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

Abstract

Background. Even though medications play a major role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems. Drug-related problems are frequent and may result in reduced quality of life, morbidity, and mortality.Objectives.e study was aimed to identify, characterize, and resolve drug-related problems in the Pediatric Hematology/ Oncology ward of Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Methods. A prospective observational study was conducted from 25 June to 25 October 2018 to assess DRPs on patients admitted at the pediatric hematology/oncology ward of Tikur Anbessa Specialized Hospital, which is the highest level governmental tertiary care hospital in Ethiopia. Data were obtained from patients' medical charts, physicians, patients/caregivers, pharmacists, and nurses. All the collected data were entered and analyzed using the Statistical Package for the Social Sciences version 25e. Descriptive statistics were used to represent the data. Results. Among the total 156 participants, DRPs were identified in 68.6% of the study subjects. Dosing problems which include dosage too low and high were the top ranking (39.3%) of all DRPs followed by needs additional therapy (27.2%) and nonadherence (14.0%). Systemic anti-infectives were the most common class of drugs involved in DRPs. Trimethoprim-sulfamethoxazole, methotrexate, vincristine, ondansetron, and metoclopramide were frequently involved in DRPs. e addition of drugs and change in drug dose were the two most proposed intervention types. Among the proposed interventions, 223 (92.15%) were fully accepted, 9 (3.72%) partially accepted, and 10 (4.13%) not accepted. Conclusion. DRPs are common among Pediatric Hematology/ Oncology ward patients. e hospital should develop a pediatric dosing chart for the commonly prescribed medications to prevent drug-related morbidity and mortality. e integration of clinical pharmacists can mitigate risks associated with DRPs.

Retrospective Assessment of the Clinical Pharmacist Sheets among a Few Iraqi General Hospitals

“…Similar findings were reported previously in 2011in one of the national hospitals where dosage or frequency of medication followed by addition of drugs to therapy represented the most common issue (32.4% and 19.5% respectively) 26 Globally, as per a study conducted at a multi-specialty teaching hospital, the suboptimal dosing was the most common DRP, 27 Most of the common improper drug selection was related to antibiotics, which is in line with a previous study where anti-infective was the most common class of drug for DRPs. 28 In the current study, the overall percentage of DRPs was 8.5% of the total clinical pharmaceutical sheets reviewed, which was less than that of the internal medicine ward probably due to low number of drugs dispensed pre and post-operatively. This percentage could be acceptable compared to a few studies done in developed countries that showed that the values reported in a German orthopaedic and accident surgery ward using the APS-Doc coding and Swiss cardiovascular surgery ward using a simplified PCNE classification system were 2.6% 29 And 1.7%, 30 respectively.…”

A Atuação Do Farmacêutico Clínico Como Interventor Na Identificação De Problemas Relacionados a Medicamentos Em Hospitais: Uma Revisão De Sistemática

“…(2020), onde o percentual de aceitação das IF realizadas foi de 92% e as intervenções mais efetuadas pelos farmacêuticos foram os ajustes de dosagens, inclusão de terapia adicional e a não-adesão ao tratamento. Esse estudo foi feito entre pacientes com câncer infantil da Etiópia, onde os autores relatam que tratar esse tipo de doença ainda é um dos mais complexos desafios enfrentados pela medicina, pois, está associado a muitos PRM, como por exemplo, os efeitos adversos, EM, interações medicamentosas e não adesão ao tratamento, fatores estes que foram identificados no estudo em questão (19).…”

Clinical pharmacy services in pediatric hematology-oncology: A real need

“…2 Thus, drug-related problems (DRP) are common among pediatric cancer patients and clinical pharmacy plays an essential role detecting and resolving them. 3 We read the article by Diop et al 4 that evaluated prescriptions of anti-infective drugs and potential drug interactions in a pediatric oncology-hematology unit. They analyzed 195 prescriptions; 6.6% of them contained at least one over-dosed drug and 26.7% contained at least one under-dosed drug.…”

“…2 Thus, drug-related problems (DRP) are common among pediatric cancer patients and clinical pharmacy plays an essential role detecting and resolving them. 3…”