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A STUDY ON ROLE OF DOCTOR OF PHARMACY IN IDENTIFYING AND REPORTING OF DRUG RELATED PROBLEMS AND ITS COMORBIDITIES IN INPATIENT UNITS OF A TERITARY CARE TEACHING HOSPITAL

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ABOUT AUHTHORS
M. Manasa Rekha*,
Department of Pharmacy Practice,
Annamacharya college of Pharmacy,
Rajampet, Andhra Pradesh,  India.
*manasarekharoyal@gmail.com

ABSTRACT: AIM: The study aims to assess the role of DOCTOR OF PHARMACY in identifying drug related problems in inpatient units in a tertiary care teaching hospital. OBJECTIVES: The main objective of the present study includes identification and reporting of drug related problems like Drug-drug interaction, Adverse drug reactions, Drug use without indication, Therapeutic duplication, Allergy/intolerance/poisoning, Improper drug, dose, route, regimen, Awareness/adherence problems.

Reference Id: PHARMATUTOR-ART-2543

PharmaTutor (Print-ISSN: 2394 - 6679; e-ISSN: 2347 - 7881)

Volume 5, Issue 12

Received On: 04/08/2017; Accepted On: 08/08/2017; Published On: 01/12/2017

How to cite this article: Rekha MM;A study on role of Doctor of Pharmacy in identifying and reporting of drug related problems and its comorbidities in inpatient units of a teritary care teaching hospital; PharmaTutor; 2017; 5(12);68-73

INTRODUCTION: Drug Related Problems are problems that araise due to drug during medication therapy like Drug-drug interaction, Adverse drug reactions, Drug use without indication, Therapeutic duplication, Allergy/intolerance/poisoning, Improper drug, dose, route, regimen, Awareness/adherence problems. Doctor Of Pharmacy is the branch of pharmacy in which pharmacists provide patient care that optimizes the use of medication and promotes health, wellness, and disease prevention. They are Clinical pharmacists who cares for patients in all health care settings but the clinical pharmacy movement initially began inside hospitals and clinics. Clinical pharmacists often work in collaboration with physicians, nurse practitioners and other healthcare professionals.

METHODOLOGY:
AIM:
The study aims to assess the role of DOCTOR OF PHARMACY in identifying drug related problems in inpatient units in a tertiary care teaching hospital.
OBJECTIVES:
 The main objective of the present study includes identification and reporting of drug related problems like
1. Drug-drug interaction.
2. Adverse drug reactions.
3. Drug use without indication.
4. Therapeutic duplication.
5. Allergy/intolerance/poisoning.
6. Improper drug, dose, route, regimen.
7. Awareness/adherence problems.

METHODOLOGY:
Study Design: It is a observational and interventional study.
Study Period: The Present study was conducted for a period of 24 months from july 2015 to july2017.
Study site : The Present study was conducted in  GENERAL MEDICINE, PEDIATRICS, , OPHTHALMIC, SURGERY, ORTHOPEDICS, ENT, ART, STD  Departments at Rajiv Gandhi Institute of  Medical Sciences ( RIMS), Kadapa.
Sample size: The Patients admitted in hospital with multiple diseases with poly pharmacy during the study period of 12 months and a total of 2742 prescriptions were collected for this study.
Source of Data: All the patients satisfying the inclusion criteria were selected from GENERAL MEDICINE, PEDIATRICS, OPHTHALMIC, SURGERY, ORTHOPEDICS, ENT, ART, STD department in Rajiv Gandhi institute of medical sciences (RIMS) Government Hospital, Kadapa. All the required data was collected from patients through Patient representative interview and case sheets and treatment charts.

 

Inclusion criteria:
• Prescriptions of Patients with aging above 18 years with multiple diseases with poly pharmacy, in GENERAL MEDICINE, PEDIATRICS, OPHTHALMIC, SURGERY, ORTHOPEDICS, ENT, ART,STD  inpatient wards.
• Prescriptions of Patients having previous history of medical, medication problems
• The Patients who are willing to participate in the study.
Exclusion criteria:
• Prescriptions of Patients who are not willing to Participate in the study.
• Prescriptions of Patients below 18 years of age group.
• Prescriptions Other than GENERAL MEDICINE, PEDIATRICS, OPHTHALMIC, SURGERY, ORTHOPEDICS, ENT, ART, STD all the remaining wards are excluded.

RESULTS:

Table1.1DISTRIBUTION OF MALE AND FEMALE PATIENTS IN DIFFERENT WARDS:

NAME OF THE INPATIENT UNIT.

NUMBER OF FEMALE POPULATION

NUMBER OF MALE POPULATION

TOTAL

GENERAL MEDICINE

 

354

290

644

PAEDIATRICS

 

98

104

202

OPHTHALMIC

 

100

108

208

SURGERY

 

450

286

736

ORTHOPAEDICS

 

90

106

196

ENT

 

169

100

269

ART

 

97

102

199

 STD

 

165

123

288

TOTAL

1523

1219

2742

 

 

 

 

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Fig 1.1 DIGRAMATIC REPRESENTATION OF DISTRIBUTION OF MALE AND FEMALE PATIENTS IN DIFFERENT WARDS:

Fig1.2  DIAGRAMATIC REPRESENTATION OF DISTRIBUTION OF FEMALE PATIENTS IN DIFFERENT WARDS.

Fig1.3   DIAGRAMATIC REPRESENTATION OF DISTRIBUTION OF MALE PATIENTS IN DIFFERENT WARDS.



TABLE 1.2: DISTRIBUTION OF PRESCRIPTIONS WITH MUTILPLE DISEASES AND WITH POLYPHARMACY IN DIFFERENT WARDS:

NAME OF INPATIENT UNIT

NUMBER OF PRESCRIPTIONS

GENERAL MEDICINE

644

PAEDIATRICS

 

202

OPHTHALMIC

 

208

 

SURGERY

736

 

ORTHOPAEDICS

196

 

ENT

269

ART

 

199

 

 

STD

 

288

 

TOTAL

2742.

 

Fig1.4: DIAGRAMATIC REPRESENTATION OF DISTRIBUTION OF PRESCRIPTIONS WITH MUTILPLE DISEASES AND WITH POLYPHARMACY IN DIFFERENT WARDS:

Table.1.3 DISTRIBUTION OF DRUG RELATED PROBLEMS THAT ARE OVERCOMED BT DOCTOR OF PHARMACY.

 

Types of DRUG Related Problems.

 

Total number of DRUG Related Problems that are Overcomed During by doctor of pharmacy.

Drug-drug interaction.

 

NUMBER

PERCENTAGE

450

16.41137

Adverse drug reactions.

 

 

398

14.51495

Drug use without indication.

 

 

305

11.12326

Therapeutic duplication.

 

 

590

21.51714

Allery/intolerance/poisoning.

 

 

192

7.002188

Improper drug, dose, route, regimen.

 

 

400

14.58789

Awareness/adherence problems.

 

407

14.843180

 

Total=2742

Total percentage=100.

 

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Fig.1.5 DIAGRAMATIC REPRESENTATION OF DISTRIBUTION OF DRUG RELATED PROBLEMS THAT ARE OVERCOMED BT DOCTOR OF PHARMACY.

RESULTS AND DICUSSION:
In the present study a total of 2742 prescriptions were analyzed for Drug related problems  among them1523 prescriptions belongs to female patients and 1219 prescriptions belongs to male patients. After Analysis the following drug related problems were overcome. Drug-drug interaction (450), Adverse drug reactions (398), Drug use without indication (305),Therapeutic duplication (590),Allergy/intolerance/poisoning (192),Improper drug, dose, route, regimen (400)    Awareness/adherence problems(407). And a total of 2742 Drug related problems were resolved .Prism Graph Pad software is used for this study and the P-Value Is < 0.001 which concludes the present study is  highly significant.

CONCLUSION:
The present study concludes that Doctor Of Pharmacy professionals are those whose main objective is promotion of appropriate medication usage, and they can prevent the drug related problems which are not yet reported in Indian hospitals. In India there is imbalance between physician and patient ratio as per recent surveys for every 1000 patients there is only one physician available due to this there is increased work load on physician due to this the physician cannot look over the complete safe medication therapy management here Doctor Of Pharmacy can serves as bridge between physician and patient in appropriate medication usage, so it is the duty of Indian government to get involve the Doctor Of Pharmacy in the actual patient care in Indian hospitals where they can prove themselves. 

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