Assessment of a Clinical Pharmacy Activity in a Pediatric Inpatient Department in Cote D′ivoire

Abstract

Background:Clinical pharmacy activities in a pediatric inpatient department help to improve the management of patients clinically and economically.Objective:To assess the relevance of pharmaceutical interventions (PIs) in a pediatric inpatient department in Abidjan (Cote d’Ivoire).Materials and Methods:We carried out a cross-sectional, descriptive study from February to September 2014. The information collected was classified according to the classification of drug-related problems (DRPs) and PIs of the French Society of Clinical Pharmacy. The score assigned to each PI varied from PI0 (without direct clinical impact) to PI3 (vital clinical impact) as the importance of the potential clinical impact of the DRP was correlated to the severity of clinical consequences avoided by the PI. The relevance of PIs was assessed by their rate of acceptance by physicians and by the analysis of their clinical impact.Results:A total of 116 PIs were performed with 31% performed during medical rounds, 68.1% during patients’ records analysis, and 0.1% on patient's admission. The main DRPs were related to noncompliance with recommendations (24.1%), overdose (21.1%), and underdosing (13.8%). The most important PIs were dose adjustment (31.8%), accuracy of drugs administration modalities (29.3%), and proposals of therapeutic choice (27.6%). The acceptance rate of PIs was highly significant (94.8%). The majority of PIs (67.3%) was assessed as having a significant clinical impact (PI1) and 16.4% of PIs as very significant clinical impact (PI2). A single PI (0.9%) was found with vital clinical impact.Conclusion:PIs performed were relevant and contributed to the therapeutic optimization and the prevention of iatrogenic events in pediatric inpatients.

Identification and Resolution of Drug-Related Problems among Childhood Cancer Patients in Ethiopia

“…Based on this classification system, anti-infectives for systemic use (ATC group J) was the most common (30.7%) drug class associated with DRPs in this study. is finding is in agreement with other studies done in patients with hematology malignancies [37] as well as other patients [22,24,30,31,38]. Anti-infective drugs encompass the largest number of drug classes widely prescribed in TASH and associated with DRPs needing pharmaceutical interventions.…”

“…e addition of a drug, which accounted for about 31.4%, was the most common recommendation made, and this is consistent with an Indian study (29.3%) [27]. e second most common intervention recommended was dose adjustment (30.2%), and a similar rate was also reported in a Cote d'Ivoire study (32%) [31]. Interventions were fully accepted in 223 (92.15%) and not accepted in 10 (4.13%) of the cases.…”

“…e most frequently encountered DRPs were inappropriate dosing (high and low dose) followed by needs additional drug therapy and nonadherence to the prescribed medications. In line with this, several studies have also reported dosing problems (high and low dose) to be the most frequently (34.9%-61.8%) encountered DRPs in their settings [24,31,32]. e drugs more associated with dosing problems in this study included TMP/SMT, vancomycin, vincristine, metoclopramide, cimetidine, furosemide, and doxorubicin.…”

“…Various acceptance rates have been reported from different countries. e current rate is similar with the National Cancer Centre of Singapore (93%) [39], slightly lower than that of the Cote d'Ivoire (94.8%) [31] and France (96%) [37], and higher than that of Norway (75%) [20], India (86.6%) [40], and South Korea (88.3%) [41]. However, a very low acceptance rate (37.4%) was also reported in a study conducted in Iraqi hospitals [42].…”

Influence of Pharmacist–doctor Communication on Pediatric Antibiotic Prescriptions

“…The other antibiotics in this group were rifampicin (33.3%) and isoniazid (16.7%). Abrogoua et al [9,10] conducted a study on pharmacist intervention in outpatient prescriptions and found that the proportion of drug-related problems involving a subtherapeutic dose was 11.1%; the antibiotic that was most frequently involved was amoxiclav (61.9%).…”