scholarly journals Identifikasi Drug Related Problems (DRPs) Pada Pasien Pediatri Pneumonia Komunitas di Instalasi Rawat Inap RSD Madani Provinsi Sulawesi Tengah

Author(s):  
Putu Maharani Ajeng Astiti ◽  
Alwiyah Mukaddas ◽  
Safarudin Atho Illah

Drug Related Problems (DRPs) are events or circumstances involving drug therapy that actually or potentially interfere with desired health outcomes. DRPs may occur in the treatment of various diseases such as community acquired pneumonia (CAP). This study aims to determine the percentage of DRPs in pediatric inpatients with CAP. This is a descriptive and observational study design with prospective data conducted in November 2015 until February 2016 at Madani Hospital, Central Sulawesi. The results obtained from 28 patients showed that incidences of DRPs categories of inappropriate drug is 1 event (1,7%), inappropriate drug combination 35 events (58,3%), drugs dose too low 18 events (30%), drugs dose too high  6 events (10%), and no indication for drug 0 event (0%).

Author(s):  
Mengist Awoke ◽  
Tsegaye Melaku ◽  
Mohammed Beshir

Abstract Background Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited. Objective This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia. Methods A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant. Results Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs. Conclusion The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.


Author(s):  
Tadesse Sheleme ◽  
Tamiru Sahilu ◽  
Desalegn Feyissa

Abstract Background People living with diabetes are more vulnerable to drug-related problems due to the presence of multiple diseases. This study aimed to identify drug-related problems and contributing factors among diabetic patients. Methods This study used a prospective observational study design. The study was conducted among diabetic patients during follow-up at Mettu Karl Referral Hospital from 15 April to 09 August 2019. The consecutive sampling was utilized to collect data. The identification of drug-related problems was performed using the Pharmaceutical Care Network Europe version 8.03. Following data collection, data were entered into Epidata manager version 4.4.2 and exported to the SPSS version 24.0 for analysis. Multivariable logistic regression analysis was done to identify predictors of drug-related problems. Results A total of 330 people with diabetes were included in the study, among whom 279 (84.5%) had at least one drug-related problem. A total of 455 drug-related problems were identified. Effects of drug treatment not being optimal (52.7%) and untreated symptoms or indications (30.1%) were the most commonly identified drug-related problems. About 865 interventions were provided for identified drug-related problems and 79.8% was accepted. Diabetes duration $$\ge 7$$ ≥ 7  years [AOR = 2.02; 95% CI (1.06, 3.85); p = 0.033] and the presence of comorbidity [AOR: 2.33; 95% CI (1.18, 4.60); p = 0.015] were factors identified as predictors of drug-related problems. Conclusion The present study identified that drug-related problems are common among diabetic patients. Effects of drug treatment not being optimal and untreated symptoms or indications were the most commonly identified drug-related problems. Longer diabetes duration and the presence of comorbidities were predictors of drug-related problems.


2021 ◽  
Vol 9 ◽  
pp. 205031212198962
Author(s):  
Firomsa Bekele ◽  
Ginenus Fekadu ◽  
Kumera Bekele ◽  
Dinka Dugassa ◽  
Jiregna Sori

Introduction: Drug-related problems can affect the treatment outcomes of hospitalized patients and outpatients that lead to morbidity and mortality. Despite this, there were scanty of studies among patients with infectious diseases in Ethiopia. As the result, this study was tried to assess the magnitude and determinants of drug therapy problems among infectious disease patients admitted to the medical wards of Wollega University Referral Hospital. Methods: A prospective observational study was conducted from May to August 2019. The prevalence and types of drug- related therapy problems were studied using the Pharmaceutical Care Network Europe Foundation classification system, and adverse drug reaction was assessed by using the Naranjo algorithm. Multivariable logistic regression analysis was used to determine the predictors of drug-related problems, and a significant association was declared if p-value < 0.05. Result: Of the 172 study participants, 106 (61.6%) were males, and the patient’s mean age was 39.1 ± 14.31 years. Over the study period, 123 (71.51%) patients had drug-related problems. Need for additional drug therapy was the widely occurred drug-related problem that accounts for 107 (22.77%), and the most common drug-associated with the drug therapy problem was ceftriaxone (77 (44.77%)). This inappropriate use of ceftriaxone might be due to the preference of physicians to prescribe this broad spectrum antibiotic in which it was prescribed for the majority of the infectious disease etiology. Polypharmacy (adjusted odds ratio (AOR) = 2.505, 95% confidence interval (CI): 1.863–11.131), length of hospital stay ⩾ 7 days (AOR = 4.396, 95% CI: 1.964–7.310), and presence of co-morbidity (AOR = 2.107, 95% CI: 1.185–4.158, p = 0.016) were determinants of drug-related problems. Conclusion: The magnitude of drug-related problems was found to be high. Hence, the clinical pharmacy service should be established to tackle inappropriate indications, ineffective drug therapy, and adverse drug events in the study area.


2021 ◽  
Vol 3 (1) ◽  
pp. 25
Author(s):  
Pratiwi Diva Yanti Luh ◽  
I M.A.G. Wirasuta ◽  
Luh Rai Maduretno Asvinigita

Background: Monitoring drug therapy based on Permenkes RI No. 73 of 2016 is one of the pharmaceutical care standards in pharmacy practice. Monitoring drug therapy is a process that includes activities to ensure safe, effective and rational drug therapy for patients. Patients who receive drug therapy are at risk of experiencing drug-related problems. Objective: This study aims to determine the implementation of monitoring drug therapy in one pharmacy in Badung Regency. Methods: The type of research is a descriptive observational study conducted by interview session one pharmacist in X Pharmacy, then analyzed descriptively according to Permenkes RI No 73 of 2016. Results: The results showed that in January-June 2020 there were 34 patients with disease categories requiring monitoring drug therapy: 27 patients with asthma (79%), six patients with diabetes (18%), and one patient with tuberculosis (3%). Patients with the largest visits were geriatric, which were 19 out of 34 patients. Conclusion: The monitoring of drug therapy at Pharmacy X has fulfilled all the parameters in the Standard Operating Procedure (SOP) for the implementation of in Pharmacy based on Permenkes RI No.73 of 2016.Keywords: Monitoring drug therapy, Implementation, Pharmacy, Pharmacist


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Gina Agarwal ◽  
Melissa Pirrie ◽  
Dan Edwards ◽  
Bethany Delleman ◽  
Sharon Crowe ◽  
...  

Abstract Background Individuals living in poverty often visit their primary care physician for health problems resulting from unmet legal needs. Providing legal services for those in need may therefore improve health outcomes. Poverty is a social determinant of health. Impoverished areas tend to have poor health outcomes, with higher rates of mental illness, chronic disease, and comorbidity. This study reports on a medical-legal collaboration delivered in a healthcare setting between health professionals and lawyers as a novel way to approach the inaccessibility of legal services for those in need. Methods In this observational study, patients aged 18 or older were either approached or referred to complete a screening tool to identify areas of concern. Patients deemed to have a legal problem were offered an appointment at the Legal Health Clinic, where lawyers provided legal advice, referrals, and services for patients of the physicians. Fisher’s exact test was used to compare populations. Binary logistic regression was used to determine the factors predicting booking an appointment with the clinic. Results Eighty-four percent (n = 648) of the 770 patients screened had unmet legal needs and could benefit from the intervention, with an average of 3.44 (SD = 3.42) legal needs per patient screened. Patients with legal needs had significantly higher odds of attending the Legal Health Clinic if they were an ethnicity that was not white (OR = 2.48; 95% CI 1.14–5.39), did not have Canadian citizenship (OR = 4.40; 95% CI 1.48–13.07), had housing insecurity (OR = 3.33; 95% CI 1.53–7.24), and had difficulty performing their usual activities (OR = 2.83; 95% CI 1.08–7.43). As a result of the clinic consultations, 58.0% (n = 40) were referred to either Legal Aid Ontario or Hamilton Community Legal Clinic, 21.74% (n = 15) were referred to a private lawyer; one case was taken on by the clinic lawyer. Conclusion The Legal Health Clinic was found to fulfill unmet legal needs which were abundant in this urban family practice. This has important implications for the future health of patients and clinical practice. Utilizing a Legal Health Clinic could translate into improved health outcomes for patients by helping overcome barriers in accessing legal services and addressing social causes of adverse health outcomes.


Author(s):  
NASIBEH GHANBARLOU ◽  
MEKKANTI MANASA REKHA ◽  
MAHSA NAZI

Objective: The present study aims at implementing the doctor of pharmacy services in the identification and reporting of drug-related problems in the in-patient units of cardiology and pulmonary medicine departments of ESI Hospital, Bangalore. Methods: A prospective interventional study was conducted from September 2018 to March 2019. Determination and categorization of drug-related problems (DRPs) were performed by the pharmacist using the PCNE classification scheme for drug-related problems V5.01. The DRPs identified by the pharmacist were reported and interventions made were subsequently recorded. Results: 180 drug-related problems were identified in the study, among which the major problems were drug-drug interactions (13.88%), followed by generic substitution (10%). The mean drug-related problem per patient was found to be 1.06. A total of 196 interventions were made by the clinical pharmacists among which, 109 (55.61%), 56 (28.57%), 17 (8.67%) interventions were at the prescriber, drug, patient levels, and 14 (7.14%) cases were the rest of interventions or activities. Distributions based on type and degree of acceptance of interventions showed that among 56 drug regimen change interventions proposed by the pharmacist, only 55.35% were accepted. The results further indicated that out of 68 monitoring required interventions made by the pharmacist, and among 17 cases that required counseling by the pharmacist in verbal, 77.94% and 88.36% of cases were accepted, respectively. Also, regarding the cases that required communication between the pharmacists and other healthcare professionals, 85.36% of a total of 41 samples and all of 14 adverse drug reporting cases made in a formal note form were accepted. Conclusion: The clinical pharmacist’s/doctor of pharmacy professional’s timely interventions in the patient’s drug therapy is required to prevent or minimize the occurrence and the risk of DRP. Rational drug therapy and optimal medication safety can be achieved by clinical pharmacy services.


Author(s):  
Kosisochi Chinwendu Amorha ◽  
Anthony Chukwuma Onu ◽  
Chigozie Gloria Anene-okeke ◽  
Chinwe Victoria Ukwe

Objective: To evaluate drug therapy problems in asthma patients visiting a secondary and tertiary hospital in South-Eastern Nigeria.Methods: This study was a retrospective, cross-sectional analyses of the medical records of adult asthmatic patients receiving care in two hospitals in Enugu State, within a 15-year period. The Pharmaceutical Network Care Europe (PCNE) tool version 6.2 was used to assess drug therapy problems. The IBM Statistical Product for Services Solution (SPSS) version 20.0 was used for analysis. For all results, P ≤ 0.05 was considered statistically significant.Results: Majority of the patients were below 60 y old (81.2%); female (68.8%) and were on more than two drugs (95.3%). Majority of the identified drug therapy problems (DTPs) were adverse reactions (65.7%). The inappropriate drug combination was the major cause of DTPs (65.6%). Only about 23.4% of the intervention outcomes were known. University of Nigeria Teaching Hospital (UNTH) had more interventions (35.9%) than Medical Centre (8.0%) (χ2 = 6.323; df = 1; **P = 0.012); and more of the outcomes of their interventions known (38.5%) compared to Medical Centre (0.0%) (χ2 = 12.559; df = 1; **P ˂ 0.001).Conclusion: Adverse reactions and inappropriate drug selection were the major identified DTPs and major cause of DTPs, respectively. Most DTPs had no interventions. The documented interventions included stopping of the drugs, change of drugs or dosage, change of instructions for use and starting of new drugs. Most interventions had unknown outcomes. UNTH had more interventions with known outcomes than the University of Nigeria Medical Centre.


2018 ◽  
Vol 6 (1) ◽  
pp. 43
Author(s):  
Desy Amanda ◽  
Santi Martini

Background: The prevalence of hypertension in Indonesia was 25,80% in 2013 found in people aged above 18 years old. One of the risk factors is obesity. Purpose: This study aimed to analyze the relationship between the demographical characteristic and central obesity with the risk of hypertension in the health center of Sidoarjo. Methods: This analytical observational study design was cross sectional. There were 50 respondents selected through accidental sampling. The independent variables of this study were respondents’ characteristic and central obesity status. However, the dependent variable was hypertension. Overall, respondents were divided into two groups based on sex (female and male) and age (> 59 years old and ≤ 59 years old). Data were analyzed with chi-square statistical analysis. Results: Respondents with central obesity had a higher risk to get hypertension, with majority male respondents aged above 59 years old. Conclusion: There was a correlation between age and hypertension (p = 0,01), sex and hypertension (p = 0,04), also between central obesity status and hypertension (p = 0,01). 


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