ROLE OF PHARMACISTS IN REDUCING DRUG-RELATED PROBLEMS IN HEMODIALYSIS OUTPATIENTS

Romauli Lumbantobing; Rani Sauriasari; Retnosari Andrajati

doi:10.22159/ajpcr.2017.v10s5.23110

Authors

Romauli Lumbantobing Department of Pharmacy, Universitas Kristen Indonesia Hospital, Jakarta, Indonesia
Rani Sauriasari Department of , Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.
Retnosari Andrajati Department of , Faculty of Pharmacy, Universitas Indonesia, Depok, Indonesia.

DOI:

https://doi.org/10.22159/ajpcr.2017.v10s5.23110

Keywords:

Role of pharmacists, Drug-related problems, PCNE-602, Hemodialysis, Outpatient

Abstract

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Â Objectives: Hemodialysis outpatients have a higher risk of developing drug-related problems. Pharmacists play a key role in identifying and preventing these drug-related problems. This study aimed to assess the effect of pharmacist intervention on the number and types of drug-related problems in outpatients undergoing hemodialysis at Indonesia Christian University Hospital.

Methods: This pre- and post-prospective study was conducted from January 2013 to June 2013. We evaluated 86 patients who were prescribed 804 drugs.

Results: A total of 337 drug-related problems were identified (41.86% of the total drugs prescribed). The types of drug-related problems identified were as follows: Failed therapy (18.69%); sub-optimal therapy (52.23%); indication of non-administration of therapy (2.37%); and non-allergic adverse drug effects (26.71%). The physicians received 59 recommendations, and the patients received 278 recommendations. These recommendations resulted in a decrease in ineffective drug therapy or therapeutic failure (18.69-0%), sub-optimal therapy (52.23-21.36%), indications of non-administration of drug (2.37-2.08%), and non-allergic adverse drug effects (26.71-9.20%). The factors that significantly affected the occurrence of drug-related problems were hemodialysis frequency, number of comorbidities, and number of drugs prescribed. Patients undergoing hemodialysis 3 times a week were more likely to experience a decrease in drug-related problems than those undergoing hemodialysis twice a week (odds ratio 26.33, 95% confidence interval 2.710-255.884).

Conclusions: Pharmacist intervention could decrease drug-related problems in hemodialysis patients.

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References

Pharmaceutical Care Network Europe Foundation. Classification For Drug - Related Problems. V6.2 (revised 14-01-2010vm). PCNE; 2010.

Tozawa M, Iseki K, Iseki C, Oshiro S, Higashiuesato Y, Yamazato M, et al. Analysis of drug prescription in chronic haemodialysis patients. Nephrol Dial Transplant 2002;17(10):1819-24.

Hassan Y, Rowa JR, Aziz NA, Ghazali R. Drug use and dosing in chronic kidney disease. MRCP Clinical Pharmacy Programme. Penang: School of Pharmaceutical Science, University Sains Malaysia; 2009.

Manley HJ, McClaran ML, Overbay DK, Wright MA, Reid GM, Bender WL, et al. Factors associated with medication-related problems in ambulatory hemodialysis patients. Am J Kidney Dis 2003;41(2):386-93.

Lie-A-Huen L, et al. On-ward participation of a hospital pharmacist in a Dutch intensive care unit reduces prescribing errors and related patient harm: An intervention study. Crit Care 2010;14(5):R174.

Komputindo; 2003. 7. Klopotowska JE, Kuiper R, van Kan HJ, de Pont AC, Dijkgraaf

Alderman CP, Farmer C. A brief analysis of clinical pharmacy interventions undertaken in an Australian teaching hospital. J Qual Clin Pract 2001;21(4):99-103.

Bosma L, Jansman FG, Franken AM, Harting JW, Van den Bemt PM. Evaluation of pharmacist clinical interventions in a Dutch hospital setting. Pharm World Sci 2008;30(1):31-8.

Kopp BJ, Mrsan M, Erstad BL, Duby JJ. Cost implications of and potential adverse events prevented by interventions of a critical care pharmacist. Am J Health Syst Pharm 2007;64(23):2483-7.

Arnold FW, McDonald LC, Newman D, Smith RS, Ramirez JA. Improving antimicrobial use: Longitudinal assessment of an antimicrobial team including a clinical pharmacist. J Manag Care Pharm 2004;10(2):152-8.