Assessment of Drug-Related Problems among Inpatients in a Tertiary Care Hospital of Eastern Nepal (original) (raw)
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Exploratory Research in Clinical and Social Pharmacy, 2024
Background: Inpatients are at higher risk of Drug Therapy Related Problems (DTRPs), and early identification and management of these DTRPs is crucial for optimal treatment outcomes and ensuring rational drug therapy. Objective: This study aims to assess DTRPs in a general medicine ward of a tertiary care hospital in eastern Nepal. Methods: A three-month prospective observational study was conducted on inpatients admitted to the general medicine ward of the hospital. Pharmacists routinely performed patient drug therapy reviews, by which suspected DTRPs were identified and recorded as per the Pharmaceutical Care Network Europe Association (PCNE) v.9.1 guidelines. Binary logistic regression analysis was used to determine the influence of predictor variables on the occurrence of DTRPs. Results: A total of 301 inpatients were enrolled, out of which 233 (77.4%) had one or more DTRPs. Altogether, 528 DTRPs with an average of 2.27 ± 0.92 DTRPs per patient were identified. The primary causes of the DTRPs were drug selection (40.47%), treatment duration (16.71%), dispensing (15.75%), and dose selection (13.12%). Antimicrobials were involved in 55.18% of the DTRPs. DTRPs were more prevalent in elderly, comorbid patients, patients with longer hospital stay days, and polypharmacy, which was statistically significant (p<0.05). Furthermore, multivariate binary logistic regression analysis showed that geriatric patients had a higher risk of experiencing DTRPs, with an adjusted odds ratio of 1.832 (1.021-3.286) at p-value < 0.05. Conclusion: DTRPs are frequently prevalent in hospital wards, emphasizing the crucial role of clinical pharmacists in identifying, resolving, and preventing DTRPs in inpatient settings for optimal treatment outcomes.
Assessment of Drug Related Problems in a Tertiary Care Teaching Hospital, India
Asian Journal of Pharmaceutical and Clinical Research, 2017
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.Res...
Objective: To evaluate the drug dispensing practices and patients' knowledge on drug use among the outpatients and to identify and analyze the problems in drug prescribing and dispensing. Methods: A prospective cross-sectional descriptive study was conducted using World Health Organization (WHO) core drug use indicators from July 13, 2008 to August 15, 2008 in Manipal Teaching Hospital, Pokhara, Nepal. Results: A total of 4231 prescriptions were encountered with the total of 10591 drugs prescribed. The average number of drug per prescription was 2.5. Only 13% (n= 10591) of drugs were prescribed by generic name. Percentage of drug prescribed from WHO model list of Essential drugs, Essential drug list of Nepal and Nepalese National Formulary was 21.7%, 32.8% and 42.3% respectively. Antibiotics and injections encountered were 28.3% and 3.1% respectively. Average cost per prescription was found to be Nepalese Rupees (NRs) 285.99 (US $ 3.73). Patient knowledge on correct use of drugs and appropriate labeling was found to be 81% and 1.4% respectively. Average dispensing time per prescription was 52 seconds. Conclusion: The finding from current study shows a trend towards irrational prescribing and dispensing. Hence, there is a need for effective intervention programme to encourage the physicians and dispensing pharmacists in promoting more rational drug use (JPMA 59:726; 2009).
Journal of Pharmaceutical Policy and Practice, 2019
Background: The rational use of medicine improves patient's quality of life. Excessive and inappropriate prescriptions result in severe consequences. The study of drug use patterns and prescription errors is necessary to promote rational drug use in developing countries. The aim of the study was to evaluate prescription practice and help to the quality use of medicine. Methods: A retrospective, cross-sectional and quantitative study was conducted at Bharatpur District Hospital in central Nepal. The outpatient prescriptions retained at the pharmacy from November to December 2017 were used to evaluate prescription patterns and errors. The total of 770 prescriptions were reviewed. The stratified random sampling method was used.
Nepal Journal of Epidemiology
Background The risk of adverse drug reaction ranges nearly from zero to high level depending upon the drug itself and the patient factor. The process of detection, assessment, monitoring and reporting of adverse drug reaction is necessary to prevent its occurrence in future. Materials and Methods Information related to suspected Adverse Drug Reactions(ADRs) were collected by pharmacists from general medical ward using ADRs reporting form from Manipal Teaching Hospital (MTH)during ward rounds. The details of suspected drug, drug reaction and all related data were documented. Naranjo Algorithm, modified Hartwig and Siegel and modified Shumock and Thornton scale were used for assessment of causality, severity and preventability respectively. All suspected ADRs were reported to National Pharmacovigilance Center and then to Uppsala Monitoring centre through the electronic online data base named Vigiflow. Results Among 1,105 patients, 51 patients experienced ADR (4.61%). Incidents of ...
Asian Journal of Pharmaceutical and Clinical Research, 2021
Objective: This study aims to identify inpatient medication problems and analyze the association between patient characteristics and the incidence of the drug-related problem (DRP) experienced by patients. Methods: The cross-sectional study was conducted at Haji Regional General Hospital, Makassar, using medical record data for inpatients from January to February 2020. Data were collected from September to October 2020. A total of 247 inpatients were identified using the Indonesian version of the Pharmaceutical Care Network Europe. Results: The most common DRP problem found is the effect of drug treatment not optimal (P1.2) by 35.76% and the most common cause found is no or incomplete drug treatment despite existing indication (C1.6) by 20.16%. Bivariate analysis shows that age, length of stay, and the number of drugs received are significant different with the incidence of DRP in patients (p < 0,01) respectively. Multivariate analysis using logistic regression shows that age, se...
Europasian Journal of Medical Sciences, 2021
Background: Periodic assessment of morbidity and drug use at various levels of healthcare delivery system is important to recognize common prevalent morbidities and rationalize the use of medicines. The study was conducted to determine the common morbidities and audit prescription using WHO prescribing indicator in government operated tertiary hospitals of eastern Nepal. Methods: A cross-sectional study was carried out in government tertiary hospitals of Province 1, Nepal, from March 2019 to August 2019. For analysis, descriptive statistics were used. Prescribing characteristics were evaluated using recommended guidelines of the World Health Organization (WHO) prescribing indicators. Results: Six hundred prescriptions were analyzed. The most prevalent morbidity was endocrine, nutrition & metabolic diseases (21.5%) followed by diseases of the respiratory system (19.8%), circulatory system (17.6%), and digestive system (12.8%). The most frequently encountered individual disease entit...
2018
Objective: The study aimed to assess the incidence, nature of drug related hospital admissions (DRHAs) and factors associated with DRHAs. Method: A retrospective study was conducted to evaluate the medical records of patients admitted to general medicine department for six months. Drug related hospital admissions were assessed using Helper and Stand Classification. Crude odds ratio (COR) and adjusted odds ratio (AOR) were determined using univariate and multivariate logistic regression analysis. Results: The results of analysis of 1177 medical records reveal that 202 (17.2%) patients were admitted due to 248 DRHAs. Of which, the most common DRHA was non-compliance that accounted for 50.50% (102). Out of 248 drug related hospital admissions, 65.8% (n=163) were definitely preventable, 30.2% (n=75) were possibly preventable and 4.0% (n=10) were definitely not preventable. However, multivariate regression analysis results indicate that hypertension, diabetes mellitus, and polypharmacy a...
Journal of BP Koirala Institute of Health Sciences
Background: Prescription is a written instruction by a health care personnel to pharmacist to dispense drug(s). Irrational drug prescribing is a global problem, particularly in developing and transitional countries. This study was conducted to see the status of World Health Organization (WHO) core prescription indicators, complementary indices and prescription errors. Methods: It was a quantitative cross-sectional descriptive study carried out among inpatients of general surgery of tertiary hospital in eastern Nepal. Ethical approval for the study was obtained from the Institutional Review Committee. It was a convenience sampling. Calculated Sample size was 224. Enrollment of patients started on 16 May 2018 with the last case being enrolled on 1 Oct 2019 after obtaining informed consent. Relevant data was entered in a semi-structured proforma. Microsoft excel 2016 and IBM Statistical Package for the Social Sciences (SPSS) v. 21 were used for descriptive statistics. Results: Median a...
2020
Background: Adverse drug reaction (ADR), medication error (ME) and drug-drug interaction (DDI) are the major medication related problems that affect the pharmacotherapy success. Aim: To know the pattern of ADR, ME and DDI and to assess their causality, severity and preventability among the hospitalized patients in different Intensive Care Units (ICU). Methods: Cross-sectional and Prospective Cohort study was carried out in ICU, coronary care unit (CCU) and Neuro Intensive Care Unit (NICU) at Manipal Teaching Hospital in Western Nepal. Data were collected during physician’s ward round, nursing round using the patients profile form, ADR form, ME form and DDI form. Naranjo Algorithm, modified Hartwig & Siegel and modified Shumock & Thornton Scales were used for assessment of causality, severity and preventability of ADR respectively. The medications were analyzed for possible DDI using standard drug interaction database micromidex 2.0 (Thomson Reuters). Descriptive statistics were used...