Pattern of drug therapy problems and interventions in ambulatory patients receiving antiretroviral therapy in Nigeria

Abstract

*Objectives: We describe the frequency and types of drug therapy problems (DTPs), and interventions carried out to resolve them, among a cohort of HIV-infected patients on ART in Jos, Nigeria. Methods: A prospective pharmacists' intervention study was conducted between January and August 2012 at the outpatient HIV clinic of the Jos University Teaching Hospital (JUTH). Pharmacists identified DTPs and made recommendations to resolve them. The main outcome measures were number of DTPs encountered, interventions proposed and acceptance rate of recommendations. Results: A total of 42,416 prescriptions were dispensed to 9339 patients during the eight months study. A total of 420 interventions (Intervention rate of 1 per 100 prescriptions) were made to resolve DTPs in 401 (4.3%) patients with a mean age of 41 (SD=10) years, and made up of 73% females. DTPs encountered were drug omission (n=89, 21.2%), unnecessary drug (n=55, 13.1%) and wrong drug indication (n=55, 13.1%). Recommendations offered included; Addition of another drug to the therapy (n=87, 20.7%), rectification of incomplete prescriptions (n=85, 20.2%), change of drug or dosage (n=67, 16.0%), and discontinuation of the offending drug (n=59, 14.0%). A total of 389 (93%) out of 420 of the recommendations were accepted. In all, 50.4% (212) of the problematic prescriptions were changed and dispensed, 22.2% (89) were clarified and dispensed, while wrong identities were corrected in 11.7% (49). However, 7.5% (30) (21) were not dispensed, and 3% (12) were unresolved. Conclusion: Our findings suggest that pharmacistsinitiated interventions can ameliorate DTPs in patients receiving ART given the high intervention acceptance rate recorded. The implication of this finding is that pharmacists with requisite training in HIV pharmacotherapy are an excellent resource in detecting and minimizing the effect of antiretroviral drug-related errors.

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

“…12,14 Apart from; the acceptance rate was reported in the range of 47% to 93%, with a higher acceptance rate in developing countries. 12,14,20,42,[51][52][53][54] The current study depicted that the most common type of interventions provided were: discontinue drug(s) followed by add drug(s), change dose, and change route which was roughly similar with other studies. For instance, the most common interventions provided by Clinical Pharmacists were: add a drug, rectification of incomplete prescriptions, change of drug or dosage, and discontinue drug by the first study; 52 while add drug followed by reduce dose by the second study; 53 and reduce dose by the third study .…”

Polypharmacy and drug-related problems among people living with HIV/AIDS: a single center experience

“…Billedo et al showed that the clinical pharmacist's participation in the Antiretroviral Stewardship Program contributed to a reduction of drug-related errors and improvement of drug safety in patients (24). Evaluation of patients' treatments and recommendations to physicians and patients during ART by pharmacists have been reported by numerous studies in literature (10,22,25). In our study, half of the interventions were geared towards the physicians, 43% towards the patients, and 7% towards both the physicians and the patients.…”

Determinants of Willingness to Pay for Pharmacists Provided Medication-Related Services Among Outpatients in South-Eastern Nigeria Teaching Hospitals

“…This situation had been attributed to lack of motivation via rewards or reimbursement for the services as it is currently free-of-charge 18 . Pharmacists' lack of motivation might likely explain the growing trend of medication-related problems, particularly among outpatients with chronic diseases [19][20][21][22] . To date, no prior study has assessed the economic value of pharmacist-provided services in the hospital.…”