Identification Of Drug Therapy Problems And Intervention By Pharmacist In Selected Tertiary Health Facilities In South West Nigeria
Keywords:
Drug-therapy-problems, PCNE –V5.01, Tertiary hospitals, Pharmacists’ interventionAbstract
Background: With administration of drugs, the potential for outcomes that may diminish the patient’s quality of life is always present. Regular medication reviews by pharmacists will assist in the prevention of Drug Therapy Problems (DTPs). This study was carried out to document and evaluate the occurrence of DTPs in selected tertiary health facilities in two Southwestern States and evaluate types of pharmacists´ interventions.
Method: This descriptive, prospective study was carried out simultaneously at four tertiary health institutions, with two each in Lagos and Ogun States. Pharmacists were pre-trained to document all identified DTPs and mode of interventions for a six month period (June - Sept 2013) for both out – patient and in – patients using the form, PCNE version 5.01. Data was analyzed using SPSS version 15 and presented as frequencies and percentages.
Result: Among the 456 prescriptions studied, 193 DTPs were identified and the most frequently identified was drug dosing problem (46.64%) with drug dose too low 20.19% and drug dose too high 28.54%. The second most reported was drug choice problems (23.84%) with inappropriate drug form 5.41% and duplication of drug 8.86%. Acceptance rate of pharmacists’ interventions by prescribers was 91%. Pharmacists also intervened through interaction with patients and caregivers 26.01%.
Conclusion: Pharmacists identified DTPs in the tertiary hospitals and occurrence was of high magnitude. Pharmacists’ involvement in the monitoring of drug therapy and consequent interventions are highly acceptable to the doctors.
References
Oparah AC (2010). Essentials of Pharmaceutical Care, pp 83-92. Lagos: All Deals Inv. Co. Ltd.
Foppe VM,(2005). Effectiveness of interventions by community pharmacists to improve patient adherence to chronic medication: a systematic review. Annals of Pharmacotherapy 39(2): p. 319-28. 127
Leemans L, Veroeveren L, Bulens J, Hendrickx C, Keyenberg W and Niesten F (2003). Frequency and trends of interventions of prescriptions in Flemish community pharmacies. Pharmacy World and Science; 25 (2): 65 – 69.
Lampert ML, Kraehenbuehl S, Hug BL.( 2008). Drug-related problems: evaluation of a classification system in the daily practice of a Swiss University Hospital. Pharmacy World and Science; 30(6): p. 768-76. 86.
Ojeh VB, Naima N, Abah IO, Falang KD, Lucy O, London I, Dady C, Agaba P, and Agbaji O (2015) Pattern of drug therapy problems and interventions in ambulatory patients receiving antiretroviral therapy in Nigeria Pharm Pract (Granada) 13(2): 566.
Eze Uchenna IH Eze and Adebiyi O Olowu Prescribing Patterns and Inappropriate Use of Medications in Elderly Outpatients in a Tertiary Hospital in Nigeria Tropical Journal of Pharmaceutical Research February 2011; 10 (1): 19-25
Ogbonna BO, Ezenduka CC, Opara CA, Ahara LG. (2014) Drug Therapy Problems in Patients with Type-2 Diabetes in a Tertiary Hospital in Nigeria International journal of Innovative research and Development ISSN 2278 – 0211 (Online)
Onifade M, Oreagba I, Usman S, Onwuchuluba E. (2013) Drug Therapy Problems and Pharmacist Intervention in Lagos State General Hospitals. West Afr J Pharm 24(2):83-93
Kaboli PJ, Hoth AB, McClimon BJ and Schnipper JL (2006). Clinical pharmacists and inpatient medical care: a systematic review. Archives of Internal Medicine; 166 (9): 955 - 964.
Berthouzoz S, Berger L, Bonnabry P and Pannatier A (2012). The hospital pharmacist: An important contributor to improved patient safety in the hospital. Chimia (Aarau); 66: 300- 303.
Bakare M, Oreagba AI and Adeniran B (2011). Drug therapy problems: pharmacists´ interventions and outcomes in Lagos state general hospitals, South West, Nigeria. West African Postgraduate College of Pharmacists (Nigerian Chapter) Newsletter; 1 (4): 10. 29.
Nickerson A, MacKinnon NJ, Roberts N and Saulnier L (2005).Drug-Therapy Problems, Inconsistencies and Omissions Identified During a Medication Reconciliation and Seamless Care Service. Healthcare Quarterly 8: 65 - 72.
Odili VU, Egiebor BO, Oparah AC.Identification of drug therapy problems in patients with diabetes treated in a secondary care facility in Benin City. Nat J Trop Research, 2011; 9(1) 72-81. 30
Paulino EI, Bouvy ML, Gastelurrutia MA, Guerreiro M and Buurma H.( 2004). Drug related problems identified by European community pharmacists in patients discharged from hospital. PharmacyWorld and Science ;26:(3)53-60.
Eichenberger PM, Lampert ML, Kahmann IV, van Mil JWF and Hersberger KE (2010). Classification of drug-related problems with new prescriptions using a modified PCNE classification system. Pharmacy World and Science; 32: 362–372.
Rao D, Gilbert A , Strand L, Cipolle R, (2007) Drug therapy problems found in ambulatory patient populations in Minnesota and South Australia Pharm World Sci; 29:647 – 654
Kheir N, Manal Z, Husam Y, Maguy EH, Kerry W, Peter J. (2008) Pharmacy education and practice in 13 Middle Eastern countries. Am J Pharm Educ. 72(6):133. http://ukpmc.ac.uk
Haugbolle LS, Sorensen EW. (2006) Drug-related problems in patients with angina pectoris, type 2 diabetes and asthma–interviewing patients at home. Pharm World Sci 28(4):239–247.
Patrick E, Manuel H, Markens L, Kurt E. and Heberger (2010) Provision of Pharmaceutical Care by Community Pharmacists. Pharmacy World and Science 20:(4)53-60.
Blix HS, Viktil KK, Reikvam A, Moger TA, Hjemaas BJ and Pretsch P Vraalsen TF, Walseth EK. (2004). The majority of hospitalised patients have drug-related problems: results from a prospective study in general Hospitals Eur J Clin Pharmacol. 60 (9):651-8.
Hammerlein, A, Griese N, and Schulz M (2007). Survey of drug-related problems identified by community pharmacies. Annals of Pharmacotherapy; 41(11): p. 1825-32.
Bondesson A (2008). Aspects on optimization of drug therapy in the elderly. PhD thesis, clinical chemistry and pharmacology department, Lund university, Lund, Sweden.
Pichala PT, Kumar BM, Zachariah S, Thomas D, Saunchez L and Gerardo A (2013). An interventional study on intensive care unit drug therapy assessment in a rural district hospital in India.Journal of Basic and Clinical Pharmacy; 4 (3): 64 – 67.
Williams M, Peterson GM, Tenni PC, Bindoff IK, Curtain C, Hughes J, Bereznicki LR, Jackson SL, Kong DC and Hughes JD (2011). Drug-related problems detected in Australian Community Pharmacies: The Promise Trial.Annals of Pharmacotherapy 45 (9): 1067-1076.
Viktil KK, Blix HS, Moger TA and Reikvam A (2006). Interview of patients by pharmacists contributes significantly to the identification of drug-related problems (DRPs). Pharmacoepidemiology of Drug Safety 15(9): p. 667-74.
Lisby M, Thomsen A, Nielsen LP, Lyhne NM, Breum-Leer C and Fredberg U (2010). The effect of systematic medication review in elderly patients admitted to an acute ward of internal medicine. Basic Clinical Pharmacology and Toxicology 106 (5): 422 – 427
Stemmer Stemer G and Lemmens-Gruber R (2011). The clinical pharmacist's contributions within the multidisciplinary patient care team of an intern nephrology ward. International Journal of Clinical Pharmacy 344 (5): 678 – 683
