Identification of Drug-Related Problems: A Prospective Study in Two General Hospitals

Maher      R. Khdour; Anan      S. Jarab; Heba      O. Adas; Ekhlas      Z. Samaro; Tareq      L. Mukattash; Hussein      O. Hallak

Abstract

Drug-related problems (DRPs) can reduce the potential clinical benefits of treatment with medicines and waste valuable resources. No previous studies were published to examine the nature and frequency of drug related problems among hospitalized patients in Palestinian hospitals. Methodology: Prospective observational study was conducted to report and record the natural and frequency of drug related problems in two general hospitals. Results: The study included 212 patients, 54.4 % female, with a mean age 62.2 (±10.6 SD). 88% of the patients were reported with one or more DRPs, with an average of 1.9 DRPs per patient were found. The most prevalent DRP was incorrect dosing regimen which was represented by (22.2%), followed by drug-drug interaction (19.4%), drugs need laboratory tests (15.2%). Ceftriaxone, warfarin, enoxapirin and dogixin were the drugs causing most frequent DRPs. The drug groups causing most DRPs were anti-infective agents, anti-thrombotic agents and non-steroidal anti-inflammatory agents. Once discovered, the majority of DRPs (71.6%) were accepted by the physicians and solved immediately, while 11.5 % of pharmacist advice was not approved. Multiple regression analysis indicated that the number of medications (RR 1.99; 95% CI 1.31-3.76) and the number of medical conditions (RR 1.81; 95% CI 1.11-3.13) independently predicted the number of DRPs. Conclusion: DRPs in general hospitals are frequent, serious and predictable. Most of the problems identified as DRPs by the pharmacists were accepted by the physicians and solved. Pharmacists in the hospital setting are well suited to identify and resolve DRPs.

Keywords: Adverse drug reaction, DRPs, hospital setting, Palestine, pharmacist intervention, Patients and Design, chronic diseases, drug-drug interaction, Paracetamol, Spiranolactone.