Occurrence Of Drug-related Problems Research Articles

Drug-Related Problems in Pulmonary Hypertension with Valvular Heart Disease.

The occurrence of drug-related problems (DRPs) and their causes specifically among pulmonary hypertension (PH) with valvular heart disease (VHD) has not been evaluated and is unknown. Therefore, this study aimed to determine the percentage of occurrence, types, and causes of DRPs among PH with VHD patients. An observational retrospective study was conducted at Cardiology Centre, Hospital Serdang, from 1st January to 30th April 2021. Data were collected from medication charts, medical progress notes, laboratory and operative charts through electronic Health Information System (eHIS). The types and causes of DRPs were identified and classified based on Pharmaceutical Care Network of Europe's (PCNE) classification system V9.02. The data were analyzed using descriptive statistics. All patients (100%) experienced at least one DRP. Total number of DRPs identified was 120 encounters which were associated with 503 causes. The majority of problems were related to treatment effectiveness (59.1%) and treatment safety (33.4%). The causes of DRPs are mainly related to inappropriate monitoring including therapeutic drug monitoring (18.6%), inappropriate combination of drugs, or drugs and dietary/herbal supplement (10.3%), drug dose was too high (8.9%), drug dose was too low (8.2%) and inappropriate timing of administration or dosing intervals (7.7%). The percentage of DRP occurrence was high in the studied population. Treatment effectiveness and treatment safety issues were the main DRPs identified with various preventable causes. The findings may be useful to guide the planning of measures to prevent and solve future DRPs in the population.

Improving Antibiotic Use in Surgical Care: Impact of Clinical Pharmacist Interventions on Optimizing Patient Therapy

Objectives: To assess the nature of drug-related problems (DRPs) associated with antibiotic use and to evaluate the level of significance of clinical pharmacist interventions in surgical care. Methods: This prospective interventional study was carried out for 1 year in the wards of General Surgery. The in-patients were followed daily and reviewed for DRPs. The identified DRPs were categorized according to the Hepler and Strand classification. Drug-related problems other than those in Hepler and Strand classification were categorized separately based on medical literature and clinical practice evidence. The identified DRPs were conveyed and discussed by the clinical pharmacist with the surgeon, and ideal suggestions for further action. A bivariate logistic regression analysis was performed to identify the predictors of the DRPs associated with antibiotic use. Findings: Of the 614 patients, 64.49% were males. 414 DRPs were identified, wherein improper duration of drug use (20.86%) was the most common DRP. The significance level of pharmacist intervention was found to be ‘major’ in 49% of cases. The incidence of DRPs associated with antibiotic use was 67.42%. The rate of acceptance of pharmacist interventions was 99%. A strong association between the occurrence of DRPs and age, the presence of two co-morbid conditions, the intake of two and three antibiotics, and length of stay (LOS) of 6–10 and 16–20 days (P < 0.05) was noted. Conclusion: Even though antibiotics are necessary for surgical management, their vigilant use is warranted. The clinical pharmacist plays an enormous role in optimizing antibiotic therapy in surgical patient care. Novelty: To the best of our knowledge, such an interventional study of its kind that exclusively focused on the surgery ward was not conducted in India previously, and not many studies of a similar kind have been carried out in other parts of the world that have assessed the prevalence and frequency of DRPs related to antibiotic use, the predictors associated with the DRPs, the role of clinical pharmacists in the surgery ward, and the acceptance rate of pharmacist interventions by the surgeons. Here, an attempt to identify the predictors of drug-related problems associated with antibiotic use was made to help prevent and resolve drug-related problems earlier, therebypromising optimized therapy. Also, it highlights the importance of a clinical pharmacist’s role in surgical care regarding patient safety. Keywords: Antibiotics; Surgery; Clinical Pharmacist; Predictors; Interventions; 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.

Drug-Related Problems of Patients in Primary Health Care Institutions: A Systematic Review.

Introduction: Drug-related problems (DRPs) are not only detrimental to patients' physical health and quality of life but also lead to a serious waste of health care resources. The condition of DRPs might be more severe for patients in primary health care institutions.Objective: This systematic review aims to comprehensively review the characteristics of DRPs for patients in primary health care institutions, which might help find effective strategies to identify, prevent, and intervene with DRPs in the future.Methods: We searched three English databases (Embase, The Cochrane Library, and PubMed) and four Chinese databases (CNKI, CBM, VIP, and Wanfang). Two of the researchers independently conducted literature screening, quality evaluation, and data extraction. Qualitative and quantitative methods were combined to analyze the data.Results: From the 3,368 articles screened, 27 met the inclusion criteria and were included in this review. The median (inter-quartile range, IQR) of the incidences of DRPs was 70.04% (59%), and the median (IQR) of the average number of DRPs per patient was 3.4 (2.8). The most common type of DRPs was “treatment safety.” The causes of DRPs were mainly in the prescribing section, including “drug selection” and “dose selection”, while patients' poor adherence in the use section was also an important cause of DRPs. Risk factors such as the number of medicines, age, and disease condition were positively associated with the occurrence of DRPs. In addition, the medians (IQR) of the rate of accepted interventions, implemented interventions, and solved DRPs were 78.8% (22.3%), 64.15% (16.85%), and 76.99% (26.09%), respectively.Conclusion: This systematic review showed that the condition of DRPs in primary health care institutions was serious. In pharmaceutical practice, the patients with risk factors of DRPs should be monitored more closely. Pharmacists could play important roles in the identification and intervention of DRPs, and more effective intervention strategies need to be established in the future.

A retrospective study of drug related problems and contributing factors among type 2 diabetes mellitus patients on follow up at public health institutions of kemisse town, north east Ethiopia

BackgroundDrug related problems interfere with the desired treatment outcomes of type 2 Diabetes mellitus. This study was conducted to determine prevalence of drug related problems and associated factors among patients with type 2 Diabetes Mellitus in public health institutions of Kemisse town, northeast Ethiopia from May 01 to 30, 2019. MethodsInstitution based retrospective cross sectional study was conducted among type 2 Diabetes Mellitus patents on follow up at public health institutions of Kemisse town, northeast Ethiopia. ResultFrom the total of 156 patients included in the study, 126 (80.8%) patients have at least one drug related problem with a total of 149 drug related problems. The most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Identified causes of need for additional drug therapy were the need for prophylactic drug therapy (statins and antiplatelet), 83.3%; presence of untreated medical condition (Hypertension, diabetic nephropathy and diabetic foot ulcer), 11.7%; and the need for combination therapy for better efficacy, 5%. This study revealed that age ≥45 years (AOR = 5.59, 95% CI = 1.38–20.64, P = 0.016), presence of comorbid condition (AOR = 3.22, 95% CI = 1.75–13.47, P = 0.014 and emergency visit in the last one year (AOR = 5.08, 95% CI = 1.14–18.71, P = 0.033) were significantly associated with the occurrence of drug related problems. ConclusionA total of 149 drug related problems were identified in 80.8% of type 2 diabetes mellitus patients. The three most prevalent drug related problems were need for additional drug therapy 60 (40.3%) followed by non-compliance 51 (34.2%) and unnecessary drug therapy 12 (8%). Additionally, age ≥45 years (AOR = 5.59, P = 0.016), presence of comorbidity (AOR = 3.22, P = 0.014) and emergency visit in the last one year (AOR = 5.08, P = 0.033) were significantly associated with the occurrence of drug related problem.

Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study

BackgroundNeonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited.ObjectiveThis study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia.MethodsA hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant.ResultsOf 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs.ConclusionThe burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.

DRUG-RELATED PROBLEMS AND ITS PRESCRIBING INDICATORS IN STROKE PATIENTS: A PROSPECTIVE OBSERVATIONAL STUDY

Objective: The objective of the study was to assess the drug-related problems (DRPs) and the World Health Organization (WHO) core prescribing indicators among stroke patients.&#x0D; Methods: A prospective observational study was conducted among stroke inpatients of Acute Medical Care and General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data about demographics, clinical characteristics, WHO prescribing indicators, and DRPs. Descriptive statistics were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Chi-square test was employed to test the significant association between the demographics and the occurrence of DRPs.&#x0D; Results: Among 174 patients included in the study, 89 had one or more DRPs. A total of 122 DRPs were identified in the study population. Drug interactions (48.4%) and adverse drug reactions (ADRs) (17.2%) were commonly observed DRPs. A significant direct association was observed between the occurrence of DRPs and number of comorbidities (p&lt;0.001), polypharmacy (p&lt;0.001), and hospital stay (p&lt;0.05). The average number of drugs per prescription was 7.2. Of drugs prescribed, 67.6% were in their generic names. The percentage of encounters in which an antibiotic, injection was prescribed was 65.5% and 89.6% respectively. The percentage of drugs prescribed from an essential drug list was 91.2%.&#x0D; Conclusion: The rate of drug interactions and ADRs was high in treatment of stroke patients. Patients suffering from comorbidities, polypharmacy, and long hospital stay were positively associated with occurrence of DRPs in stroke. Regular monitoring and screening for drug interactions and ADRs were advised to reduce the burden DRPs in stroke patients admitted in a critical care unit.

Prescribing Pattern and Medication Related Problems in Hospitalized Diabetic Patients: A Hospital-Based Study

Aim: To assess the drug-related problems (DRPs) and World Health Organization (WHO) core prescribing indicators among hospitalized diabetic patients.&#x0D; Methodology: A prospective, observational study was made among the diabetic inpatients of the General Medicine Department of a tertiary care hospital located in Tirupati, Andhra Pradesh, India. A suitable data collection form was used to collect the data pertaining to demographics, clinical variables, DRPs, and WHO prescribing indicators. Descriptive statistics like frequency, mean, and percentage were used to represent the demographics, distribution of DRPs, and prescribing indicators in the study. Inferential statistics like Chi-square test was employed to test the significant association between the demographics and occurrence of DRPs.&#x0D; Results: A total of 199 diabetic patients were enrolled in this study. The mean age of the study participants was 55.8±11.3. The study shows the prevalence of DRPs in diabetic in-patients was 48.7%. The most commonly identified DRPs are drug interactions (53; 45.3%), adverse drug reactions (24; 20.5%), and untreated indication (21; 17.9%). Patient characteristics like, advanced age (≥60 years), presence of co-morbid condition, comprising more than 5 drugs in prescription, and stay in the hospital for more than four days are significantly associated with the development of DRPs. Findings of WHO indicators show the average number of drugs, percentage of drugs prescribed by the generic name, percentage of encounters with an antibiotic, injection, and from essential drug list have deviated from standards of WHO.&#x0D; Conclusion: The prevalence of DRPs in diabetic in-patients was 48.7%. Drug interactions and adverse drug reactions are the most common DRPs found in our study. Developing the drug policy guidelines focused on factors associated with DRP and WHO prescribing indicators may reduce the burden of DRPs and improves patient outcomes.

IDENTIFICATION OF DRUG-RELATED PROBLEMS IN ADULTS WITH TUBERCULOSIS AT THE TEBET SUBDISTRICT HEALTH CENTER FROM JULY TO DECEMBER 2018

Objective: Tuberculosis (TB) is a highly prevalent infectious disease caused by Mycobacterium tuberculosis. The recommended TB treatment is acombination of various antibiotics in the form of a fixed-dose combination tablet or kombipak; however, this increases the prevalence of drug-relatedproblems. Therefore, this study aimed to identify drug-related problems of patients receiving TB therapy at the Tebet Subdistrict Health Center fromJuly 2018 to December 2018.Methods: The study was designed as a cross-sectional study using the retrospective data retrieval method from prescriptions of patients withTB from July 2018 to December 2018. The classification system prepared by Cipolle, Strand, and Morley was used for the classification of drugrelatedproblems; this system includes unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and druginteraction.Results: The percentage of unnecessary drug therapy, required additional drug therapy, ineffective drug, dosage error, and drug interaction was2.85%, 6.89%, 1.54%, 12.46%, and 66.18%, respectively, with the occurrence of drug-related problems being the highest.Conclusion: The administration of anti-TB drugs can potentially cause drug-related problems. Therefore, the assessment needs to be optimizedbefore the administration of medications to patients and medications should be prescribed and monitored regularly to achieve rational drug use

Medication follow-up in newborns with extremely low birth-weight.

Objective:The medication follow-up in infants with extremely low birth-weight in a neonatal intensive care unit is described, identifying drug-related problems (DRP), drug-related negative outcomes, and the relationship between the occurrence of DRP and birth-weight of newborns and their impact on pharmacotherapy and length of hospital stay.Methods:A descriptive and exploratory study was performed in which medication follow-up of a population of infants with extremely low birth-weight admitted to the neonatal intensive care unit of a government-run maternity hospital was carried out by clinical pharmacists. Monitoring comprised assessment of patients’ pharmacotherapy needs through visits to the neonatal unit, evaluation of prescriptions and information on medical records, identification of issues associated with pharmacotherapy and follow-up of the newborns’ clinical evolution to determine whether desired results were achieved.Results:The subjects were 33 infants characterized by extremely low weight at birth. Analysis of patients’ pharmacotherapy showed that 39.4% (n=13) of the neonates presented some type of DRP, totaling 37 DRPs and a mean of 2.8 problems/patient. Fourteen drugs were identified with the occurrence of DRP. Vancomycin and cefepime were the most prevalent, with 18.9% (n=7). Occurrence of DRPs and several clinical characteristics of newborns and their pharmacotherapy were compared. The most prevalent drug-related negative outcomes identified were “untreated health problem” (40%, n=10) and “quantitative ineffectiveness” (32%, n=8). Pharmaceutical interventions were performed for all problems associated with pharmacotherapy, with a prevalence of “treatment day count correction” and “dose correction”, both with 21.6% (n=8), and “correction of dosage” (16.2%, n=6).Conclusion:The research evidenced the role of the clinical pharmacist in the solution and prevention of drug-related problems, contributing with the multidisciplinary team to obtain a safe and effective pharmacotherapy. Further, current study confirmed that there is an association between the characteristics of the newborns under analysis (eg. birth-weight, pharmacotherapy) and the occurrence of drug-related problems.

Pharmacists Intervention Reduced Drug-Related Problems in the Treatment of Patients with Type 2 Diabetes Mellitus.

BACKGROUND:Type 2 Diabetes Mellitus (T2DM) remains as a global public health problem, including Indonesia due to its continuous increasing prevalence.AIM:To analyze the impact of pharmacist intervention on drug-related problems (DRPs) occurred in the management of patients with T2DM admitted to Tebing Tinggi Hospital (TTH), Indonesia, period March through August 2018.METHODS:This six-month retrospective prospective cohort study evaluated the impact of pharmacist intervention on the occurrence of DRPs in the management of patients with T2DM (n = 45) insured by Social Security Organizing Body in TTH, North Sumatera, Indonesia. The inclusion criteria were T2DM patients with age ≥ 18 years and under treatment of antidiabetic drugs. A questionnaire was used to assess the characteristics of the patients and antidiabetic drugs provided. The incidence of DRPs in groups with usual care for the previous three-month and with pharmacist interventions for the next three-month admissions were analyzed using Pharmaceutical Care Network Europe (PCNE) DRP classification system version 8.01 that consists of 3 primary domains for problems, 8 primary domains for causes, and 5 primary domains (PCNE, 2017) and trustable literatures. The obtained data were analyzed using descriptive statistics and paired t test in the program of Statistical Package for the Social Sciences version 19 (p < 0.05 was considered significant).RESULTS:Most (66.7%) of the patients were female. Their mean age was 61.96 ± 6.45 (years). The three most widely provided drugs were metformin, glimepirid, and gliclazide. Total incidence of DRPs in groups with: usual care, 128; intervention, 39. There was a significant difference between the incidence of DRPs in groups with usual care and intervention, p ≤ 0.001.CONCLUSION:Pharmacist intervention reduced the incidence of DRPs in the management of T2DM patients.

Risk assessment of patient factors and medications for drug-related problems from a prospective longitudinal study of newborns admitted to a neonatal intensive care unit in Brazil

ObjectiveTo identify patient factors and medications associated with the occurrence of drug-related problems (DRPs) in neonates admitted to neonatal intensive care units (NICUs).DesignProspective, longitudinal study.SettingNICU of a teaching hospital in...

Drug-related problems in patients with rheumatoid arthritis.

BackgroundRheumatoid arthritis (RA) patients are at risk of acquiring drug-related problems (DRPs). However, there has been a lack of studies on DRPs in patients with RA up to now.MethodThis retrospective study was conducted in a tertiary hospital in Malaysia from January 2012 to December 2017 with the purpose of assessing DRPs in RA patients and factors associated with its occurrence. A total of 200 patients who had received pharmacological treatment for RA were enrolled in this study. Assessment of DRPs was based on the Pharmaceutical Network Care Europe tool version 5.01.ResultsA total of 289 DRPs with an average of 1.5±1.0 problems per patient were identified, in which 78.5% of the population had at least one DRP. The most common DRPs encountered were adverse reactions (38.8%), drug interactions (33.6%), and drug-choice problems (14.5%). Factors that had significant association with the occurrence of DRPs were polypharmacy (P=0.003), multiple comorbidities (P=0.001), hyperlipidemia (P=0.009), osteo (P=0.040), and renal impairment (P=0.044). These data indicated that the prevalence of DRPs was high among RA patients.ConclusionEarly identification of types of DRPs and associated factors may enhance the prevention and management of RA.

ASSESSMENT OF DRUG RELATED PROBLEMS IN A TERTIARY CARE TEACHING HOSPITAL, INDIA

ABSTRACTObjective: Drug related problems (DRPs) are frequent in hospitalization where multiple changes in patient’s medication regimen and lack of continuity of care may be accompanied. The aim of present research was to identify drug related problems, drug classes involved in DRPs as well as associated factors with the occurrence of DRPs and to assess the pharmacist interventions in a tertiary care teaching hospital.Methods: A prospective observational study was carried out in a tertiary care teaching hospital, over a period of six months from November 2015 to April 2016. All the in patients admitted to all departments of hospital, who satisfied the selection criteria, were included in this study. Necessary demographic and clinical data was collected from the case records. The Pharmaceutical Care Network Europe Classification Version (PCNE) 5.01 was used to classify DRPs. The treatment data was analyzed to determine the rate, pattern, clinical significance, and outcomes of DRPs.Results: A total of 300 patient case sheets were reviewed during the study period, out of which 143 drug related problems were identified from 93 patients. Male (%) predominance was noted over females (%). The most common DRP was drug Interactions 47.55% (68) followed by drug use problems 19.58% (28), drug choice problems 14.68% (21), others 11.88% (17), dosing problems 4.89% (7), and adverse reaction 1.39% (2) were identified.Conclusion: Drug related problems are common among the wards of hospital. Clinical pharmacist’s role in identification, resolution and prevention of drug related problems helps in achieving better therapeutic outcomes and improved patient healthcare.Keywords: DRP’s, Adverse Drug Reactions, Drug Interactions (DI), Drug choice problems, Dosing problem, Drug use problems, Paediatric, Medicine, PCNE

Analysis of drug-related problems in three departments of a German University hospital

During the last decades, pharmaceutical care services have been developed and implemented to optimize drug therapies and ensure medication safety. To investigate the need for pharmaceutical care services, drug-related problems can be measured. Thus, the aim of this study was to analyse number, type and occurrence of drug-related problems in different clinical departments. A pharmaceutical care service was established on general wards in Urology, Neurology and Gastroenterology at the University Hospital RWTH Aachen, Germany. For each of a total of 306 patients, a pharmacist conducted an extended medication history, performed medication reconciliation, conducted medication safety checks and if drug-related problems were discovered, gave valid recommendations to the attending healthcare team. Drug-related problems were classified using the APS-Doc system. For statistical analyses, SAS(®) 9.1.3, SAS Institute, Cary NC, USA was applied. The project was approved by the local ethics committee. Type, occurrence and frequency of DRP in different medical departments. On average, 2.3 drug-related problems per patient were documented for all three departments. Drug-related problems were found in each category of the APS-Doc system. The most pronounced drug-related problems found were drug-drug interactions (34.6%). 37% of the identified drug-related problems occurred before hospital admission, 27% during transitional care, and 36% on the ward. Subgroup analysis revealed specific drug-related problem patterns for each clinical department. The number of drug-related problems was found to be associated with the number of drugs and age. Drug-related problems frequently occur in all investigated clinical departments. A holistic pharmaceutical care service could be an option to address this issue. In case of limited resources, individual drug-related problem patterns can be used as a basis for a tailored pharmaceutical care service. As number of drugs and age have been shown to be significant risk factors, it is crucial that the healthcare team including the pharmacist pays special attention to elderly patients and those with polymedication.

Drug-related problems in a clinical setting: a literature review and cross-sectional study evaluating factors to identify patients at risk

ObjectivesThis study aims to summarise existing evidence on risk factors for drug-related problems (DRPs) in hospitals as well as ambulatory care or nursing homes and adds additional empirical evidence on...

Drug-related problems in medical wards of Tikur Anbessa specialized hospital, Ethiopia.

Objective:This study was aimed to determine the prevalence of drug-related problems (DRPs), identify the most common drugs, and drug classes involved in DRPs as well as associated factors with the occurrence of DRPs.Methods:A prospective cross-sectional study was conducted on 225 patients admitted to medical wards of Tikur Anbessa Specialized Hospital, Addis Ababa from March to June 2014. Data regarding patient characteristics, medications, diagnosis, length of hospitalization, investigation, and laboratory results were collected using data abstraction forms through review of patients’ medical card and medication charts. Identified DRPs were recorded and classified using DRP registration forms. The possible intervention measures for the identified DRPs were proposed and communicated to either the physician or the patient. Data were entered into Epi Info 7 and analyzed using SPSS version 21 (IBM Corp. Released 2012, Armonk, NY: IBM Corp).Findings:DRPs were found in 52% of study subjects. A drug-drug interaction (48% of all DRPs) was the most common DRP followed by adverse drug reaction (23%). Anti-infectives and gastrointestinal medicines were commonly involved in DRPs. Drugs with the highest drug risk ratio were gentamycin, warfarin, nifedipine, and cimetidine. The number of drugs taken by the patient per day is an important risk factor for DRPs.Conclusion:DRPs are common among medical ward patients. Polypharmacy has a significant association with the occurrence of DRP. Drugs such as gentamycin, warfarin, nifedipine, and cimetidine have the highest probability of causing DRP. So, patients who are taking either of these drugs or polypharmacy should be closely assessed for identification and timely correction of DRPs.

PREVALENCE OF POLYPHARMACY AND DRUG TO DRUG INTERACTIONS IN A TERTIARY CARE TEACHING HOSPITAL

Drugs are the most common medical interventions for betterment of the patients but they are fatal too. Inappropriate prescri ption and using of multiple medications can lead to morbidity and mortality. Polypharmacy is a n important factor for occurrence of drug related problems like adverse drug reaction s and drug - drug interactions , especially in elderly and ICU treated patients. Concomitant use of multiple medications associated with increased risk of hospitalization , increase in economic burden to patient and can potentially leads to therapeutic failure. The study was aimed to assess the prevalence of po lypharmacy and drug - drug interaction s . The study was carried out in a 500 bedded tertiary care teaching hospital for a period of four months . About 940 prescriptions were screened for the study , in this male were 50.95 % (n = 479 ) and female 49.04 % (n = 4 61 ) . About 51.06 % (n = 480 ) patients had major poly pharmacy followed by 22.97 % (n = 216 ) patients with minor polypharmacy and 25.95 % (n = 24 4 ) patients with non - poly pharmacy. In present study, majority of thepatients had respiratory followed by cardio vascular diseases. There were 512 ( 54.46 %) prescriptions which had drug - drug interactions and 420 ( 45.53 %) prescriptions had no drug - drug interaction . Out of 512 prescriptions there were 734 drug - drug interactions among them 16.75 % (n = 123 ) were major, 41.82 % (n = 307 ) were moderate and 41.41 % (n = 304 ) were minor drug - drug interactions. Poly pharmacy has a very high prevalence among hospitalized patients especially in ICU , resulting in more drug interactions. Physicians should prescribe a rationale c ombination and pharmacist should provide

IDENTIFIKASI DRUG RELATED PROBLEMS (DRPs) PADA PASIEN ANAK DEMAM BERDARAH DENGUE (DBD) DI INSTALASI RAWAT INAP RSUD UNDATA PALU TAHUN 2011

Drug Related Problems (DRPs) is an unexpected incident patients experience consequences or unforeseen consequences could potentially interfere with drug therapy to therapy outcomes. Dengue Hemorrhagic Fever (DHF) is one of diseases that occur in children and have a great chance to be the occurrence of DRPs. This study aims to find out the extent of potential DRPs in the incidence of DHF in children patients at the RSUD (public hospital) Undata Palu. This research was non experimental study using a descriptive retrospective study. The research was conducted by collecting data from the medical records of children patient (1-12 years old) undiagnosed DHF at RSUD Undata Palu. The data analyzed includes unnecessary drug therapy, wrong medicine, subtherapy dose and overdose. Based on the results of the study, we obtained that from 103 patients who met the criteria there were total of around 171 cases of DRPs cases, i.e. 103 cases (57.89%) was clasified as unnecessary drug therapy category, 25 cases (14,62%) was categorised as wrong medicine, 39 cases (22,81%) was over dose categories, and 8 cases (4,68%) was subtherapy dose category. The most often DRPs incidents occurs in this study were unnecessary drug therapy should be as large as 57,89 % of the total cases of DRPs.