Patient risk factors for developing a drug-related problem in a cardiology ward

Urbina, Olatz; Ferrández, Olivia; Luque, S.; Grau, Santiago; Mojal, Sergi; Pellicer, Rosa; Riu, Marta; Salas, E.; Comín‐Colet, Josep

doi:10.2147/tcrm.s71749

Cited by 43 publications

(78 citation statements)

References 28 publications

(40 reference statements)

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“…High numbers of available medications and associated comorbidities have resulted in polypharmacy worldwide . Polypharmacy is an increasing problem in the care of multimorbide patients, leading to increased treatment‐related problems (TRPs), hospital emergency department visits and hospitalisation rates . Irrational drug use has also been associated with high occurrence of TRPs which is a major concern in health care leading to increased morbidity and total healthcare costs .…”

Section: Introductionmentioning

confidence: 99%

Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates

Basheti

Abu‐Gharbieh

2017

J Pharm Health Serv Res

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Objectives To explore types and frequencies of treatment‐related problems (TRPs) amongst outpatients with chronic diseases recruited through community pharmacies and clinics in the UAE via conducting the medication management review (MMR) service. Methods This observational study was conducted over three months in 2013 in the UAE. Ethical approval was obtained, and patients were recruited randomly by two pharmacists from different outpatient settings. Patient interview was conducted at the community pharmacy or clinic to collect demographic data, followed by a visit to the patient's home to collect the medical data. TRPs for each patient were identified by the clinical pharmacist. Key findings A total of 125 patients (mean age: 52.40 ± 12.60) completed the study. More than half of the patients (57%) were classified overweight (BMI > 24.90 kg/m2), and many (22%) were smokers. Mean number of medical conditions was 2.77 ± 1.44; mean number of medications taken was 3.12 ± 1.29. Most prevalent diseases included diabetes mellitus (24%), hypertension (21%), coronary artery disease (11%) and asthma (9%). Mean number of identified TRPs was 1.76 ± 1.44 per patient. The most common TRP categories were inappropriate adherence (68.5%), inappropriate dosage regimen (35.4%), untreated conditions (29.2%) and ineffective/incomplete drug therapy (26.2%). Conclusions Prevalence of TRPs among outpatients living in the UAE is a concern that needs addressing. None adherence is a major TRP amongst patients with chronic conditions. The MMR service delivered by pharmacists is needed to identify, prevent and resolve outpatients’ TRPs.

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Section: Introductionmentioning

confidence: 99%

Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates

Basheti

Abu‐Gharbieh

2017

J Pharm Health Serv Res

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“…Unfortunately, polypharmacy increases the risk of a drug-related problem (DRP), defined as an event or circumstance involving drug therapy that can interfere with a desired health outcome. 9 The occurrence of DRPs can reduce the benefits of drugs and cause increased morbidity and mortality. 10 According to the classification scheme of the Pharmaceutical Care Network Europe Foundation (PCNEF), four types of DRPs exist, including drug effects, adverse drug reactions (ADRs), treatment cost-related problems and other problems.…”

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confidence: 99%

Evaluation of a Clinical Pharmacist Intervention on Clinical and Drug-Related Problems Among Coronary Heart Disease Inpatients: A pre-experimental prospective study at a general hospital in Indonesia

Sagita

Bahtiar

Andrajati

2018

Sultan Qaboos Univ Med J

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abstract:Objectives: This study aimed to evaluate the role of a clinical pharmacist intervention in decreasing subsequent clinical and drug-related problems (DRPs) among coronary heart disease (CHD) inpatients with at least one previous DRP. Methods: This pre-experimental study with a pre-post design was carried out from January to April 2017 among inpatients with at least one previous DRP at a general hospital in Tangerang District, Banten, Indonesia. Clinical and DRPs were documented prospectively by a clinical pharmacist, with DRPs classified using Version 6.2 of the DRP classification scheme of the Pharmaceutical Care Network Europe Foundation. The intervention consisted of a discussion of identified DRPs with physicians, patients, pharmaceutical logistics clerks, nurses and nutritionists. Following this, any subsequent clinical and DRPs were re-identified and further interventions were conducted as necessary. Results: A total of 75 inpatients were included in the study. Pre-intervention, there were 443 DRPs and 202 clinical problems. The most frequent DRPs were adverse drug reactions (52.6%), followed by drug effects (41.8%). Most DRPs were of moderate severity and would have resulted in moderate consequences had the pharmacist not intervened. The interventions resulted in a significant reduction in the number of DRPs, type of DRPs and number of clinical problems (P <0.05 each). Patients with complications were 26.047 times more likely to have no reduction or an increased number of clinical problems compared to patients without complications (P <0.05). Conclusion: Clinical pharmacist interventions were found to reduce subsequent DRPs and clinical problems among CHD patients with at least one previous DRP. Keywords

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“…20 Other studies conducted on the cardiology ward, reported DDI and drug-food interactions frequency altogether or assessed only DDIs in the heart failure patients. 21,22 The potential of using supporting electronic systems to manage pDDIs in CVD patients was not assessed. In this regard, the aim of the study was to describe the type and prevalence of potentially relevant pDDIs in CVD patients, and to assess the concurrent exposure to additional risk factors such as renal or liver disease, which may further affect drug exposure and therapy outcomes.…”

mentioning

confidence: 99%

The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study

Kovačević

Miljković

et al. 2017

Int J Clin Pract

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SummaryAim: The aim was to describe the type and prevalence of potentially relevant drugdrug interactions (pDDIs) in a population of patients admitted for cardiovascular diseases (CVD), and management strategies for reducing the occurrence of pDDIs. Methods:A retrospective cross-sectional study was performed on Cardiology ward of University Clinical Hospital Center in Belgrade, Serbia. A total of 527 patients, with more than one prescription during hospital stay, were enrolled in this study. Data were obtained from medical records. LexiInteract was used as the screening tool.Results: At least one potentially relevant pDDI was identified in 83.9% of patients.Occurrence was significantly more prevalent in patients with higher number of drugs, multimorbidity, longer length of stay, arrhythmia, heart failure, infectious and respiratory disease. About 13% of pDDIs exposures were accompanied with concurrent renal or liver disease, as an additional risk for DDI manifestation. Among CVD, patients with a history of myocardial infarction possessed the highest additional risk. The most common potential clinical outcome was the effect on cardiovascular system 48.5%, renal function and/or potassium 22.3%, bleeding 9.5%, impaired glucose control 6.8% and digoxin toxicity 4.6%. Main management strategies to avoid X or D class included using paracetamol instead of NSAID or alternative NSAID (38%), alternative antibiotic or antifungal (20.4%), H 2 receptor antagonist instead of PPI (8.3%), avoiding therapeutic duplication (7.3%), and alternative HMG-CoA reductase inhibitor (7%). Heart rate, blood pressure, electrolytes/potassium and blood glucose could have been employed in monitoring for potential consequence of 72.2% C class pDDIs. Conclusions:Use of drug interaction screening tools can be beneficial risk mitigation strategy for potentially relevant pDDIs in CVD patients. DDI screening software could be linked to the patient's laboratory results or clinical data regarding renal or liver function, as an approach to reinforce DDIs alert quality.

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Patient risk factors for developing a drug-related problem in a cardiology ward

Cited by 43 publications

References 28 publications

Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates

Revealing treatment-related problems for outpatients with alarming health status in the United Arab Emirates

Evaluation of a Clinical Pharmacist Intervention on Clinical and Drug-Related Problems Among Coronary Heart Disease Inpatients: A pre-experimental prospective study at a general hospital in Indonesia

The prevalence and preventability of potentially relevant drug-drug interactions in patients admitted for cardiovascular diseases: A cross-sectional study

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