<p>Drug Therapy Problems and the Role of Clinical Pharmacist in Surgery Ward: Prospective Observational and Interventional Study</p>

Abstract

Background: Drug therapy problems (DTPs) are of major concern in health care because of the associated increased cost of treatment, morbidity, and mortality. Thus, clinical practice should constitute the mainstream practice of clinical pharmacy in every ward. However, nothing is known about DTPs and the role of clinical pharmacist in the surgical ward of Ethiopia (the neglected ward). Objective: To assess the prevalence of DTP among patients hospitalized at the surgical ward and the role of clinical pharmacists in their identification and resolution. Methods: Hospital-based prospective observational and interventional study design was used with daily patients' chart review using a semi-structured questionnaire among hospitalized adult patients at the surgical ward. After identification of DTP, verbal communication was used as a means of intervention with the treating physician. Acceptance of clinical pharmacist's intervention was considered only if a change was made to the patients' medication order. To identify determinants of DTPs, multiple stepwise forward logistic regression analysis was done by SPSS version 20.0. Statistical significance was considered at p-value < 0.05. Written informed consent was sought and the data were secured. Results: The response rate was 97.1% (300) for the final analysis. The mean (±SD = standard deviation) age of the participants was 42.62 ±18.29 with male (67%) predominance. DTP was identified in 76% of study participants. A total of 449 DTPs were identified, which equates with an average of 1.97 per patient. Dose too low 124/449 (27.6%) and dose too high 81/449 (18.0%) were found to be the most common types of DTPs. The intervention rate was 86.0% (196/228 per patients) and 86.2% (387/449 DTPs), with the acceptance rate of 85.2% (167/196 per patients) and 78% (302/387 per DTP) which mean (67.3%) 302/449 of the problems were fully resolved by the clinical pharmacist. Poly-pharmacy [AOR, 7.23; 95% CI, 2.29-22.13: P-value < 0.001] and hospital stay > 20 days [AOR, 5.42; 95% CI, 2.74-10.70; p < 0.001] were the only independent predictors for DTPs. Conclusion and Recommendation: This study identified a high prevalence of DTP which was independently predicted by the presence of poly-pharmacy and >20 days of hospital stay. The rate of intervention provided and acceptance from the physician was high, which is one indicator that the role of clinical pharmacists in the identification and resolution of DTP was paramount in the surgery ward and should be implemented as a must not as optional.

Value of pharmacy services upon admission to an orthopedic surgery unit

“…The medical team was receptive to the interventions made by the pharmacy resident as demonstrated by the high rate of intervention acceptance (around 85%). This acceptance rate is higher than what is documented in the literature for general pharmacy recommendation acceptance rate (48 to 73%) [ 31 – 34 ], but similar to what is documented for medication reconciliation recommendations (78%) [ 31 ] and recommendation of clinical pharmacists on surgical wards (85%) [ 35 ]. The majority of rejected recommendations, however, were associated with omission of antihyperlipidemic agents or multivitamins that the physicians considered unnecessary during the course of hospitalization.…”

Drug-related problems and associated factors in Ethiopia: a systematic review and meta-analysis

“…Of the total included studies, eight studies were conducted in Jimma University Medical Center (JUMC) [26][27][28][29][30][31][32][33], seven were conducted in Tikur Anbesa Specialized Hospital [25,[34][35][36][37][38][39]. Three studies were conducted in Hiwot Fana Specialized University Hospital [40]- [42] and two studies were conducted in Dessie Referral Hospital [43,44].…”

<p>Antimicrobial Drug Therapy Problems Among Patients in the Outpatient Department of Ataye Hospital, Northeast Ethiopia</p>

“…16 In the USA, DTPs were the 4th-6th cause of death with total costs of $130-177.4 billion. 17 DTP can occur everywhere, inpatient or outpatient, in every ward where drug therapy is applied for prevention, diagnosis, or management of the disease. 17 Identifying DTPs is a major task that can be performed by clinical pharmacists and other health-care providers.…”

“…17 DTP can occur everywhere, inpatient or outpatient, in every ward where drug therapy is applied for prevention, diagnosis, or management of the disease. 17 Identifying DTPs is a major task that can be performed by clinical pharmacists and other health-care providers. On the other hand, the educational intervention of patients by clinical pharmacists can improve patients' adherence to drug therapy.…”