Validating a drug-related problems classification system in outpatient setting in Iran

Roshanzamiri, Soheil; Eslami, Kaveh; Najmeddin, Farhad; Izadpanah, Mandana; Hadidi, Elham; Ganji, Reza

doi:10.4103/jrpp.jrpp_18_17

Cited by 3 publications

(4 citation statements)

References 17 publications

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“…As patients don't have enough knowledge on DRPs they are only taken as a source of information but not in decision making. By this system, it is easy for both the clinical pharmacist and medical professional in intervening the DRPs [11,12]. Among these problems, unnecessary drug treatment accounts for a major percentage (95.08%).…”

Section: Discussionmentioning

confidence: 99%

The IMPACT OF CLINICAL PHARMACY SERVICES IN GENERAL SURGERY

Battula

Tejaswini²,

Shankar³

et al. 2020

Int J Pharm Pharm Sci

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Objective: The objectives of this study include performing pharmaceutical care-related research and documenting regarding drug-related problems in the surgery department. Further, these types of studies may bring consciousness to both physicians and patients regarding drug use in surgery. Methods: A Prospective interventional study was conducted in a general surgery hospital. The prescriptions were analyzed for the use of inappropriateness of drugs using the classification for drug-related problems. Results: Out of 100 cases, 62 patients were observed with drug-related problems. The number of antibiotics prescribed was 0, 1, 2, 3, 4, 5, 6 in 8, 11, 12, 32, 18, 18, 1 cases respectively. A significant increase in the outcome of antibiotic rationality and cases adhered to guidelines was seen in November compared to October and somewhat decreased in December due to some limitations. The overall study states that prescribing has a more important cause of Drug-related problems compared to dispensing and the use of the drug. Conclusion: Drug-related problems have to be acknowledged as a very important contributing treatment factor for the best health care outcome. Our study shows the importance of clinical pharmacists in every hospital for identifying and resolving drug-related problems and medication errors.

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Section: Discussionmentioning

confidence: 99%

The IMPACT OF CLINICAL PHARMACY SERVICES IN GENERAL SURGERY

Battula

Tejaswini²,

Shankar³

et al. 2020

Int J Pharm Pharm Sci

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“…Moreover, the incidence of DRPs has shown a tendency to increase with time. For instance, the incidence of DRPs in ambulatory care units has increased from 9.1 to 16.9 per 1000 persons between 1995 and 2005 [ 7 ]. If unresolved, some of the DRPs are severe enough to cause serious negative health consequences that result in drug-related hospital admissions (DRHAs), which are hospitalizations due to one or more of the DRPs.…”

Section: Introductionmentioning

confidence: 99%

Drug‐Related Hospital Admissions and Associated Factors among Adults Admitted to Felege Hiwot Comprehensive and Specialized Hospital, North West Ethiopia

Kemal

Shewaga

Sema

2022

Journal of Environmental and Public Health

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Background. A drug-related problem (DRP) is an event involving drug therapy that actually or potentially interferes with the desired therapeutic outcome. Drug-related hospital admission (DRHA) is hospitalization due to one or more DRPs. Objective. This study was aimed at assessing the prevalence of DRHA and factors associated with it among adults admitted to the internal medicine wards of Felege Hiwot Comprehensive Specialized Hospital. Methods. A prospective cross-sectional study was conducted using a previously validated tool, AT-HARM 10. Data were collected by two clinical pharmacists from July 1 to September 15, 2020. The data were entered into EpiData software (version 4.2.0.0) and then transported to Statistical Package for Social Sciences (SPSS®) software (version 24) (IBM Corporation) for analysis. Descriptive statistics were presented using frequency and proportion. Binary logistic regression was applied to identify factors associated with DRHAs with a 95% confidence level, and significance was declared at a p value <0.05. Results. The prevalence of DRHAs was 31.9% (95% CI = 27.7%–36.4%). From this, noncompliance (37.8%) (95% CI = 29.6–45.9), untreated indication (31.9%) (95% CI = 23.7–40), and adverse drug reaction (15.6%) (95% CI = 9.6–21.5) cause the majority of DRHAs. More than a quarter (28.8%) of all admissions were preventable. Most DRHAs were moderate (76.3) and preventable (80.7%). Lower to medium Charlson comorbidity index scores, longer duration of therapy, and not having health insurance were significantly associated with DRHAs. Conclusion. The prevalence of DRHAs was considerably high. Noncompliance, untreated indications, and adverse drug reactions were the commonest DRPs that caused DRHAs. Lower to medium Charlson comorbidity index scores, longer duration of therapy, and not having health insurance were significantly contributing factors of DRHAs. Therefore, all healthcare providers should prevent, identify, and resolve DRPs to decrease DRHAs in the hospital.

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“…Îäíàê ïðè öüîìó çðîñëà ³ ê³ëüê³ñòü ïàòîëîã³÷íèõ ñòàí³â, ïîâ'ÿçàíèõ ³ç âaeèâàííÿì ë³êàðñüêèõ çàñîá³â (ËÇ). Ïðîáëåìè, ïîâ'ÿ-çàí³ ³ç ËÇ (ÏÏËÇ, àáî DRPs -Drug Related Problems), â íàø ÷àñ äîñèòü ïîøèðåí³ ³ ñïðè÷èíÿþòü çíà÷íó çàõâîðþâàí³ñòü ïàö³ºíò³â, â äåÿêèõ âèïàäêàõ ïðèçâîäÿ÷è äî ëåòàëüíèõ íàñë³äê³â, à òàêîae çá³ëüøóþòü âèòðàòè íà îõîðîíó çäîðîâ'ÿ [29].Çàïðîïîíîâàíî áàãàòî ð³çíèõ ñèñòåì îö³íêè ÏÏËÇ [6,9,15,28]. Íàïðèêëàä, âèä³ëÿþòü 6 îñíîâíèõ êàòåãîð³é òà 12 ï³äêàòåãîð³é ÏÏËÇ: âèá³ð ËÇ, âèá³ð äîçè, íåñïðèÿòëèâ³ ïîá³÷í³ ðåàêö³¿ (ÍÏÐ), âçàºìîä³ÿ ËÇ, íåïðàâèëüíå âèêîðèñòàííÿ, ïîë³ôàð-ìàö³ÿ òîùî [29].…”

mentioning

confidence: 99%

“…Çàïðîïîíîâàíî áàãàòî ð³çíèõ ñèñòåì îö³íêè ÏÏËÇ [6,9,15,28]. Íàïðèêëàä, âèä³ëÿþòü 6 îñíîâíèõ êàòåãîð³é òà 12 ï³äêàòåãîð³é ÏÏËÇ: âèá³ð ËÇ, âèá³ð äîçè, íåñïðèÿòëèâ³ ïîá³÷í³ ðåàêö³¿ (ÍÏÐ), âçàºìîä³ÿ ËÇ, íåïðàâèëüíå âèêîðèñòàííÿ, ïîë³ôàð-ìàö³ÿ òîùî [29].…”

mentioning

confidence: 99%

RISK MANAGEMENT OF USE DRUGS WITH NARROW THERAPEUTIC INDEX IN CLINICAL PRACTICE. Review

Кhaitovych

2019

Med. Sci. of Ukr.

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Relevance. Today, the pharmacotherapy of many diseases is significantly expanded. However, the amount of pathological conditions associated with the use of drugs has increased. Drug related problems in some cases can be fatal and increase health care costs. It is necessary to be able to anticipate in advance the possibility of developing such conditions, to prevent them. Therefore, the analysis of the causes and mechanisms of development of these conditions is relevant. Objective. To find out the most common causes of drug related problems and consider the mechanisms of such states. Methods. Analysis of scientific publications in PubMed by keywords for the period 2001-2018. Results. The therapeutic index is the ratio of the dose that causes toxic effects in 50% of patients to the dose that causes the expected therapeutic effect in 50% of patients. The therapeutic index ≤ 3 is an indicator that defines drugs with narrow (small) therapeutic index. These drugs include insulin, digoxin, warfarin, levothyroxine, aminoglycoside antibiotics, carbamazepine, lithium, phenytoin, etc. The risks associated with these drugs are: the use of generic drugs with insufficient bioequivalence, pharmacokinetic interaction and polymorphism of genes of drug metabolism. The main mechanisms of their pharmacokinetic interaction at the stages of absorption (alteration of digestive tract motility, influence on the activity of P-glycoprotein), distribution (competition for blood plasma proteins and tissue proteins), and biotransformation (inhibition or induction of metabolism). The role of polymorphism of genes encoding the activity of isoenzymes cytochrome P450 2C9 and 1A2 and glycoprotein P in the development of adverse drug reactions of drugs with a narrow therapeutic index is presented. Conclusion. Risk management of using drugs with a narrow therapeutic index should include therapeutic drug monitoring of especially generic drugs, assessment of the risks of pharmacokinetic interaction, widespread introduction pharmacogenetic tests for determine the polymorphism of the genes of metabolism enzymes and drug transporters in the clinical practice.

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Validating a drug-related problems classification system in outpatient setting in Iran

Cited by 3 publications

References 17 publications

The IMPACT OF CLINICAL PHARMACY SERVICES IN GENERAL SURGERY

The IMPACT OF CLINICAL PHARMACY SERVICES IN GENERAL SURGERY

Drug‐Related Hospital Admissions and Associated Factors among Adults Admitted to Felege Hiwot Comprehensive and Specialized Hospital, North West Ethiopia

RISK MANAGEMENT OF USE DRUGS WITH NARROW THERAPEUTIC INDEX IN CLINICAL PRACTICE. Review

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