INPATIENT DRUG RELATED PROBLEMS AND PHARMACIST INTERVENTION AT A TERTIARY CARE TEACHING HOSPITAL IN SOUTH INDIA-A RETROSPECTIVE STUDY
Mounica. Bollu*, Nalluri. Kranthi Koushik, Muddana. Nagaloh
ABSTRACT
BACKGROUND: Now-a-days drug related problems were seen very
commonly within the health care practice. These could result in the
medication errors,adverse events,drug interactions and harm to
patients. Pharmacist has an identified role in minimizing and
preventing such type of problems. OBJECTIVES: To detect the
incidence of drug related problems for the hospitalized patient, and to
analyze the clinical pharmacist interventions performed during the review of prescription
orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large
tertiary care teaching hospital. METHODS: It was a retrospective, observational and
interventional study .The analysis took place daily with the following parameters: dose,rate of
administration, presentation and/or dosage form, presence of inappropriate/unnecessary
drugs, necessity of additional medication, more proper alternative therapies, presence of
relevant drug interactions, inconsistencies in prescription orders, physical-chemical
incompatibilities/solution stability. From this evaluation, the drug therapy problems were
classified, as well as the resulting clinical interventions. For a period starting November
2012 until December 2014, the inpatient medication charts and orders were identified and
rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services
in a tertiary care teaching hospital on routine daily activities.Data was collected and
evaluated. The causes of this problem were identified. RESULTS: A total of 360 patients
were followed .Male (71.66%) predominance was noted over females (28.33%). Drug related
problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors(26.11%),improper drug selection
(17.22%),followed by untreated indications (14.4%) Majority of the clinical pharmacist
recommendations were on need for proper dispensing(26.11%), and drug change (18.05%).
Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate
and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist
recommendation and change in drug therapy was found to be high (86.66%).
CONCLUSION: Our study showed that the prescriptions reviewed had some drug therapy
problem and the pharmacist interventions have promoted positive changes needed in the
prescriptions. In this context, routine participation of clinical pharmacists in clinical medical
rounds facilitates the identification of DRPs and may prevent their occurrence.
Keywords: Drug related problems,Clinical Pharmacist,Drug prescriptions,Drug related problems, Intervention.
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