Pharmacist interventions in the management of drug-related problems among renal dialysis patients: a cross-sectional observational study
Main Article Content
Keywords
adverse drug events, medication error, Renal Dialysis, Hospital Pharmacy Service, Polypharmacy
Abstract
Background Patients with renal failure are at high risk of disease complications, polypharmacy, and associated drug-related problems (DRPs).
Objectives This study aimed to address the frequency and causes of DRPs and pharmacists’ drug-related interventions in Tabuk, Saudi Arabia.
Methods A prospective observational study was conducted in the renal dialysis unit of a tertiary care hospital over four months. The ward pharmacists reviewed patients’ medication records and identified causes of potential DRPs using the Pharmaceutical Care Network Europe Association (PCNE) Classification for Drug-Related Problems V9.1. The proposed pharmacists’ drug-related interventions to resolve DRPs and optimize drug therapy were documented. Multivariate logistic regression was used to determine the predictors associated with the occurrence of DRPs.
Results: The medical records of 124 patients on peritoneal and hemodialysis were reviewed. The pharmacists identified 72 DRPs out of 733 prescribed drugs, yielding a medication error rate of 9.7%. The most common DRPs were drug selection problems (27.1%), inappropriate dosing (27.1%) and underuse of drugs (24.3%). About one-half of DRPs (49%) were classified as causing temporary patient harm. Pharmacists proposed recommendations to resolve the identified DRPs that ranged from laboratory drug monitoring to pausing and starting new drugs. The physicians approved 87% of pharmacists’ interventions. Multivariate logistic regression analysis revealed no significant factors to increase the likelihood of DRPs.
Conclusion: Polypharmacy was highly prevalent and DRPs were likely to occur in patients receiving renal dialysis. Pharmacist-provided interventions contributed to early detection of drug problems and lowered the risk of patient harm.
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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Mostafa A. Sayed Ali, Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia; Department of Clinical Pharmacy, Faculty of Pharmacy, Assuit University, Egyp
An associate professor, Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk
Abdullah Alrakaf , Pharmacy graduates, Faculty of Pharmacy, University of Tabuk, Tabuk, Saudi Arabia.
Pharmacy graduates