Clinical Pharmacist Intervention on Drug‐Related Problems among Elderly Patients Admitted to Medical Wards of Northwest Ethiopia Comprehensive Specialized Hospitals: A Multicenter Prospective, Observational Study
Samuel Berihun Dagnew, Gashaw Binega Mekonnen, Ejigu Gebeye Zeleke, Samuel Agegnew Wondm, Tesfaye Yimer Tadesse
Abstract
Background: Drug therapy in the elderly needs an emphasis on age‐related changes in drug pharmacokinetics and pharmacodynamics profile. Hospitalized elderly patients are at risk of more than one disease and polypharmacy associated with these; they are at risk of drug‐related problems. This study aimed to assess the role of clinical pharmacy on identifying and resolution of drug‐related problems among elderly patients admitted to medical ward of Northwest Ethiopia comprehensive specialized hospitals. Methods : A multicenter prospective observational study was conducted. A systematic sampling technique was used. The identified drug‐related problem was recorded and classified using Cipolle, and adverse drug reaction was assessed using Naranjo algorithm of adverse drug reaction probability scale, and Medscape was used for drug‐drug interaction. Data were analyzed by using STATA software version 14.1. Logistic regression was used, and results were reported as odds ratios (ORs) with 95% Confidence intervals with P value < 0.05 statistically significant. Result : A total of 389 study participants were included in the study. About 266 (68.4%) of the participants had at least a single drug‐related problem. About 503 drug‐related problems were identified with a mean of 1.32 (CI: 1.27‐1.36) drug‐related problem per patient. The three‐leading categories of drug‐related problems were dose too high 108 (21.5%), nonadherence 105 (20.9%), and adverse drug reaction 96 (19.1%). Alcohol use (AOR = 2.2, 95CI%: 1.23‐3.94), source of the drug (AOR = 2.85, 95CI%: 1.63‐4.98), length of hospitalization (AOR = 2.32, 95CI%: 1.37‐3.95), number of comorbidities (AOR = 1.48, 95CI%: 1.09‐1.99), and polypharmacy (AOR = 3.06, 95CI%: 1.72‐5.46) were important risk factors for drug‐related problems. From the intervention provided, 84.7% were accepted by prescribers. Among the total drug‐related problems 67.4% of the problem was totally solved. Conclusion : This study revealed that DRPs were high among elderly patients admitted to medical ward of Northwest Ethiopia. Comorbidity, length of hospitalization, ploy‐pharmacy, payer, and alcohol drinker were more likely to developed drug‐related problems. Treatment optimizations were also done by clinical pharmacists and interventions were well accepted by prescribers.