Identification of Drug Related Problems by Clinical Pharmacist in Prescriptions with Polypharmacy: A Prospective Interventional Study

    Published on:October 2018
    Journal of Young Pharmacists, 2018; 10(4):460-465
    Original Article | doi:10.5530/jyp.2018.10.100
    Authors:

    Mohan Greeshma1, Selvan Lincy1, Eswaran Maheswari2*, Shankar Tharanath3, Subeesh Viswam2

    1Department of Pharmacy Practice, M.S. Ramaiah College of Pharmacy, Bangalore, Karnataka, INDIA.

    2Department of Pharmacy Practice, Faculty of Pharmacy, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka, INDIA.

    3Department of General Medicine, M.S. Ramaiah Hospital, Bangalore, Karnataka, INDIA.

    Abstract:

    Objectives: Drug Related Problems (DRPs) and prescriptions with polypharmacy may lead to increased health care cost, morbidity, mortality and decreased quality of life. The objective of the study was to assess the pattern of DRPs associated with polypharmacy. Methods: It is a hospital based prospective interventional study carried out for 6 months in the Department of General Medicine. The DRPs were identified by researchers during ward rounds by reviewing the patient case reports. Problems identified and recognized was documented and discussed with the concerned health care team. Results: During the study period, 150 patient case sheets were reviewed to identify 213 DRPs. The most common DRP was found to be Adverse Drug Reactions (ADRs) (45%) followed by needs additional drug therapy (26.8%), untreated indication (13.6%) and Drug-Drug Interactions (DDIs) (11.7%). Binary logistic regression was performed to identify the predictors of DRPs. It was observed that number of comorbidities (Adjusted odds ratio (AOR) = 3.68 (p < 0.001)), geriatric population and polypharmacy were the major predictor. Conclusion: The study highlights the importance of drug therapy review to minimize DRPs, ADRs, polypharmacy, framing of new deprescribing guidelines and algorithms for drugs which are utilized inappropriately, deprescribing of redundant drugs during routine clinical practice and appointment of clinical pharmacist in hospitals to achieve better therapeutic outcomes and improved patient care.

    Key words: Adverse drug reactions, Clinical Pharmacist, Deprescribing, Drug related problems, Polypharmacy, Predictors.

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