Sanmol, Ketorolac, Risperidon, ranitidine; drug overdose in 12 cases (24.0%) which included Tracetat, Sanmol Syrup, Codipront, Citicolin, Lansoprazole, Lancid, Furosemid; wrong drug 0 cases, drug interaction 19 cases (38.0%) with major (10.5%), moderate (68.4%) and minor (21.1%) categories; and adverse drugs 0 cases. Conclusion: Several treatments for pneumonia patients at the Tasikmalaya City Hospital for the period January to December 2021 experienced DRPs.

Identifikasi Drug Related Problems (DRPs) pasien diabetes mellitus tipe 2 yang terkonfirmasi Covid-19

Drug Related Problems (DRPs) are events or circumstances related to drug therapy that actually or have the potential to interfere with the desired therapeutic outcome. This study aims to identify the incidence of DRPs in patients with type 2 diabetes mellitus who are confirmed to have Covid-19. This research is a type of observational research with a cross sectional design. Data collection was carried out retrospectively by tracing patient medical record data. The number of patients who met the researcher’s inclusion criteria was 125 patients and on average each patient had DRPs. The categories of DRPs that occurred were indications without drugs for 57 patients (45,6%), drugs without indications for 11 patients (8,8%), inappropriate drug selection for 45 patients (36%), inadequate doses for 28 patients (22,4%), overdosage in 46 patients (36,8%), and drug interactions in 88 patients (70,4%)

Pharmacist Intervention to Address Drug Related Problems in Patients with Decompensated Liver Cirrhosis

Background: Patients with decompensated cirrhosis are often given therapeutic and prophylactic drugs. Polypharmacy raises both the likelihood of prescription errors and the complications associated with drugs. Clinical pharmacists are excellent at recognizing, addressing, and preventing clinically significant drug-related problems. Objectives: Identification types of pharmacist interventions to address drug-related problems in patients with decompensated cirrhosis and assess the acceptance/implementation of these recommendations. And identify patient factors associated with accepting pharmacist recommendations. Subjects and Methods: Prospective, interventional, clinical study for 80 hospitalized decompensated cirrhosis patients was conducted at Baghdad Teaching Hospital and lasted for four months, from the first of December 2021 until the last of March 2022. The study involved two phases, the first one was observational to identify drug-related problems and classify them according to the Pharmaceutical Care Network Europe classification version 9.1, and the second phase was interventional to increase the awareness of patients and health care providers about those problems and to propose a proper solution for each one. Results: The most frequent pharmacist intervention was proposed to the prescriber (54.7%), followed by speaking to the caregiver (37.7%). Acceptance and full implementation were highly observed in 71.1% of the intervention. There is a significant association between occurring ascites and bleeding in patients and accepting/implementing pharmacist recommendations Conclusions: Patients with decompensated liver cirrhosis have a significant prevalence of drug-related problems. Clinical pharmacists are excellent at recognizing drug-related problems and reducing their incidence, and their interventions were well accepted.

Strategies for Avoiding Typical Drug-Drug Interactions and Drug-Related Problems in Patients with Vascular Diseases.

Background and objectives: Drug-drug interactions and drug-related problems in patients with vascular diseases are common. To date, very few studies have focused on these important problems. The aim of the present study is to investigate the most common drug-drug interactions and DRPs in patients with vascular diseases. Materials and Methods: The medications of 1322 patients were reviewed manually in the time period from 11/2017 to 11/2018; the medications of 96 patients were entered into a clinical decision support system. Potential drug problems were identified, and a read-through consensus was reached between a clinical pharmacist and a vascular surgeon during the clinical curve visits; possible modifications were implemented. The focus was on additional dose adjustment and drug antagonization on drug interactions. Interactions were classified as contraindicated/high-risk combination (drugs must not be combined), clinically serious (interaction can be potentially life-threatening or have serious, possibly irreversible consequences), or potentially clinically relevant and moderate (interaction can lead to therapeutically relevant consequences). Results: A total of 111 interactions were observed. Of these, 6 contraindicated/high-risk combinations, 81 clinically serious interactions, and 24 potentially clinically relevant and moderate interactions were identified. Furthermore, 114 interventions were recorded and categorized. Discontinued use of the drug (36.0%) and drug dose adjustment (35.1%) were the most common interventions. Mostly, antibiotic therapy was continued unnecessarily (10/96; 10.4%), and the adjustment of the dosage to kidney function was overlooked in 40/96; 41.7% of the cases. In the most common cases, a dose reduction was not considered necessary. Here, unadjusted doses of antibiotics were found in 9/96, 9.3% of the cases. Notes for medical professionals summarized information that did not require direct intervention but rather increased attention on the part of the ward doctor. It was usually necessary to monitor laboratory parameters (49/96, 51.0%) or the patients for side effects (17/96, 17.7%), which were expected with the combinations used. Conclusions: This study could help identify problematic drug groups and develop prevention strategies for drug-related problems in patients with vascular diseases. A multidisciplinary collaboration between the different professional groups (clinical pharmacists and surgeons) might optimize the medication process. Collaborative care could have a positive impact on therapeutic outcomes and make drug therapy safer for patients with vascular diseases.

Abstracts 13th PCNE Working Conference “Pharmacies' new roles in pharmaceutical care: bridging research and practice”

Abstracts 13th PCNE Working Conference “Pharmacies' new roles in pharmaceutical care: bridging research and practice”

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.

Drug-related problems in patients admitted for SARS-CoV-2 infection during the COVID-19 pandemic.

Introduction: Drug-related problems (DRP) are events or circumstances in which drug therapy does or could interfere with desired health outcomes. In December 2019, a new coronavirus, SARS-CoV-2, appeared. Little knowledge about this type of infection resulted in the administration of various drugs with limited use in other pathologies. Evidence about DRP in patients with COVID-19 is lacking. Objective: The aim of the present study is to describe identified cases of DRP and those drugs involved in the first wave of patients with COVID-19, and evaluate associated risk factors. Material and methods: Observational, retrospective study performed in a tertiary university hospital between 14th March 2020 and 31 May 2020 (corresponding to the first COVID-19 wave). We recruited patients admitted during the study period. Exclusion criteria included age < 18years; admission to critically ill units; and care received either in the emergency room, at-home hospitalization or a healthcare center. Results: A total of 817 patients were included. The mean age was 62.5years (SD 16.4) (range 18-97), and 453 (55.4%) were male. A total of 516 DRP were detected. Among the patients, 271 (33.2%) presented at least one DRP. The mean DRP per patient with an identified case was 1.9. The prevailing DRPs among those observed were: incorrect dosage (over or underdosage) in 145 patients (28.2%); wrong drug combination in 131 (25.5%); prescriptions not in adherence to the then COVID-19 treatment protocol in 73 (14.1%); prescription errors due to the wrong use of the computerized physician order entry in 47 (9.2%); and incorrect dosage due to renal function in 36 (7%). The logistic regression analysis showed that patients who received only prescriptions of antibacterials for systemic use (J01 ATC group) faced a higher likelihood of experiencing a DRP (OR 2.408 (1.071-5.411), p = 0.033). Conclusion: We identified several factors associated with an increased risk of DRPs, similar to those reported in other pre-pandemic studies, including a prolonged length of stay, higher number of prescribed drugs and antimicrobial administration. The relevance of pharmacists and tools like pharmacy warning systems can help prevent, identify and resolve DRP efficiently.

Drug-related problems and satisfaction among patients receiving pharmacist-led consultations at the initiation of cardiovascular drugs.

Drug-related problems (DRPs) lead to substantial morbidity and mortality and increase healthcare costs. Several interventions have been developed to reduce DRPs and improve the outcome of drug therapy. To investigate DRPs identified through a pharmacist-led intervention and to assess patient satisfaction with the intervention. Patients received two pharmacist consultations 1-2 weeks and 3-5 weeks after collecting a new cardiovascular medicine. Information about patient characteristics, beliefs about medicines (BMQ), DRPs, and patient evaluations were collected using questionnaires. Pharmacists identified DRPs among 52.4% and 43.1% of the 633 patients at consultation 1 and 2, respectively. Of the DRPs reported in consultation 1, 43.7% were solved at consultation 2. Among patients with side effects, patients who received advice on managing these in consultation 1 where more likely to have solved problems at consultation 2 (61.2% vs. 42.6%, p=0.008). Female gender, high BMQ concern and the number of new medicines were associated with DRPs. Patients were highly satisfied with the intervention. Predictors of satisfaction were female gender, older age, higher BMQ necessity, face-to-face consultations, longer duration of consultation 1, and solved problems in consultation 2. The results indicate that the pharmacist-led follow-up intervention can aid early identification and solving of DRPs in patients prescribed new cardiovascular drugs. Knowledge of factors associated with DRPs and patients' satisfaction may allow further improvement of the intervention.

Drug-Related Problems in Bariatric Surgery: a Retrospective Study.

With the rapid increase of bariatric surgery worldwide, drug-related problems (DRPs) in this area seem to be rising. This study aimed to investigate the incidence and characteristics of DRPs in patients undergoing bariatric surgery. Medication records for patients who underwent bariatric surgery were analysed retrospectively between January 2019 and December 2020 in our center. We classified and analysed DRPs using the Pharmaceutical Care Network Europe classification (PCNE version 9.0). Rating severity of these DRPs was based on the National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) classification. Continuous variables were analysed by Student's t-test, and categorical variables were compared using the chi-square test. One-way ANOVA was used to compare the numbers of DRPs. Totally 347 patients were reviewed, and 760 DRPs were identified with an average of 2.19 ± 1.36 DRPs for each patient. The most common DRPs were problems related to perioperative antibiotics accounting for 29.47%, 25.62% and 14.34% for hepatoprotection and proton-pump inhibitors (PPI), respectively. The leading causes of DRPs were inappropriate medications for antibiotics, hepatoprotection, ancillary drugs and PPI. 89.34% of the DRPs were rated at severity categories B-D (which means potential adverse reactions that may occur), whereas 10.66% were rated as categories E-H. There were relations between DRPs and older (32.22 ± 9.29 vs. 29.11 ± 6.53years), fewer concomitant surgeries (1.89 ± 1.25 vs. 2.99 ± 1.31), longer postoperative fasting time (PFT) (1.18 ± 0.55 vs. 1.06 ± 0.24days) and more comorbidities (6.71 ± 2.63 vs. 5.23 ± 1.46) (P < 0.05). The incidence of DRPs in the perioperative period of bariatric surgery is high. Patients with fewer concomitant surgeries and longer PFT are prone to DRPs. It is necessary for clinical pharmacists to participate in medication monitoring and reviewing to facilitate enhanced recovery after bariatric surgery.

A comprehensive medication review of a polypharmacy patient population: A cross-sectional observational study

BackgroundIt is well documented that polypharmacy status is associated with manifold drug-related problems (DRPs). In this cross-sectional observational study, a type 1 medication review of a polypharmacy patient population in Greece was carried out. ObjectivesThe study aim was to quantify the prevalence of unaddressed DRPs in a representative Greek polypharmacy patient population. The secondary aim was to report on the average monthly medication cost per polypharmacy study patient. MethodsThe study population consisted of 91 older, high-risk polypharmacy patients registered at 10 community pharmacies in Athens. The cross-sectional medication review was conducted by 10 independent pharmacists during September of 2020. DRPs were assessed and classified according to ‘The PCNE Classification V 5.01’ by two clinical pharmacists and researchers. ResultsA median concurrent use of 8.45 medications per patient was found, with an average of 1.89 identified DRPs per study subject. A total of 172 DRPs were observed in the study population. 75.6% of all DRPs were classified as drug-drug interaction problems, with a mean of 1.42 identified drug-drug interactions per study subject. The mean monthly cost per polypharmacy patient was calculated at €38.64 ($45.20 USD). ConclusionThere is urgent need to improve in-pharmacy medication monitoring and advising to optimize drug concordance and to reduce DRPs among polypharmacy patients in Greece. Further research is warranted to investigate larger scale polypharmacy-related iatrogenic harm potential due to overlooked and unaddressed DRPs within Europe and globally. Investigation into the predictors of and risk factors for DRP incidence in polypharmacy patient populations is also needed. Broadly, this study underscores the need for continuous and perspicacious monitoring of unaddressed DRPs in patients using multiple drugs by community pharmacists.