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A Prospective Study on Assessment of the Drug Interventions during Ward Rounds in the Department of General Medicine at a Tertiary Care Hospital.
Corresponding Author(s) : Veena Gadicherla
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 12 No. 3 (2024): 2024 Volume -12 - Issue 3
Abstract
The aim of the present study was a prospective study on assessment of the drug interventions during ward rounds in the department of general medicine at a tertiary care hospital. Out of 18 drug need not prescribed were 3(16.66%), inappropriate dosage form were 6(33.33%), wrong dose taken were 1(5.55%), dose too low were 3(16.66%), dose too high were (5.55%) and duration of treatment inappropriate were 4(22.22%). Highest number of interventions identified were minor 48.71%. Having highlighted the importance of clinical pharmacist in this study, a multidisciplinary team approach is required to effectively minimize the potential of drug related problems. Furthermore, the high degree of acceptance by prescribers encourages clinical pharmacists to continue their service and to extend it to other wards and departments. The present results point to the establishment of drug related problem reporting system at each hospital and to share data with other hospitals healthcare settings. Participation and interventions of clinical pharmacists in health care positively influence clinical practice. Many studies have monitored interventions in clinical areas to provide quantitative and qualitative data on pharmaceutical input.
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- Garin, N. et al. Global multimorbidity patterns: a cross-sectional, population-based, multi-country study. J. Gerontol. A Biol. Sci. Med. Sci. 2016; 71, 205–14.
- Parekh, A. K. & Barton, M. B. Te challenge of multiple comorbidities for the US health care system. JAMA. 2010; 303, 1303–04.
- Cassell, A. et al. Te epidemiology of multimorbidity in primary care: A retrospective cohort study. Br. J. Gen. Pract.2018; 68, e245–e251.
- Kalyesubula, R. et al. Trends of admissions and case fatality rates among medical in-patients at a tertiary hospital in Uganda; a four-year retrospective study. PLoS ONE. 2019; 14, e0216060.
- Contel, J. C., Muntané, B. & Camp, L. L. atención al pacientecrónicoensituación de complejidad: elreto de construir un escenario de atenciónintegrada. Atención Primaria.2012; 44,107–113.
- Maher, R. L., Hanlon, J., Hajjar, E. R. & Hajjar, E. R. Clinical consequences of polypharmacy in elderly. Expert Opin. Drug Saf. 2014; 13, 57–65.
- Barrett, K., Lucas, E. & Alexander, G. C. How polypharmacy has become a medical burden worldwide. Clin. Pharm. 2016. https://doi. org/10.1211/CP.2016.20201251
- Olmos, R., Garcia, O., Velasco, J. & de la Rubia, A. Prevalence of polypharmacy in older hospitalised patients. Eur. J. Hosp. Pharm. 2012; 19(242), 3–243.
- Lazarou, J., Pomeranz, B. H. & Corey, P. N. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998; 279, 1200–05.
- Pharmaceutical Care Network Europe Foundation. Classifcation for Drug related problems: Te PCNE Classifcation V 6.2. PCNE. 2010. https://www.pcne.org/upload/fles/11_PCNE_classifcation_V6-2.pdf
- Gleason, K. M. et al. Results of the medications at transitions and clinical handofs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission. J. Gen. Intern. Med. 2010; 25, 441–447.
- Ferrández, O. et al. Validation of a score to identify inpatients at risk of a drug-related problem during a 4-year period. Saudi Pharm J. 2018; 26, 703–708.
- Blix, H. S. et al. Te majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals. Eur. J. Clin. Pharmacol. 2004; 60, 651–658.
- Leendertse, A. J., Egberts, A. C. & Stoker, J. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch. Intern. Med. 2008; 168, 1890–96.
- Blix, H. S., Viktil, K. K., Moger, T. A. &Reikvam, Å. Characteristics of drug-related problems discussed by hospital pharmacists in multidisciplinary teams. Pharm. World Sci. 2006; 28, 152–158.
- Pippins, J. R. et al. Classifying and PredictingErrors of Inpatient Medication Reconciliation. J. Gen. Intern. Med. 2008; 23, 1414–1422.
- Taxis, K., Dean, B. & Barber, N. Hospital drug distribution systems in the UK and Germany—a study of medication errors. Pharm. World Sci. 1999; 21, 25–31.
- Ali, M. A. S., Khedr, E. M. H., Ahmed, F. A. H. & Mohamed, N. N. E. Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases. Int. J. Clin. Pharm. 2018; 40, 1257–64.
- Hailu, B. Y., Berhe, D. F., Gudina, E. K., Gidey, K. & Getachew, M. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. BMC Geriatr. 2020; 20, 13. https://doi.org/10.1186/s12877-020-1413-7
References
Garin, N. et al. Global multimorbidity patterns: a cross-sectional, population-based, multi-country study. J. Gerontol. A Biol. Sci. Med. Sci. 2016; 71, 205–14.
Parekh, A. K. & Barton, M. B. Te challenge of multiple comorbidities for the US health care system. JAMA. 2010; 303, 1303–04.
Cassell, A. et al. Te epidemiology of multimorbidity in primary care: A retrospective cohort study. Br. J. Gen. Pract.2018; 68, e245–e251.
Kalyesubula, R. et al. Trends of admissions and case fatality rates among medical in-patients at a tertiary hospital in Uganda; a four-year retrospective study. PLoS ONE. 2019; 14, e0216060.
Contel, J. C., Muntané, B. & Camp, L. L. atención al pacientecrónicoensituación de complejidad: elreto de construir un escenario de atenciónintegrada. Atención Primaria.2012; 44,107–113.
Maher, R. L., Hanlon, J., Hajjar, E. R. & Hajjar, E. R. Clinical consequences of polypharmacy in elderly. Expert Opin. Drug Saf. 2014; 13, 57–65.
Barrett, K., Lucas, E. & Alexander, G. C. How polypharmacy has become a medical burden worldwide. Clin. Pharm. 2016. https://doi. org/10.1211/CP.2016.20201251
Olmos, R., Garcia, O., Velasco, J. & de la Rubia, A. Prevalence of polypharmacy in older hospitalised patients. Eur. J. Hosp. Pharm. 2012; 19(242), 3–243.
Lazarou, J., Pomeranz, B. H. & Corey, P. N. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998; 279, 1200–05.
Pharmaceutical Care Network Europe Foundation. Classifcation for Drug related problems: Te PCNE Classifcation V 6.2. PCNE. 2010. https://www.pcne.org/upload/fles/11_PCNE_classifcation_V6-2.pdf
Gleason, K. M. et al. Results of the medications at transitions and clinical handofs (MATCH) study: an analysis of medication reconciliation errors and risk factors at hospital admission. J. Gen. Intern. Med. 2010; 25, 441–447.
Ferrández, O. et al. Validation of a score to identify inpatients at risk of a drug-related problem during a 4-year period. Saudi Pharm J. 2018; 26, 703–708.
Blix, H. S. et al. Te majority of hospitalised patients have drug-related problems: results from a prospective study in general hospitals. Eur. J. Clin. Pharmacol. 2004; 60, 651–658.
Leendertse, A. J., Egberts, A. C. & Stoker, J. Frequency of and risk factors for preventable medication-related hospital admissions in the Netherlands. Arch. Intern. Med. 2008; 168, 1890–96.
Blix, H. S., Viktil, K. K., Moger, T. A. &Reikvam, Å. Characteristics of drug-related problems discussed by hospital pharmacists in multidisciplinary teams. Pharm. World Sci. 2006; 28, 152–158.
Pippins, J. R. et al. Classifying and PredictingErrors of Inpatient Medication Reconciliation. J. Gen. Intern. Med. 2008; 23, 1414–1422.
Taxis, K., Dean, B. & Barber, N. Hospital drug distribution systems in the UK and Germany—a study of medication errors. Pharm. World Sci. 1999; 21, 25–31.
Ali, M. A. S., Khedr, E. M. H., Ahmed, F. A. H. & Mohamed, N. N. E. Clinical pharmacist interventions in managing drug-related problems in hospitalized patients with neurological diseases. Int. J. Clin. Pharm. 2018; 40, 1257–64.
Hailu, B. Y., Berhe, D. F., Gudina, E. K., Gidey, K. & Getachew, M. Drug related problems in admitted geriatric patients: the impact of clinical pharmacist interventions. BMC Geriatr. 2020; 20, 13. https://doi.org/10.1186/s12877-020-1413-7