The evaluation and classification of drug-related problems by a clinical pharmacist in an internal diseases intensive care unit: A prospective cohort 7-month study

Abstract

Background and Aims: Drug-related problems can cause morbidity and mortality as well as increase health-care costs. Clinical pharmacists provide many benefits to healthcare systems by detecting, decreasing, and preventing drug-related problems. It was aimed to determine and classify drug-related problems and determine risk factors for drug-related problems. Methods: Drug-related problems were evaluated prospectively between August 16, 2021, and March 16, 2022, in 257 patients during their hospital stay who were hospitalized in the internal diseases intensive care unit and took at least one drug. Patients who were not administered any drug or who were younger than 18 were excluded from the study. The Pharmacetical Care Network Europe v.9 method was utilized to classify these problems. Clinical and demographic characteristics of patients with and without drug-related problems were compared by statistical analysis. Risk factors of drug-related problems were determined by logistic regression analysis. Results: At least one drug-related problem was detected in 157 of the 257 patients and a total of 399 drug-related problems were recorded. 399 recommendations were made, and 349 (87.5%) of these were accepted and 50 (12.5%) were not accepted. Drug selection (C1) was the most common cause of drug-related problems at 42.2%, and dose selection (C3) followed this by 41.5%. The results of regression analysis showed that atrial fibrillation (OR: 2.985, CI: 1.158-7.692), hematopoietic stem cell transplantation (OR: 3.883, CI: 1.256-11.999), antibacterial drugs (OR: 3.285, CI: 1.563-6.904), or polypharmacy (OR: 3.955, CI:1.207- 11.071) were risk factors of drug-related problems. Conclusion: The most common drug-related problem category was found as treatment safety and the causes of them were found as drug selection and dose selection. Clinicians should pay attention when prescribing new drugs to patients with atrial fibrillation and a history of hematopoietic stem cell transplantation. Furthermore, clinicians and clinical pharmacists should pay attention if polypharmacy and antibacterial drugs are present in medical therapies.

Keywords

• Clinical pharmacy
• drug-related problem
• intensive care unit

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