ABSTRACT
Objectives: This study aimed to evaluate the role of a clinical pharmacist intervention in decreasing subsequent clinical and drug-related problems [DRPs] among coronary heart disease [CHD] inpatients with at least one previous DRP
Methods: This pre-experimental study with a pre-post design was carried out from January to April 2017 among inpatients with at least one previous DRP at a general hospital in Tangerang District, Banten, Indonesia. Clinical and DRPs were documented prospectively by a clinical pharmacist, with DRPs classified using Version 6.2 of the DRP classification scheme of the Pharmaceutical Care Network Europe Foundation. The intervention consisted of a discussion of identified DRPs with physicians, patients, pharmaceutical logistics clerks, nurses and nutritionists. Following this, any subsequent clinical and DRPs were re-identified and further interventions were conducted as necessary
Results: A total of 75 inpatients were included in the study. Pre-intervention, there were 443 DRPs and 202 clinical problems. The most frequent DRPs were adverse drug reactions [52.6%], followed by drug effects [41.8%]. Most DRPs were of moderate severity and would have resulted in moderate consequences had the pharmacist not intervened. The interventions resulted in a significant reduction in the number of DRPs, type of DRPs and number of clinical problems [P <0.05 each]. Patients with complications were 26.047 times more likely to have no reduction or an increased number of clinical problems compared to patients without complications [P <0.05]
Conclusion: Clinical pharmacist interventions were found to reduce subsequent DRPs and clinical problems among CHD patients with at least one previous DRP
ABSTRACT
To examine the influence of pharmacists' demographic characteristics on dispensing antibiotics purchased with and without a prescription in the community pharmacies. This cross-sectional study was conducted in 24 randomly-selected community pharmacies located in Abu Dhabi, United Arab Emirates between March and September 2009. Data were collected through a closed-structured questionnaire and analyzed using the Statistical Package for Social Sciences Version 17. Descriptive statistics, odds ratios, significance and 95% CI and logistic regression analyses were then used to analyze the resulting data. Participating pharmacists conducted a total of 1645 antibiotic transactions [1211 [73.6%] dispensed with prescriptions versus and 434 [26.4%] without]. Gender and socioeconomic status of the patients had a significant effect in acquiring antibiotics without prescription [p=0.012, p=0.001]. Clarithromycin [91.5%], cefuroxime [91.3%], and co-amoxiclav [66.4%] were dispensed with prescription. Ceftriaxone [53.3%], amoxicillin [47.8%] and co-amoxiclav [33.6%] were dispensed without prescription. Dispensing of antibiotics with prescription were frequently given a 5, 7, or 10 day regimen, while those without prescription were frequently given 3-7 days duration. Co-amoxiclav for sore throat was commonly dispensed without prescription. Ceftriaxone for sexually transmitted diseases was dispensed at a similar rate, both with and without prescription. Dispensing antibiotic without prescription is illegal and alarming. Patient interviews and interventions to improve the current prescribing pattern for both prescribers and pharmacists are highly warranted