CLINICAL PHARMACIST'S INTERVENTIONS ON DRUG RELATED PROBLEMS IN A TERTIARY CARE HOSPITAL
Keywords:
Drug Related Problems, Clinical pharmacists, Drug interventions, Drug interactions, Adverse drug reactionsAbstract
Objective: To identify various drug related problems in patients admitted to the general ward of a tertiary care hospital and to make suitable drug therapy recommendations.
Methods: A prospective observational study was conducted in the Annex General ward in B Block of Amrita Institute of Medical Sciences, Kochi for a period of 6 months. All the patients admitted to the general ward on particular day of each week and who satisfied the selection criteria were included in this study.
Results: During the study period, a total of 598 drug related problems were identified of which 55.51% were due to prescribing of interacting drugs followed by drug choice problems (12.71%). Three hundred and thirty two drug interactions were observed in 224 patients. Thirty nine adverse drug reactions were observed in the study patients and cardiac drugs were the main class of drugs involved. Eighty seven drug interventions were done in 224 patients. It took an average of 25-35 minutes per intervention. Out of the total 87 interventions made, 41.4% (36) were at the prescriber level followed by 30% (27) at drug administration level. 23% of drug interventions were made at the patient level. 88.5% of the interventions were accepted and 11.5% were rejected.
Conclusion: This study shows the positive impact of clinical pharmacists in identification and resolution of drug related problems in a tertiary care hospital.
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References
Ernst FR, Grizzile AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc 2001;41:192–9.
Meyboom R, Egberts A, Edwards R. Principles of signal detection in pharmacovigilance. Drug Saf 1997;16:355-65.
Pirmohamed M, Breckenridge AM, Kitteringham NR. Adverse drug reactions. BMJ 1998;316:1295-8.
Consensus Committee. Second consensus of Granada on drug therapy problems. Ars Pharm 2002;43:179-87.
World Health Organization international drug monitoring: role of national centers. Geneva WHO, Tech Rep Ser WHO; 1972. p. 48.
Academic Health Centres. Leading Change in the 21st Century. 1st ed. Washington, DC: National Academy Press; 2003.
Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm 1990;47:533-43.
Reis WC, Scopel CT, Correr CJ, Andrzejevski VM. Analysis of clinical pharmacist interventions in a tertiary teaching hospital in Brazil. Einstein 2013;2(2):627.
Celin A, Seuma J, Remesh A. Assessment of drug related problems in stroke patients admitted to a south Indian tertiary care teaching hospital. Ind J Pharm Pract 2012;5(4):28-33.
Ganachari MS, Kumar M, Shashikala C, Fibin M. Assessment of drug therapy interventions by clinical pharmacist in a tertiary care hospital. Ind J Pharm Pract 2010;3(3):22-8.
Shareef J, Sandeep B, Shastry CS. Assessment of drug related problems in patients with cardiovascular disease in a tertiary care teaching hospital. J Pharm Care 2014;2(2):70-6.
Parthasarathi MS, Remesh M, Madaki S. Assessment of drug related problems and clinical pharmacist’s interventions in an Indian teaching hospital. J Pharm Prac Res 2003;33:272-4.
Van Mil JWF, Westerlund TLO, Herberger KE, Schaefer MA. Drug-related problems classification system. Ann Pharmacother 2004;38(5):859-67.
Lexi-Comp Online TMInteraction Analysis. Wolters Kluwer. c 1978-2015. Available from: www.uptodate.com/crlsql/interact/frameset.jsp. [Accessed on 12 Jan 2015].
Hartwing SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 1992;49:2229-32.
Al Ameri M, Makramalla E, Albur U, Kumar A, Padma Rao. Prevalence of Poly-Pharmacy in the Elderly: Implications of age, gender, co-morbidities and drug interactions. SOJ Pharm Sci 2014;1(3):1-7.
Kumar KS, Venkateshwarlu K, Ramesh A. A study of medication administration errors in a tertiary care hospital. Indian J Pharm Practice 2011;4(2):37-42.
Huysmans K, De Wulf I, Foulone V, De Loof H, Teurhaut S, Boussery K, et al. Drug related problems in Belgian community pharmacies. J Pharma Belg 2014;1:4-15.
Baniasadi S, Habibi M, Haghgoo R, Karimi Gamishan M, Dabaghzadeh F, Farasatinasab M, et al. Increasing the number of adverse drug reactions reporting: The role of clinical pharmacy resident. Iran J Pharm Res 2014;13(1):291-7.