1887
Volume 2024, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Background: Unidentified drug-related problems (DRPs) can cause negative health and economic consequences if not addressed appropriately. The literature revealed that interventions conducted by clinical pharmacists can positively impact patient safety and treatment outcomes. The role of clinical pharmacists has been continually growing while posing significant improvements in the provision of healthcare.

Objective: To describe clinical pharmacist interventions in hospitalized patients with cardiovascular disease (CVD) in Qatar.

Methods: This is a retrospective analysis of clinical pharmacist interventions documented in an electronic patient medical database. Data were retrieved from three date ranges and comprised demographic information, interventions, medical wards, drug therapy, and medical disorders. Clinical pharmacist interventions were categorized using a standardized intervention reporting sheet from the medical database in the hospital.

Results: A total of 845 interventions relating to 262 patients were included in this study. The study population consisted mainly of males ( = 158 [60%]) with an average age of 61 years (SD ± 13.05). The leading documented interventions were the addition of medication ( = 278 [32.9%]), medication discontinuation ( = 196 [23.2%]), and an increase in medication dosage ( = 155 [18.3%]). A similar trend was observed throughout all subcategories investigated in this study, that is, interventions according to age, ward, and gender. An exception to the common trend was demonstrated in the emergency department, where medication discontinuation was the most frequent intervention. The classes of medications with the highest frequency of reported interventions included cardiovascular medications, followed by endocrine and hormonal agents ( = 393 [46.51%] and = 159 [18.7%], respectively).

Conclusion: Interventions conducted by clinical pharmacists have proven to have a positive impact on patient safety in addressing and resolving DRPs. Healthcare systems may benefit from future efforts directed toward studies of a prospective nature while developing a unique indicator of the validity and precision of documented interventions.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2024.27
2024-08-27
2024-10-06
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2024/3/qmj.2024.27.html?itemId=/content/journals/10.5339/qmj.2024.27&mimeType=html&fmt=ahah

References

  1. European Commission. DG Health and Consumer Protection [Internet]. Patient safety-making it happen! Luxembourg Declaration on Patient Safety. 2021 [cited Sep 12 2021]. Available from: http://www.cpme.be
    [Google Scholar]
  2. Joint Commission. 2008 National Patient Safety Goals [Internet]. Hospital Program. 2021 [cited Sep 12 2021]. Available from: http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals/
    [Google Scholar]
  3. Morimoto T, Gandhi T, Seger A, Hsieh T, Bates D. Adverse drug events and medication errors: Detection and classification methods. Qual Saf Health Care. 2004; 13:(4):306–14doi: 10.1136/qhc.13.4.306
    [Google Scholar]
  4. Kohn LT, Corrigan J, Donaldson Molla S (editors). Institute of Medicine Committee on Quality of Health Care in America. To err is human: Building a safer health system. Washington, DC:National Academy Press; 2000.
    [Google Scholar]
  5. Pharmaceutical Care Network Europe. Pharmaceutical Care Network Europe (PCNE) DRP Classification V9.00. Available from: https://www.pcne.org/upload/files/410_PCNE_classification_V9-0m.pdf
    [Google Scholar]
  6. Cipolle RJ, Strand LM, Morley PC. Chapter 5, Drug therapy problems | Pharmaceutical care practice: The patient-centered approach to medication management services, 3rd ed. AccessPharmacy | McGraw Hill Medical [Internet]. 2021 [cited Nov 4 2021]. Available from: http://accesspharmacy.mhmedical.com/content.aspx?bookid=491&sectionid=39674905
    [Google Scholar]
  7. Alomi YA, Al-Shaibani AS, Alfaisal G, Alasmi NM. Clinical outcomes of drug-related problems in Saudi Arabia: Patients’ and healthcare providers’ perspective. J Pharm Pract Commun Med. 2018; 4:(2):77–82doi: 10.5530/jppcm.2018.2.19
    [Google Scholar]
  8. National Coordinating Council for Medication Error Reporting and Prevention [Internet]. About medication errors. 2021 [cited Oct 26 2021]. Available from: https://www.nccmerp.org/
    [Google Scholar]
  9. Patel P, Zed PJ. Drug related visits to the emergency department: How big is the problem? Pharmacotherapy. 2002; 22:(7):915–23doi: 10.1592/phco.22.11.915.33630
    [Google Scholar]
  10. Jatau AI, Aung MM, Kamauzaman TH. Prevalence of drug-related emergency department visits at a teaching hospital in Malaysia. Drugs Real World Outcomes. 2015; 2:(4):387–95doi: 10.1007/s40801-015-0045-2
    [Google Scholar]
  11. Patel N, Desai M, Shah S, Patel P, Gandhi A. A study of medication errors in a tertiary care hospital. Perspect Clin Res. 2016; 7:(4):168–73doi: 10.4103/2229-3485.192039
    [Google Scholar]
  12. Walsh EK, Hansen CR, Sahm LJ, Kearney PM, Doherty E, Bradley CP. Economic impact of medication error: A systematic review. Pharmacoepidemiol Drug Saf. 2017; 26:(5):481–97doi: 10.1002/pds.4188
    [Google Scholar]
  13. Ben-Yehuda A, Bitton Y, Sharon P, Rotfeld E, Armon T, Muszkat M. Risk factors for prescribing and transcribing medication errors among elderly patients during acute hospitalization. Drugs Aging. 2011; 28:(6):491–500doi: 10.2165/11590610-000000000-00000
    [Google Scholar]
  14. Mekonnen A, McLachlan A, Brien J. Effectiveness of pharmacist-led medication reconciliation programmes on clinical outcomes at hospital transitions: A systematic review and meta-analysis. BMJ Open. 2016; 6:(2):e010003doi: 10.1136/bmjopen-2015-010003
    [Google Scholar]
  15. George D, Supramaniam N, Abd Hamid S, Hassali M, Lim W, HSS A. Effectiveness of a pharmacist-led quality improvement program to reduce medication errors during hospital discharge. Pharm Pract. 2019; 17:(3):1501doi: 10.18549/PharmPract.2019.3.1501
    [Google Scholar]
  16. Richardson TE, O’Reilly CL, Chen TF. Drug-related problems and the clinical role of pharmacists in inpatient mental health: An insight into practice in Australia. Int J Clin Pharm. 2014; 36:(5):1077–86doi: 10.1007/s11096-014-9997-7
    [Google Scholar]
  17. Aljadhey H, Mahmoud MA, Mayet A, Alshaikh M, Ahmed Y, Murray M, et al.. Incidence of adverse drug events in an academic hospital: A prospective cohort study. Int J Qual Health Care. 2013; 25:(6):648–55doi: 10.1093/intqhc/mzt075
    [Google Scholar]
  18. Dahal PR, Venkataraman R, Fuloria PC. Assessment of clinical pharmacist intervention in tertiary care teaching hospital of Southern India. Asian J Pharm Clin Res. 2013; 6:(2):258–61.
    [Google Scholar]
  19. Al Rahbi HA, Al-Sabri RM, Chitme HR. Interventions by pharmacists in out-patient pharmaceutical care. Saudi Pharm J. 2014; 22:(2):101–6doi: 10.1016/j.jsps.2013.04.001
    [Google Scholar]
  20. Dean B, Schachter M, Vincent C, Barber N. Prescribing errors in hospital inpatients: Their incidence and clinical significance. Qual Saf Health Care. 2002; 11:(4):340–4doi: 10.1136/qhc.11.4.340
    [Google Scholar]
  21. Hammad E, Qudah R, Akour A. The impact of clinical pharmacists in improving Jordanian patients’ health outcomes. Saudi Med J. 2017; 38:(11):1077–89doi: 10.15537/smj.2017.11.21453
    [Google Scholar]
  22. Al-Hashar A, Al-Zakwani I, Eriksson T, Sarakbi A, Al-Zadjali B, Al Mubaihsi S, et al.. Impact of medication reconciliation and review and counselling, on adverse drug events and healthcare resource use. Int J Clin Pharm. 2018; 40:(5):1154–64doi: 10.1007/s11096-018-0650-8
    [Google Scholar]
  23. Salman B, Al-Hashar A, Al-Khirbash A, Al-Zakwani I. Clinical and cost implications of clinical pharmacist interventions on antimicrobial use at Sultan Qaboos University Hospital in Oman. Int J Infect Dis. 2021; 109:137–41doi: 10.1016/j.ijid.2021.07.002
    [Google Scholar]
  24. Babelghaith S, Wajid S, Alrabiah Z, Othiq M, Alghadeer S, Alhossan A, et al.. Drug-related problems and pharmacist intervention at a general hospital in the Jazan Region, Saudi Arabia. Risk Manag Healthc Policy. 2020; 13:373–8. doi: 10.2147/RMHP.S247686
    [Google Scholar]
  25. Rayes I, Saleh Abrika O. In-patient and out-patient pharmacist intervention in the management of diabetes mellitus conditions in Dubai, United Arab Emirates: A qualitative approach. Res Pharm Health Sci. 2017; 3:(2):303–7.
    [Google Scholar]
  26. Elewa H, Jalali F, Khudair N, Hassaballah N, Abdelsamad O, Mohammed S. Evaluation of pharmacist-based compared to doctor-based anticoagulation management in Qatar. J Eval Clin Pract. 2016; 22:(3):433–8doi: 10.1111/jep.12504
    [Google Scholar]
  27. Abdulrhim S, Saleh R, Mohamed Hussain M, Al Raey H, Babiker A, Kheir N, et al.. Impact of a collaborative pharmaceutical care service among patients with diabetes in an ambulatory care setting in Qatar: A multiple time series study. Value Health Reg Issues. 2019; 19:45–50. doi: 10.1016/j.vhri.2018.12.002
    [Google Scholar]
  28. Alzahrani A, Alwhaibi M, Asiri Y, Kamal K, Alhawassi T. Description of pharmacists’ reported interventions to prevent prescribing errors among in hospital inpatients: A cross sectional retrospective study. BMC Health Serv Res. 2021; 21:(1):432doi: 10.1186/s12913-021-06418-z
    [Google Scholar]
  29. Tan E, Stewart K, Elliott R, George J. Pharmacist services provided in general practice clinics: A systematic review and meta-analysis. Res Soc Admin Pharm. 2014; 10:(4):608–22doi: 10.1016/j.sapharm.2013.08.006
    [Google Scholar]
  30. Hawksworth G, Corlett A, Wright D, Chrystyn H. Clinical pharmacy interventions by community pharmacists during the dispensing process. Br J Clin Pharmacol. 1999; 47:(6):695–700doi: 10.1046/j.1365-2125.1999.00964.x
    [Google Scholar]
  31. Desai M, Patel N, Shah S, Patel P, Gandhi A. A study of medication errors in a tertiary care hospital. Perspect Clin Res. 2016; 7:(4):168–73doi: 10.4103/2229-3485.192039
    [Google Scholar]
  32. Lester R, Haigh K, Wood A, MacPherson E, Maheswaran H, Bogue P, et al.. Sustained reduction in third-generation cephalosporin usage in adult inpatients following introduction of an antimicrobial stewardship program in a large, urban hospital in Malawi. Clin Infect Dis. 2020; 71:(9):e478–86doi: 10.1093/cid/ciaa162
    [Google Scholar]
  33. Arnett D, Blumenthal R, Albert M, Buroker A, Goldberger Z, Hahn E, et al.. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation. 2019; 140:(11):e596–646doi: 10.1161/CIR.0000000000000678
    [Google Scholar]
  34. Kheir N, Hooper R, Adam A. Pharmacist-documented interventions during the dispensing process in a primary health care facility in Qatar. Drug Healthc Pat Saf. 2009; 1:73–80. doi: 10.2147/dhps.s5534
    [Google Scholar]
  35. Dooley M, Allen K, Doecke C, Galbraith K, Taylor G, Bright J, et al.. A prospective multicentre study of pharmacist initiated changes to drug therapy and patient management in acute care government funded hospitals. Br J Clin Pharmacol. 2004; 57:(4):513–21doi: 10.1046/j.1365-2125.2003.02029.x
    [Google Scholar]
  36. Naseralallah L, Al-Badriyeh D, Atchan M, Abdul Rouf PV, Hail MA, El-Kassem W, et al.. Characteristics of the clinical pharmacists’ interventions at the main general tertiary care hospital in Qatar. Qatar Med J, 2023; 4:28. doi: 10.5339/qmj.2023.28
    [Google Scholar]
  37. Countrymeters. Qatar population (2021) live—Countrymeters [Internet]. Countrymeters.info. 2021 [cited Nov 2 2021]. Available from: https://countrymeters.info/en/Qatar
    [Google Scholar]
  38. Al-Badriyeh D, Kaddoura R, AlMaraghi F, Homosy A, Hail MA, El-Kassem W, et al.. Impact of clinical pharmacist interventions on economic outcomes in a cardiology setting in Qatar. Curr Prob Cardiol. 2023; 48:(9):101838doi: 10.1016/j.cpcardiol.2023.101838
    [Google Scholar]
/content/journals/10.5339/qmj.2024.27
Loading
/content/journals/10.5339/qmj.2024.27
Loading

Data & Media loading...

  • Article Type: Research Article
Keyword(s): drug-related problemsinterventionmedicationpatient safety and pharmacy
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error