Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

Abstract

Background Although medications play a vital role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems (DRPs). DRPs are common in hospitalized patients. Specifically, pediatrics population are easily affected by DRPs, as dynamic and kinetic behaviors of drugs in this population are usually different than in adults. Objectives To assess the prevalence of DRPs and associated factors in a pediatric setting in Ethiopia. Setting Pediatric ward of Zewditu Memorial Referral Hospital, Addis Abbeba, Ethiopia. Methods A cross-sectional study was conducted on 285 randomly selected patients. Data were obtained through review of physician medication orders and patient files. The prevalence and type of DRPs were studied and documented using the Pharmaceutical Care Network Europe Foundation classification system. The results were summarized using descriptive statistics including frequency, mean, and standard deviation. To identify the independent predicators of DRPs, logistic regression analysis was run and a P value ≤0.05 was considered as statistically significant. Main outcome measure DRPs, types of DRPs, drugs that are frequently involved in DRPs, and factors associated with DRPs. Main outcome measure Number of DRPs. Results Of the 1055 medication orders reviewed, a total of 106 DRPs were identified in 90 patients. This gives an overall rate of drug-related problems of 31.57%. The most frequently identified DRPs were dosing problems, with dose too low being 34.9% and dose too high being 7.5%. This was followed by drug–drug interactions(38.67%) and adverse drug reactions (8.49%). The number of prescribed drugs (AOR 2.3, 95% CI 1.3–4.3, P = 0.007) and total number of disease conditions (AOR4.8, 95% CI 1.9, 12.1, P = 0.001) were potential risk factors for occurrence of DRPs. Conclusion The present study demonstrated that DRPs were common at the pediatric ward of Zewditu Memorial Referral Hospital and that it needs great attention. The most frequently identified DRPs were dosing problems, followed by drug–drug interactions and adverse drug reaction. Poly-pharmacy and number of disease conditions have been identified as important risk factors for occurrence of DRPs. The investigators recommend establishing a system for reporting DRPs in the pediatric ward of the hospital as it may facilitate appropriate measures for prospective interventions, such as training the healthcare team, as well as detail precautions to be followed by the practitioners. In addition to this, improving communication between the healthcare team members such as physicians, pharmacists, nurses, and other healthcare workers in the hospital is recommended.

Drug-Related Problems in Cardiac Neonates Under Intensive Care

“…This result was higher than what has been found in international and Brazilian studies conducted in general pediatrics, in which DRP ranged from 20 to 70%. [16][17][18][19][20][21] The result, however, is lower than what was observed in the study by Sabry et al, 11 in which all 60 cardiopathic children evaluated were exposed to DRP while in an Egyptian hospital. However, it is worth noting that local specificities, population characteristics, methods of identification and classification of DRPs and the follow-up time of the study make these comparisons difficult.…”

“…22,23 Similar to pediatric studies, antimicrobials were the group of drugs most involved in GRP. [16][17][18][19][20]24,25 Some authors state that the risk of adverse events related to each drug is directly associated with the frequency of prescription. 24,25 However, similar to the findings of Blix et al, 26 in our study the most involved medications were not necessarily the most prescribed, showing that the risk of damage is related to the chemical and pharmacological characteristics of the medications, as well as patient characteristics.…”

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

“…Although data in the literature are scarce in the area, comparison with available data indicates that the frequency of DRPs was higher than a study done in a similar setting, where 0.6 DRPs per patient was reported [22]. e prevalence was also higher compared to other studies conducted in the pediatric wards of local (32%) and overseas (21%) hospitals [23,24]. Studies performed in adult cancer patients also reported either a lower (55%) [25] or higher (93.8%) [26] prevalence than the current study.…”

Incidence, types and acceptability of pharmaceutical interventions about drug related problems in a general hospital: an open prospective cohort

“…They are considered adverse events and occur in patients at all levels of healthcare, whether home care, 2 institutional long term care, 3 community pharmacy 4 or hospital. 5 In the hospital setting, incidence rates of DRP have been reported for specific patient populations, with high incidence rates in children 6 and the elderly, 7 as well as in certain clinical specialties such as cardiology, 8 neurology 9 and surgery. 7 This high incidence of DRP negatively affects the quality of life of the patient and increases the economic and social burden of illnesses.…”