scholarly journals Medication Review for Hospitalized Pediatric Patient: Clinical Pharmacist Interventions

2020 ◽  
Vol 54 (4) ◽  
pp. 237-243
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.

2020 ◽  
Vol 54 (4) ◽  
pp. 218-224
Author(s):  
Merve Nur Işık ◽  
Nazan Dalgıç ◽  
Betül Okuyan ◽  
Zeynep Yıldız Yıldırmak ◽  
Mesut Sancar

Objective: The aim of this study is to evaluate clinical pharmacist-led medication review service for hospitalized pediatric patients. Material and Methods: This cross-sectional study was carried out between November 2017-April 2018 in an education and research hospital in Istanbul. Clinical pharmacist-led medication review was conducted by using Pharmaceutical Care Network Europe (PCNE) Classification V8.02 in hospitalized pediatric at general pediatric service. Potential drug-related problems (DRPs) were identified and classified. These DRPs were presented the physicians and the percentage of accepted recommendations by the physician were recorded. Results: Among forty-three patients (21 male and 22 female), the median age of them was calculated as 6 (3-36) months. Of them, 25.58% had 16 DRPs. The most common DRPs were associated with potential drug-drug interactions (n= 9); and dose selection (n= 5), which represented 56.25% and 31.25% of drug-related problems, respectively. It was observed that 63% of these problems were occurred during selection of drugs (at prescription level) according to PCNE classification. Of the clinical pharmacist’s recommendations regarding these DRPs, 87.5% were accepted by the physician. Conclusion: To optimize rational drug use, numerous studies related with clinical pharmacist-led medication review by using PCNE classification were present in adult patients; however, there was no sufficient studies conducted in pediatric patients. Clinical pharmacists have an important role in the classification of DRPs and to provide rational drug use in pediatric patients.


2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Moses A. Ojo ◽  
Cecilia I. Igwilo ◽  
Thomas Emedoh

Irrational drug use is associated with adverse consequences including drug resistance and avoidable adverse drug reactions. Studies of rational drug use in psychiatric facilities are scanty. This study evaluated prescription practices and perception of health care professionals regarding causes of irrational drug use. A retrospective study conducted at the outpatient clinic of Federal Neuro- psychiatric Hospital, Yaba, Lagos. Data on drug use indicators were analyzed. A cross-sectional assessment of perception of prescribers and dispensers regarding rational drug use was conducted. A total of 600 prescriptions were analyzed. Mean number of drugs per encounter was 3.5 and percentage generic prescribed was 58.5%. Poly-pharmacy (P=0.024, 95% CI=1.082-1.315) and non-generic prescribing (P=0.032, 95% CI=1.495-1.821) were significantly associated with young prescribers. Factors associated with irrational drug use include demand from patients, patients’ beliefs about injection drugs and influence of pharmaceutical sale representatives. Certain aspect of prescribers indicators are still poor in the hospital studied. Health care professionals identified possible associated factors for irrational drug use. Concerted efforts are required to ensure rational drug use especially in psychiatric facilities in Nigeria.


2019 ◽  
Vol 2 (2) ◽  
pp. 119-124
Author(s):  
Nisa Febrinasari ◽  
Abdur Rosyid ◽  
Leny Angelina

Rational drug use (RDU) is an indicator to evaluates a treatment given to patients, like proper medication, precise diagnosis, precise dosing. Community Health Center (CHC) has the risk of irrational drug use. In this study, researchers selected N and BL CHC, aiming to evaluate the prescribing indicators based on three diseases which are non-pneumonia acute respiratory infection (ARI), non-specific diarrhea and myalgia, and the facility indicators with DOEN (list of essential national medicines) availability and 20 mandatory drugs. This research was a descriptive-analytical study with cross-sectional methods where the data retrieval of the prescribing is taken from January to December 2018. The study used the normality test and homogeneity test before independent sample T-test, from the third outcome of the test, the N and BL CHC could be said to differ significantly of RDU. It can be concluded that rational drug use is reviewed from a prescribing indicator based on disease and facility indicator. The results of RDU are rational in N CHC, in contrast with BL CHC which is not rational with the results of the RDU in N CHC is 101.44% and BL CHC is 89.81%. The results of N CHC is better than BL CHC, which both CHCs have fulfilled the target of the government, for 68% in 2018. In both CHCs for the facility indicator, there are a DOEN and 20 essential medicines.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Amura Francesca Fog ◽  
Ibrahimu Mdala ◽  
Knut Engedal ◽  
Jørund Straand

Abstract Background Residents at nursing homes (NHs) are at particular risk for drug related harm. Regular medication reviews using explicit criteria for pharmacological inappropriateness and classification of drug related problems (DRPs) have recently been introduced as measures to improve the quality of medication use and for making the treatment more uniform across different institutions. Knowledge about variation in DRPs between NHs is scarce. To explore if increased attention towards more appropriate drug treatment in NHs have led to more uniform treatment, we have analyzed variations between different nursing homes’ drug use and DRPs. Methods Cross-sectional medication review study including 2465 long-term care residents at 41 NHs in Oslo, Norway. Regular drug use was retrieved from the patients’ medical records. DRPs were identified by using STOPP/START and NORGEP criteria and a drug-drug interactions database. NHs were grouped in quartiles based on average levels of drug use. The upper and lower quartiles were compared using independent samples t-test and associations between drug use and DRPs were tested by logistic regression. Results Patients’ mean age was 85.9 years, 74.2% were women. Mean numbers of regular drugs per patient was 6.8 and varied between NHs from 4.8 to 9.3. The proportion of patients within each NH using psychotropic and analgesic drugs varied largely: antipsychotics from three to 50%, benzodiazepines from 24 to 99%, antidepressants from nine to 75%, anti-dementia drugs from no use to 42%, opioids from no use to 65% and paracetamol from 16 to 74%. Mean DRPs per patient was 2.0 and varied between NHs from 0.5 to 3.4. The quartiles of NHs with highest and lowest mean drugs per patient (7.7 vs. 5.7, p < 0.001) had comparable mean number of DRPs per patient (2.2 vs. 1.8, p = 0.2). Using more drugs and the use of opioids, antipsychotics, benzodiazepines and antidepressants were associated with more DRPs. Conclusions The use of psychotropic and analgesic drugs was high and varied substantially between different NHs. Even if the use of more drugs, opioids and psychotropic drugs was associated with DRPs, no difference was found in DRPs between the NHs with highest vs. lowest drug use.


2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Bekalu Dessie ◽  
Getachew Atalaye ◽  
Esubalew Diress ◽  
Alamirew Getahun

Background. The rational use of drugs requires that patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community with full information and with the lowest possible cost. If one of these is not met, it is referred to as irrational drug use. Many drugs have been sold or prescribed inappropriately in the world, and a significant part of the world population lacks access to essential medicine. The aim of this study was to assess practice towards rational drug use at Finoteselam and Asirade Zewudie hospitals. Methods. A cross-sectional study design was used for this study, and the study was conducted from October 11 to November 30, 2019. A total of 770 prescriptions were selected as per WHO criteria by using systematic random sampling and reviewed with the help of an observational checklist. The data were entered and processed with SPSS version 25 and evaluated using the WHO criteria. Result. The average number of drugs per prescription was 1.8 and 2.05, antibiotics encountered were 77.7% and 72.5%, injections encountered were 5.97% and 7.01%, percentage of drugs prescribed by generic names was 97% and 93.4%, counseling time was 1.6 minutes and 2.25 minutes, and dispensing time was 51.3 seconds and 62.72 seconds at Finoteselam and Asirade Zewudie hospitals, respectively. Conclusion. The majority of WHO core drug use indicators were not met in the two hospitals. The average number of drugs encountered in Asirade Zewudie hospital was slightly higher than the WHO recommended range, whereas the average number of drugs encountered in Finoteselam hospital was exactly equal. The percentage of antibiotics encountered was very high compared with WHO recommendation, but the percentage of injections encountered was below the WHO recommended range and time spent on counseling and dispensing was too short when compared with WHO recommendation. In addition to this, both hospitals had no essential drug list or formulary as well as a key drug list.


2020 ◽  
Vol 30 (Supplement_2) ◽  
Author(s):  
D Fernandes ◽  
A Jesus

Abstract Introduction Many drug-related problems are caused by drug interactions (DIs) that result from the pharmacological influence of one drug on another when taken together. DIs may have beneficial and predictable effects, but may also cause undesirable results, such as treatment ineffectiveness or serious adverse effects. There are a number of available databases with information about DIs. Although the information they provide is not always consensual, it is a useful tool in analysing the occurrence of potential drug interactions (PDIs) and in preventing unwanted or even fatal consequences for patients. Objectives To compare the convergence of two databases (Micromedex/Drugs.com) regarding the classification of DIs and their mechanism of action. Methodology A cross-sectional, descriptive and exploratory observational study was carried out using prescriptions from users with diabetes, dyslipidaemia or both pathologies from pharmacies in two districts, Porto and Braga. Information from each sample group was further analysed using two databases, Micromedex/Drugs.com. Results Of the 57 pairs whose interaction potential was analysed, 64.3% converged on the classifications in both databases. Micromedex assigns moderate potential interaction to 36 drug pairs, and of these, 28 get the same rating on Drugs.com. Regarding the major PDIs, the degree of agreement was 40%. There are 4 drug pairs with potential for major interaction at Micromedex to which Drugs.com assigns moderate PDI. Minor PDIs were found on Drugs.com in 4 drug pairs, which Micromedex rated as major or moderate. For the remaining twelve divergent rating pairs, Drugs.com does not assign them potential for interaction while Micromedex gives them potential for major or moderate PDIs. Regarding the consequences of the occurrence of PDIs, there is agreement between Micromedex and Drugs.com, except for pair AAS/Loop Diuretics. Conclusion Micromedex identifies a higher number of PDIs and assigns higher severity to a higher number.


2005 ◽  
Vol 39 (3) ◽  
pp. 527-532 ◽  
Author(s):  
Claudia Vacca ◽  
José Orozco ◽  
Albert Figueras ◽  
Dolors Capellà

BACKGROUND: Appropriate dispensing is one of the steps for rational drug use, so it is generally advised that the dispenser should have relevant and updated knowledge, skills, and attitudes. OBJECTIVE: To assess pharmacies and nonprofessional employees' (NEs) skills and knowledge, as well as their response to several specific case simulations in Bogotá, Colombia. METHODS: A descriptive cross-sectional study was performed on a random sample of 371 pharmacies in Bogotá. Information from each pharmacy was obtained using 2 approaches: (1) direct interview to collect data on organizational aspects of the store and characteristics of NEs, and (2) simulation (both by direct interview and by telephone) to assess dispensing responses in 6 simulated clinical cases. RESULTS: More than half of the simulated clinical situations resulted in inappropriate dispensing (direct simulations 57%; telephone simulations 55%). The proportion of correct answers to theoretical questions regarding a specific therapeutic problem during interviews was higher than the response when a simulation presented that same case and a dispensing act was expected. The educational background of the NEs included in the study points to a specific problem: two-thirds of the individuals selling medicines had completed only secondary-level education and only 2% of the sample had a pharmacist as technical director. Continuing education courses were either directly organized by drug manufacturers (one-third of the courses attended by pharmacists) or sponsored by them (more than an additional one-third). CONCLUSIONS: NEs should be considered part of the therapeutic chain and, if appropriately updated or instructed, could play a very important role in the always difficult promotion of rational drug use. Public health institutions and universities should be more actively involved in the provision of independent, unbiased, and essential information on common therapeutic problems, safety concerns, and new drug prescription restrictions.


2020 ◽  
pp. 11-18
Author(s):  
Kurniatul Hasanah ◽  
Retnosari Andrajati ◽  
Sudibyo Supardi

Drug reconciliation is needed to get rational treatment therapy. The purpose of this study was to analyze the relationship between the completeness of filling out the form of drug reconciliation and rational drug use at Bekasi X Hospital. The study design used a cross-sectional comparative study to compare between 56 completed drug reconciliation forms and 133 incomplete drug reconciliation forms. Sampling is done in total sampling. The research sample that fulfilled the inclusion criteria was 189 forms (40.6%) of all (466) drug reconciliation forms in November 2015-end April 2016 at X Hospital Bekasi. Data was analyzed using Chi-square test. The results showed that the largest percentage of filling out drug reconciliation forms was incomplete (70.4%), carried out by the pharmacist (56.1%) and not signed by a doctor (63.5%). Percentage of rational drug use by 7.9%, with details: correct diagnosis 53.4%, correct indication 53.4%, correct selection of medicine 33.9%, correct dosage 8.5%, exactly how to administer 37.6%, on time giving 13.8% and correct time giving 14.8%. There is no significant relationship between the completeness of filling out the drug reconciliation form, the types of health workers, the presence/absence of a doctor's signature and rational drug use in inpatients (p> 0.05).Tthere is no significant relationship between the completeness of filling out the reconciliation form and rational drug use in inpatients at Bekasi X Hospital (p> 0.05)


Sign in / Sign up

Export Citation Format

Share Document