Reducing outpatient drug-related problems through pharmacist led interventions: A multi-center interventional study in provincial hospitals in Vietnam

Abstract

Background: Drug-related problems (DRPs) significantly affect patient safety, clinical outcomes, and healthcare efficiency. Pharmacist-led interventions have demonstrated potential in improving prescribing practices, yet limited data exist on their effectiveness in outpatient settings in Vietnam. This study evaluated the impact of structured pharmacist interventions on reducing DRPs in outpatient prescriptions at multiple healthcare facilities in a province in Vietnam. Methods: A pre-post interventional study was conducted at three hospitals in a province in Vietnam. Pharmacists systematically reviewed outpatient prescriptions identified DRPs using version v9.1 of the Pharmaceutical Care Network Europe (PCNE) classification and selected criteria from Vietnam’s Ministry of Health classification, and provided structured interventions, including quarterly seminars, hospital DRP bulletins, and personalized physician-specific DRP information sheets. Multivariate logistic regression assessed factors associated with DRP. Results: In total, 4,070 prescriptions preintervention and 4,051 prescriptions post-intervention were analyzed. Pharmacist-led interventions significantly reduced the proportion of prescriptions with at least one DRP from 21.7% (pre-intervention) to 9.1% (post-intervention; p<0.001). Significant reductions were observed across multiple DRP categories, including inappropriate drug indications, contraindicated medications, unnecessary drug prescriptions, incorrect dosing, improper timing of administration, and clinically significant drug-drug interactions (p<0.001). Factors independently associated with higher DRP risk included patient age ≥60 years (OR=1.554; p<0.001) and prescriptions containing five or more medications (OR=2.435; p<0.001). Proton pump inhibitors, gastrointestinal motility regulators, and non-steroidal anti-inflammatory drugs (NSAIDs) were most frequently implicated in DRPs. Conclusions: Pharmacist-led interventions effectively reduced DRPs in outpatient prescriptions at provincial hospitals in Vietnam. Older patients and those receiving polypharmacy were at higher risk, highlighting the need for targeted pharmaceutical care. This intervention model is practical, scalable, and well-suited for integration into electronic prescribing systems, significantly enhancing medication safety and prescribing quality.