Identification of drug‑related problems and pharmacist’s interventions in asthmatic patients at a private tertiary care facility‑Pakistan

Background: Drug‑related problems (DRPs) potentially contribute to morbidity, mortality
and financial indicators. There is increasing evidence that participation and interventions
of clinical pharmacists in health care have a positive influence on clinical practice.
Objectives: The main focus of this study was to identify DRPs, evaluate
clinical pharmacy services and document pharmacist ’s interventions.
Materials and Methods: A 3 months prospective observational study from
October, 2014 to January, 2015 was carried out on 80 asthmatic patients
admitted to pulmonology unit at Northwest general hospital and research center,
Peshawar, Pakistan. The drug therapy details of the patients were collected from
inpatient treatment charts using a predesigned questionnaire. The DRPs were
identified, and clinical interventions made by pharmacists were documented.
Results: A total of 37 patients (61.25%) presenting 91 DRPs were identified, including
potential drug‑drug interactions 39 (48.75%), drug selection 27 (33.75%), drug use
process 12 (15%), drug monitoring 5 (6.25%), adverse drug reactions 5 (6.25%) and
dosing 3 (3.75%). Clinical interventions documented by pharmacist were drug information
response 21 (26.25%), patient education and counseling 14 (17.5%), change/clarify
medication order 11 (13.5%), proper storage and cost effectiveness 10 (12.5%), medication
error/brand duplication 7 (8.75%), change of drug/dosage 3 (3.75%), dose calculation
in special population 3 (3.75%) and discharge plan 2 (2.5%). Of 91 interventions, the
pharmacists contacted the consultants for 24 (30%) interventions, postgraduate medical
officers/registrars 34 (42.5%), nursing staff 21 (26.25%) and the patients/attendant
12 (15%). 15 (18.75%) interventions were approved by concerned prescribers.
Conclusion: To minimize the risks of DRPs and prevent their occurrence, drug
therapy requires pharmacist’s timely and effective interventions at all levels.