Critical analysis of drug related problems among inpatients in the psychiatry department of a tertiary care teaching hospital: A pharmacist led initiative

Abstract

Introduction: Drug Related Problems (DRPs) frequently take place in modern medical practices, increasing the morbidity and mortality as well as the cost of patient care. Objective: The current study was undertaken to identify and evaluate various DRPs among the inpatients of the psychiatry department in a tertiary care teaching hospital using APS-Doc classification system and to identify the most recurrent drugs causing the DRPs. Method: ology: A prospective observational study was conducted forduration of six months among 198 patients using APS-Doc classification system. The data was statistically analysed and tabulated. Results: A total of 205 DRPs were identified in 102 patients, among which 115 (56.1%) were potential drug-drug interactions (pDDI) and 62 (30.2%) were adverse drug reactions (ADRs). 21 (10.2%) DRPs belonged to the category of incorrect spelling of the trade name and 3 (1.5%) among them belonged to unintended prescription of the same drug. Two out of 205 DRPs (1%) belonged to the class of prescription of an incorrect dosage form or no dosage prescribed. One DRP each were categorised under wrong dosage form prescribed and inadequate generic substitution respectively. Out of the total of 314 drugs, risperidone (n = 43, 13.7%) was found to be the drug associated with the most number of DRPs followed by olanzapine (n = 38, 12.1%) and lorazepam (n = 32, 10.2%). Conclusion:The study revealed that more than half (51.5%) of the patients presented with DRPs and the most commonly identified DRPs were pDDIs and ADRs.

Drug-Related Problems and Clinical Pharmacist-Led Medication Therapy Management; Three-Year Survey in an Educational Pharmacotherapy Clinic

“…Several studies have previously examined DRPs in hospitalized patients (11,(21)(22)(23); however, few data are available from regular community pharmacies (24). While we found our most common DRPs, studies with predominantly inpatient settings have shown that DRPs such as the need for a new medication or dose increase (9), suboptimal drug effect (22), and lack of therapy (25) are signi cant problems in inpatients.…”

“…Several studies have demonstrated pharmaceutical care's effectiveness in all settings (9)(10)(11). In particular, research shows that pharmacist medication review can positively impact adherence, improve prescription appropriateness, and potentially reduce emergency department visits.…”

Drug-related problems and associated factors among adult psychiatric inpatients in Northwest Ethiopia: Multicenter cross-sectional study

“…In addition, the current finding also showed that lesser prevalence of ADR than studies done in India and Japan, 43.5% and 63%, respectively. 3,29 The possible reason is due to the setting difference (outpatient versus inpatients), difference in sociodemographic characteristics of the patients and method of assessment of ADR (severity was done using the modified Hartwig and Siegel scale), but in this study, severity was not determined.…”

Reduced prevalence of drug-related problems in psychiatric inpatients after implementation of a pharmacist-supported computerized physician order entry system - a retrospective cohort study

“…Polypharmacy, as a common practice in psychiatry ( 9 ), increases the risk for drug-related problems including adverse drug reactions ( 10 , 11 ). The Pharmaceutical Care Network Europe (PCNE) defines a drug-related problem (DRP) as an event or circumstance involving drug therapy that actually or potentially interferes with desired health outcomes ( 12 ).…”